Ending Aging « Rogue Scholarship on Aging

Youth is a wonderful thing. What a crime to waste it on children. ~ George Bernard Shaw

For a small piece of paper it carries a lot of weight Oh, that mean, mean, mean, mean, mean green – Almighty Dollar!
~ For the Love of Money – The O’Jays

Like a preacher stealing hearts, At a traveling show, For love or money money money
~ Desire – U2

I figured out one thing. If you’re growing older or getting younger it really doesn’t make any difference. Whichever way you’re going you have to make the most of what this is.
~ Benjamin Button – from the movie, “The Curious Case of Benjamin Button”. Screenplay by Eric Roth. Based on the short story by F. Scott Fitzgerald.

Prologue

There are serendipitous events – meaningful intersections – that help to keep the momentum going when writing about the various topics that weave into the domain of the aging experience. For example, the following text indented below was copied directly from a website (complete with a Twitter pitch!) – and the link (the URL) was captured by the many alerts that I have set up to bring in information as it intersects the topic of aging. But first a quick preface (in the prologue no less).

What I hope to achieve with this post is to roguishly examine the topics of “anti-aging medicine” (and a few of the attendant concordant terms such as: prolongevity) – all of which brings up the prospect of negligible senescence (or SENS via Aubrey de Grey who poses the question: Must we age? – which begs the question on just about any other ‘issue’ associated with living – Must we pay taxes? Do I have to stop at red lights? Can I have it all? ) – or better yet (or worse?) – and can I go ahead and say it? – Can we achieve IMMORTALITY? Which ontologically speaking – may not be the same as reversing aging per se; in other words, one hopes not to get any older, but rather to stay “young” (whatever that means – what chrono set point is that?) because let us not forget that we humans do want to have our cake and eat it too.

So reader beware: I also plan to use the descriptors of the films from the Matrix trilogy as inspiration and heuristic to frame the development and serve as guideposts along way and to establish the need for a critical re-examination of the whole project that claims to be “anti-aging.” Why the need? Because I want to propose that the enterprise is not going to slow down nor will it stop given the presence of two major motivational forces that serve as both catalyst and lubricant to keep the enterprise moving – rapidly.

The “scientific process” – persons who seek to unveil the hidden, the mysterious, the unknown, the challenging, the secrets, to simply know “it” – and perhaps to be either the first or at least a significant part of the legacy (team work) that would lead to the discovery of the raw and primary factor(s) that would slow, stop, and reverse the aging process. I have scientific process above in scare quotes here to indicate the highly charged atmosphere that surrounds this activity – what does it mean to be involved in a scientific process such that some degree of legitimacy and provisional ‘truth’ is established for colleagues in the field and for the lay person (aka “the consumer”)?
The aging baby boomers. Read – their drive, their motivation, their desire, their money, their narcissism, their legacy, their gullibility, their relentless search for the ‘dream’, their final push to “get it right’, and their fetish to finally create and exist in a human-derived nirvanic garden of eden that has eliminated disease, aging, and death.

Thus my concern that between the two forces we have heavy potential for the anti-aging movement to see the fountain of youth as an opportunity for subprime activity (to get people to buy into it – when there other concrete higher priorities here and now; my point and as appetizer: To me this akin to the debate about space missions – we can do it – but is it all worth it? – and to what end ? Can we afford it – or is it a necessary debt to embrace because the benefits are so obvious and there is little risk). The other blunt issue is how the baby boomer cohort may be seen as one big cash cow – ripe for the taking – the mother of all hedge funds.

I also want to submit a working framework to tackle the dynamics of the enterprise will follow a sequential and incremental breadcrumb trail that goes something like this:

The Aging Enterprise > Revisited > Reloaded >Revolution

which sounds very familiar – because it follows the title sequence for the Matrix trilogy films – but here I use to facilitate textual examination and discourse on where we have been – and where we/are are/we going (?) {that can be both statement and question}.

I want to present the catalyst – the key event of the information first, then I will share with you some commentary related to the topic at hand {the anti-aging market} Here then is the blurb that caught me eye and lit the fuse for my reflections – and hopefully our discussion.

Global market for anti-aging products and services worth $274.5 billion in 2013

First, some observations:

1) I do not know how you feel about the numbers being thrown around in the news item above, but given recent policy decisions at the federal level – a billion here and a billion there – $275 billion does not seem to carry the same gravity of an impressive jaw-dropping amount especially after having to (or at least to try) getting a grip on such sky-high amounts of money such as $700-billion federal banking bailout or our mega-trillion deficit in the US, but still – $ 275 billion is significant and substantial in its own right;

2) What I was impressed with was the wide net that was cast which purports to capture or represent the anti-aging market including the segments of disease, appearance, and fitness. In fact, I was both impressed and incredulous over such a claim that disease-oriented products and services would be under the rubric (or the matrix) of the anti-aging market.

