Size Matters: How Height Affects the Health, Happiness, and Success of Boys - and the Men They Become [NOOK Book]

INTRODUCTION "Squirt"

Anatomy is destiny.

— Sigmund Freud, The Dissolution of the Oedipus Complex


When I was eleven years old, attending the sixth grade in a small mill town in
Massachusetts, the boys would gather in the schoolyard before classes
started to play games and work off energy, much as schoolchildren do today.
The play sometimes got rough, especially when we engaged in a brutal
Darwinian contest of survival sometimes known as British bulldog.

The rules, as best I can recollect, went like this: all but one of the
boys lined up at one end of an outdoor basketball court, while the remaining
boy stood in the middle of the court. At an agreed-upon signal, the mass of
boys dashed toward the opposite end while the lone boy in the middle
attempted to grasp, tackle, snag, impede, trip, dragoon, or otherwise wrestle
to the ground one of the dozens of boys barreling across the court. Once a
boy was tackled, he joined the growing group in the middle attempting to
tackle the remaining participants. With each rush from end to end, more and
more boys would get tackled and wind up in the middle. When there was no
one left to tackle, that round of the game ended. And then it would start all
over again — with the first boy tackled in the previous round standing alone in
the middle.

The distilled, stylized aggression of this game resembled a
minimalist football game in which there were only fullbacks and linebackers,
all colliding and scrapping and plowing through the snow.

In retrospect, I realize that this brute-force exercise crystallized for
methe parlous transition from boyhood to manhood. Like many games, it
informally codified the cultural insistence on physical aggression (even
violence) for boyhood "success." It ritualized, and elevated to mass
entertainment, the serial ostracisms of the One, for each round of the game
established the lowest-ranking member in the physical (but also, inevitably,
social) pecking order. It thrived on the animating tension of isolation and
exclusion, singling out one boy for ignominy (and thus inadvertently
accentuating the loneliness many boys feel on the cusp of adolescence).
And of course this daily rite of passage was built around a mindless set of
rules, legislated by children and enforced in the absence of adults. It was
also, I hasten to add, a great deal of fun. Boys do like to collide.

But the game always left me feeling chagrined for a completely
different reason. The fundamental lesson I learned on the playground, rightly
or wrongly, was that size matters.

Children are acutely aware of who among them is "bigger." In
earliest childhood, this instinctual grasp of social hierarchy primarily involves
age (that is, who's older), not size. But for most of childhood, and especially
during puberty and adolescence, this consciousness evolves into self-
consciousness, an excruciatingly diligent examination of differences in
physical size, pubertal maturation, shape, strength, and appearance. I
remember this elementary school gauntlet-of-the-fittest so vividly because in
this particular school population, two boys were notably smaller than the
rest, and consequently were always the first to be tackled. Indeed, they
usually took turns trying to tackle each other when each new game started —
a kind of inside game of humiliation and desperation that satisfied the
demands of schoolboy aesthetics, which call for entertainment seasoned
with cruelty.

One of the boys, Albert Destramps, was much smaller than all the
other boys, with almost delicate, doll-like features. He endured the usual
razzing, names such as shrimp and shortie, and I confess I probably lent my
voice to the chorus of insults a time or two. His size, however, didn't seem to
diminish his zest for participation or the stream of acid, often witty insults he
habitually spewed.

To be tackled by Albert on this particular playing field was the
height of preadolescent humiliation, and the desperation on the faces of
those in danger of being brought down by this diminutive motor mouth
remains etched in my memory still. The terrorized boys who found
themselves even partially in his clutches had the look of farm animals striving
to escape a burning barn, wide-eyed, thrashing, as if they were about to
die — of embarrassment. An inability to tackle Albert, conversely, became
an empty-handed trophy of failure. Thus are echelons of respect and fear,
hierarchies of dominance, and psychological strategies of behavior
incorporated into the deepest marrow of boyhood. It's a particularly intense
form of emotional education, and each day's lesson was completed before
the bell rang for the first class.

It became something of a ritual in this primal exercise that Albert,
because he was such an easy target, would always be grabbed, tackled, and
smothered at the start of each game (if he wasn't in the middle himself) by
the next-smallest boy in the school. That boy was me.

Albert was the only kid I could pick on, the only kid over whom I
could exercise even a nanosecond of physical mastery, and so, without
regret and indeed almost with relief, that's what I did. I wasn't the only one to
pick on him, of course, but I should have known better. Albert and I
tormented each other down there on the lower rungs of the pecking order —
and believe me, he gave as good as he got. But it was our shared destiny
and bad fortune to be physically smaller than the rest of the boys at a time in
male development when size becomes a prominent, even dominant, factor in
status and self-esteem.

The fact that I so vividly remember the casual humiliations of
those frigid Massachusetts mornings after more than four decades attests to
the raw power of such childhood encounters. Many male friends to whom I've
mentioned my interest in size, including the tall ones, have unburdened
themselves of similar tales of size-related tribulations (if not traumas), which
suggests that a child's experience of size disparity — and the sense of
otherness it cultivates in the developing mind, the feeling of involuntary and
unwanted citizenship in a despised land — is enduring, resilient, deep,
almost universal. The playground, the lavatory, the cafete- Introduction | 3 ria,
the locker room, the hallways: to children during their formative years, and to
boys in particular, these are fields of random cruelty, corridors of fear,
chambers of dread. They are makeshift arenas of physical confrontation,
where incidents we forever remember from our childhood and adolescent
years become incorporated, like knots in tree bark, into the adults we will
become. Wherever boys play games, as on the playing fields of nature,
where predation and aggression have shaped animal behavior for tens of
millions of years, sheer size makes a difference. You won't find that fact in
many textbooks, but it may be the single most important lesson of
unsupervised schoolboy existence.

The way those feelings of beleaguerment, insecurity, and
behavioral adaptation live on in adult psychology has been insightfully
captured by the cartoonist Garry Trudeau, the creator of Doonesbury. In a
lovely 1996 essay called "My Inner Shrimp," Trudeau admits that "for the rest
of my days, I shall be a recovering short person" with "the soul of a shrimp."
Trudeau, unlike some of us, benefited from a delayed but explosive growth
spurt that propelled his final height to over six feet. But it's the feelings he
experienced at age fourteen, when he was the third-smallest kid in his high
school class, that still perfuse his adult soul. Trudeau sometimes pondered
going to a high school reunion to show off all those postpubertal inches. But
the Little Man Inside nixed the idea.

