Our Smartest Hive: Discovering a New Altruism

“But never before has it been easy to solicit and collate contributions from thousands or millions of unknown collaborators.“

–Walter Isaacson

 

One of my pet follies is keeping a few beehives in our back yard.  It’s a folly because, since moving our hives from the leafy suburbs into our leafy city neighborhood six years ago, only once have I harvested honey from them and not once has even one of the four hives I’ve bought each spring survived a full year.  Is it pests or pesticides or colony collapse or a dearth of pollen in the city woods around us that kills our hives?  Andrew Kartal, who supplies us with our bees each year and inspects our hives when I have a crisis, thinks we don’t have enough pollen in town.  But, being a devoted fool, I keep trying to figure out city beekeeping by fiddling with how I feed them and how I treat them for pests and any other trick I can try.

I don’t do it for the honey.  I do it for the fascination of watching the collective wisdom of these hives in action.  How do they figure out who does what when?  The stray honey bee that follows me into the kitchen when I’m preparing the feeding buckets appears as dumb as a house fly.  But as one of the thousands in the hive, that bee plays several key roles in what makes a hive miraculously smart.  How do they all figure out when to requeen and when to swarm and how many drones should tend the larvae while others forage for pollen?   I’d love to be a fly-on-the-wall in those council meetings.

Under more favorable conditions and in the hands of better beekeepers, three thousand drones and a queen make a plenty smart enough hive to thrive through the years.  What interests me more urgently is what the sufficient number and composition is for our own species to thrive through the years.  One of my colleagues, Jurgen Unutzer at the University of Washington, signs his emails followed by the motto “None of us is as smart as all of us.”  This turns out to be a quotation from Kenneth Blanchard, the author of The One Minute Manager, a popular book on corporate leadership.  But I wonder how we should read “all of us.”

Under most circumstances all of us in large numbers are not very smart.  Mob justice is never patient, compassionate, or subtle.  The crowd psychology of rioting protesters is rarely creative or clever and usually ends badly.  Even large peaceful, well-organized demonstrations involving hundreds of thousands of people can at best deliver a single message for a day or two: stop the war, give us our freedom, end racism.  Our largest effort at collective decision-making, national elections, which involves millions, is limited to a list of yes/no votes on a single day—not a complex or sophisticated process.  Historically our most productive efforts at collective intelligence have taken place in huddles, councils, board rooms, and committees, which do their best work when the number in the room is less than twenty, often closer to ten.

Then along comes the Internet, and with it the discovery of a new capacity of the human species.  Listen to how Walter Isaacson summarizes this discovery in the last chapter of The Innovators: How a Group of Hackers, Geniuses, and Geeks Created the Digital Revolution (2014, p 482):

“Like the computer, the ARPANET and the Internet were designed by collaborative teams.  Decisions were made through a process, begun by a deferential graduate student, of sending around proposals as ’Requests for Comments.’ That led to a weblike packet-switched network, with no central authority or hubs, in which power was fully distributed to every one of the nodes, each having the ability to create and share content and route around attempts to impose controls.  A collaborative process thus produced a system designed to facilitate collaboration.  The Internet was imprinted with the DNA of its creators.

The Internet facilitated collaboration not only within teams but also among crowds of people who didn’t know each other. This is the advance that is closest to revolutionary.  Networks for collaboration have existed ever since the Persians and Assyrians invented postal systems.  But never before has it been easy to solicit and collate contributions from thousands or millions of unknown collaborators.  This led to innovative systems—Google page ranks, Wikipedia entries, the Firefox browser, the GNU/Linux software—based on the collective wisdom of crowds.”

Finally, after eons of evolution, we invented a tool, the computer, that allowed us to tap into a capacity we didn’t know we had.  We’ve done this man-and-tool trick before.  The invention of musical instruments revealed our capacity for elaborate musical communications.  Ships led to distant travel that revealed our capacity for learning foreign languages.   Guns and steel revealed our capacity for large-scale warfare and massacres.  Now the Internet and the systems it has spawned have revealed our capacity to work with many thousands of strangers on a mission that serves people we will never know.  We have done this not for love or money or fame, but for the chance to participate in and belong to something meaningful and useful to “all of us.”

The revolutionary discovery is that under a novel set of conditions a large self-selected group of people can cooperate through a governance structure by consensus to create highly sophisticated systems of open-source software.  No bosses, no experts, no voting, no pay, no credit.  The built-in mechanisms for self-improvement of these systems increased the chances for survival of the invented software.

One of the conditions that allowed Jimmy Wales and Wikipedia to eclipse Nupedia, which was edited by experts, and Encyclopedia Britannica in just a few years was the counter-intuitive premise that allowing anyone—not just experts—to contribute and edit articles would improve the quality of the articles rather than diminish it.   That open-door and hands-on policy, which looked to most like an invitation to chaos, proved key to tapping this unrecognized resource.  With just a few guidelines created collaboratively by the Wikipedia community (such as “articles should strive for a neutral point of view” and disputes about facts required mediation), Wikipedia mushroomed from 1,000 articles in 2001 to 100,000 articles in 2003 with 500 active editors.  When the Encyclopedia Britannica quit publishing its print edition in 2010, its electronic edition had 80,000 articles, less than 2 percent of the articles in Wikipedia.  In 2014 Wikipedia had grown to 30 million articles in 287 languages.  This growth of Wikipedia represents knowledge power and dissemination on a scale unimaginable in 2001.

Isaacson wonders why some people have devoted thousands of hours to these projects.  This is “commons-based peer production” driven by “a diverse cluster of motivational drives and social signals,” he writes.  He cites the reward of interacting with others and the personal gratification of doing useful work, the same altruism that makes us do old-fashioned church work or food drives or litter pick-ups.  Caring for our neighborhood is good for us.  But now we have “wiki-crack, the rush of dopamine…when you make a smart edit and it appears instantly in a Wikipedia article.”  This is a new kind of altruism on a new scale with a greater reach.

The Internet and some of its offspring appear to have created a big room for a subset of “all of us” in which the wisdom of the crowd really does create a smarter hive for the rest of us.  Now what is the next currently unimaginable invention that will tap this deep well of altruism?  Is the power of this resource equal to the challenges of our big problems: poverty, famine, plagues, warfare, corruption?  If Google can’t tell you, just Wiki that question.

Our Silent Heart-to-Hearts

When Naomi backed in through their apartment door, arms loaded with her handbag, gym bag, and the box of dinner ingredients from Fresh Hello, Arturo was waiting for her, suavely dressed in his Armani shirt, arms outstretched, grinning, folding her into his embrace.

“Hello, my love!” he cooed.  “Tonight we celebrate.”  He set her bags and the box on the counter, raised her hand, and lightly spun her.  She shuffled around, saying, “Celebrate?”

“Rollerblade down to the waterfront. Maddie and Jimbo want to sail us out around the Statue of Liberty and back.  Barbecue on the back of their boat in the twilight.  We’re going to celebrate this baby coming and the raise I got and spending a chunk of it on remodeling our closet into a nursery.”

“Okay,” she said, wondering what else he had in mind.  “I guess this box dinner can wait till tomorrow night.”

“Okay?” he said, looking deep into her eyes.  “What does that mean?”

She turned away to peel off her jacket and hang it on the hook behind the door.  “Okay means let’s do it,” she said in a voice that didn’t convince him.

“Whoa,” he said. “It’s time for a heart-to-heart.” He pulled out his phone and tapped his Social Coherence app.

