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Part 04 - Why Your Love Matters

13 - What’s Love Got to Do with It?

The heart that loves is always young.

—Greek proverb

There is an aspect of our lives that healthy traditional cultures have always understood to be of paramount importance to human happiness, well-being, and longevity: Nothing is more important, they believe, than the quality of their human relationships. As individuals and as communities they are sustained through all kinds of hardships by the boundless commitment they have to support one another, and their complete readiness to provide mutual aid at any time.

If you happen to leave your wallet on the sidewalk in Okinawa, you can fully expect to come back the next day and find it still there. If it’s gone, it’s probably only because some anonymous stranger who picked it up will soon return it to you, completely intact.

Similarly, in Abkhasia, people are valued over anything else. Wealth is counted not by the amount of money a person has, but by the number and quality of relationships he or she maintains. In Abkhasia, people are not said to be successful as a result of having a large bank account, much land, or many possessions. Instead, people are considered successful if they have a large and vibrant network of loyal and devoted people in their home, extended family, and community.

In Vilcabamba and Hunza, too, the sense of connectedness people have with one another and the way they relate to each other are held to be of primary significance. Generosity and sharing are the highest values. Nothing is more important than how people treat each other. After the American doctor Y. F. Schnellow returned from Hunza, he reflected on the remarkable health he had witnessed: One of the most noteworthy aspects of my experience in Hunza was the palpable sense of love and connection I felt among the people. They looked after each other, they rejoiced together, there was an atmosphere of friendliness everywhere. I could not help but think that it is this great affection and reciprocity they have for one another that underlies and makes possible their unparalleled health.

LOVE AND HEALTHCARE

Thirty years ago, anyone who said there were profound medical consequences to human relationships would have had their sanity questioned by modern science. And anyone blaming loneliness for physical illness would have been laughed at. But in the last few decades there has been an explosion of scientific understanding about the deep connections between interpersonal relationships and health.

As you may know, there is in Western medicine a great deal of concern about risk factors like high blood pressure, high cholesterol, smoking, and obesity—and deservedly so, for they are very often linked to serious disease. But an ever-increasing body of medical research is coming to the surprising conclusion that the quality of your relationships with other people is every bit as important to your health as these indicators—if not more so. Chronic loneliness now ranks as one of the most lethal risk factors determining who will die prematurely in modern industrialized nations.

Though the science has been accumulating for the last thirty years, many physicians have been slow to accept the idea that something as intangible as interpersonal relationships could have so much medical significance. They tend to view love as a frill or a luxury, as something that distracts from a rational approach to patient care. Western medicine still often trains physicians and other health professionals to keep emotionally distant from their patients. It’s a great loss that even if health professionals are deeply caring people, they receive little approval for their kindness, their gentleness, and their empathy. Rachel Naomi Remen, M.D., describes how this affected her: The second day of my internship in pediatrics I went with my senior resident to tell some young parents that the automobile accident from which they had escaped without a scratch had killed their only child. Very new to this doctor thing, when they cried, I had cried with them. After it was over, the senior resident took me aside and told me that I had behaved very unprofessionally. “These people were counting on our strength,” he said. I had let them down. I took his criticism very much to heart. By the time I myself was senior resident, I hadn’t cried in years.

During that year, a two-year-old baby, left unattended for only a moment, drowned in a bathtub. We fought to bring him back but after an hour we had to concede defeat. Taking the intern with me, I went to tell these parents that we had not been able to save their child. Overwhelmed, they began to sob. After a time, the father looked at me standing there, strong and silent in my white coat, the shaken intern by my side. “I’m sorry, Doctor,” he said. “I’ll get a hold of myself in a minute.” I remember this man, his face wet with a father’s tears, and I think of his apology with shame. Convinced by then that my grief was a useless, self-indulgent waste of time, I had made myself into the sort of person to whom one could apologize for being in pain.

