Apparently people on the East Coat can't conceive of it. It's that East Coast Bubble thing. It's not the fact that they don't do it that places them in that bubble, it's the fact that they still didn't know that the rest of the country doesn't follow their East Coat Weiner Protocol.

He got tired and left early. He's a tired old man in his late 70's and he had a long plane ride home.
He's tired all the time from minimal activity.