Buying Life

Imagine you could get a simple medical treatment—a shot, a pill, a couple of hours in a machine, a powder to mix with water and drink before breakfast—that would keep you alive until you were 150. Or 200. Or 250. Would you take it?

With the first shock of the suggestion, you might have a gut reaction, shaped by your age and history. Perhaps you’ve had a frightening illness or a near-death experience to make you appreciate the sweetness of living. That might incline you to say “yes.” But perhaps your troubles have too often nailed you to the earth with grief and you don’t see things getting better. Then the thought of extra decades in this world might make you shudder—not for nothing did the Buddha say that life is suffering. Or perhaps your faith, like most, teaches that human lives are LIMITED to a fair share of years, for good and eternal reasons. Many people, for many Reasons, would say “no.”

But don’t be too quick to decide. Hunches can be wrong. Before you accept or decline, it might be wise to ask a few clarifying questions.

1. How long would it give me?

That, for example, is the first question that occurs to John Boone, a key protagonist in Kim Stanley Robinson’s three-novel, centuries-spanning epic about the colonization of Mars. If you want to contemplate how it might feel to choose to double your life span, you should turn to Robinson’s rigorous and science-based fiction. The scene he describes—a quiet chat after a routine physical, offering the chance to live two or three times as long as you’d expected—can only happen in the future.

Still, it’s worth thinking about how you might respond to a proposal to extend your life by tens of thousands more days than the 30,000 or so you can expect to have now. The reason is simple: The question won’t be science fiction for much longer. More than ever, “radical life extension” is the purview of serious scientists and serious money. And they agree that the pleasures and pains of living to 100, 120 or even longer are likely to face millions of people soon.

Skeptics argue that humanity has been down this road before, and never successfully—from Ponce de León’s search for the Fountain of Youth to the operations of Serge Voronoff, a French surgeon who in the 1920s implanted pieces of monkey ovaries and testicles into women and men, who—he proclaimed—would be “rejuvenated” by the procedure.

What makes today’s interest in life extension different is the depth of biomedical knowledge. While biologists still don’t know all the answers, they are no longer taking shots in the dark (or the gonads).

“We really do have the emerging technologies to be able to do this now,” David A. Sinclair, the co-director of the Paul F. Glenn Laboratories for the Biological Mechanisms of Aging at Harvard University, has said. This recent confidence that the mysteries of life span are cracking has attracted some of the best minds in biology and business.

In 2013, Google joined the movement, launching the California Life Company, or Calico, a $1.5 billion research firm dedicated to finding “life-enhancing therapies for people with age-related diseases,” in the words of its CEO, Art Levinson, the former CEO of Genentech. The longer-term goal, as Google co-founder Larry Page made clear at the time, is to extend life.

A few months after Calico’s founding, J. Craig Venter, the superstar biologist who raced the U.S. government to map a human genome and later created synthetic life, founded Human Longevity Inc. with $70 million in venture capital backing. Human Longevity Inc. sequences 40,000 human genomes a year, looking for genetic variants associated with long life and other DNA clues to the aging process—not only in human cells, but in the genomes of the bacteria, viruses and fungi that live by the trillions in a normal human body.

Then, some months after Venter’s launch, it was the turn of Leonard P. Guarente, a professor of biology at M.I.T. who was Sinclair’s mentor in anti-aging research years ago. Earlier this year, he founded Elysium Health. Guarente has spent years looking at genes that affect aging—and at compounds that affect the rate at which those genes are active. The company has five Nobelists in biology as advisers.

Nonprofit initiatives are also proliferating—like the Palo Alto Longevity Prize, a $1 million award that will be split evenly between the first researcher or team who can show a 50 percent increase in the average life span of a mammal population and the team that brings the heart-rate measurements of an aging mammal back to young-adult measures. Meanwhile, the Methuselah Foundation in Springfield, Va., awards prizes and grants to advance “regenerative medicine.” It was founded by the philanthropist and entrepreneur David Gobel and Aubrey de Grey, a biomedical gerontologist who is cofounder and chief science officer of the SENS (Strategies for Engineered Negligible Senescence) Research Foundation, an organization whose goal is to “reimagine aging.”

The convergence of money and talent on life extension hasn’t occurred because of a single breakthrough—few researchers think they will find a “magic bullet” soon. On the contrary, work is heating up because of the many promising pathways—genes, telomeres (the structures at the end of chromosomes that supply DNA when a cell divides to make a younger copy of itself), metabolic processes like homeostasis (the maintenance of a steady state for blood pressure, blood-sugar production, heart rate and other vital processes that deteriorate with age; it’s one focus of the Palo Alto prize). Anti-aging research is experiencing an embarrassment of riches.

