The pieces of equipment look familiar: all those usual-suspect stationary bikes, treadmills, cable machines and exercise balls. The difference is who's making use of them.
"We're kind of the health club for the unhealthy," Kerry Stewart says with a smile.
As director of the Johns Hopkins Clinical Exercise Center, Stewart splits time between workout facilities at Bayview Hospital and Greenspring Station. His client list is small (a constantly rotating cast of about 150) and, medically speaking, exclusive: It's geared toward cardiac rehab patients, diabetics and people struggling with obesity, hypertension and other at-risk conditions.
Not your normal buff-me-up gym crowd.
"What we offer is expertise and a safe, supportive environment," explains Stewart, noting that the center's "value-added services" include constant blood-pressure and blood-sugar testing as well as heart monitoring.
At a traditional health club, Jennifer Lopez and other MTV divas cavort on overhead TVs. At Hopkins, you watch your electronic pulse dance across the screen.
Sessions cost $20 and are by appointment only. There are no weekend hours, no locker room, no sauna. The majority of the clients come with doctor referrals and are new to any kind of fitness routine.
"Most of them say, 'I just don't know what my body can do anymore,' " says Diana Kuykendall, one of the staff exercise physiologists at Greenspring Station.
At age 53, Bob Smith, head physician at a Baltimore diagnostic laboratory, is one of Kuykendall's younger patients. He had a heart transplant in January and comes in three mornings a week for about 90 minutes of weight lifting, stretching, stationary biking and treadmill work.
Smith prefers the Hopkins center in part because his anti-rejection medication leaves him prone to infections, and he believes high-volume commercial gyms can be germ factories. His insurance will cover about three months of visits.
"I'm on a monitor the whole time here," says Smith, an avid runner and cyclist until heart problems idled him five years ago. "My goals are to rehabilitate and slowly build up. Moderation will save the day."
Velma Moseley, 62, had double bypass surgery and is now two months into a 10-month rehab program. She's pumping weights for the first time in her life and doing nine minutes of biking every session.
She also is breathing better, sleeping better and no longer relying on a cane or walker around the house.
"It's exciting," says Moseley, who has long battled her weight, "because I've come down two dress sizes."
Hopkins started a pure cardiac rehabilitation program in the late 1980s, then over the years branched out into general medical rehab. About 10 years ago, the hospital delved into studying the physiology of exercise.
"I don't know of anyone else who has tried to integrate the clinical and the research into one center," says Stewart. "I think that's what sets us apart."
Stewart, 57, began his career on a lower rung of the fitness ladder: He taught seventh-, eighth-, and ninth-grade physical education in Brooklyn, N.Y., before leaving the public school system to earn a doctorate in exercise physiology. He became director of the Clinical Exercise Center in 1993.
Stewart's primary focus is tracking the effects of exercise on people with Type 2 diabetes. But he's also involved in research on the impact exercise has on cancer, angioplasty and heart-failure patients.
Those research results often filter down to the exercise center.
"I think we were the first to start using weight lifting in a cardiac setting," says Stewart. "We start them three to four weeks after a heart attack."
His studies have shown that diabetics who exercise regularly process blood sugar more efficiently, thereby lowering the amount of insulin they require. Likewise, exercise helps reduce the rate of tissue rejection in heart-transplant patients.
Stewart has come to think of exercise as an all-natural alternative to the controversial "polypill," a blend of aspirin, folic acid and cholesterol- and blood pressure-lowering drugs that some researchers hail as the silver bullet of good health and others dismiss as bunk.
"If exercise was a pill, it would truly be a polypill," says Stewart. "There's very few systems of the body that it doesn't affect in a positive way."
Unfortunately, there's another thing Stewart has learned over the years about exercise: "Getting people to do it is the hardest part."
Kerry Stewart, director of clinical and research exercise physiology at Johns Hopkins Medical Institutions, has spent most of his professional life studying the human body under duress. Here are a few of his basic fitness principles:
Don't be intimidated by the conventional wisdom that you need a medical clearance before starting a workout regimen. That precaution primarily applies to people with prior at-risk conditions.
"Basically, anybody can start a moderate exercise program," says Stewart. "More people are harmed by not exercising."
Don't be in a rush to join a health club or outfit a home gym. Get a trial membership. Test equipment before you buy. "More treadmills are used as a clothes hanger than as a piece of exercise equipment," Stewart says.
Cholesterol levels and blood pressure are reliable health indicators, but impractical yardsticks for the average person. Just keep an eye on your belly to monitor your workout progress, says Stewart: "To the extent that your waistline is shrinking, you're doing well."
Be patient and persistent with any exercise routine. "It's probably going to take six months before you see meaningful benefits, not six weeks."