Human responses to the color red are really interesting. In some people, it evokes a sense of unease, as if something menacing or risky is lurking. Think of the red traffic light that warns us that if we cross disaster may strike. Or, the flashing red lights you see in the rearview mirror when a police car signals you need to pull over. And then there is the red fire engine, wailing and rushing off to an unknown disaster somewhere.
Further, we often use the color red in language when we want to connote something negative:
Others look more positively on the color. Advertising specialists and graphic designers tell us that red connotes a sense of power, of virility, of breaking down conventions:
When you boil it down, these varying uses of the color red are often meant to convey the same message: POWER.
It has been shown that red radiation is more conducive to producing epileptic seizures than blue light. Conceivably, it could be because the red color is associated with danger and therefore increases an anxiety response to a certain degree, as measured by heart rate and EEG studies.
Psychological research has shown that subtle red color cues can inhibit cognitive performance, increase dominance in competitive interactions, and modulate people’s mating behavior. In many situations, red is associated with danger and perceptions of threat.
A paper published in PLOS in 2015 delved into the question of the connection between red and the sensation of danger, using the design of a website. Specifically, the investigators tested, in two studies, whether red color increased risky behavior. In the first study, they found that including a red (vs. gray) headline in a web-based survey led users to behave in a more risk-averse way (i.e., to choose less risky options).
Likewise, in the second study, users chose a less risky strategy in an online game when the target stimulus was red rather than blue. Both studies provided comparable evidence that including the color red in online environments can decrease the likelihood of users taking online risks that could result in financial losses.
These findings are strengthened by the use of two different control colors, which support the conclusion that the observed differences in online risk-taking are a consequence of the color red and not the chosen control conditions. Overall, the results of both experiments support the view of red as an avoidance trigger.
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Here is the amazing thing: At the beginning (and this is not a biblical fable), there was no color discrimination, only black and white. It makes sense, right? Night and day are the very basic and the strongest factors that control the rhythm of life, be it for plant, animals, the savannah, or Manhattan.
The first color to be registered in our ancestors’ brains was most likely red, the color of blood (connoting danger) and fire (power, both beneficial and destructive).
How do we know? Of course, there is no way to have definitive proof for such an assertion because we weren’t there at the time, but we do have a lot of supporting evidence.
Paul Mckay and Brent Berlin, both of UC Berkeley, devised an ingenious experiment to uncover the evolutionary progression of humans’ color discrimination. They proposed that every culture in history invented words for colors in the exact same order.
They reached their conclusion based on a simple color identification test, where 20 respondents identified 330 colored chips by name. If a language had six words, they were always black, white, red, green, yellow, and blue. If it had four terms, they were always black, white, red, and then either green or yellow. If it had only three, they were always black, white, and red, and so on. The Yele language of Papua-Mew Guinea has 5 basic color words, but they all describe shades of black, white, and red.
Red is one of the first colors to be used by humans as art or body painting. In an archaeological site in South Africa, Pinnacle Point, ochre-colored iron oxide drawings were discovered dating back to 170,000 years ago, coinciding with the time that Homo sapiens transformed from archaic to its modern form.
So as soon as people felt the need to do more than merely exist, they expressed themselves in art painted on cave walls—in black, white, and red. There is no hint of any other color being used, although green, blue, and other pigments were abundant.
As late as 40,000 years ago, cave paintings still depict animals in black, white, and red. Imagine, 130,000 years of a world in black, white, and red.
But wait, there is more! As late as the 12th century BC, Homer describes the Aegean sea in the Iliad as “the wine-red sea.” He does not use blue or green to describe the sea or anything else for that matter.
In the 20th century BC ancient Indian Mahabharata, or the 18th century BC Ugarit tablets, or the 8th century BC Bible, there is no mention of the color blue (the Bible actually mentions colors that were interpreted as blue, but modern research concludes that they were actually referring to purple).
What’s going on? Were they all color blind?
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In 1898, the psychiatrist W.H. R. Rivers went to the Torres Straits Islands, between New Guinea and Australia. There, he investigated the Islanders’ perception of colors. He was astonished to hear the elders describe the sky as black, and a child describing the color of the sky as dark as dirty water.
He and other anthropologists concluded that early humans and isolated cultures were not color blind. They saw all the colors that we see, but consider them as simply hues of white or black or red, not worth inventing a special word for. And, by the way, like the Himba people of Namibia, they paint their bodies with, you guessed it, red ochre.
Neurobiologists believe that it is not just a simple case of nomenclature, the islanders indeed perceive the sky a bit darker than we do. When we get used to seeing two hues as different colors, language trains us to see them as different entities. The brain then exaggerates these differences, especially at the border areas between them.
Thus red, or blue for that matter, which we perceive as lighter and totally distinct from black, is in reality probably a bit darker and closer to black. In a sense, the “obvious” distinction between black and red or blue is a figment of our imagination.
And, consider this. Following brain trauma, in some cases, there is a temporary loss of color discrimination where everything is in black and white. The first color to come back is red, possibly because the neuronal circuits involved in perceiving black and white are the most ancient and the most developed, and next to them are the ones responsible for the perception of red.
Guy Deutscher is an Israeli linguist and author of Through the Language Glass: Why the World Looks Different in Other Languages. In the book, he advances the argument that the basis of language is informed by the way we perceive and name colors. It was translated into 8 languages and was selected by the New York Times, The Economist, and the Financial Times as one of the best books published in 2010.
To extend his observations, we can add the effect that colors, through language, affected brain structure throughout human evolution. This is a remarkable example of how the environment, culture, and natural selection “colluded” to shape our brains.
As my granddaughters would say, “cool!”
First published on July 26, 2015. It has been reviewed and updated by the author.
Early in the pandemic, Dr. Deborah Birx, the Coronavirus Response Coordinator for the White House Coronavirus Task Force, reminded the public of the critical importance of individual and collective human behaviors to change the course of the COVID-19 pandemic. She said,
“It’s communities that will do this. There’s no magic bullet. There’s no magic vaccine or therapy. It’s just behaviors. Each of our behaviors translating into something that changes the course of this viral pandemic over the next 30 days.”
The pandemic continues to profoundly change our “normal” lives many months later. The good news is that we appear to be coming off of the devastating third wave of the pandemic. Further, vaccinations are proceeding at a decent pace – more than 2 million per day.
Recently, the CDC announced guidelines for fully vaccinated individuals that begin to normalize their lives. For instance, it’s now ok for them to gather in very small groups with others who are also vaccinated. (Read the full recommendations here).
However, we are not home-free yet. Some experts predict that early reopenings with full relaxation of public health measures in many states could be followed by a fourth wave. This once again reminds us of the importance of human behavior in combatting the pandemic. Despite tireless, ongoing efforts, until we reach levels of vaccination that approach herd immunity, we are still at risk of relapse.
There has been some good news on the therapy front. Clinicians have gotten much better at treating hospitalized COVID patients leading to a drop in the death rate. Further, there are a number of new drugs that significantly alter the course of the illness. The bad news is that the continued global pandemic has resulted in the spread of many new strains of the virus. Some are more infectious and some more virulent. We still don’t know for sure how effective existing vaccines will be in halting transmission of the virus.
So, for now, we continue to depend on human behavior to contain the spread of the virus.1 And, according to experts, we will do so for the coming months (or longer) until most of the population is fully vaccinated.
The challenge of employing human behavior to combat a crisis of this magnitude is that behavior is often unreliable and unsustainable. We’ve already seen this play out in some areas of the country where people are agitating for freedom from the public health mandates of masking and distancing. Because of these challenges, and the fact that a medical solution is still somewhere in the future, many are asking, “how do we move forward?”
A good place to start is to gain a deeper understanding of why people act the way they do during times of immense stress and uncertainty. Behavioral science can help inform our country of the next steps we need to take to enact real, meaningful change in our country’s overall response to the coronavirus.
In this piece, we’ll explain how stress can influence our behavior. And, we will share actionable insights that can be used to inform both our individual and collective responses to the coronavirus pandemic.
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In times of crisis, most of us are exposed to increases in both acute (in-the-moment) and chronic (consistent over time) stress. Stress2 can impact us in a variety of different ways, including how we process and perceive information in the world around us.
As a function of evolution, we’re wired to preferentially notice, process, and remember emotional information3 over non-emotional information. For example, many of us can vividly remember that embarrassing moment from middle school. However, we might be hard-pressed to recall what we had for breakfast three days ago.
Stress has many physiological and psychological effects.4 One is the heightening of our awareness of negative, rather than positive information.
Again, this is an evolutionary response. Humans become stressed because there is a threat in our environment. Heightened awareness of negative information increases our chances of identifying and dealing with the source of our stress.
Today, we are seeing, hearing, and experiencing a large amount of negative and fear-inducing information. And, we are more likely to retain that negative information, and have it be top of mind.
That chronic exposure to emotionally-negative stimuli can lead to increased stress. It can also provoke neurobiological changes that predispose us to be more likely to notice other negative stimuli.
One classic example is the phenomenon of many experiences after breaking up with a romantic partner. To them, it seems like every song they hear on the radio is about breaking up or falling out of love.
While this is helpful for survival in some cases (being hyper-aware of animal noises while walking in the woods at night, for example), it can be very cognitively taxing for us in situations like the one we are in right now.
Chronic stress impacts our decision-making. In fact, even in “normal” circumstances, much of our behavior, including buying, is driven by a balance between two motivations:
Those two cognitive “needs” operate more or less in balance with one another. This balance is disrupted by negative emotions, such as:
Under those conditions, our desire to make ourselves feel better gets amplified. And, we put much less effort into controlling our impulses. That is why many of us went out and stocked up on toilet paper and other essentials when the pandemic first began. We did it even though we knew we didn’t necessarily need it or could have saved it for someone else.
With a deeper understanding of how stress impacts human behavior, we can start to make informed decisions about the most effective ways to move forward.
There are steps we can take both individually and collectively that can enact meaningful change and help change the course of the coronavirus pandemic for the better.
Individually, we can work to reduce our negative exposure and protect ourselves from becoming overly stressed by:
Physical activity,5 even around the home, can mitigate the production of stress hormones like cortisol. It also reduces anxiety-like symptoms. Physical activity also promotes oxygenated blood flow to the brain. This can both reduce cognitive load and promote long-term brain health.
Social interaction6 provides myriad mental health benefits. Even virtual interactions, via webcam or even text-based communication, promote the release of oxytocin. Oxytocin7 is a reproductive hormone that can increase feelings of bonding and closeness. It also drives prosocial behaviors.
