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Authors: James McBride Dabbs,Mary Godwin Dabbs

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Page 169
it's safe to assume he was low in prolactin. Men with high levels of prolactin do not have "ballistic" sex drives. Prolactin, like cortisol, moderates the effects of testosterone, but unlike cortisol, it has a calming effect. Prolactin is generally known as the hormone that stimulates milk production in new mothers, but it is present in men and women and in vertebrates other than mammals. Often related to nesting and nurturing activity, elevated prolactin levels signal male penguins and both male and female pigeons to produce crop milk, a sort of nondairy creamer that nourishes their young. Although prolactin sometimes encourages nurturing behavior in new fathers, it rarely stimulates milk production in male mammals, but there are exceptions. In rare cases, when the milk-producing apparatus has been exposed to higher-than-normal levels of estrogen and progesterone, prolactin can stimulate milk production in males. Biologist Roger Short talks about Claymore, a remarkable goat with a high prolactin level who didn't let being male interfere with producing milk. Claymore liked his own milk and sometimes nursed himself; he also provided milk for billy goat milk cheese. He was a member of a small family of Scottish goats in which both males and females produced milk. Claymore's grandfather, who died of mastitis, had enough testosterone, in spite of his high prolactin levels, to achieve reproductive success.
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Above-average levels of prolactin have an effect on personality that is different from testosterone's, partly because it inhibits testosterone production. The simplest way to describe prolactin is to say that it makes people "nice." People with high levels of prolactin are agreeable, helpful, and do what they are asked. They have little interest in sex or in starting fights, but they do not hesitate to protect their young. Maternal aggression is triggered not by prolactin but by other factors, which include the hormone progesterone. It is easy to see how the offspring of mothers with proper levels of progesterone and prolactin had an evolutionary advantage. Progesterone would have come into play when it was necessary for mothers to fight off dangerous intruders. In the absence of danger, prolactin would have motivated our primitive female ancestors to take good care of their babies and not wander away looking for fights and sex. During most of human evolutionary history, young children could not survive without their mothers' care. Protective mothers who avoided unnecessary fights were more likely to pass on their genes to
 
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future generations than were mothers who risked their lives and the lives of their children with frequent fighting.
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Like the other hormones that gave our ancestors an evolutionary advantage, prolactin can sometimes be too much of a good thing. Every once in a while, something goes wrong with the pituitary gland, where prolactin is produced, and causes hyperprolactinemia, in which prolactin levels climb to five or six times normal and dramatically affect personality. I talked to two endocrinologists about hyperprolactinemia. One told me that hyperprolactinemia has similar effects on personality in both men and women. Hyperprolactinemia patients are polite, indirect, and unaggressive, sometimes to the point of obsequiousness. I asked the endocrinologist to give me an example of their behavior. He said, ''If I am late for an appointment, most of my patients will show at least some sign of irritation, but not my hyperprolactinemia patients. There have been occasions when I've had emergencies that put me an hour or so behind schedule, and I've had two patients waiting, one with hyperprolactinemia and one with a thyroid disorder, and the one with hyperprolactinemia has the earlier appointment. I have to resist an impulse to see the thyroid patient first, because I know he or she is the one who is impatient. I know when I apologize to hyperprolactinemia patients for keeping them waiting, they'll say something like, 'Your time is more valuable than mine. All I have to do is sit.'"
I asked him if there was a difference between the way high-prolactin and other low-testosterone patients acted. He said that male patients in both categories tended to see him because they were concerned about libidinal changes and erectile dysfunction. Both want their problems fixed, but the person who is low in testosterone and normal in prolactin is more in a hurry about it. At his first appointment, such a person might say, "I want a testosterone shot today and every day until I'm better," or say, "I'm going on vacation in two weeks and I want to be cured by then." On the other hand, a high-prolactin patient would be more likely to say, "I'm supposed to go on vacation in two weeks. Maybe you'd like to start my treatment after that."
The endocrinologist also said that his new male hyperprolactinemia patients were generally not in a big hurry about seeing a doctor, and they tended to be more advanced in their condition when he first saw them than were their female counterpartsmissed menstrual periods
 
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prompted women to seek treatment sooner. Even though he saw many women before their symptoms were advanced, their demeanor almost always revealed the elevated prolactin levels that laboratory tests would later confirm. In addition to being polite and unaggressive, these women were likely to express feelings of inadequacy and dependency.
The endocrinologist's adult male patients may have had similar feelings, but they kept those feelings to themselves. Social conditioning probably partly explains why the endocrinologist noticed that only men whose problems started before puberty were likely to reveal feelings of inadequacy and show dependency on others. For example, sexually immature young men and many women hyperprolactinemic patients would bring companions with them to their medical appointments, as if they depended on other people to make sure they did things right.
One such patient was a man whose condition resulted from a tumor on his pituitary gland. The tumor had interfered with his sexual development, and although he was a twenty-five-year-old man, he had the body and mind-set of a thirteen-year-old boy. His mother brought him for most of his appointments during the early stages of his treatment. At first he was a model patient, showing up on time for every appointment and following instructions exactly. As the tumor shrank, prolactin began to drop and testosterone began to rise, and he began to miss some of his appointments. At that point, the patient's mother told the endocrinologist that she was furious about what he had done to her boy. When he had started treatment, she said her son had been well-behaved. After treatment, he had begun to misbehave, and sometimes now he stayed out all night.
With treatment of hyperprolactinemia, it is not unusual to hear that when patients begin to produce testosterone, they get into trouble. The other endocrinologist I talked with told me about a nice married man whose prolactin level was too high. The endocrinologist lowered the man's prolactin level, and his marriage became unstable. The man worked as a traveling salesman, and in his new high-testosterone state he began to marry other women in other towns.
A final link between prolactin and testosterone has to do with smiles. Medical internists are taught that patients who are high in prolactin have wrinkles around the corners of their eyes, and this is usually
 
