I have a 5% chance of having a heart attack in the next 10 years.  That’s not so high, but it’s higher than I want it.  Most of that risk is due to my cholesterol and my age.  I can’t do anything about the latter, but the former is under my complete control.  Cholesterol medications can improve my cholesterol significantly.  So can proper diet and exercise.  That’s not true of everyone; some people will never improve without medication, but I’ve found that my numbers respond at least somewhat to lifestyle modification.

Around the same time I last checked my cholesterol, my wife was headed to Washington, D.C. to help out a friend at the Marine Corps marathon.  Her friend’s brother was a Marine Corps major and was killed in Iraq six years ago.  Needless to say, it wasn’t his heart.  He believed strongly in what he did, and gave his life for his Marines and his country.  His friends and family have honored his memory by raising money for injured Marines and their families, a sad necessity. In my daily work I see preventable death and illness every day, but not the kind caused by rockets and gunfire.  I was happy my wife could be in D.C. to help out.  I couldn’t be there, but I was at least helping others at home, helping to prevent illness and death.

But like many people who work for a living, I’ve sacrificed a bit of my own health along the way.  A colleague of mine, about 15 years my senior, had a major heart attack at work earlier in the year.  That scared me.

Last week I was at a party, a fund-raiser for local schools.  The hosts have a beautiful home.  Everyone looked lovely—on the outside.  I knew that many of them had had their own struggles: mastectomies, insulin pumps under their shirts, bypass scars hidden by high-neck blouses, tattoos from radiation therapy.  Everyone has a story, if they’re willing to tell it and you’re willing to listen, or even bother to ask.

As I thought about this, I stood and talked to one of our friends there.  He’s an avid runner, one of the crazy ones.  Like most runners, he’s happy to share advice about running and I drilled him on how to get started, especially with the Midwestern winter coming.

I don’t want to be a cautionary tale, a bugbear people invoke over donuts.  I resolved to cut my risks.  Many others can’t, but I can.  In the process, I can give encouragement to others.  I agreed to train for 10K so that I can run with my friends at next year’s Marine Corps Marathon.  I made plans to cut out one of my evening shifts to add sanity to my schedule, and to run mostly in the mornings.

I haven’t run in years, and was pretty apprehensive, but so far, so good.  The first run felt fine, but for days afterward, my quads and shins were a mess.  I couldn’t run again for several days.  But I’ve run several times since and I’ve seen clear improvement.

And mornings are beautiful.  The cold air is so clear.  I walk out and see Orion in front of me.  Deer scatter as I head down the road.  And it’s quiet.

I hope to hell I can keep this up, for my friends, for my family, and for myself.

“PalMD” is an internal medicine physician who blogs at White Coat Underground.

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