Through diet, exercise, cosmetic surgery, or all combined, we ardently seek it. The means may differ but the end is always the same: how to stay young, how to avoid growing old. Everyone has felt the lure of remaining young. I know I have.

Impossible of achievement, the quest is inevitably frustrated; for youth, though it can sometimes be prolonged a bit, cannot really be maintained much beyond its normal span. Trying to do so is a game that can’t be won. Not that this stops vast numbers of people from playing, as witness the crowds at gyms and jogging tracks. “Fitness is about sex and immortality,” Wilfred Sheed has written. “By toning up the system, you can prolong youth, just about finesse middle age, and then, when the time comes, go straight into senility.” Or, I suppose, be in near perfect shape just in time for death.

— Joseph Epstein, “Grow Up, Why Dontcha?,” Narcissus Leaves the Pool

You hear this sort of wisecracking a lot about what a waste of time it is to stay in shape since we’re all going to die eventually. Of course, if you want to pursue this line of thought more rigorously, you could further argue that thinking of time as a limited commodity that can either be invested wisely or frittered away foolishly is an illusion, since nothing ultimately matters at all, and we might as well all just live short lives of debauched hedonism. But reductiones ad absurdum aside, a physical fitness routine doesn’t have to represent vanity, fear, or immaturity; it can just as easily embody discipline, gratitude and humility.

Right around my twenty-eighth birthday, I went to my doctor for a pain in my right wrist that had been nagging me for a few weeks. The first thing he did was a blood test. “Well, you don’t have arthritis,” he said. I was surprised that had even been a consideration. Of course not, I vaguely thought to myself. Arthritis is for old people. Since the possibility had already been dismissed, I likewise banished the thought from my mind.

Three and a half years later, I was finally diagnosed with rheumatoid arthritis, after having had three wrist and hand surgeries which, of course, were about as effective at slowing down an autoimmune disease as the Maginot Line had been against the Wehrmacht. By chance one day, I showed my orthopedic surgeon some tiny bumps near my elbow which he informed me were rheumatoid nodules. He then sent me to get an MRI, which prompted the diagnosis and a referral to a rheumatologist, where I learned that I am apparently in the lucky 20% of people who don’t show a positive rheumatoid factor on a blood test, which is why this wasn’t caught at the beginning. You keep hearing horror stories about scalpel-happy surgeons and overzealous doctors, but in my experience, all my doctors’ mistakes were ones of caution, of proceeding a little too much by-the-book, as it turned out.

I was in rough shape, as you can imagine. Every joint in my body was inflamed and aching. It hurt my back and knees to stand for more than ten minutes. It hurt my hips to sit for ten minutes. I couldn’t sleep too deeply because lying on one side or the other hurt my shoulders, hips, and back too much, so nights were filled with painful tossing and turning. My hands were slowly transforming into bird claws, and my shoulders and elbows were becoming increasingly immobile. I basically had to stay in slow, gentle motion as much as possible to avoid the inevitable stiffening up, like slowly shuffling away from a predator who has all the time in the world to enjoy this sadistic game.

After six months, the medication finally started to do its magic, and shortly thereafter, I embarked upon the first serious exercise routine of my adult life, the first one since being banished from the Garden of effortless fitness that I had always enjoyed as a youth and adolescent soccer player. Let me assure you, you don’t really appreciate what it is to be able to walk. You got over that thrill when you were still a toddler. But I, I can say that to this day, I still consciously reflect on how wonderful it is after 45 minutes on the treadmill, to feel so alive and full of endorphins, to be able to swing my legs without reflexively wincing. Two months ago, I pulled a muscle in my lower back/tailbone area which forced me to have to take a break from walking, and it was a serious blow to my equanimity, rather than a sweet reprieve from labor. I don’t exercise to “stay young” — I long ago forgot what it even feels like to be “young.” Even now, I probably ignore and accept more aches and pains than I should, partially because I’m not sure what “normal” aches and pains would be at my age, but partially because, hey, it’s not nearly as bad as it once was! Who am I to complain? No, exercise is a practice of gratitude, my ritual of thankfulness for not being crippled, for still being capable of doing activities that most people long ago gave up on out of cynicism. In a time before modern medicine, I would have been an invalid, a burden on others, assuming I didn’t commit suicide out of pain and despair. I try regularly to be appreciative of that fact and show it through effort.

As I age, I’m aware, almost to a morbid degree, of the possibility of injury, disease and premature death. Every day spent in good health and cheer is to me a hard-won prize from an indifferent world. Hiking, walking on a treadmill, doing yoga, doing the “ups” (pushups, pullups, situps), eating right — these all fit comfortably into my tragic, Sisyphean view of life. They reflect my conviction that nothing is guaranteed, good things in life require constant maintenance to avoid corruption and decay, and anything worth having requires disciplined effort. They have nothing to do with a shallow vanity or refusal to grow up and accept my fate. The only pride involved is the pride justly taken in the results of long, hard work. For better or for worse, humanity will never stop trying to understand and control as much as possible. Wisdom does indeed consist in knowing and accepting the difference between the things you can change and the things you can’t, but when you know what to do to live a longer, healthier life, for example, and don’t, is that wisdom, or something more like laziness and cowardice? Why would resigning yourself to a pot belly, a bum knee, and high blood pressure represent a mature acceptance of life? If the thrill is indeed in the chase, I’m sure the Grim Reaper will appreciate you making him work for it.