Triumphs of Experience: The Men of the Harvard Grant Study (2 page)

I acknowledge readily that the Grant Study is not the only great prospective longitudinal lifetime study. There are others, three of which are better known than ours. Each has its own strengths and weaknesses. The Berkeley and Oakland Growth Studies (1930–2009)
from
the University of California at Berkeley include both sexes and began when the participants were younger; they provide more sophisticated childhood psychosocial data but little medical information.
5
These cohorts have been very intensively studied, but they are smaller and have suffered greater attrition than ours. The Framingham Study (1946 to the present) and the Nurses Study at the Harvard School of Public Health (1976 to the present) boast better physical health coverage, but they lack psychosocial data.
6
These are wonderful world-class studies, invaluable in their own ways, and more frequently cited than the Grant Study. But even in this august company the Grant Study is unmistakable and unique. It has been funded continuously for more than seventy years; it has had the highest number of contacts with its members and the lowest attrition rate of all; it has interviewed three generations of relatives; and, most crucial for adult development, it has consistently obtained objective information on both psychosocial and biomedical health.
7
Finally, perhaps alone among the world’s significant longitudinal studies, the Grant Study has published, with the men’s permission of course, lifespan histories as well as statistical data.

Other studies exist now in Great Britain, Germany, and the United States that are larger and more representative than these older ones, and will join them in length of follow-up in another decade or two. The Wisconsin Longitudinal Study, for example, began in 1957 and included about a third of all of Wisconsin’s high school graduates of that year; it has endured for over half a century so far.
8
Eighty-eight percent of its surviving members are still active in the study at age sixty-five. (By way of comparison, 96 percent of the surviving Grant Study members are still active at age ninety!) The Wisconsin Study is more demographically representative than the other studies, and its economic and sociological data are richer and better analyzed. It has a weakness too, however; it lacks face-to-face medical examinations or interviews. We can anticipate a great wealth of prospective life data as
these
younger studies come into their own. But they will supplement, not supplant, the riches already offered by the Grant Study and its contemporaries.

When I came to the Grant Study in 1966, I was a very young man of thirty-two, and had not yet achieved the pragmatic relativism of Heraclitus. I had been studying stable remissions in schizophrenia and heroin addiction—recovery vs. no recovery, white vs. black. I spent my first ten years at the Grant Study identifying thirty unambiguously good outcomes and thirty unambiguously bad ones out of a randomly selected sample of one hundred middle-aged men from the classes of 1942–44. In 1977 I published a book,
Adaptation to Life,
demonstrating this accomplishment.
9
It made quite a splash. I was forty-three. What did I know?

Today I am seventy-eight. The men of the Grant Study are in their nineties. They’re not the same as they were when they joined the Study, and neither am I. I have learned to appreciate how few blacks and whites there are in human lives, and how we and our rivers change from moment to moment. The world we live in is different; science is different; even the technology of documenting difference is different. As the Grant Study becomes one of the longest studies of adult development in the world, it is not only the men of six Harvard classes who are under the microscope. All of us who have worked on the Study—the Study itself, in fact—are now as much observed as observers.

ADULTS, GROWING

The laws of adult development are nowhere near as well known as the laws of the solar system or even the laws of child development,
which
were only discovered in the last century. It wasn’t all that long ago that Jean Piaget and Benjamin Spock were still kids, and the phases of childhood so stunningly elucidated by them still regarded as unpredictable. Now, however, we watch children develop the way our ancestors watched the orderly waxings and wanings of the moon. We worry; we pray; we weep; we heave sighs of relief. But we are no longer particularly surprised. We know what to expect. Our libraries are full of studies of human development—up to the age of twenty-one.

What happens after that remains in many ways a mystery. Even the notion that adults
do
develop, that they don’t reach some sort of permanent steady state at voting age, has been slow to gain traction. Some of the reasons for this are obvious. It is much easier to achieve a long perspective on childhood than on an entire life. And as in physics, once Time gets into the picture you can say good-bye to the old Newtonian verities. There are certainly patterns and rhythms to adult life, and when we circumvent the distorting effects of time upon our own vision, we can sometimes discern them.

