As physicians, we are trained to prescribe, to fix, to optimize. Our patients expect it, and frankly, so do we. I built a career around lipid panels, trial data, and prescriptions meant to shave percentage points off cardiovascular risk. But lately, I find myself offering something far less high-tech and far more radical: a walk.
Walking is slow. Impractical. Rarely the efficient choice. Which is exactly why it matters.
Everywhere around us, the health care conversation is saturated with metrics: steps per day, calories, VO2 max. Patients come in with apps, wearables, and questions about the next injectable that promises not just weight loss but immortality. And yet, the nervous system does not need another hack. What it craves is simplicity, movement at a human pace.
When you walk, you reconnect. Not just with your cardiovascular system, but with your mind. You catch your breath, not because you have sprinted to exhaustion, but because you finally gave yourself permission to slow down. You notice things: the maple tree on your block that is beginning to turn, the neighbor you have waved at but never really spoken to, the silence between your own thoughts.
Patients sometimes look surprised when I prescribe walking as if it were a statin. But I have watched walking do things no pill can. It lowers blood pressure, yes; but it also lowers rumination. It improves insulin sensitivity, yes; but it also builds resilience. And unlike nearly every intervention I could order, walking comes with no prior authorization battles, no copay, no side-effect profile longer than the benefits.
Of course, there is a paradox here. Walking feels unproductive. In a culture obsessed with efficiency, the act of slowing down can feel like failure. Patients, and physicians, often resist it for that reason. We would rather optimize, quantify, and track than risk being present.
But health does not happen at eighty miles an hour. It happens when we allow space for slowness.
So here is my advice: Put the phone away. Leave the tracker at home. Choose the longer route through your neighborhood or, if you want my personal favorite, wander through a cemetery path. The headstones remind you of scale and perspective. The pace forces you to breathe differently. The absence of hurry recalibrates a body and mind convinced it must always be doing more.
I have come to believe that walking is not exercise. It is medicine.
Larry Kaskel is an internist and “lipidologist in recovery” who has been practicing medicine for more than thirty-five years. He operates a concierge practice in the Chicago area and serves on the teaching faculty at the Northwestern University Feinberg School of Medicine. In addition, he is affiliated with Northwestern Lake Forest Hospital.
Before podcasts entered mainstream culture, Dr. Kaskel hosted Lipid Luminations on ReachMD, where he produced a library of more than four hundred programs featuring leading voices in cardiology, lipidology, and preventive medicine.
He is the author of Dr. Kaskel’s Living in Wellness, Volume One: Let Food Be Thy Medicine, works that combine evidence-based medical practice with accessible strategies for improving healthspan. His current projects focus on reevaluating the cholesterol hypothesis and investigating the infectious origins of atherosclerosis. More information is available at larrykaskel.com.
