Book Review: Why Zebras Don’t Get Ulcers

I am a geek, pretty thoroughly. I like much of the geek canon, from LOTR to Star Wars, though I am more of an academic than a gamer. I’m not a gamer at all. But I have a lifelong love of learning which extends into most subjects, though my interest in some of them is specific and random. I enjoy many of the sciences. Among my specific interests is health and nutrition, though I have—sometimes out of necessity—dabbled in psychology and mental health. When a thick, science book on stress-related disease popped up on my book club list, I didn’t think twice about it. But now I’m wondering if—for the sake of others—I should have.

Image from Amazon.com

I suppose science books (or history, for that matter) are not for everyone. Even the books that are written in such a way as to make them have more appeal and to speak to the layman, are just not for everyone. Why Zebras Don’t Get Ulcers by Robert M. Sapolsky has been popular and celebrated since its first edition publication in 1994. (I believe we’re on the third edition.) But there are two reasons that—two weeks into February—I had to send out an email giving my book club members permission to put the book down or skip to the end. One: it’s still a book on science and it is really dense, especially if this stuff isn’t usual to you or you aren’t interested in it. Two: it’s a stressful read, ironically.

I was reading this book with my Pandemic Book Club precisely because it has been a stressful year. We are seeking emotional health. Zebras was supposed to educate us about how stress is affecting our bodies and then show us some ways to prevent or reverse those effects. Well, on page 308 out of 339, we were still working our way up to the practical application, still finding out, chapter by chapter, how stress is killing us and making us miserable. In fact, the final chapter begins, “By now, if you are not depressed by all the bad news in the preceding chapters, you probably have only been skimming” (p309). Which is what I told my ladies to do, if the book was counterproductively stressing them out.

Sapolsky, you see, is a serious scientist and as such, has to be very thorough and exacting in his presenting of the science. He also happens to be one of the more entertaining and approachable scientists I have ever read, which makes his books popular and—if you go in for that kind of stuff—interesting. If you can take it all cooly, with a grain of salt, then, well, I was LOLing at points. (I don’t want to bring your expectations up too high, but I was certainly, regularly chuckling, anyhow, which is very strange for a health science book.) If you are already stressed out and you tend to get more stressed out about either reading dense books or discovering that your mother’s techniques have doomed your cardiovascular system, then perhaps a stressful time is not the time at all for this book. Like I said, ironically.

In the end, I didn’t breeze through this book, and occasionally I realized I had zoned out during some especially technical passage with more multisyllabic words than a Twinkies ingredients list. Overall, though, I found Sapolsky to be an exemplary science writer. Like I said, funny, interesting, approachable, engaging, full of anecdotes and stories. And wry. Sometimes sarcastic. Balanced, calm, collected. I didn’t feel like he was trying to sell me something. And still, all the while, very careful about what he’s claiming and not allowing others to claim. I was also disappointed by the very small amount of help that Sapolsky suggests at the end and, more importantly for me, how disorganized it is. I would like a list, please, with clear directives or at least suggestions. He gives us little to be going on with, mostly ideas instead of concrete steps. Still. If you have any interest in reading the best of science books, or if you have an interest in stress-related disease, aging (well), psychology/psychiatry, Savannah baboons, or social experiments on rats, then this is a book I would recommend for you. I only wish every subject had a book as well-written as this one for the more-average Joe to read. I’m tempted to explore his other titles, which are:

  • Stress, The Aging Brain, and the Mechanisms of Neuron Death
  • The Trouble with Testosterone (essays)
  • A Primate’s Memoir (memoir)
  • Monkeyluv (essays)
  • Behave: The Biology of Humans at Our Best and Worst

At least the memoir and Behave. All of them have good ratings.

QUOTES:(from the 2nd edition)

“We humans can experience wildly strong emotions (provoking our bodies into an accompanying uproar) linked to mere thoughts” (p6).

“They are generally shortsighted, inefficient, and penny-wise and dollar-foolish, but they are the sorts of costly things your body has to do to respond effectively in an emergency” (p13).

