Could I possibly be warm enough in my Elvis outfit?  

     This question does not plague me often, but prior to the Memphis Marathon it was paramount.  I have always eschewed the wearing of costumes, tutu’s, face paint, or edible underwear in races, but Memphis screamed out for a running Hunka Hunka burning love.  With the latest check of the weather, my intuition about shedding the white bejeweled jumpsuit for an Under Armor cold gear ensemble was verified.  I donned my black tights and compression shirt as my wife giggled and said I looked like an aging ninja in tennis shoes.  Not dissuaded, I self satisfyingly sat on the bed knowing I would be toasty and compact.  I would put Elvis on hold until the Las Vegas Marathon later in the year.  

     I had grown up in Memphis, left after grade school, then returned for medical school.  I began running in medical school, largely in response to coffee and an impossible biochemistry course, so I was returning to familiar running turf, so to speak.  The medical school is about a mile from the Mississippi River, on which whose bluffs Memphis is perched, so after flunking another biochemistry test I would head out in my Adidas trainers and run to the river (after a particularly bad test even considering jumping in) and back.  It was not particularly far, but cathartic none the less.  Needless to say the downtown had changed over the past 30 years.  No longer did I see the friendly homeless guy I had treated for DTs in the ER hanging out in the downtown park nor did I have to dodge the broken beer bottles and used needles.  Now the downtown area was ripe with hipster bars and upscale bistros.  They had even built a baseball stadium smack dab in the middle of the city, right across from the hallowed Peabody Hotel.  The Peabody ducks now had to compete with quarter beer night and bad organ music.  I won’t say I missed the needles, but it did have somewhat of a yuppie feel, for better or worse.

     The St.Jude Memphis Marathon has grown over the years and now spawns about 20,000 runners traversing everything from a mile fun run up to the marathon.  We were told to self segregate into waves based on our projected pace as to facilitate the start.  Let me say asking a marathoner to predict his likely pace throughout the race is like asking Donald Trump to predict which way his hair will lay on any given day.  I am as guilty as anyone as I often start a race as a Kenyan and end as a spastic jellyfish.  I lined up with my fellow Ethiopian wannabes in wave 5, the 9 minute a mile pace group, and imagined my winged feet carrying me to a new PR, given what I had gleaned from the topography graph of the race course.  What I learned is that those dreaded topographers are demon possessed liars whose sole mission in life is to make my quads scream for glycogen like a lawyer screams for billable hours.  I mistakenly thought there were only three small hills, going as far as to memorize where they fell in the course, only to find that the map makers (those hounds from Hades) “smoothed out” the graph for “simplicity”.  In other words there were a heck of a lot of small rolling hills in between the mountains (okay, I exaggerate).  I don’t like hills.  I like leprosy more than I like hills.  As I get older my major criteria for choosing marathons are which ones have free beer at the end and which ones don’t have the damned hills!

     As a young medical student running on the asphalt of downtown Memphis I was immune to much of my environment.  Today I took in the various landmarks like Charlie Vargo’s Rendezvous, home of dry rub pig parts (some refer to it as barbecue), sixteen places where Elvis slept (it seems he had trouble finding Graceland at night), Rhodes College (It was Southwestern when I was there but they got all full of themselves and became a Yale wannabe, but it was a pretty campus), and Beale Street, home of the Blues, and black toenails by the time I made it to that point of the race.  
Probably the most memorable moment, besides the beer at the finish, was running through the St.Jude Hospital campus.  There were patients and employees lining the route making sounds that rivaled the girls of Wellesley at the Boston Marathon, and they were much better looking!  Having those folks cheering us was surreal.  They are the heroes every day.


     The race concluded in the minor league baseball stadium in the middle of the downtown.  It was a great finishing spot as it was literally steps from the hotel and a hot shower.  I will never forget walking to my first marathon years ago.  We were walking with a girl we had just met and she found out it was my first race.  She told me that the shower after a marathon was better than sex.  It does feel good, but all I can say is that poor girl has had a very disappointing sex life.  
     
     Two thirds of adults and one third of kids are either overweight or obese.  This comes as no great revelation to most of us as it is a simple matter of looking around.  I find it tedious and unproductive to badger someone about their weight.  Let’s be honest.  If you are overweight, you know it.  You don’t need some self-righteous, “thinner than thou” doctor harping on you to lose weight.  That accomplishes nothing, and I should know because I did that for 20 years.  I would admonish a patient to lose weight at their yearly checkup only to have them return a year later twenty pounds heavier.  I was shirking my responsibility as their physician, and possibly even worsening the problem because I really didn’t understand the problem to begin with.  Gaining weight and losing weight is a very complex undertaking involving physical, emotional, and even spiritual aspects.  I have come to realize that out thoughts and emotions play at least as much if not more a role than our DNA.  There is no question that genetics, hormones, and physiology contribute to thickness or thinness, but happiness, stress, and depression also contribute mightily to the equation.  To simply tell someone to eat less and exercise more to lose weight is akin to telling the Arabs and Israelis to just get along.  It’s not that simple.
     
