YOU
In 1952, two cardiologists named Meyer Friedman and Ray Rosenman decided it was time to re-upholster the chairs in the waiting room of their medical offices in San Francisco.
The upholsterer pointed out to Dr. Friedman that the chairs were worn out in an uneven fashion; Most of the wear appeared to be on the front of the seat cushions and armrests, suggesting to the good doctor that, while waiting for their appointment, most of their patients were literally sitting on the edge of their seat.
At the time, major risk factors for heart disease were fairly well-known; Diabetes, hypertension, high cholesterol levels, unhealthy dietary habits, a sedentary lifestyle, and of course, cigarette smoking. These risk factors (and others) are still widely accepted by the medical establishment to be mainly responsible for over 375,000 deaths from heart disease every year in the United States.
Even so, many cases of heart disease occur in people who possess none of the requisite "official" risks. Friedman and Rosenman wrote in 1974 that "at least half of the people who get heart attacks can be linked to none of the known and causative factors.”
"Plainly, another factor is at work here," the two heart specialists wrote. Their suspicion, first raised by their unevenly worn waiting-room chairs, led to some further investigation and odd observations.
First, the doctors studied the serum cholesterol levels and blood clotting times of a group of accountants during tax season. They found that, independent of changes in diet or physical activity, the accountants experienced “a marked rise in serum cholesterol level and acceleration of blood coagulation”
They were stunned to find that these elevated levels almost universally returned to normal after April 15th.
Friedman and Rosenman also noted that the personalities of a disproportionate number of their patients, as well as those seen by their fellow heart specialists, exhibited striking similarities:
Put more succinctly, one might say these patients simply had an adversarial relationship with time.
These largely anecdotal observations, noted by the doctors in their private practice, evolved into a formal medical study published in 1959 under the title “Association of Specific Overt Behavior Pattern with Blood and Cardiovascular Findings.“ The doctors studied three groups of men, roughly equal in number, with a negligible difference in average age, physical and dietary habits, alcohol consumption, and smoking habits.
Group A exhibited the personality traits described above. Group B exhibited almost the opposite characteristics. Group C (the control group) was made up entirely of unemployed blind men because, as the doctors put it, they "exhibited little ambition, drive or desire to compete" but nevertheless had high levels of stress and anxiety in their lives.
Though the doctors were expecting to find some correlation between personality and heart disease, they were astonished to find that the men in Group A were more than twice as likely to have coronary heart disease as those in either of the other groups.
Group A and its behavioral traits soon evolved into "Type A," and thus was born the sensational and controversial "Type A Personality Theory." These esteemed cardiologists, respected in their field and passionate about improving the well-being of their patients, believed they had discovered nothing less than "the major cause of coronary artery and heart disease.”
The findings of their study truly revolutionized cardiology; it was the first time anyone had shown a causal link between personality and heart disease, and several studies attempting to support or reject this theory, as well as to test the efficacy of different forms of treatment, have been conducted in the years since.
Hard at work in the post-WWII era, the American workforce took notice of the theory, and "Type A" became a household phrase, used (usually pejoratively) to refer to impatient, short-tempered workaholics. At the time, deaths from heart disease had risen steadily since the Great Depression, with a sharp uptick in the years following Japan's surrender.
Getting worried? Well, solid evidence about the real risks involved in being Type A is hard to come by, and very little is actually known about the real physiological effects. While not all Type As are openly hostile, it is believed that people who exhibit an excess of hostility as well as other Type A behaviors have a much higher risk of heart disease.
Beyond a few recent studies and Friedman and Rosenman's body of research into the subject, there doesn't seem to be any movement towards a consensus, much less any definitive word on whether being Type A is a risk at all. At the time of this writing, no mainstream source for information about heart disease lists Type A Behavior Personality as a known factor.
Complicating matters is the fact that many Type A behaviors are not intrinsically negative. Maybe you're a great multi-tasker, and maybe you don't think being competitive is a bad thing. Maybe the same qualities that make you Type A make you a good leader, a passionate advocate for a good cause, or a success in your chosen profession.
Maybe Lao Tzu had some ideas about the Type A Personality Theory when he wrote "The flame that burns twice as bright burns half as long."
Decades into the Information Age, workers in the United States are working harder in every industry, driven to compete not just with others but against time itself. Our obsession with productivity, and the idea that we can always be better, accomplishing and earning more in less time, are classic characteristics of our collective Type-A(merican) personality.
By any standard, we are exceptional at advancing our ability to chip away at the supposedly immutable structure of time, but as Friedman and Rosenman might ask any of their patients, what is it that we do with the extra time we’ve earned? Do we use it to examine and enrich our lives, or do we simply mark it and proceed to the next task and then the next, methodically crossing each one off from a lifelong to-do list?
For anyone with a Type A personality, that list extends beyond the horizons of the imagination, its end invisible beyond the far edge of the average human lifespan, if there is an end at all.
Friedman and Rosenman knew this, and would tell their Type A patients that, in actuality, no lifelong list of goals was ever finished until the moment that life ended. This would seem to make their theory a self-fulfilling prophecy; those obsessed with finishing everything often do, sometimes at a tragically young age.
Dr. Friedman, who described himself as a “classic” Type A, suffered two heart attacks and underwent multiple bypass surgeries in his lifetime. Despite his cardiac health and personality type, he lived for 90 years, and before he died in 2001 he was fond of crediting his longevity to diligently rejecting his own Type A traits.
“I saved my own life,” he often said, “by making time my best friend."
Matt Glaser lives in San Francisco and often taps his foot while he eats.