Although these responses are mitigated for virtual, rather than in-person, interactions, maintaining social relationships has obvious benefits over social isolation.
Effortful regulation of our emotions8 can be challenging. But it is very effective for our well-being. We may be tempted to turn off the news, close our laptop, and avoid as much negative information as possible. However, this strategy of emotion suppression – ignoring or pushing away our negative thoughts and feelings – only delays (and, sometimes, amplifies) negative emotional states.
Reappraisal9 is a method of thinking critically and re-framing the negative information we are exposed to and reframing how it relates to us. This way of thinking is much more beneficial to our long-term emotional health. Further, it can have protective effects when we encounter new, negative stimuli. Reappraisal often takes cognitive effort, but the long-term effects are worth it.
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As a society, we choose to focus on and highlight the positives as much as possible. We do this both for our emotional health and also for effectiveness in our communication.
Emotionally, there is a lot to feel negatively about right now. Many of us have lost loved ones, our livelihoods, and social relationships. Those things, of course, are incredibly difficult to deal with.
Acknowledging those negative stressors is important. However, ruminating10 on them is harmful to ourselves and to others around us.
Highlighting negative information is a less-effective communication strategy. For example, there has been ample research over the last three decades on anti-smoking PSAs.11It shows that a focus on the negative health outcomes of smoking are often ineffective at promoting smoking cessation.
This is because our default response is to shut out that information. We think, “This can’t happen to me” or “I don’t want to see that.” In some cases, those PSAs12 may actually prime smoking behavior13 because they cue smokers to think about nicotine.
More effective messaging focuses on the positive consequences of behavior change:
Whether you are a manager, a health official, or even a parent, understand that negative information can get peoples’ attention. However positive information can be more effective at promoting behavioral change.
We are all the main characters in our own story. However, getting through a crisis is a collective and social experience.
It can be difficult to be vigilant to the needs of others. But, putting in the effort to do so is critically important.
Try not to become frustrated or hurt if your partner wants to take a few hours to read a book quietly. Or jump to conclusions about work ethic if a team member needs to take an afternoon off to decompress.
Do something, even if it is small, like reminding yourself, “That’s what they need to do for themselves right now.”
It can be an effective way to reappraise the situation. And, it helps you put yourself in the shoes of someone else.
As we await the official end of the pandemic, our behaviors remain an important weapon in the fight against coronavirus. Despite its unpredictable nature, especially in times of crisis, we must find ways for human behavior to help, not hurt or hinder, our response to the pandemic.
We must take what we know about human behavior during times of chronic stress, and apply it to how we move forward as individuals and a collective. It will help us shape a response that is better suited for human behavior. One that can, ultimately, change the course of coronavirus.
Published 6/28/20. Updated by Patricia Salber, MD on 3//9/21.
Working well with your own emotions is key to creating a healthy, happy life. Psychologist Dr. Daniel Goleman coined the famous term emotional intelligence in his book by that name. It refers to the ability to perceive, control, and evaluate emotions. I believe that emotional intelligence becomes even more important as we age.
Unfortunately, our modern society often projects negative attitudes and stereotypes about aging and older people. Therefore, it becomes very important to nurture our emotional health as the years pass. There are challenges that arise as we grow older, but it can also be one of the most rewarding times of life if we approach it with the right mindset.
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The good news is that older people are naturally happy people, despite whatever challenges aging may bring. The Los Angeles Times reported on a survey of people in San Diego, CA, about their level of happiness. It showed that people in their 20s were the least happy. And, surprisingly, people in their 90s were the happiest! The older they were, the happier they became through the entire life span, something that brain scientists call “the paradox of aging.”
This does not mean that all older people are as happy as they can be. Nor does it mean that they all have great attitudes about aging. Many people do pick up negative attitudes about aging, and this can negatively affect the aging process. For example, it is well known among older adults that exercise can help reduce the effects of aging , but negative attitudes about the aging of the body stop many people from exercising as they get older.
A positive attitude about aging is especially important for the brain. A study published in the scholarly journal Psychology and Aging shows that people with a poor attitude about aging had greater cognitive decline than those who approached aging more positively.
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Also, while things like processing speed and memory decline with age, some things, like verbal ability and crystallized intelligence, improve or remain stable with age. Further, it is possible to foster brain changes in ways that steadily increase your wisdom.
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I wrote a book called I’ve Decided to Live 120 Years: The Ancient Secret to Longevity, Vitality, and Life Transformation. In it, I encourage people to set the goal of living to 120.
I focus on the age of 120 years because that does seem to be the approximate upper limit of human life span . The oldest living person whose age was verified was Jeanne Calment of France, who lived to 122 years of age.
That doesn’t mean, however, that I believe everyone will live to 120 just by setting a goal to do so. Many people will fall short of that even if they live a very healthy lifestyle.
Perceiving that as a goal and a possibility, however, rather than focusing on the average of 70 or 80 years, will help you see a long-range possibility for your life instead of assuming that your older years are all about decline and impending death.
You can imagine how a person who is turning 65 will have a different attitude about their remaining years if they think “I might have 50 or more years left” instead of “I probably only have 15 years left to live.” Remember, at least half of people do live beyond the average. And there is much you can do to make those years happy, healthy, and productive.
This 120-year attitude is important for understanding that you always have time to learn and grow and to set exciting goals for yourself.
A study published in the Society for the Psychological Study of Social Issues shows that older workers avoid professional growth opportunities because they perceive themselves and being “out of time,” whether that is true or not.
Even if you live a shorter-than-average life span, don’t you want to be active and involved in life for as long as possible? An ambitious young person thinks they can do a lot in five or ten years, and so can you.
I encourage people of any age to set a grand vision for their lives, one that will satisfy them physically, mentally, and spiritually. This might look different at 50 or 70 than it did at 30. Young people have a need to establish their households and their professional status in the world.
One of the blessings of age is that you probably have less concern about material success and social status because you have already established yourself in the world. Further, you most likely have developed the wisdom that allows you to see that these things are not the ultimate source of happiness. This may well be the reason why older people are naturally happier. This allows you much greater freedom to establish a vision for your life that is truly satisfying.
Ultimately, it is you who should establish the parameters of the goals you set for yourself. Ask yourself, “What will help complete my journey here on earth and give true fulfillment to my heart?” The answer, if you are honest with yourself, will probably be something that is of true service to humanity.
The world badly needs the wisdom of its elders, so look for the thing that makes your heart happy while also making the world a better place. It could be working with young people, expressing yourself through the arts, getting involved with civil rights. Do whatever uplifts your heart while also providing challenges that keep your body and mindfully engaged.
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Although older people are overall happier than younger people, it doesn’t mean that there are no emotional struggles. As we get older, many of our friends and family pass away. We may have to face difficult illnesses, we might miss our old careers. Finally, a rapidly changing world might make us feel out of touch and out of sorts.
It’s important to remember, though, that you have a great deal of control over how to respond to these challenges. There will be times of resentment and sadness. However, ultimately you can choose how long you will hang on to those feelings before you replace them with acceptance and gratitude.
In the end, nothing in this life is permanent. Eventually, your life will end and everything you know about this world must be left in the hands of the generations that come after you. Do your best to forgive anyone who has harmed you and relinquish your control over other people, society, and the future. The best thing you can do is to guide them and bless them in whatever way you can without any attachment to the outcome.
Sometimes, people speak in negative terms about the “graying” of society. This is the trend for people to live longer that results in more older people relative to the number of young people. Studies have found that the negative impact of that is exaggerated and that we can make choices, such as encouraging older people to remain productive, that establish balance.
Most importantly, you can determine that you will be a person that has a positive influence on people around you and on the world as a whole, regardless of your age. Really, leaving the world a better place is the ultimate legacy anyone can leave. We can all do that if we choose.
 Netburn D. The aging paradox: The older we get, the happier we are. Los Angeles Times. Published online August 24, 2016. Accessed February 19, 2021. httpss://www.latimes.com/science/sciencenow/la-sci-sn-older-people-happier-20160824-snap-story.html
 Sabau E, Niculescu G, Gevat C, Lupu E. The attitude of the elderly persons towards health-related physical activities. Procedia – Social and Behavioral Sciences. 2011;30:1913-1919. doi:10.1016/j.sbspro.2011.10.372. Accessed February 19, 2021. httpss://www.sciencedirect.com/science/article/pii/S1877042811021975
 Andrews RM, Tan EJ, Varma VR, Rebok GW, Romani WA, Seeman TE, Gruenewald TL, Tanner EK, Carlson MC. Positive aging expectations are associated with physical activity among urban-dwelling older adults. Accessed February 19, 2021.The Gerontologist. 2017;57(suppl_2):S178–S186. doi:10.1093/geront/gnx060. httpss://academic.oup.com/gerontologist/article/57/suppl_2/S178/3913377 Accessed February 19, 2021.
 Siebert JS, Wahl H-W, Degen C, Schröder J. Attitude toward own aging as a risk factor for cognitive disorder in old age: 12-year evidence from the ILSE study. Psychology and Aging. 2018; Volume 33(3):461–472. doi:10.1037/pag0000252. httpss://psycnet.apa.org/record/2018-21485-007 Accessed February 19, 2021.
 Trafton A. The rise and fall of cognitive skills. MIT News. Published online March 6, 2015. Accessed February 19, 2021. httpss://news.mit.edu/2015/brain-peaks-at-different-ages-0306
 Perera A. Fluid vs crystallized intelligence. Simply Psychology. Published online December 14, 2020. Accessed February 19, 2021. httpss://www.simplypsychology.org/fluid-crystallized-intelligence.html
 Ananthaswamy A. The wisdom of the aging brain. Nautilus. Published online May 12, 2016. Accessed February 19, 2021. httpss://nautil.us/issue/36/aging/the-wisdom-of-the-aging-brain
 Ruiz-Torres A, Beier W. On maximum human life span: interdisciplinary approach about its limits. Adv Gerontol. 2005;16:14-20. httpss://pubmed.ncbi.nlm.nih.gov/16075672/ Accessed February 19, 2021.
 Kooij D, Zacher H. Why and when do learning goal orientation and attitude decrease with aging? The role of perceived remaining time and work centrality. Journal of Social Issues. 2016;72(1):146-168. doi:10.1111/josi.12160. httpss://spssi.onlinelibrary.wiley.com/doi/abs/10.1111/josi.12160 Accessed February 19, 2021.
