Chapter 32 Fitness

As a boy growing up in a small town, I played four or five sports in a day, rode my bike for miles, went for a swim, and finished the evening doing gymnastics on the furniture. Active play, sports, and other exercise were a huge part of my life. It was hard to imagine a day without them. Fitness as a kid was fun, so it seemed easy.

When I became an adult, life kept getting in the way of exercise. I found it hard to carve out the time for fitness and even harder to find a way to enjoy it. If I played a pickup soccer game in the park on a Sunday, I would be so bruised and sore that I wouldn't feel good enough to exercise again until Thursday. When I tried to turn myself into a recreational runner, the rest of my brain and body had other plans. It turns out that running only works for me if I'm chasing some sort of ball or if something with fangs is chasing me.

I tried tennis with some success, but finding a partner of equal ability, matching our schedules, and finding available public courts was all a chore. I was lucky to play once a week. I certainly understand why so many adults let their fitness slide. Exercise is hard work in every imaginable sense. When you add marriage and kids into the mix, exercise can become completely impractical for many people. I get that. So considering all of life's natural barriers to remaining fit, is there any system that can work?

I think so. After a lifetime of trying nearly every exercise tip, trick, fad, and sometimes scientifically proven techniques, I have condensed the entire field of fitness advice into one sentence:

Be Active Every Day

Allow me to acknowledge how spectacularly useless that sounds. I'm sure you already knew that being active is a good thing. You're probably thinking that a cartoonist has nothing to offer on the topic of fitness. I'll be the first to admit that you might be right. But stick with me for a page or two and I might surprise you. I'm not a health and fitness expert by any stretch of the imagination, but I do have a cartoonist's knack for simplification. And simplification might be just what you need.

Simplification is often the difference between doing something you know you should do and putting it off. You don't mind brushing your teeth because it's simple. But you probably put off finding out why there's a strange smell coming from the attic. That could get complicated.

Simplification done right also helps connect the important parts of exercise, diet, career, finance, and your social life. If any of those becomes too complicated, you're forced to borrow time, willpower, and resources from something else you also care about. I won't try too hard to sell you on the benefits of simplicity because you see them in your own life every day.

If you are young and don't have crushing responsibilities, you probably have everything you need to exercise regularly. But after a certain age, life transforms exercise from one of your highest priorities to the thing you give up first when things get busy. That can literally be a death trap.

My challenge in this chapter is to convince you that if you get one simple thing right—being active every day—all other elements of fitness will come together naturally without the need to use up your limited supply of willpower.

That last part is the key. In my experience, any form of exercise that requires willpower is unsustainable. To stay fit in the long run, you need to limit your exercise to whatever level doesn't feel like work, just as kids do. When you take willpower out of the equation and achieve a solid baseline of daily physical activity, your natural inclination will be to gradually increase your workout. You'll do it because you want to and because it feels easy—and because it feels good. No willpower needed.

If you walk two miles every day for a month and enjoy the leisurely pace, your brain will automatically start to think that walking an extra mile might be even more fun—or that running half the way and walking the rest might be interesting. That's how you turn boredom into a tool. When you are active every day and your body feels good about it, you'll find it easier to exercise more rather than less. Ask any dedicated runner, biker, or swimmer how they feel on the occasional off day. They don't like it. That's where you want to be. And the only way that happens is if you make fitness—of any kind—a daily habit. Once exercise becomes routine, you won't need willpower to keep going because your body and brain will simply prefer physical activity to being a couch spud. And your natural inclination for variety will drive you to do more stuff over time.

You probably know someone who is a long-distance runner, putting in five to ten miles every day. If you're not that fit yourself, you might think those runners have extraordinary willpower. That's probably more of an illusion than reality. Long-distance runners are born with a certain genetic gift that allows them to feel good when running. No one needs willpower to do the things they enjoy.

Most normal adults, including me, find running to be little more than the most cost-effective way to be bored and uncomfortable. A dozen times over the course of my life, I have tried to force myself to enjoy running, or at least to do it anyway for the health benefits. Each time, my willpower crapped out a few weeks into it.

You wouldn't flap your arms and try to fly just because you saw how well it worked for a bird. Likewise, I don't recommend adopting an exercise plan just because people who have completely different bodies and brains seem to enjoy it. No matter how charismatic that exercise guru on YouTube sounds, don't believe that someone else's specific fitness plan will work for you. No one is like you.