Indeed, an often-overlooked truth about the era of life extension and all its potential benefits and problems: It is already here.

Until about 30,000 years ago, archaeologists believe, the average human being could expect to live no more than 30 years. By 1800, life expectancy extended only a few years longer than the Neolithic total. In the 200 years since then, life expectancy in many nations has doubled. It continues to rise and will lead, demographers predict, to a much grayer population later this century.

The quest for life extension includes research on cancer, diabetes and other ailments of older people. But those illnesses aren’t just a hindrance to greater longevity; they are also a consequence of past advances. Dealing with a longer-than-expected life is and will be an issue for millions today and in the near future.

This is why the troubles of today’s graying world are not just a medical issue for advocates of life extension. The advances in public health in the 19th and 20th centuries—clean water, sewage systems, vaccinations, better and safer food—gave millions a path to a life that was eight or nine decades long. But the quality of those extra years has been largely disappointing. Diabetes, stroke, heart ailments, cancers and dementia have contributed to an impression that life is being extended past the point of enjoyment and competence. This could be a huge problem. Ponce de León went searching for the Fountain of Youth—if it were a fountain of dementia and arthritis he would not have bothered.

Fearful of having that sort of long life, 56 percent of American adults would answer “no” if offered a medical treatment that would slow aging and let them live to 120 or more, and 40 percent agreed with the statement that medical breakthroughs in general “often create as many problems as they solve.”

So, as you contemplate that question and imagine yourself extending your days, the first question you should ask is this:

2. What kind of years would those extra ones be? Or, put it this way: What do I get besides more time?

Increasingly, life extension advocates have an answer. They have become, for reasons political as well as medical, advocates of better lives as well as longer ones. Some have even dropped talk of the “life span,” preferring “health span” or “youth span.” Few now talk about sheer number of years. Their emphasis instead is on maintaining vitality—making 90 or 100 or 110 the “new 60.” And, that, for most of us, is a lot more appealing than more candles on our birthday cakes. Even if you have found life difficult, the thought of keeping your wits and energy about you for 50 more years must raise the hope of fixing what went wrong before, making your peace with life’s pain and writing a new chapter.

In fact, considering the mixed effects of success in lengthening the human life span to 80 or beyond, you could argue that today’s life-extending research is essential to our future well-being. On current trends, according to estimates by the World Health Organization, our planet in 2050 will have some 2 billion people coping with dementia. If, as expected, the total population then will be peaking at around 9 billion, that means that nearly one person in five at midcentury will be struggling with the cognitive impairments that come with advanced age. If you don’t like the idea of research to make people live longer, think of it as research to prevent them from living miserable, dependent and unproductive lives during the added years they’ve already received from modern civilization. Those two research programs are now largely the same.

As those population statistics suggest, choices about life extension can’t be taken in a social vacuum. Do you want to spend long years going to funerals and finding fewer and fewer family and friends in the pews? If you are going to live to 120 or more, you’ll want to ask:

3. Can my loved ones come on this trip too? Will they want to?

The answer to that one is not as simple as it might seem. We all hope our children and heirs will appreciate and cherish us (as most do). Yet there are many times in life when younger people need their elders to die.

Begin with the intricate psychology of parent and child, which leaves many adult children feeling they haven’t reached maturity until they find, as British writer John Mortimer wrote about the death of fathers, “sudden freedom, growing up, the end of dependence, the step into the sunlight where no one’s taller than you and you’re in no one’s shadow.” There is no malice in an adult offspring wanting to flower in a way the older generation prevents. That is—still, for now at least—a part of life. Consider Virginia Woolf, whose father died at 71. A quarter-century later, on his birthday, she noted, “he would have been 96, 96, yes, today … but mercifully was not. His life would have ended mine. What would have happened? No writing, no books—inconceivable.” Woolf was an extraordinary writer, but there wasn’t anything extraordinary about the situation she described. In 2004, Susan Dominus of the New York Times described the case of a 73-year-old Massachusetts lawyer who wanted to retire. He could not, though—his 100-year-old father (and law partner) wouldn’t hear of it.

This is why many tell pollsters they don’t want to live “too long”—they don’t wish to get in the way of the next generation.

