Moderate optimism may have survival value

Key Points

"I think I can, I think I can."

-The Little Engine that Could

"No pessimist ever discovered the secrets of the stars, or sailed to an uncharted land, or opened a new heaven to the human spirit."

"The optimist proclaims that we live in the best of all possible worlds, and the pessimist fears this is true."

-James Branch Cabell

Now scientists at New York University have used functional magnetic resonance imaging to map "the upbeat brain" and found that a cluster of neurons "the size of a martini olive" accounts for this human tendency to have a positive outlook. The rostral anterior cingulate cortex (no doubt you remember this structure from medical school) lights up when people think about their hopes and aspirations, and can impart a positive, optimistic bias.

Supposedly, optimism has survival value. The article said that optimists are more likely to use sunscreen and to eat healthy and exercise after coronary artery bypass surgery. Optimists work longer, expect to retire later in life, are less likely to smoke, are more likely to remarry after divorce, invest more in individual stocks, and pay their credit card bills more promptly. This information makes me wonder whether pessimists are less likely to comply with glaucoma therapy or treatments for other eye diseases. To my knowledge, this topic has not been researched.

There is such a thing as too much optimism, however, according to Manju Puri, who is an economist at Duke. People who are too optimistic pay their bills late, have trouble thinking beyond tomorrow, and are more likely to be day traders. Puri said, "Optimism is a little like red wine. In moderation it is good for you; but no one would suggest you drink two bottles a day."

Personally, I like being around optimistic people, and my personal observation of ophthalmologists who have made important discoveries to advance our field (people like Charles Kelman and Arnall Patz) is that they tend to be remarkably optimistic as well as extremely smart. Probably such a positive outlook allows them to persist with new and interesting ideas, whereas others would be more likely to give up after initial lack of success. So I think Helen Keller was right when she said that pessimists are less likely to drive progress. The few billionaires I've gotten to know have been extremely optimistic and self-confident as well.

According to the article, being optimistic (but not overly so) typically helps people be more successful in life than their talents alone would have allowed. The one exception to this is said to be lawyers: pessimistic students at University of Virginia School of Law got better grades, were more likely to make law review, and received better job offers. So if you were finding that you were not so fond of lawyers, now you know why.

Ophthalmology Times readers are an optimistic lot. How do I know? Because so many tell me that they continue to read these columns of mine, issue after issue, based on the optimistic (and sadly misguided) notion that they will be more interesting, better written, or less annoying than the previous versions.

What does all this mean for us in 2008? First, we should resolve to remain optimistic despite the challenges that face our medical specialty. Second, we should resolve to limit ourselves to only one bottle of red wine per day-which is too bad, because these columns start to make a lot of sense after the second bottle.