"Adolescent hierarchies," he writes, "have a way of enduring; I'm
sure I am still recalled as the Midget I myself have never really left behind."


"Stature" is one of those beautiful words that has a narrow meaning — in this
case referring to physical height — but that easily expands to much larger,
even metaphoric, dimensions when it refers to less quantifiable but more
important human qualities that we admire, aspire to, and devote so much life
energy to attaining. Turning the concept inward, "stature" also refers to how
we view ourselves in the mirror as well as in that private chamber of self-
identity where we really undress our hopes, fears, vanities, insecurities, and
self-appraisals.

If Garrison Keillor's Lake Wobegon is that mythical place
where "all the children are above average," I have lived most of my life way
south of Wobegon. At any stage of physical development and growth, from
infancy to adulthood, in any country on the planet — and we could be talking
here about the Netherlands, where the average Dutch citizen is taller than the
average height anywhere else on earth, or those parts of equatorial Africa
where pygmies still gather and hunt — about half of us are, by definition,
below average in height for our particular tribe. That's not to suggest that this
half of the population is abnormal. But in a social context that focuses on
physical appearance and celebrates physical performance, size is an aspect
of our identity on which we are constantly measured throughout life, even
though the quantity measured lies almost totally outside our control. In ways
subtle and blunt, physical stature affects who we are and who we become:
the way people treat us, the activities we pursue, the games we play, the
spouses we choose, the respect we command, even the salaries we receive.

Although many men who were small as children or adolescents
reach average or above-average height, the fear of remaining forever below
average carves one of the deepest furrows in the otherwise hardscrabble
surface of a man's emotional and psychological life. From a parent's point of
view, size becomes one of the earliest areas in which we compare, as we all
do, our own children against other children. They're all beautiful, of course,
but we carry around in our heads our children's percentile positions on the
growth chart just as proudly as we carry their photos in our wallets. Their
height represents the signature of our genes scribbled, however briefly, on the
unfurling scroll of human events. During adolescence, a child's deep
emotional frustration about being short can yank parents down into the
disturbing world of teenage anguish and pain and remind us of our own
limitations as parents. Trudeau recalls the night he fell sobbing into his
father's arms: "We both knew," he writes, "it was one problem he couldn't
fix." The inability of parents to fix the "problem" of small stature, and the
sense of betrayal that helplessness incurs in their offspring, can color, often
darkly, the relations between parents and children.

Having lived this experiment, I know the feeling. Of all the
childhood terms of endearment I endured — shrimp, runt, peewee, pip-
squeak, punk, peanut, bug, mouse, gnat, midget, Mr. Peabody — I had a
particular favorite: squirt. It might seem odd to embrace an insult, but I loved
the short, explosive burst of energy the word captured. Though intended to
diminish me, it was at the same time subversive, irrepressible, and
relentless, perhaps even avenging. Nonetheless, all the nicknames were
diminutives; on the phylogenetic ladder of adolescence, I was down there
with mice and mascots. When I was a high school freshman, my height
placed me in what would be the first percentile on today's standard growth
chart. I didn't need a chart, however, to be reminded that 99 percent of my
male peers were taller than I was. They reminded me every day, with teasing,
taunts, and occasionally physical assault.

Since then I've inched upward to a fairly respectable smaller-than-
average adult size. However, physical size was the most consuming
emotional issue of my youth, especially during adolescence — more
consuming than, but not unrelated to, peer acceptance, dating, bullying,
classroom performance, sexual maturation, and almost anything else
considered essential to adolescent self-image, not to say self-loathing. And I
gather I'm not alone. I've been surprised at how widespread and intense this
lingering obsession about developmental size is among perfectly normal,
seemingly well-adjusted adults whenever the topic comes up. I think we never
entirely outgrow the sensation of being small, of being different, of being
physically vulnerable. The emotional impulses we learn, usually as a matter
of day-to-day survival in the difficult, formative times of adolescence, are like
the reptilian brain, deep inside, surrounded by more civilized tissue but never
totally disconnected, just waiting for the right conditions — perhaps a
sufficiently stressful situation — to emerge.

The human life cycle relentlessly reinforces the dominant role of
physical size in our personal development. I have been in the delivery room
when a ruler was first laid against the fat, writhing masses of my newborn
children. I've been the last boy picked for sports games. I sent away for my
Charles Atlas booklet when I was a scrawny twelve-year-old. As an
adolescent with delayed puberty, I stood in front of the mirror searching —
even praying — for the first visible hint of sexual maturity. I stood on tiptoes
to kiss a high school date. And I grew increasingly impatient with and
distrustful of my parents' repeated assurances that I would undergo a growth
spurt — which, when it finally arrived, seemed too little and too late. I have
spent a lifetime being asked by photographers to sit in the front row —
except the photographer at my own wedding, who nonchalantly asked my
wife to sit in a chair while I stood behind her, so that the disparity between
my height and hers (about three inches) would not be so apparent.

At another level, though, size becomes a visual shorthand for the
fundamental difference among us. With the possible exception of gender and
skin color, our physical size is probably the first thing other people notice
about us, especially if we vary significantly in any direction from the mean,
whether short or tall, thick or thin. We are socialized to value cultural factors
such as intelligence, creativity, empathy, and perseverance, but the society
of children does not always embrace those values — especially when the
adults are not looking. Kids are keenly aware of big and small, short and tall,
strong and weak. Indeed, these categorizations are among the earliest
organizing principles in how children see the world and their place in it.
Before we even utter a word, other people think they know something about
us. And, in a way, they are right, because size matters.

It matters from the moment we are born, for size at birth is of
great importance. Babies whose birthweights are unusually low are at risk for
a lifetime of inferior health. Indeed, provocative recent research suggests that
low birthweight predicts serious adult health problems such as diabetes and
cardiovascular disease. Size also matters to the parents of an infant, who —
whether they admit it or not — thrill or fret, depending on which quartile of the
growth chart their child inhabits. Size matters to the presocialized child,
whose infantile impulses governing territoriality and aggression precede the
civilizing influence of education. Children who are bigger than their peers
quickly learn how to get their way. Physical aggression in humans actually
peaks between ages two and three, according to one prominent researcher
who has recently begun conducting experiments to prevent aggressive
behavior, such as bullying, by intervening with pregnant women through
counseling before the child is born.

