EDITORIAL:

‘Tyrolean Iceman’ makes a good argument in reform debate

What we can learn from the 5,000-year-old man

Last year, we reported on a study (May 30, p. 36) of Egyptian mummies. One subject was of particular interest: a 3,500-yearold princess who became the earliest known person to have had clogged arteries. The princess was part of an examination of 52 mummies in Cairo and the U.S. Among those that still had heart tissue, about half showed chunks of calcium stuck to their arteries—an indication of clogging. So much for the idea that heart disease is a modern ailment. “Atherosclerosis clearly existed more than 3,000 years ago,” said Dr. Adel Allam, a cardiology professor at Al Azhar University in Cairo, who led the study with Gregory Thomas, director of nuclear cardiology education at the University of California at Irvine. “We cannot blame this disease on modern civilization.”

Added Thomas: “We think of atherosclerosis as a disease of modern lifestyle, but it’s clear that it also existed 3,500 years ago.”

There was speculation that the diet of the Egyptian elite contributed to their condition. The princess lived during prosperous times. Allam was quoted as saying even poor people would have eaten a lot of pork and bread mixed with honey, and the nobility would have consumed an even richer diet. But the study authors also noted that the princess was no porker and seems to have been petite.

Skip to late last month, with word in the journal Nature Communications on the latest findings regarding an older gentleman nicknamed Otzi. He is better known as the “Tyrolean Iceman,” a 5,300-year-old corpse preserved in ice and snow in the Italian Alps. Since the discovery of his body in 1991, scientists have learned much about his physical condition. He was about 46 years old, had knee problems and died as a result of a violent encounter. He had brown eyes, brown hair and was lactose intolerant, which is logical since in Otzi’s time and location there may have been little or no cattle.

Here comes the connection to the first study: Scientists concluded that Otzi harbored a strong genetic predisposition to heart disease and showed signs of artery hardening—almost 2,000 years before the Egyptian princess. Again, the perception of heart disease as solely a modern problem associated with rich food and a lack of physical activity appears flawed. And you clearly can’t attribute Otzi’s problems to drinking too much milk. And here’s a familiar conclusion: “But obviously, this disease was present already 5,000 years ago,” said Albert Zink, an anthropologist at the European Academy of Research in Bolzano, Italy, and one of the study authors. “So now we can get a better understanding why such diseases develop.”

On our Commentary page in this issue (p. 24), the chairwoman of the American College of Healthcare Executives cautions colleagues about assumptions and the problems they can create. It is sage advice. The Egyptian and Italian studies suggest the popular wisdom is incomplete and other factors may be more important in heart disease and other illnesses as well. Possibilities include genetics or chronic inflammation.

These studies should prompt us to re-examine assumptions and engender a little humility and compassion. The healthcare reform debate was an occasion for some to complain that they shouldn’t have to pay for people who get sick because it’s almost always their fault. Well, many times yes, and a lot of the time we don’t why. We have insurance because life is full of uncertainties and unknowns, and illness could happen to you, too. It’s a very, very old story.