     A good friend of mine who has been in the weight management field for many years says, “To change your weight, you have to first change your mind.”  There is great wisdom in that simple statement because it summarizes a terribly complex effort.  Changing one’s mind is like turning the Titanic for some of us.  I can’t even begin to address the complexity of emotions, beliefs, unconscious imprints, desires, and needs that go into mind changing, but suffice it to say each of us has a roadmap to change that only we can navigate.  In other words, no one can change your mind for you, or tell you exactly how it is done.  What I can do is give you some tools and insights as to the process and maybe outline a path for you to begin your journey towards better health.
     Psychologists tell us that we humans are motivated largely by two opposite drives.  We want to avoid pain and we desire pleasure.  What is fascinating is that often we will spend much more time and effort avoiding perceived pain than seeking pleasure.  I realize this goes against the grain of a society that promotes things like “Hedonism” and “Naked Dating”, but the impact of  emotional pain in particular is a very powerful agent for change.  I have seen this play out in my own practice when working with folks on weight loss.  I will never forget the middle aged lady who had come to me wanting to lose forty pounds.   On her first visit she looked across the table at me and tearfully said, “If I don’t get healthy, I’m not going to be able to play with my grandkids.”  She was ready, and by gosh, she has done it!  I could have screamed at her incessantly about her risk of heart disease, diabetes, and stroke from being overweight, and it would have all been for naught.  She wanted desperately to avoid the pain of missing time with her family, and that was monumental motivation.
Often, with our weight management folks, I will have them do a simple exercise that crystallizes their motivations.  I have them make two simple lists.  On the left side of the paper I have them write three things they will gain by losing weight and on the right side of the paper I have them write three things they will lose by not losing weight.  The key is the things have to be very personal and real.  Then I have them sit quietly and imagine how they would feel if each of the things came true.  I insist that they visualize each thing, good and bad, as vividly as possible and try to truly experience the emotions that it elicits.  The I have them post this list somewhere where they will see it daily.  I ask them to feel the emotions when they think of the bad things, as well as the joy from the good things.  These emotions become massive motivators. It works, as these feelings often become the key that unlocks the desire to make changes.

Changing your mind can change your weight.  

   Men are wimps.  Okay, maybe I need to clarify that a bit.  Navy Seals are not wimps…Ultimate Extreme Martial Arts fighter people are not wimps… Chuck Norris is not a wimp…but many men are wimps when it comes to being sick.  Maybe this is just some type of deep psychological rationalization on my part because the honest truth is that I, me, myself am such a pitiful soul when I am sick, I only hope and pray other men are as ridiculous as me.  The only way I can fathom being as wimpy as I am is to only assume all others graced with the XY chromosome pair are similarly endowed.  It has to be a genetic thing, because it is too universal to be just limited to me.  Besides I am told by all the women I know that it is true.

     So let me be very clear, men in general are courageous in battle, will protect their offspring with the voraciousness of a badger in heat, will heroically sacrifice life and limb for their fallen brothers, and will even spend an afternoon shopping with their wives in a fabric store, but if they get a sniffle or a tummy ache, God help them!  I consider myself a pretty healthy dude.  I run marathons, work out with weights, eat tofu and kale, and take enough vitamins to support a small refugee village, but occasionally I get sick.  This illness is generally not anything like leprosy or flesh eating bacteria sick, it usually is your run of the mill sinusitis.  The stuff all of us get now and then (living in the pollen killing fields of Augusta, Ga.) but when I get sick I turn into a whiney, wisp of my former self.
It begins with a sore throat, and generally I assume I have throat cancer or some other malady rather than a cold.  Ever since medical school I have had the strange proclivity to develop any disease I was currently studying.  At least I developed it in my head.  I remember reading about a parasite called  Naegleria fowleri.  It had the unpleasant habit of burrowing in the brain of unsuspecting, paranoid hosts and gnawing on their cerebrum. The nose is the pathway of the amoeba, so infection occurs most often from diving, water skiing, or performing water sports in which water is forced into the nose. But infections have occurred in people who dunked their heads in hot springs or who cleaned their nostrils with Neti pots filled with untreated tap water.  I always knew Neti pots were tools of the devil and this just confirmed it.  Even though I had not recently dunked my head in a hot spring (do people really do this?) I had been in a lake, so when I developed a headache I naturally assumed I had a brain eating parasite.  Given that  this sort of logic was akin to thinking you really had a chance to win the Lotto jackpot, I laid in bed for a day until my headache subsided and reluctantly put writing my will on hold.

