by Stephen Cave
If Condorcet, who died in the upheavals of the French Revolution, had lived longer, he would have witnessed something like the progress he described. Life expectancy in the France of his day, as in most of the rest of the world, was around thirty years. These people—your great-great-great-great-great-grandparents—lived in a world of grand cities and gunpowder, yet still their life expectancy was little better than that of cavemen. By the end of the nineteenth century, life expectancy had made the significant leap to over forty, as the scientific method began to be applied to questions of public hygiene and the practice of medicine. But then came the real breakthrough: if we fast-forward just a few more generations, children born at the end of the twentieth century in France, as in most of the Western world, could expect to live to over eighty years of age. That is, in one century, life expectancy doubled. This is one of the most extraordinary achievements in history—without which there is a high chance that neither I nor you, dear reader, would be here.
A host of discoveries came together to make this leap possible. One of the most important was that deadly infectious diseases were caused by microbes—tiny organisms that could be spread through contaminated water or bodily fluids. This led to the development of the first vaccines, as well as huge programs of sanitation to clean up the stinking cities of the newly industrialized world. Combined with the discovery in 1928 of the antibiotic penicillin, this sent infectious diseases into rapid retreat: whooping cough, measles, diphtheria and scarlet fever, for example, together accounted for thirty-four thousand deaths in England in 1901, and exactly none in 2001.
Which means we who are alive today are very lucky indeed. Those born in a developed country in the second half of the twentieth century have a very high chance of living well into retirement age, a situation previously entirely unknown in the long history of our species. This was the first longevity revolution—the first real revolution in humanity’s attempt to transcend its natural limits and stay alive for longer. After countless thousands of years of trying in vain, in the last few generations humanity has finally managed to make measurable progress toward taming mortality.
No wonder, then, that the narrative that promises we can engineer our way to immortality is so prevalent: it has already produced very real results. The belief that death is an insurmountable problem is paralyzing: if death is certain and could come at any time, then what is the point in struggle or innovation? The belief that death is a set of solvable problems, on the other hand, is a great motivator: it encourages exactly the kind of research and development that brings progress and drives our civilization forward. Now every week come new breakthroughs in our understanding of cancer, heart disease and countless other ailments. This progress is real and is lengthening lives, and every time we read about it, the promise that we can one day altogether eliminate aging and disease is renewed and made more credible. The Engineering Approach appears to be working.
BEYOND HUMAN
THE modern version of the Staying Alive Narrative is working because it focuses on the details, taking problems apart and analyzing them. But this approach has another benefit in addition to actually solving some of these problems: it also distracts us wonderfully from the first part of the Mortality Paradox—the awareness that we will die. By breaking mortality down into innumerable bite-sized problems, we all end up with a lengthy to-do list of tasks to keep ourselves busy, and so we go jogging, do yoga, watch our weight, read food labels for the right kind of fat, drink coffee or avoid coffee, drink wine or avoid wine, and so forth. Newspapers are daily full of such prescriptions. They give the illusion that mortality is something we can do something about—that it is in our hands.
The Austrian philosopher Ivan Illich called this the “medicalization of daily life.” The sociologist Zygmunt Bauman has subsequently described it as the primary strategy of modern times for suppressing the fear of death. Following the Engineering Approach, we break death down into its individual manifestations—from salmonella to car accidents—and persuade ourselves that they are individually avoidable if we take the right precautions. “Keeping fit, taking exercise, ‘balancing the diet,’ eating fibres and not eating fat, avoiding smokers or fighting the pollution of drinking water are all feasible tasks,” wrote Bauman, “tasks that can be performed and that redefine the unmanageable problem … of death … as a series of utterly manageable problems.” And through pursuing those precautions, by avoiding smokers or keeping fit, we can avoid facing up to what Bauman calls “the great metaphysical futility of it all.”
For the most part, the ultimate goal of this strategy goes unstated; the promise of immortality is implicit in the illusion of control and the downgrading of death, fed by the continual stream of new cures and other innovations announced by the press. Our ever-expanding death-avoidance to-do lists successfully distract us from dwelling too long on the real prospects of the Engineering Approach. Only occasionally does the underlying promise come to the surface when the media declares once again that science is on the verge of finding an elixir of life.
But all such movements need their prophets and rabble-rousers to restore flagging faith and inspire the masses, and this version of the Staying Alive Narrative has a growing band. The most ardent of them claim not only that “medical immortality”—that is, immunity to aging and disease—is theoretically possible, but that it is attainable by those alive today, such as you and me. One prominent group of such believers goes by the name of “transhumanists,” so called because they believe we are entering a transitional stage in our development, evolving from mere humans into something far superior—posthuman immortals.
The transhumanists are an odd mix of engineers and ethicists, entrepreneurs and otherwise ordinary people. They are conducting experiments, writing pamphlets and lobbying governments in order to make their vision a reality. For the real advocates of the Engineering Approach believe that radically extending life is not only possible; it is our moral obligation.
