We have all heard of this saying, and all of us agree. A skilled laparoscopic surgeon plots to take out huge tumors and cysts through the keyhole method, while the dinosaur surgeon tends to think of employing his hands to remove organs (like the appendix) that may have been better left alone.

Let me tell you a small story about myself. Not too long ago, at a Bariatric Surgery conference three or some years back, I had a chat with a renowned endocrinologist who was known for his work in obesity and diabetes. At that time, I was 86 kgs heavy, and most of it was fat. A hard-working surgeon, I was in the peak of physical un-fitness and a heart attack waiting to happen. My resting heart rate was always around 100 and my blood glucose was similarly poised over the century mark. I asked this gentleman how I could improve my markers and lose my fat. I also didn’t want to become a diabetic, I said.

He told me what anyone in his position would have: take a metformin pill, and do some walking. If your sugar levels go up, we will add another drug, he said.

I thought long and hard over what he said. I embarked on a new journey in life: a life of health and fitness. I trained hard and started IF (Intermittent Fasting). After an year of blundering along, I found my groove and results came in: resting heart rate down to 6o, blood glucose and lipid levels normal, and body fat well down (BW now 75 kgs).

To come back to the point, the doctor I asked hit my problem with the drug hammer he was holding by default. I did the smart thing by trying something different. I now firmly believe that everyone should try healthy eating and exercise in order to improve health and reduce body fat. As bariatric surgeons, we should not use the surgery hammer to hit every obese patient. When there is clear burden of disease (diabetes, hypertension, sleep apnea, gallstone disease, etc.) and the level of obesity is such that it is statistically unlikely to come off with lifestyle regulation, we recommend bariatric surgery. Not otherwise.

In other words, as specialists dealing with obesity and related diseases, we should have a broad perspective. We are always in danger of using a narrow knife-wielder’s perspective and eyeing every patient as a potential victim. We must be very careful. At BMI, we never stop telling each other this.

In clinical practice, the psyche of the patient is very important. But a more important factor (and an often unrecognized one) is the psyche of the doctor.

Halfway through my practice, a couple of trucks bearing sand and soil, came to the ground and started dumping them near me. I had to escape the dust and fumes, and abandoned the training.

(An Indian truck looks like this; pic source- from here)
But the disquiet of an incomplete session did not leave me as I proceeded home.

I live on the sixth floor of a building in Kolkata. As a routine, I never use the elevator, as part of my NEAT principle (check out the link).
Today, I decided to make a workout of my return home from the ground floor.
I walked to the floor above with one kettlebell (Kali- the 25 kg bell), ran down and brought back the other one (Sita- the 17 kg). Then I ran all the way down to the ground floor and back up. Now I had to carry one bell to the next floor, run down to two floors below, bring the other bell back, and then run down all the way to the ground floor and back. In other words, whenever both bells were on one floor, I had to run down to the ground floor and back up.
So, to put both bells up from, say the 3rd to the 4th floor, I carried one bell up straight from the 3rd to the 4th, ran back to the 2nd floor, sprinted up (two stairs at a time) to the bell at the 3rd floor, and carried it up to its partner in the the 4th floor. For the next round, I would start by going down to the ground floor and sprinting up all over again.
I calculated the floors and steps run in the few minutes of this workout:
1st- 2
2nd- 3
3rd- 6
4th- 7
5th- 8
6th- 9
TOTAL—35 floors
18 steps per floor—630 total steps up.
I am not calculating the steps run down.
At the end of it, my legs were saying, “PLEASE!!”
I was happy. No excuses training. That is what I want. So, the next time I take 3 kettlebells out, I know I would love the return of the kettlebells home.