 International Institute for Applied Systems Analysis. Effects of population aging have been exaggerated, new analysis suggests: More appropriate retirement ages?. ScienceDaily. Published online September 10, 2010. Accessed February 18, 2021. httpss://www.sciencedaily.com/releases/2010/09/100909141523.htm
Financial Disclosure: Contents of this post are related to, but not quoted from, Ilchi Lee’s book, I’ve Decided to Live 120 Years: The Ancient Secret to Longevity, Vitality, and Life Transformation***. This book also served as the basis of a prior post on TDWI, These 8 Life-Changing Tips Will Help You Age Well.
This is a story about color. More specifically, it is the history of two particular colors: purple and blue. I think you will find it fascinating. But first, let’s start our journey with a story of what piqued my interest in the topic.
A few years ago, when my wife and I were traveling in Peru, we visited the village of Chinchero, high in the Andes. We stumbled on a weaving shop where you learned how the area’s alluring textiles were made.
We stood, watching five squatting Quechua Indian women. They were artists, weaving Andean llama, alpaca, and vicuña wool into dazzling fabrics famous for their vivid hues and striking designs.
As I watched them work their magic, I wondered, where did these vibrant pigments come from? We drew closer to see the details. The women placed a small heap of grayscale insects, called cochineal (pronounced co-chee-kneel), they had collected by hand from prickly pear cacti. One woman crushed the pile of insects with a pestle. Another poured some wood ashes on their pulverized bodies.
We gasped – the ashen powder turned red, then red-purple, and finally a radiant blue-purple.I closed my eyes, recalling the wonder I felt in elementary school when the teacher demonstrated the litmus test. We had just witnessed an elaborate experiment carried out not by chemists in their laboratory but by people who are one with their environment and are living its most intimate secrets. Whether they understood the molecular basis of the change, as laboratory chemists would, was irrelevant.
As my kids would say: AWESOME! Envision the Quechua learning that these insects produce color. Crushing one of them between your fingers stains them a bright red. The bodies of the dried female insects contain 12-16% carminic acid which is a vivid shade of crimson.
But, how did they learn to combine different additives to the crushed dried bodies of these insects in order to create different shades of the original color? They likely experimented, as scientists do in their laboratories.
Wood ash and other alkaline substances increase the pH of the mixture to create purple. Small amounts of iron can also be used to transform the red to purple. Adding an acid, such as lemon juice, produces a bright scarlet. This brings me back to my wonder when I learned of the litmus test.
The dye was called Tyrian Purple, after the Phoenician port city of Tyre. They also extracted another dye, Royal Blue, from a closely related species.
As we’ll see later, the process of getting the blue dye was not straightforward and was very laborious. Couldn’t the ancients find an easier way to get blue?
As Baruch Sterman, a physicist in Israel, explains that our eyes can only see an object as blue when it absorbs red light. This is something few naturally occurring materials do.
Stones and plants were among the handful of naturally occurring blue materials in ancient times, including:
Ground-up lapis lazuli can be used to make paint, but not to dye textiles. Sadly, while indigo and woad dye fabric, they eventually fade.
Part of what made murex dye so valuable was that its colors remain brilliant. For example, 2,000-year-old pieces of murex-dyed wool found in caves near the Dead Sea are still vibrant today [REF]. Unlike the Andean women we observed in Chinchero, there are no Phoenicians around to explain how they did it.
An article in the journal, Archeology, describes new evidence of a robust dye industry that endured on the Mediterranean coast for millennia. A dig in Tel Shikmona, south of the city of Haifa in Israel, yielded dozens of pottery vessels and shards covered with purple and blue stains. They also unearthed industrial pools and mounds of murex shells.
Some aspects of the process of dye-making are currently unknown. However, we do know that it involved breaking open sea snail shells, removing the hypobranchial gland, and harvesting the clear fluid inside. In a process that took several days, this liquid was then heated and dissolved in an alkaline solution believed to have been made from urine or certain plants. This eventually produced a yellow fluid, into which yarn was dipped. Upon being exposed to light or oxygen, the yarn turned a rich shade of purple.
Extraction was tedious and inefficient. Thousands of Murex shells were required to dye just one Roman toga. The Phoenicians demanded a very high price for these precious goods. Their fabulous profits led to resentment. They were considered gougers and thieves. However, we now know that the traders were simply reacting to the reality of supply and demand. They had, after all, cornered the market.
Because the purple stuff was so expensive, only kings and emperors could afford it. They allowed senators to have togas with a stripe of purple, but that was it. Commoners could only wear white, or earth tones like brown or green.
In fact, sumptuary laws were passed that regulated who could wear what. These laws were ostensibly designed to avoid conspicuous consumption. In reality, they fixed the demarcation between the aristocracy and the rest of us (assuming, dear reader, that you are not an aristocrat).
As a consequence (not completely unintended), these laws limited the demand for these sumptuous dresses, keeping the price more affordable for the nobles, and away from the hoi polloi.
After the sack of Constantinople in 1204 by the crusaders whose stated mission was to liberate Jerusalem, rather than the reality of plundering the capital of the Christian Byzantine Empire, the impoverished Byzantine emperors could not afford the glorious purple dye anymore.
Later, medieval kings and fabulously rich Popes (who weren’t sworn to poverty at the start of their ecclesiastical careers) adorned themselves with Tyrian purple dresses.
The Church also controlled the message by paying its favorite artists de jour quite handsomely to tell the stories of the Bible through art. So only the artists close to the trough could afford the brilliant purple dye. And the message? Only the VIPs, such as Jesus, Mary, and some favorite kings merited Tyrian Purple.
And so it went until the 18th century and the Age of Enlightenment when liberal and democratic ideals swept away the symbols of Church and State hierarchy. About this time, chemistry began producing brilliant pigments affordable by the new middle class.
More articles from the author:
The Fascinating History of the Color Red
Science Shines a Light on the Evolution of Music and Language
While you may not remember all of the details of the Iliad and the Odyssey, you may recall Homer’s enigmatic description of the “wine-red sea.” Wine-red? Has anybody ever seen the sea in anything even remotely resembling this color?
Could the famous blue of the Aegean Sea, where the Homeric events took place, ever be other than brilliant blue? Literary scholars struggled mightily with this strange depiction. Some attempts were so convoluted as to be laughable, but none were persuasive.
To compound the mystery, the colors red, black, and white are mentioned many times in the ancient manuscripts. In the later ones, such as the Bible and the Koran, green and yellow are mentioned as well. In fact, biblical red is described in many of its hues (“argaman”—dark red, just like Homer’s sea, “shani”-pink, “siqrah”-deep red). And so is green: olive green, grass green.
But not a hint of blue.
William Gladstone, a famous British prime minister at the beginning of the 20th century, was a classical scholar. He published a 1700-page study of Homer’s epic poetry. In a 30-page chapter, he describes Homer’s strange choice of colors – sheep wool and ox skin as purple, honey as green, horses and lions as red. The sky is studded with stars, wide, having an iron or copper hues. Not one mention of blue.
Scientists believe that the historical mislabeling of colors (by today’s standards) is not just a simple case of nomenclature. When we get used to seeing two hues as different colors, language trains us to see them as different entities. And the brain then exaggerates these differences, especially at the border areas between them.
Everyone is a bit different in how they perceive and call out the name of colors. I see red in many hues – dark red or light red. My wife sees peach and orange and strawberry as distinct colors
Blue, which we perceive as lighter and totally distinct from black, is in reality probably a bit darker and closer to black. The “obvious” distinction between black and blue is a figment of our imagination. Modern neurobiological research provides ample evidence for that.
The evolutionary explanation is quite straightforward: Ancient humans had to distinguish between night and day. Red is important for recognizing blood and danger. Even today, the color red causes an increase in skin galvanic response, which is a sign of tension, and alarm.
Green and yellow entered the vocabulary as the need to distinguish ripe fruit from unripe, grasses that are green from grasses that are wilting, etc. What is the need for naming the color blue? Blue fruits are not very common and the color of the sky is not vital for survival.
Stay with me. First, here is a totally unexpected phenomenon: language influencing brain function. But even more fascinating is the realization that the way we see the world is somewhat of an illusion. It is a product of a trick played on us by none other than our own brain.
This brings us full circle to the ancient Greeks and Plato’s allegory of the cave. He posited that reality is an illusion. It is like the shadows of cave dwellers cast on the walls of a cave by a fire at the cave’s opening. We, standing outside the cave, see the shadows only, not the real occupants.
Reality, as we see it, is illusory.
With the democratizing effect of chemistry-for-the-masses came another revolution: the Biology Revolution. It was an exhilarating time for people curious about the inner workings of living things:
Now they could visualize exactly how the heart muscle is organized, how one lymphocyte type differs from another, and how neurons are organized in the brain.
As important as this pigment revolution was, it had a major shortcoming. It only showed the cells as static objects. In biology, nothing is static. Cells move within tissues and all around the body. Inside the cells, there is a constant flow of proteins and organelles performing their duties.
For many years, researchers could only speculate on what’s happening inside the cell, based on visual cues. But then a quantum jump occurred in the development of pigments that made tracking of cell components inside the cell possible.
The discovery of green fluorescent protein (GFP) in jellyfish spawned such an impressive revolution in cell biology and medicine that its discoverers, Martin Chalfie, Osamu Shimomura, and Roger Y. Tsien were awarded the Nobel Prize in Physiology and Medicine in 2008.
Here are some short quotes from the Nobel committee:
“To obtain such knowledge (of the dynamic behavior of cells), new experimental and conceptual tools were required. Now, at the beginning of the 21st century, we are witnessing the rapid development of such tools based on the green fluorescent protein (GFP) from the jellyfish Aequorea victoria, its siblings from other organisms, and engineered variants of members of the “GFP family” of proteins.
Indeed, no other recent discovery has had such a large impact on how experiments are carried out and interpreted in the biological sciences, as witnessed by the appearance of more than 20,000 publications involving GFP since 1992”.
To close the loop, a paper published in the May 2008 issue of Genetics announced the discovery of a new Purple Fluorescent Protein. Now we can track simultaneously many proteins and organelles as they course through the cell. Some stain green, some blue, some red, and yes –some stain a brilliant, majestic purple – a ballet in astounding colors.
At the time of the discovery of YInMin blue, it had been more than 200 years since a new inorganic blue pigment was created. The last being the discovery of cobalt blue in 1802. Oregon State University materials science professor, Mas Subramanian, inadvertently created it while searching for inorganic materials that could be used for electronic devices.
He put a sample containing manganese, yttrium, and indium (thus the name) in a very hot furnace (more than 2,300 degrees Fahrenheit) and was surprised to find it turned a “brilliant, very intense blue.” Dr. Subramanian noted that this color was a “true” blue as opposed to many blues in nature that appear blue because of the way they reflect light.
