Can you live forever? Two experts argue immortality

Itās a Friday morning and they enter the cafe. Bortz appears first: tall, lean, tanned, in a white polo shirt and brown sport coat, with a shock of white hair. Three months ago, Bortz participated in his 10th Boston Marathon, and 43rd marathon overall. He is 83.
De Grey, 50, materialises next. He looks like some sort of steampunk shaman: long russet-gray hair, pulled back in a ponytail; equally long beard, with a footlong mustache to match; lavender striped shirt unbuttoned past his sternum; dark jeans; and what appear to be black Dr Martens boots. De Grey is six feet, 150 pounds or so. Wraithlike. He has saved us a table near the window.
Bortz and de Grey have never met before, but they have a lot to talk about. Iāve asked them to come to the Tied House today ā de Grey from eight streets away, where his Sens (Strategies for Engineered Negligible Senescence) Research Foundation is headquartered; Bortz from nearby Stanford, where he teaches medicine, to discuss a subject that has obsessed both of them for decades: the process of aging, and how it may change in the decades ahead.
Questions about the future of aging have been in the air lately. Are humans on the cusp of living to 120, 130, or more? What will aging look like in this new world of longevity? Will we just be adding 30, 40, 50 years to the end of life, or can we delay the process and lead normal lives to such advanced ages? Is 100 the new 60?
In 2012, the John Templeton Foundation awarded UC-Riverside philosopher John Martin Fischer $5m (ā¬3.7m) to study immortality, and in May, Fischer announced that nearly half of that money would be going to 10 scientificresearch teams from the United States and Europe.
Earlier this year, Prudential Insurance launched a new ad campaign centreed on a simple prediction: āThe First Person to Live to 150 Is Alive Today.ā And in June, two rivals for the title of the worldās oldest person-Japanās Jiroemon Kimura, who, at 116, was the longest-living man ever verified, and Chinaās Luo Meizhen, who claimed to be 127, died within days of each other.
Neither Bortz nor de Grey is a stranger to publicity. A former co-chairman of the American Medical Associationās Task Force on Aging and past president of the American Geriatrics Society, Bortz, a physician by training, is one of Americaās foremost experts on robust aging, having published more than 150 scientific articles on the subject. His āthesis,ā as he calls it, is that exercise is the key to extending the human life span. āWe know enough to live 100 healthy years,ā Bortz says, ābut we screw it up.ā
De Grey has been a favourite subject for journalists since the early 2000s. As an undergraduate at Cambridge, he studied computer science; his speciality was artificial intelligence. But soon after graduation, he met and married Adelaide Carpenter, a Cambridge fruit-fly geneticist 19 years his senior, took over the genetics departmentās drosophila database, and immersed himself in the biology of aging. In 1999, de Grey published The Mitochondrial Free Radical Theory of Aging; a year later, Cambridge awarded him a Ph.D.
De Greyās new theories were grand. He believed that by dividing the diseases of old age into seven categories of cellular and molecular damage, and then by working to conquer each category through as-yet-undeveloped medical technologies, it would be possible to ācureā aging ā not to stop it, or to slow it, but to repair and reverse it, the way one would restore an aging automobile, and to live indefinitely as a result.
In 2000, de Grey co-founded the Methuselah Foundation, which awarded multimillion-euro grants to scientists who extended the healthy life span of mice, and in 2009, the organization evolved into Sens, a nonprofit that sponsors and funds scientific rejuvenation research. Its major benefactor is Peter Thiel, the billionaire founder of PayPal.
Despite equally high profiles, however, Bortz and de Grey come from different sides of the scientific tracks. Bortz is a man of medicine; de Grey is a man of ideas. For years, scientists have been wary of jousting with de Grey. āI prefer not to be involved with Aubrey de Grey,ā one told me. āMy policy is to stick closely to the science.ā What he does and what we do are different, others say. We rely on the scientific method. He is merely making predictions.
