"I go into a trance," he says. "It helps me get more perspective on my patients' problems."
After his exercise break, Cohen, 64, returns to the office and continues seeing patients through the evening. He has been following this practice for 27 years, seven days a week. He rarely skips a day.
In 1992, when he was 45, he did miss a month of tennis - the consequence of having slogged through a marathon, on Penn's track, 26.2 miles, 105 laps.
"I did it for the sheer joy of the challenge," he says.
He is 5-foot-7, 135 pounds, exactly what he weighed when he was soundly vanquishing Ivy League opponents as captain of Penn's tennis team. He enrolled there after compiling an equally dazzling record at the Haverford School and as a phenomenal junior player. In eighth grade, he was rated the top high school player in the state and from then on rarely lost a tournament.
He was known for his speed, strategy, stamina, intensity, and, above all, hustle. In one match, he scooted through a gate to retrieve a shot that had bounced over the fence. He lobbed the ball back and later won the point.
Still fiercely competitive, he is ranked No. 1 among players 30 and above, and 50 and above, by the Middle States Tennis Association.
A scientist of the sport, he is meticulous about stroke mechanics, which explains his mastery of them. His rallies are of legendary duration. During his afternoon workouts, it's not unusual for Cohen and his partner to put a ball in play and still be swatting it back and forth 45 minutes later. In 1980, during a championship match at the Cynwyd Club, he and his opponent engaged in a record-setting point that lasted one hour, 29 minutes, and 55 seconds, he said.
"One reason I can deal with stress is that my cardiovascular system can handle it," he says. "It's better to have a good lipid panel than a million dollars."
His resting heart rate: 41.
His office across from the Art Museum is replete with photos and trophies attesting that the family racket is tennis. Cohen is not only a prodigious player himself, but also coach and sire of tennis prodigies. His wife, Nancy, and two children are all highly regarded and ranked.
After dominating in junior play, Josh, 26, and Julia, 21, were both all-Americans at tennis powerhouse University of Miami. Julia is now touring the world as a fast-rising pro, and Josh helps coach the Philadelphia Freedoms and the tennis team at Penn. Rich Cohen's proudest moment: winning both the national father-son and father-daughter titles in 2007.
For Cohen, tennis is pastime and therapeutic tool, an example of "prophylactic medicine" - something that protects health by preventing disease. Cohen is convinced that engaging in regular physical activity and enjoying a passion ("something you love to do every day") are essential to sanity. When he interviews new patients he takes an "exercise history," and he prescribes exercise to treat minor depression and wean patients off antidepressants.
"Medication is helpful, but it can be overused," Cohen says. With exercise, there are no risks or harmful side effects beyond injuries. It boosts mood-altering brain chemicals, improves self-esteem, fortifies the immune system, and relieves stress and anxiety, he says.
In his office, Cohen has a treadmill and stationary bicycle. For several years, he shared space with a chiropractor who taught patients how to exercise.
"I love chiropractors," Cohen exclaims. "I know that's heresy for an M.D., but they know about the body's kinetic chain and the importance of stretching."
Cohen refers patients to chiropractors, undergoes a chiropractic tune-up himself every two weeks, and is, by his own admission, obsessive-compulsive about his 20-minute morning stretching routine - key to his ability to continue scampering around the court, he believes.
In case it's not clear by now, Cohen is a character. At a recent tennis banquet, where the Cohens once again harvested a bushel of hardware, Cohen was moved to share a song he wrote. The refrain:
Tennis, making spirits sublime
A game for all seasons
A sport for a lifetime
Contact columnist Art Carey at 215-854-5606 or firstname.lastname@example.org.
For more information, visit www.rwcohenmd.com.