In other words, I am still trying to understand what IS NOT a part of the anti-aging market (?) – Is there a boundary or firewall to demarcate “anti-aging” services and products from other types of activities that address aging issues but do not necessarily state explicitly that they are “anti” so instead we might have – just good ole – regular – traditional – conventional – status quo – market for dealing with transitions of aging.

But perhaps that sounds like caving-in – throwing in the towel so to speak – that if you are not “anti” (and read: progressive and bucking the status quo) – you are part of the “establishment” that is “for” aging (?). I can hear it now: “Sure, you say are for health and well-being, but pull the curtain back, and you still find those who are really the “biomedical disease model types” that are pessimistic and more into treating chronic conditions – than preventing them.

The “establishment” are (perhaps) all those who focus on career building (as you shall soon read – a soft connection to the scholarship of Carol Estes on the “Aging Enterprise” circa 1993; see next subheading below) on the “problems” of aging, rather than those in “anti-aging” who are more interested in the “solutions” of aging (i.e., stopping or reversing the aging process).

But, I digress somewhat here. We will get back to this boundary issue further into this post;

and 3) Now what was missing in this news blurb above was the explicit primary audience to which the commercial products could be (will be) targeted for – that is, the AGING BABY BOOMERS – and it is interesting to consider whether the primary audience (boomers) is asking for (seeking out) the products so that the “market” can react to and catch up to the demands of the baby boomers or is some or all of it based on the assumption that the baby boomers will react to advertising and commercial plugs that highlight “anti-aging” and thus cater to the assumed profile of this cohort as – extremely interested in anti-aging products (but they just don’t know it yet, thus most boomers are to be viewed as gullible and an easy mark to peddle anti-aging products to) or that it is all a perfect storm of outlandish vanity, and a desire to be healthy and “younger” by appearance (for example, the plethora of skin care products to make you “look” younger – at least on the surface) and by biomedical status

(for example, as Chopra & Simon did claim in their book [Grow Younger, Live Longer, 2001] that if you follow his recommendations, you can “reset” your Biostat {biological, or functional age} up to fifteen years younger than your chronological age) and that the boomers are more than willing to dedicate a significant part of the income/assets to this pursuing this endeavor in working (and buying) their way to (and into) the “fountain of youth.”

I continue on with more detailed information from the BCC Research (www.bccresearch.com) website which specifically (and explicitly) indicates the “rationale for the analysis” (please note that this is NOT the full report):

Perhaps I have overlooked something along the way, but it appears to me that this emphasis on the “market” – the commoditization” of products and services to create the ‘anti-aging’ experience is bound (and determined) to facilitate a tiered (or caste) system of the haves and the have-nots when it comes to accessing the services and products. In other words, not all baby boomers will have this disposable income to spend – nor can we assume that even if they did, would they necessarily want to spend their money in this fashion: on anti-aging services and products.

Furthermore, I am still waiting to hear more on the potential scenario of where ONLY the elite –well-resourced and financially deep – may have the capacity to “buy” or pay for such services that claim to slow, stop, or reverse the aging process. The news blurb above speaks more to the investment potential – the venture capital possibilities – in benefiting (profiteering) from the projected sales and revenue created from the anti-aging market. When you think about it more – and deeper – this news blurb is pointing in the direction of the supply and demand route – and I wonder, or at least I am willing to hear and discuss more about how all of this anti-aging medicine activity will then benefit the commonwealth – the citizens – directly. Sure, I could hear about reduced costs (like the DRGs from the past) in terms of health care expenditures – over time and for certain segments of our society, but I ask: will this supposed rising tide of benefits from anti-aging medicine and all of these products and services – lift all the boats (ever-body?) or only those boats that have the income (and ability) to actually leave the harbor? There is also the rationale that any investments by private companies and corporations have to protect their interests and seek to maximize their profits for their “stockholders” (or is that stakeholders?) – and turn a profit for the general well-being of the company.

But again, with all of the marketing, publicity, hype, and promise of anti-aging medicine/services and the projected revenue to be generated, the money spent (or invested) has to come from somebody – and their wallets.

The questions that I have an interest in related to this – are: 1) Is the $275 billion (or so) spent going to amount to a significant change in the quality-of-life (having a life) whether one lives an additional two more years or twenty? If you can reset your aging clocks – then what? What is gained? More time? Time for what? If you were to slow, stop, or reverse aging, what are the implications of that monumental shift in the life course structure (and trajectory) for our social-cultural-ecological resources? – And 2) Aside from the notion that science or medicine or technology will trump all else, is there also room for (and the possibility that) philosophy or ethics or existential discourse may matter on this topic? Or at least enter the equation? Or is it all reductionistic scientism {is that an oxymoron?} from here on out? For example, what is it? – What is the underlying motivation and desire for this historical and contemporary quest in our humanity that would seek to be engaged relentlessly (cross-culturally) in “anti-aging” activities? That is, is the attempt to re-invent or re-create the life course away from – for what some might refer to – as the natural order of organic existence and being – something that is inherently human after all? And therefore can be based on what human characteristic? Or attribute? Or process? Is it a biological drive? Or is it something psychoanalytic? Or it is beyond the bounds of rational (reasoned) thinking – and instead more a metaphysical goal and attraction that is more akin to an affinity with Greek mythology? Perhaps the quest is Platonic – like existing in the cave of shadows – to break free of the chains that restrain our “true” potential – if we could only climb out into the light of longevity – and freedom to exist forever.

