by A. J. Jacobs
Yell this stuff in a room for long enough, and you start to believe it. I can do anything! I can write an epic poem! I can design a hydrogen fuel cell! Unfortunately, one thing I cannot do is convince Julie the class was worth her time.
“I feel like I was just at a Hare Krishna meeting,” she says as we’re packing up to leave.
Julie won’t be coming back. Though for the next two weeks, she did incorporate intenSati into our lives.
“Can you hand me the business section?” she said the next morning. “I want it. I want it. I really, really want it!”
In the end, I probably won’t be a regular intenSati-goer either. But I see its charms. Some level of delusional optimism is healthy. As long as that delusional optimism is balanced with a sensible understanding that we have pathetically little control over our fates. It’s a tricky mix, but a crucial one.
You need both. Without some delusional optimism, you’ll suffer from Depressive Realism. This psychological theory holds that the people with the most accurate view of the world aren’t happier—they’re clinically depressed. Studies show they have a correct perception of how much they control the outcome of events—namely, very little—and it crushes them. (Not all scientists buy this theory, but the ones who don’t are probably, you know, deluded.)
If your worldview is too real, you might spend all your time in bed eating Bugles corn chips feeling overwhelmed and listless. You’ll be too aware of all the thousands of factors toying with your destiny—from the weather to your genes to a misplaced pair of socks.
On the other hand, if you’re too delusionally optimistic, you’ll be unbearable. You’ll refuse to save money or make backup plans. You’ll invade foreign countries and expect to be greeted as liberators. Like everything else in health, you need balance.
Chapter 9
The Lower Intestine
The Quest to Go to the Bathroom Properly
I’VE STUMBLED ACROSS some strange information in my health research. There’s Capgras syndrome, in which a person believes that his mother (or sister or best friend) has been replaced by an identical-looking impostor. There’s a disease called “pica,” where the sufferer has an overwhelming desire to eat dirt, paper, glue, or clay.
But right now I’m being told the oddest, most baffling detail I’ve heard all year.
I’m in the office of Dr. Lester Gottesman in midtown Manhattan. And he’s describing to me an elective surgery that he’s performed not once, but several times.
It’s for people who want to change the way they sound.
When they fart.
Yes, these patients want to change the timbre of their flatus, usually from a high pitch to a lower pitch. From a piccolo to a bassoon. Apparently, that’s more aesthetically pleasing.
So he’s done several procedures to tweak New Yorkers’ sphincters. “I try to talk people out of [the surgery], but some people have a whole psychodrama about farts.”
I’m not sure how to react to this information. Mostly, I’m thinking that if the revolution comes, this fact alone will make it hard to fault the insurrection. “Well, I don’t approve of mass executions of the ruling class,” we’ll have to admit. “But on the other hand, there’s that trend of plastic surgery to upgrade our farts. We really were asking for it.”
As a committed experiential journalist, I also wondered if I should submit to the operation and become a baritone myself. But Dr. Gottesman says it has no known health benefits. Which is a relief.
But I do need to address other aspects of my colorectal health. I can’t ignore my bottom. I’ve spent months obsessing about what to eat, but not a minute on how to take out the body’s trash. It seems imbalanced. It seems unhealthy.
I’m not a big scatology fan, unlike my sons, who can amuse themselves for an entire afternoon by repeating the phrase “crocodile fart.” So I’ll spare you from an overabundance of detail in this chapter. This chapter will be somewhat soft focus, like the TV camera in a Barbra Streisand interview.
I found Dr. Gottesman because he’s been included on New York magazine’s Best Doctors list for the last eight years and has written, in his words, a “shitload” of academic articles.
When I first arrived, I filled out my paperwork in the waiting room, which had a sign that said NO EATING. That seems unnecessary. You’d hope that the word “colorectal” would dampen one’s hunger for a chalupa.
Soon after, Dr. Gottesman calls me into the exam room. He’s soft-spoken, so much so that I find myself leaning forward to hear him. He’s got orangish hair, which is tousled in a just-woke-up way.