On this day in 2025 this will be the second time Naomi has heard that call for a social coherence check.  Earlier that day she will have heard it from her boss, Ruth Havens, head acquisitions editor.  During their weekly review conference the usuals had been present around the small table in the conference room: Jill and Abdul, the two other assistant editors, Tim from marketing, Alfie from finance, and Hema the intern.  Ruth was pushing for closure on whether to go ahead with investing in a series of young adult books by an unknown author on the tricky topic of gaming as a teaching technique for high schoolers.  After going around the table and getting an apparent unanimous consent to offer the contract, an uneasy pause settled on the room.  Ruth shuffled some papers, looked again at her team, and announced, “This doesn’t feel like unanimous consent.  Social coherence check. All got your wrist bands on?” She pulled out her phone and tapped the app. The others around the table reluctantly tapped in as well.

In five or ten years could social coherence monitoring be as routine an event for the device-devoted as texting is today?  So far, there’s no app for it.  Social coherence is a concept, but too complex to have made it to the popular market.  Still, I find the possibility mesmerizing—that the physiologies of two people (or seven!) could synchronize—not just their thoughts, but their heart beats, their breathing rates, their hormones.  Why not?  Herd animals and flocks of birds must synchronize in these ways.  Mothers and infants sometimes can synch their breathing and voices and even their heart rates.  Why not two adults, or many?  We can synchronize our steps when we march and our voices when we sing.  How deep does this synchrony go?

I picture a graphic on their phones that reveals how well or poorly synchronized their hearts are.  Maybe two lines, or seven, showing each of the rhythms of the variations in heart beats and some overlay that measures the degree of coherence or incoherence.  Instant feedback.  Well-trained participants could then use their skills to try to get their physiologies in sync with the other(s).  Think of it as group biofeedback.

The term “social coherence” has emerged in the psychophysiology lingo recently.  It rests on the concept of coherence within a physiologic system, such as the cardiovascular system.   Physiologic coherence begins with the observation that a rhythmic process in our bodies, such as breathing or heart rate, can oscillate in a range of patterns, some of which have high degrees of order, stability, and efficiency.  Your car engine, which also operates in rhythmic cycles of cylinders firing, can run in a range of patterns, including an optimal idle speed and an optimal cruising speed around 55 mph.  Coherence in these oscillating systems refers to optimal patterns of efficiency.

We recognize these efficient physiologic patterns partly through feelings of pleasure.  We find a steady resting heart beat around 60 more comfortable than heart beats as low as 30 or as high as 110 beats per minute.  Evolution has made us so we enjoy these more efficient states.  And we know the opposite, chaotic physiologic states, as the absence of pleasure, or as discomfort or pain.  This lack of physiologic coherence can be as distressing as incoherence in speech or thought.  We recognize when a person’s speech crosses a certain line between order or sense and disorder or nonsense.  Alarm bells go off in all of us.  Are we less good at recognizing physiologic incoherence?

There is a published definition of cardiac coherence, based on the physiologic measure of heart rate variability.  This concept of heart rate variability refers to the fact that resilient hearts vary their rates widely in response to challenges; aged or diseased hearts are less flexible and can vary their heart rates much less. In a recent review the authors of this definition found that cardiac coherence may be related to other measures of health, such as the ability to regulate strong emotions, maintain stability of the autonomic nervous system, and control blood pressure.

Cardiac coherence is an attractive possibility, but neither the concept nor this specific definition has spread much beyond the circle of the authors in the nine years since it was first published, so it’s not yet clear how useful this definition of cardiac coherence may be.  If you google “cardiac coherence,” the only published scientific article in the first three pages of listings is the 2014 article cited above.  One of the more promising of these listings is the University of Pittsburgh Medical Center’s page for the Center for Integrative Medicine offering “cardiac coherence training.”

There is also a self-report measure of the effectiveness of coping with stress, called the Sense of Coherence, by Aaron Antonovsky, which may be loosely related to the concept of physiologic coherence, though no one seems to have studied that link.  A paper published this year found that this Sense of Coherence measure explained a substantial amount of the risk for developing diabetes in a group of people with chronic stress.  Maybe a person’s low sense of coherence reflects an “incoherent” or disordered physiologic state that paves the way to chronic illness.

There are lots of gaps that need to be filled in this potential story.  If this is more than the coincidental use of the same word by two silos in the psychophysiology world, it’s possible that our sense of effective coping includes sensing cardiac coherence as well as other forms of physiologic coherence.   Steven Porges, in his book The Polyvagal Theory (2011), makes clear the evolutionary origins of the links among emotions, social attachments, and heart rate variability in animals and humans, all of which are essential to adaptation and health.  And there’s good science suggesting that in humans mother-infant synchrony of several types, including heart rate variability, during the first three months of life predicts later capacities for self-regulation of emotions among toddlers, attachment security at 6 years old, and empathy in adolescence [link to ref].  This is evidence for social rhythms entraining biological rhythms that later pave the way to more complex social rhythms, such as the sometimes surprising capacity of teenagers to experience empathy for others.

So is it possible that we can not only sense coherence within our own physiologies but in the physiologies of others, first our mothers and later our lovers or colleagues? Can I intuitively adjust my heart to sync with yours? So far the evidence is not persuasive.  Many gaps need to be filled before we can confidently say so. Maybe with better group biofeedback we can learn this fine art.  What kinds of synchrony might we be experiencing without knowing it when we dance, sing, or have an intimate heart-to-heart talk.  How many levels of conversation are we conducting?  I can sense your breathing.  Can I sense your heart beats too?  If our hearts are in sync, do our words matter?

Smart scientists have a lot more work to do on the devices and the data analysis and the apps that can translate all that data from our wrist bands into a few simple graphs that will guide us to adjust our behavior and our heart beats for finer harmony among us.  Until then, to find some kind of social coherence, we’ll have to rely on our intuitions and looking deep into other people’s eyes and listening to how they say their words and guessing if we’re in sync.

Then some day there’ll be an app for that.

Medicine’s Next Frontier?

I just finished reading a collection of essays by a forester from Hümmel, Germany, outside of Cologne, titled The Hidden Life of Trees.  That could be a good title for a parody, but Peter Wohlleben is an earnest forester with an urgent message. He’s the first to make me believe that trees are social creatures.  And he taught me that much of the interesting life of trees takes place underground.  No wonder it’s hard to believe that trees in forests develop a symbiotic relationship with an elaborate web of fungi through which their roots communicate with the roots of other trees and share nutrients—dubbed the “wood wide web.”  It’s enough to make me think I should throw away my chain saw.

Isn’t it impressive how much time we can spend around trees without understanding one of the most basic aspects of tree life—that they are social creatures that have evolved elaborate ways of depending on each other? We know this about people and animals.  Why should it be different for trees?

This book resonates with another book I’ve been thinking about, the one I’m trying to write.  My working title, The Healer’s Blind Spot, tells you that it too is about the hidden life, in this case the life beneath the turf of our awareness where stress gnaws like a beetle infestation at the roots of our health.  The humble forester spent his career tending to one forest in central Europe, and I’m one clinician who has tended to my group of patients in the Midwest of America.  I too think I have an urgent message for the world about the hidden life.

The National Institutes of Health once declared the 1990’s would be “The Decade of the Brain.”  Before then the brain was beyond the frontier, something few of the best clinicians claimed to understand. Of course it took more than a decade, but now we can see the brain in action and we know the brain, at least the basics of how it works.  The brain was the last major organ to be mapped in detail at multiple levels of understanding, a bit like exploring our last major continent.  In my lifetime before the brain, modern medicine declared the frontier was the heart and then cancer.  In my parent’s generation the frontier was infections, antibiotics, and vaccines.  Imagine life and modern medicine without an understanding of the hidden life of microbes, the heart, cancer, and now the brain.  It’s hard to appreciate what we don’t know until we can see it.

