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« And To All A Good Night | Main | The Rest Of The Story »

Accelerating Toward Actuarial Escape

Lawrence Altman describes the tremendous advances in medicine that we've made in the last half century:

Few people appreciate that medicine has advanced more since World War II than in all of earlier history. Newer drugs and de-vices and better understanding of disease mechanisms have vastly improved the care of patients. For male babies born in this country in 1960, the life expectancy was 66.6 years; for female babies, it was 73.1 years. In 2004, the figures, respectively, were 75.2 and 80.4. Medical advances account for much, though not all, of the gain.

My father had his first coronary in 1968, at the age of 45. He had a second one a little over ten years later, and died at age 55. I'm now several years past the age at which he had his first, and approaching the point at which I'll live longer than he did, partly due to massive changes in lifestyle (he smoked and was overweight, and grew up on a typical Jewish diet of that era), but also because we can now monitor such things, and keep control of blood pressure and cholesterol, and if I do have a coronary event, I'll have a much better chance of rapid and useful care than he did in either case. I continue to hope that I'll live to see actuarial escape velocity.

Even more interestingly (at least to me), he also writes about the hubris and unjustified arrogance of the medical profession:

During my training, most professors said that all diseases were known. That hubris left doctors unprepared when AIDS came along in 1981 to cause one of history’s worst pandemics. H.I.V. has infected an estimated 60 million people and killed 25 million of them.

...We may snicker over Eisenhower’s treatment. But imagine the laughter in 2056 as people look back at the brand of medicine and public health that we consider so sophisticated today. For all that doctors have learned in the last half-century, we are ignorant about far more.

I've written about this subject in the past, in the context of MDs who refuse to believe or even imagine that future technologies may hold powers of cure (including curing the damage caused by cryonic or other suspension) that don't exist today. As he points out, while the medical progress within our lifetimes to date has been astounding, the future, and perhaps even the near future, holds much more.

Posted by Rand Simberg at December 26, 2006 07:07 AM
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Perhaps I'm just a more pessimistic person, but I'm increasingly convinced that (absent something like cryonic suspension) I will not live to see that point. I am currently 47, by that way.

The problem is that aging appears to be related to overall genetic damage in the body (and an evolutionarily adaptive response to it that damps down cell replication to delay the onset of cancer). This distributed damage is a very hard thing to reverse, probably requiring high-capability nanotechnology. I don't see this nanotech arriving anytime soon.

Posted by Paul Dietz at December 26, 2006 09:14 AM

I've long taken doctor's advice with the proverbial grain of salt. There is a considerable amount of wisdom contained in what doctors tell us to do. For instance, I eat a reasonable diet and get significant exercise. I don't slavishly follow the food pyramid, though, or go along with Puritanical demands (e.g., no or almost no alcohol consumption).

A few years I had some interesting confirmation of how limited medicine is today. I was doing computer support on survey research that was trying to get a picture of Americans' health. There were tons of questions about smoking, for instance. There were also questions about various psychological conditions, for example, attention deficit disorder, oppositional defiance disorder, etc.

What was missing? Well, for one thing, questions about how much sleep subjects got. Doctors for a long time thought sleep was not important. This conclusion was reached with little or no real research -- mostly physicians' personal thoughts on the subject. Recent research tends to indicate that sleep is quite important.

I developed the idea -- not exactly original, mind you -- that research is often driven by things other than pure scientific curiosity. The project I was supporting tended to examine some things that were considered problematical to people who had some power. For instance, ADHD. School isn't boring, those kids have ADHD. Never mind that ADHD seems to go down when children are given bits of freedom (e.g., recess) and go up when their days are scheduled to the minute.

So -- listen to the research on health. Just remember that too often the questions that are being researched aren't necessarily the best but are the ones that powerful people want researched.

Posted by Chuck Divine at December 26, 2006 11:16 AM

You may want to ask the nuclear fusion or AI folks about future predictions of a given technology. It's not a surprise that every area of science is experiencing and expecting "breakthroughs" any day now. Their continued funding depends on it. It would be an interesting exercise to go back through 10 year old Discovery magazines and check on the results for all the near future predicted breakthoughs.

Posted by K at December 26, 2006 11:35 AM

K, that's not an indictment of science. That's an indictment of funding agencies. Sennytor Proxmire (long may he rot) did more damage to science than all the Intelligent Design kooks could working together.

"Science" and "engineering" are different disciplines with much less in common than it may look like to the outsider. Breakthrough discoveries don't come on schedule and can't be ordered up for $X, however many zeroes "X" may have.

Tom Swift could announce that he intended to invent something, then repair to the lab and do exactly that. In the real world, if it could be anticipated or planned for it wouldn't be a discovery, let alone a "breakthrough". But if scientists don't make Swiftian promises to their beancounting bosses, there's no funding at all.


Posted by Ric Locke at December 26, 2006 01:31 PM

I agree, the "breakthrough any day now" PR is a function of science funding. But I also meant to point out that science moves along an uneven terrain, rather like exploring unknown territory. You can be going along great guns down the river, and then encounter a mountain range. There's too much linear extrapolation in scientific/technical prediction and it's driven by funding PR and wishful thinking. And now, if you'll excuse me, I'll just jump into my flying car and head off to the time transport chamber.

Posted by K at December 26, 2006 08:11 PM

"the singularity approaches"

One thing about discussions about things like actuarial escape velocity. The people who say they believe in this type of thing don't act like they believe in this type of thing. I'd think people who expect to have greatly extended lifespans would, for example, drive only if it was absolutely necessary and spend a great deal of money otherwise insuring that they would not experience an accidental death which could potentially cost them hundreds of years of life rather than a few dozen years. I'd also expect that they would not be to worked up over things like space policy, as all the predictions I've read about the singularity, assuming we don't destroy ourselves, mean that we'd have plenty of resources and technology for doing things like space colonization and exploration. Either that or we'd no longer care. The age of getting into space on top of big chemical rockets built of industrial age materials would certainly not be what we were doing in such a situation.

Posted by Jeff Mauldin at January 5, 2007 01:56 PM

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