Size matters in sports throughout childhood. As one of those
Saturday- morning soccer dads, I've been struck by how physical size
often — not always, but often — translates into physical superiority and
athletic dominance, and how greater size can trump, or at least neutralize,
greater athletic skill in a smaller child. Size matters especially during
adolescence and even into adulthood, because it clearly has an impact on
social perceptions, romantic interactions, workplace hierarchies, and our self-
perception long after we've stopped growing. To hear some researchers tell it,
adult stature may determine everything from our earning power to our
happiness.

But why does size matter so much? The answer may be obvious,
but it took a six-year-old child to make it clear to me.

During a summer vacation in upstate New York a few years ago, I was sitting
at the lunch table with my son, Alessandro. It was a hot, humid August
afternoon, and as he munched on cheese and blueberries, he threw out an
idle but astonishing observation: he said he hoped that he could continue to
sleep in, as he had that morning, because that would mean he was growing
taller. There is a kernel of truth in this misinformation: bodies tend to grow
more at night, during sleep, and one's height can be as much as an inch
taller at the moment of awakening than it will be by the end of the day. But I
had told him, somewhat mischievously, that the more he slept, the more he
would grow. In fact, I had joked the previous day that it seemed as if he was
growing an inch or two every night. He had taken all this in and settled on a
plan of action.

Parents — at least this parent — should know that even the most
innocent throwaway line can become a bone that a child will gnaw on for
hours, if not days. "Yeah," Sandro continued, "if I sleep in again tomorrow, I'll
probably grow two more inches!" The motivation, it became clear, was to
grow taller than his older sister.

"But what happens if you're taller than Micaela?" I asked
him. "That doesn't mean you're going to be smarter or . . ."

"No, but it would be more fun!"

How so?

"You know, you could reach for more stuff?" he replied in that
slightly sing-songy interrogative way children sometimes talk. "I could reach
for the sky."

What struck me especially was the way this six-year-old groped
to articulate the philosophical and psychological advantages of height. From
one angle he saw height as a passport to a very practical level of
achievement: reaching — presumably for the cookies and chips we
deliberately place on the highest shelves of the pantry. But "reach" is a word
that embraces both ambition and achievement; having greater height, at least
in Sandro's eyes, meant being able to both aspire to more ("reach for") and
attain more. And I couldn't ignore the remark about fun. To a growing child,
being bigger is always more fun, because larger size suggests that all the
discouragements and frustrations of early childhood will dissipate, that with
parity in size will come the dissolution of the age and size hierarchies in
which children are on the bottom rung.

The main point, however, is that at the level of emotional
education, virtually every developing human being wants to be taller. You
could even argue that the desire is an anchoring thread in the weave of
human nature. Throughout early childhood, children are confronted with
the "unfairness" of small size. Even if tall for their age, they are smaller than
many of the other beings in their immediate world. They can't reach things.
They can't make the rules. They can't dunk basketballs. They are thwarted in
matters significant and trivial by people bigger than they are, from playmates
a year or two older to "big kids" to parents. They associate their short
stature, however temporary, with constraint, limitation, and frustration. They
associate height with a solution to those problems, with dominance, with
getting one's way — a desire not to be underestimated in children or in the
imperfect adults they become. These raw emotional desires inevitably
become tempered by myriad complicating issues of development and growth,
but they are there early, they are powerful, and, I believe, they become part of
almost everyone's subconscious psychological makeup during
childhood. "It's a no-brainer," said David E. Sandberg, a researcher at the
University of Buffalo who has studied the psychology of stature for many
years. "Everyone wants to be taller. If you're five-ten, you want to be six-two.
So when you ask a child 'Do you want to be taller?' they all say 'Yes!'" In the
eyes of virtually all children, in other words, tallness is both a universal desire
and a philosophical good.

My chat with Sandro unsettled me. I was saddened that my son
seemed to have already incorporated into his vault of subconscious biases
the lesson that bigger is, if not better, at least more fun and that greater size,
however metaphoric or abstract his intent, would allow him greater self-
actualization. This is subtle, shifting ground, of course, open to easy
generalization. Every child wants to be "bigger." But I suspect that the fervent
desire to grow turns effortlessly into a desire to be tall (or taller than average).

And that raises a key distinction to bear in mind when we think
about size. Growth is a process; height is the product. Growth is biology;
height is a measurement, a marker. Like all measurements, height can be
distorted by social values that have nothing to do with science or health.

The growth of most children is normal (though very different from
one child to the next); when it is abnormal, it demands medical intervention.
But height itself is never abnormal, unless small (or, rarely, tall) stature
results from some underlying pathology, such as a failure to grow. So while
medicine uses height to understand healthy growth, society — and,
increasingly, some people in the medical profession — sees in it many of the
same values that a six-year-old might: aspiration, self-actualization,
happiness.


Given this universal longing to be tall, and given the emotional distress that
short stature can cause, it's surprising how relatively little attention we pay to
the subject of growth. Not until I began to think in earnest about the issue of
stature did I realize that I knew next to nothing about growth, which is, along
with birth and death, among the most fundamental of shared human
experiences. Size has an impact on every stage of our development, from the
time we are in the womb to that agonizing instant when we realize that our
bodies, shifting into reverse, have begun to shrink with age. Even subsets of
size — penis size for boys, breast size for girls, brain size (increasingly, as
we gain new tools to measure it) — become crude, misleading, yet culturally
pervasive yardsticks by which we gauge our lot in society, our sense of self,
our standards of identity.

Human growth is not the smooth, ascending line suggested by
pencil marks etched higher and higher on a door frame. At the moment of
birth, the rate of growth — known as growth velocity — will never be higher in
all of one's lifetime, and even then the velocity is sharply decelerating.
Growth speeds up and slows down; it is different for boys and girls; it is
different among boys and among girls; it is even different among social
classes, primarily because of variances in nutrition and access to medical
care. How could such dramatic differences between siblings, peers, genders,
and classes not have profound social and psychological repercussions?

