You’re a mean one, Mr. Grinch. And maybe ill, too. Consider the symptoms from Dr. Seuss’ How the Grinch Stole Christmas and its adaptations.

Grinch’s heart is an empty hole, two sizes too small, looking like a dead tomato splotched with moldy purple spots. His head isn’t screwed on right, his brain is full of spiders. His shoes are too tight.

What ails this grumpiest of grumps?

Residents at Rutgers University’s medical school have an idea, based on the school’s innovative program that teaches them psychopathology through lessons in film and literature. They examined The Grinch.

A hint of depression is found in his very grinchiness. A head that isn’t screwed on right, and spidery brain, suggests a disorder of the central nervous system. We know The Grinch is an angry soul, pointing to a major depressive disorder.

But the empty-hole heart hints at a link between the central nervous and cardiovascular systems. Is this heart disease a consequence of depression?

Perhaps it’s Takotsubo [tack a soup o] cardiomyopathy, or broken-heart syndrome, a heart condition triggered by acute, intense emotional stress. And what of the heart two sizes too small and shoes too tight? It begins to make sense.

Holiday stress caused by the commercialization of Christmas triggers broken-heart syndrome and congestive heart failure in The Grinch. The heart two sizes too small is a description of a reduced blood flow out of the heart, leading to excess water in the body and a swelling of the feet.

Ultimately, The Grinch recovers with a heart that grows three sizes in a day. Cardiac symptoms abate with his shoes no longer feeling tight.

All is well at the Whoville E.R.