They point out that around 150,000 people die worldwide each day—and of those, 100,000 die from age-related diseases. That is a body count the equivalent of the 2004 Indian Ocean tsunami or the 2010 Haiti earthquake every two days. When such tragedies occur the world pools its resources to ensure such massive loss of life never happens again. Yet we accept those hundreds of thousands who fade away because of aging. This must change, the transhumanists argue. If we believe it is right to save lives, then we should do everything we can to save the lives of those being taken by infirmity and old age.
The transhumanists are aware, however, that the task is immense. No one even yet fully understands what causes aging. Indeed, it seems most likely that it is not one single process but a whole host of malfunctions and accumulated damage. This complexity means we will not in the near future invent a simple pill that stops aging in its tracks. Yet many of those who dream of conquering death are already feeling the first effects of time’s passing—they know that they cannot wait forever for the cure to come.
Fortunately, they believe they won’t need to. This is the beauty of the Engineering Approach: we do not have to win the war against aging all at once. The twentieth century already saw an additional forty years added to life expectancy in developed countries; perhaps, they argue, the next wave of breakthroughs will give us another forty. And in this time, we could be developing the technology that could buy us yet more decades; and in those decades, we could then achieve the breakthroughs that would give us another century—and so on, until the discovery is made that can grant us medical immortality. This is what the optimistic transhumanists describe as achieving “longevity escape velocity,” or living long enough to live forever.
THE transhumanists have various strategies for breaking down the problems of mortality into manageable chunks. One prominent advocate, the gerontologist Aubrey de Grey, has suggested that there are exactly seven problems that must—and can—be solved for humans to achieve indefinite youth. They are summed up in his “Strategies for Engine
ered Negligible Senescence” (“senescence” being a term for the deterioration caused by aging), a paradigmatic example of the Engineering Approach to immortality.
Like most people in his field, de Grey relies on technologies that are now in their infancy but whose promise seems immense—in particular genetics, stem cells and nanomedicine. Genetic engineering should enable us to rewrite our bodies’ instruction books, ensuring many diseases that are now fatal never arise. Stem cells, which have the ability to develop into any kind of tissue, from skin to neurons, hold out the promise of growing healthy tissue to replace that which is diseased or worn out—even whole organs. And nanotechnology (engineering on the scale of atoms or molecules) gives hope of the ability to repair our bodies from the inside out using billions of tiny, targeted machines.
These technologies—especially genetics—are already starting to produce real results. As they steadily advance, they demonstrate the huge creative power of the Engineering Approach to the Staying Alive Narrative. Like a self-fulfilling prophecy, the belief that the problems of mortality can be solved is helping to make it so, as thousands of researchers dedicate themselves to finding new cures. As a consequence, life expectancy continues to rise, further confirming faith in the underlying narrative of progress.
The most ardent transhumanists paint a picture of a world in which humans are fully transformed, like the Taoist sages after drinking the elixir. They argue that there is no real difference between preventing disease and enhancing our bodies to become stronger and cleverer. The same technologies that might enable us to triumph over decay will be exactly those technologies that offer superhuman powers: the interventions that, for example, could save our fading senses could also give us X-ray vision; the therapies that allow us to cure muscle wasting would allow each of us to become as strong as Hercules.
Even more revolutionary will be our ability to remodel our gray matter. Researchers believe we will soon be able to control our attention, emotions and appetites. Some transhumanists argue that nanobots be used not only to heal disease and halt aging but to literally expand our minds: within a couple of decades we might be able to supplement the hundred trillion or so existing neuronal connections in our brains with vast armies of nanobots, exponentially increasing our powers to remember, reason and create. Such implants could also be wirelessly connected to each other and to the outside world: we would control computers simply by thinking about it—which, given that all complex objects will soon be computer driven, will mean everything from flicking TV channels to driving the car. We would be effectively telepathic—communicating with each other over vast distances by thought alone and surfing the Internet in our heads.
This, dream the futurists, is the point at which humans and their technology will become effectively indistinguishable. At this point our ability to take hold of our biological destinies will, they believe, take off exponentially. As we use enhancements to become cleverer, new discoveries will become easier and we will be able to design computers and machines that are ever more powerful, which in turn will lead to further enhancements. Before too long we will reach an apotheosis they call superintelligence—the point at which some person or device or combination thereof becomes so phenomenally clever that its understanding of the physical universe is effectively total. At that point, everything would become possible: it is the last thing we would ever need to invent; after that, it (or he or she) would be able to do all the work for us, not least answer the little question of how to live forever.
THE TITHONUS PROBLEM
SUCH fantasies of cyborgs and supermen are hugely prevalent in popular culture, reflecting the widespread narrative that we are on the verge of transcending these mortal frames. Of course, not everyone is comfortable with this idea, and it has many outright critics. Many of these subscribe to alternative immortality narratives that could be threatened by the Engineering Approach, such as religions that teach that bodily death is decreed by God for a reason. But when it comes to assessing the plausibility of the Staying Alive Narrative, it is the attacks from within science itself that are the most damaging.
