In
the early years after the second world war, health researchers in
Britain noticed a curious epidemic: people had begun dying of heart
attacks in unprecedented numbers. Nobody knew why, and so a scientist
in London named Jerry Morris set up a vast study to examine the
heart-attack rates in people of different occupations – schoolteachers,
postmen, transport workers and more.
Morris is today a neat,
bird-like man who uses a cane to get around. He turns 100 next May but
still regularly makes his way to his poky little office at the London
School of Hygiene and Tropical Medicine. It is here that he describes
the day he saw the data that changed medicine. “The very first results
we got were from the London busmen,” says Morris, in Glaswegian tones
undimmed by seven-odd decades in London. “And there was a striking
difference in the heart-attack rate. The drivers of these double-decker
buses had substantially more, age for age, than the conductors.”
The
data were so telling because drivers and conductors were men of much
the same social class. There was only one obvious difference between
them. “The drivers were prototypically sedentary,” explains Morris,
“and the conductors were unavoidably active. We spent many hours
sitting on the buses watching the number of stairs they climbed.” The
conductors ascended and descended 500 to 750 steps per working day. And
they were half as likely as the drivers to drop dead of a sudden heart
attack.
 |
| Morris found that bus conductors had fewer heart attacks than sedentary drivers |
Today,
almost everyone understands that physical exercise can help prevent
heart disease, as well as cancer, diabetes, depression and much else
besides. But on that day in 1949 when Morris looked at the bus data, he
was the first person to see the link. He had inadvertently – “mainly
luck!” – stumbled on a great truth about health: exercise helps you
live longer.
That’s a truth even more relevant in 2009 than it was
in 1949, because so few of us now perform vigorous physical tasks as
part of daily life. If present generations are going to live longer, we
must exercise. But if that depends on us getting on rowing machines in
our spare time, it won’t happen.
Morris is not simply a man with
a mission – he is a man with several missions. But since reading those
numbers about busmen, he has wanted to help everyone exercise more.
Then we might live lives something like his.
Morris grew up in
the lost world of the Southside of Glasgow “in a
two-bedroom-and-kitchen house, father, mother and three boys”, he
recalls. “We were next door to a slum street. I still remember the
screaming women on Friday night and Saturday night, when they were
beaten by their drunk husbands. As you can imagine, I have a contact
with social inequalities and with poverty that most of my colleagues
know from the literature.”
He began exercising in early
childhood. “My father used to take me on a four-mile walk from Glasgow
once a week, when I was a schoolboy. We used to aim to do the four
miles in an hour. If we did that OK, I got an ice-cream. If we did it
in even a minute less, I got a choc-ice.
“Many years later, when
I became interested in these things, I challenged him, and he had no
idea where he got this four miles an hour from. I was eager for a
quote, you see. And he couldn’t produce it. Except, ‘It’s always been a
habit.’”
Morris warbles a line from a song: “‘What comes
naturally…’ This is from one of my favourite musicals. ‘Na-tu-rally.’
It’s probably from Guys and Dolls.”
In Morris’s own
words, he always was a “do-gooder”. He once went to his local Labour MP
to volunteer for campaign work, but was rejected on the grounds of
being 12 years old. He joined Labour aged 16 in 1926, and remains a
due-paying member, despite breaking with the party over the Iraq war.
“I remember writing to Blair: ‘How many of your cabinet have even seen
the Blitz?’ None, is the answer. I was in London during the Blitz.
Since 2003, I have voted Green.”
But he remains obsessed with
the old Labour issue of inequality in health. From the neat paper trays
that cover his office, he ferrets out one of his recent reports:
“Minimum income for healthy living: Older people.” Morris’s office
features none of the awards or pictures of handshakes that you see in
many old men’s playrooms. Other than some obituaries of dear
colleagues on his noticeboard, this is a working person’s office. He
has even organised our lunch himself: a cheese-and-tomato sandwich, a
slice of cake and an orange juice await me.
When Morris went into
medicine, he took a novel approach: he wanted to know why different
kinds of people got different diseases. Epidemiology, as this science
is now called, barely existed then. In the 1930s, he became obsessed
with juvenile rheumatism. His boss, a fashionable Harley Street doctor
who also worked at Eton College, remarked that he never saw a case at
Eton. Morris dryly calls this “a good clinical observation”. Only the
poor got juvenile rheumatism.
He spent most of the war as a
military doctor in India. “We ran a first-class hospital in the swamps
of Assam in the middle of the summer, where you got boiled alive the
moment you woke up.” Demobbed afterwards in London, he landed in a
golden age of British medical research. During the war, researchers in
Oxford had helped develop penicillin. After it, Morris’s political
hero, Nye Bevan, created the National Health Service, the world’s first
completely free healthcare system. And what epidemiology there was in
the world was led by Britain. In 1950, another London health
researcher, Richard Doll, published a study showing that smoking – and
not Tarmac or car fumes, as many had suspected – was causing the new
epidemic of lung cancer.
