Why Do We Call Some People 'Type A'?

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We all have at least a few Type A people in our lives, and we might have even butted heads with one or two of them. The highly competitive, angry, impatient, perfectionist sort of person who strives to be the best at everything is a familiar type, whether you consider them models of success or workaholics with tunnel vision.

"I tell my students, they call it Type A, not Type B, for a reason," Susan Whitbourne, a psychologist based at the University of Massachusetts Amherst, tells Mental Floss. "You want to be Type A-plus, if you're Type A."

The phrase Type A wasn't just born out of the ether: It was created as a way to identify people with certain patterns of behavior prevalent among those with coronary heart disease. In the 1950s, a pair of American cardiologists, Meyer Friedman and Ray Rosenman, were sharing an office in San Francisco when an upholsterer repairing their waiting-room furniture made an odd remark. He was surprised by the wear pattern on their chairs, he said, in which only the front edges of the seats were worn, rather than the back. Patients were literally waiting on the edges of their seats for their name to be called—rather than reclining comfortably toward the back.

At first the pair were too busy to take much note of the upholsterer's comments. But in the mid-1950s, they began looking at the literature around coronary heart disease and wondering if something other than diet (then painted as the most significant culprit) might be playing a part. In a 1956 study of San Francisco Junior League members, they found that diet and smoking didn't seem like adequate explanations for the different rates of heart disease they were seeing in women and men, since husbands and wives tended to share the same food and smoking habits. Female hormones were dismissed as a factor, since black women were suffering just as much heart disease as their husbands. They discussed the issue with the president of the Junior League, who responded, "If you really want to know what is going to give our husbands heart attacks, I'll tell you … It's stress."

That's when Friedman and Rosenman remembered the upholsterer's remarks, and began researching the link between stressed-out, achievement-driven behavior and heart disease. In 1959, they identified a type of behavior pattern they called Type A—highly competitive, very concerned with time management, and aggressive—and found that patients with this behavior pattern had seven times the frequency of clinical coronary artery disease compared to other groups.

The pair also created a Type B label, which basically encompassed behaviors and attitudes that weren't defined as Type A. People with Type B behavior were easy-going and enjoyed lower levels of stress, and while they may have been just as ambitious and driven, they seemed more secure and steady. The pair wrote a popular 1974 book about their research, Type A Behavior and Your Heart, which helped spread their ideas in the general consciousness. And while their initial emphasis was on behavior patterns, not entire personalities, the public quickly began referring to Type A and Type B personality types.

Over the next few years researchers began accepting that there could be a link between Type A behaviors, especially hostility, and lethal heart failure. The picture of the fuming man with high blood pressure who succumbs to a rage-induced heart-attack isn't just a cliché, Whitbourne says. (In fact, some modern studies have supported the idea of an increased risk of heart attack after a bout of intense anger.)

But as time went on, researchers began to notice quite a few problems in the Type A/Type B paradigm. In part this was because our understanding of coronary heart disease improved, and doctors and physiologists began to better understand how diet, physical activity, genetics, and the environment relate to blood pressure and cholesterol. As the decades went on, it became apparent that aggressive personality alone was severely limited in its ability to predict heart disease.

Outside the implications for human health, psychologists also began to critique the Type A/Type B system of personality labeling as reductionist, arguing that it lumped together many different traits and folded them under one of two extremely large umbrellas. Many psychologists now feel that human behavior is too complex and intricate to be described in such a binary way: People might be driven and organized, but not necessarily hostile and prone to angry outbursts. People might also be irritable or impatient, but perhaps rarely cross the threshold into hostility.

"It's not that we don't believe in it anymore," Penn State University psychologist John Johnson tells Mental Floss. "It's just that it's run its course. Type A does have a lot of components, but those are components that can be better explained in other ways in personality psychology."

One prominent newer system for describing personality and behavior is the Five Factor Model, developed in 1961 but not reaching academic prominence until the 1980s. The Five Factor Model assesses personality through five domains: openness, conscientiousness, neuroticism, extraversion, and agreeableness. Johnson likens its impact in personality psychology to the Periodic Table of Elements for chemistry.

Many Type A traits, Johnson says, are probably better described under the Five Factor Model. For example, striving for achievement, a big part of Type A personality behavior, would easily fall under high conscientiousness. Type As might also score high on extraversion, but low on agreeableness, since they're less attuned to see others as collaborators.