What you need is a natural and easy way to evolve a fitness routine that works for your specific brain and body. And you want to do that without relying on willpower. The starting point for that journey is nothing more than physically activity every day regardless of the specifics.

I did an Amazon.com search on the keyword "exercise" and got 125,508 book suggestions. I'm not trying to be the 125,509th variation on largely familiar material. I haven't read many of those books, but I assume most of them require you to use a degree of willpower. That's a losing strategy no matter how you dress it up or how inspirational the author might be. In the long run, any system that depends on your willpower will fail. Or worse, some other part of your life will suffer as you deplete your limited stockpile of willpower on fitness.

The fitness approach I prefer differs from the norm both in its simplicity and because it doesn't require willpower at any stage. In fact, if you follow the system of being active every day, you'll feel more energetic, and that can replenish your willpower.

I use the word "active" in an intentionally ambiguous way. That's what makes the rule a system and not a goal. As you know, goals are for losers. If the rule were "Run ten miles every day," that would be a goal. And it would probably set you up for failure since most people can't do something specific every day. But almost everyone can be active in some way every day. That could mean anything from playing basketball to cleaning the garage to taking a walk. Under my system, any physical exertion counts, and none is better than the other. I'll explain in this chapter how all paths can lead to optimal fitness if you follow a few simple rules for manipulating your willpower.

The most important and powerful part of the "Be active every day" system is the "every day" part. Everything springs naturally from that. And if you have trouble fitting exercise into your busy schedule as most adults do, I'll give you some suggested fixes for that, too.

Fitness is a simple experience made absurdly complicated by market forces. If you want to make money as a fitness expert, you must make a novel claim about the value of your product or service. Each new idea is layered on top of old ideas until the entire field is so complicated it becomes intimidating.

How often should you work out? What should you eat before and after working out? Should you have a different diet for cardio workouts versus weightlifting? How much should you customize your workouts for your age, gender, and situation? Will an abdominal exercise hurt your back or help it? How much rest should you get between days of weightlifting? Is long-distance running beneficial enough to your overall health to justify the wear and tear on your knees? The questions and complexity are endless. Here are a few of the exercise "musts" you hear all the time.

1. Thirty minutes of aerobic exercise daily.

2. Stretch.

3. Hydrate.

4. Eat protein within thirty minutes of strength training.

5. Carb-load the night before a big exercise day.

6. Do resistance and weight training every other day.

7. Do three sets of ten to fifteen reps.

8. Get lots of rest.

9. Vary your workout to create "muscle confusion."

10. Use proper form for lifting.

That's just a partial list. The only people who can do all that right are serious athletes, personal trainers, the unemployed, and the socially unpopular. For everyone else, it's simply not practical.

For married people, an excellent way to fail at exercise starts like this:

YOU: "Hey, honey, would you like to take a walk with me in an hour?

SPOUSE: "It depends. Maybe."

(And then life gets in the way.)

Here's another way to fail.

YOU: "I'm going to the gym at two o'clock."

SPOUSE: "But that's exactly when Timmy needs to be taken to his birthday party."

And another ...

YOU: "Chris asked me to play tennis at seven tonight."

SPOUSE: "I was hoping to see a movie with you then, but if you like Chris more than you like me, fine."

By the way, if you assumed "spouse" means "wife" in those examples, you might be a sexist jerk. It works both ways. As soon as you try to satisfy two schedules instead of one, all your seemingly optional activities such as exercise get pushed to "later." So what's the fix?

There are three practical ways to schedule exercise in a marriage or marriage-like situation:

1. Join an organized team.

2. Always exercise at the same time every day.

3. Exercise together (if you both really mean it).

When my wife, Shelly, tells me she has a tennis league match scheduled on a Thursday night, her absence never makes me feel abandoned. For starters, I always have advance notice and can make my own plans, which is great. But even more important, I know Shelly didn't pick the specific date and time of the match. The fact that the game is scheduled by some unknown third party makes it okay with me because I know that Shelly didn't make a conscious choice to be away at that specific time. Sure, sure, on some level, it's the same thing because Shelly knew in advance that matches would be on Thursday nights, and she chose to join the team. But it feels different. And that's what matters. Whenever you can, join a team sport that has a set schedule. Your spouse will still be inconvenienced, but it won't feel personal.

