Illustration by Matt Collins November 2019, ScientificAmerican.com 83ANTI GRAVITY
THE ONGOING SEARCH FOR
FUNDAMENTAL FARCESSteve Mirsky has been writing the Anti Gravity column since
a typical tectonic plate was about 36 inches from its current location.
He also hosts the Scientific American podcast Science Talk.Chair Man
Cardiovascular disease’s link
to stress sat in plain sight
By Steve Mirsky
Rarely does a speaker at a conference have to
abandon a talk because he’s seasick. But I saw it
happen in August on a Scientific American/ Bright
Horizons cruise around the U. K. and Ireland, as
our ship hit rough seas. The nauseated narrator
finished his talk a few days later in calmer waters.
And for the porpoises of this ocean-going column,
all you need to know is that he was not Robert
Sapolsky. I mean purposes.
Sapolsky, a neurobiologist and primatologist
at Stanford University, got through his talks with
no lunch losses. One presentation dealt with the
health effects of chronic stress. “This link between
stress and cardiovascular disease is so solid,” he
said, “that it accounts for the most famous per-
sonality profile in all of medicine.” Type A person-
ality, that is. “And I would guess if you’re using a
cruise to sit and listen to Scientific American lec-
tures, this applies to like 80 percent of us in this room.”
Sapolsky continued, “Type A was first described by a pair of
cardiologists, [Meyer] Friedman and [Ray] Rosenman, in the
1950s ... time-pressured, hostile, poor self-esteem, joyless striv-
ing.” The docs announced that these traits actually raise your risk
of heart disease.
“[Other] cardiologists hated these guys. You’re some 1950s
cardiologist, all you think about is Ozzie and Harriet and heart
valves... and instead here’s these guys saying, ‘No, you need to
sit down your patients and talk to them.’ Who wants to talk to
their patients?!” Indeed, the happiest doctors I have ever met
are pathologists.
“It wasn’t till the 1980s that there were enough data in for peo-
ple to say type A is for real,” Sapolsky said. “It is a bigger risk fac-
tor for cardiovascular disease than if you smoke, than if you are
overweight, than if you have elevated cholesterol levels.”
So how did Friedman and Rosenman identify this condition?
“I actually got to hear this story from the horse’s mouth himself,
Meyer Friedman,” Sapolsky said. “He and his partner had this
cardiology practice in San Francisco—everything was going
great. They had this one problem, though. For some reason, they
were wearing out chairs in the waiting room at an incredibly
high rate.... Every month this upholsterer comes in, fixes a chair
or two. One month the upholsterer is on vacation. A replacement
upholsterer comes in, takes one look at the chairs and discovers
type A personality. He says, ‘What is wrong with your patients?
Nobody wears out chairs this way.’ ”
Sapolsky then showed a photograph of one of the chairs,
which you can see in his book Why Zebras Don’t Get Ulcers. “The
front two inches of the seat cushion and the arm rests are total-
ly shredded. The rest of the seat is perfectly fine. It’s like every
night there’s dwarf beavers, and they’re clawing at the chairs.
What is this? This is what [a type A person] does when they’re
sitting in the waiting room of their cardiologist’s office waiting
to find out if there’s bad news. Not just figuratively but literally
sitting on the edge of their seat and clawing and squirming.
“So what’s supposed to happen at this point if things worked
right: Friedman grabs him and says, ‘Good God, man, what you’ve
discovered!’ [And there are] midnight conferences between uphol-
sterers and cardiologists. And [there are] teams of idealistic young
upholsterers going across America and coming back with the news
that, no, you don’t find chairs like these in podiatrists’ offices.”
What did the nonagenarian Friedman tell Sapolsky he actually
did back in the 1950s? “He said, ‘I told my nurse ... get this man out
of my face, he’s wasting time, give him his damn check.’ He was too
type A to listen to the guy. And it wasn’t until five years later, they
were collaborating with psychologists, out popped the type A pro-
file, and they said, ‘Oh, my God, the upholsterer, he was right!’
“To this date, they have no idea who that man was. Now I’m
willing to bet ... go to some bar in the Mission District in San Fran-
cisco, and there’s gonna be this 110-year-old retired upholsterer.
And get him started, and he’s gonna go on and on about how he
discovered type A personality.” And in so doing—you might want
to take a seat yourself for this—changed the fabric of medicine.JOIN THE CONVERSATION ONLINE
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