EVIDENCE THAT STUNS EVEN THE SKEPTICS

It is a sad statement about modern medicine that so many physicians consider it to be their professional obligation to remain emotionally distant from their patients, when in fact the healing power of love and relationships has been documented in an ever-increasing number of well-designed scientific studies involving hundreds of thousands of people throughout the world. In his 1998 book, Love and Survival, Dean Ornish, M.D., describes reviewing the scientific literature and being amazed by what a powerful difference love and relationships make on the incidence of disease and premature death from virtually all causes. “I am not aware of any other factor,” Ornish concluded “—not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery—that has a greater impact on our quality of life, incidence of illness, and premature death from all causes.” Dr. Ornish is not the only esteemed medical icon to be convinced of the healing power of our relationships with one another. In May 1989, a Stanford Medical School professor of psychiatry and behavioral sciences, David Spiegel, M.D., told the annual meeting of the American Psychiatric Association of an unexpected finding. He and his colleagues had been studying eighty-six women with metastatic breast cancer. The women had been randomly placed into two groups. Both groups received the same medical treatment, but one group also attended weekly support group meetings. To the amazement of the researchers, the ten-year study found that the women who participated in the support group had twice the survival time of the women in the control group. They lived an average of 37 months after entering the program, compared to an average of 19 months for the other women. “I must say I was quite stunned,” said Spiegel. He told the Los Angeles Times that he “undertook the study expecting to refute the often overstated notions about the power of mind over disease,” which he said he had found “clinically as well as theoretically irritating.” His intention was to disprove the idea that psychosocial interventions could have medical value for women with breast cancer, partly because he was tired of being confused with Dr. Bernie Siegel, who had written several bestsellers affirming that patients’ attitude and degree of social support could play a dramatic role in their medical outcomes.

The women in the support group not only lived twice as long, they also experienced fewer mood swings and less pain and fear than their counterparts. These gains came from meeting for an hour and a half a week, during which the women were encouraged to express whatever they were feeling, including (though not limited to) their fears, anger, anxiety, and depression.

The women who participated the most actively in the meetings experienced the greatest lengthening in survival time. Although all of the women in the study had been considered “terminal,” three were still alive when Spiegel made his presentation twelve years after the study began. Tellingly, these women were among those who had been most involved in the sessions.

Spiegel was not the only medical professional who was astonished at the results. Dr. Troy Thompson, a professor of psychiatry at Jefferson Medical College in Philadelphia, remarked, “This is a marvelous study, a surprising study to me as well. I would have bet the mortgage of my home that it would not have come out this way.”

If a chemotherapy drug existed that had the ability to increase survival as greatly as participation in the emotional support group did, it would be adopted as the standard of care and administered to virtually all women with metastatic breast cancer. Pharmaceutical companies would be making billions of dollars off the drug. Patients would be paying many tens of thousands of dollars each, and would be willing to endure toxicity and reduction in quality of life from the chemotherapy in order to obtain the added years. The support group, on the other hand, cost almost nothing, and added substantially to the women’s quality of life.

Could Spiegel’s study have been an aberration? A few years later, Dr. F. I. Fawzy and his colleagues at the University of California at Los Angeles Medical School conducted a study similar to Spiegel’s, this one dealing with the survival rates from malignant melanoma in two groups of patients. As in Spiegel’s study, the patients in both groups received the same medical treatments, and were equivalent at the beginning of the study in how far their cancer had progressed. The only difference was that one group also met regularly for mutual support. Five years later, the researchers were stunned to find that individuals in the group that did not participate in the support group were three times more likely to have died than those who had the opportunity to talk to others about their experiences. I do not know of any study that has found a higher incidence of disease or mortality for people with strong social support than for those without. But many important studies tell us that people with more love in their lives and more social support have lower incidence and lower mortality from cancer and many other diseases.

I believe these studies are providing us with a glimpse into one of the deep secrets of health and longevity.