De Grey admits as much. āI say people who are alive today are going to be able to live indefinitely because this technology is foreseeable, and people respond that thereās no scientific evidence available for that,ā he says. āWell, of course fucking not. Itās technology. Itās not science. Technology isnāt like that. You have to make these leaps of faith, but you also have to have some idea how realistic those leaps of faith are, and you have to say so or else no oneās going to be interested. No oneās going to be enthusiastic. And no oneās going to pay for the research to get there.ā
In other words, de Grey sees himself less as a scientist than as an activist bent on expanding the horizons of aging R&D. And not all experts think heās nuts. In 2005, the MIT Technology Review offered $20,000 to any molecular biologist who could demonstrate that de Greyās plan for curing aging was āso wrong that it was unworthy of learned debate.ā
The judges, who included Nathan Myhrvold, former chief technology officer of Microsoft, and J. Craig Venter, who shares credit for first sequencing the human genome, found that ānone of the ārefutationsā succeeded,ā as Myhrvold later told The Washington Post.
ā[They] were either ad hominem attacks on de Grey, or arguments that his ideas would never work (which might be right, but that is what experiments are for), or arguments that portions of de Greyās work rested on other peopleās ideas. None of these refute the possibility that he is at least partially correct.ā
At first Bortz was reluctant to engage with de Grey, too. But after reading about de Greyās ideas, he sent me an email. āVery interesting,ā Bortz said. āWill study.ā
Itās now a few weeks later, and Bortz and de Grey are settling into their seats at the Tied House. Both order the tandoori pork kabobs; de Grey requests a pint of dark beer. I have dozens of questions. Is Bortzās version of the future of aging-exercise a lot, live to 100-enough? Or should we be looking beyond it as well, to de Greyās?
Then again, is de Greyās future even attainable? Or is it just a fanciful theory, unworthy of the time, energy, and money it would take to get even a fraction of the way there? Below is an edited version of our conversation.
My inspiration for this story is seeing an ad which said āThe first person to live to 150 is alive today. What is your reaction to it?
I didnāt believe it. Maybe a couple thousand years from now it might happen. One of my reference points is the International Supercentenarian Registry. Itās a list of people who are 110 or older. We know there are about 80 supercentenarians out there. And my take-home from seeing photos of them recently was this: you donāt want to be a supercentenarian.
What was your reaction to the billboard, Aubrey?
My reaction was the exact opposite of Walterās. I predict that the first person to live to 150 is probably already in middle age, and that most people who are in their 20s now will probably live to at least that old. But the reason I say that is only because of the specifics of the type of biomedical technology that I think is going to come along.
What kind of biomedical technology are we talking about?
The work we do at the Sens Foundation is all about regenerative medicine. Itās not about slowing down aging at all, but bona-fidely reversing aging-repairing the accumulation of molecular and cellular damage that builds up throughout life, as a side effect of the bodyās normal operation, and eventually kills us.
Now, if we can do that fairly comprehensively ā and it has to be comprehensive, because if we only do half of it, the other half kills us anyway ā then itās not just people who are born at that time who are going to benefit. Itās people who are already in middle age or older who are going to benefit.
Someone who is in their 30s right now, theyāll be in their 60s 30 years from now. I think we have a good chance at being able to repair them so well, rejuvenate them so well, that we will be able to take them back to being biologically 30 or 40. And to do that repeatedly so that people can stay genuinely youthful for a lot longer... health is the main risk factor for death, so if we can keep people youthful and healthy, then weāre going to stop them dying.
So in your vision, Aubrey, the future of aging is that we donāt age at all ā that we donāt spend an increasingly long time as old people, but rather that we reverse the process before we ever get āoldā in the first place.
Correct.
Why do we age?
In broad terms, the accumulation of damage happens because there are gaps in the inbuilt self-repair machinery the body has. When one animal lives longer than another, it is simply because their automatic self-repair machinery is more comprehensive-the gaps are smaller, if you like. So less damage accumulates, or the damage accumulates more slowly.
Itās really just the same way we see aging in any simple man-made machine. Machines with moving parts do tend to accumulate various types of damage. Initially itās harmless, whether itās rust on a car or whatever. That damage eventually makes the doors fall off.
