The Rabbit Effect

New Zealand white male rabbits develop heart disease much like humans if fed a high-fat diet. Today most people know that eating fried food and steaks daily is asking for trouble. But back in 1978, researchers were still trying to establish the relationship between high blood cholesterol and heart health. Dr. Robert Nerem and his team designed a straightforward experiment using what he calls 'the standard rabbit model” to show the link.

Over several months, he fed a group of rabbits the same high-fat diet. At the end of the study, he measured the animals' cholesterol, heart rates, and blood pressure. As expected, the cholesterol values were all high and virtually identical to one another. The rabbits had similar genes and ate the same diet. Now they all seemed destined for a heart attack or stroke.

As the last step, Dr. Nerem needed to examine the rabbits' tiny blood vessels. Looking through the microscope, he expected all the rabbits to show similar fatty deposits on the inside of their arteries. Instead, Dr. Nerem had a shock. As it turned out, there was a huge variation in the fatty deposits between the animals. One group of rabbits had 60 percent fewer deposits than the other. It made no sense. He recalls wondering, 'What in the world could this be?” There was no clear biological explanation for these findings. He was staring down his microscope at a medical mystery. Dr. Nerem and his team searched for clues. They looked again at the research design. Nothing unusual. But Dr. Nerem knew to keep looking. He said, 'Sometimes there are things involved in a protocol that we don't take into account.” So the research team looked at themselves.

A Canadian postdoc named Murina Levesque had recently joined the lab. Dr. Nerem remembers, 'She was an unusually kind and caring individual.” When it became apparent that all the animals with fewer fatty deposits were under Murina's care, the team dug deeper. They noticed that Murina handled the animals differently. When she fed her rabbits, she talked to them, cuddled and petted them. She didn't just pass out rabbit kibble…she gave them love. As Dr. Nerem explains, 'She couldn't help it. It's just how she was.”

Now a professor emeritus of bioengineering at Georgia Tech, Dr. Nerem says, 'We were not social behavioral scientists,” but the team decided they could not ignore the findings of the social environment's effect on physiology. The research group repeated the experiment, this time with tightly controlled conditions. They compared the arteries of one group of rabbits cared for by the new postdoc to the arteries of another group of rabbits cared for in the standard way. They found the same effect again and published these findings in the prestigious journal Science.19 Take a rabbit with an unhealthy lifestyle. Talk to it. Hold it. Give it affection. And many adverse effects of diet disappear. The relationship made a difference. But how?

Medical training teaches doctors to break the body down into disparate parts: organs, tissues, cells, and molecules. Physicians divide by specialty in this same way. There are doctors for every bit: heart, kidney, gut, bone, brain, and so on. This fragmented view stems from the underlying theoretical premise that disease arises from internal biological processes gone haywire. It is an exciting inner-world journey that has dominated medical thinking for the last century, and it is what I…and countless other medical doctors…spent all those years painstakingly studying.

But then there were the rabbits. These studies indicate something is missing in the traditional biomedical model. It wasn't diet or genetics that made a difference in which rabbits got sick and which stayed healthy; it was kindness.
It turns out the rabbits were just the introduction to a much larger story. I call it the Rabbit Effect.

When it comes to our health, we've been missing some crucial pieces: hidden factors behind what really makes us healthy. Factors like love, friendship, and dignity. The designs of our neighborhoods, schools, and workplaces. There's a social dimension to health we've completely overlooked in our scramble to find the best and most cutting-edge personalized medical care. Even having something that motivates us to get up and out of bed in the morning makes a difference to our physical well-being.

Because, as it turns out, being and staying healthy isn't something that can be addressed through biomedical advances alone. Or by more and more spending on health care. Even the usual self-help directives…'Eat better! Work out! Get more sleep!”…will only get us so far. All these approaches overlook the critical social dimensions to ensuring sound minds and bodies. Ultimately, what affects our health in the most meaningful ways has as much to do with how we treat one another, how we live, and how we think about what it means to be human than with any- thing that happens in the doctor's office.

This book will empower you to change your health. But not in the usual ways. I won't give you a ten-step fitness plan or a two-week diet. That's not what you need. That's not going to make you healthier in the long run. Instead, I'll take you with me through the halls of the hospital, invite you into the room with my patients to discover why they are sick and what might make them well. Together, we'll investigate clinical puzzles that defy expectations, unearthing the hidden factors that determine who is sick and who is well, who will live and who will thrive. We'll discuss stories from communities renowned for their longevity, and data from studies that turn conventional thinking on its head.

We'll also explore the surprisingly strong connection between mental and physical health. Together let's examine how that physiological link, in turn, is aggravated by hidden factors awry in our environment. In other words, to better understand why and how we get sick…and how individuals can boost health…we'll look at the brain and body in the context of our day-to-day interactions. We'll then zoom out to an aerial view and look at solutions that boost collective health for all of us. At the end of each chapter there is a tool kit that offers ideas for your own process of self-discovery.
None of this means I'm going to insist you see a therapist. Or try to convince you to take more pills. Instead, we'll learn to pay attention to how symptoms, such as anxiety or depression or fatigue or pain, may reflect a red flag that something going on in your world needs attention. And how once we've addressed our own red flags, we can individually and collectively help others address theirs.

Ultimately, we will come to see how the larger ties that bind us…ties of love, connection, purpose…have ripple effects on our health and the world at large. And throughout the process, we'll consider fundamental questions about how we live. I'll ask you to examine your family, your relationships, your community, your neighborhood, your work, and your passions. I'm going to ask you to forget everything you think you know about health and wellness, and together we'll open our minds to a new paradigm, a new way of thinking about how we live and what it means to thrive.