Also, because it is chemically derived as opposed to being an organic plant-based dye, this intense blue color should remain stable over time. This blue already has widespread applications in a number of industries, including commercial paints for buildings, fashion, art, and even cosmetics.
The history of the colors purple and blue goes beyond amazing. It is a metaphor for the eternal struggle between the haves and have-nots. Originally the pigment was so expensive so as to only be afforded by kings, emperors, and the church hierarchy.
These powerful people passed laws ostensibly to prevent conspicuous consumption. In reality, these sumptuary laws were designed to restrict competition for the pigment. Thus, ensuring lower prices for themselves.
With the dawning of the enlightenment and the empirical science of chemistry that it gave birth to, the pigment purple became affordable to the masses. These dual triumphs of democratization and the flourishing of technology resulted in the totally unforeseen explosion of knowledge applied to the understanding of our biology and the development of modern medicine.
First published 5/5/11.
As in other periods in our history, ours is a battleground between two basic views of statecraft: 1) the liberal view of social change for the good of the people and 2) the conservative belief that any “social engineering” is doomed to failure at best and is tyrannical at worst.
Our present-day heated, even venomous arguments, are nothing new. Abraham Lincoln, not a rabid Socialist, had to contend with the reactionary Democratic Party of his time. It was called the “know nothing” party. It was true to its name.
Teddy Roosevelt (TR) fought the big money interests of his time. He also planted the seeds of the progressive movement. His fifth cousin Franklin Delano (FDR) gave us the “New Deal”, a social experiment of profound dimensions. And Lyndon Johnson completed the work of Lincoln, TR, and FDR with his much underappreciated “War on Poverty”.
This seemingly inexorable process of progressivism was punctuated with conservative backlash. The most profound was initiated by Ronald Reagan whose worldview could be summed up by his own pithy phrase from his 1981 Inaugural address:
“Government is the problem, not the solution.”
This conservative trend continued during George Bush’s two terms and assumed its most extreme form in the Libertarian ideology of Ron Paul. A stance that is perpetuated by his son, Senator Rand Paul.
This was followed by two terms of the progressive, Barack Obama. In addition to digging us out of the economic mess left by the preceding president, he also was able to get the Affordable Care Act signed into law. Although it fell short of the universal coverage that many progressives hoped for, it did significantly increase coverage, particularly in the left-leaning states that expanded Medicaid.
And, then came Republican Donald Trump who has spent his first term trying to undo everything that Obama had put into place. True to his promise, he slashed taxes primarily benefiting corporations and the rich. He also implemented severely restrictive immigration policies.
Other articles by this author:
The Unfortunate Consequences of Disbelieving in Free Will
What is the Science Behind the Spread of Fake News?
However, His biggest coup when it comes to conservative social policy may come on November 10, 2020. This is when the newly lopsided Supreme Court votes on whether The ACA is constitutional or not.
So, who’s right?
An important book by Timothy Wilson, Redirect: The Surprising New Science of Psychological Change, reviews the track record of “social change through policy”.
Wilson is a social psychologist at the University of Virginia who has made groundbreaking discoveries in the study of intuition and introspection. Who better to judge whether intuition and ideology are sufficient? Although written in 2011, it is still quite relevant today. In fact, it is an eye-opener.
Equally important to read is a review of Wilson’s book in Science Magazine that was written by Geoffrey L. Cohen of Stanford University’s Departments of Education and Psychology. It appeared shortly after the book was published.
Here is what he said,
“When the father of the field, German refugee Kurt Lewin, conducted his seminal studies, the problems of World War II preoccupied him:
At the heart of Lewin’s approach rested a novel idea: social problems are amenable to experimentation. ‘The best way to understand something is to try to change it,’ he was fond of saying. Beyond descriptive and correlational studies, Lewin championed experimental manipulation: Introduce an exogenous shock to the system and see how it responds.”
Cohen goes on to say,
“Lewin also advocated a diagnosis stage in what he dubbed ‘action research’. First, assess the relationships among variables in a system. In doing so, one could identify the pressure points where a small nudge might have large consequences.
For example, to encourage families to eat cheap-cut meats like sweetbreads during the war (because the finer cuts had limited supply), Lewin showed the importance of the gatekeeper, the person who controls the behavioral channel—in this case, the housewife.
He also demonstrated the impotence of persuasion and the power of the small group. Bring housewives together into a new group supportive of change, freeing them from the grip of their old familial norms, and they would try the novel foods far more frequently than if they were lectured to.
Time and again, Lewin showed that what often seem problems of bad attitudes, lack of information or economic incentives were instead problems of group influence, identity, and social perception.
But most revolutionary was Lewin’s method. There was a combination of optimism and folly in the idea that researchers could, through the experimental method, change reality, and improve social conditions for the better.”
In Redirect: The Surprising New Science of Psychological Change, Timothy Wilson reviews much of this history and revisits the field of social psychology 70 years after Lewin’s pioneering work.
To summarize his findings from this extensive review, it becomes clear that policies based on ideology and intuition are almost always doomed to failure. On the other hand, policies based on controlled studies—employing the best techniques science provides—have an infinitely better chance to succeed.
Such studies start with a limited population sample. Once proven effective, they are scaled up to larger and larger populations. Fortunately, our thousands of municipalities, tens of thousands of school districts, and 50 culturally-diverse states offer an enormous laboratory for such social experiments.
Interventions that defuse blacks’ and whites’ fear of interracial rejection increase their likelihood of becoming friends. And reminiscent of Lewin, there are studies that cleverly manipulate social norms to reduce teen alcohol use and encourage energy conservation.
Now let’s consider the “ideologically-based” policies, such as, for instance, the “ownership society” of George Bush. The idea was basically quintessential conservative:
Give people property and they’ll become conservative. This is because they now have something to lose. Hopefully, they start voting Republican—a not-so-fringe benefit of the policy’s advocates.
The catastrophic failure of this policy is still reverberating through our economy today and will, I believe, continue to do so for many years to come.
Cohen, the Stanford scientist, concludes:
“Wilson wants society to adopt more of an experimental approach to solving social problems—putting interventions to the test with randomized controlled trials. This is a good idea, at least when the ambition is to disseminate the interventions widely. However, one problem that “Redirect” does not explicitly address concerns limitations in the experimental method itself.
There is nothing better than an experiment for testing causality, whether an intervention A affects a social problem B. However, a positive experimental result risks deluding us into believing that A is both necessary and sufficient to solve B.
But as Lewin taught us, the effect of A will depend on the context into which it is introduced—the preexisting system of variables. Encourage students to see their academic fates as within their own control and they will thrive., provided on inhabiting a classroom that provides them with opportunities for growth, such as committed teachers and quality instruction.
Many of the interventions Wilson reviews act like catalysts. They will not teach a student who cannot spell to spell, but they will encourage the student to seize opportunities to learn how. Because the effects of interventions are context-dependent, there will be no silver bullets.”
Wilson compellingly argues that effective interventions validated by social-science research are rarely implemented. This is a problem. Why are such interventions ignored in favor of ideology and intuition? What can we do to prevent this? What interventions should we be implementing today?
Richard Thaler is an economist at the University of Chicago and Cass Sunstein is a professor of law at Harvard Law School. These professors, both with an unimpeachable conservative (in the academic sense of the word) track record, did something unique in our ideology-soaked political environment: They looked at the science.
Specifically, they examined the field of behavioral economics as developed by Daniel Kahneman and his colleagues. And in doing so, they arrived at a surprising conclusion:
When based on science, both a conservative and a liberal approach to social policy can be married.
In their book, Nudge: Improving Decisions About Health, Wealth, and Happiness, Thaler and Sunstein state:
“The libertarian aspect of our strategies lies in the straightforward insistence that, in general, people should be free to do what they like and to opt-out of undesirable arrangements if they want to do so. On the other hand, ‘it is legitimate for choice architects to try to influence people’s behavior in order to make their lives longer, healthier, and better.'”
They dubbed this theory Libertarian Paternalism, somewhat of a dissonant contradiction to my ears. Their argument is that you don’t have to compel people to do what’s good for them, rather you can nudge them toward it. For example:
You get the picture.
How such an approach would fare with anti-maskers and anti-vaxxers who detest wearing their facial covering or getting their children vaccinated against deadly diseases, is left unanswered.
I suspect that part of the answer will not be wholly acceptable to “libertarian paternalists” a la Thaler and Sunstein; let’s call it “soft coercion”.
Take, as an example, smoking cessation. The science is unequivocal: smoking cigarettes is deadly!
But libertarian ideology says that as a free society we should be free to smoke and if it kills us, well, that was our choice. This argument totally ignores the societal harm done by smoking, such as:
So how did we, as a society that lives in reality rather than in an ideological ivory tower, deal with it? We followed the science and banished smokers from all spaces where people congregate. Further, we limited them smoking to circumscribed spaces (smoking rooms, outside of their office building) that were not always very inviting.
We raised the prices of cigarettes to make them less affordable. We forced cigarette manufacturers to label their products with prominently warning labels. We even made them pay the cost of anti-smoking public service announcements.
This approach did not outright ban smoking, acknowledging our society’s libertarian streak, rather it nudged smokers into quitting this harmful habit.
So when it comes to dealing with the ideological anti-vaxxers school districts may face funding penalties for not mandating children’s immunization. To deal with the anti-maskers, companies could become legally liable if they do not mandate wearing a mask at work.
Does this tactic sound too coercive? I suggest it is a middle ground between mandates and laissez-faire, between liberal and conservative approaches. And, it was demonstrated to be successful in dealing with the man-made cigarette pandemic that afflicted the world.
I believe that, just as with the smoking problem, at the end of the day we will be forced to acknowledge science and abandon intuition and ideology.
It gives me hope that examined dispassionately through the lens of scientific evidence such seemingly irreconcilable ideologies as Libertarianism and Liberalism can rise above the ideological cacophony and give us enlightened policymaking.
Is it too much to ask?
In the current environment, probably.
Published 12/28/11. Updated and republished 6/16/17. Updated and republished again 11/2/20 because of the remarkable relevance of the arguments to today’s political environment. We hope it adds to the much-needed conversation about U.S. policy approaches.
A few years ago, I was treated to shocking news. One of my own relatives voted for Donald Trump! To protect his identity, I will call him “Z.” What’s so shocking about it, you might ask? It’s because I know that he believes in science. I wondered how on earth can you vote for Trump if you believe in science.
I thought I knew this young man. I have been in his life since his infancy. He has a great disposition and a good sense of humor. He is always optimistic, low-key, and level-headed.