You will notice that I'm talking primarily about boys. I do not mean
to minimize the importance of size issues for girls, and in fact I often refer to
the psychology related to their growth and development in this book. But I
focus primarily on boys, because their growth and size represent phenomena
that are significantly different, biologically and psychologically, from those in
girls, and also because I am writing in part about, and from, my own personal
experience. But girls play more than a walk- on role in this story. Just as
females exert significant influence in determining male hierarchies in
numerous animal species simply by choosing the male with whom they want
to mate (sexual selection), girls confer dominance on certain boys in the
volatile society of developing adolescents.

Even restricting the argument mainly to boys, the topic of size
and stature quickly enlarges to embrace many developmental experiences,
such as physical aggression, body image, and sexual identity. In the
emotional inventory of male development, these experiences are big-ticket
items. Although they are discussed all the time, they rarely are viewed
through the lens of physical size.

Every time I mentioned this project to friends and acquaintances,
especially men, I felt like a psychological acupuncturist: the slightest prick
touched a nerve and immediately provoked a cataract of memories (mostly
unpleasant), a gush of self-history both painful and instantly accessible. One
friend, a writer of average height and far-above-average intelligence,
immediately recalled how "huge" the issue of short stature had been during
his adolescence. Another friend, a six-foot-four corporate consultant,
suggested that context is critical; although he was above average in height
even as a youth, he recalled how small he felt (and was made to feel) by his
even taller brothers. Yet another friend, who writes about the arts, vividly
described episodes of hazing and beatings at school when the topic of
bullying came up. An immunologist I know — an excellent doctor and
wonderfully levelheaded scientist — volunteered that he had pushed hard for
one of his sons, who was short, to be treated with human growth
hormone. "You know what it means to be short during adolescence," he told
me ominously.

Perhaps the most important point was the immediacy of these
memories.

Although children, and the adults they become, dig deep wells to
bury the memory of these experiences, they are easily tapped. Like
radioactive waste with a very long emotional half-life, the unpleasant emotions
associated with size persist for a very long time and can quickly surge to the
surface. They are woven into our pasts, into our daily lives, into our families,
our generational relationships, and our friendships. And the prickly issue of
size is not limited to small stature, although that is the side of the divide with
which I am most familiar. Friends who have always been taller than average
frequently lament the psychological estrangement they felt because of their
physical distinction. They too attracted unwanted attention because they
deviated from the mean; they too were tormented for the uncontrollable sin of
being biologically different. It is as if many of us slept in an emotional bed
made by Procrustes, the bandit of Greek mythology who offered overnight
hospitality to weary travelers and then, as they slept, either stretched out the
bodies of those he deemed too short or chopped off the feet of those he
considered too long. By Procrustean standards, any body that varied from
the average faced a harsh reckoning.

At some level, variation in size, being tall or small, is merely a
subcategory of being different, of being other, for which there has always
been a social and psychological price to pay. In his memoir Self-
Consciousness, John Updike perfectly captures our complex love-hate
obsession with otherness. Although writing about his own bouts with
psoriasis, he could as easily be describing small stature or any other visible
physical shortcoming. The skin disease, he writes, "keeps you thinking.
Strategies of concealment ramify, and self-examination is endless. You are
forced to the mirror, again and again; psoriasis compels narcissism, if we
can suppose a Narcissus who did not like what he saw. "We can easily
suppose a gnomish Narcissus, fascinated with, yet repelled by, his small
size, his delayed development, his banjo-string muscles. "An overvaluation of
the normal went with my ailment," Updike notes, "a certain idealization of
everyone who was not, as I felt myself to be, a monster."

But this self-consciousness is not merely a matter of what we see in the
mirror. Size matters to all of us in some deep, fundamental way that
connects the internal life of vulnerability and incompleteness to the external
life of culture, history, morality, and human endeavor. Its essential nature
underlies some of our most timeless and cherished myths: David and
Goliath; Gulliver among the Lilliputians; Don Quixote and Sancho Panza;
Mutt and Jeff; "the Stilt" and "Shoe" — Wilt Chamberlain and Willie
Shoemaker, immortalized in the classic photograph by Annie Leibovitz; King
Kong; Tom Thumb. As long as people have told stories about the world,
made sense of the world, and made pictures of the world, we have framed our
perceptions of the world, at least in part, in the wordless vocabulary of relative
size.

The cultural obsession with height is omnipresent and, like
Updike's psoriasis, may reveal society's underlying pathologies and
anxieties. Not long ago, a gossip columnist in the New York Daily News
reported that Candace Bushnell, in her latest novel, Lipstick Jungle, had
gleefully described a fictional Manhattan mogul as "small and uncannily
rodentlike."

The chattering classes were quick to venture guesses as to whom
she meant. The same day, in the business section of the New York Times, a
self-described "red-neck" entertainment lawyer boasted about his business
acumen. The six-foot-one J. P. Williams said, "I'm into low costs and big
profits, and I bet I make more money than the execs running the studios —
none of whom are over six feet." In neither case was size central to the topic
under discussion. Indeed, the casualness of both unremarkable anecdotes
conveys, in cultural shorthand, a gratuitous human glee about the humiliating
physical detail. If anything, these are the rare on-the-record utterances that
reflect widely shared, if infrequently articulated, private sentiment.

The virtue of height, and the disparagement of short stature, is
hardly a modern phenomenon. Everyone knows that Sir Isaac Newton
attributed his genius as a scientist to having "stood on the shoulders of
giants." It is less well known that Newton, in this seemingly humble
statement, was taking a poke at a smaller scientific competitor. "The
remark," as the science historian Walter Gratzer noted recently in Nature, "is
generally interpreted as a dig at his detested rival, the diminutive Robert
Hooke, rather than a mark of modesty, an attribute wholly alien to Newton's
temperament." The favoritism accorded tall people colors the oddest corners
of fiction. In the very first sentence introducing Harry "Rabbit" Angstrom to
readers of Rabbit, Run, Updike mentions his height. Why?
Because it
says something about the arc of Harry's life, his character, his
entitlement. "To be tall," writes the tall essayist Phillip Lopate, "is to look
down on the world and meet its eyes on your terms." Even the king of Lilliput,
as Jonathan Swift slyly reminds us, "is taller by almost the breadth of my
Nail, than any of his Court, which alone is enough to strike an Awe into the
Beholders." Size may be relative, but even in the land of the Lilliputians, it
matters.

