Forever Young
“May your hands always be busy
May your feet always be swift
May you have a strong foundation
When the winds of changes shift
May your heart always be joyful
May your song always be sung
And may you stay
Forever young” — Bob Dylan. Forever Young. Planet Waves.
“You’ll live to be a hundred years old or more. I can pretty much guarantee that. [Long pause] Now go plan accordingly!” I’ve made this comment to friends and family several times recently as we sip wine and talk about the future. Most of these conversations are with people roughly my own age, in their late forties and early fifties.
It’s interesting to watch their faces as they slowly realize they’re barely half way through their lives. Most have been thinking, in incremental terms, about the next couple of decades and how they’re going to survive them. Quality of life during their retirement years is something they worry about constantly but most of them are resigned to the inevitable decline of old age and a whole host of chronic diseases.
If I’m talking to one of a younger generation, a twenty or thirty year old, the message is slightly different: “You will live for a hundred more years. Plan accordingly.” A century is a long time. I like to tell them to think about how the world was at the dawn of the 20th century and how different it is today.
The responses I elicit, once I explain my logic, run the entire gamut from incredulity to confusion to nervous laughter to “Holy crap, you’re right!”
It’s easy to make a chart showing that life expectancy was, say, forty years a century ago and now stands at double that number. Projecting forward, it would be just as easy to predict a life expectancy of 100+ in a few decades.
Unfortunately, such charts are skewed by the high incidence of infant mortality and infectious disease in the past. Many scientists have pointed out that it would be misleading to compare data from 1900 (or earlier) to those of 2000 since much of the increase in life expectancy in the recent past is due to elimination of the root causes of childhood diseases and death as well as the advent of antibiotics. It would be more accurate, the argument goes, to exclude that data from the discussion. Doing so would show that “real” life expectancy hasn’t improved nearly as much as it seems.
According to a study by University of Pennsylvania, “Infants and children — who are especially vulnerable to infectious diseases because of their developing immune systems — accounted for nearly half of all deaths in 1900, while those over 65 accounted for fewer than one fifth. As infectious disease mortality declined and deaths from cardiovascular disease and cancer rose over the course of the century, the age distribution of mortality shifted dramatically: By 2013, the infant and child share of deaths was around 1 percent, while the elderly share was nearly three quarters.”
Infectious diseases were easier to defeat than the chronic ones ailing the older population today, so we shouldn’t expect similar increases in life expectancy going forward. That’s the argument anyway.
I beg to differ. We attacked infectious diseases back then because we barely had sufficient technology to solve those types of problems and because they were responsible for a larger percentage of deaths at the time. We’ve just been pealing the onion. With advances in modern medicine and genetics as well as the shift in research emphasis, we’re making rapid progress in solving chronic conditions such as Alzheimer’s, cancer, and cardiovascular disease. I’m convinced we’ll cure these diseases in the coming years through new methods such as gene editing and mRNA vaccines. Moderna, the company that came up with the Covid-19 vaccine in a matter of days, is now working on using the technology to address HIV and cancer among other diseases.
I pointed out to a 59-year old friend recently that his 87-year old father is still alive and well, as is mine at 81. Both are survivors of several major diseases, each of which would have easily killed them a few decades ago. In the case of my father, the list includes multiple strokes, two bouts of cancer, high blood pressure, osteoporosis, and an insatiable sweet tooth — the classic recipe for adult onset diabetes.
Did I mention he is a child of the Middle East who has lived almost his entire life in a third world country without the benefit of all the latest medical advances? Did I also mention that he has basically never exercised in his life?
My mother has had multiple run-ins with cancer, had half of her stomach removed a decade ago in a fight with stomach cancer, has higher cholesterol than the GDP of most third world nations, and wouldn’t know what to do with a pair of sneakers or a bicycle.
The papers are full of stories of people dying before their time and grizzly tales of death and disease but they rarely tell you about the millions of people who, even if not the picture of health, are at least still standing upright at age 80 and beyond. If our parents are living into their eighties, are you honestly going to tell me you and I (the typical you and I) can’t live to be 100?
Before you answer, consider that we’re talking about an eventuality roughly fifty years in the future. Now walk backwards the same number of years and remember what the world looked like back then.
Back in the good old days of 1968, we were still working on eradicating smallpox and polio. The human genome project was not even a twinkle in someone’s eyes. MRI scanners didn’t exist and no one had heard of AIDS or mRNA vaccines. Artificial hearts, smart prosthetics, and gene editing were still the stuff of science fiction.
As for technology, there was no internet, no personal computers, and no smartphones. There was no Google and no Wikipedia. If you told someone to access their MRI scan results in the cloud, they’d think you were nuts. The age of the Jetsons seems to have arrived while we weren’t looking.
Look at all we’ve accomplished in a mere fifty years, then turn around 180 degrees and project forward the same number of years into the future. When you do so, consider that technological progress (including its applications to medicine and genetics) is exponential in nature, that we have already hit the knee of the curve, and that our progress will be even more rapid in the future.
Alzheimer’s. Cancer. Diabetes. Heart Disease. Bring it on! We’ll defeat ‘em all.
You will live to be 100 years old. Now, you can choose to be a sick miserable centenarian hooked up to a dialysis machine or you can help your own cause by living a healthy life, by exercising, by reducing your stress level, by eating properly, and by keeping your mind sharp. The doctors and scientists will keep us alive. The quality of the experience is up to us.
Yes, sure. I know you have a genetic predisposition for cancer. I do, too. But that doesn’t mean you need to compound the problem by bringing on diabetes with your diet, clogged arteries with your lack of exercise, and mental obsolescence thanks to your unwillingness to read a book (No, Abraham Lincoln: Vampire Slayer doesn’t count; that’s just junk food for your brain, more likely to clog up your synapses than to ward off dementia).
It’s not too late. You will live to be 100 years old. I promise. Plan accordingly. Do your part.
At this point in the discussion, there’s usually some serious mumbling going on as my friend or relative asks me to pour some more wine and starts rethinking his approach to “middle age”.
If I’m talking to a twenty-something or a thirty-something, I like to shock them by informing them that they’ll live for another century! The contrast is even more stark between the worlds of 1921, 2021, and 2121.
Back in 1921, penicillin hadn’t even been discovered yet. Doctors routinely made their patients worse due to lack of antiseptics and proper hygiene. 70 percent of the world population was illiterate. The Spanish Influenza killed millions around the world and we were seemingly helpless against it. We didn’t know what DNA was, let alone how to edit it. I could keep going but you get the idea.
Look at everything that has happened in the past century. Look at all the advances in science and the massive amount of data available at our fingertips, then turn around 180 degrees, face forward, and project a hundred years into the future. Because you’ll live that long. I pretty much guarantee it.
The world of 2121 will be as alien to us as the world of today is to those living a hundred years ago. The major diseases of today will all be a thing of the past. As for what the world will actually look like, I wish you the best of luck but you’re on your own. I have about as much luck predicting that world as your great grandpa had of predicting the Internet of Things or nanobots.
It’s only when I force people to think in these terms, on the scale of 50 or 100 years, that they take their eyes up from the page (or their iPhone) and take a broader look around them. They’re definitely not comfortable doing so, being preoccupied most of the time with the next few months and years.
Don’t just think about your next job, think about your next career. Don’t just think about your grandchildren sitting on your lap in a few years, think about going for a hike with your great grandchildren in a few decades. Don’t just think about surviving, think about thriving.
