When Death Gets Dis­rupted

Read our se­ries Fu­ture Watch by Colin Cullis

South African Country Life - - In This Issue -

You can live long, and you can live well. Ideally, you would like both. In the past, your genes and wealth would be the most sig­nif­i­cant fac­tors, and that re­mains the case. But a greater un­der­stand­ing of the con­di­tions that af­fect us, and bet­ter ways to treat or even pre­vent them, might see us chase the Grim Reaper fur­ther away than at any other time in his­tory.

I will sep­a­rate the ef­forts to ex­tend life from the ef­forts to make death less scary. It is fair to say that this and the next gen­er­a­tion will not cheat death, but the idea that fu­ture gen­er­a­tions may achieve a form of im­mor­tal­ity is look­ing less like sci­ence fiction than ever be­fore.

At best I can only of­fer a sum­mary of why hu­mans age and die. We may as­sume that all things die, but their life­spans would look like im­mor­tal­ity com­pared to ours. From 400-year-old sharks to 500-year-old clams, to 5 000-year-old trees, the range of the old­est or­gan­isms makes our 100-year lives seem very short. But theirs is short, too, com­pared to the es­ti­mated age of sponges in Antarc­tica that are be­lieved to be 15 000 years old.

They are not im­mor­tal be­cause, should con­di­tions change or they move from their en­vi­ron­ment, they will die. In that re­spect noth­ing is im­mor­tal.

What they lack is senes­cence which is the com­bined ef­fects of the process we call age­ing. For the most part, we age as a re­sult of dam­age over time. The im­pact of the sun, our habits, con­stant at­tacks by bac­te­ria and viruses, and phys­i­cal in­jury.

Even if we took ex­cel­lent care of our­selves, we would still die be­cause in many an­i­mals, and par­tic­u­larly in mam­mals, our cells are pro­grammed to stop repli­cat­ing and die. Pro­grammed cell death might sound like your body is out to get you and, in the end, it is, but you need first to un­der­stand why it does so in the first place.

You prob­a­bly as­sume you are who you al­ways have been. The re­al­ity is that you are mostly a teenage ver­sion of your­self. Cells di­vide to main­tain the body, and if they kept di­vid­ing but did not die you would keep grow­ing. Your skin is con­stantly shed­ding as the el­e­ments dam­age and scrape at it. Cuts get healed by fill­ing the wound. Even un­dam­aged cells will stop di­vid­ing once they have repli­cated about 50 times.

You are ar­guably a new per­son ev­ery 20 years be­cause most of the cells that ex­isted to make you would have died and been re­placed by new ones. Some parts of your brain, eyes and teeth don’t get re­placed, but most of you is new.

The rapid cell divi­sion and re­place­ment is ex­cel­lent for re­cov­er­ing from an in­jury or dis­ease and also to find use­ful mu­ta­tions, but the rapid divi­sion is also a risk as the cell could turn can­cer­ous. Skin and in­testi­nal cells are fre­quently re­newed, in part the rea­son cancers of those or­gans are so com­mon.

So far, this has looked at the past, but what does it say about the fu­ture and how we might live to be­yond 100? There is one more re­mark­able piece from the past. A sam­ple of cer­vi­cal can­cer cells that claimed the life of Hen­ri­etta Lacks in 1951. It was found that, un­like any other hu­man cells, the cells in this

sam­ple did not stop di­vid­ing.

They still are, and from that small sam­ple, a mas­sive num­ber of cells have been cul­tured, many more than make up a hu­man and enough to weigh many tons. Could this be the se­cret to us liv­ing for­ever? Per­haps, but the cells are so dif­fer­ent from hu­man cells some con­sider them a new kind of cell al­to­gether. How­ever, the 60 000 stud­ies re­lat­ing to those cells have al­lowed us to be­gin look­ing for ways to keep cell di­vi­sions oc­cur­ring with­out the cells de­grad­ing over time.

Un­til that hap­pens, we need to fo­cus on lim­it­ing the dam­age and im­prov­ing the op­ti­mal con­di­tions to look af­ter the ones we do have.

This is where tech­nol­ogy be­gins to play a more sig­nif­i­cant role. At the most ba­sic, health mon­i­tors like the Ap­ple watch, men­tioned in an ear­lier ar­ti­cle, can keep us mov­ing and spot a po­ten­tial prob­lem be­fore it be­comes dan­ger­ous.

Eat­ing well and stay­ing ac­tive will get us far if there are no ma­jor ge­netic is­sues, so the next part is the stim­u­la­tion needed to keep us men­tally ac­tive too. More forms of en­ter­tain­ment and more ac­tiv­i­ties that al­low us to re­main en­gaged in so­ci­ety are crit­i­cal.

