Although much stress is financial- or job-related, a recent trip to Hawaii reminded me that culture also plays a role in our response to life’s challenges.
Recall that Hawaii became our 50th state fairly recently, in 1959. Centuries of Polynesian cultural independence antedated this entry into the union. Some of that history is violent, such as the 18th century battles to unify the diverse islands of Hawaii, under King Kamehameha the Great.
But on a recent trip to Hawaii, which I returned from a week ago, I was also reminded that living in the islands tends to confer a lower level of psychosocial anxiety and stress. Indeed, a California-émigré friend of mine currently practicing in Hawaii suggested to me that people in our state with stress may just “need a little Hawaii.”
Could it be that emulating cultural rhythms of the Pacific island region could be good for those of us mired in the working life of the mainland? It seems possible to me. Here are a few things that I observed in Maui, Oahu and Molokai, during our recent travels.
People tended to exercise for fun. My friend, for example, routinely swam around a lagoon, behind a reef that kept the tiger sharks at a distance. My routine in California tends to involve setting aside time to exercise. If you routinely walk to the ocean and pursue habits such as swimming and surfing, you burn a number of calories without even thinking about it. Cardiovascular fitness also improves. I thought that I was observing a sub-set of persons on vacation, but I am beginning to think that even the longterm inhabitants tend to walk more than we do in our automobile-driven society on the West Coast.
Speaking of cars, I never got honked at once in Hawaii. It seems that people in the islands, particularly away from Honolulu, make it a point to give other drivers the benefit of the doubt when they hesitate at a crossing or change lanes. As soon as I returned to California, I got honked at in my own neighborhood when I slowed down for a moment. Stress in traffic tends to raise blood pressure, which is unhealthy. I suppose there is stress associated with more easy-going driving habits, for those who are running late to appointments. On balance, however, I prefer the “hang-loose” hand gesture of Hawaii to a honking horn or an obscene gesture.
The issue of clothing also caught my eye in Hawaii. My friend described a gradual dissolution of his dressing habits at the state hospital where he practiced, from coat-and-tie to dress shirt and slacks, to Aloha shirt and jeans. Although I like to look professional in my practice, there is something to be said for the egalitarianism of casual dress. A person does not have to endlessly stress out about what to wear to work the next day. I also find the habit of wearing flip-flops everywhere to be generally a good thing. Most of the fungal infections we treat on the skin are caused by accumulation of moisture. In a hot climate, it is healthy to let your skin breath.
Visiting a place on vacation is not the same as living there, of course. The day-to-day existence of Hawaiians should not, perhaps, be unrealistically romanticized. For example, obesity, diabetes and hypertension exist in Hawaii, as do crime, poverty and stress.
Recognizing these points, I still think that Hawaii teaches us a bit about the importance of exercise and simplicity, versus stress and materialism. Beyond that, I am still figuring things out, along with everybody else. And I miss Hawaii! Aloha for now . . .
Scott T. Anderson, M.D., Ph.D. (email@example.com) is clinical professor of medicine, UC Davis. This column is informational, and does not constitute medical advice.