HOW IMPORTANT LOVE CAN BE

“We cannot live for ourselves alone,” wrote Herman Melville. “A thousand fibers connect us with our fellow man.” Perhaps this explains why we are often moved by people caring deeply for one another. A story illustrating the point, perhaps apocryphal, is told by a friend of mine, the noted author Dan Millman:

Many years ago, when I worked as a volunteer at Stanford Hospital, I got to know a little girl named Liza who was suffering from a rare and serious disease. Her only chance of recovery appeared to be a blood transfusion from her five-year-old brother, who had miraculously survived the same disease and had developed the antibodies needed to combat the illness. The doctor explained the situation to her little brother, and asked the boy if he would be willing to give his blood to his sister. I saw him hesitate for only a moment, before taking a deep breath and saying, “Yes, I’ll do it if it will save Liza.” As the transfusion progressed, he lay in a bed next to his sister and smiled, as we all did, seeing the color returning to her cheeks. Then his face grew pale and his smile faded. He looked up at the doctor and asked with a trembling voice, “Will I start to die right away?”

Being young, the boy had misunderstood the doctor. He thought he was going to have to give her all his blood.

We find it inspiring to think of a child being so selfless and generous that he would give his life for his sister. The fact that such a simple story can move our hearts is evidence that we are all capable of acting from our higher selves more often than we do, that we are all capable of more cooperation than we often think.

There are also medical implications to whether we think of others or only of ourselves, as Larry Scherwitz found out when he conducted a most unusual study. Now the director of research at California Pacific Medical Center’s Institute for Health and Healing in San Francisco, Dr. Scherwitz taped the conversations of nearly six hundred men. About a third of these men were suffering from heart disease; the rest were healthy. Listening to the tapes, he counted how often each man used the words I, me, and mine. Comparing his results with the frequency of heart disease, he found that the men who used the first-person pronouns the most often had the highest risk of heart trouble. What’s more, by following his subjects for several years thereafter, he found that the more a man habitually talked about himself, the greater the chance he would actually have a heart attack. Apparently, counting the times a person said “I” was an ingenious way to quantify self-absorption. It seems that the less you open your heart to others, the more your heart suffers. Dr. Scherwitz counsels: “Listen with regard when others talk. Give your time and energy to others; let others have their way; do things for reasons other than furthering your own needs.” This is sound medical advice, and it speaks also to our spiritual and emotional needs. Many religions have taught that being trapped in the illusion of separateness is the source of much of our suffering.

Modern Western society, of course, has become highly competitive. You see it perhaps most conspicuously in sports. “Winning is not the most important thing,” said the famous football coach Vince Lombardi. “It’s everything.” Said another coach, “Show me a good loser and I’ll show you a loser.” I’m sure these coaches were trying to urge their players on to greater effort, but when we become hyper-competitive, we may lose touch with honor, decency, and sportsmanship. And we almost certainly lose touch with each other.

Special Olympians train long and hard for their events and are every bit as committed to winning as are athletes in other athletic competitions. The Special Olympics is not a casual social outing. These are highly organized sporting events taken very seriously by all involved. But people at the Special Olympics Washington office have verified that the following incident took place at a 1976 track and field event in Spokane, Washington: Nine contestants, all physically or mentally disabled, assembled at the starting line for the hundred-yard dash. At the gun they all started out running as fast as they could. All, that is, except one boy who stumbled on the asphalt, tumbled over a couple of times, and began to cry. Hearing the boy cry, several of the others slowed down and paused. Then they turned around and went back. One girl with Down’s syndrome bent down and kissed him, and said, “This will make it better.” Then they all linked arms and walked together to the finish line. Everyone in the stadium stood, and the cheering went on for ten minutes.

Why do we find a story like this so moving? Could it be that beneath the many ways we have of being separate, we are nevertheless somehow deeply part of each other? Can children sometimes remind us of an essential part of our humanity that we so easily forget in modern society?

In societies like Okinawa, Vilcabamba, Hunza, and Abkhasia, there are many forms of healthy competition, but no one is ever shamed because of being less able. Who wins is important for the moment, but then immediately forgotten. The quality of how people treat one another is remembered long after.

THE HEALING POWER OF RELATIONSHIPS

Most of us are conditioned to view as scientifically valid only that which can be measured in a laboratory. Something as fuzzy and ephemeral as human relationships can seem “touchy-feely,” hardly the stuff of sound science. But sophisticated research has confirmed that we are social creatures to our core, and our sense of being in touch with others and feeling connected to them has enormous implications for our health and longevity.

