Triumphs of Experience: The Men of the Harvard Grant Study (32 page)

Garrick went through a lot of occupational and marital unhappiness in midlife, and both the Study staff and I dismissed him as a failure on the strength of it. He had given up his career of choice and settled for second best. At fifty-three he separated from his first wife, and his sex life for a while was so uninspired that he turned to archery in sublimation. But as it turned out, those setbacks were temporary. Garrick spent the second half of a very long working life in one distinguished repertory company after another. At eighty, he had long stopped needing archery; many fifty-year-olds would have envied him his passionate marriage. Daniel Garrick was not the only Grant Study man who rediscovered in middle age a life of feeling that had been left behind in childhood. If women, at least until recently, have
been
socialized into giving up vaulting ambition at menarche, boys in grammar school are encouraged to abandon right-brain heart for left-brain reason. If they’re lucky, the tide may shift in maturity, so that they can develop conscious emotional lives. I can never resist quoting E. M. Forster in this context: “Only connect the prose and the passion and both will be exalted.”
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As he got older, Garrick finally outgrew the emotional inhibitions that had so plagued him as a young actor. Neuroscientist Francine Benes has demonstrated that with maturity the frontal cortex of the brain, the executive center, becomes more securely attached to the brain’s emotional center, the limbic system.
17
In his early fifties, Garrick quit his “day job,” giving up his tenured drama professorship to become a paid actor in a Shakespearean repertory theater out West. That is the point at which I’d say he achieved true Career Consolidation, although even before that he had already received standing ovations in an off-Broadway
King Lear.
About that performance, one reviewer wrote: “Garrick is the greatest Lear I can imagine. He appears to be the living man, in all his arrogance, petulance, fear, and confusion. A truly unforgettable experience.”

Daniel Garrick had matured emotionally to the point where he could now support himself by sharing not just his ideas, but his feelings, with an audience. He no longer needed to separate them, as young people, defensively, often do (see
Chapter 8
). He had also learned how to play; I think of Marlon Brando as the semi-retired Godfather, chasing his grandson joyfully around his garden. At fifty-five Garrick took his first vacation ever. After the long sedentary years of teaching, he began jogging and returned to long bicycle rides. And there’s the chicken-egg question again. Was he unusually healthy because of all the bicycle touring at fifty-five? Or was the bicycle touring possible thanks to an unusual endowment of good health?

At
seventy-six, Garrick had a stint of alternating performances of
King Lear
with a more famous actor. A reviewer wrote, “I found Garrick’s interpretation the stronger in many ways. . . . his fury, his self-pity, his pain, and his madness more vital and deeper reaching. I feel very fortunate to have seen him.” Garrick would eventually play opposite Gwyneth Paltrow, Lynn Redgrave, and Olympia Dukakis.

Garrick got married again at seventy-eight, to his longtime companion. When he was eighty-six, Maren Batalden wrote, “Garrick. . . . is thoughtful, intelligent, warm, self-aware, humble, curious, engaged, emotionally present, enthusiastic, honest. . . . He is extraordinarily successful in both love and work. His marriage to Rachel is clearly a deep, joyful connection that sustains him, surprises him, and makes him weep with gratitude. The marriage is remarkable for the freedom each has given the other to be independent—they each have separate spheres, their own friends and interests and social styles, but nevertheless enjoy each other’s company and love each other’s bodies.” It’s wonderful to hear that bodily love can arise
de novo
so late in life, and exist so passionately after eighty. Discoveries like that require longitudinal study.

Batalden continued, “In many ways, these seem to be the best of times for Daniel Garrick—he now relishes the fruits of his discipline. He loves loosely and well, works passionately, keeps his mind and heart open and engaged, makes new friends, relishes his hobbies, takes real nourishment from the past, permits himself a wide range of deep sorrow and great joy, adapts stoically to the inconveniences of aging in his body by staying focused on the things that matter to him.”

Since age eighty, Garrick has enjoyed the highest possible mood scores. He did give up biking at seventy-six due to multiple aches and pains; nevertheless, at eighty-six his only medicine was Viagra “as needed”—twice a week, he boasted. Yes, he had begun to feel his age,
but
for the next five years he kept up with the demands of a major Shakespearean theater, memorizing his lines and rehearsing, and all the while serving as docent and teacher at the local art museum.

