New Yorkers have the highest life expectancy in the nation. Why? They smoke less, walk more, and have more friends and neighbors. And because of a bunch of other reasons. Guess it’s time to put those “urban health penalty” myths to rest.
The physical bodies that you’re using to sit on these chairs, for example, aren’t the ones that you walked in with a little while ago. Even with one breath you take in 10 to the power of 22 atoms. An astronomical amount of raw material that ends up as your heart, brain and kidney cells, your neurons, your DNA. With each breath you breathe out 10 to the power of 22 atoms. It’s an astronomical amount of raw materials that is coming from every bit of your body. You are literally breathing out bits and pieces of your brain tissue and heart and kidney. Actually, technically speaking, we are intimately sharing our organs with each other all the time.
If you do radioactive isotope studies which have been done very elegantly, you can prove beyond a shadow of doubt that you replace 98% of all the atoms in your body in less than one year. You make a new liver every 6 weeks, a new skin once a month, a new stomach lining every 5 days, a new skeleton – it seems so hard and solid, but the skeleton you have now you didn’t have three months ago. Even the brain cells that you think with as carbon, hydrogen, nitrogen and oxygen, as those basic elements, they weren’t there one year ago. And the DNA that holds memories of millions of years of evolutionary time, in fact hundreds of millions of years; the actual raw material of it comes and goes every six weeks. Those atoms drift in and out like migratory birds every six weeks.
And if you want to be a real stickler about it and account for the last atom and every little sinew and collagen and cartilage, then in less than two and a half years you replace every atom in your body down to the last single atom. So if you think you are your material body then you certainly have a dilemma. Which one are you talking about? The 1991 model is not the same as the 1990 model or even the one from a few months ago.
Photo by me.
EMA. Breakfast. One of my favorite albums of the year.
This assumption—that understanding a system’s constituent parts means we also understand the causes within the system—is not limited to the pharmaceutical industry or even to biology. It defines modern science. In general, we believe that the so-called problem of causation can be cured by more information, by our ceaseless accumulation of facts. Scientists refer to this process as reductionism. By breaking down a process, we can see how everything fits together; the complex mystery is distilled into a list of ingredients. And so the question of cholesterol—what is its relationship to heart disease?—becomes a predictable loop of proteins tweaking proteins, acronyms altering one another. Modern medicine is particularly reliant on this approach. Every year, nearly $100 billion is invested in biomedical research in the US, all of it aimed at teasing apart the invisible bits of the body. We assume that these new details will finally reveal the causes of illness, pinning our maladies on small molecules and errant snippets of DNA. Once we find the cause, of course, we can begin working on a cure.
The problem with this assumption, however, is that causes are a strange kind of knowledge. This was first pointed out by David Hume, the 18th-century Scottish philosopher. Hume realized that, although people talk about causes as if they are real facts—tangible things that can be discovered—they’re actually not at all factual. Instead, Hume said, every cause is just a slippery story, a catchy conjecture, a “lively conception produced by habit.” When an apple falls from a tree, the cause is obvious: gravity. Hume’s skeptical insight was that we don’t see gravity—we see only an object tugged toward the earth. We look at X and then at Y, and invent a story about what happened in between. We can measure facts, but a cause is not a fact—it’s a fiction that helps us make sense of facts.
I know I’ve debated with Jay before but if you know me, you know I think debate can be a healthy part of constructive discourse. I also think he’s doing something really important: He does SOMETHING.
Next month, we’ll be launching a new company, Sherpaa. I’m looking for a medical student who wants to learn a few things about starting a health company. You must be:
Send me an email if you’re interested. Let’s talk.
UPDATE: I found a really great intern. Thank you for reading and for those who were interested. If not now, maybe we can work together in the future.
I spoke at Stanford a few months ago and one of the speaker’s gifts was sitting for a daguerreotype portrait.