Drop Dead Healthy

by A. J. Jacobs

  Now we have a more scientific wave of rejuvenation techniques. Thousands of men take testosterone supplements, either with gels, creams, or injections. The promises remain the same, except for the better eyesight part. The questions about treatments’ efficacy remain as well. Data are mixed. Some studies show testosterone shots increase muscle mass and energy. Others—including a major study published in The Journal of the American Medical Association in 2008—indicate that men taking testosterone did not improve in mobility, strength, or quality of life.

  Skeptics also say we don’t know the long-term effects. One doctor I talked to said that the current vogue for testosterone supplements reminds her of the hormone replacement therapy trend in the 1990s. Millions of menopausal women underwent HRT to combat low libido and energy, only to find out later that it can raise the risk of breast cancer and heart disease.

  Fisch says he’s not doing testosterone replacement therapy. He calls it “testosterone normalization.” He recommends against the testosterone gels and creams for me. I have children, and if I hold my kids against my gelled-up chest, the testosterone could rub off. Next thing you know, Jasper needs to borrow my Gillette Mach3.

  Instead, Fisch recommends a drug called clomiphene or Clomid. This will make me produce my own testosterone. Oddly, this drug is usually used by women to boost fertility, but it also works in men to increase hormones called FSH and LH, which spur testosterone creation. Also, Clomid resets your baseline testosterone level, so you don’t have to keep taking it the rest of your life, Fisch says.

  When I get home, I tell Julie.

  “What are the side effects?” she asks suspiciously.

  “Well, it’ll increase my sex drive.”

  “I think your sex drive is just fine.”

  “There’s a chance it’d increase my baldness.”

  “That’s not good.”

  I tell Julie many doctors are leery, seeing as the science behind it is new, and we don’t know all the side effects yet.

  “No, I think it’s a bad idea.”

  “I should at least try it.”

  “No, don’t do it.”

  She shut me down. So for a week, I didn’t pursue it. Which I thought was appropriate, in a way: You can’t get much more testosterone-deprived than having your wife forbid you from taking testosterone supplements.

  But in the end, I defied my wife, just to see what a higher testosterone level can do. I start popping 50 mg of the chalky-white pill every day.

  The blogger Andrew Sullivan wrote a story in The New York Times Magazine several years ago about his experience of injecting synthetic testosterone to counteract the effects of HIV. For him, it was like a magic potion that transformed him into a Nietzschean Übermensch. His energy, confidence, and libido exploded.

  My transformation is more subtle. If Sullivan’s testosterone shots were a double espresso, my pills were a mild chamomile tea. Since I began taking them two weeks ago, I do feel slightly more energetic. My three miles on the treadmill at the gym seem easier. I don’t get the postlunch hunger for a nap.

  And yes, my libido is higher. The sexual thoughts bubble up even more relentlessly than usual. I try to read Esquire, since it’s my job and all, and I get sidetracked by a photo of a Barcelonan model named Claudia Bassols. She seems interesting. She was in a film with Jean-Claude Van Damme and has been a judge on Iron Chef. I should probably check out her website, as an Esquire employee. Thus commences ten minutes of clicking through her photos.

  I’m not allowed to give details of Julie’s and my sex life, but I’ll say this: We are definitely ahead of the Japanese average.

  Am I more aggressive? Well, the other day, I’m on line at the subway station to buy a Metrocard. There are three Metrocard machines, but a single line that feeds into all three. Everyone’s taking their turn. It’s civilized.

  Then this guy in a charcoal suit walks right up to the machine on the left, cutting all eleven of us on line.

  “Excuse me,” I say. “There’s a line here.”

  “The line’s only for those two machines,” he says, pointing to the other two.

  “Really?” I say. “You’re really going to cut all these people?”

  He pecks away at the keypad. I’m not just annoyed, I’m furious. What a selfish liar.

  “I can’t believe what an asshole you are. I mean, I hear about people like you, but I rarely see it in person.”

