Spring Chicken Page 2
Hangovers now seemed to last for days, my wallet and my keys liked to go AWOL, and as for reading a restaurant menu by romantic candlelight, forget about it. I seemed to be tired all the freaking time. A handful of friends had already died of cancer, or come close. In idle moments, I found myself dwelling more and more on middle-aged regrets, stuck on the idea that my best years were behind me, and that God was checking his watch. Right on schedule: Some scientists believe that the woes of midlife reflect the fact that we have reached a kind of biological “tipping point,” where the damage of aging has begun to outpace the ability of our body and our mind to repair themselves.
When I went in for a physical exam, somewhere around age forty-three, I learned that I had mysteriously gained fifteen pounds, and my cholesterol levels now approximated those of chocolate milk. For the first time ever, I had the beginnings of a beer belly, which shouldn’t have been surprising since I love beer, but it bummed me out nonetheless. All of this my doctor chalked up to “normal aging.” She smiled as she said it, as if it were nothing to worry about, and certainly no reason to take action. Nothing to be done, her slight shrug said.
Really? I wanted to know more. Like, can we make it stop? Or at least slow down? A little? Please?
Finding a “cure” for aging, a way to defeat death, has been the dream of humankind literally since we began writing down our dreams. The oldest existing great work of literature, the nearly four-thousand-year-old Epic of Gilgamesh, in part chronicles a man’s quest for the elixir of eternal life. He actually finds it, in the form of a mysterious thorny plant that he retrieves all the way from the bottom of the sea, only to have it stolen by a serpent (spoiler alert). “When the gods created man they allotted him death,” the hero Gilgamesh is told, “but life they retained for their own keeping.”
Staying young, or at least looking young, has been much on our minds. One of the oldest known medical texts is an Egyptian papyrus dating from circa 2500 BC that contains a “Recipe for Transforming an Old Man into a Youth.” Unfortunately, the recipe turns out to be a face cream made from fruit and mud, probably not all that different from the pomegranate- and melon- and milk-infused “anti-aging” creams that Americans spent an estimated eleventy bajillion dollars on last year. My favorite is a seaweed-based potion called Crème de la Mer that sells for more than $1,000 a pound; a British cosmetic chemist named Will Buchanan determined that its actual ingredients cost about $50.
When Gilgamesh was written, relatively few humans lived long enough (or well enough) to die of old age; life expectancy hovered around twenty-five years, as it had for millennia. On the day you are reading this, ten thousand Baby Boomers will celebrate their sixty-fifth birthdays. Tomorrow, another ten thousand will crank up the Jimmy Buffett and float across the Rubicon of “old age”—and so on and so on for the next two decades. At this rate, we will run out of birthday candles well before 2060, when the number of Americans older than sixty-five will have doubled to more than ninety-two million, making up 20 percent of the U.S. population. For comparison’s sake, over-sixty-fives make up just 17 percent of the population of Florida right now.
The entire planet is turning into Florida. There are more older people on earth right now than ever in history, even in recently “developing” nations like China, where the one-child policy has skewed the population balance in a breathtakingly short period of time. For most of human history, the age distribution of the human race has resembled a pyramid, with a great many young people at the base, and relatively fewer oldsters as you move up toward the peak. Now, as lifespans get longer and birthrates get smaller, the industrialized countries have become top-heavy with old folk, more like mushrooms than pyramids. According to the Nikkei newspaper, Japan will soon sell more adult diapers than diapers for children. Instead of succumbing to tuberculosis or polio or the plague, as in previous generations, these “new old” will die of heart disease, cancer, diabetes, and Alzheimer’s—the four horsemen of the geriatric apocalypse.
