The Village Effect: How Face-to-Face Contact Can Make Us Healthier and Happier (33 page)

How do baboons demonstrate friendship? They stay near each other, groom each other’s fur, and help out when there’s a conflict, much as human girlfriends do. They also share food, as we learned in
Chapter 4
. Still, tokens of friendship don’t always resonate. When I was in Moremi in 2007, I observed a pair of female baboons squatting face-to-face with a pile of fresh elephant dung between them. They were carefully extracting undigested nuggets of fruit and nuts with their fingernails and feeding them to each other.

Other species have more appealing habits. Female elephants keep in touch with their chums through frequent exchanges of low-pitched vocalizations called rumbles. “We liken it to an elephant cellphone,” said Joseph Soltis, a research scientist who works with elephants at Disney’s Animal Kingdom in Florida. “They’re texting each other, I’m over here. Where are you?” science journalist Natalie Angier wrote in an article about female connections in nonhuman species.
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British primatologist Julia Lehmann has discovered that female West African chimpanzees stay within eye contact of their friends while foraging during the day, and rest with their backs propped up against each other at night.
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Clearly women have a long evolutionary history of forming tight social networks. Those intimate
female bonds act as catalysts for the village effect, and being married allows men to share the health benefits.

BLISTER STUDIES

If you were a young couple, probably the least romantic activity you could think of would be to check into a hospital together so researchers could observe your marital fights. Yet eighty healthy American couples did just that, not just once, but twice.
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After agreeing to two twenty-four-hour hospital stays and a post-hospital week of daily checkups, the couples allowed a nurse to insert heparin wells in their arms. These are like IV ports, but instead of enabling fluids to enter the body, they allow blood samples to be taken without the subjects having to face a hypodermic needle each time. “People don’t notice it at all once it’s in,” Dr. Kiecolt-Glaser told me.

The second step: nurses used a small tube to suction up the skin on the tender undersides of the couples’ forearms. The suctioning process went on for at least an hour, until eight blisters had popped up. The size of plump blueberries, the blisters were hard to ignore, especially as the researchers then sliced the skin off the top of each, covered it with plastic, and then injected the blister with saline solution. Finally the researchers positioned the couple in chairs facing each other and asked them to discuss neutral topics (first session) or disagreeable ones that engendered conflict (second session). The scientists watched what happened from behind a curtain while videotaping the proceedings. Later they analyzed the couples’ interactions, along with their blood and blister samples.

Though it sounds like some twisted episode of
Survivor
, this scenario was a way to simulate, under controlled conditions, what happens when married couples bicker about money, sex, badly behaved kids, meddling in-laws, dirty laundry, or whatever it is that makes them angry—sometimes for years on end. The point was to see how their face-to-face interactions might influence inflammation and
wound healing. “Some were supportive and helpful. Some were downright nasty,” is how Dr. Kiecolt-Glaser described the interactions. Marital hostility was measured as expressing disgust, contempt, or belligerence by glowering, stonewalling, or talking in a threatening way—all cues to that marriage’s short shelf life.

Along with Sybil Carrère, psychologist Jack Gottman and his team found that they could reliably predict whether a couple would divorce within the next six years, based on three minutes of their conversation when they were newlyweds. Did the couple try to solve a problem during a conflict, or did they try to wound their partner or create distance with sarcasm or disdain?
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If such hostility—or its converse, supportive comments—gets under our skins somehow, how do our bodies register these interactions?

Part of the answer to that question is what was in those fluid-filled blisters. Kiecolt-Glaser and her researchers expected that couples who showed more marital hostility would produce fewer pro-inflammatory cytokines in their blisters, but higher cytokines in their blood. Cytokines are proteins that act as messengers between immune cells. With fewer pro-inflammatory cytokines at their blister sites, hostile couples would heal more slowly, while higher amounts of these compounds in the bloodstream have been linked to a host of age-related diseases. The researchers also expected that, compared to men, women would show more physiological evidence of marital conflict.