And should we take as prima facie data (“fact”) that if “we” (humanity as the ultimate arbiter of this decision) seek to break the cycle of pain, suffering, aging, death (sort of related to the Nirvana principle) – who are we to decide? Or who amongst us shall decide? Shall I defer to Aubrey de Grey? Shall I pledge allegiance to the American Academy of Anti-Aging Medicine {hereafter A4M – and “Established 1992. A non-profit international medical society of 20,000 member physicians and scientists who believe answers to aging related disease are available now.” – from their web site} and then just get the hell out of the way and let the “pros” do their job in regenerative and biomedical technologies? Should I begin to trust that “they” have my “well-being” (physical and economic) in mind as they venture forth with capital and good intentions (naïve or otherwise) to discover the ‘scientific’ fountain of youth?

But I get the sense that a lot of the questions and concerns about anti-aging activities, outcomes, and side effects are neatly escorted to a back room where the speaker will politely tell us – “We will cross that bridge, when we get there.” But typically when we get there, the bridge has already been built – and burned down. I am not against the “American way” of enterprise and free-market ideologies (such as they are), but I detect that the greyhounds of science and technology have slipped the leashes – and are out of the gates – already chasing the rabbit of immortality. And this time it is different. This is not at the level of selling snake oil and bull testicles. This is a full-fledged industry – an entire enterprise at work – and as we have seen and read previously – the market related to “it” is not peanuts, especially with the working assumption that aging baby-boomers will demand that “we” do something about that nuisance – that bummer and bad trip experience of aging – and death. “Why haven’t we come up with a cure for that yet?” The invisible hand has got a new market segment to tap into – our quest, our desire, our dream, our fetish, our need and want – to eliminate and eradicate “it” – the new enemy to fulfillment and happiness and satisfaction in our culture – senescence.

And that makes me wonder further more about our current state of affairs within our country about decisions and priorities that affect all population segments of the life course: environmental, economic, military, medical, education, industrial, and technological. Is this where we want to go? Will this be our legacy as aging baby boomers? The quest to make sure we did it – we were the ones who broke the chain of generations. The search for the fountain of youth would mean that we refused to march into the abyss of frailty and morbidity. Yes! We are the dragon slayer and we have killed the beast that has haunted humanity for centuries upon centuries. No longer do we build edifices of religion, government, philosophy, art, and culture on the certainty of mortality – the finiteness of time – we can slow aging – reverse aging – and live forever – and let the chips fall where they may. We can all become the Curious Case of Benjamin Button – but with new spin: The Ordinary Case of Baby Boomers (or because we are boomers = The Extraordinary Case !) who all grow younger over time – and let everyone benefit from our willingness to become the pioneers into immortality. Don’t you see? We are doing it for you! Everyone. Let someone else build the new paradigm of meaning and purpose – after all, we will have forever to figure it all out.

In fact, I can see it now: the aging baby boomers will have given us the ultimate gift of certain procrastination as we have no longer have the sense of hurry, there is no loss, no deadlines, no pain, no suffering, no end game at all; we will always have tomorrow. And what would you rather have? – The direction of youthful (a la Brad Pitt) progression? – Or morbidity and mortality associated with the end of a measly 80 years of life – or so. My guess would be that we want more – and both. We have made our preference very clear to all – youth without youth – eternal adolescence – healthy adulthood in perpetuity. And therein lies the heart of the issue – how to explain that preference? From where does it originate? And why? Is it a primordial drive within us to “naturally” define the aging process as the ultimate “fall”, a failure, a corruption, incredible loss, and chronic suffering. Well, because it is? And if it is – then we must overcome and defeat “it.” On one hand we could read Jean Amery’s “On Aging: Revolt and Resignation” and go into a funk because it is soooooooo depressing (albeit “real”) – Or you could pick up the numerous “cotton-candy” – “can do” optimistic books on aging that are apt to become best-sellers because they offer “the promise” of a “secret” that has been kept from us – the promise of eternal wellness – if you would only do the following (after buying the book or the tapes or the download) x, y, and z.

Yes, it is unfair – death is. It is a bitch that aging has to happen. Life is unduly truncated and perhaps we all want to believe that “science” will be the weapon – the ultimate tool – at our disposal to finally conquer death. And so to be rid of all things gerontological and geriatric would be….well, might as well say it – the deification of humanity. We are the gods that have reversed more than some original transgression – we have arrived back into the Garden of Eden. We have disconnected the awful burden of being human – to know that we will age and die. And so a human being – would forever be-ing (sorry Heidegger fans, I can tell you are getting antsy over your Dasein at this point – a being-in-time would no longer be in time – but outside of the time we used to be “thrown into” – now we appear and stay relentlessly in existence).

