Almost 100 years ago, Harvard University enrolled several hundred individuals in a long-term study of why some people live longer than others. This study is one of the most comprehensive and statistically validated programs in the medical literature.
Scientists began tracking the health of 268 Harvard sophomores in 1938 during the Great Depression, as part of the Harvard study of adult development.
The findings have been validated and are consistent with smaller studies and quite honestly could have been predicted using the rule of common sense. The individuals who lived the longest were in stable long-term relationships, were physically active, had hobbies and interests over and above their professional activities, did not smoke, and used alcohol sparingly.
Bottom line: They took care of themselves.
Okay, we all get it. Unfortunately, as a culture, we in America have one of the lowest life expectancies because of lifestyle issues and choices. As a culture, we are overweight, we smoke, we drink too much, we do not have physical activity imbedded into our lifestyle, and we are prone to diseases of despair: suicide, chemical dependency, addictions, high blood pressure, and other maladies related to our lifestyle.
But let us get up close and personal and see a real-life laboratory of a group that defied the odds here in Lake Wobegon country.
For almost thirty years my spouse, Peggy, had been a registered dietitian in the cardiovascular department of a major medical center in the upper Midwest. She developed a close personal and working relationship with about ten female colleagues who brought a joy and a professionalism to the workplace where the dietitians and other associates were sometimes dealing with very difficult situations for patients with end-stage heart failure, hypertension, and diabetes.
With the pace of life, this group somewhat went their separate ways, but once every year or so there would be a gathering at a local restaurant or at a park just to reconnect and check in and just see how everybody’s doing.
Let me give you a snapshot of one recent evening—an evening with important lessons for each of us.
Among the couples, the average age was about midsixties. They reflected the spectrum of life in the upper Midwest. As for the men (some details are changed for confidentiality): A foreman for a residential construction company was responsible for delivering materials to worksites. With the vagaries of Midwestern winters and a short building season, trucks had to be on time and all the appropriate material had to be loaded. Every day was game seven of the World Series. One was a prominent livestock and grain farmer. Another an administrator quarterback for a high-end home remodeling corporation. His clients wanted everything done yesterday. Another gentleman was a supervisor director for a clinical laboratory, and one of the other attendees a major leader in livestock and resource management.
Although I did not know them well, each shared a modest lifestyle, did not live beyond their means, did not have extravagant vacations or over-the-top hobbies. Each were fishermen and hunters and had the usual accessories for those activities but were sensible with their purchases. None went off on some junket to Africa to hunt big game. They were very much stewards of their communities, sensitive to climate change, and respectful of our limited national resources. And interestingly, most closely followed our professional baseball team, which has not done well over the last several decades.
They seemingly had mastered a life/work balance.
The women were engaging, funny, and genuinely enjoyed each other’s company. As the evening unfolded there were the usual discussions about health, well-being, the political and military chaos in our world, the uncertainties of healthcare. They also reflected on some frustrating decisions in the workplace, but there was none of the vitriolic whining and bitterness that sometimes can infect these gatherings. These men and women were realistic, honest, and simply described some of their frustrations.
No family was immune or isolated from the sufferings and anguish of life. Aging parents, the prodigal son and daughter, and career opportunities that were blocked because of unclear reasons. But there was no bitterness, no angst or anguish—just looking back with this sense of nostalgia about what might have been. A recurring theme, “I just play the hand that I was dealt.”
Over draft beers and pizza, there were some humorous moments about the mindless trivia that can absorb each of us, but these stories were shared with a light-hearted demeanor.
But one recurring theme jumped off the page.
Each of these couples, including Peggy and myself, was engaged in a supportive, long-term committed relationship despite the pressures on families these days. A particular accomplishment was a couple whose extended family involved several hundred individuals, and there was not one divorce among the families.
We all shared the attitude of stepping up to the plate when there was an illness. If Grandma was in the hospital, there was a loose schedule where someone would show up almost every day. Grandpa, in his nineties, lived alone in a small community, and it was understood that every weekend someone would show up with a casserole. Family members took an active interest in the medical care of the elderly and were very much aware of his medications, dosing, and schedule.
Another recurring theme was a thoughtful anticipation of retirement. My sense was that each had saved, their investments were sensible and prudent, but a dark shadow consistently loomed over everyone. How can I access the healthcare delivery system? A wonder and concern about who would take care of us.
Because the women all came from a healthcare environment, they understood the issues of burnout and stress among providers. The pressures in the daily clinical encounters. But I sensed a real uneasiness about who will show up and take care of each of us when those moments of crisis occur.
With the to-go boxes packed up, the down coats, scarves, hats, and mittens in place, we all hugged as best we could in this post-COVID world, and the evening closed down with a warm sense of nostalgia and some sadness as we skated across a frozen parking lot clicking out ignition fobs to try to find our cars in a typical blizzard.
Garrison Keillor was correct. Lake Wobegon is that mythical town out there on the edge of the prairie that time forgot. But here in our little community we had at least for a few precious hours a snapshot into the reality of life and, yes, my friends, there is a small group of people trying to make a go of it, and who honestly try to be kind and optimistic during increasingly perilous times.
Edward T. Creagan, MD, FAAHPM, is the author of How Not to Be My Patient: A Physician's Secrets for Staying Healthy and Surviving Any Diagnosis and Farewell: Vital End-of-Life Questions with Candid Answers from a Leading Palliative and Hospice Physician.