The results? The blisters of the couples who were more hostile to each other did, in fact, take longer to heal: seven days versus five days. The hostile couples had more cytokines circulating in their bloodstream and fewer at the blister site. Interestingly, their sores hung around longer after the session when they discussed divisive issues, compared to when they just chatted with each other. “It destroys one’s nerves to be amiable every day to the same human being,” former British prime minister Benjamin Disraeli is reputed to have said. The evidence proves just the opposite.

The difference between the couples’ communication styles was significant too. The hostile couples’ blisters healed at 60 percent the rate of the other couples.
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In other words, if you’re married, don’t fight dirty. Even thirty minutes of marital hostility can have a dramatic impact on your ability to fight infection and how quickly your wounds will heal.
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Given this evidence, it’s a wonder that doctors don’t ask about the state of their patients’ marriages as a matter of routine, along with checking their vital signs and palpating their prostates. Dentists should ask too. After all, people with a low opinion of their marriage are more likely to have gum disease and cavities than those who are happily married. Patients with Parkinson’s disease, rheumatoid arthritis, and Alzheimer’s disease who have critical or over-involved spouses have more debilitating symptoms than those with supportive, responsive ones.
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Even physical pain is moderated by marital love, especially in women. One Finnish study found that women with back problems who were unhappily married had more acute pain and disability than matched controls. Conversely, being close enough to be touched by one’s partner attenuates physical pain. California neuroscientists Naomi Eisenberger and Shelley Taylor have found that a woman who holds her loved one’s hand (as opposed to the hand of a stranger) during an invasive procedure feels less physical pain.
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We can all hum “All You Need Is Love,” but these results are still surprising. Who would expect that snide remarks from a spouse can rot your teeth? But it makes sense. If human infants and other primates are hardwired to react to the presence of a loving parent (versus a careless, anxious, or absent one), and if other face-to-face relationships buttress our immune systems, then the endocrinological armature that registers the tenor of one’s romantic relationships must be able to write its signature on adults’ bodies too. The evidence is building that a spouse has a direct, biochemical impact on the production and migration of our white blood
cells and the way our genes are expressed.
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And nowhere is this more obvious than in the acute suffering of widowed men.

THE WIDOWHOOD EFFECT

My friend Lou is a handsome man in his early sixties with a silvery beard, a receding hairline, and large aviator glasses. When he laughs, which is often, his mouth opens wide and his blue eyes crinkle up so that there’s just a glint of pupil showing. Solidly built, with a powerful chest and a rumbling bass voice, Lou has a reassuring physical presence, which is a very good thing, as he’s a psychologist who works with substance abusers. He seems at home in his own skin, and that easygoing affability is probably what attracted Natalie to him in the first place.

But Lou didn’t feel all that affable when they met. Though he was participating in his usual activities—going to work, visiting with his grown kids and their partners, swimming regularly, and going to synagogue—in early 2008 he was mainly spending time with his wife, Anna, whose breast cancer had returned after a five-year remission. When she first became ill, they had decided together that she should have a mastectomy to ward off a future recurrence; they would celebrate together after the surgery was over. “What can I say? It was a time of closeness. We were so close. And we traveled to China after that. We did things, we went down the Yangtze River, and it was wonderful,” Lou recalled wistfully, also remembering the boisterous family dinners they hosted between Anna’s first breast cancer diagnosis and its recurrence.

But within four months of the cancer’s return, Anna was gone. It seemed inconceivable. Her parents, both Holocaust survivors, had lost their only child. The youngest of Lou and Anna’s three kids was eighteen and not yet in college—not ready to lose his mother, if one ever is. And Lou had lost his
beshert
.