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assumed to be caused by the thinness of their skin; but prolactin wrinkles look like the crinkles around the eyes in the smiles of low-testosterone men. At this time, there have been no studies comparing the way high-prolactin and low-prolactin people smile, but a reasonable hypothesis is that high-prolactin people and low-testosterone people would have similar smiles.
Happy people have smile crinkles around their eyes, and they tend to be kind and helpful. Try the following experiment. Make a list of the ten people you know best. Put an H beside each one you believe is happy. Then put an U beside each one you believe is unselfish. When you look at the results, you will find that you often put H and U by the same person. Psychologist Bernard Rimland had two hundred students do this exercise. They marked about half the two thousand people they listed as happy, and they marked about half as unselfish. They marked the majority of the people, 79 percent, as unselfish and happy, or as selfish and unhappy. Only 4 percent were both happy and selfish.
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A study at the University of Western Ontario showed a link between low testosterone and kind and gentle altruism.
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Students answered questions about themselves and provided saliva samples for testosterone measurement. The questions measured empathy, helpfulness, and concern for others, and together they produced an overall altruism score. The study found that lower-testosterone students were more altruistic. They were people who would appreciate the sentiment expressed in a popular bumper sticker: "Practice random kindness and senseless acts of beauty."
Altruism and Mixed Motives
Perhaps kind and gentle altruism is purer when it is practiced by low-testosterone people. Altruism can take on some of the characteristics of a competitive sport when it is practiced by high-testosterone people.
Even though everybody knows "it is more blessed to give than receive," there's often a touch of genteel self-interest in altruistic gestures. A sociable person gives wedding gifts to his friends' children, and then, when his children marry, they get presents from his friends. With most people it's not exactly quid pro quo, but sometimes it comes close. Mary eloped to marry her first husband, and his mother was irate. She
 
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told the newlyweds, "I've been giving people wedding presents for years, and now it's their time to give the presents. Since you didn't have a wedding in Atlanta, you're just going to have to come to Jacksonville. I'm going to have a reception down here." Mary suspects that her first mother-in-law was a high-testosterone woman.
Humans, like Mary's first mother-in-law, aren't the only species to mix a little testosterone with altruism. Dr. Tim Clutton-Brock, a Cambridge University behavioral ecologist, can attest to the fact that meerkats have mixed motives, and his recent research on meerkats in southern Africa illustrates the point. For years, biologists have used meerkat sentinels as examples of animal altruism. The sentinels watch for hawks from high, seemingly vulnerable perches, providing security for other meerkats as they look for food and eat. But now Clutton-Brock, after he and thirty colleagues spent thousands of hours over a five-year period watching meerkats, questions the purity of the sentinels' altruism. Behind the altruism, they noticed some behavior that looked more like competitiveness. The scientists saw hawks kill other meerkats, but never a sentinel. The scientists also observed that meerkats volunteered for sentry duty only after they'd eaten well, and then they chose perches near hiding holes. Furthermore, well-fed meerkats sometimes fought over who got to be the sentinel, not surprising once it became evident that the first meerkat to spot a hawk would be the first one down the hiding hole. Nevertheless, the sentinels were altruistic enough to delay diving for cover long enough to shout a warning call. While not the heroes they were once thought to be, they did provide a valuable service to the meerkat community.
The mixed motives of meerkat sentinels do not negate the fact that among some other animals, including the dwarf mongoose, sentinel work is unselfish, heroic, and often deadly. Dwarf mongoose sentinels watch from behind as the rest of the group hunts for food. The sentinels' rearguard position makes them easy targets for predators.
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Whether altruism is selfless and pure or not, it is a good thing. Life is a tangled path. Altruism tainted with self-interest and competitiveness is better than no altruism at all. It is in the interest of civilization to promote and reward altruism, the kind and gentle variety as well as the heroic variety, which is the subject of the next chapter.
 
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8
Heroic Altruism
A Walk on the Crust of Hell
In a steel mill in Pennsylvania, two hours before dawn on October 14, 1970, Joseph Wiest's partner was working with a furnace of molten steel. He was thrusting a rod through a hole in the furnace door to measure the temperature of the steel as he stood on a platform thirty feet above a pit that collected slag from the furnace. Suddenly the platform collapsed, and he fell to the bottom of the pit. He was badly injured and could not move. Wiest leaped down three flights of iron stairs to find his partner trapped in a corner behind a pool of slag. Below a thin crust that had hardened over its surface, the slag was red-hot and molten. If Wiest tried to walk across, he might break through the crust and be burned alive. He said later, "I didn't think, you just don't think." He walked as quickly and lightly as he could across the slag, the inch-thick soles of his boots beginning to smoke. His face felt as if it were frying. The fumes were choking, and the furnace of molten steel was hanging over his head. Wiest lifted his injured partner, a man taller than himself, and started back across. He could feel the crust cracking beneath his feet. He stumbled once and fell, landing on his left hip with the full weight of his partner across him. The crust did not break. He managed to lift his partner again and carried him off the slag. Other workmen came running and doused them with water. Wiest's trousers were burned away on the left side, and he had second-degree burns. A few days later, his partner died of multiple injuries. Wiest received the bronze Carnegie Hero Award medal for his action.
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