Outlive: A arte e a ciência de viver mais e melhor

This is part of why I place so much importance on taking a detailed family history from my patients: I need to know when your relatives died and why. What are your likely “icebergs,” genetically speaking?

Frenchwoman Jeanne Calment, who once joked, “I’ve only ever had one wrinkle, and I’m sitting on it.”

as the great philosopher Mike Tyson once put it, “Everyone has a plan until they get punched in the mouth.”

This means that we have delayed your death without significantly improving your quality of life—something at which Medicine 2.0 is quite adept. This is the Marginal Decade that most of us can expect, in our current system.

In Medicine 2.0, you are a passenger on the ship, being carried along somewhat passively. Medicine 3.0 demands much more from you, the patient: You must be well informed, medically literate to a reasonable degree, clear-eyed about your goals, and cognizant of the true nature of risk.

Second, Medicine 3.0 considers the patient as a unique individu

First, Medicine 3.0 places a far greater emphasis on prevention than treatment.

The trouble began with Hippocrates. Most people are familiar with the ancient Greek’s famous dictum: “First, do no harm.” It succinctly states the physician’s primary responsibility, which is to not kill our patients or do anything that might make their condition worse instead of better. Makes sense. There are only three problems with this: (a) Hippocrates never actually said these words,[*1] (b) it’s sanctimonious bullshit, and (c) it’s unhelpful on multiple levels.

In late 2007, after six months of round-the-clock work, we had a big meeting with the top brass of our client, a major US bank. Normally, my boss, as the senior partner on the project, would have handled the presentation. But instead he picked me. “Based on your previous career choice,” he said, “I suspect you are better prepared to deliver truly horrible news to people.”

The time to repair the roof is when the sun is shining.
—John F. Kennedy

There are the true believers, who insist that if you follow their specific diet (the more restrictive the better), or practice meditation a certain way, or eat a particular type of superfood, or maintain your “energy” properly, then you will be able to avoid death and live forever.

Exercise is by far the most potent longevity “drug.” No other intervention does nearly as much to prolong our lifespan and preserve our cognitive and physical function.

Almost all “diets” are similar: they may help some people but prove useless for most. Instead of arguing about diets, we will focus on nutritional biochemistry

Unfortunately, in today’s unhealthy society, “normal” or “average” is not the same as “optimal.”

Even when someone dies “suddenly” of a heart attack, the disease had likely been progressing in their coronary arteries for two decades. Slow death moves even more slowly than we realize.

It gutted me every time I had to tell someone suffering from cancer that she had six months to live, knowing that the disease had likely taken up residence in her body several years before it was ever detectable. We had wasted a lot of time.