Too Much of a Good Thing by Lee Goldman, MD

Too Much of a Good Thing: How Four Key Survival Traits Are Now Killing Us by Lee Goldman, MD (Little-Brown, 2015) 344 pages.

TMOAGT Goldman

One of the things we are finding out (see the March 2016 issue of Discover magazine) is that, as a species, homo sapiens isn’t a unique type of animal. What we are is the sole survivor of a large group of similar species who might have lived in the same place at the same time in Africa. We survived and they didn’t because our species was more than likely better at four things than all the competition. Ironically, the very traits that let us prevail when climate change, animal migration, warfare, and other forms of environmental stress tested our species are now the biggest threats that we have to endure far into the future.

Goldman’s book is the first I’ve seen to systematically explore some of these characteristics. He focuses on four things (and as a doctor, I trust him to be able to judge these kinds of things). These four things once helped us, but now hinder us as civilization replaces the wilds our species grew up in. There are three possible outcomes to the situation humanity finds itself in (p. 6): first, everything can keep getting worse until our children’s children’s children down the line no longer live long enough, or remain healthy enough, to raise enough people to keep the species going. Or, we can radically change our lifestyles enough so that we are able to counter the negative effects of these four things and continue, as a species, to make progress (although some might not be able to make the journey). Finally, we can take advantage of new scientific discoveries to either counter these four things genetically (through genetic modification) or treatments designed to counter their effects as we live our lives.

Before going on, just what are these four things Goldman focuses on? Here they are, as I would translate them (from p. 4) into all their simple glory:

  1. Hunger
  2. Thirst
  3. Fear
  4. Blood clots

Of course, there has to be a bit more about how these four basic characteristics, obviously critical to the survival of any individual in primitive surroundings, have become as much as liability as a benefit in modern civilization.

Let’s look at the list again and add some details:

  1. Hunger: We are still genetically a species that is programmed to eat and eat and eat when food is available in order to stock up on calories in the form of body fat to get us through the lean times between feasts and good harvests (I’ve read elsewhere that without fertilizers and irrigation, 4 out of every 10 crop years were utter failures). But now we’ve eaten ourselves into a world where half of the people in it are overweight, a significant portion of those are downright obese, and “lifestyle diseases” like heart disease and weight-related diabetes are rampant.
  2. Thirst: Our need for water, and the related need to replace the salts we shed through urine and sweat, makes us crave salty foods to the point where we are all at the risk of high blood pressure (HBP). This in turn elevates our risk of heart attack and stroke (the same process essentially causes both).
  3. Fear: We were and are a violent species, understandable enough when we had to fend off lions and tigers and bears (oh my!), but civilization has allowed most of us to turn our violent tendencies onto each other and assign peacekeeping tasks to police and armies. As a result, post-traumatic stress disorder (PTSD) and the related mental distress caused by bottling up much of our impulsive rage are making “normal” life hard for those we rely on the keep violence from spreading everywhere. I wrote about this type of thing before, in 2015 (Deep Violence by Bourke).
  4. Blood clots: Our species benefited in a violent environment by being able to stop bleeding quickly, before we all bled to death from a deep scratch. But this ability also can complicate our normal aging process, especially when coupled with high blood pressure (see #2 above). Fast clotting was even more critical in the days before hospital births, when bleeding to death was a frequent complication for women who had just delivered (this still occasionally happens, even in a modern hospital).

One thing struck me as strange when I read Goldman’s book. I was amazed at how many of the things we take for granted as leading to a “healthy lifestyle” were only discovered recently. For example, a cardiology textbook in the 1940s defined a blood pressure of 200/100 as high, but “mild” and “benign” (p. 110). Walk into any doctor’s office or ER today with that blood pressure and your next stop is likely to be the hospital and a heart monitor.

President Franklin Roosevelt died on 19 April 1945 of a stroke, but what killed FDR was really his high blood pressure (p. 88). FDR was 63 years old, an age considered very old back then, but not even of normal retirement age today (FDR had been US president for 13 years by then: how many presidential candidates are over 63 in 2016?) . Oddly, the effects of his high blood pressure were masked somewhat by his polio and the resulting inability to walk at all or stand (with hip braces) for any period of time.

But by 1945, the years of stress through WW II and the Depression had taken their toll. In 1931, before he became president, FDR’s blood pressure was 140/100. By 1937, as war clouds gathered, it went to 162/98, and then to 200/108 by D-Day in 1944 (p.166). At his fourth inauguration, in January of 1945, Roosevelt only spoke 500 words and was never seen on his feet again. At Yalta early in 1945, FDR was at 260/150, or “off the charts.” His doctors belatedly recommended a low salt diet (!), but by the time he complained of “a terrific pain in the back of my head” and died, his blood pressure was at 300/190 (p. 117).

Bottom line: always, always, always have the nurse or doctor take your sitting blood pressure in each arm, after five minutes of rest (p. 108). If they don’t, they’re taking shortcuts that put you in peril.

One more short take: as late as 1990, 1% of women died in childbirth in the poorest parts of the world, and 1 in 300 (one-third of all childbirth deaths) were the result of uncontrolled bleeding (p. 161), mainly as a result of unfortunate placenta separation (it turns out that much depends on where the attachment is made in the first place).

This book will teach you many things and, if you’re anything like me, scare you enough to make real changes in what you do and eat each day. (Last night, I went to a drive-through craving a burger and found they had just added to calorie count to their menu. Instead of the burger with 1150-1650 calories (plus the fries!), I ordered the simple chicken sandwich at 650 and fed the fries to the dogs. You have to start somewhere.)

(In a couple of weeks, I’ll talk about a little book I found called The Wandering Falcon that acts as a kind of counter-balance to the whole “what would we do without modern civilization?” line of thought.)

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