But although many psychologists feel the Type A and B model has outlived its usefulness, they say it has an important legacy in modern psychology. "The study of Type A and related personality traits really revolutionized behavioral medicine and behavioral health," Whitbourne says. "There are many psychologists that look at behavior and health hand-in-hand," and much of this work has a foundation in what Type A pioneered, according to Whitbourne.

So if many psychologists (not to mention cardiologists) feel the framework is outdated, why do we still call people Type A? According to Johnson, one of the biggest reasons probably has to do with how easy it is to recognize. "We all know people who are very driven and single-minded about achieving something, but they don't treat other people very well," he says. "It's a familiar thing to most of us."

10 Facts About Rosacea

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Rosacea, a skin condition characterized by redness and swelling, is incredibly common: A recent study found that an estimated 300 million people worldwide suffer from it. Here’s what you need to know about the condition.

1. IT HAS A LONG HISTORY.

According to the National Rosacea Society (NRS), rosacea was first described in the 14th century by a French surgeon named Dr. Guy de Chauliac; he called it goutterose (“pink drop” in French) or couperose and noted that it was characterized by “red lesions in the face, particularly on the nose and cheeks.”

2. SCIENTISTS AREN’T SURE WHAT CAUSES IT ...

But they have some theories. According to the NRS, “most experts believe it is a vascular disorder that seems to be related to flushing.” Scientists also think that because rosacea seems to run in families, it might be genetic. Other things—like mites that live on the skin, an intestinal bug called H pylori (common in those who have rosacea), and a reaction to a bacterium called bacillus oleronius—could also play a role in causing the condition. One 2015 study suggested an increased risk among smokers.

3. … BUT SOME PEOPLE ARE MORE LIKELY TO HAVE IT THAN OTHERS.

Though people of all ages and skin tones can get rosacea, fair skinned people between the ages of 30 and 50 with Celtic and Scandinavian ancestry and a family history of rosacea are more likely to develop the condition. Women are more likely to have rosacea than men, though their symptoms tend to be less severe than men’s. But men are more likely to suffer from a rare rosacea side effect known as rhinophyma, which causes the skin of the nose to thicken and become bulbous. It’s commonly—and mistakenly—associated with heavy drinking, but what exactly causes rhinophyma is unclear. According to the NRS, “The swelling that often follows a flushing reaction may, over time, lead to the growth of excess tissue (fibroplasia) around the nose as plasma proteins accumulate when the damaged lymphatic system fails to clear them. Leakage of a substance called blood coagulation factor XIII is also believed to be a potential cause of excess tissue.” Thankfully, those who have rhinophyma have options available for treatment, including surgery and laser therapy.

4. THERE ARE FOUR SUBTYPES.

According to the American Academy of Dermatology (AAD), rosacea “often begins with a tendency to blush or flush more easily than other people.” All rosacea involves redness of some kind (typically on the nose, cheeks, chin, and forehead), but other symptoms allow the condition to be divided into four subtypes: Erythematotelangiectatic rosacea is characterized by persistent redness and sometimes visible blood vessels; Papulopustular rosacea involves swelling and “acne-like breakouts”; Phymatous rosacea is characterized by thick and bumpy skin; and Ocular rosacea involves red eyes (that sometimes burn and itch, or feel like they have sand in them [PDF]), swollen eyelids, and stye-like growths.

5. IT’S NOT THE SAME AS ACNE.

Though rosacea was once considered a form of acne—"acne rosacea" first appeared in medical literature in 1814—today doctors know it’s a different condition altogether. Though there are similarities (like acne, some forms of rosacea are characterized by small, pus-filled bumps) there are key differences: Acne involves blackheads, typically occurs in the teen years, and can appear all over the body; rosacea is a chronic condition that occurs mainly on the face and the chest and typically shows up later in life.

6. YOU CAN FIND IT IN CLASSIC ART AND LITERATURE.

Both Chaucer and Shakespeare likely made references to rosacea. Domenico Ghirlandaio’s 1490 painting An Old Man and His Grandson seems to depict rhinophyma, and some believe that Rembrandt’s 1659 self-portrait shows that the artist had rosacea and rhinophyma.

7. IT MAY BE TRIGGERED BY CERTAIN FOODS AND ACTIVITIES.

According to the National Institutes of Health (NIH) [PDF], people report that everything from the weather to what you eat can cause rosacea to flare up: Heat, cold, sunlight, and wind, strenuous exercise, spicy food, alcohol consumption, menopause, stress, and use of steroids on the skin are all triggers.

