As someone who suffers, sometimes very painfully, from gout, I have tended to seek out insight into areas that relate to this most patrician of maladies.  It is said that gout, like childbirth, is among the most intense forms of pain that people can feel, and as someone whose pain from gout has been at times very crippling, that is something I can certainly agree with.  That said, there is an upside of gout, and that upside has something to do with creativity.  It may seem strange, at first, that gout and creativity are connected with each other.  Most people think of gout as a disease that wealthy people who like pork and beer too much get, like the pampered aristocrats and monarchs of generations past.  Rest assured that I am no such pampered aristocrat myself, except insofar as being an American of reasonable income and fairly typical American appetites is pampered when compared with the standard of the world as a whole.  If I am no sybarite, then certainly I do not live a spartan existence of deliberate deprivation either, and that is perhaps enough to encourage the gout I have.

How is it that one can demonstrate a connection between gout and creativity?  Several approaches have been conducted.  For example, a historical analysis of great figures in European history has demonstrated a strong relationship between gout and prominence, as in the following research:  “Gout (“dominus morborum et morbus dominus”) afflicted an extraordinary number of the most eminent Europeans from the seventeenth to the nineteenth century, and recent controlled studies show a correlation between serum uric acid concentrations and such traits as “range of activity” and “drive” (though not “level of responsibility”) [1].”  Whether one looks at contemporary studies which look at the connection between higher uric content in the blood and a greater degree of productivity among contemporary academics, for example, or one looks in history at the high degree of correlation between eminence and goutiness, the same correlation would appear to be in evidence.

Correlation, though, is not causation.  How would gout be positively related to creativity and productivity?  After all, acute gout attacks are immensely painful, and it is unlikely (based not least on personal experience) that acute gout attacks would be positively related with productivity and creativity.  What does appear to be the case is that having a high degree of uric acid in the blood serves as a natural stimulant that would spur on creativity and productivity without the person necessarily being aware of it.  Even evolutionary biologists have the same idea:  “Orowan suggested that the high serum concentration of uric acid in man, consequent on the evolutionary loss of uricase in the higher primates, -has been a stimulant of brain activity and growth and thus a cause of his rapid intellectual development [1].”  We might say, therefore, that gout is the trade-off of the higher mental development and mental stimulation that comes from having uric acid in the blood as opposed to being secreted through uricase as is the case in other animals.  Again, we see an example of economic benefits and trade-offs, as greater mental capacity comes with the downside of excruciating pain due to the depositing of uric acid in places where it does not belong.  Given the similarities of the structure of uric acid and caffeine [1], the connection between gout and additional stimulation appears very likely.

How then are we to deal with this?  The fact that gout and high degrees of mental and creative achievement are connected together suggests that creativity is involved in complex trade-offs where that which increases creativity also increases the risk or the experience of some sorts of suffering.  To the extent that we live in a society that accepts trade-offs and welcomes the positive side of these difficulties as providing a reason and a justification for the suffering that comes as a result of such providential aspects, we can place the suffering even of painful diseases like gout in some sort of context.  To the extent that we live in cultures and have attitudes that wish to remove from us all risk or experience of pain and suffering, we will also remove from our lives the sort of positive aspects that come with some degree of risk and suffering.  If the presence of uric acid spurs us on to greater achievement and is associated with drive and with prolific writing and creation as appears the case, there is a limit to how much uric acid we would want to remove from the body so as to avoid those painful and debilitating acute gout attacks.  Creativity is far from a straightforward manner, and it even includes trade-offs as to the chemical composition of our blood and to the beneficial but also sometimes painful loss of the ability to metabolize uric acid efficiently in the blood.

[1] Edward Hare, “Creativity And Mental Illness.”  British Medical Journal Vol 295 19-26 December 1987, p.1588.