Lemuel Gulliver began his travels just as humankind began its
systematic self-measurement. It would be nice to say that the thirst for pure
knowledge drove this flurry of quantitative activity, but the reality is less
flattering. The wide-scale measurement of human height began primarily as a
way to recruit tall men to serve in eighteenth-century European infantries, and
it is hard to ignore the martial sheen that tallness began to acquire in
Western societies. The king of Prussia, who associated height with military
prowess, created an elite corps of tall soldiers. To give classical legitimacy to
this cultural celebration of size, the Prussian court reached back to Tacitus
and Caesar, who frequently extolled strength and tallness as cultural virtues.
By the nineteenth century, Francis Galton, the cousin of Charles Darwin,
promoted the idea of measuring people, especially children, as a prelude to
the selective breeding of desirable genetic traits, including height; he named
that pursuit eugenics. Eugenics legislation enacted in the United States in
the 1920s, which specifically targeted physical weaknesses, partially
inspired the much more ruthless application of the philosophy in Nazi
Germany. Perhaps it belabors a touchy point, but the Nazi justification of
racial purity has been traced in part to a specific passage in Tacitus that also
extols height as a particular physical — and moral — virtue of the ancient
Germanic tribes. The intellectual roots of heightism, it seems, draw on a
poisoned well.

The cultural fascination with variations in size has always been
marbled with contempt, perhaps never more obviously than at the extremes:
dwarfs and giants. Yet this contempt may be a perverse form of narcissism,
an obsession with what the critic Leslie Fiedler called "the secret self." When
we contemplate the extremes of size, of physical otherness, we aggravate
nerves connected to our own vulnerability and fears. The morbid fascination
with giants and dwarfs is another way of saying grace. As the sideshow
impresario says at the beginning of Tod Browning's 1932 film, Freaks, "We
didn't lie to you, folks. We told you we had living, breathing monstrosities.
You laughed at them, shuddered at them. And yet, but for the accident of
birth, you might be even as they are."

The seemingly modern impulse to objectify the body stretches
back to ancient Greece and Egypt, where rulers kept dwarfs as objects of
court fascination, and probably reached its sorry apex after the Renaissance.
As Betty M. Adelson recounts in The Lives of Dwarfs, for centuries European
monarchs "collected" dwarfs as if they were playthings. Peter the Great of
Russia kept one hundred dwarfs at court, and the scaled-down apartments
that Isabella d'Este, Marchioness of Mantua, constructed for her dwarf
subjects at the turn of the sixteenth century are still a tourist attraction
today. One of Diego Velázquez's most famous paintings, Las Meniñas,
depicts several dwarfs from the Spanish court. The original is in the Prado;
reproductions hang in the hallways of many pediatric endocrinology clinics.

But the infatuation with dwarfs went beyond such royal
collections. Several monarchs attempted to breed their dwarfs to create self-
perpetuating colonies of little people. At the opposite end of the scale, King
Frederick William of Prussia attempted to mate his special group of tall
soldiers, the Grenadier Guards, with tall women to produce a class of giants.
Such amateur experiments in eugenics, a clumsy harbinger of later attempts
to create a master race, reduced human existence to a form of animal
husbandry. The great eighteenth-century British surgeon John Hunter and his
agents stalked a giant named Charles Byrne all over London in hopes of
obtaining his body for scientific study after he died. As recently as 1906, the
New York Zoological Society numbered among its recent "acquisitions" the
famous African pygmy Ota Benga, who attracted streams of spectators to
the Bronx Zoo. And at the 1933 World's Fair in Chicago, one of the most
popular attractions was the Midget Village.

This cultural fascination with extremes of physical size,
trespassing as it does upon human dignity, betrays social attitudes toward
the extremely tall and the extremely small that probably play out, much less
overtly, in daily life all the time. It would be nice to think that they were the
product of earlier, less enlightened times, but then how to explain the brew of
contempt and voyeurism that allowed the Fox Broadcasting Company to air a
reality show in 2004 called The Littlest Groom, which chronicled the
courtship of a pathetic dwarf named Glen?

There is a fascinating paradox in the social perception of size:
although the contempt for extremes is a covert celebration of the average, we
don't embrace average height, or any form of physical averageness, as a
desirable value. We see the world through the eyes of a six-year-old: taller is
better. The historical embrace of height as a cultural virtue survives,
apparently, to the present day in the factors that guide our choice of
America's most important military figure, the commander in chief. The tallest
presidential candidate almost always wins; pip-squeaks need not apply for
the Oval Office. That is merely the most obvious and topical of height-related
cultural values. Indeed, tall stature has become so synonymous with
success, wealth, leadership, and sexual desirability that a kind
of "altocracy" — if I can coin a word — has emerged. Countless social
science surveys have shown that the public uncritically ascribes positive
traits to tall people — more intelligent, more likable, more dependable, and
better leaders.

But as I hope to show, the social and psychological advantages of
being tall are a little more complicated than they initially appear. A
fascinating study published in 2004 by a group of American economists, for
example, suggested that an adult male's income could indeed be predicted
by his height — but not his height as an adult. Rather, it was his height as
an adolescent, regardless of the height he ultimately attained as an adult,
that appeared to be the key factor. "Inner shrimpdom" may have economic
repercussions, too.

The notion of shortness as a psychological disadvantage —
indeed, disability — runs deep and persistently through a huge scientific
literature on human physical stature. For example, writing about growth
hormone (GH) treatment in 1990, David B. Allen and Norman C. Fost
noted, "If the goal is to alleviate the disability of extreme short stature, we
should treat GH-responsive, short, healthy children only until they reach a
height within the normal range." At the same time, there is an inescapable
suggestion that such a "disability" can produce monstrous, world-altering
behavior. Consider that noted amateur psychologist James Bond. In
Goldfinger, one of Ian Fleming's most popular spy novels, Fleming
writes, "Bond always mistrusted short men. They grew up from childhood
with an inferiority complex. All their lives they would strive to be bigger than
others who had teased them as a child. Napoleon had been short, and Hitler.
It was the short men that created all the trouble in the world."