Now that the major organs have been explored, what’s the next frontier for modern medicine?  After mapping the surface of the world, we can only go out or in.  “Out” for medicine could mean exploring out from the individual person to the social and environmental dimensions of health, a bit like exploring our place in the universe of people and environments.  How does group behavior affect individual health through families, teams, institutions, neighborhoods, and prisons?

“In” could mean exploring more deeply the genetics and epigenetics of health and illness, but we’ve already crossed into that frontier.  We’ve mapped the human genome and are starting to understand how it works.  Clones for humans are threatening and a few tantalizing clinical benefits of epigenetics are just beginning to reach the common press.

Another inward frontier that is currently harder to see than genes is the nether world of the stress response system.  This system is the ancient orchestration of our major organ systems that evolved to allow us to respond to challenges in ways that are so quick and automatic that we don’t have to think or be aware of them.  The blink of an eye, the jump in heartbeat, the flinch, the crouch, the sudden sweat—that quick, that automatic.

I saw this frontier with a new clarity a few weeks ago at a conference for psychiatrists in Orlando while attending a talk by Curt LaFrance, MD, about “functional neurologic disorders.”  The term “functional disorders” refers to a group of illnesses or syndromes that cause substantial suffering and disability but don’t fit our current measures and notions of pathology. Every specialty has at least one functional disorder, and they’re usually regarded as the orphans in the specialty’s family of illnesses.  About 5-10% of visits to these specialties are for these functional disorders, so it’s hard for specialists to ignore them, if they’re inclined to.

In neurology it’s psychogenic non-epileptic seizures and functional tremors.  In cardiology it’s atypical chest pain.  In rheumatology it’s fibromyalgia. In gastroenterology it’s irritable bowel syndrome.  In psychiatry it’s somatic symptom disorder.  Most specialists and primary care clinicians regard these disorders as orphans because they don’t fit our trained ways of thinking; they don’t reveal themselves through standard diagnostic measures; and they don’t respond to the traditional and most remunerative treatments so cherished by each specialty.

One of the themes of my book is that most doctors have a blind spot for the role that stress plays in our most common chronic illnesses such as diabetes, heart disease, and obesity.  When LaFrance flashed a slide with a table of the specialties and their functional disorders, I recognized that table as one I’ve seen many times.  But this time I saw it through the lens of this book I’m working on and asked myself what these functional disorders share in common.

The first answer that came to me was treatments.  In spite of these disorders being treated in very different specialties in a variety of ways over the years, they’re all now most effectively treated with various combinations of a) cognitive behavioral therapy, b) graded exercise or physical therapy, c) antidepressant or antianxiety medications, and d) meditation or relaxation techniques.  These are not the usual tools for neurologists, cardiologists, rheumatologists, or gastroenterologists.

The second answer that came to me from the realization that functional disorders respond to a common set of treatments was that these functional disorders share a common mechanism, a chronic dysregulation of the stress response system called autonomic imbalance.  This simply means that for too long their autonomic nervous systems have been overactivated or hyperaroused, with too little time resting or relaxing between activations.  The sympathetic nervous system is too active while the parasympathetic nervous system, which promotes rest and digestion and tissue repair, has not been protective enough.  Like an infestation of the tree’s roots and the fungal web that feeds them, autonomic imbalance destabilizes us at our roots. This condition of autonomic imbalance can be traced to many of our corrosive habits of modern life: ruminations and worry, cheating on sleep, physical inactivity, artificial stimulants, noxious diets, excessive work hours, clinging to unsafe relationships, and social isolation.  If we strain our stress response systems long enough and relentlessly enough, they falter into these disabling syndromes which we euphemistically call “functional disorders,” or diseases that are easier to diagnose, like diabetes, depression, and heart disease.

But most clinicians, even good ones, are not in the habit of thinking about the stress response system.  The stress response is invisible to us in part because we don’t have standard measures for stress in the clinic.  We don’t see the stress response system because most of the stress response occurs deep in the subconscious mind and deep in the organs we can’t see or often feel until we’re in big trouble.  We see and feel the trouble when it’s too late, after the diagnosis of a heart attack or the prescription of insulin for diabetes.

Our current understanding of our bodies and our health is like our current understanding of our global climate.  To explore the deeper oceans of our subconscious mind and our stress response system, we will need new ways of studying them and analyzing what we find.  Detailed monitoring of multiple organ system responses to multiple daily challenges across many people, often called “ecological momentary assessment,” will provide the kind of big data needed to make sense of the mysteries behind how toxic stress makes us ill.  Climate science is a big data challenge.  So is stress science.  Only in the last decade has it become possible to apply these new big data analytic approaches to understand the complexity of the stress response system in your lifespan or mine.

Imagine what that frontier can reveal to us about the hidden costs and benefits to our health of childhood trauma and prayer, unsafe neighborhoods and a belly-laugher joke, an abusive spouse and an easy hug, rush hour road rage and a note of forgiveness or thanks.  Some day these frontier mysteries could become our familiar underworld.  Imagine how it would change medical care if we could see both the crown and the roots.

Making the Human Race Great Again

Before you move to Canada, before you leave me for some place better, have one more think. Please? I found a pair of glasses, so to speak, that will make things look brighter for you and for me and for the human race.

I know it looks bad. Creationism on the rise. Incarceration rates on the rise. Suicide rates on the rise. Global temperatures and drowning seawater on the rise. The gerrymandering that dooms our hopes for a more democratic system. Our cancerous national debt. And we have only ourselves to blame for electing this guy. With all these wrong kinds of rises, it can seem like our world is sinking, or turning backwards. If we’re not careful, we’ll all be running with the lemmings for the cliffs, or Canada.

Look again. Here’s how you see what you’ve never seen before. Count. Count with Steven Pinker. Count big and think big. Pinker shows us how to count and think about the world in his most recent book Enlightenment Now (2018). Through his lenses, when you learn to count as Pinker counts, our world and the human race look different than the one we see on the news. Pinker, a psychology professor at Harvard, has been doing this kind of counting for a while. This is his eleventh book. You may have heard of his eighth book, The Better Angels of our Nature: Why Violence Has Declined (2011). His optimism is well tested.

Look at the big numbers for life expectancy, health, nutrition, wealth, economic inequality (poverty), the environment, war, safety, terrorism, democracy, civil rights, knowledge, quality of life, and happiness. The short version of this book can be seen in a glance at the 75 graphs sprinkled throughout its 453 pages. Here are a few of my favorites:

Life expectancy 1771-2015

Child mortality 1751-2013

Calories 1700-2013

Childhood stunting 1966-2014

Famine deaths 1860-2016

Gross domestic product per capita 1600-2015

Global inequality 1820-2011

Social spending 1880-2016

Income gains 1988-2008

Poverty US 1960-2016

Oil spills 1970-2016

Battle deaths 1946-2016

Death penalty abolitions 1863-2016

Executions US 1780-2016

Hate crimes US 1996-2015

IQ gains 1909-2013

 

In graph after graph the curves move dramatically in the direction of progress. And it’s hard to fudge these numbers. Our world is improving in almost every way you can look at it, and has been for hundreds of years. The key to this kind of vision is to first ask the questions, then choose long or large enough windows that allow you to see the big picture over time, then gather the data. And keep it simple.