“I knew who she was,” he said of Natalie when I asked where they’d first met. “But I was not available in any way to meet or
speak to people in a romantic kind of way. I still continued in Bakol. But I was all in my grief and I was not listening to what was going on. As a matter of fact, I went to one of those retreats and was wondering,
What the hell am I doing here? I really feel so shitty. All this spiritual stuff, my mind is not in it at all. All I am is in my grief
. So I told her—just the way I would feel comfortable telling you—and she listened and she was nice. And I went off by myself in the woods.”

Four years later, Lou and I were chatting in my backyard after a midweek dinner, just two months after Lou and Natalie’s spring wedding. Natalie was away in France visiting family, and Lou, my husband, and I had just demolished a zucchini frittata, a salad, and a bottle of Chianti while the fireflies flashed in and out of the azaleas. The sun had set and Martin had generously offered to do the dishes so Lou and I could talk. Among other things, I wanted to know how he had emerged from the dark tunnel of widowhood—a place that swallows up so many other men. At any age, widowhood increases a man’s risk of dying within a year of losing his spouse by 20 to 40 percent. A powerful gender difference tells us that hormonal and social factors are at play, though it’s not clear exactly how.
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It’s more than just the loss of homecooked meals, or the solicitous care they received when they were married.
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When they lose their spouses, men are at a heightened risk of sudden death or suicide because of extreme loneliness. Women, who tend to have more social supports, are not.
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And though the phenomenon hits men of all ages, the impact is far more dramatic among those over sixty. The risk that an older married man will die within a few months of his wife’s death increases by
30 to 90 percent
, a danger that ratchets even higher among more educated men.
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Called the widowhood effect, I’d witnessed this disaster in my father-in-law, Charlie. He dropped fifty pounds, became disoriented, and experienced multiple life-threatening cardiac events in the months
after my mother-in-law suddenly died.
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A dapper Clark Gable lookalike with trimmed moustache, felt fedora, and a wry sense of humor, Charlie had had a mild heart attack in his mid-forties, but then had been healthy for more than three decades. Losing his wife literally unhinged his heart. He lost not only the physical presence of his loving wife but the structure of his days: driving her to the grocery store and to the hair salon, their card games and movies with friends, their family dinners. Like many men, his primary social contact was his wife, and when she was gone, their joint social network disappeared with her.
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Unacknowledged while they’re married, this warm web of connections often evaporates once a man becomes widowed. Not only has the man in question lost his only confidante and main source of social support, but after the post-funeral casseroles are gone, the invitations often vanish too.

Though Lou felt miserable for a long time after Anna died, his health hadn’t taken a hit. What protected him? There are likely lots of factors, including the genetic recipe that fostered his easygoing nature, being somewhat younger than many widowers, and his commitment to a regimen of regular exercise. But there was also something else. Lou’s daily routine included a variety of social encounters. He participated in a handful of community, religious, therapeutic, and team sports activities. And if there’s any scientific consensus at all about the impact of our relationships on our health, it’s that a single bond—no matter how intimate—isn’t sufficient on its own to protect us. When epidemiologists make mortality predictions based on decades of data, it’s social integration that matters most: being married
and
belonging to a religious group
and
playing bridge every Wednesday
and
volunteering at the church. The more types of face-to-face ties you sustain—both close relationships and the weaker ties with people who regularly cross your path—the better you will be at warding off the Grim Reaper.
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Lou was surrounded not just by close family and friends but by a coterie of supporters with whom he connected, even if they weren’t billed as such. He was a joiner. Like Sylvie, whom we met in
Chapter 1
, Lou was connected to a large network of people who were there when the chips were down. “When I was afraid of sinking into a depression,” as Lou put it, they propped him up even if they didn’t know that’s what they were doing. “One of the things that I did throughout Anna’s illness and afterwards is that I kept on swimming,” he told me when I asked how he had fended off the physical assaults of grief. “When my father got sick and went through many months in the hospital and then died, I would also go swimming. It helped me. And I even competed. I competed during Anna’s illness,” he told me, “though there was one year when Anna was very sick that I missed the championships.”