When I talk with my patients about exercise, I often tell them the story of Sophie, my friend Becky's mother, who died of respiratory illness at age 83. When I flew to San Francisco to attend the funeral, I hadn't seen Sophie in 15 years. I remembered her as a vibrant, athletic woman who seemed ageless. She had been relatively active even in retirement. She played golf and worked most days in her garden. It wasn't a structured "exercise" program; she was just doing the things she loved. But then she injured her shoulder, and then her knee, requiring surgery for both. After surgery, her activity level dropped off almost to zero. As Becky related to me, her mother mostly sat around the house, depressed. Her cognitive decline quickly ensued.
This made me incredibly sad as I sat there in the pew at her funeral. Yet her story was all too familiar. We have all seen older friends and relatives go through a similar ordeal, slowly (or not slowly) weakening until they can no longer find enjoyment in the things they once loved to do. What could have been done, I wondered, to change Sophie's fate?
Had she simply needed to "exercise more"? Go to the gym and use the elliptical? Would that have saved her somehow?
It wasn't clear that the answer was that simple. I had done plenty of exercise in my own life, but by the time of Sophie's funeral, I was nursing a handful of pet injuries that I'd accumulated over the years. Fit as I was, it wasn't clear that. I was on a better path.
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