Just Like That | Rethinking life and death in the age of longevity

The rapid advancements in medical science and biotechnology are driving the quest for longer lives. In this quest, what does life and death mean for us?

My father died at the age of 49 in 1965 from an ailing heart condition. I was only 11 years old then. Just a decade or so later, the cause of his death had an easy cure through a stent or a bypass. For me, it has always been a matter of enduring grief that he passed away from a disease that is far from fatal today, and most people recover to lead a healthy and long life.

The rapid developments in modern medicine have dramatically improved our lives' longevity. In 1960, the average life expectancy in India was 45; by 1986, it had increased to 57; in 2020, it was 67. This is much below that of other countries, especially in the developed world. Japan has the highest life expectancy of 84 and in most West European countries, it is above 80. Surprisingly, in the US, it is only 76, while in China, it is slightly high at 78.

The desire to live longer has remained with humankind forever. Even in ancient times, there was a search for the mythical elixir of immortality. We fear the finality of death and are afraid of our mortality. The desire to remain youthful, and to delay death is a universal aspiration to the point that the standard blessing in India is "Ayushman bhava" (May you live long).

Now science is raising the hope of an average life-span of 120 to 150 years. The longest-living human was Jeanne Louise Calment of France, who died in 1997 at the age of 122. There are a dozen or so other recorded deaths of people who lived to 118 or 119. But today, biomedical gerontologists like Aubrey de Grey argue that new sciences like strategies for engineered negligible senescence may enable human beings to live for a thousand years! Many eminent scientists scoff at Aubrey, and call his theories "pseudo-science". Yet it is a fact that science has established that ageing occurs when the cells of the body lose their ability to renew themselves and begin to disintegrate; if some way can be found to delay or prevent this cellular senescence—the scientific term for ageing—greater longevity can, indeed, be ensured. A host of leading biotechnology firms are working precisely in this field. The market for anti-ageing and rejuvenating technologies has soared and is expected to cross $600 billion by 2025, a study by the Luxonomy Group says.

Who can say when a breakthrough could come? Medical knowledge today doubles every 73 days, when only a few years ago it did so every three and a half years. Simultaneously, costs of key areas of research, such as genome sequencing, have come down by 99 per cent.

But there is a flip side to this too. Finding a way to slow ageing is one thing, and using advances in medical science to delay death, is quite another. Atul Gawande, a surgeon and one of the top doctors in the US, wrote Being Mortal: Medicine and What Matters in the End, which became a New York Times bestseller. In this unputdownable work, Gawande concedes that strides in medical science can prevent a person from dying almost indefinitely. But is this a life worth living? Indeed, can this be called living? He deals, in particular, with terminally ill patients, and argues that very often, when they are in acute pain or discomfort, and there is no hope of recovery, it is better to let them go than to use medicine to keep them alive.

Life is worth it not in the life span that medical science can contrive for you, but in the health span that you have, Gawande writes with deep knowledge and compassion. If death can be constructively delayed, and a person can remain healthy for much longer, it is a good thing. But merely delaying death at the cost of the quality of life is sometimes worse than the ability to keep a person technically alive. That is why many people now write a living will, in which they specifically state that if they are on a ventilator, or otherwise totally incapacitated, with little or no hope for recovery, the switch should be switched off.

Yet, it is difficult to give up on life. The great poet Zauq wrote: Ho umar-e-khizr bhi tau kahenge bawaqt-e- marg, hum kya rahein yahan abhi aaye abhi chale (If our life were as immortal as even Khizr, we still would say, we just came and now we are gone.) Iqbal, I think, rightly said, "I believe in the breadth of life, I do not seek its length." While new science may prolong our lives, the best thing is to live as happily as we can while alive.

As a Tibetan proverb says, the secret to living is to eat half, walk double, laugh triple, and love without measure.

Pavan K Varma is author, diplomat, and former Member of Parliament (Rajya Sabha). Just Like That is a weekly column where Varma shares nuggets from the world of history, culture, literature, and personal reminiscences with HT Premium readers. The views expressed are personal

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