“Kneel there, pull down your pants, and lie on your stomach,” he says.
I follow orders.
“Can you give me an estimate on the pain?” I ask over my shoulder.
“It shouldn’t hurt too much. Unless you want it to.”
I phone in a half snort, half laugh. I’m guessing proctologists have to memorize ten such responses for their board certification. Just as the Talmud must require mohels to make circumcision jokes.
After the exam—which hurt much more than I “wanted”—we went to his office for a debriefing.
I sat down across from his desk. He had on a concerned face.
“Do you read while going to the bathroom?”
“Sure,” I say. “Who doesn’t?”
“I could tell you did. You have significant hemorrhoids. They’re not huge, but they’re not small.”
This diagnosis seems spectacularly unfair. One of the least welcome pieces of news in my project so far. They can take away my Doritos. They can forbid me Diet Cokes. But reading on the toilet? That’s practically in the Bill of Rights.
Dr. Gottesman is stern.
“Don’t read novels on the toilet,” he says. “Don’t write novels on the toilet. If you keep doing it, then you’ll have to get surgery. And hemorrhoid surgery is not fun.”
Reading distracts you, causing you to sit on the toilet longer. Sitting on the toilet causes swelling of the veins in the anal canal. And that swelling results in enlarged hemorrhoids—a condition that affects more than 70 percent of Americans at one time or another.
I promise to keep magazines out of the bathroom. I then ask Dr. Gottesman some other common colorectal questions.
How often should I be moving my bowels?
Some zealous health experts say we should go frequently and in great quantity. On Dr. Oz, I watched a gastroenterologist rave about sub-Saharan people whose three-times-a-day movements are “the size of my head.” Also, some doctors recommend that the poop be in the shape of an S-curve.
Dr. Gottesman—echoing the recommendations from the American Society of Colon and Rectal Surgeons—is less specific. Anything from once every three days to three times a day is acceptable, he says. And the S-curve is fine, but not necessary.
How much fiber should I be getting?
A huge amount. The Institute of Medicine says thirty grams a day. Which is a challenge. An apple—one of the most high-fiber foods—has only three grams of fiber.
When should I get a colonoscopy to screen for colon cancer?
Unless I have a family history or symptoms (thank God, I don’t), most experts recommend fifty.
Should I wipe while standing or sitting?
Sitting. It’s easier to get fully clean, he says.
Should I get a colonic?
“They don’t help, but they probably won’t hurt.” Colonics are supposed to wash away toxins that build up in your bowels. There’s scant scientific evidence to support any health benefits. (Incidentally, as part of my project, I did get a colonic, but I’ve decided not to write about it at length. I didn’t find it helpful or enlightening. I can tell you what it felt like, though: It felt like someone shooting water up your butt.)
Operation Squat
Dr. Gottesman’s no-reading-on-the-toilet commandment is a good, if unwelcome, piece of advice. But the more I learn, the more I realize it’s only a half measure.
To h
ave the ultimate healthy bathroom experience, I shouldn’t be sitting at all. I should be squatting.
I first heard about the joys of squatting from Vlad, the raw-meat-loving caveman who told me I had a flat chest. He informed me that he goes to the bathroom by perching on the seat of the toilet. But since I’m a novice, I should buy an apparatus on the Internet to help position myself.
I dismissed his squatting lecture as caveman crazy talk. But oddly enough, there’s bonafide evidence that squatting is better for you. I e-mailed Gottesman, and he backed it up.
As Daniel Lametti points out in a definitive Slate magazine article on the topic, the sit-down toilet is a recent invention, dating back to the sixteenth century. Lametti quotes a proctologist in Time magazine who said, “We were not meant to sit on toilets, we were meant to squat in the field.”
Sitting puts more strain on the bowels than squatting, leading to an increase in hemorrhoids. Several studies address the issue. One Israeli scientist compared subjects who squatted over a plastic container and those who defecated on a high toilet. The squatters averaged 51 seconds per movement. The sitters, 130 seconds. And the squatters also rated the experience easier.
