freediver
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At my desk.
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I am reading The Third Chimpanzee, one of Jared Diamond's earlier books. He points out a fundamental challenge that modern medicine faces in preventing or reversing ageing.
He makes an interesting parallel with cars. Cheaper modern petrol cars are only designed to last 10 to 20 years, and to 200,000 to 300,000km. The life can be extended, but at some point it becomes so unreliable, unpleasant to drive and so costly to maintain that you are better off replacing it. This is a strategic decision made in the design of the car as a whole, and the same decision goes into the design of every component. Making each component last longer costs money and probably additional weight, so there are always tradeoffs involved. Each component is designed to either last reliably up to the design life of the car as a whole, or to be easy and cheap to replace several times during the useful life. There is no point spending extra money or using extra weight to make a component more reliable if it gets discarded because the rest of the car falls apart. But if a component is so dodgy that it is likely to reduce the life of the car, it is probably worth spending the extra money on it.
Evolution has 'designed' all living things with the same tradeoffs. Making and maintaining bodies that last a long time costs more energy - both upfront and in maintenance. So at some point it is better to replace it. Hence reproduction. There is always a tradeoff between energy spent on reproduction and energy spent of self maintenance and longevity. This is why nothing really lasts forever (though the method of replacement can look very different).
The human biological strategy is for long life and high investment in a small number of offspring. Humans are unique in that females generally live well past their reproductive age. This is part of the strategy of child rearing - women must continue caring for children long after they are born. It is also part of communal lifestyle, in particular assisting with the raising of grandchildren, nieces and nephews etc. In additional, hunter-gatherer tribes store a lot of information, without the benefit of writing. Old people come in handy there also. This is why grandparents are naturally inclined to want to 'help'.
Back to medicine. The difficulty faced by medical researchers is that aging is not simply controlled by a biological switch they need to find, just as car life is not deliberately reduced by a sinister executive who wants to force you to discard a perfectly good one so you buy another. Like the cheap car, every single component is simply not built to last beyond a useful life span. So once you get beyond 80 or so, literally everything slowly falls apart. All of our internal biological systems for maintaining and replacing parts of our body are only designed to keep us alive for a certain period of time.
If there were a few simple tricks to make a cheap car last longer, the designers would have built them in. They do not actually design a car to fail. Rather, they put in the bare minimum resources to make it last until the warranty period is over, or to whatever life span the market strategists come up with. Likewise with the human body, there are no simple tricks to make it last longer (other than avoiding the self destructive things we do). A longer lasting body would require one of a fundamentally different design, where more energy is expended right from the beginning on longevity and where parts and systems are built differently. Among mammals, we are already at the extreme end of lifespan. So a system to extend our life will need to take care of just about everything - which is where modern medicine is heading. To extend life, we need more and more fundamental medical interventions as we get older, to take care of every possible part as it starts to fail, like trying to keep a 30 year old hyundai on the road with 300,000km already on the clock.
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