When researchers from Case Western Reserve University in Cleveland studied almost ten thousand married men with no prior history of angina (chest pain indicating heart disease), they found that those men who had high levels of risk factors—including elevated cholesterol, high blood pressure, diabetes, and electrocardiogram abnormalities—were more than twenty times as likely to develop angina during the next five years. They were amazed to discover, though, that those men who answered “yes” to the simple question “Does your wife show you her love?” had substantially less angina even when they had high levels of these risk factors. In a related study, researchers followed 8,500 married men with no history of ulcers. These men were given a questionnaire to fill out, and then tracked for five years. Those men who reported a low level of love and support from their wives at the beginning of the study were found to have more than twice as many ulcers in the ensuing five years as the other men. And those who said “My wife does not love me” were almost three times as likely to develop ulcers. In this study, having the feeling that their wives didn’t show them love and support was more strongly associated with ulcers than smoking, age, high blood pressure, or job stress. The medical value of intimacy, of having a loving relationship with a spouse or a very dear friend, became overwhelmingly apparent to researchers who published a study in the British Medical Journal in 1993. For seven years, they followed 752 men. At the outset of the study, these men had been given a medical exam during which they were asked about their emotional stress. The study found that those men who had reported being under serious emotional stress at the time of their initial exam—who were experiencing financial troubles, feeling insecure at work, defending a legal action, or going through a divorce—had more than triple the risk of dying during the seven years following the initial exam. Being under these kinds of stresses at the beginning of the study turned out to be a stronger predictor of dying within the ensuing seven years than medical indicators such as high blood pressure, high concentrations of blood triglycerides (linked to coronary artery disease), or high serum cholesterol levels.

Okay, you might say, serious stress breaks people down and can even kill them. That’s no surprise, but what does it have to do with love? What made this study astounding was that for those men who said at the outset of the study that they had a dependable web of intimacy—a spouse or close friends—there turned out to be no correlation whatsoever between high stress levels and death rate.

Loving relationships, medical science is clearly telling us, have an extraordinary ability to defuse the negative medical effects of stress. And we have some understanding of the mechanism by which this happens.

Certain hormones (cortisol and the catecholamines epinephrine and norepinephrine, which are also called adrenaline and noradren-aline) are produced in your body when you are under stress. When these chemicals are secreted and surge through your body, your immune cells are less able to perform their functions, leaving you more susceptible to disease. In this way, stress suppresses immune resistance. There may be an evolutionary wisdom operating in this suppression, in that energy is conserved, enabling your body to put a priority on handling the immediate emergency. In extreme instances this could make the difference between life and death. But if stress continues over time, your health inevitably suffers. Social support seems to neutralize the effect of stress by lowering the production of these stress hormones.

Modern research is now repeatedly finding that your relationships with others are medically potent. Your connections with the significant people in your life—if they are positive and loving—can prevent stress-induced illness, greatly contribute to your health and healing, and add many years to your life. This corroborates what we’ve seen in Okinawa, Abkhasia, Vilcabamba, and Hunza. An abundance of positive, meaningful relationships is one of the secrets of the world’s healthiest and most long-lived peoples.

One of the most remarkable people I’ve had the good fortune to know is Eleanor Wasson. The recipient of the Lifetime Achievement Award given by Physicians for Social Responsibility for her outstanding work for world peace, Eleanor, now nearly 100 years old, is still alert, vital, strong, healthy, and actively working for a better world. I’ve known Eleanor for many years, and I’ve found her always to be an uplifting and inspiring influence on others, even under the most challenging circumstances. I talked to her shortly after the publication of her autobiography, titled 28,000 Martinis and Counting: A Century of Living, Learning, and Loving. I asked what she would consider the secret to a long and healthy life. “Having loving parents,” she said. “I always felt loved as a child. I had such wonderfully loving parents that I never knew, until years later, that not everyone had that gift in their lives. And maintaining friendships. Deep and lasting friendships are precious beyond words.”