He is also a great husband and father. He believes in education and made sacrifices so his children could attend college. Further, he is an executive in his company where he has to make judgments based on hard facts. In short, he’s a normal guy just like you and me.
And, as I’ve already said, he believes in science. So how could he vote for a president whose relationship with facts and the truth is so tenuous, to put it mildly?
Even more puzzling is that he still supported him even after Trump denounced climate change as a Chinese hoax? At the time, he lived in a state that was hit hard by a terribly angry Mother Nature, for heaven’s sake!
I have watched the crowds in Trump’s rallies with a mixture of fascination and horror. Why the horror? Because sometime after the 2016 election, I visited a museum in Nuremberg, Germany with the apt, though deceptively antiseptic, name: “The Documentation Center”. The displays in the museum documented, in minute detail, the rise and fall of the Nazi Party.
Although I am not comparing our president to Hitler, the film clips of the huge crowds in the Nazi rallies enthusiastically cheering every utterance of the Führer bore a chilling resemblance to what we witness when we watch the Trump campaign rallies on television.
The hateful chants of “lock her up”, the dog-whistle references to Latinos and Blacks, and the thuggish response to their leader’s incitement against the press are all eerily reminiscent of the German mobs lusting after the blood of Jews, journalists, academics, “degenerate” artists, and intellectuals in general.
What causes our American brethren to fall into this odious state of frenzy? Honestly, I am stumped. You can’t paint them with a broad brush as racists. After all, many of them voted for Barrack Obama.
And, they are not all religious fanatics. In fact, I doubt that most of them even go to church. Further, you can’t dismiss them with the euphemism of “low information” because many of them are college graduates, business owners, lawyers, and engineers. Some are even college professors.
So is the common denominator of all these people? What draws them to these events? Of all the myriad theories, spun by psychologists, pundits, and “strategic advisers”(whoever asked those strategists to “strategize”?), none sound convincing to me.
An article in Scientific American Mind titled “How Trump Won” by Stephen D. Reicher and S. Alexander Haslam made a light bulb go off in my head. Notably, the authors are both non-Americans.
Reicher is a professor of psychology at the University of St. Andrews in Scotland. And, Aslam is a professor of social and organizational psychology and Australian Laureate Fellow at the University of Queensland.
This is interesting because it allows them to examine the evidence more dispassionately than people from America. Given the intensity of emotions surrounding this presidency, I believe it is almost impossible for an American to maintain a purely clinical disinterest. I know I can’t.
Of course! How could I miss it? That’s exactly what I felt watching the German crowds shouting their Aryan superiority and their hatred of anybody who is not.
If the Trump rhetoric strikes you as retrogressive, even reactionary, here is the reason. This is tribalism in its purest and most malignant form. Anybody who doesn’t belong to the white Anglo-Saxon tribe has no business living here. In fact, if the lady doth protest too much, she may have no right to live, as events in Charlottesville grimly demonstrated.
Or as a Trump supporter once put it to Katy Tur, the MSNBC journalist who covered his 2016 campaign, “he saw us.” The rest of us were simply oblivious to their existence. I can imagine their feelings of insult and rage. Never mind that this new Messiah of the unheard and unseen descended from his golden Trump tower to enthrall West Virginians with promises that he would send the black-lung-afflicted back to the coal mines. His admirers were not looking for a message of hope—they wanted revenge.
Sorry, Hillary, your comprehensive analysis misses the mark: That’s what really happened.
It’s an astute analysis and even sounds right. Except that Z, the subject of our case study, doesn’t fit in.
None of the theories that I read or heard explain this particular individual’s steadfast support for this bizarre president.
He is not filled with hatred against anybody who doesn’t look like him. He does not fit economically on the “categorical grid” of most Trump supporters. And, I don’t think he is the type to go to any rally, let alone a frenzied Trump rally.
To tell the truth, Z and people like him stump me. I don’t think there is an easy explanation. So, when we don’t have an answer to a difficult question what we do – and what I’ll do here – is to provide a non-answer that sounds credible.
Related content: Conservative vs. Liberal Views of Social Change. Who’s Right?
What makes people join cults is a problem that has occupied many a psychologist and sociologist. Many answers have been proposed, none all-encompassing or persuasive, but yet here we are: People join cults.
How can they keep believing in false prophets who predict that on a date certain the world will come to an end? And to believe so fervently that they sell all of their belongings. Or, as in the case of the Jonestown massacre, even willingly die for their dear leader?
Remember Trump’s infamous quote that he could kill somebody on Fifth Avenue in broad daylight and his fans will stick with him? He was (and is) probably right.
King David (Ecclesiastes 1:9) said it best:
The thing that hath been, it is that which shall be. and that which is done is that which shall be done. and there is no new thing under the sun.
Yes, King David, there is nothing new here. We’ve seen this phenomenon before.
Since antiquity, there have been all sorts of cults, the members of which were not always “low information.” On the contrary, many were highly intelligent, articulate, and even deep thinkers. But they followed a leader, a messiah, a guru, a holy man—all who eventually revealed in time not to be who or what they pretended to be.
But we don’t have to dig into the distant past to find examples of brilliant people who believe deeply in things that seem antithetical to the scientific evidence. For example, Dr. Francis Collins was the head of the Human Genome Project. He is also a devout Catholic. I wonder, does he square Catholic dogma of the creation with evolution and natural selection? Why doesn’t he suffer from a severe case of irreconcilable cognitive dissonance?
I also know a geologist who is an expert on the Cambrian explosion (an explosion of new animal species approximately 541 million years ago). He is also a born-again Christian. As such, he believes in the biblical story of the creation of the world that is said to have occurred less than 10,000 years ago.
He is not alone: 37% of Americans believe in Creationism. Coming to think of it, this is also approximately the same number as the percentage of rock-solid Trump supporters until very recently. Coincidence? Is this the size of the cult? If so, pretty disheartening.
But, we still didn’t answer the original question:
What compels otherwise rational, educated, loving, even compassionate people to believe in an obviously psychologically-impaired con man?
Personally, I don’t think we ever will:
With respect to the cultists among Trump’s ardent followers, who in my opinion are the majority, there is very little that can be done. Their “mind” is made up, and no amount of fact-based reasoning will change it.
For a while, I thought that talking to Z and people I know who think like him. I wanted to tell them that science has predicted everything that is unfolding every day right in front of our eyes. I hoped I could miraculously help them to see the light, so to speak. But boy, was I wrong!
Dan Kahan and his colleagues from Yale, Temple University, and George Washington University conducted a study to test whether the public knows too little of science to understand the evidence and avoid being misled.
In short, they found no support for this hypothesis. People with the highest degrees of science literacy and technical reasoning capacity were not the most concerned about climate change. Rather, they were the ones amongst whom cultural polarization was greatest!
How to explain this astonishing observation? The authors suggest it stems from a conflict of interest between the following two perspectives:
Put another way They, like most people, do understand the primacy of scientific facts in ordering our personal and public life. However, a more primal imperative usually wins out—that of tribalism.
If being an avowed Trumpian means denying climate change or proclaiming the pandemic a hoax, then so be it. How naive of me to think that if I could only show them the evidence, they would change their minds.
So what should I do about my wayward relative, Z? Probably nothing. I will never be able to comprehend the puzzle of his choice. So, I’ll just accept him and love him as he is, warts and all. And, hopefully, he will do the same for me. After all, none amongst us is perfect.
Related content: Election Day Reminder to Vote Like Your Life Depends On it
About a week after the original blog post was published, I heard from family members who are very close to Z. These are people who really know him.
Unfortunately, the picture is not as pretty as I painted it. They told me the guy is actually control freak and a bully to his family and employees.
Needless to say, I was disappointed to learn this. But at least the puzzle I posited at the top of the blog is no more: the guy fits the mold of the Trump tribe.
This was first published on 9/24/2017 less than a year after Trump took office. It is, unfortunately still relevant in 2020 just a few short months away from the 2020 election.
The COVID-19 pandemic has placed a tremendous strain on the mental health of our frontline healthcare workers. Not only are they working long hours under extremely stressful circumstances, but many of their patients are dying despite heroic efforts to save them.
In addition, many live in fear that they might contract and transmit the disease to their family and friends. This has led some workers to isolate themselves from loved ones, adding grief and loneliness to their distress.
A recent study published in JAMA Psychiatry illustrates how great the impact on frontline healthcare workers’ mental health can be. The authors surveyed 1,257 health workers at 34 hospitals in China using several different validated instruments, including the Chinese versions of the following:
They found many reported mental health symptoms as follows:
Nurses, women, frontline health workers, and those working in the epicenter of the outbreak, Wuhan, had more severe symptoms than those with other characteristics. For example, frontline workers “engaged in direct diagnosis, treatment, and care of patients with COVID-19” had a higher risk of depression, anxiety, insomnia, and distress compared to workers who were not doing these activities. They concluded that mental health interventions need to be implemented immediately with a special focus of women, nurses, and frontline workers.[i].
For some people working in health care systems, the symptoms of stress will subside with the crisis. However, others will need additional help to restore their mental health.
The figure below illustrates how mental health issues for workers may persist long after the cases of viral infection have diminished. Many will be suffering some kind of mental health issues, including post-traumatic stress, symptoms of major depression, generalized anxiety, and substance use disorders.
So, what can healthcare workers do to ensure that they are prioritizing their mental health? Evidence-based self-care behaviors and activities that may help health workers cope with an often-chaotic environment should be readily available.
In fact, self-care tools should be considered an essential component of any healthcare system’s mental health plan for workers, including:
Healthcare system leaders throughout the country can help their employees deal with the current crisis and the aftermath of the pandemic by ramping up employee mental health and well-being plans now. In addition, they should be prepared to sustain that level of support for at least a year post-crisis.
For some, self-care practices may not be enough. Stress may be overwhelming for employees who are burned-out in their jobs or who were experiencing depression or anxiety before this crisis. For them, it may be a struggle to get through another day.
For this reason, mental health response plans should include support by mental health care professionals who can prescribe medications and other appropriate mental health support services, as needed.
It is crucial that employees self-advocate during this difficult time. However, it is also critical that leaders in the healthcare systems step up to ensure they are taking care of their own.
We often see health care workers as very self-reliant people who do not readily ask for help when it comes to their own well-being. To ensure that employees are getting the support they need, health care system leaders must encourage and normalize asking for help. It’s also essential that employees be able to ask for help anonymously so that they feel comfortable seeking support.