If team sports aren't your thing, the next best solution is to schedule your exercise for the same time every day. Shelly can tell you where I will be on any given Tuesday at 12:40 PM. I will be at the gym, just finishing my resistance training and heading for some stretching before cardio. Shelly finds my regular exercise schedule inconvenient at times, but it doesn't feel personal because it's my system. I don't decide to be unavailable for a romantic lunch with my wife; I simply have an exercise system. On some level it's the same, but it sure feels different. And that's the beauty.

I exercise at lunchtime because mornings are better for my creative work and afternoons are unpredictable in terms of work and family time. Other successful exercisers get up long before the sun to do their workouts. Still others go straight from work to the gym. In each case, the key is to have a predictable system. The method that never succeeds is exercising whenever you have some spare time. If you're like most adults, you haven't seen spare time in years.

Motivation to Exercise

My system for staying in the mood to be active every day has several parts. I already explained the importance of diet in keeping your energy up. After that, the most important rule is that you should never exercise so much in one day that you won't feel like being active the next day. To put that another way, the right amount of exercise today is whatever amount makes me look forward to being active tomorrow.

My old exercise system involved working out so hard I could barely move the next day. No pain, no gain, I thought. I figured the harder I pushed myself, the better. But pushing takes willpower, and if I use up my willpower at the gym, I can barely drive past the donut shop without being sucked in there.

And the soreness is like a penalty for exercising. Humans aren't that different from dogs: If you give me a penalty every time I do something, eventually I'll find a reason to stop doing it. And that reason will be something along the lines of "too busy."

What you want is for your daily exercise to give you a reward every time. Light exercise does just that; it reduces your stress and boosts your energy. Over time, as you become fitter, you will naturally increase your exercise level, but by then your body will be equipped to handle it.

If you want to make a habit of something, the worst thing you can do is pick and choose which days of the week you do it and which you don't. Exercise becomes a habit when you do it every day without fail. Taking rest days between exercise days breaks up the pattern that creates habits. It also makes it too easy to say today is one of your non-exercise days—and maybe tomorrow, too.

Reward

I find it important to reward myself after exercise with a healthy snack I enjoy, some downtime that involves reading interesting articles on my phone, or a nice cup of coffee. By putting those pleasures at the immediate end of my exercise, I develop a strong association between the exercise and the good feelings. That's habit-forming.

As I've mentioned—and it's worth repeating—a big part of my exercise motivation is coffee. Coffee boosts athletic performance but more importantly makes you willing to put in the effort. 68-70 If you're not exercising every day and don't drink coffee, maybe you should give it a try. I can't tell you how many times I ruled out exercise because I was too tired, only to completely change my mind after a cup of coffee.

I also find that ibuprofen (as found in Advil and other brands) helps reduce my soreness on those days I overdo it. If I take the ibuprofen on days I'm stiff, there's a good chance I'll feel up to exercising the next day. Without the ibuprofen, I feel like the Tin Man on The Wizard of Oz—all I want is my oil can. I can't recommend ibuprofen for you because I'm not a doctor and because there are risks if you overdo it. Ask your doctor.

So how do you exercise on those days when all you want to do is sit on the couch, eat ice cream, and feel bad? Can you jump-start your body when one part of your brain knows that exercise is a good idea but another part of your brain is using its veto power?

The trick I've found that works best takes advantage of certain cues in your life, or "keys," as hypnotists like to call them. For example, if you were bitten by a German Shepherd dog as a child, every time you see that type of dog you might get a little burst of fear. That's a cue—a key. Your life is full of these little cues and keys that can control your attitude. The trick is manipulating your own cues in a way that programs your mind.

Here's what I do when I know I should exercise but I feel too tired and droopy to imagine doing a vigorous workout. Instead of doing what I feel I can't do, I do what I can do—which is put on my exercise clothes and lace my sneakers. (You might call them tennis shoes or running shoes where you live.) Central to my method is that I grant myself 100 percent permission to NOT exercise, even after getting suited up for it. This is important because I know I won't take the first step of donning my exercise clothes if I feel committed to something that just seems impossible in my current frame of mind.

But once the sneakers and shorts are on, a funny thing happens, and it happens quickly. The physical feeling I get from my exercise clothes triggers my going-to-the-gym subroutine in my brain, and my energy kicks up a notch. It's like Pavlov's salivating dogs. The exercise clothes cause me to think positive thoughts about exercising, and that boosts my energy.