The most fervent pro-squatters say the posture also prevents cancer and Crohn’s disease, though these claims remain unproven.
Following Vlad’s orders, I found a squat-aiding apparatus on the Internet. It’s called “Nature’s Platform.” Apparently, demand is high. The website was out of stock.
Regardless of the warning, I ordered it, and Nature’s Platform arrived a few days later. The platform consists of a folding metal frame topped by a white plastic board with a volleyball-size hole in it. You assemble Nature’s Platform yourself, put it over the toilet, climb on top, and squat, essentially turning your flush American Standard into a third-world hole in the ground.
I install my Platform before Julie comes home from a meeting. She heads to the bathroom. I wait.
“Not funny!” she shouts from inside. “Not funny at all.”
She says that, but in truth, she’s laughing. It’s hard to resist the charms of Nature’s Platform.
Julie gives Nature’s Platform a test-drive while peeing, and pronounces it “interesting.”
“Flowers are a more traditional gift,” she tells me when she gets out.
I’ve been using Nature’s Platform for a couple of weeks. It definitely speeds things up. Though it does turn reading on the toilet into a dangerous acrobatic balancing act. Books are out of the question. Which would make Dr. Gottesman even happier.
By the way, after going, one other health tip: I make sure to shut the lid before flushing. Otherwise, an explosion of tiny droplets of bacteria-ridden toilet water will coat your bathroom walls and toothbrushes. You’re welcome!
Checkup: Month 9
Weight: 158
Total steps this month: 230,000
Push-ups till collapse: 58
Days in which ate cayenne pepper powder in morning because a study showed spicy food lowers hunger: 12
Overall health: I’m finding the project exhausting—but oddly, mentally as much as physically. Dozens of times a day, I try to figure out what’s the healthiest course of action. But often, I feel lost in the fog of conflicting advice.
Take the treadmill. After about three hours, my treadmill starts to stink like burned rubber. My son Jasper holds his nose when he’s nearby. So are the positive benefits outweighed by these noxious fumes?
If I have an extra hour in my day, should I go to the gym or visit my family? All the health books emphasize the importance of family and friends.
Should I get a carpet because it blocks noise, or will that send allergens into the air?
When I have water at a restaurant, should I ask for a twist of lemon, because lemon juice lowers the glycemic index? Or demand that no lemon get within a yard of the glass, because microbe experts say restaurant lemon wedges teem with germs?
I bought a steamer, because you can’t get much healthier than steamed vegetables. But my steamer is made of plastic. Am I making myself some hormone-disrupting broccoli?
I need to relax.
Chapter 10
The Adrenal Gland
The Quest to Lower My Stress Level
IT OCCURS TO ME THAT writing a book about health is not healthy. In fact, writing any book is bad for you.
There’s the sedentary lifestyle (which I’ve curbed somewhat with my treadmill desk). There’s the isolation—being alone breeds depression, which helps explain the absurd number of authors who’ve come to unhappy endings (Hemingway, Woolf, Plath—I could fill up the rest of the page).
And then there’s the pressure. I’m way behind schedule. My publisher keeps reminding me of my deadline, and I keep replying that deadlines are incompatible with health. As are book releases. If and when my book comes out, what if I get the flu or an eye infection or something? I worry about that a lot. “You see the world’s healthiest man?” they’ll say. “He’s the one in the corner with a hacking cough.”
To combat this conundrum, I’m wrestling with stress this month.
Before this year, I was a bit of a skeptic. I was still too much of a Cartesian dualist to believe that stress was all that bad for your body. No more. Stress is not like vibes or auras. There’s an Everest of data showing that stress wreaks all sorts of physiological havoc.
The term “stress,” as psychologist Dr. Esther Sternberg writes in her book Healing Spaces, was coined by a Hungarian endocrinologist named Hans Selye. So obsessed was he with the concept, he had the chemical structure of the stress hormone cortisol carved into the stone above his front door.