But even the most carefully designed prospective study in the world can never free us completely from time’s confounding influence. Lifetime studies have to last many, many years, and over those years everything will be changing—our questions, our techniques, our subjects, ourselves. I’ve been studying adult development since I was thirty, and I know now that many of my past conjectures, apparently accurate at the time, were contingent or just plain wrong. Still, the Grant Study is one of the first vantage points the world has ever had on which to stand and look prospectively at a man’s life from eighteen to ninety. Having it doesn’t save us from surprises, frustrations, and conundrums; quite the contrary. Nevertheless, a continuous view of a lifetime is now possible for human beings. Like that time-lapse film of a flower blooming that Disney made famous in the sixties, it is an awesome gift.

When
the Study was undertaken in 1938, what we knew about human development across the whole of life was mostly based on inspiration or intuition. William Shakespeare delineated seven ages of man in
As You Like It
in 1599; Erik Erikson defined eight stages in
Childhood and Society
three hundred and fifty years later.
10
But Shakespeare and Erikson didn’t have much by way of real data to go on. Neither did Sheehy and Levinson. Neither did I, in
Adaptation to Life. Nobody
had access to prospectively studied whole lifetimes. I hope that this book, written in 2012, will begin to correct that lack.

THE ART OF THE POSSIBLE

A few caveats as we proceed. It is well known that the Grant Study includes only white Harvard men; Arlen V. Bock, the physician who founded it, has frequently been criticized for arrogance and chauvinism on that account. It’s less well known that the Grant Study was not an attempt to document average health over time, like the more famous Framingham Study, but to define the best health possible. And we must therefore keep in mind two realities. First, lifetime studies, like politics, are the art of the possible. As Samuel Johnson famously quipped about dogs walking on their hind legs, “It is not done well, but you are surprised to find it done at all.” Second, in such huge undertakings, one must optimize one’s chance of success. Columbia neuroscientist Eric Kandel did not choose a random sample of the world’s population of
homo sapiens
when he did his Nobel-winning work on the biology of memory; he chose the obscure sea snail called
Aplysia.
Why? Because
Aplysia
has unusually large neurons. And it was precisely the gender and privilege of the Grant Study men that made them so useful for a study of human adaptation and development. Men don’t change their names in midlife and disappear to follow-up as women do. Well-to-do men don’t die early of malnutrition, infection, accident, or bad medical care, as happens much too often to poor
ones.
These men had a high likelihood of
long
life, a necessity for this sort of study. (A full 30 percent of the Grant Study men have made it to ninety, as opposed to the 3 to 5 percent expected of all white male Americans born around 1920.) Glass ceilings and racial prejudice were unlikely to hold them back from achieving to their fullest potential, or from the careers and lives that they desired. A Harvard diploma wouldn’t hurt either. When things went wrong in the lives of the Grant Study men, they would have a good chance of being able to set them right. Last but not least, they were unusually articulate historians. Bock needed all those advantages. You can’t study the development of delphiniums in Labrador or the Sahara. The Grant Study’s College cohort and
Aplysia
may not be perfectly representative, but they both afford us windows onto landscapes we have never been able to see before.

One further note on Bock’s choice of a homogeneous population. If we want to learn what people eat, we have to study many different populations. If we want to learn about gastrointestinal physiology, however, we try to keep variables like cultural habits and preferences uniform. Societies are forever changing, but biology mostly stays the same. This was another reason for the Grant Study’s strategy. It was examining healthy digestion, not traditional menus. When possible, however, the Grant Study has checked its findings against other homogeneous studies of different populations, especially the disadvantaged men of the Inner City cohort and the highly educated women of the Terman cohort.