No wonder, then, that boys are self-conscious about their size;
that growth can be normal, while stature can be seen as a sign of disease;
and that people are willing to take extreme measures to increase their height.
Fast-forward to the world of modern pharmaceuticals. In the summer of 2003,
the U.S. Food and Drug Administration (FDA) approved the use of genetically
engineered human growth hormone (hGH) for the treatment of normal, healthy
children who happen to be unusually short, ranked in the first percentile of
height for their age. Many bioethicists lamented this decision because it
medicalized a condition in healthy children who just happened to be shorter
than average. Roughly 4 million babies are born in the United States each
year, about 125 million worldwide, and now 1 percent of them — roughly
40,000 each year in the United States, 1.25 million globally — by definition
theoretically satisfy the newly relaxed criteria for using hGH because of this
perceived psychological disability. (Nor is the obsession with height peculiar
to Western cultures. A friend recently forwarded to me an article describing
how thousands of men and women in China have opted for an expensive and
arduous medical procedure to increase their height; called limb-lengthening,
it involves severing the leg bones and then inducing the severed bone to grow
longer. "Height consulting" businesses are thriving in Beijing, job applications
in China often stipulate minimum height requirements, and, as the Los
Angeles Times noted, "In this increasingly competitive society, height has
emerged as one of the most visible criteria for upward mobility."

With this globalization of height awareness, many normal children
may reasonably believe they have a disability because of the societal attitude
toward small stature, and now that "disability" can legitimately be treated for
many years with a powerful, expensive drug. To understand how radical this
form of medical intervention is, consider an analogous situation. Imagine the
FDA approving, for otherwise healthy and normal African Americans, a drug
that would change their skin color to white, with the argument that it is easier
to treat the disabling social "handicap" of skin color than to deal with
underlying social attitudes that cause the "disability" in the first place. In
effect, we have reached the point where we are treating the victims of social
prejudice with pharmaceuticals.

If you pair this newfound technological ability with every child's
plaintive cry of "I want to be bigger!" you begin to understand the enormous
social pressures that are building up and nudging us toward widescale
manipulation of physical size. The border between normal and abnormal,
between acceptable human variation and unacceptable otherness, is
becoming a battlefield peopled by doctors, surgeons, bioethicists, and drug
companies. Contemplating the issue of size allows us to consider one of our
oldest concerns in the context of our newest biological powers.

Fortunately, those myths about size can, in their own way, be
medicinal. When David challenges Goliath (who is "over nine feet tall,"
according to the Bible), we are at first reading of a conflict between physical
unequals. King Saul tells David: "You are not able to go out against this
Philistine and fight him; you are only a boy, and he has been a fighting man
from his youth." But then, the story of David and Goliath is not just another
tale about fractious Middle Eastern politics, not just another lopsided boxing
match. It is a metaphor about adversity and character, about underdogs
against bullies, about taking on seemingly overwhelming physical challenges
and managing to triumph, if not by sheer strength, then by skill and guile and
divine assistance (it never hurts, of course, when God has your back). It is an
attitude, a worldview, and an inspirational tale all in one, and you don't have
to be small like David to identify with its message. The world, after all, is still
peopled with Philistines.



Thinking about size inevitably leads to thinking about growth, and
that leads to what, for me, has been one of the major revelations of this book.
In 1953, while James Watson and Francis Crick were toasting each other in
the Eagle pub in Cambridge for having discovered "the secret of life" in the
structure of DNA, a scientist named James Tanner was making monthly
pilgrimages to Harpenden, a small village about an hour north of London, to
measure the heights and weights of a group of children living in an
orphanage. In the half century of molecular biology since Watson and Crick
described the double helix, there have been spectacular discoveries, and
scientific fame (as well as grant money and cultural attention) has attached
to genes and what they do. By contrast, few areas of science seem more
like a backwater, more a Victorian diversion, than the measurement of bodies
and the study of human growth, in which the most sophisticated tool is a
glorified ruler and the most significant data come in the same units of
measure used by butchers and carpenters, namely inches and pounds. You
don't need a microscope, much less a DNA gel, to produce data.

Among molecular biologists, there is a certain disdain for those
poor fellows who try to do science dealing with real, messy, complicated
human beings rather than microscopic bugs and genetically identical mice.
But I'll argue here that growth scientists (and physical anthropologists), long
before molecular biologists, understood that genes, though incredibly
powerful, are nonetheless often hostage to environmental forces that regulate
them. Since the completion of the Human Genome Project in 1999 — which
has explained much, and yet much less than we may have been led to
believe — the new buzzword in biological circles has been "epigenetics." That
term refers to the factors that control when, where, and how genes are turned
on and off. At a practical level, growth scientists have known about
epigenetics all along. Indeed, they could not help but see the power of
environment writ large upon genes as the bottom line of all their meticulous
measurement. As far back as the beginning of the nineteenth century, a
French public health official noted, correctly, that "physical stature is greater,
and men grow faster, the wealthier is the country; in other words, misery
produces short people, and delays the achievement of final height." That
knowledge has made a huge difference in the health and welfare of children
worldwide. Simple health practices that have improved gestational nutrition
and perinatal medical care have arguably had a much broader impact on
global well-being than anything that has yet come out of the genomics
revolution. Tanner exemplifies the uncelebrated science that grasped the
importance of nurture during key developmental periods and acted upon it.

Tanner's name crops up repeatedly in this narrative, for good
reason. In addition to being a rigorous scientist of human biology and
childhood health, his research, like that of all great scientists, has influenced
and reshaped entire fields of endeavor. His monthly trips to Harpenden
yielded the first statistically sophisticated modern growth chart, now an
indispensable document in the life history of all children. His charts also
offered a more generous definition of normality in child development than
subsequent growth charts used now in many parts of the world. His
meticulous photographic record of the boys and girls of Harpenden,
documenting the physical changes they went through during adolescence,
made him the first scientist to visually and rigorously delineate the stages of
pubertal development. The so-called Tanner stages are still widely used
today, half a century after their initial publication. Recently it has become
clear that certain genes trigger puberty and that these genes are to a certain
extent under environmental control.

