I got passed by an ambulance while riding my electric bike to Edward Hospital yesterday. I knew they were headed there, too, and I knew the person inside was probably about to meet my sister, whose 5am shift as ER physician was not quite up.

It was one of those moments we all get daily: a chance to be grateful for the health we have, to reflect that “time and chance happeneth” to us all but today, anyway, we get to be the one cycling on a sunny afternoon (with an electric motor doing the work) instead of the one in the ambulance.

I was going for my first ever routine physical, to get a final go-ahead to climb Mt. Kilimanjaro in six weeks. As the son of a doctor, I got free healthcare at home and as an adult, I never saw the need. Fortunately I was healthy until depression and a series of stupid excuses led me to make destroying my health a habit. It took just a few years to find myself in that same ER, too weak to climb a flight of stairs, never mind a mountain in Africa. It was a lesson for me in the power of habits to destroy and to save, to break us and, if we’re grateful and patient, to remake us.

One of the most common reasons Americans find themselves in ambulances is chest pain and other symptoms of a heart attack. Heart attacks usually result in part from years of habits. Undoing heart disease means adopting new habits, but by some miracle, undoing the damage often takes less time. That’s because we’re helping, rather than opposing the body’s will to heal.

Other reasons people end up in ambulances come from poverty: tooth abscesses in people who can’t afford a dentist, minor infections that got worse because the person couldn’t take off work to see a doctor or doesn’t have health insurance, or both. Obamacare has reduced the number of people with the last problem by over 10 million.

The other problem is harder to change. The fact that most of us, not just Walmart workers, can’t take family and sick leave freely, is the result of a bad habit we’ve adopted as a society: a screwed-up version of capitalism that forces companies to value short-term shareholder profits and productivity above the long-term health of the company and its employees. The places where we work are rarely designed to make us healthy, even those like mine which give you a free gym membership.

Yet somehow, we vote for people who tell us it’s right and patriotic to overwork so shareholders can profit; and only lazy people—millenials, liberals, mothers—want to undermine productivity. We vote to have our tax dollars selectively benefit those already wealthier than us. We make a lifestyle of waiting in drive-thrus for coffee we’ll barely taste as we commute, of sending our kids to school in the dark instead of letting them learn to love mornings, and of being, despite all the tweets and texts and status updates buzzing in our pockets and purses, more lonely than we need to be.

Loneliness is a major cause of heart disease. You can be lonely in the middle of a meeting or a crowded supermarket. A traffic jam is a lonely, crowded place. Too often, so are school and work. It’s a habit we can undo if we decide to.

Another common reason people find themselves in ambulances, a peculiarly American reason, is that they got shot. They usually got shot by another American, with a handgun, not an assault rifle, that the shooter bought secondhand and off record. We have ten 9/11s a year in America from firearms and don’t even notice.

When Omar Mateen, who was born a few miles from the birthplace of Donald Trump, a fellow child of immigrants, shot 49 people in Orlando, a startling story emerged: of Mateen acting out his self-hatred for being gay on those who were openly gay, of him using a perverted idea of religion to mask his doubt and fear, of his history of violence towards women. Omar Mateen didn’t just snap and become “radicalized.” In his long loneliness, he slow-brewed terrible habits of thought that led to harmful actions. That’s not hard to understand, sadly. It was a tragedy of personal habits amplified and armed by habits of culture.

Our American cultural habit, recently confirmed by the US Senate, is to value gun ownership so much we won’t stop suspected terrorists like Mateen from buying them. It’s not a hard habit to break if we choose. 90% of Americans want stronger gun laws like No Fly, No Buy. If our elected representatives don’t make such laws, then they are failing to represent us. The solution is simple: elect people who will represent us and not the NRA. Drop the others like a bad habit.

My new doctor says I’m in shape to climb Mt. Kilimanjaro. The biggest surprise came when the nurse said my pulse was only 64 bpm. I asked her to check again, then checked it myself. It’s never been under 70. It usually fluttered around 80.

Recently, Charles Duhigg’s brilliant book The Power of Habit: Why We Do What We Do in Life and Business reminded me that if you want a goal, focus on the habits that will get you to it. So in February I got the brilliant Couch to 5K app for my phone. I went ridiculously slow and I let go of my old habit of worrying about how I was doing. Soon 90-second jogs became 30-minute runs. Lately I’ve been climbing 25 flights of stairs in my office building every day after work. It’s what happens any time you focus on the process: the outcome takes care of itself. Why do I keep forgetting that?

Maybe if we can re-engineer our habits, spend less time trying for more productivity, and more time being less lonely and unfulfilled, the outcome will take care of itself. Fewer people in ambulances they long feared would be part of their future, and more people getting to bike to the doctor to hear, forgive the pun, heartening news.

Photo: “ Oxford Bicycles” by Craig Stanfill on flickr (CC 2.0)