Dungeons and doctors

Inside a dingy garage in a neighborhood still sleeping, Greg Mishkel, MD, lies on a bench and puffs short breaths with each push of weights from his chest toward the ceiling.

His sleeveless burgundy shirt reveals straining muscles as he pumps the barbell up and down over his slender frame. His focused stare shows the determination that keeps the cardiologist coming to this makeshift gym before most people get their newspaper.

Three days a week, before work, Dr. Mishkel and three colleagues from St. John's Hospital come to lift weights at the Dungeon Training Center, a garage-turned-gym in Springfield, Ill. With its concrete floor, exposed wiring and insulation and duct-taped window, it seems an unlikely place for doctors to exercise.

But they love the camaraderie here, the workout routines and the physical and mental boost that pumping iron provides. Proudly, they are slaves to the dungeon.

"It's freezing in the winter and it's boiling in the summer. There are times when it's cold and I wish at 5:30 in the morning we had some heat," said Dr. Mishkel, 45. "It's not a gym that one would normally associate a bunch of physicians to be at."

From about 5 a.m. to 6:30 a.m. Monday, Wednesday and Friday, the Dungeon is where you will find Dr. Mishkel, Stephen Jennison, MD, Richard Ammar Jr., MD, and Kriegh Moulton, MD. All four work for Prairie Heart Institute at St. John's in Springfield. They range in age from 37 to 50.

The workouts offer them a way to practice what they preach. Advice about staying fit means more coming from a healthy doctor than one who's noticeably out of shape.

"It's very hard to preach to patients if you're overweight. In many ways, you can motivate patients if they see you're in reasonable shape," said Dr. Mishkel, who stands 5 feet 9 inches and weighs 170 pounds.

Dr. Ammar agrees. "Coming from a slightly pudgy cardiologist, patients are like, `Yeah, right buddy. What about you?'"

Dr. Ammar started coming to the Dungeon more than five months ago after being nudged by Dr. Jennison. He hadn't been at a gym regularly for a few years, but is now seeing his 6 foot-5-inch frame slowly sneak back into shape.

"I was totally off the wagon," he said. "I have a little more energy. I'm in a little better shape, but I've got a long way to go."

In general, today's doctors are more fitness-minded than physicians of the past.

"There's definitely a difference with my generation. For my dad, who was a doctor, there was no such thing as exercise on a routine basis," said Dr. Moulton, medical director of the electrophysiology department.

The Dungeon was created 12 years ago when owner Ken Wyatt built an addition to his two-car garage. Today, 150 gym members enter through a side door of the one-story building, which has an odd exterior of brown siding and exposed graying wood.

Inside, weights and machines are spread throughout a room with mirrored walls. Patches of carpet cover portions of the gray floor. A small space heater near the owner's desk provides the only warmth.

Each of the doctors comes in on his own. Though the four don't spot one another on weights, they pass each other as they go through their presses, curls and squats. That's ample time to share small talk and take the occasional verbal jab.

"Dr. Mishkel carries a bottle of flavored water. There's no way I'm going to be seen next to him," joked Dr. Jennison, 46, medical director of Prairie's congestive heart failure program.

The four say they don't compare notes on the others' progress. But the gym's owner senses their competitiveness. "Even though they're not competing with one another per se, there is some competition of who's going to look better or lift more. It's almost like a silent challenge," Wyatt said.

Dr. Jennison was the first to join the Dungeon, in August 2001. He talked Dr. Mishkel into coming, then Drs. Moulton and Ammar followed.

"This is nicer than the place I used to work out - my basement," said Dr. Ammar, 37.

Dr. Jennison likes the idea of com­bining strength training with jogging 3.8 miles from his home to the gym. He also likes the place for its down-to-earth charm.

"It's not like the other clubs in Springfield where it's chichi, everybody there has little designer clothes and it's very much a case of having the right leotard on," Dr. Jennison said. "Pretty girls wandering around the place doesn't sustain you if you want to keep exercising."

For a $30-a-month membership, gym members get written workouts each visit from Wyatt, a former competitive power lifter who determines what muscle groups to exercise.

Getting started wasn't easy. When Dr. Jennison invited Dr. Mishkel to the Dungeon about a year ago, Dr. Mishkel almost turned around when he saw the gym.

"I had to think twice about going in," recalled Dr. Mishkel, co-director of the cardiac catheterization lab.

After his first workout, Dr. Mishkel's muscles ached at the slightest move. "I couldn't raise my arm over my head to comb my hair. It was like lockjaw."

But with pain has come gain.

Drs. Moulton and Mishkel said the training has helped relieve back problems. And people around them have also noticed changes. One hospital technician was stunned when she saw Dr. Mishkel's physique as he put on gloves before a procedure.

Dr. Mishkel smiles when he relates the story. "She panicked and said, 'Oh my God! Your arms are swollen.'"

No wonder these doctors don't mind how the Dungeon looks - it makes them look and feel better.