Walter, do you agree with Aubreyās definition of aging?
My definition of aging is broader in that itās not just human-driven. Itās universal. Everything in the universe ages. To me, aging is the effect of an energy flow on matter over time. That is not confined to life. Itās inorganic as well as organic. It takes in canyons and Chevys and everything.
Whatās the longest a person can live, as far as we know? Whatās the outer limit?
Madame Calment ā I believe there is a consensus ā was the oldest person on record to be validated. She was almost 123 in Arles, France. Thatās as old as we know. Itās possible that there have been older people, but most experts have said itās unlikely.
And what about the average person? How long can most of us expect to live today?
My first book title was We Live Too Short and Die Too Long. I want to go full bore and get it over with. The way you do that is keep your foot down on the pedal of life. And keep your RPMs at a certain level. Iāve described what I call a metabolic field that has metrics āit has parameters to it.
And there is this range of optimality. If you go too fast, thatās stress. But thereās frailty: the result of ineffective, insufficient energetic stimulus. Stay in between those two extremes. The golden mean. I think that gets us to 100. After 100, itās negotiable. Maybe we can go on to 120. But I still think the average human life span is energetically ordained around 100.
Why 100? Why that number?
I think that came down genetically. Thatās what we were given. Itās a measure of use and disuse, repair and disrepair. One hundred is a legitimate medical goal based on what we have now. We know enough to live 100 healthy years, but we screw it up.
Aubrey, do you agree?
Iām basically in agreement with that. Iām perhaps not quite so optimistic as Walter about what the average person can do today. Iād probably put it in the early 90s as opposed to 100.
What I am absolutely sure of is that, with current medicine, no one is going to live much longer than 120. Jeanne Calment died in 1997. Nobody has beaten her in 15 years. The runner-up was three years behind. 119. And that was only a couple of years after Jeanne Calment herself. At the moment, the oldest person is 116, I think. This is particularly remarkable because the number of living people over 110 ā the number of validated supercentenarians ā has basically not changed over the last decade. Itās stayed around 80, as Walter said. And yet the number of centenarians has rocketed by a big factor. Itās a paradox.
Why has the number of supercentenarians stalled out around 80?
Between 100 and 110 years old, some kind of wall of death is hitting people who have everything going right for them. Itās different in different countries. Different diseases hit at different times. Different diseases become prevalent depending on diet and culture, and also prosperity. But thereās definitely a phenomenon there.
Weāre basically bumping up against the current limits of the human life span. But whatās next for aging? What do you expect to happen in the short term ā over the next 10 or 20 years?
I would say over the next 10 or 20 years, itās highly likely that the increase in average life expectancy that weāve seen ā and thatās been going up by a couple of years each decade for quite a long time now ā thatās actually going to level off.
It may even go down.
Why?
Because of increasing obesity and diabetes.
Thatās true. Either way, the gains achieved by simply improving peopleās prosperity, improving peopleās nutrition early in life, ending infant mortality, and so on, have pretty much been made already, and therefore people who are dying 10 years from now will have had pretty much the same early-life health as the people who are dying today, so they will die at pretty much the same age.
Is there anything we can we do, in the short term, to live longer?
Change behaviour. Exercise is the current anti-aging process. The most powerful thing we can do today is to get people to take a walk. How do you do that? Thatās the frontier.
At the moment, there is far too much emphasis on treatment and far too little on prevention. The psychology of addressing aging now revolves around waiting until people are already sick and then doing your best to fix them up for as long as you can ā which isnāt very long. Itās pathetic.
So what is your vision for aging after, say, 2033 or so?
I believe that, based on what we can already do, and on the research that is going on both in our labs and elsewhere, that within 25 years we have a good chance ā maybe a 50/50 chance ā of developing therapies that are good enough that they can really be called comprehensive.
The wonderful thing about aging is that it doesnāt actually matter until you get into middle age. In other words, the body is made up to tolerate certain amounts of these various types of damage. So if you can fix most of the damage, so long as you can fix most of every type of damage ...
