I play tennis at 6am before a theatre list. This is not a fitness habit. It is medicine.
show up first, improve later
Movement · #5phabit
“Show up first. Improve later.”
Wednesday, 6 am — court note
I am not a personal trainer. I am a surgeon. And I am telling you that the most powerful prescription I have ever encountered does not come from a pharmacy. It comes from movement — consistent, imperfect, early-morning movement.
Before a full operating list, I play tennis. Not because I am disciplined. Because I have watched what happens to people — including colleagues — when they stop moving. The body slows. The mind follows. And by the time the warning signs appear, the cost is high.
What the evidence actually says
A 2024 meta-analysis in the BMJ — reviewing over 1,000 clinical trials and 128,000 participants — found that exercise can be as effective as antidepressants or therapy for depression and anxiety. This is not wellness culture talking. This is the same standard of evidence we use to decide whether a drug enters clinical practice.
A JAMA Psychiatry meta-analysis in 2023 found that 75 minutes of moderate activity per week — a brisk walk every other day — significantly reduced depression risk. And a 2018 study in the American Journal of Psychiatry found that people who exercised regularly were 44% less likely to develop depression, regardless of age, background, or genetics.
Movement raises serotonin and dopamine. It lowers cortisol. It promotes neurogenesis — the growth of new brain cells. These are not metaphors. These are measurable physiological events.
A note to those who care for others
As a trustee of Doctors in Distress, I see what happens when the people who deliver healthcare forget to apply its most basic principles to themselves. We are taught to treat. We are not always taught to rest, move, or ask for help.
Movement is not a luxury for healthcare workers. It is a clinical necessity. If you are reading this after a night shift, or between back-to-back clinics, this is your reminder. You do not need a plan. You do not need a programme. You need to start.
Start where you are
It does not need to be tennis. It does not need to be early. A walk around the block. A stretch at sunrise. Ten minutes that belong entirely to you.
The best movement is not the most intense. It is the one you will repeat tomorrow. Simple. Joyful. Yours.
References
Noetel M et al. BMJ, 2024; 384:e075847 · Pearce M et al. JAMA Psychiatry, 2023; 80(4):365–374 · Harvey SB et al. AJP, 2018; 175(1):28–36 · Cooney GM et al. Cochrane Review, 2020 · Stubbs B et al. Frontiers in Psychiatry, 2021