I went to look a some commercial property in downtown Mobile yesterday and was reminded of the Roger Miller song, “King of the Road.” The building, clearly built in the 1920s had gone through a tragedy of some sort. The second story was apparently removed and added onto the structure in the 1940s were about 20 8×8 rooms, each with a sink. There was a door labelled “Office.” There was a common bath for all of the rooms. The word was that it was a “hotel” although I suspect that was being euphemistic. The whole area had been sealed in the 1960s (judging from the papers on the floor) and had not been maintained since. The roof had many leaks, the boards were suffering from dry rot, and even the rats seem to have abandoned the space for fear of disease.

We were looking for potential investment property and this would certainly allow us to invest quite a bit of money (sort of like a sailboat). The truth is that with enough money, the building could be made into a showplace. An article in the New England Journal reminds us that the body does not work that way. In this article people’s blood pressure, cholesterol level, smoking status, and diabetes status looked at in various ways. The investigators found that of the people who were 55 and had everything well controlled, 85% were very likely to live beyond 80 years of age regardless of race or sex. Of people who had two or more of their risk factors uncontrolled or who smoked, 50% were likely to be dead of heart disease or a stroke before age 80.

To fix this building, we would likely have to tear out the entire interior and retrofit it with a modern building. We would end up with a 1920s facade in a 1920s neighborhood but would functionally have a 2010s building. Many of my patients would like to believe that if they let their insides go, I can retrofit them as well. A better approach for the building would have been ongoing maintenance over the past 90 years. It turns out that it is the only approach for the human body.

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