Although it would be easy to bring up cultural stories that offer “warnings” about seeking such a powerful attribute and outcome – such as the story of Daedalus and Icarus – I am thinking more of the entity of Gollum (aka baby boomers) in Lord of the Rings trilogy – seeking and desiring “the ring” (aka reversing aging – perpetual youth) – “So bright… so beautiful… ah, Precious.”), I will stick to the philosophical road for now as we contemplate what Robert Butler has termed, “The Longevity Revolution.”

Finally, a quick look at the person who wrote the original analysis for BCC Research (www.bccresearch.com).

ANALYST CREDENTIALS

The author of the report, Sandeep Sugla, is a chief research analyst with a Bachelor of Engineering degree from Shivaji University and over 8 years of experience in life science. He has been the author for reports such as telemedicine, sales force effectiveness, nutraceuticals, and new revenue models of pharma in the debacle of blockbusters.

Okay, that is some interesting background and credentials. And here is my point by paraphrasing Shakespeare’s Hamlet: “What’s anti-aging to him?” {I ask} “Or he to anti-aging that he should care about the topic” Cui bono? Well, who knows – which is my last reflection on this section in particular. Caveat emptor for anyone who would read this information – and at least Mr. Sugla (and BCC) inserted the “Disclaimer” at the end – because if there is any take home message for aging baby boomers (or anybody from any cohort for that matter) it is to beware and be-aware; to be cautious about any claim and product and service in the domain of anti-aging medicine or service. Furthermore, any claim to having the crystal ball on baby boomers as they age will have to be taken and interpreted with a skeptical approach. The baby boomers are not a hedge fund and to the best of my knowledge nor should the cohort be treated as though they (as a collective) were like Wall Street derivatives.

There are many possible angles to discuss with this “news item” referred to above – both good and bad – positive and negative. But my approach is more philosophical in the sense that I am still trying to understand the core motivation for humans when considering the allure of living longer – perhaps forever – and how that possibility would really change anything different than it is now – or what we currently have to confront as a living being – an entity that would rather “grow younger, live longer” (see Chopra, 2001) – in essence reverse aging – which appears at first to be against the natural order of things as we have to come know organic-multicellular life as having a beginning – and an end. And in between there is maturation, procreation, and then ultimately senescence. While I realize there are persuasive rationales and many arguments for pro-longevity and “anti-aging”, I am (personally) trying to understand the primary and the core need and want that goes beyond or transcends the casual and flip comments that are borderline banal or reminiscent of some Woody Allen lines:

I am not afraid of death, I just don’t want to be there when it happens.

I don’t want to achieve immortality through my work. I want to achieve it through not dying.

The “Aging Enterprise” Revisited (again), Reloaded, and Revolution

My goal with this final segment of the Rogue Scholarship on Aging post on this topic is to take the titles of some academic articles and mash them up with the titles of the movies from The Matrix trilogy (especially the titles of the last two movies) in order to examine the “enterprise” (the market – the business – the commoditization – the profiteering) of aging experience, but more accurately, the business of “anti-aging.” And yet, the ultimate goal here is not to argue for or against “anti-aging medicine” (as you will see, there is plenty of literature already available that addresses both sides – and then some), rather I am more interested in the philosophical underpinnings that can help us understand (and I’m not sure if it can explain, but we shall see) why humans (our species Homo sapiens) have the drive, the desire, the fetish, the obsession, and the compulsion, and the motivation to seek out the discoveries and the purported “medicines” that would slow, stop, and even reverse the aging process. In other words, I am curious about the analysis of the WHY – and less so on the scientific merits or limitations of whether or nor we can possible live forever by finding a “cure” for aging – and then supposedly defeating the ultimate inevitability of life itself – that is, to conquer death. I will begin the examination and review of this section by unpacking the meaning of the subheading of this posting:

The “Aging Enterprise” Revisited (again), Reloaded, and Revolution

This subheading reflects my desire at mashing up a series of scholarly publications on the “Aging Enterprise” (see Estes, 1993; Moody) and then slightly morphing it into a new perspective on the examination of the so called “anti-aging medicine” domain by using the titles of Matrix movies (reloaded and revolutions) as a way of looking over – and through – the matrix of the issues involved in this topic that relates to the “fountain of youth” and “anti-aging” medicine and services and the possibility of “ending aging” (see Aubrey de Grey, 2007).

One of key elements of this sub-section, but really of the entire blog post, is the notion of the “Aging Enterprise” which we first hear of in the literature with Carol Estes’ book, “The Aging Enterprise” (1979).