The transhumanists believe that science is on their side—that it has shown that we are reparable machines and already granted us decades of extra life. But science has other lessons to teach us, not all so optimistic. The progress of the Engineering Approach to immortality has not been as smooth as some would like to think—indeed, it keeps running into one very determined foe. His name is Tithonus.
According to ancient Greek legend, Tithonus was a youth so handsome that he was kidnapped by Eos, goddess of the dawn, to be her lover. Terrified at the prospect of his one day dying, Eos begged Zeus to make Tithonus immortal like her. This the god did; but Eos had forgotten to ask that her lover also be granted eternal youth. As he aged, Tithonus lost all his strength, becoming weak and demented. When all he could do was babble, Eos in desperation turned him into a cicada, forever alive but calling for death.
The Tithonus problem is that we are succeeding in postponing death but are still being struck down by debilitating illnesses. By allowing people to live into very old age, we are unleashing a host of diseases that were once rare, such as dementia, and by relying on technology that can postpone death, we are able to keep people alive who are suffering from terrible sickness and senescence. The result is not a utopia of strong-bodied demigods but a plethora of care homes and hospitals filled with the depressed, the diseased and the incontinent old.
THE transhumanists believe that if we have doubled life expectancy once we can do it again—and again. But this is not as straightforward as it sounds. The breakthroughs behind the first longevity revolution mostly prevent people from dying when young. Just a few generations ago, one in five babies died in their first twelve months—in western Europe that number is now fewer than one in two hundred. This has an enormous impact on life expectancy figures, which are based on calculations of average lifespans—dying young really brings down the averages. It is (relatively) easy to add eighty years to the life of a baby; once you have fended off infections, nature is on your side. A second longevity revolution, however, would require adding eighty years to the life of an eighty-year-old. And that comes at a much higher price.
In recent times, life expectancy in the developed world has continued to increase at the rate of about two years every decade—i.e., those born in 1990 could expect to live two years longer than those born in 1980. But only one-quarter of this additional time is spent healthy. In other words, of those additional two years, eighteen months are spent in ill health or disability. We are living longer, but we can all expect to spend many of those extra years unable to wash or dress ourselves, unable to recognize loved ones, our senses fading and our strength gone.
The brutal fact is that increasing survival rates from the deadly infections of the past means keeping people alive long enough to develop the much more lingering diseases of modernity. In the developed world, one-third of people will develop cancer in their lifetimes, while a third can also expect to suffer from some form of serious dementia such as Alzheimer’s before they die. This is not what the gung-ho transhumanists dream of when they claim science can defeat death—but it is the nightmare reality. It is not so much living longer as just dying slower.
Some researchers believe that these debilitating diseases like cancer and dementia cannot be separated from aging itself—that they are really just symptoms of the deep underlying degeneration. One demographer calculated that curing all forms of cancer would only add around three years to life expectancy, as by the time we reach the age at which cancer usually strikes, our bodies are already failing in myriad other ways. And even if we found cures for cancer, heart disease and stroke—currently the three biggest killers in developed countries—life expectancy would only push up to just over ninety years. We tell ourselves that we get these diseases only because we do not eat enough fruit and vegetables or do enough exercise. But the reality is we get them because, unlike most of our forebea
rs, we live long enough to suffer the full effects of our bodily systems collapsing. Therefore even if we find cures for these killers, our bodies are already going into shutdown.
WHY is it that science seems unable to bring health and happiness to those whose lives it has rescued? The answer most likely has much to do with the nature of aging itself. Traits that manifest themselves in an organism only after it has reproduced will not be weeded out by natural selection. So, for example, a mouse might have genes that make it particularly strong and frisky but highly susceptible to colon cancer in old age. Being strong and frisky, the mouse is likely to successfully pass on its genes in abundance. If it makes it to old age, it will however die of colon cancer. But by the time it dies, there will already be lots of little mice running around carrying its genes. So, even though those genes carry a cancerous death sentence, they will not be weeded out by natural selection. This applies not only to genes that promote cancer but to any genes that have negative effects only after a creature has reproduced.
Therefore, over millions of years, a veritable genetic junkyard has arisen, full of unsorted, useless and downright dangerous genes that nature has allowed to stay in place. As we pass our reproductive age, these genes kick in, undermining our defenses and bringing disease—in other words, we begin to crumble. To try to keep us indefinitely healthy is like trying to hold together a statue that is turning to dust.
Making the repair job even more difficult is the fact that some genes seem to have a positive effect when an organism is young but a negative one when it is old. For example, our genes allow us to make essential vitamin D by exposing our skin to sunlight, but over time the exposure to the sun’s UV rays causes skin cancer. More worrying still, some researchers believe that we have genes that are essential for energy production and that at some point in our evolutionary history made us significantly stronger and faster—but only by producing toxins (free radicals) that slowly accumulate in the body until in old age they become fatal. If the accumulation of damage to our various bodily systems is an inevitable by-product of their normal functioning, then aging will have no easy fix—there will be no molecular switch that can be flicked without turning ourselves off altogether.