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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 September 29; 335(7621): 672.
PMCID: PMC1995518
From the Frontline

Running with the pantomime horses

Des Spence, general practitioner, Glasgow

After four children a man can lose his figure. I would smile with resignation at the predictable comments: “You're looking well!” (translation: “Aren't you fat!”) But most days I was lucky to have time to brush my teeth, let alone fret about my body mass index or go to the gym. Anyway, the exercising class exercised me. It was demanding, unrealistic, and never satisfied with my explanation that simply resting might be sensible. The accessories were ridiculous: orthotic insoles, straps, isotonic fluids, food supplements. Jogging from one specialist physiotherapist to another, each giving an unlikely but grand sounding diagnosis and equally grand bill. Seemingly intelligent people were reduced to believing in the unscientific voodoo that much of sports medicine is.

But I took the plunge. Never underestimate the power of sibling rivalry: my brother had starting running. For 30 minutes I rummaged in the bargain buckets of sportswear websites. My finger hovered, hesitated, and then, clicked. The discounted running shoes arrived the next day, and I joined the exercise bores.

At first I ran each time for 15 gut-wrenching minutes, praying that I might die. Five times a week, in the margins of the day: early morning and in the evening darkness. Dim I may be, but determined I certainly am. The time crept up, to 20, 30, and then 40 minutes. With indie rock in my earphones, the miles slipped by. I splashed through puddles, loving the rain, wind, cold, and solitude. I dodged dogs and drunken local youths, and still I plodded on. My kids did a double act. “Dad's gone mental obsessive,” said my daughter, and my son twirled his finger at his temple. “Bonkers, man,” they told everyone. I endured a swollen ankle and chronic hip pain, but through the pain I pounded on. One Saturday morning I sped faster and faster up a hill, with the rising sun. Trumpets blasted: I had my Rocky Balboa moment. God, it was good to be alive.

With my previously plum shaped face now a wrinkled prune, I smile in resignation at the predictable “Are you all right? You look sick.” But exercise is an elixir of life, a treatment with a number needed to treat (NNT) of one to help prevent obesity, mood swings, cardiovascular disease, osteoporosis, and many other modern ailments. Medicine—with all its polypills, distorted risk, huge NNTs, and undebated treatment paradoxes—collapses on the starting line. So last Sunday was the Great North Run, my number 37 474—in the paddock with pantomime horses. Never mind: I am glad to be on the stage of life, not sitting in the dark watching the action, occasionally scrambling on the floor for sweets.

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