Live Long, Die Short (21 page)

We are, in fact, herd creatures. If you have ever observed other herd animals, it is clear that their behavior is influenced significantly by being with, or wanting to be with, others. Take horses, for instance. When part of a herd, a horse is more interactive, spirited, and physically active. Alone in a pasture, he is quiet, or, in some cases, anxious. If you introduce any other creature, even a chicken, the horse will “buddy up” with that other beast rather than be alone. We are similarly wired, with a preference for our own species but a definite aversion to being alone. Our penal system knows this all too well. When prisoners are unruly or difficult to manage, solitary confinement is a powerful tool to modify behavior. According to Drs. Toni Antonucci and Bob Kahn, we journey through our lives with a social support network, which they call a “social support convoy” to emphasize that these networks are dynamic, changing with our life situation and our personal development.
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And it’s a good thing that they do change, for removal from some sort of social support network is disorienting, painful, and a powerful stressor.

In a remarkable study published in 2012, bees were the subject of research on social interaction and aging. When bees age, they are removed from the duties of caring for the young and other hive-related tasks. They are assigned the task of foraging (i.e., flying out from the hive to find sources of food and nectar). This study showed rapid deterioration of the
brain in these foraging bees. When, however, these bees were experimentally reinserted into the hive to care for the young, their brain deterioration reversed!
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The new discovery of “mirror neurons” seems to highlight the idea that we are wired for social interaction. When mammals do something and when they observe something being done, the same neurons fire in their brains. Say, for instance, that you see another person in physical distress. You brain responds by activating the areas of your brain that would be activated were you in that same type of physical distress. The same goes for sadness or elation. This mirroring is theorized to have many purposes, from learning to empathy, but the presence of this ability is yet another example of the social wiring of our brains.
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Recently, I had to have a tooth extracted. Now, I am a product of a fluoride-ignorant generation that experienced dentistry devoid of movies in the ceiling, colorful scrubs, and painless procedures. And despite decades of technological advances, pulling a tooth still comes down to wrestling an unwilling enamel-coated appendage out of its bone home. Yes, there was novocaine and an explanation of what was about to happen, but the primitive deed still reeked of a scene from
Les Misérables
and brought back memories of dental-office dread. What helped me most, what gave me the most comfort, was the hand of Brona, the surgical assistant, on my shoulder. Whenever she wasn’t busy she rested her hand there, and that made everything less threatening, more doable. We are not wired to be isolated creatures, especially in difficult times.

I have seen dying people become more peaceful with this basic empathetic gesture. We are beginning to be able to explain such things in biochemical terms, but that does not in any way negate that we are creatures who derive desirable and salubrious effects from being with others; in fact, it validates this view.

All this is not to say that we don’t seek out time alone to reflect, be at peace, or otherwise “recharge our batteries.” And life has a way of damaging us, with friends, family, or just another of our own species; people can hurt us in a way that causes us to throw up defensive walls and to be wary of others, and, for the more damaged, to prefer to be alone rather than risk being hurt. Despite this, most of us, most of the time, prefer company.

So, we ask ourselves, can it be that something so deeply rooted in our brains and therefore in our nature as social connection is not only desirable, important for survival, but also more healthy for us? Once again, Patsy from Minnesota weighs in: “You betcha.” In fact, it appears we are
not healthy humans
unless
we are connected to others of our species. It is a critical component of our authentic health.

In his thought-provoking 2000 book
Bowling Alone,
Harvard University professor of public policy Robert Putnam tracks the decline in Americans’ participation in social organizations over the last quarter of the twentieth century.
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He concludes that we are paying a significant health price for that disengagement. He reviews a wealth of research, which leads him to conclude that the link between social connectedness and health and well-being is perhaps the most well established of all the areas of study of social connection.

Longitudinal studies (observational studies that look at the same variables over a long period) in Alameda and Tecumseh, as well as in Scandinavia and Japan, have clearly established a relationship between social connection and health. People who are socially disconnected or isolated are between two and five times more likely to die from
all causes
compared to matched individuals who have close ties with family, friends, and community.
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And according to these same studies, people who are connected have more positive health outcomes than those not so connected. These studies have established beyond reasonable doubt that social connectedness is one of the most powerful determinants of our well-being. The more integrated we are with our community, the less likely we are to experience colds, heart attacks, strokes, cancer, depression, and premature death of all sorts.
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Why this is true is not so easy to determine. Social networks may provide necessary resources such as money or transportation, which might reduce stress. Or, social networks, particularly if they consist of healthy people, may reinforce healthy behaviors. An even more interesting possibility, however, is that lack of social connection depresses immune function. The mechanism is thought to be stress, which is more common with isolation or lack of social support. Within a village environment, our ancestors were part of the whole; each individual was a small part of a larger organism with a higher purpose. As the village went, so did they. In times of trouble, the village was there to help. Today, we function more as individuals with a real and threatening fear that we will have to deal with trouble essentially on our own. Whether it’s financial or health-related or work-related problems, we will have to handle it alone. This situation is dramatically different from
how we evolved and results in a lingering, ever-present stress—chronic production of the glucocorticoids seen with stress, which, in turn, suppresses immune function. Dr. Janice Kiecolt-Glaser and her colleagues have established a strong relationship between stress, immunological competence, and health.
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Too much stress, or the chronic stress common in our frenetic society today, leaves the immune system weak or not functioning optimally, and this, in turn, leaves us vulnerable to a variety of diseases, including cardiovascular disease, cancer, depression, and infections.

