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In a recent study, participants who spent time in a wooded, natural setting felt more restored and had better moods, more creativity and vitality, and lower levels of stress compared with those who spent time in an urban (city) setting. The findings were published in the June 2014 issue of Environmental Psychology

Well, duh! We can thank statistics for stating the obvious. It isn't called the great outdoors for nothing. And yet most people spend most or all their time inside. Be it inside cars, houses, classrooms, offices, factories, retail outlets, major institutions or the like. The average person goes from home to car to office and back every day without variation. And that's not all. The minority who manage to fit a workout into their otherwise sedentary, claustrophobic existence do so at the local gym, which gets about as much fresh air as an airplane. Indeed the thin carpets and cheap upholstery remind me of LAX, not to mention the overpriced high-caloric pseudo-edible items they try to pass off as nutrition. One foot inside 24 Hour Fitness or Balleys (a decade ago I was for a brief time a member of the latter) which by now have probably been consolidated and are owned by Pepsi, and I'm instantly more tired than if I had just run a marathon in the mud uphill both ways. Running on a treadmill watching Ricki Lake (which is what I used to do) when you could be dodging traffic in 60 degree weather, feeling the breeze, with the wind beneath your feet, come on! 

And don't let inclement weather deter you. In Denver doing residency, I'd routinely head out in frigid temperatures (sometimes sub-zero Farenheit with the wind chill) for a six-miler before work, wearing shorts. Quite invigorating, skipping through the snow without socks. A recipe for frost bite, you say. I still have my toes. And each day I arrived at work having traveled farther on foot than my colleagues would in 12 hours of traipsing up and down flights of stairs seeing patients, that is if they didn't take the elevator. And I was just getting started. On days I couldn't work out outside I'd run up and down those flights of stairs, but only during down time, and there wasn't much at "the U." My greatest feat was running from the basement to the 12th and highest floor. If you've ever spent time in a stairwell, you know that they are dark, stuffy, oxygen deprived. Not exactly optimal conditions in which to exert oneself. But free, and better than your local gym, at least if you're looking for novelty. And the air in the mile-high city was already rarefied. By the time I had marched to the penthouse floor I had developed a wheeze. All in the name of breaking a sweat. Hard to come by in the hospital, which is always kept at a comfortable 68 degrees. Ideal? Then you're not me.

In fact, the air-conditioned hospital, cut off from the outside as it is, was one of the many things that drew me away from medicine. There are no windows in hospitals. This is in order to keep bacteria from entering from the outside. But an alternate view held by one microbiologist is that unwanted pathogens might gain a foothold in hospitals because in these sterile environments where doctors are always scrubbing their hands, they have too little competition from other organisms. So letting in a variety of little critters and establishing a diverse population to mirror, say, the intestines (where antibiotic use can cause imbalances in gut flora that actually make a person sick) can prevent the bacterial overgrowth that causes infection, and so windows would be a good thing. Which was the view of famous nurse Florence Nightingale, who advocated fresh air from open windows to prevent infections. And sunlight itself is one of nature's most potent antimicrobials. Who knows, if they'd have let me treat patients in the open air while working on my tan I might still be prescribing Prozac. Maybe not. Because sunlight is also a natural anti-depressant, as the study mentioned above shows. 

But the establishment is slow to change, and until those in charge recognize the obvious, I advise you to as they say do it yourself. Take matters into your own hands and step outside. It doesn't have to be for a long weekend in the mountains of Yosemite, or a week-long vacay to the sunny sands of Hawaii, though these are fun. But returning to a secluded life spent inside four walls reverses the effect of all that being free. Outside time needs to be built into the fabric of everyday life. Easiest is to exercise outdoors, which assures that you are in the sun, or the wind or the rain, or if you're like me and have a taste for it, the snow, almost every day. That is, if you wish to comply with the exercise guidelines. 

Spending an hour or so moving around in fresh air is a good start. Where you take it from there is up to you. It will require invention and creativity, if the two are any different. But if you take the unbeaten path, you will find the journey is well worth it, and the destination is freedom.


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