8. THERE ARE A NUMBER OF MYTHS ABOUT ROSACEA.

No, it’s not caused by caffeine and coffee (flare ups, if they occur, are due to the heat of your coffee) or by heavy drinking (though alcohol does exacerbate the condition). Rosacea isn’t caused by poor hygiene, and it’s not contagious.

9. THERE ARE SOME PRETTY FAMOUS PEOPLE WITH ROSACEA.

Sophia Bush, Cynthia Nixon, Kristin Chenoweth, Bill Clinton, and Sam Smith all have rosacea. Diana, Princess of Wales had it, too. W.C. Fields had rosacea and rhinophyma, and Andy Warhol may also have suffered from those conditions.

10. IT CAN’T BE CURED—BUT IT CAN BE TREATED.

The NRS reports that “nearly 90 percent of rosacea patients [surveyed by NRS] said this condition had lowered their self-confidence and self-esteem, and 41 percent reported it had caused them to avoid public contact or cancel social engagements.” Dr. Uwe Gieler, a professor of dermatology at the Justus-Liebig-University in Giessen, Germany, and one of the authors of the report Rosacea: Beyond the Visible, said in a press release that "People with rosacea are often judged on their appearance, which impacts them greatly in daily life. If their rosacea is severe, the symptoms are likely to be more significant also, from itching and burning to a permanently red central facial area. However, even people with less severe rosacea report a significant impact on quality of life."

Which makes it all the more unfortunate that there’s not a cure for the condition. Thankfully, though, there are treatments available.

There are no tests that will diagnose rosacea; that’s up to your doctor, who will examine your medical history and go over your symptoms. Doctors advise that those with rosacea pay attention to what triggers flare-ups, which will help them figure out how to treat the condition. Antibiotics might be prescribed; laser therapy might be used. Anyone with rosacea should always wear sunscreen [PDF] and treat their skin very, very gently—don't scrub or exfoliate it. The AAD recommends moisturizing daily and avoiding products that contain things like urea, alcohol, and glycolic and lactic acids.

The Surgeon Who Removed His Own Appendix

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On February 15, 1921, Dr. Evan O’Neill Kane decided to test a theory. At the time, people with heart conditions and other serious ailments could not undergo most basic surgeries because general anesthesia was considered too dangerous. Rather than knocking these patients out, Kane wondered if he could simply give them a local anesthetic.

There was only one way to be sure: Kane decided to give himself an appendectomy.

As the chief surgeon at Kane Summit Hospital in Pennsylvania, Kane could probably perform the procedure blindfolded. The 60-year-old physician had performed more than 4000 appendectomies over his 37-year medical career. (Besides, the timing was right: He had chronic appendicitis and the organ needed to be removed anyway.)

For his experiment, Kane decided to numb the area with novocaine. “Sitting on the operating table propped up by pillows, and with a nurse holding his head forward that he might see, he calmly cut into his abdomen, carefully dissecting the tissues and closing the blood vessels as he worked his way in,” The New York Times reported. “Locating the appendix, he pulled it up, cut [it] off, and bent the stump under.” Finished with the dirty work, he let his assistants tie up the wound.

When a reporter visited a few hours later, Kane declared he was “feeling fine” [PDF].

Overall, he was pleased with the procedure. “I now know exactly how the patient feels when being operated upon under local treatment, and that was one of the objects I had in mind when I determined to perform the operation myself,” Kane later explained to The New York Times [PDF]. “I now fully understand just how to use the anesthesia to best advantage when removing the appendix from a person who has heart or other trouble that prohibits the use of a complete anesthesia.”

This was hardly the beginning—or end—to Kane’s career as his own surgeon. Two years earlier, he had amputated his own infected finger. And 10 years after the self-appendectomy, when he was 70, Kane calmly operated on his own hernia, joking with nurses throughout the whole 50-minute operation. Thirty-six hours later, he was back in the operating room, this time patching up other people.

Kane wouldn't be the last doctor to scoop out his own appendix. In 1961, Leonid Rogozov, the sole physician at the Soviet Union's Antarctic research station, performed an emergency self-appendectomy with the station's meteorologist and mechanic as his assistants [PDF]. More recently, Beirut surgeon Dr. Ira Kahn allegedly removed the organ himself in 1986. Unlike Kane, however, Kahn didn’t put himself under the knife for the sake of a medical experiment: Stuck in a traffic jam and unable to make it to the hospital for emergency surgery, he performed the procedure from the comfort of his car.

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