In spite of two horrific world wars, battle deaths declined dramatically in the 20th century and are still dropping. Same with homicide rates and rates of extreme poverty. The trend to progress penetrates every big question Pinker asks about the state of the world. His conclusion is that progress, especially since the 18th century Enlightenment, is a juggernaut that can’t be stopped by our relatively minor failings, such as world wars, tyrannical communism, or the election of a narcissistic throwback. Pinker is sober about the work we have to do on the problems that face us (such as climate change, renewable energy, and the perversions of democracy), but the human race has a good track record for solving thornier problems than these.

If you find yourself thinking our world is turning the wrong way, think again about the issues that in your lifetime were once considered “progressive” or liberal or radical, and now are relatively mainstream. I’m 67 and here’s what my list looks like:

Long hair on men

Mini-skirts and braless tops

Rock music

Co-education

Opposition to war (peaceniks)

Opposition to the death penalty

Vegetarianism

Environmental protection

Recycling

Accommodations for the disabled

Civil rights for minorities, women, animals, gays, immigrants

Small, energy-efficient cars

Energy conservation

Seeking treatment for a psychiatric disorder

Women’s sports

Women in medicine, politics, CEO offices

Interracial marriages

African-Americans in commercials for soap, cars, insurance

 

What used to be the front edge of progress is now our current standard of living. If you look at the human race through Pinker’s glasses, we’ve done pretty well against steep odds. Survival used to be much harder to achieve. Threats were harder to overcome. The good life we live today was beyond the imaginations of even our grandparents a century ago: freedom from wars between the great powers, dramatic reductions in infectious diseases, steady improvements in health and longevity, widespread increases in wealth and decreases in extreme poverty, free communication across the continents, safe and affordable travel around the globe, unrestricted access to information, the expansion of civil rights to previously unrecognized groups.

Yes, we’ve got our messes to clean up. We have always had our troubles to manage and our problems to solve. Our failings and our apparent about-faces slow this rate of progress, but progress has moved us forward in ways that are dangerously easy to forget. As we raise our standards, we’re troubled now by things we used to overlook or take for granted. Sexual harassment, blatant racial discrimination, lynchings, and public torture were at various times so commonplace that they were not considered illegal or even troubling to most citizens. The recent benefits of peacekeeping forces and poverty reductions and the near eradication of polio and the absence of smallpox don’t dominate the news. These quiet advances escape our fearful attentions in favor of the latest tweet from the White House or the hurricane forecast.

So don’t move to Canada. It’s cold up there. You can count on that. And you can count on the fact that America was never greater than it is today. And in so many ways all over the world the human race is greater now than it has ever been. Let us count the ways. Once you put these glasses on, you can’t take them off.

Love Hunger

On August 5, 1944, my mother kissed her uniformed husband goodbye in the Navy yards of Los Angeles, watched his ship leave for Hawaii, and drove east to Phoenix, where she wrote him a letter that night. The next day she wrote him a second letter in which she described the news of the Hiroshima bomb dropping, wondering what this would mean for his expected assignment. She addressed each letter to him at the Fifth Service Depot, FMF Pacific, a military post office in San Francisco, where letters were sorted by grunts in a warehouse and routed according to the soldier’s assignment. She didn’t know it at the time, but it would be three weeks before he would read her first letter, and longer before she would read his. By then she was home in Cincinnati living with her mother and sister, watching the mailbox with a hunger that ruled the house.

Today most of us can see and talk with anyone we choose anywhere in the world at the tap of a phone screen, even in war zones, for less than the price of those stamps my mother licked for her love letters. We now make social connections with an ease that was unimaginable just a generation ago. We smart phone carriers should be well connected and socially well fed, right?

Not true, says a recent Cigna survey of loneliness in over 20,000 US adults. This study is just the most recent to underscore the paradox that in this age of hyperconnections, loneliness and social isolation remain a major public health problem. Using the UCLA Loneliness Scale to operationalize loneliness, the survey found that 27 percent of respondents reported feeling rarely or never really understood by others. Over 40 percent felt their relationships were sometimes or always not meaningful. One in five felt rarely or never close to people. The age group that reported the highest rates of loneliness was “Generation Z,” age 18-22.

The larger context for this latest survey was set by a 2015 review of 70 of the best studies of the effects of loneliness or social isolation on mortality. The wake-up call from this review is that whether you’re lonely or content to live alone, either one raises your risk of early death by 25-30%–as much as the more traditional risk factors of obesity, smoking, or physical inactivity. The effect of loneliness on mortality hits hardest not on the elderly but on those in middle age.

One of the believers in this loneliness epidemic is Vivek Murthy, MD, whom you may recognize as our former Surgeon General (2014-17). “We live in the most technologically connected age in the history of civilization,” he said recently, following his article in the Harvard Business Review, titled “Work and the Loneliness Epidemic”, “yet rates of loneliness are increasing.” According to one expert, since the 1980’s the percentage of American adults who say they’re lonely has doubled from 20 percent to 40 percent. Murthy attributes this epidemic to our increasing geographic mobility, our growing preferences for texting and email over direct conversation, and the recent shift in work efficiencies and habits that isolate workers from their colleagues.

Can we understand how such apparent progress in social networking could accompany a rise in loneliness with measurably poor consequences for our health? Evolution has not prepared us for these unprecedented levels of self-sufficiency that have come with first world rates of progress. We evolved to function best in small, tight families and tribes, but over the last half-century in developed countries we may have grown efficient and self-reliant to a fault, dispersing ourselves far from our origins. We have isolated ourselves through our houses, our cars, our access to information without talking to anyone, our work spaces, our recent dependence on screens and devices. This efficiency and comfort comes at the unintended expense of direct conversations and eye contact and handshakes and the smells of each other and the daily reminders that we belong to groups that need us.

Is loneliness a reasonable price to pay for our progress? Consider the physical effects of loneliness or social isolation. If we could swim among the undercurrents of the physiology of loneliness, what would we find? Resting heart rates generally go up when we’re alone or lonely, and over the long run high heart rates are hard on the cardiovascular system. We may find stress hormones rise and stay elevated, making us less resilient to hardships. Sleep is less restful, less efficient, meaning we don’t recover well; we lose that bounce. Inflammation levels creep up, infections too, both reflecting a struggling immune system. Self-care goes down. Why not skip that shower? Who needs to brush teeth if no one’s around? Cooking for one is no fun. More errors on the crossword puzzle, more forgetfulness. It matters less when no one else is around. Mental agility and judgment slide. Sometimes that opens the way to consider suicide, which is confined to the isolated, especially when their judgment slides. Almost no one tries to kill himself in the presence of another; the social prohibitions are too great. Pernicious combinations of these physical undercurrents of loneliness pave the pathways to heart disease and diabetes and early death.

So loneliness, like hunger and thirst, is an adaptive signal, if we learn to read it and respond. But the seductions of modern self-sufficiency are hard to resist. A substantial number of us are paying the steep price of loneliness. And yet our resources for combating the seductions of self-sufficiency also have never been greater. If we don’t get smart—smarter than our phones—about feeding our love hunger, our loneliness may do us in early. We don’t have to go to war to understand how writing daily love letters is a good way to survive.

Magnetic Hearts for Our Better Angels

In our church’s recent Palm Sunday passion reading, I read aloud as the Narrator the section before the crucifixion when Judas kisses Jesus: “Then the crowd laid hands on Jesus and arrested him. But one of those who stood near drew his sword and struck the slave of the high priest, cutting off his ear.” Modern day etiquette for heroes would call for Jesus to tend first to the gushing ear wound of the high priest’s sacrificial slave before addressing the crowd. Instead, Jesus chastised the crowd for treating Jesus like a common bandit. But those were the days when slaves donated more than an ear to their masters.