The Tanner stages reflect a philosophy about the study of human
growth that in itself advertises another subtle but recurring theme of this
book: much of the most valuable knowledge we have gleaned about the
biology and psychology of human growth has resulted from longitudinal
studies — measurements of the same group of people again and again over
many years of development, whether of height or of aspects of child,
adolescent, or adult psychology and behavior. As the famous British film
documentary Seven Up and its many sequels show, the virtue of this
scientific approach is that it can illustrate, with breathtaking clarity, changes
that occur over time related to growth and maturation — changes that
become clear only when you track specific individuals for years and years.
One of many recent studies that will be discussed revealed that toddlers who
were larger than average at age three were temperamentally more aggressive
by age eleven and more likely to exhibit violent behavior as young adults.
Such a conclusion would have been impossible to reach without a study that
followed the same youngsters for two decades. Longitudinal studies, alas,
are not easy. They require patience, a lot of money, long-term institutional
commitments, and a scientific culture that values long-haul work. In addition,
just as in Seven Up, such a study can suffer from attrition over time, as
participants move, drop out, or decide they no longer want to be included.
Such changes can dilute a study's statistical power. Nonetheless, these
studies are especially crucial to understanding the biological, psychological,
and emotional factors related to growth. Tanner's insistence on the critical
importance of longitudinal studies has transformed our understanding of
growth and the psychological implications of size.

The work of Tanner and many other great growth scientists of the
past half century — Nancy Bayley of the Berkeley Growth Study, Alex
Roche of the Fels Research Institute in Ohio, Robert Blizzard of the
University of Virginia, and Andrea Prader of the University of Zurich, to name
just a few — have shown how height provides an unexpectedly sharp lens
through which we can view a larger biological (and, for that matter, social)
phenomenon: the age-old debate about nature versus nurture. Preposterous
as it may sound at first (as it did to me), the average height of a society, or of
a particular group of people during a given historical era, can tell us a great
deal about the environment in which they live. That environment, in turn, can
tell us a great deal about the values of that society and the welfare of its
citizens, according to a small but increasingly influential school of
biologically attuned economic historians who were inspired — and whose
work was legitimized — by Tanner.

How could mere height become a magnifying glass of
socioeconomic values? Although an individual's height is determined by
genetics more than environment, growth scientists have long known that the
average height of a society as a whole, especially an economically
developing society, reveals something altogether more interesting. It is a kind
of mass statistical rendering of the nature-versus-nurture debate, in which
nurture appears to play a far more dominant role than the current gene mania
might lead one to believe. As Tanner recently put it, "If you are asking what
determines the height of a particular individual, it's 90 percent genetics.
Forget the environment. But if you're asking what determines the mean
height of 100,000 individuals, forget the genetics, because that doesn't
change. It's the environment. As the population as a whole gets taller, it's an
environmental change." Research has shown that the average size of urban
British children stagnated during the Industrial Revolution and that the
average height of French males dipped in the early nineteenth century as a
result of the many lives lost during the Napoleonic wars. After World War II,
the average height of Japanese males shot up. Some researchers claim that
the average height of native-born Americans has stagnated for nearly half a
century. The reason for that is still very much up in the air, but some
preliminary evidence suggests that it may reflect how inequitable a society
we have become: our children's apparent inability to achieve full genetic
growth potential may be telling us something very important about the quality
of prenatal and postnatal health care in the United States. Similarly, the high
birthweights of babies in Holland and Scandinavia may be a subtle
advertisement for health care systems that not only promise but also deliver
excellent perinatal care.

Finally, a personal note. I come to the subject of stature with two frames of
reference — two biases, if you will. Having grown up on the lower slopes of
the growth curve, I have a cerebral warehouse full of personal memories about
the role of size in physical and emotional development. I can talk with
firsthand knowledge about being a bully and, later, being bullied; about being
a shrimp in the land of giants; about being a late maturer during puberty.
Having made a living as someone who writes about science, however, I've
tried to train myself to be wary of mere anecdote, to avoid jumping to
emotionally or culturally pleasing conclusions, and to be open to every
legitimate path that may lead to the truth, however much it may contradict
my initial intuitions, however much it may turn common sense or
conventional wisdom on its head. As a result, I've undertaken in these pages
quite an eclectic journey through the landscape of size — consulting many
scientists but also recalling many personal memories, quoting from the
pages of Nature but also from the screenplay of Revenge of the Nerds. In
some respects, I ended up in a different place than I expected when I began
researching this book. But it has been science, not gut feelings, that has
guided me along the way.

When I dipped into the field of animal behavior, I learned, not
surprisingly, that physical size is closely associated with fighting ability,
social dominance within a group, and mating success. However, I also
learned that some of the traditional thinking about these issues is changing.
One of the great "crossover" metaphors from the field of animal behavior to
pop psychology has been the notion of the alpha male — the male in an
animal society that dominates his peers and enjoys privileged mating access
to females. But recent research suggests that dominance hierarchies are not
as inflexible — as dominant — as we once thought. The advent of DNA
testing, for example, has brought paternity tests to the world of animal
societies, and it turns out that there's a surprising amount of subversive
canoodling being perpetrated by lower-ranking animals. I'm not prepared to
declare the death of the alpha male, but I hope to convince you that social
dominance, and the role of physical size in maintaining that hierarchy, is not
nearly as cut-and-dried as it once seemed.

When I looked into the evolutionary biology of aggression, I
learned, not surprisingly, that physical size is a critical component in
predicting which animal will win a fight, as was demonstrated in the
pioneering mathematical models of game theory in the 1970s. However, it
has become increasingly clear that a number of related behaviors —
including deciding to get into a fight in the first place or to avoid an ill-fated
fight with a bigger rival the second time around — depend crucially on
neurobiology, and thus size-related behaviors are very much tied up with the
biology of memory. Memory also helps people stay out of fights with
particular individuals, but at a price: we never forget our childhood incidents of
fighting or bullying. Other critical cognitive functions, such as assessing the
attributes of a rival in terms of strength or gauging what is likely to be gained
from a fight, involve different aspects of neurobiology. But if hermit crabs can
size up a rival and calculate the relative benefits of combat before getting into
a fight, surely evolution has built into the human brain the cognitive
equipment to quickly appraise and compare relative strength and size. Such
inborn abilities may affect not only the way we approach a possible physical
confrontation but also the way we appraise other males at the gym, on the
playing field, and perhaps even in the images deployed by contemporary
advertising to manipulate us into buying a product.