Plans should include training to recognize signs indicating when someone needs more than self-care support. Such symptoms might consist of irritability, insomnia, and cognitive mistakes. These symptoms will require creating a framework that helps match the right support to the correct mental health status.
Visible leadership is an integral part of any preparedness plan. The current impact and aftermath of the pandemic demand accurate, timely, and frequent communication by health care system leaders.
It also requires innovative ways for leaders to stay connected with their teams so that they can communicate their gratitude to workers and their support for employees and their families.
At the very least, health workers will appreciate a simple acknowledgment of how stressful their jobs are and details about the efforts underway to support them. Having open and honest conversations with each other as well as leaders in the system can help reduce anxiety.
While leadership may not be able to address all of the issues health care workers face, being part of the conversation is an important step.
Topics of discussion can include ways that workers can protect their family and loved ones. Examples include creating separate living spaces or providing stringent protocols that guide them on how to safely enter their homes after their shift (e.g., removing clothing and showering immediately).
It is also crucial to implement measures that take into account the following issues:
Are We Prepared for Increased Healthcare Needs Post-COVID-19?
The Phases of a Disaster: Are We Headed Towards Disillusionment?
Mental Health after a Disaster: Lessons from Katrina
How to Stay Healthy During the COVID Crisis
Health care system leaders who put in place a comprehensive mental health and well-being plan for their workers now through a one-year post-crisis phase can help employees recover and grow in their careers.
When workers know that leadership is being supportive professionally and personally, it can enhance performance. It will also make our healthcare systems more reliable, and resilient in the years ahead.
[i] Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. J.A.M.A. Netw Open. 2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229
“I swear to God, if you come any closer, I will kill you,” said the 30-something-year-old, arms as wide as bazookas, eyes as piercing as the very needles I was about to stick him with. I was working as a phlebotomist as I was preparing for medical school.
The patient was hooked up to IVs on every limb, had tubes coming out of his nose and going down his throat, but other than that, he was about as physically fit as anyone I’d ever seen.
Frightened, sweaty, and wide-eyed, I quickly looked at the nurse. I was hoping she’d tell me what to do next. All the nurses so far had been nice to me, so willing to help. But not this one.
With her SpongeBob SquarePants scrubs and neon pink crocs accompanied by a how the heck should I know? look, she shrugged and left the room.
“Umm, uh, Sir…” my voice cracked. “If you just let me do this, and I promise I’ll be quick, maybe you’ll get out of here sooner.”
I really had no idea if that was actually true, but it was generally my go-to line when patients were hesitant about me drawing their blood. I fumbled around my tackle box where I kept all my supplies and grabbed the tiniest needle I could find.
“Here, look at this thing. I promise you won’t feel it at all,” I said, now sweating bullets while trying to maintain my fake smile without giving away the fact that I was truly scared shitless.
“I haven’t gotten any sleep in three days,” he screamed. “And ya’ll keep coming in here sticking me like a pin cushion! And why the hell won’t the doctor come in and tell me what is going on?”
Of course, I had no answers for him, but I was relying on my calming personality to put him at ease. No such luck. This guy really didn’t want me to come near him.
Generally, I take these threats lightly because these patients are really sick and justifiably grumpy. After all, nobody in their right mind actually enjoys being in the hospital.
But, for some reason, I truly believed this man might hurt me had I gotten any closer. There was no need to try and test it.
As I began to walk out of the room and respect the patient’s wishes, I was stopped dead in my tracks by those hideous SpongeBob scrubs.
“This is a court-ordered draw. We need you to get it today.”
Crap. My third day by myself on the floors (I had been training for a few weeks prior) and I was already in danger of getting hurt.
After praying to whatever higher-order being would listen, I gathered myself and let out a deep breath. Then, I turned back around and pleaded with the patient, explaining to him what nobody else would. I told him to give me one chance. If I couldn’t get it right away, I promised I would leave and not come back.
After about five minutes of polite begging, he angrily gave in, probably because he wanted nothing more than to get back to bed. Thankfully, his veins were the size of pipelines. I could’ve drawn the blood blindfolded.
After I finished, I thanked the sick, disgruntled man and packed up. I looked at the clock—somehow that entire interaction took just ten minutes. It felt like hours. The sweat made me feel like it had been days but it was only 6:30 in the morning. My day was just getting started. Oh well, onto the next one.
As unbelievable as it may seem, I had been threatened, punched, and talked-down-to on a regular basis during my time as a phlebotomist. Further, I was sacrificing my precious summer sleep to wake up at 4:30 AM every morning while my friends were snoozing past noon.
However, the work has provided me an opportunity to meet patients from literally all walks of life even though a whopping zero percent of them were ever happy to see me.
At 18, I was the youngest person in my department by over 10 years. I could tell that the patients with their distrusting glares and their “you actually work here?” attitudes knew it. I once had a psychiatric patient twice my size rip the needle out of his median cubital vein and try to stab me with it.
I had many co-workers who were fired for getting angry with patients or just because they didn’t care about their job. One inexplicably hit a patient!
I was on my feet non-stop for eight hours a day drawing 50 specimens a shift. Ah, a day in the life of a fledgling phlebotomist…and I loved every minute of it.
I started working at Albany Medical Center at around the same time my mom had been suffering from complications after a very common medical procedure.
For the first time in her life, my seemingly untouchable mother had to be hospitalized, and nobody had any idea why. I would get off of my shift and immediately drive over to the nearby hospital where she was staying to check up on her, looking very official with my ID badge and light blue scrubs.
“Oh, honey, you look so good in your scrubs! How was your day today?” my mom would ask with a forced smile, fighting through horrific abdominal pain.
“It was good, Mom. I’m really starting to get the hang of it. I only missed two veins today!”
It was a perfect irony—my mother, frustrated and losing obscene amounts of blood at one hospital, and me, struggling to get any and all drops of blood into those stupid little vials at another.
I watched as phlebotomists and nurses helplessly tried to find her veins and cringed whenever they “missed”. Most of the time, no apologies were given.
Further, the phlebotomists were often the ones who got upset. It was as if it was the patient’s fault that they couldn’t handle their job.
There is nothing more infuriating than medical workers who don’t seem to care about their patients.
I had now seen both sides of the patient-phlebotomist exchange. It completely changed my outlook on those few irritated patients I had to put up with every day. Nobody wants to be in a hospital.
From then on, I didn’t get upset when patients grunted as I walked into their rooms. I tried to make a point of being kind, courteous, and efficient. It’s amazing what good manners and common courtesy can do for the extremely ill.
That first summer at Albany Med reignited my fire to go into medicine. Yeah, I was pretty sure it was what I wanted to do, even after suffering through the monotony of Organic Chemistry, Physics, and Biochemistry. But, for the first time in my life, I was absolutely sure about it.
After having my own sick patients to take care of, and especially after seeing one of the most important people in my life confined to a crappy hospital bed with even crappier service for almost a month, I knew that helping people at a hospital was exactly what I wanted, no, needed, to do.
Coming to medical school this past fall, I felt I was a fringe candidate. I had gotten decent grades throughout college, but nothing spectacular. I barely did any extracurriculars, hadn’t held any leadership positions, and my volunteer work was pretty sparse.
Where I felt I had a leg up, however, was my clinical experience. I mean, come on, what better way to acquire medical knowledge than to spend all school breaks in a hospital, seeing patients of every class, creed, and culture every day?
So when it came time to conduct our first patient interviews as medical students, I was shocked at how nervous I was. How was this possible? Prior to this, I had thousands of patient interactions under my belt—good ones, bad ones, and downright scary ones.
Maybe it was because I didn’t know this hospital at all and was lost with every turn. Perhaps in some gruesome way, I felt naked without my tackle box chock full of needles. Whatever it was, I felt like I had never even talked to a stranger before.
But with one quick flashback, I was no longer worried. For once, I wasn’t doing anything that could potentially cause the patient pain. I was pretty sure I wouldn’t be threatened before I could even introduce myself. After nervously knocking on the door and putting my shaky hand out to greet the smiling man, I was finally able to breathe.
This was going to be a breeze.
This essay was written by Connor when he was a 2nd-year medical student at Georgetown University School of Medicine. It was first posted on 07/09/12, it was updated on 09/03/17 and 6/24/20.
A while back, I listened to a fascinating interview on NPR with Paul Raeburn talking about science and fatherhood. He explored the topic in depth his book, Do Fathers Matter? What Science is Telling Us About the Parent We’ve Overlooked.
Here is a smorgasbord of amazing information served in the book:
One fascinating bit of data the author shared during the interview shines some light on our social attitudes, including us scientists. In his search of the science database, PubMed, for the term “motherhood”, Raeburn found over 200,000 citations, but for fatherhood, about 20,000. That’s a ratio of 10:1.
Does that mean the father is not considered as consequential to the baby’s well-being as the mother? I can already hear the cries of protest rising from the aggrieved fathers who view themselves as great dads. Yet, isn’t it curious that all the blurbs singing the book’s praises on the full-page ad in the magazine, Scientific American Mind (July/August, 2014), were written by women?
Science actually tells us quite a bit about fatherhood. An article in PNAS (Proceedings of the National Academy of Sciences) by Israeli scientists examined the brains of fathers (not to worry, they used imaging techniques). What they found is quite fascinating.
Before we delve into their findings, let’s deal with a methodological issue. How do you control for the presence of a mother in the triangle of baby/father/mother? Whatever you may find occurring in the father’s brain, it would be open to the criticism that “obviously, the mother’s influence is not accounted for.”
Well, the ingenious solution was to measure brain oxytocin and parenting behavior in 3 groups: primary caregiving mothers, secondary caregiving fathers, and primary caregiving homosexual fathers raising infants without maternal involvement.
The study revealed that parenting implemented a global “parental caregiving” neural network that was, by and large, consistent across parents. This “caregiving neural network” integrated the functioning of two systems.
This network includes subcortical and paralimbic structures associated with vigilance, salience, reward, and motivation.
The mentalizing network involves the frontopolar-medial-prefrontal and temporoparietal circuits of the brain. It is implicated in social understanding and cognitive empathy.
These two networks work in concert to imbue infant care with emotional salience, attune with the infant state, and plan adequate parenting.
Primary caregiving mothers showed greater activation in emotion-processing structures. However, secondary-caregiving fathers displayed greater activation in cortical circuits, associated with oxytocin and parenting.
Primary caregiving fathers (these are the homosexual fathers) exhibited high amygdala activation similar to primary caregiving mothers. They also showed high activation of the superior temporal sulcus (STS) comparable to secondary-caregiving fathers and functional connectivity between the amygdala and STS.