You buy yourself more time to address the rest.
Thatās right.
What makes you so confident that your goal is achievable in a few decades?
Ultimately how far away you think some future event is in technological progress depends critically on how much we still have to do. And to know how much weāve yet to do, you have to know the literature. This is what I do. I spend all my time hanging out with the scientists at the cutting edge of all of the various disciplines that I have brought together under the umbrella of Sens. Even those scientists are more pessimistic than me. But not about their own components.
Itās the 2030s. Iām in my 50s. What does my life look like, in your vision of the future of aging?
You look and feel and function just like you do today.
How?
Because of regenerative therapies. Essentially, what I want to do is put Walter out of business. I want to make sure that we donāt have what we have today, namely the moral and financial and, you know, health obligation to behave in a particular way in order to stay healthy, because weāll stay healthy anyway. And the reason weāll stay healthy anyway is because therapies will exist at a totally affordable price that will compensate for anything that today would be bad for you.
So I wake up one morning, and I notice I canāt see as well ...
That wonāt happen. You will be going into a clinic and getting a bunch of stuff that you donāt understand that keeps you healthy.
And when will that start? At what age will I begin doing that? I have to exhibit some signs of aging ...
No you donāt. You just have to be sufficiently close enough to the age at which you might start exhibiting signs. So I would say 40, 50.
And these treatments are doing what to me?
Restoring the molecular structure and the composition of your body to how it was at a younger chronological age. There are stem-cell therapies that are putting cells back into organs that are losing cells. There are enzyme therapies that are removing molecular garbage from inside the cells that would naturally accumulate garbage. There are immune therapies that are removing garbage from the space between your cells. There are pharmaceuticals that are breaking down the chemical linkages that are stiffening your arteries. This is all stuff that scientists are working on today, and that I believe is possible to achieve within a few decades.
Give me a specific example.
Take molecular rubbish in the cell. The problem here is that weāve got really versatile rubbish-destruction machinery, but itās not completely, 100% versatile. There is some stuff it canāt break down. So what weāve been doing is actually looking for bacteria in the environment that can break down substances in the body that cause age-related ill health. And weāve found that itās rather easy to discover such bacteria. What we do then is find the genes and enzymes those bacteria have that allow them to actually destroy the substance, and we incorporate those genes and enzymes into human cells so as to augment the destruction machinery of the cells.
When we can do this, we will have a therapy that can truly eliminate cardiovascular disease. No one will need to get heart attacks and strokes anymore, because we will be able to stop fatty deposits from accumulating in the arteries.
How often would I get these treatments?
Thatās something we canāt really predict. Of course theyād always have to be applied periodically; you could never do it just once and become nonaging any more than a machine could. But itās probably going to vary from one therapy to another. Therapies that are very invasive-therapies that involve surgery to replace a whole organ ā you might only have to do every 20 years. And I would certainly hope that we wouldnāt need any therapies like that once the whole panel of interventions had become reasonably mature. An intervention that involves stem cells or the injection of genes for gene therapy āyou might have to do something like that every 10 years.
And I could imagine that some of these therapies might get to the point of not even being injections. They might be orally administered. And for things like that there seems to be no reason why, in principle, they couldnāt be applied once a month.
So I would keep reversing the signs of my own aging when it becomes troublesome and returning to the age of 25?
Exactly. When you think about it, itās obvious, really. If we have sufficiently comprehensive ability to do this repair and maintenance, then why shouldnāt it work?
Would people have to stop having children?
Not necessarily. There are other causes of death, first of all. Not just aging.
What about overpopulation?
We know that fertility rates are coming down all the time. Whenever a country reaches a certain level of emancipation and education of women, then we get this plummeting fertility rate. So thatās good. Then women are going to keep having their children later and later, and when we donāt have menopause anymore, theyāll have them later still. Possibly the most important factor is that the carrying capacity of the planet keeps increasing as a result of other technologies. So the big thing thatās going to happen fairly soon is that weāre not going to use so much fossil fuels because weāll have better renewable energy and nuclear fusion and so on.
