What a difference. The first time it took me five hours and five minutes to finish. I finished in silence. This last time it took 7.5 hours, and I finished to the cheers of a thousand Patriot's Day celebrants with flash bulbs popping, so to speak.
The first time I hadn't the slightest idea what the effort entailed, and I was in tears. This time I was a grizzled vet who knew that the back spasm I encountered at 24 miles was only a minor annoyance and nothing to halt the run.
So I finished with a big smile.
Not bad for an 80 year old. I was beaten by 30,000 other runners, including an 83-year-old woman. The winner, a Kenyan, broke the course record in two hours, five minutes. He could have lapped me twice.
This year's race also marks several decades of a particular interest of mine: healthy aging. For many years I was a practicing geriatrician with the Palo Alto Medical Clinic/Foundation and a member of the clinical faculty at Stanford University School of Medicine.
For much of that time, I was practicing standard medicine for older persons: monitoring people's vital signs and advising them on diet, avoiding bad habits and getting moderate exercise.
Then one year I suffered a badly broken leg in a skiing accident, and it had to be in a cast for many weeks. I was shocked when the cast came off and I looked down at a leg that didn't belong to me but to a very old person — all spindly and frail. My other leg, despite relative inactivity, was far younger.
I began reading up on everything I could find on the relationship between aging, frailty and physical activity, which culminated in my book, "We Live Too Short and Die Too Long ," published in 1996.
This mid-April week that I ran the most recent Boston Marathon my latest book, "The Roadmap to 100," hit the bookstores — based on 30 years of research that shows that one's lifestyle has major effects on healthy aging and longevity. "Lifestyle" includes physical exertion, social connections, even sex, and a personal and professional engagement in life.
Both research and experience shows that we humans are not just end products of our genetics!
So April was a big month for me.
Back to the marathons: In my first run, in 1971, I was beaten by only 800 other runners, and I was only among the last runners.
That run was done because my physician father, Edward, who was my alpha/ omega figure for 39 years, died abruptly that year.
I was devastated. But I was smart enough to know that running is a fabulous treatment for depression.
I'm a terrible runner. The iconic image of the runner is the fleet-of-foot whippet with wings on his shoes.
My image is a slogger wearing Army boots.
Yet being a Walter Mitty-type athlete, my father's death quickly spurred entry into the only world-class athletic event to which an ordinary Joe could aspire.
Then the Boston Marathon organizers changed the rules and created qualifying times, which effectively excluded me. That would have ended my Boston Marathon streak, if one dared call it that, except that a group of physicians under Ron Lawrence's leadership found an exemption for doctors — because of the support services we physicians provided for the qualified runners.
Shamelessly, I accepted my entry number, color-coded to identify my outlier category, and I finished.
At the end of the first run I swore I would never again submit to the tortures of this 26-mile test. After all, the first marathoner, the Athenian runner Phidippidies, died from exhaustion in 490 B.C. after the run — most people don't know he had just run 140 miles and back to seek Sparta's aid against a Persian attack.
But, as with childbirth, as soon as my first marathon was done I searched for next year's opportunity. And my search has led to runs in Athens (site of the original marathon), Dublin, New York, Australia, Beijing, Boston again (maybe 10 times) and Big Sur — my favorite. Despite its hills, its scenery is spectacular.
So this marathon story is my highly personal odyssey of a life journey. It has virtually become my religion. Exploring it has many important derivative aspects. I've learned the thermodynamics of exercise, the anthropology of running — and mostly about its health benefits.
As a geriatrician the insights provided by these decades of commitment have defined a new way of looking at growing older.
Aging's principal pathology is frailty, which is not a defined disease but is of immense importance to one's quality of life.
Its cause is principally lack of exercise. Physical activity of any type, from walking to marathon running or swimming, is both the preventive and treatment of frailty.
It is cheap, safe and effective. What other remedy can make these claims?
I'm already planning marathon 2011.
Dare to be 100.