And then there was the follow-up publication. There are a handful of journal articles (and only a handful) that, in my opinion, have presented a scholarly and provocative treatise contra to the prevailing and received view within the field of aging, which in effect has served as a Kafka-like “ice-axe” to break apart the frozen sea within us – or in other words, an article that serves as a good ole butt-kickin’ to jolt the status quo and grab the commencement regalia by the collar and shake the devil out of the pontificating old poops in the academy. When I first read this one particular article (out of the handful) I was shaken from my Kantian dogmatic slumber (and my graduate student dumber) and I thought perhaps, just perhaps, I had just read some Khunian paradigm-breaker that knocked over the applecart of normal science.

The article was authored by Carol Estes as a “follow-up” article (“The Aging Enterprise Revisited”) published in The Gerontologist (Vol. 33, No. 3, 292-298) to her original work The Aging Enterprise (the book) that was published in 1979. The article was a refreshing (and startling provocation in some regards) antidote to the received view found in many of the textbooks and readings assigned in the academic courses on aging, but what I found most engaging (an epiphany – illumination!) in the article was the philosophical exploration of the “social construction of reality” processes involved in treating and solving the “problems” of the aging experience. In other words, Estes forced the question (in a positive confrontational manner) upon the field of aging: Whose problem? What problem? Her point was this:

reflect

reproduce

And I remember thinking: What? Who me? The gerontologist-to-be? Did I do that? Am I knowingly or unknowingly contributing to the very problem I wish to address and alleviate? And so, I forever after reading that article became much more aware of the insidious messages, outlooks, attitudes, and behaviors that might weave into the discourse and the policies that relates to aging. I would see the reality of aging in a whole new way – a different way. Thus, my tie in with The Matrix movie (# 1 – written by Andy Wachowski & Larry Wachowski) and from the very first film, we have the essence of the now classic scene between Morpheus and Neo in terms of epiphany, exposure illumination, and the “true” reality conjured up by Baudrillard, Lacan, Badiou, Zizek and a host of others in terms of our understanding (however possible that is) of reality and the significance of being (or take Heidegger’s Dasien). The impact of the scene was much like perspective in the text of Estes: a cold bucket of water in your face to wake up from a long night’s sleep – the jolt, the adrenaline producing snap of the brain –the mind – at full alert as the lighthouse cuts through the fog – and one can see clearly the shoreline, the horizon, the sky, and all of the stars as the FULL picture – the entire map is suddenly (and finally) revealed because all before it was an illusion, a representation, an orchestration of constructs and slogans that masked the essence of what really is.

Neo: You could say that.

Morpheus: I can see it in your eyes. You have the look of a man who accepts what he sees because he’s expecting to wake up. Ironically, this is not far from the truth. Do you believe in fate, Neo?

Neo: No.

Morpheus: Why not?

Neo: ‘Cause I don’t like the idea that I’m not in control of my life.

Morpheus: I know exactly what you mean. Let me tell you why you’re here. You’re here because you know something. What you know, you can’t explain. But you feel it. You felt it your entire life. That there’s something wrong with the world. You don’t know what it is, but it’s there. Like a splinter in your mind — driving you mad. It is this feeling that has brought you to me. Do you know what I’m talking about?

Neo: The Matrix?

Morpheus: Do you want to know what it is?

(Neo nods his head.)

Morpheus: The Matrix is everywhere, it is all around us. Even now, in this very room. You can see it when you look out your window, or when you turn on your television. You can feel it when you go to work, or when go to church or when you pay your taxes. It is the world that has been pulled over your eyes to blind you from the truth.

Neo: What truth?

Morpheus: That you are a slave, Neo. Like everyone else, you were born into bondage, born inside a prison that you cannot smell, taste, or touch. A prison for your mind. (long pause, sighs) Unfortunately, no one can be told what the Matrix is. You have to see it for yourself. This is your last chance. After this, there is no turning back.

(In his left hand, Morpheus shows a blue pill.)

blue-pill1

Morpheus: You take the blue pill and the story ends. You wake in your bed and believe whatever you want to believe. (a red pill is shown in his other hand)

red-pill1

You take the red pill and you stay in Wonderland and I show you how deep the rabbit-hole goes. (Long pause; Neo begins to reach for the red pill) Remember — all I am offering is the truth, nothing more.

(Neo takes the red pill and swallows it with a glass of water)

And the red pill is our sign and signifier for getting to essential truth – the core essence of what is behind the constructed reality of our social programs and services for older adults.

But the red pill (i.e., a certain amount of legitimacy – scientific protocol – skepticism – testing – peer review) is needed again because the enterprise has “reloaded” into another industry – another social construction of our wants, desires, and searching for the elusive (or should I say illusive? – but of course Aubrey de Grey believes reversing aging is very much a reality – in our lifetime) holy grail of life – the fountain of age in a materialistic culture where a certain amount of capital can buy you products, services, and medicine that can ensure you everything (assuming this is pretty much all that you need) you want: growing younger, ending aging – and the Faustian bargain is no longer a “bargain” – you can have it, eternal life, not for your soul, but for your wallet, and then some. The enterprise had reloaded and it seemed everyone had came out with barrels blazing.