If your faith in human nature, like mine, needs a little resurrecting, read with me Steven Pinker’s The Better Angels of Our Nature (2010) [link]. Try snuggling down at bedtime to his detailed reminders that those were the days when, not only did high priests keep slaves, whose duties included occasionally taking a sword for their masters, but also those were the days of public torture—prolonged and painful and humiliating torture. Common custom both sanctioned and sanctified brutality as a show of high authority in action and a form of entertainment. In the Roman coliseum humans and animals were regularly ripped to shreds to the glee of the audience. Two thousand years ago a stroll up Calvary Hill could promise you the groans of souls and odors of corpses, one after another, nailed to the timbers. In later times saints were publicly martyred on the rack and in the fire. And just four hundred years ago Shakespeare and his fellow Londoners strolled across a London Bridge that was often adorned with the decapitated and rotting heads of the most recently executed, these acceptable and possibly reassuring reminders that an authority, however brutal, was in charge.

If you don’t yet feel resurrected hope for our race, read on. Your nightmares will eventually be rewarded. The subtitle of Pinker’s fascinating 696-page book is Why Violence Has Declined. This book offers the best antidote I’ve found against the popular and gloomy perception that the human race is on a path to self-destruction. What intrigues me most about Pinker is that he’s a psychologist tackling an enormous historical task to answer a compelling question: is violence an essential part of human nature? You might think Yes! after reading about the incessant patterns in almost every culture over thousands of years of warfare, slavery, institutionalized public torture, and massacres in the name of God. But on page after page Pinker makes a persuasive case that we have become dramatically less violent than our ancestors by every measure, and for good reasons.

One aspect of the psychology of violence, one of the “inner demons” that has been outdone by our “better angels” over the millennia, is our capacity to deny another person. If we bother to think at all about that specific other person, we fabricate a fantasy: that scum has no feelings, no story, no loved ones, deserves no respect, and will never mean anything to me. This empathy block is a trick that soldiers in hand-to-hand combat must learn: dehumanize the enemy. Masters do this to their slaves, jailers to their prisoners, natives to their foreigners, dominants to their submissives, perpetrators to their victims. This denial trick allows us to disconnect, dissociate, and remove ourselves from the experience of that other person. If this denial trick seems primitive or callous, think of how we deal with the experiences of animals we don’t know or love, or with that bearded opiate addict who haunts the exit ramp with his cardboard sign, squatting on a milk crate. This capacity to deny and disconnect would not be such an enduring and universal part of human nature if it were not so adaptive.

Two weeks ago I attended a conference in Louisville on the theme of stress and resilience (the annual meeting of the American Psychosomatic Society). This meeting got me thinking about the polar opposite of our capacity to disconnect. Two presenters referred to studies of heart rate variability among couples as the couples talk about tough stuff. What happens to our hearts when we are intimately connected? Heart rate variability is a measure of how much the rhythms of one heart vary with changes, such as breathing in and out, exercise, and psychological stress. Safe intimacy usually improves heart rate variability. Good health requires lots of heart rate variability. And as we age or get sick, our heart rate variability declines.

Imagine what happens to the heart rates of two lovers whispering on a park bench. Or a duet singing harmony. Or a mother and her nursing newborn. Or four old friends sitting around a card table. When the heart rates of two or more people adjust to roughly match their rates and their variations in rates, it’s called entrainment, a concept borrowed from the physics of two systems operating in synchrony. Two hearts beating in synchrony is a harmony of physiologies that may last a few precious moments, or longer. If a hundred members of an army can march in step, could their hearts could march in step too?

How could one heart communicate with another? A recent review of this topic by Rollin McCraty proposes that our hearts communicate through their magnetic fields. If that seems surreal or new agey, consider how herds move and flocks fly in exquisite synchrony. Is the exchange of magnetic heart fields a part of this miracle? Long before we developed words, our ancestors had to sense the states of their human companions. The magnetic fields of our hearts can communicate not just their beats and their variability, but the signature imprints of our feeling states. Patterns of heart rate variability differ from one emotional state to another. My state of gratitude or appreciation traces a different pattern than my anger. And your heart might be able to sense that pattern, if we’re close enough, both physically and emotionally. “Social coherence” is the term for this level of physiologic entrainment.

The company HeartMath, for whom McCraty works, is investing in this science, hoping that with the help of biofeedback about our heart rate variability, we could learn to find each other better in the board room and in the bed room. Whether HeartMath makes a bundle on it or not, the good news is that there’s lots of science out there telling us that we humans have come a long way toward understanding how to connect with people who are not like us. And now we can measure what we have always known, that one heart can magnetically attract and entrain another. And over the millennia our habits of brutality have diminished, while the better angels of our empathy have grown stronger. We still have that capacity to deny and to violate, but we’ve come a long way from slave’s ears and crucifying. “Peace on Earth” sounds to me now less like a line from a Christmas carol and more like a feat of human nature.

Milking Contact from Cows

One Monday morning in 1999 along a country road in the bush of Bungoma County, Kenya, a middle-aged man slowed his walk to watch a woman milking her cow inside the fence of her shamba. He did not know this woman, but this was a familiar sight. And on this morning he saw this milking in a way that opened his eyes.

Wrapped in a head scarf with her kikoi hiked up above her knees, this young mama sat on one overturned bucket while she pressed her head into her cow’s shallow hip cavity and milked into the second bucket. He noticed she had tightened her cow’s tether by wrapping it several times around the fencepost to keep the cow still and close against the fence while she milked. The hide of the cow stretched tight across the hip bones. Even before the milking the udder sagged.

He saw that too soon this young mama finished milking and carried her half-filled bucket across the yard that had been grazed bare except in the corners, and then she disappeared into her house. Next to the house two school-aged children played under the acacia tree where an older mama sat shelling beans and the laundry hung on the line. This was a school day, but these children wore no shoes and no uniforms—they were going nowhere this day. He could find no signs of a man’s things in this yard. Soon the young mama came out of her house and set her milk can on her head—too lightly, he thought. She exchanged a few short words with the woman under the tree, opened the gate, and started down the road toward town.

The middle-aged man, Mr Meshak Maleche, walked on the other way, troubled by this sight. He’d seen variations of this well-worn routine in the months since their move to his wife’s village of Mbakalo. Mr Maleche had recently retired at 55 from his career as a school principal. They had bought an 18-acre farm on the edge of the village, next to the Catholic church and the market. After a career in education, he knew little about the daily realities of farming. He felt like an outsider in this town, a teacher studying what farmers do in their shambas and at the market, wondering what farming might bring into his life.

Yet Maleche knew it was pitiful how light her milk can was. With the weekend and the national holiday it had been at least three days since this woman could have taken her milk to the market. Her can should be full. He thought about what his friend and priest, Father Maruti, had told him yesterday about the women he visits who are too ashamed to come to church. Many are HIV widows. They often run out of money for school fees and can’t sell enough potatoes or milk or beans to buy a dress to wear to church. One cow overgrazing an old shamba can’t feed a small family.

This day Maleche, watching this woman milking her underfed cow, sees in his mind the many other farmers dotting this countryside with their underfed low-yield cows. Maleche has watched these women carry their cans to the market and wait in the sun along with the other women for the good fortune of someone who might choose to buy her milk this day. Some days some mamas sell none. Father Maruti also told him yesterday about dairy cooperatives, how in some places the milk and the profits are shared among the farmers in a way that guarantees a market. “This woman,” he thought, as she walked away under her milk can, “will walk most of an hour to sit most of a day for money she can’t count on. She knows no other way. She just prays. God’s will be done.”