Suddenly, the idea of exercising seems possible if not desirable. There's one more step, and this, too, requires granting yourself permission to back out at any time. I drive to my local gym, walk in, look around, and see how I feel. About 95 percent of the time, this set of cues puts me in a sufficient mood to go ahead and exercise, and that in turn boosts my mood. But sometimes—and this happened perhaps five times this year, which is typical—I get to the gym, look around, turn, and leave. As I drive home, I'm not thinking I failed. In fact, I feel exactly the opposite. Failure is for people who have goals. If my goal is to exercise, leaving the gym without breaking a sweat looks and feels like failure. But what I have is not a goal; it is a system. And the system allows leakage. It's designed that way. As I drive home from the gym—a seemingly wasted trip—I never feel defeated. Instead, I feel I'm using a system that I know works overall. I win if I exercise, and I win (albeit less) if I use my system and decide not to work out. Either way, my attitude improves. And at least I get out of the house and clear my head. It's all good.

Don't be concerned about how much or how little you exercise. All that matters in the long run is that you make exercise a daily habit. Studies indicate that moderate levels of exercise are optimal for longevity.71-75

Over time, you'll naturally gravitate toward adding the variety and challenge that your body can handle.

Hair-Care Death-Spiral

In 2011,United States surgeon general Dr. Regina M. Benjamin made headlines by saying that too many women were skipping exercise because of hair-related issues. In her view, this qualified as an important health issue. The New York Times quoted Benjamin as saying, "'Often times you get women saying, 'I can't exercise today because I don't want to sweat my hair back or get my hair wet.' When you're starting to exercise, you look for reasons not to, and sometimes the hair is one of those reasons."76

Dr. Benjamin's observations match my own—and yours, too, most likely, I don't think I need to explain why putting your hair above your health is a loser strategy in the long run.

If you're a woman caught in the hair-care death-spiral, nothing I've said in this book will be much help unless you escape. Allow me to offer a possible solution.

I'm going to start with the assumption that there are three main reasons a woman wants great-looking hair: 1) attract sexual partners, 2) improve career potential, and 3) feel good about herself. Everyone is different, but those three causes probably cover 85 percent of the reasons.

The first two reasons (sexual partners and career options) are about influencing how others view you. And I would argue that feeling good about yourself only has meaning because you know you are influencing others to feel the same way. So really, hair-care is about influencing how other people feel about you. We're all social animals, so there's nothing wrong with that. The world only works when we care how other people think.

On the topic of women's hair, I can only speak from a heterosexual man's perspective. I encourage you to check with the men in your life for confirmation. My best guess is that what I say next is as near a universal opinion as men can have:

We Prefer You Healthy.

I've never known a man who would prefer an unhealthy-looking woman with movie star hair over a fit woman with a ponytail. And if I ever do meet that guy, I'll try to avoid him because he sounds like a creep.

A hiring manager will always have a subconscious bias for the healthier-looking applicant, male or female. Humans evolved to have favorable opinions about anyone who looks healthy because it's a marker for good reproductive odds. That's why society needs laws that limit discrimination against the differently abled. If your main reason for spending time on your hair is to feel good about yourself, a healthy body will always trump a good hairdo.

I won't pretend to understand the minds of women when it comes to hair. And every woman is different. Some women are three different people before lunchtime. But I can tell you with certainty that men prefer you to be in good health, even if it means we miss the best of your hair potential.

I would imagine it's very hard to break a hair-care routine that has been part of your life for years. But it might help to think of this in a different way. If you skip exercise because of your hair, remind yourself during those many hours of brushing, curling, straightening, and drying that the long-term payoff for your efforts is to become less attractive, less employable, and less healthy. When you change how you think, you eventually change how you behave.

Having great hair is a short-term goal. Fitness is a system. Systems are for winners.

Chapter 33 Voice Update II

Three years had passed since I lost my voice. It was getting hard to imagine it could ever be fixed. Outwardly, my life looked to be on track. Dilbert was running in over 2,000 newspapers in sixty-five countries. I married Shelly, and we started building a home. Externally, things were great, but on the inside, I was badly damaged. My optimism was getting its ass kicked twenty-four hours a day, but somehow it still had a pulse.

The simple things in life had become terrors. Every time the phone rang, my heart sank. Every time someone asked a question, I died a little on the inside. Emotionally, it was confusing. Half my life was great while half was darkly broken. I continued doing my affirmation—"I, Scott, will speak perfectly."— but I was running out of potential remedies to try. My future looked bleak.

