The Deadliest Disease

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philosophy / reading / tech

I know hardly anything about Galahad except that everybody dislikes him.”
“Dislikes him?”
“They complain about him being inhuman.”
Lancelot considered his cup.
“He is inhuman,” he said at last. “But why should he be human? Are angels supposed to be human?”

T.H. White, The Once and Future King

History of Aging

It’s interesting to look at the societal shift in how we view our elders: a story that harkens back to the siutation in antiquity between Athens and Sparta. In Homer’s time, Athens famously prided itself on favoring the young over the old – the Council of Elders was a mere mirage of power while the young reigned over everything. In Sparta, the elderly Gerusia, 28 members over the age of 60, controlled affairs through a top-down approach. The Englightenment returned to the time of Athens by rejecting ugliness, traditional wisdom, and anything to do with old age. The printing press and the freedom to read books were the killing blows to the power of elders over their societies. Why listen to a church elder when there were hundreds of books at your disposal?

Fast forward to a century ago. Telling a Londoner that they could feasibly expect to live to the age of 80; or that they could have kids without fear of mortality; or that they and their family could be incoculated against smallpox and measles would have justifiably thrown you into the asylum.

“But I don’t want comfort. I want God, I want poetry, I want real danger, I want freedom, I want goodness. I want sin.”

Aldous Huxley, Brave New World

What’s Different Now?

Today all of that is taken for granted. We forget that medicine is a modern scientific subject if you can even call it that. It was only after Louis Pasteur discovered the germ in the 19th century that one could make the claim that medicine was a science. Historically, it’s the field that has attracted the most charlatans and snake-oil salesman; today they venture into the fields of macroeconomics and AI risk/safety.

Medical and biological advancement has been moving faster than many think. There are swaths of the medical community who agree that the next frontier in the field is curing aging. Why aging?

Finishing the book Lifespan by David Sinclair made me reconsider how much progress, ideologically and scientifically, we’ve made in the field of aging research. If you had the power, wouldn’t you aim to cure the meta-disease – the one that causes all the others? That meta-disease is aging.

Our bodies have hardware and software. The hardware encompasses our cells while our software would be the eigenome or how our genome is instantiated: which ones are turned on and how our genes should be expressed. As we get older, our epigenome falters and becomes less accurate in determining how to tackle the new diseases that enter our bodies; effectively, our cells take longer to repair and metabolize. Think of it as the signal to noise ratio dropping.

Therefore, when we look at statistics that claim heart disease is the biggest killer in the USA, what we should pay attention to is that aging changes the structure of the heart and depreciates it over time. The biology community should be looking at the root causes of disease and not solely addressing each one as it arises. Imagine a crew taking an outdated ship out to sea teeming with holes; instead of patching them all at once, they deal with each hole separately. At some point, you have to wonder why they don’t buy a new ship or completely renovate the one they’re using (let’s not dive into the Ship of Theseus argument). Even though we can’t get new bodies, we can focus our efforts on stopping the biggest problem of all.

Personally I see a lot of similarities between how our society looks at aging and economics. Welfare and social security are largely based off of outdated processes. The idea of both are wonderful, but the implementation leaves much to be desired. These are myths that we continue to believe and so we continue to fund them with lackluster success. The same is true of the aging community. We live in a different time now where exponential progress in curing many facets of aging are possible. To give up on the dream because our ancestors died in the same format for millenia is an insufficient excuse.

Guidelines on increasing our lifespans:

  1. Placing ourselves in situations where we undergo hormesis: stressing our cells so that they grow and remove cellular debris. One example would be walking outside in the freezing cold while wearing a T-shirt, spending time in a suana as is custom in Finland, or like Joe Rogan, undergoing cryotherapy.
  2. Eat less meat and fewer calories in general. Humans never evolved for a sedentary lifestyle – we were made to hunt and explore; to burn calories. Fewer calories means that your body removes waste, so senescent (read: dead) cells are among the first to die. A few popular diets include the 16:8, not eating for 16 hours in a row, or the quarterly week-long fast, where one spends a week fasting each quarter.
  3. Supplements. Reservatol is lumped as a polyphenol, acting as a sort of antioxidant, while NAD+ is fundamentally import to the Krebs cycle our bodies use to gain energy. They’re both vitamins that the author takes, lending a shred of skin in the game to what is a field of charlatans. A Roman among Greeks.

Aging FAQs:

Will only the rich be able to afford or see the benefits in anti-aging research? Will this only boost inequality?

I’m not convinced that this only exists for the wealthy and there a few reasons why it won’t be the case. The capitalistic argument is that research costs money. R&D is incredibly expensive today – Eroom’s Law states that every 7 years the cost of the FDA approval process goes up by a billion dollars. In a competitive market, the way to make more money is to choose the price of the drug that the most people can afford. Aging is not an orphan drug that only affects 1 in 200,000 people. Your total addressable market is everyone.

Another is that previous life-enhancement techniques haven’t been secluded from the rest of society. Sure, treatments are prohibitively expensive in the USA, but supplements aren’t exorbitantly expensive for the average person. There might a hysteresis where the treatments are too expensive for most consumers when the discovery is first announced; yet, the price does fall. Indeed, we drink the same soda and use the same painkillers as Bill Gates.

Consider the fact that we’re in a globalized world now. My take is that in a collaborative economy, research is open-sourced and open to the public with tools like Github and arxiv. This is happening even in the pharma community; people are realizing they can achieve pareto optimal outcomes cheaper by crowdsourcing research in the same vein of Numerai in the investing space. I see a whole suite of drugs in this space – not one player that decisively cures aging. It’s a process. For something as important as this, it doesn’t seem likely that only one company will have monopolistic power with no oversight. Aggregation theory doesn’t apply to pharma companies.

Do we have space for everyone to live forever? Are we not overpopulating and overconsuming our planet as it is?

Emperically, our problem is that people are not having enough kids rather than too many. Noah Smith has a thesis that Japan is the future of the western world; an old, barren population that has chosen the Cartesian world of the mind rather than the body: the virtual, not the physical.

Counterintuitively, a step function increase in our age might mean that we take global problems seriously for once. The cognititive dissonance about global warming should recede when people are alive for the aftermath of their poor consumption habits. I agree that consumption across the West is absurd: we waste too much food, water, and energy. But technology aims to change that – the internet age is still in the early days of helping us understand our bodies and lifestyle choices. As John Doerr says: measure what matters. When sensors in the home allow everyone to know how much matter they’re using, I can see people reducing uncessary consumption.

Isn’t death natural? Why are we artificially messing with a biological construct?

Isn’t medicine messing with this construct? We wouldn’t one day solve cancer and then say “well that’s it, looks like we’re done curing disease.” Either we go extinct or we end up letting people live as long as they want: the true end goal of medicine.

But death isn’t going away. In the comic series Asterix, the druid Getafix makes potions for the Gauls that render them invincible but not immortal. They can still die, but they have superhuman capabilities while the potion lasts. My point is that what’s natural is not always what’s best. If we have the means, the next step is in programming biology (and then matter itself) for better physical outcomes. To summarize T.H. White’s quote: why should we be human and not seek to be angels?

1 Comment

  1. Pingback: Links – 005 (Saturday) – Lama Al Rajih

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