When Maleche told him about his morning walk, Father Maruti said, “They would trust you with their milk money.”

Maleche said, “No. I’m not from this village. They could see I’m no dairy farmer like them. Why should they trust a school teacher from outside with what little they have?”

Father Maruti said, “They will trust you because you have managed the funds for two schools and for many years. I have told them about you. You know the transparent way to do business. You have earned the trust of families in other places. You are the one to show them how to work together, how their poor cows can bring school fees. If you show them how to create a secure market, they will follow.”

Maleche could not sleep at night. He traveled to Nairobi to learn about dairy cooperatives. He read about how it is done in Europe and elsewhere in Africa. He talked to dairy farmers at the market about what they do and what could be done. When they formed the cooperative, instead of naming Maleche the director, they named him the treasurer, because that was the role that would secure the trust of the farmers.

After several months of planning, they began with eight farmers from the church, including several men, who agreed to allow him to pick up their milk cans each day in his lorry, take them to the market, and sell the milk for them. At the end of the first week they were surprised when Maleche showed up at their homes with their milk payments. The payments were as good or better than when they had sold on their own.  By the end of the first month, Maleche had recruited twice as many farmers and had twice as many cans in his lorry most mornings.

As the numbers of farmers and milk cans grew, the cash he had to carry also grew, and that made Maleche nervous. One day he found himself carrying KSh 350,000 home from the market ($3500) in his jacket pockets. He had no safe and no bank account for this milk money, so he hid it in his home. He worried that if anyone knew he was handling this amount of cash for the farmers, he would get robbed on the road. So Maleche told Father Maruti that now he, the priest, would have to make pastoral visits to the homes of these farmers to deliver their monthly milk payments. No one would suspect the priest of carrying cash under his robes, much less dare to rob him.

Soon they opened a bank account in the nearby town Naitiri. As the numbers of farmers in the cooperative grew, they started talking with each other about how to improve their milk yields. Most of the cows produced around 5 liters of milk a day. They used some of the income to buy feed for the most stressed cows, and their milk production increased. They learned to identify the sick cows and to get treatment for some of them, which also increased their yield. More milk for the group meant more money for the members. These farmers now talked to each other in new ways. Some of that money they agreed to spend on efficiencies, such as better milk cans, less wasted milk, access to refrigeration, medicine for infected cows, and healthier feed. Within a few years the average daily milk yield rose to 20 liters a day, four times what it had been.

Word spread. More farmers joined. At the market, Maleche learned about negotiating prices for milk. He started charging a price that allowed the cooperative to pay the farmers KSh 17/liter. That meant that the farmers barely made a dollar a day from their milk, but it was now a reliable dollar, every day. By the end of the month to have a reliable KSh 3000 ($30) was something.

As the quantity of the group’s daily milk supply increased, the quality also improved. He soon found he could sell more and charge more, which meant the farmers were earning 20 and soon KSh 25/liter. From the same cow, farmers were now earning two to three times the income they had been earning on their own. That made it attractive to keep more than one cow active for milking. So the total number of cows in the cooperative grew fast.

Now the Naitiri Dairy Farmers Co-operative Society Ltd, or NADAFA as it is called, pays KSh 35/liter. Coupled with the higher yields per cow, now around 30 liters a day for the most productive ones, this translates into a five to tenfold increase in income for some farmers since the early days of the cooperative. The only thing they had to invest for this big return was their trust in Mr Maleche.

As the cooperative grew, he had to be careful whom he hired to help him. First he needed a driver for a second lorry, and a trustworthy accountant to keep track of the milk coming in and the cash going out. Then he needed a manager to recruit new members, orient them to the procedures, and field their questions. Soon he was managing a team and a growing group of farmers. In some ways it was like managing a faculty and a student body.

Now NADAFA has grown to 8000 members with 47 collection stations in a 40 kilometer radius around Naitiri. A team of over 25 motor bike drivers collects the modern 10 liter milk jugs designed by the Gates Foundation twice a day and delivers them to the central processing station where the milk is measured, tested, pasteurized, and then distributed in a 5,000-liter dairy truck to urban markets in the region. The cooperative can serve as a lending bank for its members. It pays its farmers either directly into bank accounts or by digital M-Pesa accounts, averting the threat of theft and making its records transparent and available to its members for scrutiny. Last year NADAFA began providing veterinarian services to keep the cows healthy and more productive. It sells feed that increases the milk yield. And it trains its farmers to practice smart farming.

One farmer has educated his three children with three cows producing 20 liters a day. The NADAFA payments bringing him KSh 60,000 a month. One cow can educate one child through secondary school.

Now when Maleche walks through the town of Mbakalo, he sees these HIV widows in the tailor’s shop getting a church dress mended; he sees their children walking to school in the required uniforms; and he sees Father Maruti smiling because these women come to church now and they leave donations in the church basket and they sing in his choir. God’s will be done.

That’s a high return on a modest investment for every member. That’s a retired teacher harvesting cooperation from a community of underfed cows. That’s collective wealth created out of collective poverty. That’s Rifkin’s third industrial revolution taking hold in pockets of rural Kenya. And that’s the kind of contact that saves lives.

Stress and Your Social Gradient

How’s your social gradient treating you? This past summer I traded the stress of a full-time job as an academic psychiatrist for the stress of a half-time job as an academic psychiatrist, which allows me to spend my mornings stressing over a book I want to write about stress and illness. By choosing to make this move now I may have dropped a few notches on my social gradient, but maybe not. Maybe this book will save me, someday. I’ve waited most of my working life for the privilege to write each morning, and, so far, most days it’s been fun, the good kind of stress.

My current challenge this month is to figure out how to pack into one chapter the most compelling evidence on how some kinds of chronic stress turn into some of our most common illnesses, such as diabetes, heart disease, obesity, and depression. The timeliness of this issue—and its timelessness—came to me through an NPR piece this month on a recent survey about the effects of racial discrimination on poor health outcomes—not only through big unjust events, such as being passed over for a job or a mortgage, but also through the “little indignities” of disrespect in daily life.

Top on my list for this chapter is a story about two scientists, Robert Sapolsky and Michael Marmot, who have separately and around the same time during the 1990’s captured the same key point about stress and illness: the most powerful determinant of your health and the length of your life is your social rank. It’s true if you’re a human and true if you’re a baboon. (It’s also true if you’re a pig, a rat, or a rhesus monkey.) For you humans, Sapolsky and Marmot tell us, your social rank may be a more powerful determinant of your health than the other common culprits, such as your genes, your income, your education, your family history, or your zip code. And they tell us why. But of course there’s also a catch, which will help you sleep tonight.

Robert Sapolsky is a primate biologist at Stanford University, a short, thickly bearded, long haired professor and self-proclaimed nerd—as a boy he was often chosen last in neighborhood pick-up whiffle ball games because he was uncoordinated and usually had a book in his hand. Sapolsky spent 12 summers in Kenya studying the behavior and biology of baboon troops. He has taught and written extensively about stress and illness, most notably in his entertaining and enlightening book Why Zebras Don’t Get Ulcers (1994, 2004). National Geographic featured Sapolsky and his work in a documentary Stress: A Killer (2008).

Also featured in that documentary is Sir Michael Marmot , a professor of epidemiology and public health at University College London. He is the author of the Whitehall Studies and most recently The Health Gap: The Challenge of an Unequal World (2015). I saw Marmot give a rousing call to action last spring at the annual meeting of the American Psychosomatic Society. He’s a trim, well dressed, eloquent speaker with a refined sense of humor and a hard-earned sense of indignation about social injustices.