  I’m not the confrontational type, so my words are startling even to me. The other people on the line look at me with what seems like a mix of gratitude, embarrassment, and nervousness.

  The line-cutter makes some response, but I can’t hear it, perhaps because the blood is pumping in my ears. Plus my hands are shaking. That can’t be good for me.

  I’m guessing the T had something to do with my uncharacteristic rage. There’s clear scientific data that links testosterone and aggressive behavior. But, of course, I never underestimate the placebo effect. Especially when it comes to my slightly higher energy and confidence. It turns out the evidence linking those to testosterone is flimsier.

  A few weeks later, I take another testosterone test. When the e-mail with the results pops up in my in-box, I don’t want to click it. What if I’m lower? But I man up and open the document. Yes! Four hundred and sixty-five. I’m higher, and in the normal range. I am officially masculine. After two months of pill-popping, my testosterone rose to 650, which, I told Julie, is somewhere between lumberjacks and Italian prime ministers.

  But it occurs to me, maybe this is the worst time in history to be upping my testosterone. As Hanna Rosin points out in The Atlantic, perhaps modern society is better suited to women. “For the first time in American history, the balance of the workforce tipped toward women, who now hold a majority of the nation’s jobs . . . The attributes that are most valuable today—social intelligence, open communication, the ability to sit still and focus—are, at a minimum, not predominantly male. In fact, the opposite may be true.”

  So maybe I should be taking estrogen supplements instead. In fact, I recently read a study that women’s language skills are at a peak when they are ovulating and the estrogen levels are highest. So maybe estrogen injections would make me a better writer.

  For now, I’m going to get off the Clomid. In part, because I’m sick of checking my temples to see if I’m getting balder.

  Checkup: Month 21

  My grandfather’s back in the hospital, this time because he’s having trouble breathing. I take a cab up to visit him.

  “Oh, the hospital,” says the driver, when I told him the address. “Hey, what’s the difference between a doctor and God?”

  “I dunno.”

  “God doesn’t pretend he’s a doctor.”

  What is it with taxi drivers and doctor jokes? I smile politely. I’m not the best audience for Borscht Belt comedy right now.

  I board the elevators filled with low-talking visitors and get out on the ninth floor. I make a right at the flower display, and a left at the end of the hall, and end up in room 134.

  There’s my grandfather. He’s lying on his right side, propped up by three pillows. He’s got a white-and-blue hospital gown, an oxygen tube under his nose, and eyebrows as bushy as ever.

  His mouth is open in an oval shape and his lips seem to have all but disappeared.

  “Look who’s here!” says his daughter Jane. She’s slept here the night before in her blue tracksuit. “All these visitors are better for you than antibiotics!”

  “Hi, grumpy Grampa,” I say. He breathes heavily and shallowly and looks at me through half-lidded eyes. He lifts his hand about half an inch off the bed—it seems so small and limp now, almost ladylike—and I take it in mine. He squeezes my fingers. Or maybe that was my imagination. I can’t tell.

  Jane is holding a stick with a moist cubic green sponge on the end, and is dabbing it around his mouth to keep him moist. She leans over and kisses his cheek.

  Bloomberg business channel plays on
the television. A businessman till the end.

  I feel like I should try to entertain him. That’s my job. So I tell him stories about my sons and my work. I tell him about my Esquire interview with George H. W. Bush, during which the former president said, off the record, that a certain politician’s wife had a “pickle up her ass.” I tell him in a loud and upbeat voice, because Jane says he responds better that way.

  He doesn’t laugh, but he nods slowly, and his big eyebrows twitch a bit.

  The hospital gown doesn’t cover his legs, which are red and yellow, veiny and sausagy. I hate those gowns.

  My sister, Beryl, knocks on the door and comes into room 134. Her face goes a little white when she sees his body, which seems so shrunken. “Hi, Grandpa,” she says, shakily. “How are you doing?” She then excuses herself to go to the bathroom. A couple of minutes later, she comes back red-eyed.