STUDYING THE STUDY

It is reasonable to ask whether this book is necessary. Over its seventy-five years of existence, the Study of Adult Development has so far produced 9 books and 150 articles, including quite a number of my own (see
Appendix F
). Why another? Well, because it’s not always easy
to
see how reports of any given instant relate to the future, or even to the past. How do we understand a seventy-five-year-old article from a news daily? The short answer is, it depends on what’s happened since. Whatever the world’s papers were printing in the summer of 1940, England did not in fact fall to the Luftwaffe. Reporters do the best they can with what’s available, but momentary glimpses can never capture the totality of history, and things may well look different later on. This in a nutshell is why longitudinal studies are so important. And to reap their full value, we have to take a longitudinal view of the studies themselves. When I sit down to summarize my forty-five years of involvement with the Grant Study, much of what I’ve written in the past seems to me as ephemeral as the 1948 headlines that trumpeted Dewey’s victory over Truman, for only now do I understand how the story has really turned out. So far. As the people’s philosopher Yogi Berra observed long ago, “It ain’t over till it’s over.”

So as I see it, there are five reasons for this book. First, the Harvard Study of Adult Development is a unique, unprecedented, and extremely important study of human development. For that reason alone, its history deserves documentation.

Second, the Grant Study has been directed by four generations of scientists whose very different approaches beg for integration. The first director focused on physiology, the second on social psychology, the third (myself) on epidemiology and adaptation. The priorities of today’s director, the fourth, are relationships and brain imaging. As any methodologist can see, the Grant Study had no overarching design. In 1938, there weren’t enough prospective data on adult development even to build solid hypotheses. Like the Lewis and Clark Expedition and Darwin’s passage on the
Beagle,
the Grant Study was not a clearly focused experiment but a voyage of discovery (or, as some have less charitably suggested, a fishing trip). The findings I report in this book are largely serendipitous.

This is the first time in forty-five years I have allowed this awareness
into consciousness, let alone confessed it in print. In my repeated requests to the National Institutes of Health for funding, I always emphasized the potential of the Study—the power of its telescopic lens, its low attrition rate—rather than any specific hypotheses I planned to test. I analyzed data whenever I had a good idea; like a magpie I’d scope out our huge piles of accumulated material looking for a telltale glint or glimmer. I have often wondered whether there is a Ph.D. program in the country that would have accepted the plans of any of the four Grant Study directors as a thesis proposal. But what a wonderful harvest serendipity has produced. As I will demonstrate with pleasure, unpredictability is an inevitable and sometimes infuriating aspect of large prospective studies, but it gives them a startling richness that more narrowly focused endeavors can never achieve. All the better for magpies. Perhaps it was a good thing that I never took a course in psychology or sociology. At least I had no preconceived ideas ruining my eye for an emperor’s new clothes.

Third, this book collects in one place material scattered across seventy years of specialty journals, in which the publications of each decade modified the findings of the previous ones, and were modified again in turn as new contexts cast new light on old data. Until now, for example, there’s been no recognition of the importance of alcoholism in studies of development. But it’s clear that earlier findings in some very unexpected areas are going to have to give way in the face of the Harvard Study of Adult Development’s accumulating evidence about the developmental effects of alcohol abuse. It proved to be the most important predictor of a shortened lifespan, for one thing, and it was a huge factor in the Grant Study divorces, for another. Science is a changing river too.

Fourth, the Grant Study has seen and absorbed many theoretical and technological transitions, especially in the evolving field of psychobiology. It began in a day when blood was still typed as I, II, III,
and
IV. Race, body build, and (more speculatively) the Rorschach were considered potentially predictive of adult developmental outcomes. Data were tabulated by hand in huge ledgers—even punch cards sorted with ice picks were a yet-undreamed-of technology. For calculation, the slide rule ruled. Today we grapple with DNA analysis, fMRIs, and attachment theory, and 2,000 variables can be stored on my laptop and analyzed instantly as I fly between Cambridge and Los Angeles. Here, too, documentation and integration are called for.