I have to admit: my first reaction is to imagine some sort of science-fiction dystopia.
But why are you imagining that? Youāve seen too many films. I think that it is really tragic that people have such a knee-jerk tendency to presume that the defeat of the thing that kills two thirds of all people is actually going to do more harm than good. Itās outrageous, really.
The reason why we want to live a long time is not to live a long time. Itās that we want to not get Alzheimerās. Do you want to get Alzheimerās?
Not particularly.
All right. Do you think thereās some age at which you will want to get Alzheimerās?
Probably not.
Exactly. Itās the same for cancer and other diseases. Thatās why itās so important for me to emphasise that any longevity benefits that we get out of this are just a side effect.
I want to bring Walter back into the conversation here. Walter, what is your response to all of this? Do you buy it?
I think itās the wrong target. If we have a finite amount of societal resources, I would rather put them into something that is tangible and knowable, like exercise. And Iām very worried about the catastrophe of complexity ā a situation in which there are so many variables. We thought cancer was this, this, and this. But cancer is just a total gamish of thousands of variables. So if youāre looking for a magic bullet, Aubrey, you need a huge shotgun. Because your target is way too big. You canāt know everything ābut you donāt have to know everything, just enough.
Walter is absolutely right. Thereās only so much you need to know to actually get results. The question is, how much do you need to know? Do we yet know enough? And the only way to find out is to try.
I think the human brain has a blockage. We think of things rather than events. Life is a verb. Itās not a noun. Thereās so much going on, and yet we are foreclosed to thinking, Iām going to get one answer to this problem. But the problem is incredibly complex and cosmic, and one thing affects another. There would be unforeseen consequences to meddling with our cells and genes.
So you think Aubreyās seven categories of damage ā and his belief that they can all be reversed ā is too reductive?
Life has been around for 4 billion years. I donāt see any immortality.
: But suppose you were wrong, Walter. Suppose there was even a little bit of chance that we could actually extend peopleās healthy, valuable, productive life by a long way. By giving this sort of message to people, what youāre doing is delaying that nirvana, right?
Iāve got no trouble with that.
But that means youāre costing lives. What youāre doing is youāre disincentivising the research that could save lives.
I know what the research says that will save lives right now.
Yes, but you donāt know enough about the research that might save lives in the future. This is exactly the same as the war on cancer. Back in the 1971, when president Nixon announced the war on cancer, he did that because, number one, scientists were actually saying if we have plenty of money we can cure cancer completely in 10 years. But he also announced the war on cancer because he thought that the public was ready for it. And sure enough it was true.
The critical thing to point out here is that even though progress against cancer has been far, far slower than it was predicted to be 40 years ago, thereās been no diminution of enthusiasm, no diminution of support, no diminution of money. Once the public gets the bit between its teeth, once politicians get the bit between their teeth, game over. Itās going to happen as fast as the science allows, however fast thatās going to be.
But what if your ideas are theoretically correct, and yet they are like being able to travel at the speed of light ā that is, a finish line we may never reach... progress on cancer has been much slower than predicted.
But itās been a hell of a lot faster than it would have been without the money.
But it doesnāt matter how fast progress is if you never arrive at your goal ā which, in this case, is a comprehensive set of regenerative therapies.
False. You are going to get there. Itās just a question of not knowing how soon. Now, I donāt care how soon. I donāt get out of bed in the morning because I want to save my own life, or your life, or Walterās life. I get out of bed in the morning because every day that I bring the defeat of aging forward is 100,000 lives that Iāve saved. And I donāt care which 100,000.
... how far in the future they may be.
Exactly.
Iām a prisoner of the serenity prayer. Change what you can. Accept what you must. And know the difference.
Aubrey, I get the sense that you disagree.
Iām not into accepting anything. My take is donāt be overoptimistic. Accept the difficulty of what you cannot yet change. But do not accept the impossibility of ever changing it.
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