These chronic diseases have become so common as to seem inevitable. Four out of five American sixty-five-year-olds are now on medication for one or more long-term ailments—for high cholesterol, blood pressure, diabetes, and sundry other complaints. Increasingly, our old age is a highly medicated one, which means that we are likely to spend the latter decades of our lives as patients—that is to say, as sick people. Public-health experts call this the period of morbidity, the portion of our lives when we suffer from chronic disease. Right now, for most people, that period consists of, basically, the second half of their lives, which is a scary thought. Scarier still is how much these legions of aging Baby Boomers are going to cost to keep around, with their medications and knee replacements and artificial heart valves—and how lousy many of them are still going to feel.
If there were ever a time when humanity needed the magic flower of Gilgamesh, this would be it.
As Montaigne observed, the real cruelty of aging is not that it kills an old person, but that it robs a young person of his or her youth. That is the greater loss, he wrote. The only mercy is that it works slowly, almost imperceptibly. Nevertheless, he wrote, Nature “step by step conducts us to that miserable state… so that we are insensible of the stroke when our youth dies in us, though it be really a harder death than the final dissolution of a languishing body, than the death of old age.”
Though I missed the Baby Boomer cutoff (1964) by three years, I did share in their grand generational delusion, that they would somehow never get old. Aging was something that had happened to old people, our parents and grandparents. We, somehow, would be immune. So much for that, obviously, but what made aging real for me, finally, was not my parents hitting seventy, or even my own impending cage-match with middle age; what brought it home, at last, was what happened with my dogs.
There were two of them, a matched pair of redbone coonhound mixes, the Southern breed featured in the children’s classic Where the Red Fern Grows. I’d had Theo from puppyhood, and Lizzy since she was very young, and now they both qualified as canine senior citizens. The interesting thing was that while Theo had stayed sort of puppyish, Lizzy had gone gray in the muzzle at seven or eight, and had developed a stiff-legged, lady-truck-driver walk. People would approach us on the street and ask, with no regard for her considerable vanity, “Is she the mother?”
Nope: They were brother and sister, born in the same litter. But they looked so different, it was like my grandfather and Emerson all over again: One seemed so much older, yet they were exactly the same age. Only with the dogs, there was no obvious explanation, like Christian Science. They had basically the same genes, and had eaten the same food and gone for the same walks since they were young. Like my grandfather and his brother, they could not have been more similar—or more different.
Everyone has noticed this, how people seem to age at vastly different rates. We go to a school reunion, and some classmates have turned into their parents, while others look like they just got home from Beach Week. What makes the difference? Is it only “good genes,” as most people seem to think? Or is it something you can control, like what you eat? How much you moisturize? Answering this big question—why some people age more slowly than others—will be a key mission of this book.
With Theo and Lizzy, I chalked it up to random chance—which actually does play a significant role in aging, scientists believe. But that wasn’t quite it, and as it turned out, appearances were deceiving. One October Sunday, I came home from a bike ride to find Theo waiting on the porch of our cabin in Pennsylvania, all excited. He used to love racing with me on the trails, and even now that he was nearly twelve, he was still up for a quick trot around the block. So I opened the gate, and he cantered alongside me for a lap, then two, then three. He seemed fine, ready for more, so it was a shock when I took him to the vet four days later and found out that he had cancer.
Our vet is a kindly man named Tracy Sane, a country boy marooned in Manhattan, and whenever he saw the two redbones, he wou
ld get a little wistful and say something like, “Those are real dogs.” I’d brought Theo in to have a small skin growth removed, which should have been no big deal. The surgery would require him to go under anesthesia, so Dr. Sane donned his stethoscope to listen to his heart. As he worked his way down Theo’s chest, his expression darkened. “Theo’s got a bit of a heart murmur,” he said.
The murmur meant that Theo’s heart was enlarged, and weakened. It happens to humans as well, and is one of the most common signs of aging. And it usually means there is something else wrong. The chest X-ray revealed what it was: The space where his spleen and liver should have been was occupied by a large, fuzzy blob, about the size of a toy Nerf football. “This,” said Dr. Sane, “is a problem.” He called it a “splenetic mass,” which was a soft way of saying “tumor.” It needed to come out—if it could be removed safely, he said. We made an appointment to come in first thing Monday morning. “Theo’s looking at a tough road,” he warned grimly.
