[RADIOLAB INTRO]

JAD ABUMRAD: This is Radiolab. I'm Jad Abumrad. We're gonna start today's program with a brief diversion to Midtown Manhattan, at the office of a neuropsychologist ...

KAMRAN FALLAHPOUR: Hey, good morning.

JAD: Good morning, how are you?

KAMRAN FALLAHPOUR: Good, thanks.

JAD: Jad Abumrad.

JAD: Kamran Fallahpour, a well-dressed man with a calm voice, calming presence and uncanny ability to calm others, which is why we're here.

KAMRAN FALLAHPOUR: Okay. Are you going to be the volunteer?

JAD: Yeah.

JAD: He walks me over to a small machine and asks for my left hand.

KAMRAN FALLAHPOUR: Can I have your left hand? Okay, what we're doing right now, we're just putting a couple of sensors that measure, basically, the flow of electrons between the two fingers here.

JAD: That would be my index and middle fingers.

JAD: There are electrons going between my fingers?

KAMRAN FALLAHPOUR: Oh, absolutely. Well, there are salts and minerals that are going to enable a very tiny electrical charge to travel from one finger to the other one.

JAD: And he explains the more anxious I am, the more sparks fly between my fingers. In other words, this is a stress test.

KAMRAN FALLAHPOUR: Okay, so I'm going to start it and ...

JAD: Am I going to feel something in my fingers?

KAMRAN FALLAHPOUR: No, you're not gonna feel anything.

JAD: But I will hear something. That whine in the background.

KAMRAN FALLAHPOUR: So if this goes up, it means that you are more stressed. So let me just make a couple of sounds here. You see that?

JAD: You're stressing me out, man.

KAMRAN FALLAHPOUR: Okay, did you see that?

JAD: Yeah, that's ...

KAMRAN FALLAHPOUR: Okay. Only with a couple of snaps near your ear, changed ...

JAD: I got all the way to the top.

KAMRAN FALLAHPOUR: Yes.

JAD: That's not good.

KAMRAN FALLAHPOUR: Well, that means that you need to relax and you need to bring it down.

JAD: Techniques to bring stress down. That is what Kamran Fallahpour has promised us. His theory is if you can hear your stress, you can control it.

KAMRAN FALLAHPOUR: Okay, so what I'd like you to do is just to sit back and when you're ready, just go ahead and close your eyes. And for now, I'm going to actually get rid of the tone here for you. We can monitor from here. And I want you to just get as comfortable as you can get right now, and gradually start to take deep, slow breaths through your abdomen. Okay. Continue to breathe slowly and perhaps make your exhalations a little bit longer and more sustained. Then perhaps you can notice as you continue to breathe slowly that perhaps with each breath you feel a little bit more relaxed and a little bit more comfortable.

KAMRAN FALLAHPOUR: Relax ... relax ... relax ... relax ... relax ... relax.

KAMRAN FALLAHPOUR: And for now, there is nothing there to worry about.

JAD: Then the phone rings. Did you see that? Now I'm all the way at the top again.

JAD: Isn't that appropriate? While you're trying to de-stress, make your life a little better, the phone rings, ruins it all, one fell swoop. Like life, really. At any moment, a dirty bomb could go off. You know this. You could get downsized, dumped, dented by a mad stroller pusher as you cross the street, a street already swimming with naked hostility and fist-sized avian flu bugs. The point is, the phone could ring at any time.

JAD: I'm kind of already getting more stressed. It's like I can't stop. [laughs]

JAD: We can't control stress. But what we can do is understand it.

KAMRAN FALLAHPOUR: Now if we lower the lights, too.

JAD:That's today on Radiolab. Conversations and stories about stress, from many different perspectives, starting with the science. When you are stressed out, these things inside you ...

ROBERT SAPOLSKY: Digestion, reproduction, growth, your heart rate.

JAD: ... change drastically and a leading researcher will explain exactly how. And later in the program, a very famous and perplexing case of stage fright.

LINDA THOMPSON: It feels like somebody's, you know, strangling you from the inside.

JAD: I'm Jad Abumrad. Riding shotgun with me is Mr. Robert Krulwich.

ROBERT KRULWICH: Who, by the way ...

JAD: Yes?

ROBERT: ... should immediately say that I think we should correct a prejudice here. You seem to be anxious about stress.

JAD: Well, maybe a little bit.

ROBERT: Stress is your friend. We need it. In midterms in eighth grade, if you didn't have stress, you wouldn't have gotten to ninth grade. You shouldn't quite just say, "Oh God, let's have less of it." Sometimes you want it to kick you in the butt.

JAD: All right, I think our first story gets at what you're saying. It comes from a guy named Colby Hall.