     I won’t go in to telling you what happened to me when I first started studying yeast infections!
Needless to say, I took this tendency to catch the disease de jour into my older years, modified with the wisdom of aging (yea…right!) so now instead of imagining I am dying of some exotic disease, I simply imagine I am dying of a common disease.  My wife could walk into the house with a hatchet in her head and she would not be complaining, in fact she would get the wash out of the dryer, start dinner, and do an online search for Masters rentals before thinking about removing the offending yard tool.  I, however, can have a stuffy nose and I lay on the couch, unable to raise my head to sip life giving water, convinced I am hypoxic from oxygen debt, begging for IV Afrin infusions, and complaining about the roughness of the facial tissue.  And don’t think about me performing any vital functions like taking out the trash or carrying on a civil conversation.  I am near death man! Can’t you see I can’t be bothered with the fact that the kids are setting up a meth lab in the basement.  

I have long maintained that the female of the species is both wiser and stronger in constitution than the male.  Yes we have more hair, generally. Yes, we are more proud of our body odor and belches.  Yes, we relish the role of protector of the hearth and provider of food, shelter, and a diversified 401K.  And yes, we like making babies, but the female trumps us majestically when we are weakest; i.e. sick with a cold or tummy ache.  She can have a brain eating parasite and still go to work, breast feed, fix the cable, and still look amazing!    
7 Things About Things

      Baby boomers like myself remember the perennial bestseller “7 Habits of Highly Effective People” as the consummate self help guide and author Dr.Steven Covey as the lifestyle guru extraordinaire.  It spawned a plethora of sound alike and look alike tomes that all were based on 7 “somethings.” (7 rules, 7 guides, 7 pillars, 7 elevens, etc)  I always wondered what was so special about 7 other than it sounded better than 16 Habits of Very Tired People, but from numerology to the Bible, 7 seemed to have a mystical book selling ability, so, in honor of 7, I humbly present the 7 Habits of Highly Healthy People. (To be distinguished from Snoop Dog’s autobiography, The 7 Habits of the High and Healthy People.)

1) They eat moderately and modestly.
There is no magic food!  Eating kale and bean sprouts all day will make you boring and rabbit like.  Eat a balance of protein, fat, and carbohydrates.  It really is that simple.  Many studies suggest that lowering the simple sugars and high glycemic carbohydrates (Google it!) will help you lose weight and maintain that loss.  Going to extremes in your diet is unhealthy, expensive, and will give you bad breath.  Also, eat fewer calories.  If you like steak, eat steak…but don’t put two pounds of butter on your potato and keep the dessert under wraps.  If you have your own private table at Dairy Queen, you need to cut back.

2)  They are active.
You don’t have to run a marathon to be healthy.  You don’t even have to run at all (I can’t believe I just said that!) You just have to get up off the “Couch of Doom” and move.  You are designed to be in motion, all your muscles and bones are crying out to be pampered.  A brisk walk or a Zumba class in ridiculous spandex will add years to your life if it is consistently practiced, and, more importantly, your children will be able to make fun of you later when they see your pictures.

3)  They laugh at themselves.
This one is easy for me as my daughters continually provide reasons for me to laugh at myself.  They are quick to point out I am not as cool as I think I am, which should be obvious as I am still using coolness as a human trait. Taking yourself and your horrible, stress filled life too seriously leads to physical and emotional stagnation.  That doesn’t mean that a laissez faire attitude at all times is optimal, but lighten up to add years to your plight.  Who knows…things could get better.

4)  They join stuff.
Dan Buettner famously pointed out in his inspiring book on longevity, The Blue Zones, that people who live the longest tend to be social animals.  They participate, whether it’s social clubs, scooter races, jello wrestling, or nude skydiving, people who continually engage tend to be healthier and live longer.  This must be tempered by a heavy dose of common sense as joining a Justin Bieber fan club will immediately result in brain atrophy.

5)  They are religious.
This one surprised me, given the whole martyr thing, but people who attend some form of religious service once a week tend to be healthier, as a group, than those who stay at home and do secular humanist things.  No one religion has a monopoly on this characteristic (sorry Rev.Osteen) but it seems having faith, practicing your beliefs, and living by the creeds of your particular orthodoxy has a beneficial effect on health.  That is assuming you are not a devotee of the Crusades or a militant extremist as their lifespans tend to be about as long as a Kardashian marriage.

6)  They de-stress.
Stress kills.  From hypertension to depression, daily stress can put more holes in your body than whiskers on a gerbil…and that’s a lot by the way.  Some studies have shown that up to 70% of visits to primary care doctors are due to stress.  If Obamacare would get rid of stress it might even work, unfortunately it seems to be having just the opposite effect.  There are a number of ways to minimize stress and none start with X A N A X. Flower arranging,counseling, exercise, yoga, meditation, hunting, full contact karate, and attending city council meetings are just a few stress relieving activities available to the general public.

7) They serve others.

Volunteerism confers as much health benefit as a daily vitamin and generally cost less and won’t constipate you.  The data is conclusive, if you focus on the needs of others and help them meet those needs, you will improve your health.  You will be better psychologically, physically, people will like you, and dogs will lick your face.  Believe me, no matter how miserable and decrepit your life is, someone, somewhere has it much worse, and it behooves you and the universe to find that person and help make their life just a bit more tolerable.