What functions does the STS serve? It is involved in the perception of where others are gazing (joint attention). Thus, it is important in determining where others’ emotions are being directed. It is also involved in the perception of biological motion (as opposed to the motion of inanimate matter).
In individuals without autism, the superior temporal sulcus also activates when hearing human voices. Among all fathers, time spent in direct childcare was linked with the degree of amygdala-STS connectivity. This dose-response relationship lends a great deal of validity to the finding.
The take-home lesson is that fathers’ brains are malleable, and the same neural pathways are activated in infant caregiving as those of mothers.
Most anthropoid primates (humans, chimpanzees, gorillas, baboons, gibbons) are slow to develop. Their offspring are mostly single births and the inter-birth intervals are long.
To maintain a stable population, parents must live long enough to sustain the serial production of a sufficient number of young to replace themselves while allowing for the death of offspring before they can reproduce.
A study published in PNAS looked into this issue. The results confirm what we knew all along. In species where the mother is the primary caregiver, she lives longer than the male. In species in which the males participate at least equally in offspring-rearing, they live as long as the female.
Additional reading: Why Your Teen is Out of His Mind
Human data from the Swedish population from three historical periods indicate a female survival advantage going back to 1780, the earliest records available.
The female advantage is evident throughout more than two centuries in spite of large differences in mortality rates. Similar female advantages were recorded in the earliest data from England and France in the 19th century.
A female survival advantage has also been found among adults in the Ache, a well-studied hunter-gatherer population living in the forests of eastern Paraguay. And, importantly, the female advantage has been present in most countries throughout the world in the 20th century.
These data strongly suggest that the survival advantage in human females has deep biological roots. Although human fathers have a significant role, human mothers generally bear the greater burden in caring for their offspring.
Before you grab the baby from mom’s arms in the vain hope of increasing your lifespan, consider these studies. One study showed that fathers reporting three or more hours of daily childcare had lower testosterone at follow-up compared with fathers not involved in care. I know, I know, it makes perfect evolutionary sense.
You don’t (or rather the mother doesn’t) want a horny father to beget (this is a biblical euphemism) a new baby while the present one needs so much care. Still, low testosterone is so…uncool.
Dr. Anna Manchin, an evolutionary anthropologist at Oxford University, shines a light on another aspect of the evolutionary advantage of the testosterone decline in newly minted dads. In an article in the NYT, she cites many studies showing a drop in testosterone levels just before and just after the birth of a man’s first child.
What causes this drop is not clear, but the hormonal and neurobiological consequences are evident. Lower testosterone means a higher ratio of estrogen/testosterone. That, in turn, leads to an increase in the bonding hormones oxytocin and dopamine.
It is noteworthy that the brain’s reward system releases dopamine. This is the same hormone and brain structure involved in addictive behaviors. The bottom line: men like it and are likely to repeat it.
There is a difference though between mother and father when it comes to the brain’s response to this hormonal change. An MRI study from Israel’s Bar Ilan University and Hebrew University showed an interesting structural difference between new moms and dads.
The researchers found increases in midbrain structures that are involved in care, nurturing, and risk avoidance in the moms’ brains. In dads, the increase is size and thickness occurred in the outside layer of the brain, or the neocortex. This is the part of the brain where conscious cognitive tasks reside, such as thought, goal orientation, planning and problem-solving. As the authors point out, evolution took care of both aspects of child-rearing.
If your worst fears of this evolutionary imperative are confirmed in another study titled, “Testicular volume is inversely correlated with nurturing-related brain activity in human fathers” I have a comforting reassurance: Your testicles are going to shrink when you take care of your baby. But don’t worry my fellow fathers, it’s not quite as bad as it sounds. The jewels regain their previous volume once the child-rearing period is over. And you are back to the races.
Happy Father’s Day!
This post was originally published Father’s Day, 2015. It is reviewed, updated, and republished every Father’s Day since. Enjoy!
We are living through different phases of a global disaster as the COVID-19 pandemic continues to wreak havoc on the entire world. In China in late 2019, a novel coronavirus, SARS-CoV-2, jumped species and found fertile ground in the human body. That unfortunate event has multiplied exponentially into hundreds of thousands of tragic deaths since then.
Communities locked down. Businesses were shut. People stayed at home. As a result, the economy came to a screeching halt. Millions of people became unemployed overnight adding financial insecurity to the widespread fear related to the spread of the contagion.
Because this is a new virus, new diagnostic and therapeutic and options are still being developed. And there is, as of yet, no vaccine to prevent the infection. All we have are human behaviors: social isolation, social distancing, hand washing, and wearing masks.
So not only have we had to take care of individuals often extremely ill because of the infection, but we have also had to keep an eye on the collective physical and mental health of our whole population.
Although it may seem like we have had to respond to this once in a generation disaster without a clear road map, we can actually learn what may lie ahead by studying existing literature on major disasters.
One useful lesson is the model by Zunin and Myers for the phases of disaster. Those phases are well-described and summarized in the following figure:
Graph Source: Graph from Samsha.gov. adapted from Zunin and Myers
The pre-disaster phase of the COVID-19 pandemic was characterized by fear and uncertainty. When the virus suddenly started killing people in the U.S., all we knew was that it had killed many people in China and that it spread very quickly. We didn’t even understand much about how it was transmitted – was it by droplets, aerosol, or touching contaminated surfaces?
Disasters with no warning, such as this one, can cause a variety of feelings of vulnerability, such as:
The duration of the pre-disaster phase varies depending on the type of disaster being experienced. It can be as short as hours, or even minutes, such as during a terrorist attack or an earthquake. Or it may be as many months-long such as occurs during hurricane season.
In the case of this pandemic, we have watched the disease move from China to Europe to the US over many months. And, we have witnessed the spread from the densely populated urban areas to less populated suburban and even rural areas as is occurring now.
According to the description of the model, disasters with a warning period, such as when the pandemic reached the U.S., “can cause guilt or self-blame for failure to heed the warnings.”
Looking back at the early days of the COVID outbreaks in our country, we can see that some of our early responses were driven by fear and uncertainty (buying large stores of toilet paper and hand sanitizer, for example). Early on it became clear that our response to the pandemic by local, state, and national governments has been inadequate to downright disastrous in places. Our leaders have vacillated between strict measures and easing up, between forthrightness and plain denial. Individuals also have varied in their responses – some self-isolating and others partying with abandon (think Spring Break in Florida). When these actions cause harm to self or others, guilt and self-blame are likely consequences.
The impact phase is usually the shortest of all of the disaster phases. It characterized by a range of quite intense emotional reactions depending on the specifics of the disaster. The psychological effects of a slow, less threatening disaster will be different from those brought on by a rapid, more dangerous disaster.
In the case of the COVID-19 pandemic, the spread has been very rapid in some places and slower in others. And, there have been mixed messages about how dangerous it is to different populations:
The model predicts that reactions in this phase “can range from shock to overt panic. Initial confusion and disbelief typically are followed by a focus on self-preservation and family protection. We’ve certainly seen a lot of that across the country as the cases mounted and many people sheltered in place even before such measures were announced.
We watched in awe as many people stepped forward, risking their lives, to honor their professions. This includes people who take care of critically ill hospitalized patients as well as patients in nursing homes (nurses, doctors, support staff, EMTs)
It also includes people whose work allowed the rest of us to stay at home. People who work in grocery stores, pharmacies, drive buses, and those who keep us safe (police, firefighters). All of these people. at various times, been honored as heroes of the pandemic.
We also witnessed many folks volunteering to help in any way that they can. For example, delivering groceries to elderly people. Donations also started pilling up. Here the model foretold: a sense of altruism, and many community members exhibit adrenaline-induced rescue behavior. As a result, risk assessment may be impaired.
This is the phase of community cohesion. Here the model says: dramatic shift in emotion. During the honeymoon phase, disaster assistance is readily available. Community bonding occurs. Optimism exists that everything will return to normal quickly. Again, we’ve seen this occur in many communities. Also, we have witnessed it, at times, in the rush to re-open social distancing before all conditions are in place (e.g., testing, effective treatment, capacity, and contact tracing).
So, if the model has been good at looking at the recent past, what does it say about the phases still to come? Here we have a warning sign as the next phase is the one marked by disillusionment.
The model warns of stark contrast to the honeymoon phase as “optimism turns to discouragement and stress continues to take a toll, negative reactions, such as physical exhaustion or substance use, may begin to surface. The increasing gap between need and assistance leads to feelings of abandonment.” It is possible that many communities in America – and around the world – are entering this phase right now.
As a psychiatrist, I want to share this with healthcare workers in general and other mental health workers, in particular. This is so that we remain vigilant and work together to support society, communities, and individuals during this time when hope for an early return to normal fades.
We must remain vigilant to help others as they lose faith. Each of us must look to our inner sources of strength and our outer sources of support to stay present for each other. We need to continue increasing the offerings of mental health support and expand its definition to be more inclusive to all working towards the greater good.
Now more than ever, mental health workers should use the tools of positive psychiatry, positive psychotherapy, and positive psychology, to support each other and the communities in need across the globe. It’s important that we work to foster a sense of community cohesion and avoid the danger of social collapse and despair.
Because we need to be prepared for the last phase: reconstruction.
We will have a lot to rebuild in America and this is yet another change to make things better and address injustice.
The model actually describes it beautifully: “Individuals and communities begin to assume responsibility for rebuilding their lives, and people adjust to a new “normal” while continuing to grieve losses.”
We must keep in mind the future and the opportunities to build a more equitable and prepared society for all. Learning the errors of the past, being here, and facing the challenges of the present, we should be offered another chance to build a new and better future after the storm.
One big crashing sound, the front of a truck beside me, broken glass in my lap, a big metal vee coming in over my lap, I remember thinking I am glad I am not fat or I would be cut in half. I knew what this was all about. There was never a moment that I didn’t know. I got hit by a truck. Seriously. I got hit by a truck. And, I survived to talk about it. Those few moments changed my life forever. It taught me the power of love.
You may think that I am going to tell you there was a lot of pain. There was. You may think that I am going to rail against the unfairness of it. I will not. You may wait for a wave of angry words. There won’t be any.
What I am going to tell you is that the power of love and goodness from strangers changed my life that day. It’s not that I meant to focus on it. It is something that happened automatically. I don’t know why. Here is what I do know. I saw a young man sobbing and crying out,
“I am so sorry I did this to you.”
A big burly EMT came into my front seat with me and held me in a loving embrace. He stroked my arm and said,
“You’ll be ok, baby girl. You’ll be ok.”
