Some theories on exercise don’t have a leg to stand on
Author, Emer O’Kelly
How many of us want to live to be 120? Or even 100? Professor Walter Bortz, Clinical Professor of Medicine at Stanford University in the US, believes that 120 should be (and probably will become) the natural span.
And he has formed his theories after serving as a primary care physician for dozens of centenarians. The secret, he believes, is physical exercise. Use it or lose it, in other words. And the good professor practices what he preaches: still working at the day job, he runs 16 miles a week, and has completed 41 marathons, including Boston as recently as 2010. A man in the prime of life, you might think. Well, by his own standards, he is: he’s 82.And like most people dedicated to a lissom body as the Holy Grail, there’s a sense of impatience in the man and his publications with those who have no interest in, or are slightly repelled by a fanatical dedication to the physical. (We Live Too Short and Die Too Long; and Dare to be 100)
Dr Bortz believes that the negative effects of ageing are due to disuse, not disease. Lucky chap: he has clearly never suffered from debilitating and increasingly painful disease, nor has encountered it among the centenarians he deals with. No doubt they’re all out running with him daily. Which is absolutely fine. Except that they couldn’t if they suffered now, or had ever suffered from certain progressive diseases.
We all agree that quality of life is very important at any age. But, personally speaking, I think that quality of life is much more about your head and your heart than the rest of your body. Physical incapacity can be dealt with (unless there is accompanying consistent, severe pain); mental and emotional incapacity takes your life out of your own hands. To be aware that you can no longer make rational decisions, or even communicate rationally, must be the greatest agonising deprivation. To put it at its most basic, there is nothing undignified in needing assistance to go to the lavatory; but to be reduced to clapping your hands and singing nursery rhymes at the age of 90 is a gross insult to your humanity. Your body is merely the machine that encases your humanity: inevitably it’s going to run down. The mind that thinks, and the heart that loves are what is important.
And Professor Bortz seems to reduce everything to the physical, reversing that pecking order. I believe he’s wrong: sometimes the body fails not through disuse, but because forms of disease make it impossible to use. Yes, there are far too many people who live on a diet of fast food, and spend their lives attempting to see the TV set from over the mounds of their bellies. But there are many other people who live perfectly healthy lives, but their bodies let them down. Take a friend of mine, about to return to work after a knee replacement, which apparently was extremely complicated. A lifelong cyclist in all weathers, slim and fit as the proverbial fiddle, there was apparently pretty well nothing useful left of his knee. He had, however, struggled on through pain for as long as he could.
I was 24 years old when I was told I had an arthritic spine. I wasn’t sporty, but I was active and I didn’t pay too much attention: at that stage my problems amounted merely to not having the best balance in the world when I wore six-inch heels, and a permanent backache. When I was 28, after I had nagged my then GP about intensified pain and an increasing numbness in my right thigh, he ordered X-rays. When the results came back he beamed at me and said, “My god, you’re in bits.” I was so gratified that at last I was proved right that I just got on with things, instead of looking for further assistance.
Things got worse and worse, as did the pain. The advantage of having a progressive crippling disease from a fairly early age is that you get used to it, and you cope. You don’t whinge endlessly. The disadvantage is that as your sight blurs from pain at a party, you head for a chair, and you mention your condition, maybe once in six months, somebody comes up with a bright solution: “Why don’t you try drinking olive oil?” “A friend of mine has taken to going for a walk every day.” The assumption is that if you haven’t yet reached the age of at least 75, the disease must be mild and tentative. Severe arthritis at any age means that you’re way beyond such things, and with the best will in the world, exercise, including walking, reduces you to prolonged gibbering agony rather than improving things. And for some strange reason, the pain becomes even more intense at night, so you don’t get much sleep, sometimes none at all.
So I got new hips six months apart about five or six years ago. When the surgeon looked at the X-rays he asked which one I wanted done first as they were pretty much of a condition: museum pieces, he implied. He also told me that he’d have done them 10 years earlier if I’d consulted him. My life improved out of all imagination. I still couldn’t climb Everest or run a marathon but with respect to Dr Bortz, I had never wanted to. But I could go for a walk. And for the first time in many years, I went on an all-day Christmas shopping spree.
Then in the past year, things deteriorated again. I was back to severe permanent pain, and unable to walk, and if I stood for even two minutes, my leg gave out and I collapsed. (My knees and elbows were permanently bruised.) And in January of this year, I had what is called a spinal fusion and extension, again under the care of a surgeon who still strikes me as a cross between a magician and a god. The top bit of my spine remains problematic and may require further surgery, I play symphonies going through airport security, and I still can’t run. According to Dr Bortz’s theories I don’t have quality of life, even at my age, much less at 100. I disagree.
I have met people like him. I have listened in disbelief as, eyes bulging, veins standing out on their foreheads, they have proclaimed, “Discipline. Discipline is the only thing that matters.” They (literally) measure every spoonful that goes into their mouths; and nothing, no tragedy, nobody else’s needs or comfort, interferes with their exercise routine.
The crime writer PD James is 91. She said last week, “I am not afraid of death, but I do fear the process of dying if it means prolonged pain, indignity and a lack of independence. I make a strong distinction between death and dying.” She doesn’t run, and walks with a stick. She is also the epitome of dignity. If I met Professor Walter Bortz tomorrow, I would not be able to run even half a mile of his 16 miles with him. But I could, and would, give him a lively argument about his theories. And if I lived to be 100, confined to a wheelchair, without teeth, and with a catheter, provided I could offer a hug, a kiss, and above all an intelligent mischievous argument, I would consider that I had quality of life.