And so the “war” began. Which also carries some Lacanian interpretative (via Zizek) potential with the rich symbolism of conflict between humans and machines al la Terminator movies – and the psychology of desire and language and “the Other” as we confront various schemas and reports and publications that claim the ‘truth’ – or at least scientific legitimacy on what is REALLY is going on “out there.” Because there is a lot at stake: profit, expenditures, careers, and of course ~ ego (oh, and did I mention the promise of immortality? – the long sought after and sought for prize by too many explorers and royalty and pirates to mention)

So what is really going on in the battle and what are the positions of the stakeholders, the scientists, and the consumers? Like a work of art on the gallery wall – it appears that much is in eye of the beholder and not so much for beauty, but rather who is claiming that they are on the “right” versus all others who are labeled with a variety of derogatory titles (and categories to put them into).

Let me conveniently begin with a report back in 2001 (the timing was the day before 9/11) from United States General Accounting Office titled, “Health Products for Seniors – ‘Anti-Aging Products Pose Potential for Physical and Economic Harm’.” (see GAO-01-1129 and GAO-01-1139T).

Yikes ! When this report went before the Special Committee on Aging, U.S. Senate and it is the report from the GAO – the supposed (and hoped for) big-time arbiter of them all – with Accountability * Integrity * Reliability, then this sort of sets the benchmark, or does it? Well, sort of. It was only the first shot in the new aging enterprise revisited and reloaded.

The battle between various scholars and researchers and disciplines (and disciples) heated up in the “Anti-Aging” domain with publications like (and see overall review by John Vincent, in Ageing & Society, 2003):

And so Harry Moody (among others) also took the concept and the shock value of the Estes article (again – in a positive manner) to examine the “new” emerging enterprise related to the domain of “anti-aging” with his publication in Generations – Winter 2004-05, “Silver Industries and the New Aging Enterprise,” (and see also the 2008 publication – http://assets.aarp.org/www.aarp.org_/articles/research/AgingEnterprise.pdf
It was in this publication that we begin to examine more closely the metamorphosis of the enterprise as it shifted into areas beyond (primarily) the bureaucracies (“the aging network”) and into the domain of the private, fee-for-service, profit-driven world of “anti-aging” services and medicine.

Moody (2004/05) elaborated the connection this way:

“It is more than twenty-five years now since Carroll Estes published her influential book The Aging Enterprise (1979), in which she described, and also criticized, the evolution of an aging human-service sector supported by government funding. Her book and her critique came at a historical moment when the human-service approach to an older population had reached its peak.”

And here Moody builds the bridge of the “new enterprise” (or Revisited – again)

The rise of “anti-aging medicine” is just one case in point. I have put quotation marks around this entire domain because, scientifically speaking, there is no such thing as anti-aging medicine, since there are no interventions (apart from caloric reduction) that have been shown to increase maximum lifespan and slow the biological process of aging, at least in nonhuman organisms. But whatever science may say, as Helen Dennis has noted in her article earlier in this issue, anti-aging medicine is thriving. To cite only one (dismaying) statistic: there are more M.D.s who are members of the American Academy of Anti-Aging Medicine than there are members of the American Geriatrics Society. To be sure, there is a legitimate and very important debate about what regenerative medicine or “prolongevity” might mean in the future (Post & Binstock, 2004). But the emergence of anti-aging medicine is already an important lesson about the power of the marketplace in an aging society. Anti-aging products are brands based on ageism and age-denial.”

But not every one was seeing the same picture – or story – on (and in) the anti-aging battlefront. For example, there was a strong rebuttal in the Journal of Gerontology: BIOLOGICAL SCIENCES (ã The Gerontological Society of America) 2005, Vol. 60A, No. 2, 139–141, a letter to the editor from a Michael J. Rae (of the Calorie Restriction Society – and please note: co-author with Aubrey de Grey with Ending Aging book that was to be published later in 2007) accused the journal (Journal of Gerontology) of “excessive pessimism in the ‘anti-aging medicine sections” which had several articles (see June/July 2004) by prominent scholars on the topic (excerpted from the letter – not the complete letter below),