He held me as they put a big plastic sheet over us so that the Jaws of Life could give me a chance to live by pulling me out of the crushed metal.
I remember a policeman asking me who he could go and get for me. He took my purse, got in his car, and brought my neighbor.
My neighbor crawled into the car with me, kissed my cheek, and told me that she would take care of things. She said she would take care of my little dog, Jackpot. She said not to worry and I didn’t.
Just like that, these things happened. Just like that. I felt the goodness and love of other human beings over and over in those few minutes. I focused on it and I kept thinking about how lucky I was.
I am lucky that I can feel that love and accept it. And, lucky that I know what it means. It helped keep me alive during those moments. And still to this day, it keeps me going.
I was able to feel the power of the human spirit when I was weak and could no longer feel the strength of my own spirit.
Modern medicine is a powerful thing in our world. We are living longer than ever before. And if we pay attention and take care of our bodies, we have a chance to combine it with a healthy lifestyle.
We have more advantages than our ancestors. We are a rushed and busy society and sometimes forget that there are other things that make us unique. It is the power of others and how they affect us and strengthen us if we understand and embrace them.
People will come forward during tragedy or sorrow and offer themselves. They love and they give. They remember that they are human. And, they want to tell you that they know that you are human, too. They also want to let you know that they love you.
Friends are wonderful at giving, but a great many strangers will step forward seeking no reward or remembrance. They do it just to give something of themselves to strengthen you in your weakness. It happened to me.
Before this accident, I would have told you that I would have refused help. I would have said I was ok. But, this was serious and I was too weak to refuse help.
Instead, I opened my heart and my mind and accepted every single ray of light that shined on me that day. I believe that it helped to save my life.
After I got to the trauma center, they worked on me for four hours. Calls started coming in and word spread. Two people that I love waited for me in the waiting room.
My condition was listed as critical. Friends were told that I might not make it. I remember very little of it. But what I faintly do remember is loving hands, kind words, and encouragement.
My body was treated with respect. I was treated as if I were still there and conscious. I was barely conscious. But I focused on the goodness and not the terrible. I remember faintly thinking how lucky I was.
After it became apparent that I would live, help started pouring in. People came to me just to bring me a chapstick that I wanted. Or a candy bar.
I remember getting calls although I was just barely conscious when I took them – I remember being loved. It wasn’t love like the feeling of a feather fan. Rather, it was strength and power from others formed into the words of love and admiration. It was as if they were saying,
“Take this. I am stronger now. Take this. I love you.”
Amazingly, my own strength returned more quickly than anyone expected. There was very little the doctors could do for me because of the kinds of injuries I had. They would either heal or they would not. I had eight breaks in my ribs, a broken clavicle, a mild concussion, a collapsed lung, and a pelvis broken in four places. Within a few days, I sat up.
There were constant calls and visits with constant good wishes. There were also many tears. People willing to turn their lives upside down for me, strengthened me.
My brother shut down his life and flew to me within hours. He showed no intention of leaving. I kept thinking, “all this for ME?” I was shocked. The pain lessened. I healed at a rapid pace. The doctors scratched their heads.
I focused on my dog. I want to raise this little guy and see him into old age. When things got rough, I saw him in my mind’s eye.
Later, he was allowed in when I was in rehab. He brought happiness to a lot of defeated people as he came through the public areas into my room each day.
I thought how lucky I was to be able to bring joy to all these sad people. And, how lucky I was to have a little dog like this.
I felt love from every direction. Surprisingly, I got stronger faster than expected and I was not depressed.
The first week, I walked with a walker. The doctors scratched their heads. I am still broken but I am stronger and I never give up.
Being able to accept the outpouring of love and affection when I was injured changed me forever. It wasn’t the accident that changed me. It was seeing what the power of love can do when it is needed. And, also finding out how easily people will give it to you. I didn’t know. Or, I didn’t notice before.
Love isn’t everything. It is not a miracle drug. It is not always clear what it is. But, there are plenty of studies that indicate that if you are injured and you focus on what is being given to you by others, your chances of survival are better. You will heal faster. Your attitude will be better. I am living proof of that.
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First posted October 28, 2012, this story is being republished on 12/21/17 and again on 5/20/20 in order to share its message about the power of love with all of our readers, new and old, all around the world. Please share it widely.
Before I dive into the scientific evidence about whether optimism and pessimism impact health outcomes, let me tell you a short story. When I was a young medical student, I had the opportunity to trail Professor John Englebert (“Bert”) Dunphy on his evening rounds. He was at that time the widely admired and beloved Chairman of the Department of Surgery at the University of California San Francisco.
The good doctor always made a point of visiting his patients the evening before their scheduled surgery. During that visit, he would engage them in a conversation about their upcoming surgery. He would also ask them about their families and their outlook on life in general.
Afterward, he would go to the nurses’ station and strike off the next morning’s list of patients those that were pessimistic about their odds of a successful procedure. I have always remembered what he told me about why he did this:
“In my experience, he said, their odds of surviving a difficult procedure or post-op period are pretty slim.”
I was awe-struck, though my feelings were mixed with a healthy dose of skepticism. In those days, surgeons justified just about everything they did with the phrase, “in my experience.”
Sometime later, an article by Pauline Chen, MD caught my attention. In it, she describes an episode from her medical practice. Her patient, a diabetic, had been hospitalized for a toe infection that should have responded to a simple course of IV antibiotics. But, in this case, it did not.
Instead, the patient required a series of amputations—each one higher up the foot—in an attempt to stem the infection. He began to lose weight and eventually required nutritional support. Then, one day, he died.
Before he died, Dr. Chen asked a consulting psychiatrist if her patient was depressed? “He’s not,” the consulting psychiatrist told her, “it’s just the way he is.” In other words, he was a pessimist by nature.
Now, these are interesting anecdotes, but you might be thinking, is there actually any scientific evidence that optimism or pessimism can impact health outcomes?
In fact, there is real scientific evidence that an optimistic disposition leads to better health. The converse is true for pessimism. Here are but a few findings, out of dozens of articles published on the subject over the last 20 to 25 years:
More by this author: The Unfortunate Consequences of Disbelieving in Free Will
A more recent study by Kim et al. in the American Journal of Epidemiology examined the association between optimism and cause-specific mortality. The strength of this study is that it was prospective. It is also statistically well-powered using data from 70,021 participants in the Nurses Health Study.
Related Content: Getting Hit By a Truck Taught Me the Power of Love
The researchers measured the participants’ optimism using a standardized instrument calls the Life Orientation Test-Revised. They then divided the study population into four groups based on their degree of optimism, from lowest to highest.
The least optimistic group was assigned a hazard ratio (HR) of 1.0. It served as the comparison group for the other more optimistic groups. An HR of less than 1 indicates that a group is less likely to have “an event” compared to the least optimistic group. In this study, the events were a type of medical condition, such as heart disease or stroke.
Here are the HRs they found when comparing the most optimistic quartile to the least for mortality from different conditions:
This suggests a strong association between high optimism and lower mortality from these different diseases. The researchers constructed various models to test whether the association was due to confounding variables, such as sociodemographic factors, depression, and prior illness. Although in some cases the strength of the association was reduced, it was not eliminated.
The good news is that there are numerous studies showing that optimists live longer. Here are a sampling of studies from a variety of well-respected researchers and institutions:
In another study, a team led by Erik Giltay, MD, Ph.D., of Psychiatric Center GGZ Delfland, Delft, the Netherlands, interviewed ~1,000 men and women (ages 65-85) about health, self-respect, morale, optimism, contacts, and relationships.
They included two key questions regarding optimism:
Answering yes to these questions revealed a sense of optimism.
During the nine-year follow-up period, Dr. Giltay and his colleagues found that those participants who reported higher levels of optimism were 55% less likely to die from any cause and 23% less likely to die from a heart-related illness as compared to the pessimistic group.
Another study, led by Dr. Hilary Tindle of the University of Pittsburgh, found similar results. The researchers used data from the Women’s Health Initiative, an ongoing government study of more than 100,000 women over age 50 that began in 1994. Participants completed a standard questionnaire that measured optimistic tendencies based on their responses to statements like, “In uncertain times, I expect the worst.”
Their results showed that eight years into the study, women who scored the highest in optimism were 14% more likely to be alive than those with the lowest, most pessimistic scores. The pessimists were more likely to have died from any cause, including heart disease and cancer.
Drilling down, they found that pessimistic black women were 33% more likely to have died after eight years than optimistic black women, whereas white pessimists were only 13% more likely to have died than their optimistic counterparts.
As Dr. Tindle notes, pessimistic women tended to agree with statements like, “I’ve often had to take orders from someone who didn’t know as much as I did” or “It’s safest to trust nobody.” She accounted for confounding factors such as income, education, health behaviors like controlling blood pressure, degree of physical activity, drinking, and smoking and still found that optimists had a decreased risk of death compared to pessimists.
It is noteworthy that the title of Tindle’s article described above is revealing: “Optimism, cynical hostility, and incident coronary heart disease and mortality in the Women’s Health Initiative.” In her study, counter to optimism is not just pessimism, rather, it is cynical hostility.
In other words, the class of “non-optimists” is not limited to the woe-is-me individual. It includes people who may feel optimistic about their own prospects, but are cynical and hostile to others.
So, the underlying factors that govern our health and longevity are not merely cheerfulness versus moroseness, they are also
Dr. Tindle expands on this profound, and uplifting theme in her aptly named book: “Up: How Positive Outlook Can Transform Our Health and Aging. I highly recommend it.
A recent study from the Rockefeller University, published in 2019, looked at the effect of optimism on longevity. According to the authors, their results “suggest that optimism is specifically related to 11 to 15% longer life span, on average.”
They also found optimistic people have greater odds of achieving what they call “exceptional longevity” – living to the age of 85 or beyond.
These relationships were independent of socioeconomic status, health conditions, depression, social integration, and health behaviors (e.g., smoking, diet, and alcohol use).
It is important to point out that these studies are all association studies. They have not been designed to prove that it was optimism that caused the better outcomes. It could be that optimistic people are more likely to have a healthier lifestyle, including eating better diets, avoidance of drugs or excessive alcohol, and exercising more. Determining cause and effect requires a randomized, controlled study design.
There is a substantial body of literature that strongly suggests an association between one’s outlook on life and one’s health outcomes, including longevity. Although, as we always say in medicine, definitive proof requires that we do more better studies.
That being said, there are no downsides to learning to be more optimistic. I suggest you try it – you just might like the results.
First published on 03/23/15. Reviewed and updated by the author on 07/07/2017 and again on 5/9/2020.