In the 1990’s while Sapolsky was collecting blood samples on a baboon troop in the bush and analyzing stress measures in relationship to each animal’s rank in the troop, Marmot was analyzing data on illness and mortality in the Whitehall II Study, a prospective study of British Civil Service workers, each of whom had a well-defined rank within the Civil Service. To their surprise they both found that how long baboons and civil servants live is directly related to where they stand on their social gradients. Lower ranks die younger. And their risk for chronic illness was also related to their social standing. This is more than poverty making the poor sick. This relationship holds true even at the higher ends of the social gradient. The higher your rank, the better your chances of being healthier, even among the top tier. It’s not fair, but it’s true.

I was surprised too. Haven’t we always heard it’s tough at the top? Down lower where fewer people can see you, hold your responsible, or shoot at you, it ought to be safer and healthier, right? Not true, said these two sets of data. Both investigators concluded that the stressful aspect of the lower end of the social gradient is the relative loss of control, resources, and rewards. We’re less in charge of our jobs and our lives. Subservience exposes us to the power plays of those above us in the social gradient. Alpha males, older siblings, clique leaders, bosses, bullies, captains—their influence on our stress response systems can be profound and lasting and sometimes toxic.

If you’re a baboon and you lose your stature to the new alpha male, you’re sunk. You don’t have an out, other than leaving the troop, usually a dangerous move. But if you’re a human, you’re probably thinking right now, I don’t have a “social rank,” or nobody could tell me what it is, not like in the British Civil Service where everyone knows whether your rank is a 13, 5 or 2. The closest thing we have in the US may be our military or the Veterans Administration.

But here’s the catch for most of us humans. Unlike the average baboon, we can choose to belong to several social orders. Most of us don’t have just one rank, and ranks change. In 1994 my boss at the University of Cincinnati demoted me from my role as Vice-Chair for Education in our department. It was a searing humiliation at the time, wrapped in what he later admitted was a form of academic bullying. Though it took a few years, and it made me mighty uncomfortable, that demotion did not quite make me sick. I was lucky and I had resources. I could recover because, though I lost a title and a role, I retained my academic rank and salary and other roles in the department. It was a loose system, not a tight one like the British Civil Service or the VA. And I retained my rank in my family and on my soccer team and in other groups that still thought I was okay, which buffered me against the power plays of my boss. I started writing in earnest. I lost an institutional voice and started working on gaining a written voice, a rank in a separate social order. Baboons should be so lucky.

What does the social gradient have to do with attachments and making contact, the theme of these blogs? One of the most powerful ways we’re attached to others is through our social hierarchies. Think about how much time and emotional energy we spend thinking about the person just above us at work, or the person we answer to, or the person who currently has the most influence on our daily lives. If that’s a nourishing relationship, we thrive, but if that’s a troubling relationship, it’s hard to turn off that kind of worry. It leaks into our sleep, it haunts our daydreams, and it can sap our energy at work and at home. You may feel an intense attachment to and lose a lot of sleep over someone you don’t know very well (where does she live, how many kids, where’d she grow up, why does she wear her hair like that?), just because she currently holds a threatening kind of power over you.

Sapolsky and Marmot remind us that evolution has made most of us acutely sensitive to where we stand in our social gradients. It’s a matter of survival. No wonder it’s stressful when the gradient shifts. No wonder we do better when we have more than one gradient to stand on. No wonder the little indignities of racism or bullying are hard on the heart as well as the soul. Even baboons know that.

Write That Voice

Tell me about Meryl Streep’s voice.  Which of her performed voices do you like best?  Her Julia Child in Julie and Julia, her Polish lover in Sophie’s Choice, her Danish aristocrat in Out of Africa, her Margaret Thatcher in The Iron Lady, or her bullying soprano in Florence Foster Jenkins?  Tell me what magic makes one of her voices so different from the others.  Is it the accent, the range, the pitch, the melody, the register, the body gestures?  It’s hard to say.

And what would Streep say about how to write those voices on the page?  A 2009 You Tube clip, “The Many Voices of Meryl Streep,” collected a selection of her movie voices since 1982.  From the written words alone, can you hear this voice?  “I’m going to try to flip this one over now, which is a rather daring thing to do.  When you flip anything, you’ve just got to have the courage of your convictions….Oooh, that didn’t go very well.”  How much clearer can you hear this voice if you first read that a tall, buxom, middle-aged lady stood behind the stove in her kitchen talking in a droll cultured accent?  With a few hints about the character and the context, it’s easier to “hear” that voice.

You imagine the voice of Sophie Zawistowska as Streep portrayed her in 1982 more clearly if you picture her in her young twenties tilting her head to the side, talking wistfully, smiling upwards at Stingo, the young American man in Brooklyn, saying “When I was little girl, my father, um, typed and I go to sleep to that sound.  It will make me feel, how do you say, secure, secure?”  In Styron’s novel, Sophie’s Choice, he spends few words on the audible sound of her voice, relying solely on the character, context, and the content to carry her voice into our imaginations.

We readers need a few clues beyond the spoken words, but having too many clues kills the effect.  Overwriting a voice leaves little room for the imagination, and the reader’s imagination is more effective at creating a voice than any detailed description.   So what are the essential features that sketch a distinctive voice?

I tried looking on my shelf of how-to-write books that I’ve collected over the last twenty-five years.  Out of 21 books, none had a chapter specifically addressing the writing of voices, but the common theme across the chapters on dialogue is that voice is driven by character.  Begin by knowing the personalities in your story well enough that you can hear them speak in ways that reveal their character.

I tried describing some of Streep’s voices from the 2009 clip.  After several feeble trains of adjectives, I came up with a variation on the game of Celebrities in which one person has to get others to guess the name of a famous person by describing the celebrity’s voice using word clues only.  What makes Hitler’s voice so different from Churchill’s?  Trump’s voice so different from Obama’s?  What makes Stephen Hawking’s voice so mechanical?  We know these voices.  They rattle around in our dreams and our day-dreams.  We recognize familiar voices instantly, but try telling what distinguishes one voice from another.

When I played this game with my wife, Vic gave me 14 clues before I guessed Jack Kennedy.  I gave her six before she guessed Hillary’s voice.  Our son Stu played this game with his wife and her parents.  Their longest run took them through six clues (“melodic and rhythmical, male voice, it’s a singer, upbeat, talks about love, has an accent from a country or a religion”) to get to the correct Bob Dylan, after false stabs at Meryl Streep, John Lennon, Elton John, and Matis Yahu.  Three times they guessed the correct celebrity after just two clues about their voices, and once all it took was one clue: “god-like” for the voice of James Earl Jones.  Those four know each other too well!  How easy or hard is it for you to guess a voice by word clues?

Faces are as complex and distinctive as voices, but easier to describe.   Why are we so inarticulate when it comes to talking about something so essential to our identities as the human voice?  Most of us learn to speak by imitation, not by instruction.  We know voices intuitively.  We learned as infants to recognize and interpret voices long before we learned to speak.  We don’t have to think much about what makes a voice unless we lose it or try to train it to yodel and sing arias.

In case you’re ever afflicted with a stroke in Broca’s speech area or operatic ambitions or the compulsion to be a writer, it’s a useful exercise to think about what it takes to make a voice, and what makes each voice unique.  Most of what we need to make a voice is a clear sense of the character, the context, and the content of their speech.  Imagine how it would change the way you hear Julia Child if, instead of being in her kitchen in Cambridge, Massachusetts, before a WGBH camera in the 1960’s having spent twenty years in France immersed in French cooking schools, Streep’s Julia were delivering those sentences in the back of a bus to an alarmed audience of riders.  Character and content depend on context.