I was greatly disappointed by the overwhelmingly negative assessment of the prospects for intervening in the aging process presented in the recent special sections on anti-aging medicine in the Journal (Part I, June 2004; Part II, July 2004). I must respectfully take the Guest Editors to task for presenting the unduly one-sided survey of the issue. All of the Guest Editors of these special sections are engaged in an ongoing (and entirely admirable) public crusade against the charlatanry of current ‘‘anti-aging’’ medical quackery. One wonders, however, if, in the process of incessant debate, they have lost sight of the wider context in which their specific battles are immersed, and of the widespread optimism within the legitimate biogerontological community on the feasibility of genuine intervention in the human biological aging process…The unconscious bias in choice of contributors was doubtless further exacerbated by the large overlap between the authors of individual articles and the guest editorship of the issue itself…In Part II—devoted to evaluating specific avenues toward intervention in the aging process—the Editors chose to primarily present articles devoted to a facile critique of the foibles of the current pseudoscientific ‘‘anti-aging’’ marketplace. While it is important for the conclusions of these articles to reach the lay public, the readership of a gerontological journal is already quite aware that neither growth hormone injections nor vitamin C capsules retard biological aging; their inclusion does not contribute to our understanding of the issues…The apparent feasibility of this panel of interventions led the authors to the conclusion ‘‘that indefinite postponement of aging—which we term ‘engineered negligible senescence’— may be within sight.” One has yet to hear a cogent rejoinder to these proposals from the ‘‘anti-aging” skeptics. Such a debate would have genuinely advanced our understanding of the technical and theoretical prospects and pitfalls of ‘‘anti-aging medicine.’’

As you can see – there are points and counterpoints along this line and in other publications, letters, and reports there is tossing of verbal grenades from one side to other that carry labels such as: charlatan, quack, crusader, conservative, rogue, mainstream, maverick, traditionalist, and so on.

And the war still goes on. However, in all the smoke and haze of battle, I did find the book edited by Stephen G. Post and Robert H. Binstock (2004)

The Fountain of Youth: Cultural, Scientific, and Ethical Perspectives (Oxford University Press) to be an outstanding overview of the issues – including what I think is most critical section of the book: Ethical and Social Perspectives on Radical Life Extension. Yeah, finally! This should be required reading for everybody – including all of the cheer-leaders for “anti-aging medicine” and the public – the consumers and taxpayers.

Here is the overview of what the book addresses:

A wide variety of ambitions and measures to slow, stop, and reverse phenomena associated with aging have been part of human culture since early civilization. From alchemy to cell injections to dietary supplements, the list of techniques aimed at altering the processes of aging continues to expand. Charlatans, quacks, and entrpreneurs proffering anti-aging products and practices have always exploited uniformed customers and instilled doubt and apprehension toward practices intended to extend life. Recently, however, the pursuit of longevity has developed into a respectable scientific activity. Many biologists are substantially funded by the government and the private sector to conduct research that they believe will lead to effective anti-aging interventions. While many embrace this quest for “prolongevity”–extended youth and long life–others fear its consequences. If effective anti-aging interventions were achieved, they would likely bring about profound alterations in the experiences of individual and collective life. What if aging could be decelerated to the extent that both average life expectancy and maximum life span would increase by forty percent? What if all humans could live to be centenarians, free of the chronic diseases and disabilities now commonly associated with old age? What if modern scientists could find the modern equivalent to the Fountain of Youth that Ponce de Leon sought?

Again, it is the - what if? - that concerns me the most; that is, the philosophical underpinnings of the why and the what for and the so what of this topic. I do not question the sincerity and the integrity of scientists like Aubrey de Grey (in fact, his book was indicated as the Rogue Scholarship on Aging book of the year) rather I want to hear more either from him (but I doubt we will get it) or his colleagues about the Ethical and Social Perspectives on Radical Life Extension. When I had the opportunity to hear Aubrey de Grey deliver his talk on his new book (at that time) at the University of Utah, I was delighted to see the roguishness of his approach, but he completely danced around the question from the audience about the “other side of the coin” – “the double-edged sword” of reversing aging in our lifetime. In essence, I remember something (de Grey’s answer) to the effect: that is not my concern, I leave that to others.

The battle for hearts, minds, and souls in this war continued as Courtney Everts Mykytyn published the article, “Anti-aging medicine: A patient/practitioner movement to redefine aging”, in Social Science & Medicine (62), 643-653 who shared with us that, “…with dramatic embrace of future biotechnologies and disdain for current medical treatments of old age, anti-aging practitioners embrace a scientific revolutionary identity.” (emphasis mine) – Revolutionary – ah sounds like the next step >> Aging Enterprise Revolution! But actually, I envision the aging enterprise revolution to cut both ways, more on that later on. Mykytyn (2006) offers a more sympathetic viewpoint to those who are dedicated to anti-aging medicine (based on her interviews of the anti-aging practitioners) which counters the notion that they are cold, calculating, reductionistic, and profiteers,

“While the mission of anti-aging medicine involves treating aging biomedicoscientifically, involvement stories reveal that the anti-aging movement is based more than abolishing or retarding aging. Anti-aging medicine is grounded in a desire to use one’s skills as a health care practitioner toward curtailing suffering seen in aging, a distaste for current biomedical practice, and an identity in the revolutionary is hero. The growing anti-aging movement, populated by patient-practitioners, challenges perceptions of aging and expects broad changes in the very near future of biomedicine” (p. 652).

In my opinion, we have left the RELOADED phase of this issue, and we have indeed entered into the REVOLUTION part of the sequence. Time for another red pill.