JAD: Colby, tell me what you had for breakfast so I can set the levels.

COLBY HALL: All right. This morning I had two hard boiled eggs.

JAD: I met Colby Hall at a party. I actually overheard him telling the story you're about to hear. It's an amazing story. So I asked him to come in and tell it to us in the studio. Now if you are squeamish, you may want to consider turning the radio down for about seven minutes.

COLBY HALL: How's that sound?

JAD: Sounds good to me. And in your headphones?

COLBY HALL: Good.

JAD: All right, cool. All right, Colby, let me start by asking you. At what point in the story did you realize you were in big trouble? That your life was changing?

COLBY HALL: Well, when someone said, "Get a tourniquet."

COLBY HALL: Fourth of July weekend, up in Vermont. Doubles tennis, foothills of the Green Mountains, barbecues, beer, lake. It was perfect in every single way. And we just said, "Let's go water-skiing." So we load up the boat with towels and we all get on there, so excited to kill an hour and a half on a beautiful lake on just a gorgeous, gorgeous day. And just as we're sort of loading up the boat, a canoe comes up to the dock and in the canoe is this family, this mother and father and their two little children. And they were staying in the house, and so we said, "Well, do you guys want to join us?" "Sure."

COLBY HALL: So the two little kids get in the boat and the father gets in the boat and we pull out from the dock and we get about 30 yards away from the dock and the boat driver stops. I have my little water ski devices belt on and it's kind of old school type, and I jump off the side of the boat and the force of me getting in the water, the water ski belt falls off of me. No big deal, I'm just gonna swim over. And I look up and the boat is closer to me than I had thought, and was actually moving towards me. I guess what the driver had done is he may have thought he had put it in neutral, but in fact, he put it in very slight reverse. And he didn't know that I was behind it. He was dealing with the rope. And so I'm in the water, buckling the water belt, and I look up and I notice and it's about 10 feet away from me. So I yell, "Hey, stop the boat."

COLBY HALL: But it's a big boat and the wind is blowing and your head is sort of at the level of the water, so no one really heard me. I couldn't move out of the way, and it literally just came right up to me. So I put my hands out to, you know, protect myself and immediately I feel these punches on my legs, which was the boat propeller. People say living in the moment, like, you—it's amazing to me how many complex thoughts you have in a split second. "Wait, is this happening? Oh my God, it's happening. Wow, this is cutting my legs. I'm trapped. I need to get out of this situation. I'm gonna push up. I'm gonna go under the boat and let it go over me."

COLBY HALL: Like, that all happened in a split second, and at the same time, you're thinking like, "Maybe this will just be a bad injury," or, "Maybe I'll lose the use of one leg." There's all these sort of weird deals that you make in your head. Like, "I don't want to die, so I'll just be in a wheelchair," or, "Maybe I'll just be really, really injured," or, "Maybe I'll never be able to play basketball again. Maybe I'll just always walk with a limp." The other side of this, this all happened one month to the day of my wedding. We had planned this really—I mean, it was a small, but beautiful wedding upstate and I wanted to walk down the aisle, I wanted to have the first dance. And it sounds odd to explain that you're having all those thoughts in that time, but you are.

COLBY HALL: So I come up on the other side of the boat and I sort of gasp for air and I say, "I'm hurt." It doesn't really hurt like you would think. That was the weird thing. It didn't hurt. It just—I mean, I feel it. Treading water and my legs are kind of numb. I look up and my fiancé is on the boat and she gets up and she sees me and she can see a ring of blood surrounding me. And the water up there is so clear that she could see through the water. She could see deep, red tissue on my legs and big flaps of skin sort of hanging off my legs, floating with the motion of the water. And it was at that point that she—the look on her face.

COLBY HALL: And it's funny, like, sometimes you don't recognize how bad something is until you see it in the eyes of someone next to you. And so when she freaked out and had the look of absolute terror in her eyes, I kind of just took over the situation because I was 10 seconds ahead of everyone else. So I yelled to the wife of the boat operator, whose name is Maureen, and I said in a very stern, serious, calm voice, "Maureen, turn off the boat." She turned the boat off, and I realized that there were two little kids on the boat and the first thought that came to my mind was, "This is something that those kids shouldn't see." Before I came up, I said, "Maureen, these kids should not see this. You should hide their eyes. You should distract them." So she took the kids to the front of the boat.