THE POWER OF LOVE

In modern society, we can get so busy that we don’t take time to feel our gratitude and receive the blessings of our relationships. Too often, we fill our lives with so much activity that we don’t have room left for the people who matter to us. We can make possessions more important than people.

This is a mistake that people living the traditional way of life in Abkhasia, Vilcabamba, Hunza, and Okinawa rarely make. They are not woken by alarm clocks. Instead, they often wake to the sound of others singing. Instead of going shopping, they go to visit one another. They have need of few belongings, for they belong to each other.

Sometimes we are loved more deeply than we realize, but it can take a crisis to break us out of our patterns so that we can receive the love that others have for us. Author Elizabeth Songster describes the dramatic events that helped her to comprehend the depth of her husband’s love:

It was right before Christmas. My husband, Dan, and a buddy of his, Mike, had gone [each in his own car] to a canyon near our home in Southern California to see if the vegetation, scorched by fires a few months earlier, was growing back. Dan and Mike were both members of the California Native Plant Society. They were real “plant hounds,” always exploring the nearby canyons and hills to see what kind of plants they could find and photograph.

That day, after Mike left [to drive home from the area where the two men were exploring], Dan decided to do a little “solo research” by hiking into Laguna Canyon, a more remote section of the area that was not often explored. He had walked into the canyon a few miles, gotten some pictures and was starting to make his way back to his truck, when he stepped on a water-soaked patch of ground that gave way. He fell thirty-five feet down the rough slope, hitting a number of trees, before he landed on a ledge. He could tell right away that something was terribly wrong with his left leg. It lay across his other leg at an “impossible angle.” Stunned by the fall, it took Dan a little while to realize that he was too crippled to walk. Then Dan knew he was in serious trouble. Night would fall soon and not a soul knew where he was. He had to get to the main trail or he might die out there before anyone could find him. He braced the broken leg against the other leg and, resting his weight on his hands, began inching his way down the canyon.

Making slow and painful progress, Dan stopped often to rest and call for help. The only response was the eerie sound of his own voice echoing off the walls of the canyon. As the sun set, the temperature began to drop. It was cold in the hills at night and Dan knew that if he stopped for too long, he would probably lose consciousness. It was increasingly hard, but Dan forced himself after each pause to keep hauling his sore body forward on his aching hands. He continued this awful journey for another twelve hours.

Finally, his strength and determination gave out. He was utterly exhausted and couldn’t move another inch. Although it seemed futile, he summoned up a last burst of strength and shouted for help.

He was astounded when he heard a voice return his call. A real voice, not another mocking and empty echo. It was Dan’s stepson—my son, Jeb. He and I were out with the police and the paramedics who were searching for Dan.

Earlier, when Dan didn’t come home, I had gotten worried and called Mike. At first, Mike tried to find Dan himself, driving from canyon to canyon looking for Dan’s truck. Finally, he called the police and reported Dan missing.

I’d kept calm and strong until the moment Jeb said he’d heard Dan’s voice. Then I dissolved into tears, finally feeling the fear and dread I’d been pushing aside for hours. It took two hours for the rescue team to bring Dan down the ravine. Then the paramedics trundled him away on a stretcher and when I got to see him at the hospital, my tears started anew. The thought of how close I came to losing this wonderful man undid me. It was only when I felt Dan’s arms around me that I finally stopped sobbing.

As I sat next to his hospital bed, my eyes fastened to the face I had been so afraid I would never see again, Dan told me his story. Immediately after his slide down the canyon, when he realized the seriousness of his predicament, Dan said that he thought of me and how much he would miss me if he didn’t make it back. As he lay at the bottom of the rough cliff, he groped around until he found a suitable rock. Using the rock, which was sharply pointed, he managed to carve a message to me in a large rock near where he lay. If the worst should happen, he hoped I would eventually see the rock and know that I had been with him always, held close in his heart.

I started weeping all over again. I knew how deeply I loved my husband, but I was unprepared for this, the depth of his love for me.

For somewhere deep in the wooded hills of Laguna Canyon, there is a large rock with a heart carved on its side. And in this heart are carved the words, “Elizabeth, I love you.”