  “The foliage is beautiful nowadays,” says Jane. “We have to get you out of here so you can enjoy it.”

  Grandpa doesn’t say anything. Just keeps breathing loudly. Is he really going to get out of here? It’s that crucial balance between delusional optimism and realism.

  I get out my laptop and show him some videos of our family, including one of Beryl’s daughter playing a mouse in a musical based on The Wind in the Willows. She looks so purposeful in her red hat and red coat, gazing off into the horizon as she sings.

  A doctor comes in to inspect the rash on his arm where the IV enters.

  Another knock on the door, this time his longtime secretary, Valerie. “Hi, Chief!” she says. Her friend is with her, and wonders if she could say a prayer. She clasps his hand and asks God to help heal this man. Does my grandfather understand what is going on? What does he, as a lifelong agnostic, think of the prayer?

  As I leave, I tell my grandfather, my voice as chipper as I can manage, “I love you, Grandpa. I’ll see you soon!” He tries to say something, but it just comes out as a moan.

  He died two days later. There was some sort of delay at the hospital, so my late grandfather’s body lay there for six hours on the bed. A strange fate for a man who was always on the move.

  Marti told me, “He looked so calm and peaceful lying there, it was hard to remember that he wasn’t just taking a nap.”

  We held the funeral for my grandfather at a Westchester cemetery on a sunny and brisk day. There were only fifteen of us gathered around the grave, just the immediate family. A public memorial would be held later.

  A little black amplifier rested on top of the pink headstone. One by one, we came up, picked up the mike, and said our goodbyes as the wind rustled the red leaves on the tree behind us.

  We talked about his civil rights work. About his love of family, justice, apple cider, and Alice’s Adventures in Wonderland. About his trips to Ghana for its liberation and the time LBJ grabbed him by the lapels for a photo op.

  Marti read a letter he wrote that showed he was a sucker for silly word games: “This letter is being written without a salutation, since you know who you are and it is silly therefore to tell you who you are. And to call you dear when everybody knows you are very cheap.”

  After the speeches, four cemetery workers lowered the coffin into the ground with thick straps. Most of the family walked to the nearby grave of my late aunt to pay respects. But a couple of us stayed behind, including me and my cousin Rachel, a psychology student from Baltimore.

  We picked up the two shovels stuck handle up in the pecan-colored dirt. We didn’t talk. Rachel began by tossing a shovelful of dirt onto the coffin. It landed with a soft thud.

  I bent my knees and tossed in a shovelful, as well. It thudded, and the dirt skittered across the coffin.

  We needed something useful to do. We needed to have a purpose, even if that purpose was pointless since the workers would do it if we didn’t. Or maybe it wasn’t. Maybe Grandpa would have appreciated it. One last show of affection from his grandchildren. It felt like tucking someone into bed for the final time.

  We worked silently as the dirt made a collection of mounds on the coffin. I was bending deep at the knees, putting my back into it. Every shovelful a heaping one. This work was physical, and physical felt good right now. I was starting to sweat under my suit. Grandpa was not a man who did things half-assed. Neither would I.

  The next day, The New York Times ran an obituary of my grandfather. It was the obituary he would have wanted. It called him a “peacemaker,” which is a pretty great noun. It talked about his passion for resolving conflicts, quoting an old New York Times Magazine article that said, “Some men look at Gina Lollobrigida and are set aflame. Kheel gets the same reaction by exposure to a really tough strike situation.”

  And it made him sound like James Bond. “Even though Mr. Kheel handled disputes for bakers, garbage collectors, plumbers, subway conductors, tugboat captains and undertakers, he was an unabashed bon vivant, fond of fast sports cars and fine food.”

  The photo showed him holding two phones, one pressed to each ear, in the middle of a negotiation between labor and bosses—maybe the bus drivers’ union, maybe the symphonies’. It didn’t say, and it didn’t matter.

  Julie clipped the obituary and pasted it onto a piece of cardboard, which I thought was a lovely, nostalgic gesture in these digital times.