In that desire to “get out of the way” there is, of course, a certain amount of fear. As we age, we can feel the world passing us by—we stop listening to new music, we cease to get the point of the latest gadgets, we don’t bother with the current slang. We know, in our bones, that those who come after us are not the same as we are. And usually our assessment is that they’re not as deep or moral or interesting as “our generation” was. What reason do we have to expect, if we stick around for a century and a half, that we’ll like what we see? Perhaps our grandchildren, taking vast life spans for granted, won’t appreciate life’s moments, because they’ll have so many. After all, as Henry David Thoreau wrote, “the price of anything is the amount of life you exchange for it.” If you have a lot of life, it follows that prices will fall—that neither work nor love nor other experiences will mean so much.

On the other hand, when you deplore an imagined future, it’s important to remember where you stand in the time line. To say “experience won’t mean as much in the future” is to say “experience won’t mean as much as it does to me.” But in some future that occurs after you have passed on, what difference does it make how you might have felt about it? Do we care that Joan of Arc or Cotton Mather would not approve of same-sex marriage, which is now legal in both their countries? We turn to the past, and to our ancestors, for inspiration, but not approval.

Extended longevity could lead to extended conflicts and friction between generations. If I live to be 100, I won’t be around to complain about the superficial twits of 2079. But if I live to 200, I will be around. And I may not be pleasant company.

Of course, there is more to society than your immediate social circle. There is also the state of your society and the world to consider. That leads to a fourth essential consideration:

4. What will happen in a world where everyone lives to 150 or 200?

One discouraging fact about this concern is that we haven’t done a great job of managing the extended lives we have won in the past century. The rapid “graying” of the global population is a source of alarm.

Consider the social safety net. China, for example, now has about six workers for each retired person. With current trends that ratio will be two workers per retiree by 2050. It’s a prescription for labor shortages, falling production and political uproar as promised pensions and healthcare for older people become impossible to pay for.

These new problems demand creative solutions. Will a world full of older people have that creativity? There are reasons to wonder.

A generation ago, the Stanford neurobiologist Robert Sapolsky, having noticed that he didn’t like his young research assistants’ musical tastes, did some testing to see at what age and how people cease to be open to new experiences. He concluded that the window for openness to music closed at age 35, while openness to new foods ended around 39.

Imagine if such a long-lived population had existed sooner. A 120-year old Thomas Jefferson could have advised Abraham Lincoln about preserving the Union; a 145-year-old Napoleon could have consulted on French strategy against the kaiser on the eve of World War I; a Meiji emperor in his 160s could have advised the Japanese government earlier this decade about ways to revive the nation. This is the sort of scenario Robinson presents in his novels, where a colonized Mars erupts in a revolutionary war for independence in 2061, led by some of the original colonists (including John Boone, in his vigorous 80s). It fails. Then, 66 years later, a second Martian revolution takes place. It succeeds—in no small part because many of the leaders of the first are still around.

Perhaps you find that an exhilarating prospect. So much wisdom and experience available to later generations! But it’s not hard to imagine a downside. With the Founding Founders looking over his shoulder, Lincoln might not have been free to reinvent the country he was fighting for. Rather than providing useful tactical insights, Napoleon might just waste the General Staff’s time insisting that they do things the way he had 100 years earlier. Ultimately, then, the question that matters most in your attitude toward life extension is an inward-looking one:

The last question: How do you think time affects people?

If you think the future is an extension of the present, and that people continue on the tracks they laid early in their lives, then adding decades or centuries to the life span will appear oppressive—for individuals, intimate relationships and society. “Truth never triumphs,” the physicist Max Planck said. “Its opponents die out. Science advances one funeral at a time.” If that’s true, and funerals wane to a trickle, what happens to the advances? If this outlook makes sense to you, then you see human life as both a blessing and a problem. Death is usually your enemy but sometimes your friend—when it removes people who, you are certain, would only take what you should have and get in your way.

However, if your sense of life—your own and society’s—is one of endless progress and growth, then you’ll see extended life as a benefit. Imagining today’s 60-year-olds at age 110, you don’t assume they will be exactly as they are today. Instead, your hunches tell you, they’ll change, adapt and discover as much in their 110s as they did in their 30s.

This is the optimist’s view of extended “health span”—a world in which people have not only more raw years and more raw health, but also more of the vitality and flexibility that characterizes them at their best. Can you live an extra 70 years and remain yourself? Which, of course, includes all those surprising changes of mind and heart that keep life interesting? If you think that’s possible, you have reason to think that the personal and social problems can be solved.

As for Boone, in Robinson’s Mars novels, he needs only a short walk to mull his questions before the answer comes clear. He takes the treatment.

“It’s not that hard a choice, is it?” says the doctor.

“‘No,’” Robinson writes. “He laughed with her: ‘I mean, what have I got to lose?’”