Hilary Tindle - Up: How Positive Outlook Can Transform Our Health and Aging

How Positive Outlook
Can Transform
Our Health and Aging

HILARY TINDLE, M.D., M.P.H.

HUDSON STREET PRESS

Published by the Penguin Group

Penguin Group (USA) Inc., 375 Hudson Street

New York, New York 10014, USA

USA | Canada | UK | Ireland | Australia | New Zealand | India | South Africa | China

Penguin Books Ltd, Registered Offices: 80 Strand, London WC2R 0RL, England

For more information about the Penguin Group visit penguin.com

First published by Hudson Street Press, a member of Penguin Group (USA) Inc., 2013

REGISTERED TRADEMARKMARCA REGISTRADA

Copyright Hilary Tindle, 2013

All rights reserved. No part of this product may be reproduced, scanned, or distributed in any printed or electronic form without permission. Please do not participate in or encourage piracy of copyrighted materials in violation of the authors rights. Purchase only authorized editions.

LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA

Tindle, Hilary.

Up : how positive outlook can transform our health and aging / Hilary Tindle, M.D., M.P.H.

pages cm

Includes bibliographical references and index.

ISBN: 978-1-101-62363-3

1. Health behavior. 2. Positive psychology. 3. AgingPsychological aspects. I. Title.

RA776.9.T53 2013

613.2dc23 2012050896

Designed by Eve L. Kirch

While the author has made every effort to provide accurate telephone numbers, Internet addresses, and other contact information at the time of publication, neither the publisher nor the author assumes any responsibility for errors or for changes that occur after publication. Further, publisher does not have any control over and does not assume any responsibility for author or third-party Web sites or their content.

For my parents,
Matt, our daughters,
and everyone who has shown me
how to find life in the desert

How Our Outlook Drives Our Health and Aging

I wonder how many times you almost died? my father asked me while we waited for our food at the Greek diner Salonica on Fifty-seventh Street, at the edge of the University of Chicago campus. In my third year of college, a previously undiagnosed congenital heart condition came crashing into my life and set me on a path to explore the attitudes that I now view as some of the most basic building blocks of health and disease. The gravity of my condition crystallized during the first week after successful cardiac surgery, and my father finally felt safe enough to pose this obvious question. There had been several times during my childhood when I had come close to collapsing, but every one of these mishaps had followed episodes of intense exertion, like running a three-hundred-yard dash in grade school or climbing out of the Grand Canyon as a high school student. Consequently, I had always passed them off as overdoing it, and sometimes didnt even mention them to anyone. My dad and I reflected on the events of the past few months: The previous summer, my energy level had inexplicably taken a dive. One Sunday morning while having dim sum with friends in Chinatown, I had dropped a full glass of watercompletely forgetting that my hand was supposed to be holding itsending it clanking over the porcelain dishes and dumplings and shattering on the floor. I had even fallen asleep during my medical school entrance exams, waking up drooling over the biology section.

Having scarcely completed adolescence, it did not even occur to me that there could be something really wrong. But after several weeks involving similar incidents, I thought I may have mononucleosis and finally made an appointment at the student health center. After hearing my story, the internist detected a loud heart murmur and immediately shipped me off to get a cardiac ultrasound. In the dark, quiet viewing rooms of the echocardiography suite, there were raised eyebrows as successively senior cardiologists were called in to help interpret the results. I looked at the shadowy pictures of my beating chambers with suspense and intrigue, as if they were part of an exciting movie. Not until years later would I realize that my state of general wonder throughout this processpeppered though it was with fear and doubtwould help preserve my sanity through the events that followed. I did not yet know how to read an echocardiogram, and could not discern the mass of tissue in the middle of the heart chamber called the left ventricle. The mass was partially attached to the mitral valvethe valve bisecting the left atrium (top chamber) and the left ventricle (bottom chamber). The walls of the left ventricle had become hypertrophied, or thickened, because of the very high pressure required to pump blood through the mass and out to the rest of my body. My heart had reached a point where it was simply no longer able to perform. I needed major surgery as soon as possible.

After the initial shock and uncertainty, I became the little patient that could. I put the surgery date on my calendar and told my relatives, friends, professors, and classmates. I met with my cardiac surgeon, the late Dr. Robert Karp, and asked him a list of twenty-two questions I had typed out on my PC, everything from how long the surgery would take (two to three hours) to the likelihood of dying on the table (5 percent or less). My final questionIs there anything that I can do as a patient to make your job as a doctor easier?produced the first grin Id seen on him yet. You already have, he told me. I didnt catch his meaning then, but now as a practicing physician I know what its like to work with a genuinely motivated patient, and I understand why he smiled at me. My upbeat attitude made me an easier patient to treat, someone willing to adhere to his medical advice and to do my part to attain the best possible outcome. That didnt mean I wasnt afraid. In fact, my concern about dying on the table prompted a couple of urgent visits to student mental health services: I didnt want to go to my grave with too much unfinished business. Within a couple of weeks I was on the operating table while Dr. Karp cut open my left atrium, reached across my mitral valve, and sliced away the offending blob.

After a brief ICU stay and four more days on the cardiac floor, I walked out of the hospital into a sharp Chicago December wind, leaning half of my body weight on each of my parents. Now on the mend, with a fresh scar traversing my chest, I basked in the warmth of my circumstanceshot Greek food, the love of my mom and dad, support of friends and professors, and the impeccable skill of my surgeon and his team, all culminating in the miracle of my being able to sit up without assistance. I had been given a second chance, and I was ecstatic to be alive.

The very experience of having felt so weak after surgery, in which it took real effort on some mornings to even hold my head up, allowed me a glimpse of frailty that most twenty-year-olds never get. Ironically, feeling close to my own mortality provided a rare and valuable reference point that only bolstered my hopefulness. During open heart surgery, my heart stopped beating for two hours on bypass, but I woke