The Magic Bullet: Exercise
Perhaps, outside of a life-threatening catastrophe, there is no advice about recovery and rehabilitation a doctor can give you that will outweigh the benefits of exercise. If there is a tonic—a fountain of youth (though not eternal)—it is exercise. I know that this is advice that everyone gets almost daily, from the Surgeon General’s Office to the latest infomercial trying to sell you a machine designed to give you abdominal “six-packs of steel.”
The reason I want to reinforce exercise, in particular, is that most patients do not understand how vital, re-invigorating, and restorative exercise can be. In its responses to “stress,” the human body is astounding in its capacity to adjust, accommodate, and improve. I am not referring to stress in the sense of anxiety but rather refer to “stress” in the engineering context of a work-load being placed on the body. The human body will strengthen itself in response to increased demand whether you are eighteen or eighty. Imagine, for a moment, how implausible it would seem if someone claimed to have developed an automobile where the engine became bigger, more powerful, and more fuel efficient the harder and faster you drove it! But that is precisely how our bodies respond.
Imagine that it was announced today that a major pharmaceutical company had discovered a compound that could substantially prolong life, reduce stress, and lose weight. Imagine it was also claimed to help individuals reverse osteoporosis, enhance sexuality, make folks look younger, and, to date, the FDA had discovered no serious side effects or long-term toxicity. It would the “wet dream” of every global pharmacologic company. For many of us, the notion that it is not a pill we can just swallow is disappointing. But exercise is not something you ingest, it’s something in which you invest. You have to discipline yourself to daily exercise. It requires participation and commitment.
Exercise has another saving grace: anyone can do it. You can start small and build yourself up. So what if your body needs to adjust to simply walking briskly for two blocks while the next-door neighbor is entering the Ironman® Triathalon. Get over it! Start! Just get going! As the Nike shoe company slogan puts it: “Just Do It!” The miraculous part of exercising is that, within a relatively short interval of consistent, persistent exercise, your body will have grown accustomed to the initial two blocks. Now it’s ready for more. If you can’t walk because you are wheelchair-bound, then don’t give up. Roll the chair! Roll it up hill, like a driveway, until that becomes easy. Then go up and down twice and so on.
Even while you are in the hospital, get up, and get moving. Crawl to the bathroom if you must. If you’re bedridden, then start by contracting your calves by pressing the balls of your feet against the footboard. You get the idea. I will put it bluntly: unless you are in a coma, you can figure out how to exert yourself. Exercise is more important to your recovery than all the drugs in the Pharmacy. I know that this may sound too simple but it’s the truth. Again, God offers us a wonderful solution to our dilemmas. In the final analysis, it is senseless to reject exercise because a sound mind can only work in a sound body. While this mortal machinery of ours must eventually fail, we show our gratitude for the gift of life by maintaining our bodies to the limit of their capabilities.
Illness As A Transformational Experience
Have a big, wide heart.
-Zen saying
Every illness, every surgery opens a door to spiritual challenge and personal transformation. Each one of us will sooner or later come to that very threshold. It is up to each of us to open that door when the time is right. Most of us can only pass through this portal when we become patients, when the lessons of the body become personal, painful, and poignant. This is when the lessons write themselves in our hearts.
Spirituality is not necessarily about religious faiths and beliefs—although, for many, it can certainly be. I define spirituality more broadly; namely, the sense that all of us feel that we are connected to something greater than ourselves—something that lies beyond our physical presence and identity. Being in the hospital, faced with terrible anxieties and fears, we are often brought face-to-face with the fragility of our own mortality. The bond between one human being and another is our conduit to hearing the language of the cosmos. It is through our relationships that the hearts of others become audible to us. Love is the language of our immortal consciousness and illness amplifies our ability to feel and receive love.
Life-threatening disease permits us to initiate a dialogue with the connections that lie beyond our physical self. Consider that love is the universally understandable and most widely accessible example of spiritual connectivity. For example, as I grew up during the Cold War of nuclear arms race, I never had any difficulty understanding the love that Russian parents must feel for their children. When the specter of nuclear annihilation hung over all of our heads, it was that universal constant of love that every human being felt for his own family that seemed the one power to which the world could appeal to stay the hand on the nuclear trigger. I know that the pain of watching children suffer today is the same in Mogadishu as it is Arizona. It is love’s commonality that creates spiritual connections.
There is another quality about love that tells us about its underlying spiritual qualities. I often ask the audiences I address: “How many of you have ever felt love for another human being?” Usually, there is hardly anyone who does not raise his or her hand in response to that question. Then I ask: “Prove it!” Of course, no one can prove we feel love for another person but we all know that we do. That is a universal quality of spiritual connections: we know they exist and there is simply no need to prove them.
So illness puts us back in touch with our need to love and our desire to feel love. So, as patients and physicians, we need to be ready for that. We need our friends, families, and doctors to be supportive as we enter our individual spiritual challenge. We each need to feel our team is behind us as we seek the courage to reach out for those spiritual connections because that is where we will finally find the inexhaustible well of strength we each need to face mortality. Being connected allows us to marshal energies and strengths far beyond our own physical reserves.
We all want our physicians to use the latest scientific research and medical technologies to help us treat our illnesses. What would we think of a doctor who ignored that my spiritual needs might be just as great as my physical ones? By contrast, imagine how unbalanced it would seem if a doctor came to us and proposed that he or she would only attend to our spiritual needs but completely ignore our pressing physical ones. It is equilibrium that we seek: a harmony between physical and spiritual forces.
As physicians, we are all too aware that a sad, depressed, isolated, lonely patient will simply not have the same potential for as rapid and as full a recovery as one who exhibits a positive, upbeat attitude. A patient who’s surrounded by loving family and friends will have a far better chance to heal quickly than one who is left unwanted and unattended. There’s not a physician in practice who has not had the experience of watching an enthusiastic patient overcome overwhelming odds to recover. We know that “spirit” matters.
We all watch sporting events and love to see those memorable occasions where a competitor harnesses his or her inner courage and resolve to become the winner. We fully accept that, in athletic contest, often victory will come down to the psychological and emotional differences between opponents and not just the difference between physical disparities in age, height, or strength. Why is it so easy to accept that “heart” matters so much in everyday athletics and not acknowledge that these same issues are at play every day in the ICU or the OR.
Courage, heart, and hope are all intangible ingredients. But they are nonetheless essential for the recipe to recovery. And just as we would never tolerate finding out that our doctor was not taking advantage of a better test, a more effective drug, or a less dangerous technique, we should not accept a physician who ignores the spiritual influences on our healing. We are far more than mortal machines. We are immortal beings enrolled in a journey of the flesh. Our soul uses the sensory experience of life to enrich and expand itself. In the end, it is our soul that infuses the physical dimensions of life with purpose.