In addition to character, content, and context, it takes anatomy to make a voice.  Does understanding the anatomy of a voice help you write it?  The shapes of the chest, trachea and vocal chords change with adolescence, laryngitis, and screaming.  Julia Child was six feet two.  When a hefty guy has a tiny voice, it’s often surprising, maybe amusing, usually revealing.  The mouth, the pharynx, the nose, and the sinuses are “resonators” for our voices.  If you pinch your nose or fill your sinuses with fluid, you change the pitch and the resonance of your voice.  The tightness or looseness of the soft palate varies with culture and with personality and with emotional tone.  Meryl Streep likely tightened her soft palate a tad for French Lieutenant’s Woman and loosened up plenty for Prairie Home Companion.

An article about our senator in the July 24, 2017, Washington Post begins with these lines: “They could hear him before they could see him — that low, rumbling outboard motor of a voice. It could only be Sen. Sherrod Brown.”  Five paragraphs down Sen. Al Franken (D-Minn) says Brown’s voice sounds “as if he’d been hit in the throat by a hockey puck.”  There’s a lesson here.  When it comes to describing voices, metaphor is more powerful than analytic details.

To sketch distinctive voices on the page, we first have to know our characters so well we can hear them speak.  A voice that reflects gender, age, culture, and physique comes to life when it also changes rhythm, speed, and content with shifts in context and state of mind.  Writing distinct voices works best when the writing comes fast, by intuition, and prods the reader’s imagination.  You can bring a voice to life with a hockey puck.

The Voice of the Heartland

In the winter of 1976 Mark Twain came to Cincinnati’s Music Hall in the form of Hal Holbrooke’s one-man show.  My then-girlfriend and medical school classmate, who knew my fascination with Twain also as my refuge from my insecurities about surviving medical school, arranged for us to usher that evening.  Luck left us with two empty seats in the 10th row, close enough to see his whiskers twitch and the smoke of his pipe curl.

Holbrooke’s Twain shuffled onto a nearly empty stage toward an arm chair and a small table set on a rug to the left of center—as though he were entering his own living room, dressed in his signature white linen suit, in the twilight of his life.  I fell in love that night with the spoken voice of Twain, so true to the voice I’d been hearing as I read—folksy, ambling, disarmingly easy, coming strong from his chest but tinted with the scratch of age and smoking, his pitch rising with excitement.  He meandered from one musing to another like a lowland river, but he made every word count—slow talk hiding fast wit—so we listened close and laughed hard.  Twain created the  voice of the Midwest small town observer with a worldly wit, the compassionate and amused chronicler of the human comedy.  And he had a sharp ear for how we talk.  Holbrooke played both sides of his dialogues.

I loved that voice above other writers until Garrison Keillor stole my heart.  It took a while, but over the past thirty years, how could Twain compete with Keillor’s prolific tales from Lake Wobegon, songwriting, radio drama, newspaper columns, speeches, and novels.  In the year since he stopped hosting “Prairie Home Companion,” I have tried to listen to the show by the same name, but I don’t stay with it.  I understand better now that over the years I was listening to that show for that voice.  The rest was extra.

Last Friday night in our town (May 19) we had “An Evening with Garrison Keillor” at our largest theater, the Aronoff Center.  It was hard to know what to expect—would he bring a crew of musicians?  Would he ad lib or do old favorites from past radio shows?   Would he talk politics and tell us things we don’t know about our home town?  When I looked him up for a preview of the show, all I could find was the St Paul StarTribune’s obituary of his 17-year old grandson who had died earlier that week on Monday, May 15.  The obituary, clearly written in the voice of his grandfather, said nothing about the circumstances of the death and it announced at the end that the visitation in St Paul would be held at 4 pm on Saturday, May 20.  Could the grandfather really be here in Cincinnati entertaining strangers the night before?

The Aronoff, when the lights are on, is a colorful blend of terra cotta walls and cactus green seats and soft amber lighting.  In contrast the stage last night looked stark as we waited for the lights to go down—one stool and a mike stand stood in a single spotlight on the enormous scuffed black stage floor with black curtains in the back.  As the house lights dimmed, Keillor walked out from stage left in his light tan suit, fire engine red tie, and signature red socks and sneakers, looking deep in thought.  The echo of Twain was unmistakable.  He nearly stumbled, as though the floor were sticky or he wasn’t used to these new shoes.  He took the cordless mike, rolled the stand behind him, and launched into an a capella ballad about love and trouble which he then blended into lines from a couple of familiar songs, beckoning us to sing along with him.  When solo, his baritone voice was full,  relaxed and resonant; when we joined him he sang at a lower volume, almost a whisper, and so did we, all 2700 of us, filling the hall with a muted, gentle chorus.

He sat on his stool, chatting as though we were potential chums, disarmingly easy, and he talked about being a misfit as a boy, awkward looking and not among the cool kids.  He got up as if to prove it.  As he moved about the stage, his gait was sometimes awkward and sometimes graceful, but always expressive.  His large hands waved about like a conductor’s, expressive like an actor’s.  He never stayed still for long.  Right from the start he made every word count, so we listened.  He kept the house quiet.

He complained about the way his 17-year old daughter and his 31-year old niece and her boyfriend butcher the English language and use their devices to avoid communication.  “I’m not complaining,” he said.  “It’s just a fact of life I have to live with.”  He talked about being 74 and the intimacies of having his prostate examined by a female urologist.  He mentioned a teenage fan of his radio show who met him in an airport and recited a limerick he’d learned on his show—after all his efforts to write novels and poetry and songs, what this kid had learned from him was a baudy six line limerick.

He told us about being punished by his parents for stealing when he was eight. They sent him to his grandparents farm in Lake Wobegon where he helped Uncle Jim bring the hay in from the fields and store it in the hayloft, until he fell through the trap door onto a cow and into the slop, where a bull with a ring through its wet nose nudged him out to where his uncle could pick him up and take him into the house—an experience he vowed to never forget, the beginning of learning to be a writer by remembering the details of life.

After an hour of talk he sauntered into the audience for what he called a “standing intermission.”  He moved up the aisle about 12 rows and invited us to sing a few lines of a few more songs with him:  Oh Susannah, Swing Low Sweet Chariot, Way Down Upon the Swanee River, Silent Night, John Jacob Jingleheimer Schmidt, and others—he played pastor, choirmaster, and fireside singalong director.

He quoted Twain and Shakespeare and mocked TS Eliot’s J Alfred Prufrock.  He talked of sharing a fraternity with Bob Dylan at the University of Minnesota.  He recited a few of his love poems, both young and recent, and told us a long tale about a first love at age 12 and her recent funeral in Lake Wobegon.  He delivered all this with the apparent spontaneity of inspired conversation, talking in his ambling manner but with a quick and restless wit that moved fast to the next line while we were still laughing at the last one.

This performance went on for two and a half hours, uninterrupted, with no props and no back up band and no notes or script.  Naked talent.  He never lost his audience, never seemed to tire or falter, one voice holding 2700 attentions for over two hours.  Is there anyone else who can write novels and radio drama, do stand up comedy, spin thirty years of tales about an imaginary town, sing gospel baritone in a quartet and solo, lead a chorus of strangers in folk songs, and hold an audience mesmerized by his voice alone for over two hours at age 74?

Twain could be proud of the kid up river who has captured the voice of the heartland.  And Keillor came to our town last night to deliver that voice in spite of the death this week of his grandson.  He never mentioned it.  In show business, that’s courage.