Chang­ing the way we ap­proach re­tire­ment is also cru­cial. South African law does not spec­ify when you have to re­tire, but most re­tire­ment plans are be­tween 60 and 70. The idea of rewiring rather than re­tir­ing sug­gests we plan for a sec­ond phase af­ter we stop our for­mal work, but stay ac­tive and en­gaged with work of some sort for as long as pos­si­ble. In many coun­tries, there is just no op­tion but to keep work­ing. De­pend­ing on the work it could be very good or bad.

We are crea­tures of habit and, if you have been in­de­pen­dent and have taken care of your­self for most of your life, you would typ­i­cally not want to give that up. Here, too, tech­nol­ogy is look­ing to help, with smart, vir­tual as­sis­tants to mon­i­tor and man­age many ac­tiv­i­ties in the home, as well as sum­mon help should it be re­quired. It is likely that, for those who are not too afraid of the cur­rent gen­er­a­tion of ro­bot as­sis­tants, they might be able to serve as car­ers in the fu­ture, al­ways pre­pared and ready to help us.

As our lives be­come more dig­i­tal, our plans for how to be re­mem­bered will change too. Face­book is the planet’s largest so­cial net­work and also the world’s largest dig­i­tal grave­yard. It has up­dated how it deals with ac­counts of those who have died since it be­gan in 2004, and you can now nom­i­nate a per­son that will be given ac­cess to your pro­file when you die and al­low it to re­main as a me­mo­rial for friends and fam­ily to con­tinue to post and cel­e­brate your life in the same way we might place flow­ers on a grave.

Wills are chang­ing, with pass­words be­ing in­cluded and in­struc­tions on what should be done with your dig­i­tal as­sets as well as your real ones. For fu­ner­als, some cre­ate videos and slideshows to be shown once they are gone, or cre­ate the playlist for their wakes.

In cir­cum­stances when a ter­mi­nal ill­ness will re­sult in a sig­nif­i­cant loss of qual­ity of life, we may see as­sisted sui­cides and eu­thana­sia be­com­ing less of a taboo.

In 2014, Brit­tany May­nard (29) was di­ag­nosed with a brain tu­mour that would claim her life and, rather than wait for it to progress, she opted to go on a trip, cel­e­brate her hus­band’s birth­day and then end her life with friends and fam­ily around her. She made her de­ci­sion pub­lic, to as­sist oth­ers fac­ing the same choice, and used a fi­nal Face­book pub­lic post to say:

‘Good­bye to all my dear friends and fam­ily that I love. To­day is the day I have cho­sen to pass away with dig­nity in the face of my ter­mi­nal ill­ness, this ter­ri­ble brain can­cer that has taken so much from me… but would have taken so much more. The world is a beau­ti­ful place; travel has been my great­est teacher, my close friends and folks are the great­est givers.

I even have a ring of sup­port around my bed as I type… Good­bye world. Spread good en­ergy. Pay it for­ward!’

Death is not some­thing that we will be able to avoid any­time soon, but is some­thing that can be de­layed and man­aged and made less scary. In time we will find a way to cap­ture our mem­o­ries not just in pic­tures and videos, but per­haps even as our conscious self.

We have been aug­ment­ing our phys­i­cal bodies with me­chan­i­cal and dig­i­tal ver­sions for many years. From pros­thetic limbs to pace­mak­ers and hear­ing aids, the slow pro­gres­sion pre­vented ma­jor mo­ral or eth­i­cal ob­jec­tions. Should we ever be able to re­place our bi­o­log­i­cal body for a dig­i­tal one, though, it will not only be a ques­tion about whether we can, but whether we should.

Re­li­gious be­liefs make fu­ture op­por­tu­ni­ties dif­fi­cult to nav­i­gate. Hu­mans, as far as we can tell, have re­garded death as a sig­nif­i­cant life event for all of our known his­tory, and that is un­likely to change. But un­til then, cel­e­brate your life and the loved ones around you.

Be­cause, even though French­woman Jeanne Cal­ment lived to a ripe old age of 122 years and 164 days, mak­ing her the old­est recorded hu­man to have lived in mod­ern times, it is still just a blink of an eye to the Green­land shark at 400 or the qua­hog clam at 500, and in­deed the Antarc­tic glass sponge at 15 000 years.

Shown is life ex­pectancy at birth in 1950, which cor­re­sponds to an es­ti­mate of the av­er­age num­bers of years a new­born in­fant would live if pre­vail­ing pat­terns of mor­tal­ity at the time of birth were to stay the same through­out life. (Graphic Our World in Data)

Shown is life ex­pectancy at birth in 2015, which cor­re­sponds to an es­ti­mate of the av­er­age num­bers of years a new­born in­fant would live if pre­vail­ing pat­terns of mor­tal­ity at the time of birth were to stay the same through­out life. (Graphic Our World in Data)

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