“If you repeatedly turn off the stress response, or if you cannot appropriately turn off the stress response at the end of a stressful event, the stress-response can eventually become nearly as damaging as some stressors themselves” (p16).

“Stress increases your risk of getting diseases that make you sick, or if you have such a disease, stress increases the risk of your defenses being overwhelmed by the disease” (p16).

“…no cell in your body is more than five cells away from a blood vessel…” (p42).

“…some parts of our body, including our heart, do not care in which direction we are knocked out of allostatic balance, but rather simply how much” (p49).

“The central lesson of this chapter is how incompatible it is to plan for the future and simultaneously deal with a current emergency” (p79).

“Sometimes a stressor can be the failure to provide something for an organism, and the absence of touch is seemingly one of the most marked of developmental stressors that we can suffer” (p92).

“In the human, an average pregnancy costs approximately 50,000 calories, and nursing costs about a thousand calories a day; neither is something that should be gone into without a reasonable amount of fat tucked away” (p112).

“Think about it: over the course of [a Kalahari Bushman mother’s] life span, she has perhaps two dozen periods. Contrast that with modern western women, who average perhaps 500 periods over their lifetime” (p115).

“…an artificial rose could trigger an allergic response in a patient” (p126).

“Although evidence is emerging that stress-induced immunosuppression can indeed increase the risk and severity of disease, the connection is probably relatively weak and its importance often exaggerated” (p127).

“The impact of social relationships on life expectancy appears to be at least as large as that of variables such as cigarette smoking, hypertension, obesity, and level of physical activity” (p143).

“As you stress the system—in this case, by making the subjects race against a time limit—scores fall for all ages, but much farther among older people” (p201).

“We humans also deal better with stressors when we have outlets for frustration—punch a wall, take a run, find solace in a hobby. We are even cerebral enough to imagine those outlets and derive some relief” (p215).

“…half of those lacking social support were dead within five years—a rate three times higher than was seen in patients who had a spouse or close friend…” (p217).

“…the more apt description of depression—‘aggression turned inward’” (p251-252)

“…when an organism is rewarded consistently with no control or predictability (that is, no matter what the subject does, it is rewarded), it also has difficulty afterward learning coping responses” (p254).

“…having a genetic propensity toward depression gives you only about a fifty percent change of getting the disease” (p260).

“Repressing the expression of strong emotions appears to exaggerate the intensity of the physiology that goes along with them” (p279).

“If you reduce the hostility component in Type A people through therapy … you reduce the risk for further heart disease” (p279).

“Instead, it says that if you want to change the SES gradient, it’s going to take something a whole lot bigger than rigging up insurance so that everyone can drop in regularly on a friendly small-town doc out of a Normal Rockwell. Poverty, and the poor health of the poor, is about much more than simply not having enough money. As Antonovsky showed, it is also about your psychological interactions with society at large and how readily society registers your existence” (p307).

“Not everyone falls apart miserably with age, not every organ system poops out, not everything is bad news” (p311).

“If you can view cancer and Alzheimer’s disease, the Holocaust and ethnic cleansing, if you can view the inevitable threshold where your own heart will cease to beat, all in the context of a loving plan, that must constitute the greatest source of support imaginable” (p317).

“They emphasize the importance of manipulating feelings of control, predictability, outlets for frustration, social connectedness, the perception of whether things are worsening or improving” (p325).

“It is true that hope, no matter how irrational, can sustain us in the darkest of times. But nothing can break us more effectively than hope given and then taken away capriciously” (p328).

“He warns against trying to assert control over something that does not need correcting or that cannot be corrected—an approach at which Type A’s tend to excel” (p334).

My shorthand list of Steps to Take:

  1. Recognize the signs of the stress response and situations responsible for it.
  2. Find a regular, scheduled outlet.
  3. Hope, reasonably and protectively. In the worse case scenario, denial is preferable.
  4. Seek control, but do not try to control the uncontrollable.
  5. Scale by a series of footholds.
  6. Seek accurate, predictable information that is neither too soon nor too late, too much or really awful.
  7. Find sources of social affiliation and support.

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