Over the weekend, my girlfriend Elizabeth and I tried not to think about Theo and his tumor. The news was all about a hurricane called Sandy that was preparing to slam into the city. It was supposed to be one of the strongest storms ever to hit New York. On Saturday we walked to the neighborhood farmer’s market, where Theo and Lizzy tugged us toward their favorite stand, the one that sold turkey sausages and gave free samples to dogs. Then we snuggled up on the couch with the TV on, watching the tall sailing ship Bounty as she sank off North Carolina. Sandy was coming.
On Sunday we hunkered down for the storm, reading the paper and drinking coffee and then switching to wine. After dinner, we tried to get the dogs out for one last walk, but Theo wouldn’t go. This wasn’t unusual. He hated storms, and he had been known to hold out for hours rather than venture out in the rain to pee. He was a stubborn guy, and there was no dragging him. I gave him a sort of doggy massage to try to relax him, rubbing up and down his back as he lay in his bed. But we didn’t think there was anything terribly wrong, other than the weather. The next morning, when the storm had passed, we’d take him in for his operation. He was three weeks short of his twelfth birthday.
But Theo had other plans, and they didn’t include surgery. We found him before dawn, lying beside his bed, still warm except for his lips. I closed his eyes, Elizabeth pulled a blanket around his body, and we wept together.
In the weeks after Theo died, more than one friend confided that they had cried harder over the death of a dog than when their own fathers had passed away. It’s not that they loved their fathers any less (or at least, not entirely that). But our parents grow old in slow motion, and we expect it. There’s something about a beloved animal’s short life and quick passing that hits too close to home. It reminds us too much of our own tenuous lease on this existence. In Theo’s lifetime, I had gone from being a still-pretty-young man, with thirty just in the rearview, to one who was no longer quite so young, even pushing fifty.
I was so old that I was actually working on a book about aging. Theo’s death pushed me into overdrive. Now I wanted to know everything about aging, this universal but still little-understood process that affects practically every living thing. I decided to approach it as a reportorial investigation, following the evidence wherever it led. I would read every study, every book on the subject of aging that I could find. I’d worm my way into the underfunded laboratories where the hard science was done, and I would ferret out the leaders of the field. But I would also seek out the mavericks, the rebels of science, the ones who had the courage to push novel insights, regardless of current dogma or fashion. I’d also look for the older people who are showing the way to the rest of us: the ones who are pole-vaulting in their seventies, thought leaders in their eighties; even picking stock-market winners past a hundred.
I had big questions: How does time transform us? What was happening to me, as I slid into middle age, and beyond? How was my mid-forties self different from my teenage self? What would change between forty and seventy? For that matter, why is my ten-year-old niece “young,” but my twelve-year-old dogs are old? What is this invisible force called aging that affects everyone I know? Everyone reading this? Everyone who has ever lived?
More to the point: How much of aging is under our control, and how much determined by fate, or random chance? My motivation was personal. Straight up, I wanted to hang on to my youth, or what was left of it, for as long as possible. I want to end up like my grandfather, diving into the waves and pruning fruit trees in his old age—and not bound to the rocking chair, like his poor brother Emerson.
And while I’d feared, early in my research, that I’d only learn a bunch of depressing stuff, that turned out not to be the case at all. Scientists are discovering that aging is far more malleable than we had ever thought—that, in effect, it can be hacked. You don’t have to endure your grandfather’s old age (or in my case, my great-uncle’s). How well you grow old is at least partially under your control. Two of the major diseases of aging—cardiovascular disease and diabetes—are largely avoidable, and even reversible in some cases. A third, the dreaded Alzheimer’s disease, may be up to 50 percent preventable.
The story of the dogs told me that there is more to longevity than simply whether or not you go to the doctor and get a weekly facial. The mystery goes much deeper than that. What’s really cool and surprising, though, is how many aspects of aging can be modified, even delayed, at the cellular level. Science has discovered secret longevity-promoting pathways and mechanisms, embedded deep within our cells, that can help beat back or slow down some of the effects of aging—if we can only figure out how to unlock them. Some of these evolutionary pathways are so ancient that we share them with the lowest life-forms, such as microscopic worms and even yeast; others we are only beginning to identify, through the enormous power of genomic sequencing.