Garrick’s son noted changes when his father reached ninety-five. “My father has declined physically and cognitively to a far greater degree than he acknowledges in the questionnaire: gradually over the past 8–10 years, but most precipitously since retiring in 2006 from his acting career. He had worked less for a few years due to his arthritis pain and difficulty remembering lines. When he finally stopped, he has sat in his chair, read books, watched TV, listened to music, ordered more books and music and exercised hardly at all. His work at the theatre had provided a regular dose of social contact and the necessity of pushing himself to analyze the play and character in order to deliver a performance. Both the social interaction and the need to push himself [has now] dwindled to a trickle.”

It’s hard to say with certainty that the decline was really the result of a lack of social and physical activity. Surely the reverse is also possible: that it was more like the collapse of the one-hoss shay after its very long life, and that Garrick, as he approached his own hundredth birthday, gave up his earlier social and physical pleasures as a result. Reality probably lies somewhere in between. Until his death Garrick took only two medications: Aleve for arthritis and Ambien for sleep. At ninety his TICS score was showing some borderline decline, and at age ninety-one, he had a brief trial on Aricept (a drug designed to slow memory loss). When he was ninety-four, his wife, who had become very frail, had to move to assisted living. For a while Garrick remained full of beans, but at ninety-five he began to display some trouble orienting himself. That’s when his son began to worry and came to live with him, doing his shopping, figuring out his taxes, and paying his bills. Garrick himself recognized that he had slowed down—he listed his activities on his last questionnaire as: “Read,
watch
TV and nap.” But he didn’t seem to be unduly troubled by the change. Daniel Garrick died at ninety-six.

Remember, Garrick was only the first of the men to reach ninety-five, and a gang of mentally alert Study-mates are waiting in the wings to surpass him. Remember, too, that for all of us the play has to end sometime. From sixty to ninety, Garrick had a long and successful run.

Can we learn anything from Daniel Garrick’s life about the keys to graceful aging? Or about what might account for his extraordinary longevity? He certainly didn’t follow most of the conventional “rules” for long life. His parents were not long-lived. (In fact our data indicate that parents’ longevity is only modestly reflected in their children.) He didn’t really start to exercise until he was almost sixty. He smoked a pack of cigarettes a day for twenty years, and nine pipes a day for decades after that. During his sixties, he drank enough that he and his future wife worried about it. Conventional wisdom tells us that we keep young by doing good for others, but he engaged in no community service activities except to become a docent in an art museum—at eighty-six. So when Garrick suddenly began riding his bicycle up to 100 miles a day, was that the cause of his great energy, or was it the effect of some innate natural vigor? Remember, way back in college Garrick had bicycled 5 miles back and forth to class after being up all night, and had gotten top marks for being “well-integrated” and “self-starting,” both traits associated with longevity in the Study.

From the very beginning Garrick had a quality of indomitability, and maybe that was really what enabled him to live so long. Nobody in the Grant Study waited longer or worked harder than he did to get a college education. Most students who lacked financial support received scholarships, but not Garrick. Most of the men who had explicit
career ambitions were able to realize them long before they turned fifty. But even during the period when Garrick had resigned himself to being a teacher, he used his spare time to act. He never gave up, and he never gave up hope.

PATHS TO HEALTHY AGING

Sometimes it looks as though cancer and heart attacks are visitations from malicious gods, and that old age is ruled by cruel fate—or at least by cruel genes. So out of control does the whole process of aging often feel that I was relieved when our wealth of prospectively gathered data revealed that some aspects of successful aging—or lack of it—are in fact negotiable.

Twenty years ago Paul Baltes, a leading gerontologist, acknowledged that research has not yet reached a stage where there is good causal (as opposed to correlational) evidence for predicting healthy aging.
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True, several distinguished ten-to twenty-year prospective studies of physical aging have contributed valuable understanding about the course of old age.
19
But few of the investigators in these studies knew anything about their members before they turned fifty, and only Warner Schaie has followed his subjects for more than twenty-five years.
20
The early facilitating factors in longevity remain unclear. But that doesn’t stop people from having strong convictions about them.

