By Tom Rath


Choices count. You can make decisions today that will give you more energy tomorrow. The right choices over time greatly improve your odds of a long and healthy life.

A hundred years ago, many people died from infectious diseases because they had no cure. But today, a majority of people die from preventable conditions. The next time you are with two friends, consider that two of the three of you are likely to die from heart disease or cancer.

The problem is, you do not see the threats that your small daily decisions pose in the moment. You have little urgency to change your diet until all those years of fried food, sugar, and processed meat cause a heart attack at age 60. At that point, reversing disease is possible but more difficult.

No matter how healthy you are today, you can take specific actions to have more energy and live longer. Regardless of your age, you can make better choices in the moment. Small decisions—about how you eat, move, and sleep each day—count more than you think. As I have learned from personal experience, these choices shape your life.

At age 16, I was playing basketball with friends when I noticed something wrong with my vision. There was a black circle in the middle of my visual field. I assumed it would go away. Instead, it got progressively worse. I finally told my mom, who immediately took me to an eye doctor.

That black spot turned out to be a large tumor on the back of my left eye. The doctor said it might lead to blindness. As if that was not enough, I needed to get a blood test to rule out other medical problems. A few weeks later, my mom and I went back to the doctor’s office for the results.

The doctor told us I had a rare genetic disorder called Von Hippel-Lindau (VHL). While VHL typically runs in families, my condition was a new mutation that affects just one in every 4,400,000 people. This mutation essentially shuts off a powerful tumor suppressor gene and leads to rampant cancerous growth throughout the body.

I still vividly recall sitting on one side of a large wooden desk as my doctor tried to explain what it would be like to battle cancer for the rest of my life. It was one of those moments when your stomach sinks and your mind races for an alternate explanation. My doctor then described how I was also likely to develop cancer in my kidneys, adrenal glands, pancreas, brain, and spine.

While the thought of losing my eyesight was tough, these longer-term issues were even more daunting. That conversation with the doctor forced me to wrestle with much larger questions about my life. Would people treat me differently if they knew about my illness? Was there any chance I would get married and have kids? Perhaps most importantly, I wondered if there was any way I could live a long and healthy life.

Doctors tried everything to save my eyesight, from freezing the tumors to cooking them with a laser. But the sight in my eye never returned. Once I got over this loss, I turned my attention to learning everything I could about the other manifestations of this rare disease.

I quickly realized that the more I learned, the more I could do to increase my odds of living longer. As new information emerged, I discovered I could stay ahead of my condition with annual MRIs, CTs, and eye exams. If doctors caught tumors early when they were small, the tumors were less likely to spread and kill me. Learning that was a huge relief. Even if it required some difficult surgeries, there was something I could do to live longer.

I have had annual exams and scans for 20 years now and currently have small tumors in my kidneys, adrenal glands, pancreas, spine, and brain. Every year, I “watch and wait” to find out if any of these tumors are large enough to require surgery. In most cases, they are not.

Waiting around for active tumors to grow may sound nerve-wracking. It could be, if I dwelled on the genetic condition that is beyond my control. Instead, I use these annual exams to stay focused on what I can do to decrease the odds of my cancers growing and spreading.

As each year goes by, I learn more about how I can eat, move, and sleep to improve my chances of living a long and healthy life. Then I apply what I learn to make better choices. I act as if my life depends on each decision. Because it does.

In my upcoming posts, I will share what I have learned over the years about health and well-being. My research and experiences have led me to believe that small choices matter most. It is these daily decisions that shape our days, health, and lives.


Adapted from the book Eat Move Sleep: How Small Choices Lead to Big Changes by Tom Rath (Missionday, 2013)


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