COLBY HALL: I'm not a real strong person, I don't know how I got sudden upper body strength, but I was able to just pull my full body weight, and I weigh like 210, 15 pounds. And I just pulled myself up on the back of the boat and there were my legs. Layers of fat. I see muscle tissue. I mean, it's hard to sort of describe. My legs were wide open. There were big hunks of flesh sort of hanging off my leg, and the muscle's just sort of there, exposed to the air. The cuts went down to my bone. It's like you're at a fish market and you see someone cut into a fish. You just see the insides, like, very, very clearly. And that's when John says, "Get a tourniquet." Because the injuries on my leg really looked like it warranted a tourniquet.

COLBY HALL: And if I were to ask you to make a tourniquet right now, what would you do?

JAD: I have no idea.

COLBY HALL: Who knows how to make a tourniquet? Right. There's no Boy Scouts on the boat. So someone had taken their shirt off and wrapped it around my leg and I said, "No look, get those towels." And so they wrapped the towels around my leg and ...

JAD: What's happening between you and your fiance at that point?

COLBY HALL: My fiance thought that I was about to die, and she was doing all that she could to kind of keep it together. And I remember looking to her and rubbing her arm and saying, "This is gonna be okay. Now is the time for us to be really brave. This will be okay." If for nothing else, I just wanted to pretend that that was the case, 'cause I didn't really know.

COLBY HALL: My name's Colby Hall and I survived a fight with a boat propeller.

ROBERT: So he survived?

JAD: Mm-hmm. It turns out the cuts he got were so clean and so deep that it allowed him to heal more quickly.

COLBY HALL: And as an aside, driving up to Vermont that weekend, we had stopped at the florist and had this big debate, my wife and I—or she was my fiancé at the time—about the color of tablecloths. You would have thought on the drive up that the single biggest issue in our lives was the color of tablecloths at the wedding. It was that significant. The drive back from Vermont after this accident, we felt so lucky.

JAD: Colby Hall is a video producer for MTV and this is Radiolab. Today's topic is stress.

ROBERT: My oh my. What a story! It happens that inside that story you've got a classic example of what always happens in a traumatic situation. I learned this from one of the leading experts on stress, Robert Sapolsky ...

ROBERT SAPOLSKY: Do you want me to incorporate your question into my answer, or does this run like a ...

ROBERT: No, just a regular conversation, so you can do whatever you want.

ROBERT SAPOLSKY: Okay.

ROBERT: ... who teaches at Stanford University, who pointed out to me that in these situations, your body is taken over, really, by stress hormones.

ROBERT SAPOLSKY: And that's that sort of alert, tunnel vision, time passage feels different, the eight seconds feel like it took for hours afterward.

ROBERT: Is that what that's about?

ROBERT SAPOLSKY: That's the stress hormones, and that's mostly adrenaline doing that.

ROBERT: So if you're flailing in the water and hit by a propeller from the boat and your leg is severed, my imagination there's two people on the dock like, "Oh my God! Oh my God!" But you say, "All right, let's call the police." You somehow are the calm one. Is that part of this thing?

ROBERT SAPOLSKY: Often that's the case, and that's another piece of the stress response. You shut down pain perception.

COLBY HALL: It doesn't really hurt like you would think. That was the weird thing. Like, it didn't hurt.

ROBERT SAPOLSKY: Pain is a very subjective state, and if it's the right setting, you blunt it. And it's not just guys in battle who've been grievously injured and they think the blood has been spattered on them from the gun and the stump is just kind of tingling and then they suddenly discover it, but that's exactly what you do with pain perception when you twist your ankle in the company softball game and you hardly even notice it. So in the face of a major physical stressor, not only is there this tunnel clarity and sensory whatever, there's also blocking of pain, this in-the-moment-ness, and we all experience it at some point or other. Where were you when you heard that Gwyneth Paltrow had named her child Apple, that sort of thing. Those moments that just define our lives, and there's a physiology of it.

JAD: I know exactly where I was.

ROBERT: Where were you?

JAD: I don't know. Does he have any idea where that physiology came from?

ROBERT: I think he does. Yeah. He thinks all mammals have these things in us that we've got from evolution. So imagine, say, you're an impala.

JAD: What's an impala?

ROBERT: It's an antelope kind of animal.

JAD: Oh.

ROBERT: So you're bounding across the savanna and you're being chased by a tiger. But you don't want this tiger to get anywhere near you, so your insides have to work hard to keep your outsides alive.

ROBERT SAPOLSKY: You're running for your life, the predator's coming after you ...

ROBERT: Certain stuff happens.

ROBERT SAPOLSKY: First thing, you need energy. Not energy tucked away in your fat cells for some building project next spring. Energy right now to go to whichever muscles are gonna save your life. Your adrenaline, other hormones go to your fat cells, pour out all the stored energy, feed it to your thigh muscles.