When I wondered what natural selection had to say about
physical size, I discovered that the fields of physical anthropology and
evolutionary biology have recently been roiled by an argument about whether,
from the viewpoint of Darwinian evolution, bigger is better. The fossil record
provides considerable evidence that species tend to evolve toward larger and
larger body size over time, up to certain well-known physiological limits. But
natural selection is always a dialogue between genes and the environment,
so when sudden changes occur in the environment — the sudden change of
a comet striking the Earth 65 million years ago comes to mind — big (as in
dinosaurs) may die out, while small (as in mammals) may survive and then
evolve into walking, talking, adaptive creatures, capable of writing and reading
and thinking about size. While reading Darwin's The Descent of Man one
day, I was stunned to come across a paragraph in which he speculates that
small size might have affected the course of human evolution, creating a
selective pressure for a nonphysical sort of evolutionary fitness in the form of
attributes such as intelligence, cooperation, and compassion. (The passage
serves as one of the epigraphs for this book.) His statement strikes me as
one of the most interesting (and overlooked) thoughts in the entire Darwinian
oeuvre. It makes a lot of sense: if you can't get your way (evolutionarily
speaking) through sheer physical dominance, you'd better develop some
alternative skills if you want to survive and send your genes into the next
generation.

Pursuing a more idiosyncratic avenue of curiosity, I wondered if I
could find any scientific support for my intuitive notion, much in line with
Trudeau's "inner shrimp" idea, that the experience of being short (or, for that
matter, tall) in adolescence could mold adult psychology and behavior.
Adolescence strongly shapes adult male psychology, and physical size and
maturation strongly influence the experiences of adolescence.

In the past ten years, evidence for the profound influence of
developmental experiences related to size has accumulated in a number of
disparate scientific areas. Some studies of childhood aggression, including
bullying, have traced adult spousal abuse and, surprisingly, social leadership
to childhood behaviors. Some studies of the biology and tempo of puberty
conclude that children who mature earlier, which is commensurate to having
an earlier growth spurt, are at heightened risk of indulging in self-destructive
behaviors such as drinking, smoking, and using illegal drugs as adults.
Studies of male body image disorders have shown that many serious
psychopathologies in adults — including a sort of agoraphobia, or fear of
leaving one's home, because of a perceived lack of muscle or strength —
have their origins in adolescence. The evidence comes from far-flung
precincts, but so far it suggests that adolescent experiences do shape the
man and that many of those experiences have a deep connection to growth
and physical size. Andrew Postlewaite, an economist at the University of
Pennsylvania who headed a study showing that a man's wage-earning
success is directly related to his height at age sixteen, said, "Clearly,
something happens in high school that has important long-term effects."


Because of findings like Postlewaite's, this book is also about memory. As
we stop to ponder whom we've become and why, we're inevitably drawn back
to formative experiences, developmental passages, and moments when
personal history might have taken a different path. I've often wondered if my
life would have been different had human growth hormone been more widely
available when I was growing up normal but unusually short. Recent
psychological studies suggest, however, that taking hGH makes remarkably
little difference in quality of life (although years of daily injections would surely
have made me more self-conscious about my "disability"). I often wonder
whether my experiences as a short boy dealing with the problems of
childhood society contributed in a positive but painful way to the empathy I
try to marshal as an adult. I wonder if the social and sexual insecurities I
experienced as a young adult had their roots in delayed pubertal timing,
which also delayed my growth spurt. I even wonder, having read some of the
more recent psychological literature, if I mistakenly used short stature as an
undeserving focal point for all the complicated issues that contribute to
adolescent insecurity and unhappiness. Size matters, but when it comes to
psychological cause and effect, one size probably doesn't fit all.

Whether you consider short stature a disability, whether you
consider social privilege a kind of birthright of tall people, the impact of
human size on the psyche can be enormous. When asked by a Playboy
interviewer in 1984 how being short affected his upbringing, the songwriter
Paul Simon summed it up this way: "I think it had the most significant single
effect on my existence, aside from my brain. In fact, it's part of an inferior-
superior syndrome. I think I have a superior brain and an inferior stature, if
you really want to get brutal about it." Darwin's point exactly. In a world of
cavemen, Paul Simon would never have become a major recording artist. But
we don't live among cavemen anymore.

I'm trying not to overindulge the bias to which I've already
confessed. Indeed, it's important to acknowledge from the outset an obvious
danger: when making an argument, we tend to see the entire world through
the narrow lens of that argument, raising expectations that cannot possibly
be met, placing a burden on a hypothesis that it cannot possibly bear. Wary
of seeing physical size (height in particular) as the single explanation of any
or all adult male behaviors, I'm more tempted to offer it as a particularly rich,
all-purpose metaphor for exploring the way being physically different during
development can inform the adults we become.

Finally, we need to be wary of our own memories — not that
they're necessarily false, but they are selective and often reflect a very self-
serving version of our personal narratives. In the course of researching this
book, I've talked to people who knew me as a child — my parents, of course,
but also people I hadn't seen in thirty-five years or more: kids I bullied, kids
who bullied me, the tall kid in high school, a few of my fellow shrimps. In part
I wanted to hear about their experiences of size during childhood and
adolescence and how those experiences affected the adults they became.
But in part I wanted to hear their recollections of me. I recommend the
exercise to everyone. It's a great way to scrape the mold off childhood
mythology (especially one's own myths) and recalibrate one's memories. My
mother, for example, recently reminded me that the baseball coach at my
junior high school refused to let me try out for the team because I was too
small and that I refused to pick up a ball and glove for months afterward. Until
she mentioned the incident, I had no recollection of it. Yet I keenly remember
the feelings attached to such externally imposed limitations.

And at the beginning of this introduction, I referred to the
playground game that the sixth-grade boys would play before school started
and described the rules "as best I can recollect." I did not recollect them
entirely correctly. When I managed to track down my old nemesis and
schoolmate Albert (we'll catch up with his story in the epilogue), he
immediately remembered the game, and provided an additional detail I had
forgotten. The boy in the middle did not randomly tackle one boy among the
horde rushing by. He called out a name first. So the game was much more
personal, primal, and potentially more humiliating than I had remembered. I
may have gotten some of the details wrong, but the essential thing, the thing
that really mattered, was size.

Copyright © 2006 by Stephen S. Hall. Reprinted by permission of Houghton
Mifflin Company.