Only occasionally in conversation do
you get a hint that Morris is a man from a bygone age. Usually it’s
when he uses extinct language, such as “refectory” for restaurant, or
“pumping ship” for going to the toilet. Otherwise, he keeps up so well
that he could probably win current-affairs quizzes. Yet he says: “I
feel like a displaced person, in many ways. On the one hand, I’m a 2009
person. On the other hand I’m a 1940s person.”
. . .
“The
1940s was the generation that said ‘Yes we can.’ You need a national
health service? You go out and do it. Eating fruit and vegetables – in
the 1940s, they would have got the best brains in nutrition, in retail,
in agriculture, and said: ‘Go away to the Hebrides and don’t come back
until you’ve got us a national programme that’s easy for everybody
every day.’”
Morris’s own mission of the late 1940s was heart
disease. He spent “interminable hours” reading the wonderful postmortem
folios of the London Hospital in the East End for 1907 to 1949. But he
still couldn’t understand why heart attacks were increasing.
“We
were in the fortunate situation,” he says, “that very little research
had been done on it. It might be hard for you to imagine a time when
heart attack wasn’t a major preoccupation of everybody.” Today, heart
disease is the most common cause of death in western countries.
“The
only hunch I had was that this might be related to occupation. It was
commoner in men than women, it was commoner as middle age advanced, and
there were some hints in the national statistics of mortality that it
might be connected in some way to occupation.” The busmen’s data were
fascinating, and the sample size was thousands of men. But Morris
didn’t treat it as proof of anything. In what he has called “one of the
tensest moments of my professional life”, he had to wait for data to
arrive for other occupations. Finally, he got the figures for postal
workers. “It was strikingly similar!” he says. The postmen who
delivered the mail by bike or on foot had fewer heart attacks than
sedentary men who served behind counters or as telephonists and clerks.
It was true: exercise prevented heart disease.
And yet Morris sat
on his data for years. If there were flaws in his theory, he was
determined to find them before anyone else could. “We set about
destroying this observation,” he says. “We brought in outside people
with no blood in their veins, no interest, to destroy it.” But they
couldn’t. His paper (“Coronary heart-disease and physical activity of
work”) finally appeared in The Lancet in 1953. His hypothesis, as he
still called it, was greeted with general disbelief. What could
exercise possibly have to do with heart attacks? True, there had always
been a vague belief that exercise was good for the soul. Mens sana in
corpore sano (“a healthy mind in a healthy body”), the Roman poet
Juvenal had written nearly two millennia before Morris, possibly with
satirical intent, and the Victorians fetishised team spirit and muddy
playing fields. But before Morris, nobody knew that exercise stopped
people dying.
 |
| A 1950s office worker smoking at work |
Even
he had no idea how exactly the mechanism worked. Only after his paper
appeared did the physiologist Henry Taylor sit him down for a solid day
in a Washington hotel room and, in Morris’s words, “schoolboy-taught me
the physiology of exercise”. Morris thinks the essential story is
simple: “Exercise normalises the workings of the body.” Humans were
meant to keep active.
With hindsight, his London bus drivers
inhabited one of the first societies on earth where exercise was
ceasing to be part of daily life. Technology was letting people grow
slothful. Even in the 1950s, Morris foresaw that when poor countries
developed, they would have the same problems. He remembers warning
then: “Their time will come to develop these diseases, and not to make
the mistakes that we made, eg a lack of exercise, eg smoking, eg our
lousy diets. Of course, nobody paid any attention.” Today, India has
the world’s worst diabetes epidemic, and in parts of rural Kenya, the
prevalence of angina has reached levels found in inner-city Glasgow.
. . .
Clearly,
if modern humans were going to exercise, it would have to be in their
spare time. But would they? After his initial studies of occupations
and heart attacks, Morris embarked on a large-scale study of British
civil servants, to find out whether they did.
This was in the
days before computers. Morris remembers: “I think of a room in this
school, with the floor consisting of piles of documents. Men of this
age, men of that age, men doing this kind of exercise or that. Going
through all of these documents to extract the cyclists, then going
through all the cyclists to extract those who cycle to work. Three very
respectable ladies would spend days and days, and another lady would
check they were not cutting corners. Changing a hypothesis now, in the
computer age, is a matter of a twiddle on the knobs. Changing a
hypothesis when we were doing important work was a major enterprise.”
Because
the civil servants in his study were middle-class British males, 91 per
cent were gardeners. “It’s what keeps us sane,” they repeatedly told
Morris’s team. Morris had thought gardening would protect them from
heart disease. It turned out not to. Only vigorous exercise, such as
swimming or playing football, was enough.
These findings were
made in an era when many British adults got no exercise beyond lighting
cigarettes. Morris, however, applied all the new epidemiological
findings to himself. Long a “stress smoker”, he read Doll’s studies and
quit cigarettes even before Iain Macleod, the health minister, held the
famous press conference in which he confirmed Doll’s findings while
chain-smoking throughout. Morris also began to jog. “I was the first
person to run on Hampstead Heath, in the 1960s. Every Sunday morning,
if the weather was at all possible, I took off my coat, and my little
boy carried my coat, I took off my jacket and my little girl carried my
jacket, and I ran for 20 minutes. People thought I was bananas.”