Already, we know that certain genes seem to be linked to extreme longevity and good health, and hundreds more such genes are on the brink of being discovered. Some of them may even be able to be triggered, or mimicked, by drug compounds that are already in the research pipeline. But not everything is pie-in-the-sky: Major longevity-promoting mechanisms, hardwired into our biology, can be triggered right now, by simply going out for a short jog, or even just by skipping a meal or two. A little bit of knowledge and prevention, it turns out, may even make the difference between bodysurfing your way through the rest of your life, and spending it on the rocker on the porch.
Chapter 2
THE AGE OF AGING
The days of our years are threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labor and sorrow; for it is soon cut off, and we fly away.
—Psalm 90:10
The divergent fates of my great-uncle Emerson and my grandfather Leonard reflect the vast increase in human lifespan that has occurred over the last century. Emerson lived his life like a man of the late nineteenth century, when Christian Science was founded: a brief, flourishing youth, followed by a long, painful decline, beginning in middle age. Frankly, it’s sort of amazing that he made it past seventy. My grandfather, meanwhile, was very much a twentieth-century man: Forward thinking and science-minded, he availed himself of the best that modern medicine had to offer. No surprise that he lived a much longer and healthier life than his brother.
And yet both men, even Emerson, had vastly outlived their predicted life expectancies at birth. When they were born, in 1914–15, a typical white American male could look forward to about fifty-two years on this earth. The leading killer of Americans, then as now, was heart disease—which had only just displaced tuberculosis and pneumonia, in retreat thanks to the advent of antibiotics. Influenza would briefly top the charts during the pandemic of 1918, but for the first time in history, more people were dying from a disease of aging than from any other cause. The Age of Aging had begun.
Today American males enjoy a life expectancy of about seventy-seven years, with another five bonus years for women, accordin
g to the World Health Organization. Globally, though, that’s nothing to brag about: We’re only ranked thirty-second, behind Costa Rica, Portugal, and Lebanon, despite spending far more per person on health care. And we keep falling behind: For some subgroups of the American population, life expectancies may already have begun to decline. Meanwhile, according to some estimates, half of all German children born this year will live to see their 105th birthdays.
This explosion in longevity has no precedent in human history. Take a walk around an old cemetery sometime, and read the headstone dates: You’ll find a tragic overrepresentation of infants and children, and young women who died in childbirth, while the luckier men generally lived to see their forties, and a few exceptional individuals made it past seventy—their biblical allotment of threescore and ten. It was still possible to live a very long time: The first English child born in Massachusetts in 1621, a girl named Elisabeth Alden Pabodie whose parents came over on the Mayflower,* managed to live for nearly a century, dying in 1717 at the age of ninety-six. Back then, particularly in the rugged realm of the Massachusetts Bay Colony, growing old was an accomplishment, not an affliction. As Montaigne put it, “To die of old age is a death rare, extraordinary, and singular, and, therefore, so much less natural than the others; tis the last and extremest sort of dying.”
Things began to change in the mid-1800s, with the appearance of urban sewers and semi-modern medicine; just the widespread adoption of hand washing by doctors reduced death rates enormously. In 1881, for example, President James Garfield died not from his assassin’s bullet, but from the massive infection that his dirty-fingered doctors gave him. Deaths in childbirth, once commonplace, became more and more rare thanks to the miracles of anesthesia, antibiotics, and the cesarean section, without which both I and my mother would surely have died from the trauma of bringing a nine-pound, eight-ounce child into the world. As clean water became more available (and raw sewage more distant), as medicine made progress against infectious disease, and as infant mortality plunged, life expectancies climbed rapidly. And more people than ever experienced the bizarre, inexplicable natural phenomenon called aging.