  There was a short video on the Times website. They must have interviewed him just a couple of years ago, and he must have known it was a pre-obituary Q&A. They filmed him, gray-haired and still articulate, against a black background.

  “How do you want to be remembered?” he is asked.

  My grandfather laughs. “I don’t want to be remembered,” he says. “I want to stick around for a while longer.”

  Chapter 22

  The Nose

  The Quest to Smell Better

  IT’S BEEN TWO WEEKS SINCE the death of my grandfather, and I’m eating too many refined carbs. I’m barely exercising, feeling fatalistic. I keep going back to the Jim Fixx argument, that chestnut of defeatist reasoning: Whatever I do, I’m still going to die, so why waste all this time and energy? And it’s not like my grandfather consumed a strict diet of cruciferous vegetables. Why should I?

  I’m bingeing. I’ll eat a handful of raisins, peanuts, and chocolate chips. Then a granola bar with twenty-four grams of sugar. And more of the trail mix. Then I have the bag in my face like a farm animal. I recently read a brilliant description of bingeing. The passage isn’t even about eating, but it was the best portrayal of a shame spiral I’ve ever come across. It is from Plato, and describes a man who walks by a heap of corpses. The man tries to look away, but then gives in and says to his eyes: “Look for yourselves, you evil wretches, take your fill of the beautiful sight!”

  That’s the way I feel about my stomach. It’s a separate beast. “Here, you evil bastard, have your Fig Newtons and shut up.”

  I need to snap out of it. A few weeks ago, I’d set up an appointment at the Monell Chemical Senses Center in Philadelphia. This is America’s biggest research facility devoted to studying human smell and taste. People are always telling me to “smell the flowers.” Maybe that’s what I need to do.

  I take the train down to Monell on a cold Tuesday morning. It’s hard not to spot the center, thanks to the entryway’s giant bronze sculpture of a nose. It’s probably a good thing the same designer didn’t work on the Harvard Urology Center.

  The eighty scientists at Monell believe that smell and taste are an underappreciated part of healthy living. It’s why I came.

  Smell and taste have been tied to health for millennia. The earliest doctors diagnosed with their nose, as Esther Sternberg points out in Healing Spaces. The scent of sweet urine meant diabetes, for instance. And now that’s coming back into vogue thanks to a field called “olfactory diagnostics,” which analyzes some of the thousands of compounds we exhale in every breath.

  It’s long been suspected that smell and taste influence mood and behavior. Florence Nightingale believed the scent of lavender
relaxed her patients. In Civil War hospitals, she would anoint the foreheads of wounded soldiers with the floral fragrance. Unfortunately, until recently, there’s been little rigorous research on the topic. Instead, we’ve gotten the fuzzy-headed but well-meaning field of aromatherapy. Aromatherapy—the use of scented essential oils—isn’t bad, necessarily, especially if accompanied by a foot rub. But it’s about as scientific as numerology.

  The Monell Center is out to fix that.

  One of Monell’s scientists, an energetic woman with blue glasses named Leslie Stein, gives me a tour of the six-story building: microscopes, truck-size freezers, mazes for mice, a dozen white lab coats hanging in a row, scientists crunching data in their offices, skullcaps with electrodes, an Oscar the Grouch doll in the children’s testing room. Oddly, it’s not a smelly building. I could only detect one researcher’s microwaved moo shu chicken.

  There’s a sense of adventure here. Smell isn’t nearly as well researched as any of the other senses. “I love it because it’s uncharted territory,” says Sweden-born researcher Johan Lundström. “Whenever I have an idea, I can design an experiment to see if it’s true, because chances are, no one’s done it before.”

  Among the experiments Monell is conducting:

  • Treating post-traumatic stress disorder, which can be triggered by odors such as the burning of explosives.

  • Regrowing nerve cells. The nose’s nerve cells have the unusual ability to regenerate after thirty days. Can doctors cause this regrowth to occur outside the nose?