Morris
has been a habitual exerciser for many decades. “It’s the only way in
which I feel entitled, as an old buffer, to give advice to people. I’m
constantly being asked: ‘Your long life, what would you advise?’ and so
forth. To start telling other people what to do – I’m very reluctant.
Except on exercise, where to a large extent I feel it’s what I’ve done
myself that’s contributed to longevity. For decades I had a pulse-rate
of 52.” Even today, Morris is often to be found shuffling up and down
stairs at the London School.
Since he discovered exercise,
medical researchers have established that it is good not just for the
heart but for almost everything. “Exercise is a universal for health,”
Morris likes to say. By now, most people have got the message. Some of
them even exercise. Did Morris improve the world by encouraging the
habit? “That’s a very generous qualification.”
Surely he got people to exercise more?
“I suppose so. And failed in many respects with my own friends.”
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| Morris: ’I’m a work addict. It’s an obsession, a compulsion. Now, that’s a happy way of getting into old age’ |
Morris
is not a man who likes to waste time celebrating himself. When friends
planned a great academic party for his 90th, he was very anxious that
it should be a proper scientific conference, and not just a bunch of
people in smart clothes standing up and saying what a good chap he was.
But when he discusses the limited take-up of exercise he is being
frank, not humble. It frustrates him hugely. The key issue is not
individual will, he insists. “It’s got to be a joint effort between the
government and yourself.”
He uses his own example: until his mid-90s,
he was a habitual swimmer (he stopped in part because he was
embarrassed by people rushing over to help him out of the pool). And,
“well, swimming means there must be pools”. Governments need to build
pools and bike paths, and pedestrianise city centres. In 1994, Morris
wrote a paper arguing that “physical activity could be today’s ‘best
buy’ in public health for the west.” Hardly anybody listened. Now
western countries spend growing fortunes curing their obese and
inactive citizens. Already 10 per cent of the NHS’s budget goes towards
diabetes.
“For the first time in history,” says Morris, “the mass
of the population has deliberately got to take exercise. It’s a new
phenomenon, which is not appreciated.” For decades he has tried to
persuade governments to make exercise easier. He was involved in the
pioneering English National Fitness Survey of 1990, which found that
half of women aged 55 to 64 could not comfortably walk a mile. These
people were in effect disabled. The government ignored the report.
Since then, British exercise levels haven’t changed much. His voice
becomes high-pitched with outrage: “Just imagine, what historians in
the future are going to say about the way we’ve allowed this epidemic
of childhood obesity. ‘Disgrace’ is a sort of mild word.”
He’s
not about to stop pushing governments now. “Unfortunately,” he tries to
look sorrowful, “I’m a work addict. It’s an obsession, a compulsion. I
don’t think it’s a disease. Now, that’s a happy way of getting into old
age. It’s better than an alcohol addict or – are there womanising
addicts in old age? They must have a tough time.”
He has two
big ambitions for government: “On the one hand, for the first time, to
have a serious programme on health inequalities. Not a large programme,
or a complicated programme or an ambitious programme, I mean the word
‘serious’.” Second, he wants government to help the new, giant cohort
of old people to exercise.
To Morris, none of this is utopian.
All you need to achieve it is the spirit of the 1940s. He’s not sure
any politician has it now, though – perhaps not even his new hero,
Barack Obama. “This phrase, ‘Yes we can’, comes up much less nowadays,
doesn’t it?” he grumbles.
He ushers me out. A car – his family
won’t allow him to use public transport any more – is arriving to take
him home. There is work to be done, experts to call, e-mails to send,
an exercise bike to ride, books to order, pupils to mentor (he
micromanaged my eating of my sandwich), governments to push, novels to
read.
In a short memoir published this year, Morris quotes Philip Roth’s Everyman:
“Old age is not a battle but a massacre.” The line was widely received
as a beautiful restatement of an ancient truth. But Morris writes: “Is
he not plain wrong?”
Simon Kuper is an FT writer based in Paris
![[FINN]](http://si.wsj.net/public/resources/images/RV-AG526_FINN_G_20120406035335.jpg)
Aaron Koblin
SuperFreakonomics
offers much the same range and amiability, but is more polished. The
book’s chapters cover prostitution; data analysis in healthcare and
counter-terrorism; altruism; innovation; and geo-engineering. The
reader may not guess the central topic from the chapter titles or the
opening pages, however, which betray a fondness for springing surprises
and putting twists in the storytelling.
The
website’s profile rose dramatically as he accurately predicted
Democratic primary elections in state after state. When it came to the
presidential poll, he predicted the vote of 49 out of 50 states, and
was the first to declare Obama’s victory, beating professional
pollsters. 
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