Two Things I Learned from My Patient Liz

Liz, a woman in her mid-eight­ies, had two main prob­lems.

Her first prob­lem was low back pain and weak­ness in her legs – sure signs of spinal steno­sis. In order to under­stand her diag­no­sis bet­ter, I timed her walk­ing down the hall­way in my office. It’s a pret­ty long hall­way, but still, it took her near­ly 40 sec­onds – way too long, if you ask me, even for a woman in her eight­ies.

older woman walking

walk vig­or­ous­ly at any age

What made her prob­lem even more of a chal­lenge was that six months pre­vi­ous­ly she had had surgery that was sup­posed to help her steno­sis.

Unfor­tu­nate­ly, the surgery was large­ly inef­fec­tive. And the hours dur­ing which her brain was anes­thetized left her with a sec­ond prob­lem: severe dete­ri­o­ra­tion of her mem­o­ry.

So the first les­son I learned from my encounter with her is – surgery is nev­er benign. I grant that some­times it’s nec­es­sary, but if anes­the­sia is part of the sur­gi­cal plan, even the most per­fect surgery car­ries with it a sig­nif­i­cant risk of loss of brain func­tion.

(My col­league the anes­the­si­ol­o­gist says that the only patients at cog­ni­tive risk from anes­the­sia are those who already have signs of mem­o­ry loss. I sup­pose the research sta­tis­tics bear him out, but — call me a skep­tic — to me that only means that even in a healthy per­son anes­the­sia tax­es the brain, but most of us have enough reserve brain pow­er to cope with the dam­age.)

Her mem­o­ry loss cre­at­ed a chal­lenge – mak­ing sure she con­sis­tent­ly per­formed the ther­a­peu­tic exer­cis­es need­ed to improve core strength and increase her walk­ing speed. In fact, each time I saw Liz she told me that she had for­got­ten to prac­tice her exer­cis­es.

But I was about to learn my sec­ond les­son.

Behind the scenes, her hus­band was coach­ing her to do her exer­cis­es every day, even though she didn’t remem­ber doing them.

And sure enough, week by week I could see the clear improve­ment. With­out real­iz­ing that she was under­go­ing a change, she soon was able to engage her abdom­i­nals cor­rect­ly, stand with­out sag­ging her pelvis for­ward, bal­ance on one foot for a lit­tle longer, and walk down my hall in under 30 sec­onds.

Through this expe­ri­ence I learned yet again how inte­gral move­ment is to the brain.

The brain has been designed by evo­lu­tion to enhance the per­for­mance of our body, not to “think.” What we think of as “mem­o­ry” and “cog­ni­tion” are only tiny tea­spoon­fuls arti­fi­cial­ly ladled from the thick soup of cal­cu­la­tions the brain makes every sec­ond.


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website,, provides more information about his approach.

Please contact him at or at 212-400-9663.

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