Lesson #1

In nursing school we talk a lot about what to expect from patients and how to handle what we see. There are risk factors for everything. And there are plenty of problems that come upon people without any reason whatsoever. But, from spending time in the colorful world of clinicals -- with real people experiencing real disease right before my (or my classmate's) eyes it's crystal clear that the decisions we make determine a great deal about our health.

We talk about 89-year-olds who don't want to use canes because a cane would make them "look old." We talk about patients in their 60s with laundry lists of problems -- obesity, diabetes, immobility, infections of many sorts. My own grandfather is still working going on age 92.

What's the secret? I certainly don't know how it all works, but I do know that there are a few things we can do to make our lives long and terrific...

• Do not smoke. Anyone who has taken A&P can tell you it degrades almost everything in your body. Smoking doesn't correlate to anything good.
  
• Exercise, move, whatever. Keep all those parts working. I can't count the number of times people have said things to me about how they can't exercise, but I still don't buy it. Swim, stretch, jump, walk, dance, touch your toes or just walk really slowly. The more you keep your body working, the better it will work.
  
• Go to the doctor. Ask the doctor questions. All the questions you have -- ask them. Don't ignore symptoms. I'm a big fan of having a healthcare notebook -- I've got one place where I write my questions, jot down my lab values and keep a log of what goes on with my doctor. It impresses my doctor (who brags to her med students about me) and it's pretty great when I want to look back at how I'm doing.
  

Is that innovative? Nope! It's pretty standard advice, but it's not common practice. I probably won't shut up anytime soon about how much behavior and lifestyle choices mean to what life turns out like. There's lots more to it, of course, and not everyone who gets sick behaved badly and not everyone who behaves badly gets sick.

But seeing patients firsthand makes me want to take walk.