Like so much else in the body, stress started out as a helpful ally back in Paleo times. Stress increases the heart rate, which is useful in the short term for running and fighting. It even helps ward off some disease in the short term. A study in the Journal of Clinical Immunology measured immune cell levels in skydivers just as they were about to jump. They had 34 percent higher disease-fighting natural killer cells.
But over the long haul, the high heart rate and constricted blood vessels suppress the immune system. The more worry, the more sickness. In one of many such studies, a researcher found that mouth wounds took 40 percent longer to heal when students were in the middle of exam week.
There’s a big problem with acknowledging that the mind plays a part in physical disease. We’re tempted to blame the patient. Stop being so grumpy and you’ll get better. You can will (or pray or think) yourself out of sickness! Buck up!
This danger fed my skepticism about the bodily effects of stress and moods. It smacks of The Secret, that bestselling but bunkum-filled book that says you can wish those cancer cells right out of your body. The last thing a melanoma patient needs to hear is that they should “turn that frown upside down” if they want to get better.
Robert Sapolsky—author of the great book on stress Why Zebras Don’t Get Ulcers—calls it a “lapsarian” view, “characterizing illness as the punishment meted out by God for sin.”
And indeed, so far, science shows no link between cancer and stress. That’s important to state, because much of America believes otherwise. Sapolsky cites a 2001 study where the majority of patients believed their breast cancer was caused not by genetics, diet, or environment, but by stress.
But when it comes to other health problems, stress gets trickier. Studies show a huge link between stress and heart disease. And studies also show that we can, to some extent, control our stress level.
At least for me, this leads to a horrible positive feedback loop of worry. If I worry too much, I’ll increase my likelihood of heart disease. So I worry about worrying too much. And that increases my worry. Which makes me worry I’m even more at risk for heart disease. I need help.
Ho, Ho, Ho, Ha, Ha, Ha
It’s Monday night, and I’ve chosen to go to a laughter club. I read about laughter clubs—also called laughter yoga—in Time magazine, and they seem like a relatively pa
inless, if dorky, way to cut down on stress.
The club I chose is led by a chiropractor named Alex Eingorn in his midtown office. Eingorn writes on the website: “It’s free, but I’ll accept $2 million donations with no questions asked.”
Eingorn, it turns out, looks a bit like Mikhail Baryshnikov. He speaks with a slight Russian accent and is happy and welcoming, as you’d hope a laughter club leader would be. He wears casual blue Nike shorts and a sweatshirt.
There are fifteen of us tonight, ranging in age from early twenties to eighties, and we stand in a circle.
“Are you ready?” asks Alex. “Okay, drop and give me twenty.”
We all chuckle.
“Any newcomers?” Alex asks.
I raise my hand.
“How’d you hear about us?”
“The Internet,” I say.
A wave of laughs and titters. I like this room. This isn’t what you’d call a tough room. This room could, in fact, be the easiest in New York City. I’m not sure why “Internet” got such a big reaction. Its association with porn? With geeks? Who knows. I’m just happy “the Internet” was considered an Algonquin-worthy quip.
Eingorn asks us to go around the room and say our names and occupations. And, he adds, somewhat unnecessarily, we should respond to each other with laughter. That will break the tension.
First guy: “I’m Tom. I’m an accountant.”
There’s some laughter.
Second guy: “I’m Steve. I’m a consultant.”
More laughs.
Third guy: “I’m also Steve.”
Big laughs. A callback.
There was a psychoanalyst (good reaction), plumber (huge one), and then me.
“I’m A.J. and I’m a writer,” I said.
Everyone busts out at that one, rivaling the response for the plumber. This time I have mixed feelings. What’s so funny about a writer? Is it really as humorous as the plumber, an occupation known for clogged toilets and low-riding pants? Intellectually, I know the group is just following orders, but a deeply buried part of me feels as though they are mocking me. A writer? In this day and age? Time to dust off the résumé, pal.