As I mentioned before, I think the revolution that is emerging due to the debate on ‘anti-aging’ issues is fruitful and represents a maturation of the discourse and dialogue. I think it began with the book by Post and Binstock, the work by Harry Moody, and then just recently with the special volume in the Journal of Aging Studies, 22, 2008. I encourage you the reader to follow-up with this refreshing example of scholarship on the topic of the anti-aging enterprise and the point at which we have arrived – which is the necessary cross-roads of the full spectrum and examination of (and pardon my Cajun French) – What the hell is going on in this enterprise?

Beginning with the editorial, “The anti-ageing enterprise: Science, knowledge, expertise, rhetoric and values” by John A. Vincent, Emmanuelle Tulle, and John Bond (2008) they offer this perspective:

a priori

Wow, how refreshing and exactly what we need – now. The guest editors then go on to state their case for the necessity of the special volume on this topic:

As editors we are ultimately concerned that, in its naturalisation of old age as a problematic biological process which can only be overcome by biology, the anti-ageing enterprise masks very important social and cultural issues which have hitherto been under-explored:

• Existential issues, ones that question the fundamental nature of the human condition. These questions include: What is old age? What is the purpose of life, and its different stages? Is life always preferable to death — is immortality desirable?

• Issues of ageism and the cultural, social and political status of older people. Should old age be considered a valued part of the life course or something to be abolished as soon as practicable?

• Issues which stem from the current advances in biology and bio-gerontology. What is biological ageing? Is it a single process or a variety of different processes? These issues are sometimes debated around the question of whether ageing should be considered to be a disease. What are the consequences of treating ageing as a disease? What are the priorities for research — fundamental biology or disease control?

• To what extent is a biological or medical model of old age an appropriate basis for policies for older people? Are there alternative models perhaps akin to the social model of disability that we should adopt and thus aspire to a more elder friendly society?

• Immediate personal issues, for example about lifestyle choices. What and how much should we eat? What exercise should we take? There are questions about preventive strategies of various kinds — what is effective in delaying the signs of ageing? What should the responsible consumer do in terms of living a satisfactory old age? How much should we demand that people regulate their behaviour and to what end?

The development of anti-ageing science and practice challenges us to consider how people should approach old age. Is it something to be avoided or something to be embraced? Is the anti-ageing enterprise part of the problem of ageism by prejudicially acting to segregate off old age and subject it to dissection, manipulation and control? Or, in contradistinction, should anti-ageing be considered as part of the resistance to ageism — as an effective way of overcoming the exclusion of the aged?

What is also at stake is the status of the body in our conceptions of valid and valued bodies and therefore personhood. Can old bodies be healthy? Can they retain cultural capital or is their ambiguity as both normal and pathological enough to deny old people any claim to a satisfactory sense of identity? Most of all we must ask whether the anti-ageing enterprise is the best way to combat ageism, to overcome the social and cultural exclusion of the old and to address the erosion of Welfare support (and its legitimation as the correct response to population ageing)

These questions are all the more urgent because in the last quarter of the twentieth century there have been activists and academics willing to challenge the ‘natural’ association of old age with illness and decline. A social movement developed in the 1980s and associated with Cambridge academic, Peter Laslett, the Third Age has sought to confront such assumptions. This social movement has attempted to create a positive image for old age as a period of personal development. While this movement has to some extent been successful in establishing the idea of a new positive stage in life, it has failed to overthrow the dominant image of old age as one of illness and decline. The concept of the Third Age can be seen in some circumstances as an attempt to prolong youth, not necessarily to create a new attitude to old age as a life stage valuable in its own right. But it is clear that despite the success of parts of the re-evaluation/emancipation agenda, the dominant contemporary cultural attitude to later life is that of ‘anti-’; predominantly western culture seeks not to celebrate ageing but to avoid it.” (p. 292-293).

(above is from Vincent, Tulle, and Bond, 2008, The anti-ageing enterprise: Science, knowledge, expertise, rhetoric and values, Journal of Aging Studies, 22, 291-294).

longevity+revolution

Very well then – let the revolution begin and I hope that the enterprise that is carried out with the full realization of the symbolic, the language, and the social constructions that are used to convey the proximate and ultimate significance of the endeavors in this domain. I hope that the revolution is by both sides of the debate and that the revolution is actually the synthesis of the two – at some point. I hope the revolution is more about quality of life and less HOW LONG we can live.

But until then, it is the aging baby boomers who will have to carefully monitor this new revolution – the longevity revolution – that is underway. For some who would seek the quick buck, ultimate hedge fund, and a group that can be suckered into buying “a stairway to heaven” – the boomers would be that group. The cohort is like a largemouth bass waiting for a shiny silver spoon to pass by (with hooks of course – and what is the hook?) – and that lure is all the promise of growing younger, living longer, and all it will take is your contribution $$$$$$$

…remember The Beatles? Revolution ? ~

Okay, you get my point … Keep that red pill handy….

thanks, Scott D. Wright