Cut From Steel

His son put the brush into a hand that could not open

Pierre-Auguste Renoir lived with severe rheumatoid arthritis for roughly the last three decades of his life.

A film of him painting survives from 1915, when he was 74. His hands in it are terribly deformed. The disease had stiffened the joints, turned his thumbs inward toward his palms, and bent his fingers back toward his wrists.

You may have heard that Renoir had brushes strapped to his wrists. The truth is plainer and rather harder to look at. His youngest son Claude, then 14 years old, stood beside him and placed the brush into his father's permanently clenched hand.

Assistants scrolled his large canvases across a specially built easel, so that the work travelled to him instead of him travelling along it. Renoir went on painting in that arrangement for years.

Renoir was not producing minor work in those years either. Some of the large bathers that hang in national collections today came off that easel, painted by a man who could not close his own hand around a brush.

He died on 3 December 1919, four years after the camera recorded him at it.

Renoir did not beat the disease and nobody should pretend otherwise. He rearranged everything around it until the work could still happen. That is the realistic ambition for most men, and it is a far bigger one than it sounds.

Time how long the stiffness lasts tomorrow morning

You get out of bed badly. Twenty minutes later you are moving normally and have stopped thinking about it, because this has been the arrangement for four years now.

I want you to put a number on it. How long the stiffness lasts in the morning is one of the practical ways clinicians separate two very different problems that both get called arthritis in ordinary conversation.

You have never actually timed it, and starting costs you nothing at all.

It's not age. It's these three.

I will give you three things about morning stiffness, and one thing to do with a clock tomorrow.

01 / The Half-Hour Line

Stiffness from ordinary wear-related arthritis tends to be brief and to ease within about half an hour of moving about. Mayo Clinic describes the stiffness of rheumatoid arthritis rather differently... worse in the mornings and after periods of rest, and lasting 45 minutes or longer. That gap is not a technicality. It points at two conditions with entirely different treatments.

02 / The Pattern Matters As Much

Mayo notes that rheumatoid arthritis usually starts in the small joints of the hands and feet before moving on to wrists, elbows, hips, knees and ankles, and that most of the time it affects the same joints on both sides of the body. Wear-related arthritis is far more likely to pick on one knee, or one hip, or the joint you damaged playing football at 27.

03 / Why The Distinction Is Urgent

Mayo advises seeing a doctor about ongoing pain and swelling in the joints that is not improving after several weeks. Inflammatory arthritis is treated with medication aimed at the disease process itself, and those treatments generally work better the earlier they are started. Waiting a year before mentioning it is the expensive option.

Take it back today

I owe you some proportion here. Most men over 50 with stiff mornings have the ordinary wear-related kind, and the answer to that is movement rather than a prescription. Joints are fed by being used, and men who stop moving because it hurts almost always hurt more six months later.

You should still take the timing seriously, because from the outside on any given Tuesday the two problems look identical. A fortnight of numbers written on paper is the most useful thing a man can hand a doctor.

I want you to check the clock tomorrow when you stand up, and check it again when you notice the stiffness has gone. Write both times down. Do that every morning for two weeks, and add a note of which joints were involved and whether it was both sides.

You have been filing a symptom under age for four years without once measuring it. Time it tomorrow morning and you will know which conversation to book. Two weeks of numbers, then a doctor.

— Travis

Insider Member's Corner

6 free habits for stiff mornings:

Stiff or not, a man needs something worth getting up for.

01 / Heat · A barrel sauna in the garden

A wood-fired barrel takes up less space than a shed and turns a cold Wednesday into something you look forward to. The Nordic countries have built their entire idea of recovery around sitting in one, and the ritual matters at least as much as the temperature. Buy the wood-fired version if you have any choice, because feeding a stove is half the point. You will use it more than the gym.

02 / Watch · Christopher Ward C65

A British brand selling directly rather than through a boutique, which is why a Swiss movement in a properly finished case costs what it does. The C65 is a restrained dive-style watch that looks considerably more expensive than it is. It is the watch to buy when you want something mechanical on your wrist and would rather not explain the price to anyone. Nobody at the table will know what it is.

03 / Book · The Count of Monte Cristo

Twelve hundred pages of a man imprisoned unjustly, escaping, becoming enormously rich and then taking his time about revenge. Dumas published it in 1844 and nothing since has improved on the formula. Get an unabridged translation and give it a winter. It is the most purely enjoyable long novel in European literature.