One day, another Google Alert showed up in my email inbox. Unlike the numerous false leads, this one looked promising. A doctor in Japan was reporting success treating spasmodic dysphonia with a surgical procedure on the neck. I was willing to fly to Japan if needed. I would have swum there if I had to. By then,I had experienced so many disappointments in my search for a cure that Shelly couldn't muster much enthusiasm for my new longshot hope. I know she didn't enjoy seeing me get my hopes up and hers as well just to be thrown against the rocks time and time again.

Following protocol, I took the news of this new operation to my regular doctor, Dr. Smith, who referred me to my Ear-Nose-Throat doctor, Dr. Cornelius Jansen III. Dr. Jansen hadn't yet heard of this new surgery, and he was concerned that the reports of success might be exaggerated. He explained that some proclaimed medical breakthroughs are more credible than others, so I shouldn't assume this report was accurate. I wasn't surprised. Realistically, how likely is it that you can fix a brain abnormality by rigging up some sort of workaround in the neck? It sounded iffy even to me.

But in the interest of exploring every option, Dr. Jansen recommended I speak to one of the top professionals in the field, Dr. Edward Damrose of the otolaryngology department at the Stanford School of Medicine. Dr .Damrose was familiar with the reports coming from Japan, but he suggested I contact a doctor closer to home who was pioneering a different type of surgery for spasmodic dysphonia. He referred me to Dr. Gerald Berke at the UCLA Medical Center.

I got off the phone with Dr. Damrose feeling puzzled. How could there be a surgical fix for this condition that I hadn't heard about until now? How could this be true if there was no mention of it on websites dedicated specifically to this disorder? The only explanation I could imagine was that this would be another false lead to another dead end. But my system was to follow all leads, no matter how ridiculous or unlikely.

I made an appointment with Dr. Berke for an initial visit and flew from my home near San Francisco to Los Angeles to meet with him. Dr. Berke is an interesting character: brilliant, confident, and a little bit mysterious. A small herd of doctors from other practices followed him from room to room to learn his ways. Dr. Berke and his tag-along doctors examined me and confirmed the diagnosis of spasmodic dysphonia. Then he explained that he had been perfecting a surgery for this condition over the past several years, with about an 85 percent success rate, which in this context means the patient had a better voice after surgery than before—not a perfect voice, but substantially improved. Unfortunately, some people got worse after surgery, losing what little was left of their voices. But Dr. Berke had a good idea why some patients were less successful, and he was refining his technique to account for it.

But here's the interesting part. Dr. Berke's surgery involved opening the front of the neck, cutting the nerves that lead from the brain to the vocal cords, then building a new path using nerves borrowed from elsewhere in your neck. Once the rewiring was done, the patient waited three-and-a-half months until the new nerve pathways regenerated and the voice came back. Until then, the patient's brain and vocal cords wouldn't be connected. There were no follow-up visits to the doctor. It either worked or it didn't.

Does that sound like the way you fix a brain abnormality? It didn't sound like a logical solution to me. So I asked for a list of past patients as references. I was hopeful but skeptical. The operation didn't make sense to me, and I was still scratching my head as to why none of this had appeared on the Internet yet.

I emailed some of Dr. Berke's patients and set up a time to speak with them—if you can call it that—by phone. This was the one group of folks I could speak to confidently on the phone because they were skilled at deciphering my broken, raspy attempts at words. They also understood that the call was mostly about them doing the talking.

And talk they did. Perfectly. Not one of them had a hitch or a hesitation in their words. There was no hoarseness or clipped syllables. Each described the recovery from the operation as unpleasant because you choke nearly every time you try to eat or drink for quite some time, but they were unanimous in saying it was worth it.

Obviously, I was only talking to the lucky people who had the best results, but I was feeling good about the possibility. Still, I needed to satisfy my curiosity about one thing: I asked Dr. Berke how he figured out that nerve surgery in the neck could fix a brain abnormality. What evidence did he see that others did not?

His answer fascinated me. I suppose it explains why doctors follow him around. I'm paraphrasing, but Dr. Berke explained that it was an inspiration that somehow emerged from the sum of his knowledge about necks and throats and voices and nerves and all the rest. He didn't call it genius, but if this surgery worked, no other description would fit quite as well.

If I decided to do the surgery, there was something on the order of a 15 percent chance my voice would not improve. In that scenario, the surgery itself might eliminate any chance I could benefit from some future treatment. It was a one-way trip to a destination unknown.

I scheduled the surgery.