Animals Can Heal Us, Too At the hospital where I practiced in Pittsburgh, other physicians often asked my advice before discharging a depressed elderly patient after bypass surgery or hospitalization for a fractured hip. Usually, I was the last person they consulted. The colleagues preceding me had already prescribed a long list of medicines: antiarrhythmic, antihypertensive, anti-inflammatory, antacid. They expected me to carry the ball and add my own "anti" to the list -- an antidepressant or anxiolytic (anti-anxiety medication). Often, however, the cause of depression was clear. The old man or woman had been living alone for years, and was no longer going out very much because of frail health. No longer playing bingo with friends. No longer being visited by their children or grandchildren, who had left for California, Boston, or New York. These men and women were idling away the hours in front of television screens. Would these patients honestly feel like looking after themselves? Even if antidepressants could have done them good, would they have taken them every day? Probably no more than those other pills, already so hard to distinguish from each other and to take as prescribed. I really did not feel like adding my two-cents' worth to that confusion. Medicines are not "limbic regulators." So, summoning up all my courage, I would add my recommendation to the patient's medical record: "As far as her depression is concerned, the best thing for this patient would be to get a dog (a small one, obviously, to minimize the risk of a fall). If the patient considers that would be too much work, a cat would do, since it does not need to be taken out. And if a cat still seems too much, a bird or a fish. Finally, if the patient still refuses, then a houseplant." At the beginning of this campaign, I received slightly irritated calls from the residents in orthopedic or cardiovascular surgery: "We asked you to recommend an antidepressant, not a zoo. What are we going to write on the discharge prescription? There aren't any household pets at the pharmacy." However I answered, my explanations seemed convincing only to myself. My colleagues invariably ended up prescribing an antidepressant themselves, mumbling about how useless psychiatrists really were. They were undoubtedly convinced that they were defending the cause of modern scientific medicine against the ever-threatening, obscuring specter of "old-wives' remedies." 
I soon realized that my approach was not working and that I was doing damage to my reputation as chief of the psychiatry division of the hospital. Instead of backing down, I prepared a document summing up various scientific studies on the question. From that point on, I attached the document to my recommendations in the patient's record. I hoped to inform my colleagues of certain remarkable results with which they didn't seem to be familiar, such as one study from the American Journal of Cardiology about men and women whose infarctions had been accompanied by dangerous arrhythmias. The patients were tracked for more than a year, and those who had had a household pet faced only one-sixth the likelihood of dying during the year compared to all the others. Or yet another study, in which older people with household pets had much better psychological resistance to life's difficulties and went a lot less often to the doctor's. I also called their attention to a study from a group at Harvard showing that simply looking after a plant lowered the mortality rate of residents in a retirement home by 50 percent. I cited research on AIDS patients showing that cat or dog owners were better protected from depression. Finally, I referred to the font of all knowledge in my colleagues' eyes -- the Journal of the American Medical Association. In 1996, it published a study about handicapped people who were virtually unable to move around unaided, very similar to the elderly patients I had been asked to see. This study showed that these people were happier and had greater self-esteem and a distinctly larger network of friends and relations if they had the companionship of a dog. In fact, another study found that the mere presence of an animal by your side makes you "more attractive" to others. Even stockbrokers feel better if they have a household pet. With one of the most stressful professions imaginable, they are constant victims of market ups and downs over which they have no control, yet they still have to meet their sales targets. It is hardly surprising that a good many of them suffer early from high blood pressure. Karen Allen, Ph.D., from the University of Buffalo, conducted an unconventional study on a group of brokers in her city. Antihypertensive medications brought their blood pressure down below the initial alarming average of 160/100. However, in moments of stress, they still showed sudden peaks of blood pressure above those numbers. To a randomly selected half of the stockbrokers, Dr. Allen allocated either a dog or a cat. (They had the opportunity to choose one or the other.) Six months later, the results spoke for themselves: Those who had received household pets were no longer reacting to stress in the same way. Not only had their blood pressure stabilized, even in periods of stress, but their performance on stress-inducing tasks -- such as rapid mental arithmetic and public speaking -- was significantly better. They made fewer mistakes, suggesting that they had more control over their emotions and thus over their concentration. In another study, Dr. Allen was able to show that older women (over 70) who lived alone but with pets had the same blood pressure as women of 25 with active social lives. My "enclosure" turned out to be effective. After that, nobody ever made the slightest comment. I no longer heard interns snicker behind my back when I left one of my "zoological" recommendations in their patient's file. On the other hand, alas, I do not think that a single patient ever went home with a cat or without his or her prescription for Prozac. The idea that a loving relationship is in itself a physiological remedy, comparable to taking medication, rests on sound scientific ground -- but it simply has not yet taken hold in the medical establishment. Copyright © 2003, 2004 by David Servan-Schreiber, M.D. |