Moreover, societies today value independence and personal control. We are drawn to the likes of the strong, capable men and women who can “do it all,” who know exactly what they want in life, and who go get it. This might be an admired image, but it is one that leaves the individual out there alone doing battle with others in order to succeed. Such a view is understandably highly stressful and frequently engages the fight-or-flight mechanism, since, in fact, success or failure, one’s very survival, is seen to be dependent on the individual’s actions alone. The village societies of our ancestors—and some communities that existed even as late as the early twentieth century—valued the common good over that of the individual. The ability to work with others to achieve a mutually beneficial goal was highly admired. When adversity struck, it was viewed as a common challenge and significant support was available. When my barn burned down, the village would mobilize and help me rebuild. Consequently there would tend to be less stress, less cortisol, and better immune system function in such societies.

Martin Seligman, a University of Pennsylvania psychologist, wrote in
Psychology Today
years ago about “Boomer Blues.” He attributed a pervasive unhappiness in the baby boomers to a generational belief in personal control and autonomy over commitment to duty and common enterprise.
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I believe he is alluding to the lack of this sense of the common good as both a motivator and a social connector, which our ancestors cultivated out of necessity.

One of my first assignments in the Air Force was at a fighter base in Germany during the Cold War. I was assigned to take care of the flyers and families of the 53rd Tactical Fighter Squadron and I was their flight surgeon. They adopted me and welcomed me as a fellow aviator, even writing my name on one of the F15s. I flew with Bubba and Fonz and Bush (the tactical call signs of Mike, Rick, and Dave) and others. I deployed with them. Paula and I traveled and partied with their families. We mourned the loss of our comrades as a community. And we all felt the profound
sense of both camaraderie and a higher purpose in our lives. I confess I have never felt the same level of satisfaction as I experienced with the 53rd TFS. And I’m not alone. Our periodic squadron reunions are big events in our lives. We witness together the weddings of our children. Years, even decades, fade away when we meet. We are forever bonded: a band of brothers, rarely found today, but the necessary rule for our distant ancestors. My deep sense of satisfaction stems from the fact that we as a species have a strong predilection for such bands, but they are getting more difficult to find.

I have a friend, Fred, who lives in a small town in Kansas. In addition to his day job, he serves as the editor of the local newspaper, published only four times per year. Fred sends me the
Tipton Times
, and in those few pages I follow the lives of the town’s several hundred residents: births, deaths, graduations, athletic accomplishments, accidents, agricultural reports, store openings and closures, the return of the railroad, the school plays, the dance recitals. I follow the lives of those who move away from Tipton, as they go to college, work, and even die in another place. And somewhere along the way I began to care. I evolved from reading Fred’s paper with bemusement to nostalgia. I, in fact, grew up in a larger town, but as a child, my world was small. I can easily substitute names from my old neighborhood for these Tipton names. And I believe the nostalgia goes even deeper, to some place within me that was handed down to me by many ancestors over eons—a sense of my humanity related to place and, more importantly, related to others. There is some of Tipton in all of us, and we need it to be healthy.

We see other examples of these village-like societies today. Earlier in this book we discussed Blue Zones, areas where extreme longevity is much more common than in other societies. In areas of Okinawa, Sardinia, Costa Rica, and Greece, there are common characteristics of those who live long. Two of those characteristics are (1) family is put ahead of other concerns, and (2) people of all ages are socially active and integrated into their communities.

In
Bowling Alone
, Dr. Robert Putnam describes a well-studied town in Pennsylvania that clearly illustrated the effects of social connection on health. Roseto, Pennsylvania, was also mentioned in Malcolm Gladwell’s book
Outliers
, because of the virtual absence of heart disease in the town,
even in the mid-twentieth century, when the nation as a whole and even neighboring towns were experiencing rising incidences of heart attacks. The town was the focus of long-term studies that ultimately established stress as a major cause of heart disease. So why was there less stress in Roseto?

The small town of approximately 1,500 people had been founded and populated by immigrants from the same region in Italy. Strong community resources, such as a mutual-aid society, churches, athletic fields, and sports clubs, together with a value system that scorned displays of wealth and encouraged tight social connection, were the distinguishing features. Rosetans drew on one another for emotional and financial support, frequently congregating on front porches or in clubs. And when the new generation of adults arrived in the 1980s and this socially mobile group began to reject some of the old ways of their parents and grandparents, the protection against heart disease began to fade.

Regardless of the mechanism, an excellent comprehensive review of the literature on social connectedness and health led by Julianne Holt-Lunstad from Brigham Young University concluded that “strong social relationships influence the health outcomes of adults,” with 50 percent more likelihood of longevity, whereas “social isolation is the risk equivalent of smoking for heart disease and cancer.”
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Although we cannot go back to the village environments of our ancestors, if we understand the importance of social connection and work to make it a core element of our modern-day environments, perhaps we can find authentic health and indeed reap the health rewards of our ancestors.

So, questions then arise: Aren’t we more connected than ever? With Facebook, cell phones, emails, texts, and tweets, don’t we have more “friends”? Aren’t we “talking” to more people every day? Shouldn’t we be getting healthier? As these are relatively new technologies, it remains to be demonstrated whether this will happen. However, if we use our ancestors as a guide to what specifically we need from being connected to others, we can make some guesses.

It’s true we need to communicate with others as a basic way to connect. It has been estimated that as much as two-thirds of communication is nonverbal:
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gestures, body position, facial features, and eye contact, for example. This would make us question whether some of these technologies
deliver on promises to enhance communication. Certainly they would seem to act as “connectors” in that they have the capacity to bring people together physically, as seen in social media–driven actions like Occupy Wall Street and the Libyan uprisings.