ROBERT SAPOLSKY: In addition, you want to deliver the stuff as fast as possible, so you increase your heart rate. Another thing you do is you shut down everything that's not essential. And right now, this is no time to worry about ovulating, this is no time to worry about growing antlers, this is no time to digest breakfast. You shut down digestion, you shut down growth, you shut down reproduction. We all know, for example, with the digestive end, the first step of that, you get nervous, your mouth gets dry.

ROBERT: Everyone has this experience. You go to—you have to make a presentation in front of a large number of people and you're standing there and you're going, "Does it work? Ladies and gentlemen." You know, you can't—if you say the word "dog," your tongue would get stuck at the top of your mouth because you got nothing going on wet in your mouth. Your digestive system is shutting down, and the first step is those fluids that would help you digest a string bean aren't there anymore. This is like the antelope.

ROBERT SAPOLSKY: In addition, you void your bowels, you void your bladder as well, get rid of the dead weight. That's why people are executed in diapers, typically. You shut down all these unessentials.

ROBERT: So if you amp up all this stuff, if you say, "Okay, I'm not growing and I'm thinking faster and my heart is pacing so I can get all this stuff," and all these things are going on simultaneously, this is not a bad thing at all. This is ...

ROBERT SAPOLSKY: It's a great thing. It's a great thing if you're stressed like a normal mammal.

ROBERT: So when people talk about stress, or stress diseases, or being over stressed, or the stressfulness of modern life, what does that mean?

ROBERT SAPOLSKY: Well, almost certainly it means it's got absolutely nothing to do with the impala running for its life. Very few parking spot fights are settled with axes. We don't have to wrestle people for canned food items in bombed-out supermarkets. Our boss never ...

ROBERT: Well, you haven't been to certain sections of New York lately. [laughs]

ROBERT SAPOLSKY: Oh yeah. Well, I love New York.

ROBERT: Anyway.

ROBERT SAPOLSKY: When you're actually getting stressed in the way that we talk about in an everyday sense, we're not being physically menaced. What we're doing is turning on the stress response in anticipation of a stressor.

ROBERT: You mean it's literally like, you're sitting there in the bed thinking, "Oh God, oh God, oh God, I have this sales meeting tomorrow," and flushing through your body are the same stress hormones and everything else that would be flushing through the impala dashing—being chased by a lion? Or you mean sort of like that?

ROBERT SAPOLSKY: Yeah, actually, you know, here's one of these try it at home exercises. Lie in bed when you're nice and sleepy and relaxed and your heart's beating nice and slow. Very carefully think, "You know, that heart isn't going to beat forever." And most likely, you're gonna turn on the exact same stress response as if you were running for your life. Same hormones, same physiological changes, same all of that. That's the ...

ROBERT: Just from the thought, "Oh my God, one day I'm gonna die"?

ROBERT SAPOLSKY: If it really has the right impact on you and the punchline of the entire field is, that's not what the system evolved for.

ROBERT: So if you're a human being and you're a nervous one and if you get scared in the nights, in your body, what's going on that will eventually make you sick?

ROBERT SAPOLSKY: Exactly the same thing. And all you have to do is that sprint across the savanna kind of writ large and out of it pops a whole bunch of diseases. If you're constantly mobilizing energy for those thigh muscles that are preparing to run you across the savanna, as you wonder, "Is social security gonna be there in 30 years?" If you're constantly doing that ...

ROBERT: You've got a really nervous person in your head.

ROBERT SAPOLSKY: [laughs] Yes, well. I study this subject. It's not by chance.

ROBERT: Okay, okay. I believe you.

ROBERT SAPOLSKY: What, did you think this was a coin toss? I worry about being ethnically cleansed by Serbian Croats, that sort of thing, and I'm sitting here in Palo Alto. If you constantly mobilize energy, you don't store it. And for really complex reasons, you're more at risk for this disease, adult onset diabetes. This is one of those great diseases that our great, great grandparents never heard of.

ROBERT SAPOLSKY: A much more accessible version is, increase your blood pressure out the wazoo to run for your life. This is not a big deal for three minutes. Increase it chronically every time you come to work, and stress-induced hypertension, you're gonna damage the walls of your blood vessels.

ROBERT: Now not everybody in the world reacts to everything as though they were an antelope being chased across the savanna. I mean, some people can handle all kinds of stress and get through the day, and other people succumb. And that's where we ought to go next, I think.

JAD: Coming up, a particular piece of furniture and its remarkable impact on public health.

ROBERT: Yes!

JAD: And a heartwarming tale of a baboon who changed his ways and in the process discovered the secret to longer life and lower stress. This is Radiolab. I'm Jad Abumrad. Robert Krulwich and I will continue in a moment.

 

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