Case No. 218
How’s this for the good life? You’re rich, and you made the dough yourself. You’re well into your 80s, and have spent hardly a day in the hospital. Your wife had a cancer scare, but she’s recovered and by your side, just as she’s been for more than 60 years. Asked to rate the marriage on a scale of 1 to 9, where 1 is perfectly miserable and 9 is perfectly happy, you circle the highest number. You’ve got two good kids, grandkids too. A survey asks you: “If you had your life to live over again, what problem, if any, would you have sought help for and to whom would you have gone?” “Probably I am fooling myself,” you write, “but I don’t think I would want to change anything.” If only we could take what you’ve done, reduce it to a set of rules, and apply it systematically.
Case No. 47
You literally fell down drunk and died. Not quite what the study had in mind.
Last fall, I spent about a month in the file room of the Harvard Study of Adult Development, hoping to learn the secrets of the good life. The project is one of the longest-running—and probably the most exhaustive—longitudinal studies of mental and physical well-being in history. Begun in 1937 as a study of healthy, well-adjusted Harvard sophomores (all male), it has followed its subjects for more than 70 years.
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From their days of bull sessions in Cambridge to their active duty in World War II, through marriages and divorces, professional advancement and collapse—and now well into retirement—the men have submitted to regular medical exams, taken psychological tests, returned questionnaires, and sat for interviews. The files holding the data are as thick as unabridged dictionaries. They sit in a wall of locked cabinets in an office suite behind Fenway Park in Boston, in a plain room with beige carpeting and fluorescent lights that is littered with the detritus of many decades of social-scientific inquiry: a pile of enormous spreadsheet data books; a 1970s-era typewriter; a Macintosh PowerBook, circa 1993. All that’s missing are the IBM punch cards used to analyze the data in the early days.
For 42 years, the psychiatrist George Vaillant has been the chief curator of these lives, the chief investigator of their experiences, and the chief analyst of their lessons. His own life has been so woven into the study—and the study has become such a creature of his mind—that neither can be understood without the other. As Vaillant nears retirement (he’s now 74), and the study survivors approach death—the roughly half still living are in their late 80s—it’s a good time to examine both, and to do so, I was granted unprecedented access to case files ordinarily restricted to researchers.
As a young man, Vaillant fell in love with the longitudinal method of research, which tracks relatively small samples over long periods of time (as in Michael Apted’s Seven Up! documentaries). In 1961, as a psychiatric resident at the Massachusetts Mental Health Center, Vaillant found himself intrigued by two patients with manic depression who had 25 years earlier been diagnosed as incurable schizophrenics. Vaillant asked around for other cases of remitted schizophrenia and pulled their charts. “These records hadn’t been assembled to do research,” Vaillant told me recently, “but it was contemporary, real-time information, with none of the errors you get from memory or the distortions you get when you narrate history from the vantage of the present.” In 1967, after similar work following up on heroin addicts, he discovered the Harvard Study, and his jaw dropped. “To be able to study lives in such depth, over so many decades,” he said, “it was like looking through the Mount Palomar telescope,” then the most powerful in the world. Soon after he began to work with the material, he found himself talking about the project to his psychoanalyst. Showing him the key that opened the study cabinets, Vaillant said, “I have the key to Fort Knox.”
Dr. George Vaillant shares insights from his decades of following the Grant Study men.
Such bravado had defined the study from the start. Arlie Bock—a brusque, no-nonsense physician who grew up in Iowa and took over the health services at Harvard University in the 1930s—conceived the project with his patron, the department-store magnate W. T. Grant. Writing in September 1938, Bock declared that medical research paid too much attention to sick people; that dividing the body up into symptoms and diseases—and viewing it through the lenses of a hundred micro-specialties—could never shed light on the urgent question of how, on the whole, to live well. His study would draw on undergraduates who could “paddle their own canoe,” Bock said, and it would “attempt to analyze the forces that have produced normal young men.” He defined normal as “that combination of sentiments and physiological factors which in toto is commonly interpreted as successful living.”
Bock assembled a team that spanned medicine, physiology, anthropology, psychiatry, psychology, and social work, and was advised by such luminaries as the psychiatrist Adolf Meyer and the psychologist Henry Murray. Combing through health data, academic records, and recommendations from the Harvard dean, they chose 268 students—mostly from the classes of 1942, ’43, and ’44—and measured them from every conceivable angle and with every available scientific tool.
Exhaustive medical exams noted everything from major organ function, to the measure of lactic acid after five minutes on a treadmill, to the size of the “lip seam” and the hanging length of the scrotum. Using a new test called the electroencephalograph, the study measured the electrical activity in the brain, and sought to deduce character from the squiggles. During a home visit, a social worker took not only a boy’s history—when he stopped wetting his bed, how he learned about sex—but also extensive medical and social histories on his parents and extended family. The boys interpreted Rorschach inkblots, submitted handwriting samples for analysis, and talked extensively with psychiatrists. They stripped naked so that every dimension of their bodies could be measured for “anthropometric” analysis, a kind of whole-body phrenology based on the premise that stock character types could be seen from body proportions.
Inveighing against medicine’s tendency to think small and specialized, Bock made big promises. He told the Harvard Crimson in 1942 that his study of successful men was pitched at easing “the disharmony of the world at large.” One early Grant Study document compared its prospects to the accomplishments of Socrates, Galileo, and Pasteur. But in fact the study staff remained bound by their respective disciplines and by the kinds of narrow topics that yield academic journal papers. Titles from the study’s early years included “Resting-Pulse and Blood-Pressure Values in Relation to Physical Fitness in Young Men”; “Instruction Time in Certain Multiple Choice Tests”; and “Notes on Usage of Male Personal Names.” Perhaps the height of the study’s usefulness in its early days was to lend its methods to the military, for officer selection in World War II.
Most longitudinal studies die on the vine because funders expect results quickly. W. T. Grant was no exception. He held on for about a decade—allowing the staff to keep sending detailed annual questionnaires to the men, hold regular case conferences, and publish a flurry of papers and several books—before he stopped sending checks. By the late 1940s, the Rockefeller Foundation took an interest, funding a research anthropologist named Margaret Lantis, who visited every man she could track down (which was all but a few). But by the mid-1950s, the study was on life support. The staff, including Clark Heath, who had managed the study for Bock, scattered, and the project fell into the care of a lone Harvard Health Services psychologist, Charles McArthur. He kept it limping along—surveys dwindled to once every two years—in part by asking questions about smoking habits and cigarette-brand preferences, a nod to a new study patron, Philip Morris. One survey asked, “If you never smoked, why didn’t you?”
It was a far cry from Galileo.
But as Vaillant points out, longitudinal studies, like wines, improve with age. And as the Grant Study men entered middle age—they spent their 40s in the 1960s—many achieved dramatic success. Four members of the sample ran for the U.S. Senate. One served in a presidential Cabinet, and one was president. There was a best-selling novelist (not, Vaillant has revealed, Norman Mailer, Harvard class of ’43). But hidden amid the shimmering successes were darker hues. As early as 1948, 20 members of the group displayed severe psychiatric difficulties. By age 50, almost a third of the men had at one time or another met Vaillant’s criteria for mental illness. Underneath the tweed jackets of these Harvard elites beat troubled hearts. Arlie Bock didn’t get it. “They were normal when I picked them,” he told Vaillant in the 1960s. “It must have been the psychiatrists who screwed them up.”