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Jack Smith

Take Heart, Type A's-- They Need Us

February 09, 1988|Jack Smith

Back in 1974 when Dr. Meyer Friedman published "Type A Behavior and Your Heart" (with Dr. Ray Rosenman), I saw myself as a classic Type A, according to his description, and accepted the probability that I would soon have a heart attack, being then at a vulnerable age.

Briefly, Dr. Friedman defined a Type A person as one who is "aggressively involved in a chronic, incessant struggle to achieve more and more in less and less time. . . . Overwhelmingly, the most significant trait of the Type A man is his habitual sense of time urgency or 'hurry sickness.' "

I considered myself the very embodiment of Type A behavior, and so naturally I psyched myself into having angina pectoris and, finally, a quadruple coronary bypass, proving that Dr. Friedman was right.

Ironically, though, that first edition of his now-famous book began with a quotation from my column: "Some time ago, I quit worrying about what to do, or not to do, to keep from having a heart attack. I was so confused by all the conflicting theories that I began developing the symptoms."

It was Dr. Friedman's book that got me to worrying again.

The irony is that Dr. Friedman's own theory has now been attacked by some of his colleagues. A study of male heart attack victims published in the New England Journal of Medicine showed that only 58% of Type A's were as likely to die of subsequent heart disease as Type Bs.

This was shocking news, I imagine, to the Type Bs who have been taking life easy, ignoring the ticking clock, not trying to do it all, content that they would outlive their anxious contemporaries.

According to one of the authors of the new study, "Type A behavior in coronary patients is not dangerous. It may be slightly protective."

The results of the new study were no sooner published than Dr. Friedman counterattacked, dismissing its methods as "deeply flawed"; he advised reformed A's not to go back to their old ways.

Almost simultaneous with the new report on Type A behavior was a report on a new study showing that aspirin could dramatically reduce the probability of heart attacks; so convincing were the results, its authors said, that midway through their experiment they began giving aspirin to their control group, rather than placebos, as an act of humanity.

As we might have expected, this announcement was followed the next day by another that denied any relationship between aspirin and heart attack prevention.

It seems to me that we are right back where I said we were in 1974. One day we are told to avoid Type A behavior and take aspirin, the next we are told to indulge our time-conscious anxieties and avoid aspirin. One day cholesterol is in, the next day it's out. One day alcohol in any form will kill you, the next day beer will prolong your life.

If I can find any cheer in all this it's that I was never able to give up my Type A behavior, even after my bypass and a later "arrhythmic episode." When we go out I still wait by the front door, fully dressed, car keys in hand, while my wife finishes dressing; at dinner before the theater I look constantly at my watch, worried about missing the curtain; I have lived all my life with deadlines, and have missed few. I am not trying to achieve anything, especially, I just want to be on time.

What would the world be without us Type A's? In his witty book of essays, "Pluto's Republic" (Oxford University Press), the British Nobel scientist Sir Peter Medawar says, "Type A's are undoubtedly the great doers of this world. Even if Type A's lead shorter lives they live much more life while they are living it; it is the existence of people of Type A that makes possible the existence of Type B; do we not all envy those composed and relaxed people who are so adept at getting other people to do their work for them?"

Even if the Friedman theory didn't hold up, Sir Peter said (in 1984), it would be useful, "for though it is the self-destructive propensities of Type A's they concentrate on, it should not be forgotten that people of Type A can also destroy the composure and ultimately the well-being of people around them. . . ."

I wonder if I'm that type.

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