For example, we are constantly urged to follow diet, exercise, or neutraceutical regimens that supposedly guarantee us sustained good health. But the formulas are rarely subjected to long-term verification, and the rules keep changing. The cod liver oil of the forties was replaced by the antioxidants of the seventies, which gave way to fish oil again ten years ago. For a while eggs were out, red meat was on everybody’s no-no list, and fruit was on the side of the angels. But one
of
the few thorough studies of nonagenarians has found that 80 percent of them ate red meat regularly all their lives, and only 50 percent ate fruit weekly.
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Perhaps fruit-eating vegetarians do not survive to ninety. Or perhaps, I, like the diet advocates, am merely revealing my own personal prejudices. Either way, survival is not as simple as the wellness gurus would have us believe. The risk factors that cure-all diets are supposed to counter aren’t discrete entities; they are reflections of complex interactions.

My own confrontation with the arbitrariness of longevity prescriptions happened twelve years ago at the Boston Museum of Science. If visitors would punch in all their bad habits, a computer there promised, it would tell them how much longer they had to live. I told the computer that I consumed a half-pound of butter daily and three packages of Camels. I only rarely let a green vegetable touch my lips, I emptied a fifth of Jack Daniels every evening, and I got off the sofa only to change the batteries in the remote. The computer thought for a while, calculated the years that each risk factor was supposedly subtracting from my life, and then informed me that I was dead already, and had been since two years before I was born!

Now I’ll grant that this is not a nice way for a person to behave who has given much of his life to collecting, fostering, and analyzing an invaluable hoard of data based on interviews and questionnaires. If the men of the Grant Study had been one-tenth as mendacious as I was. . . . Still, simply summing multiple risks together is very different from watching their complex interactions over real lifetimes, and here’s a serious illustration of that.

Harvard sponsored a symposium on aging for its own 350th anniversary. Four experts were asked to describe their research on risk factors. One spoke on exercise, another on obesity, a third on smoking. I spoke on alcoholism. None of us addressed the importance of any factor other than our own, let alone the mischief that the four of
them
could get into together. Like the computer, we treated the different factors as if each were the only coffin nail in town.

In this chapter, I’ve tried not to do that. I’m going to recount the history of four separate investigations in which we examined the antecedents of successful aging and longevity. Each led me to a different set of conclusions, and thereby hangs a tale.

FOUR STUDIES OF AGING

Study I, 1978: Mental health and physical health.
In 1978, when I was in my early forties and the men were turning fifty-five, I viewed them as over the hill and therefore ripe for a study of successful old age. That’s not much of an exaggeration. I thought that they were nearing their apogee, and that I’d better learn what I could before the long decline began. For my first study—the causes of health decline between age forty and age fifty-five—I began with the 189 active members of the Study who had been entirely healthy at forty. Eighty-eight of them had remained that way until fifty-five. What were the differences, I wondered, between them and the 101 men who by that age had either acquired minor chronic illnesses (66) or suffered serious chronic illness or died (35)? In 1979 I believed that
Table 7.2
provided the answer.
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Remember, I was a psychiatrist, not an internist and not an epidemiologist. I wanted an answer to a straightforward question: What was the influence of mental health on physical health? I tested out a number of previously assessed psychological variables: bleak childhood, recourse to mood-altering drugs, major depression, number of psychiatric visits, poor relational skills at midlife, and especially a lack of good adult adjustment between the ages of thirty and forty-seven (as defined by the capacity to work, love, and play, and require no treatment for mental illness). As
Table 7.2
shows, all six of these psycho-
logical
variables were significantly associated with subsequent poor physical health at fifty-five. By then, of the forty-nine men with the bleakest childhoods, seventeen (35 percent) were dead or chronically ill, contrasted with only five (11 percent) of the forty-four men from the warmest childhoods—a very significant difference. On the other hand, by age fifty-five, six (9 percent) of the sixty-six non-smokers and eight (17 percent) of the forty-eight heavy smokers had become chronically ill—a difference of no statistical significance at all.