Medicine for the
Long Game

For more than 30 years I've tried to make sense of "anti-aging medicine" — to make connections between the flood of scientific advances and what I can actually recommend to my patients. I've watched fads come and go: telomeres, hormone replacement, supplements, rapamycin, resveratrol, stem cells and the rest. Each one excited me with its possibilities and then, one after another, disappointed me when it didn't live up to its promise.

Curious about why this was happening, I decided to slow down and really examine the basic science of aging — system by system, and what can currently be done about each one. What quickly became clear was that every organ ages differently, and that the weakest link matters most: you are only as young as your oldest part. A young brain in an old body — think of Stephen Hawking — is no one's idea of a solution, and neither is a failing mind in a fit, healthy body.

Out of that came the tools I now build my practice around. The first is the Athena Textbook of Longevity, an in-depth, rigorous scientific look at aging for each of the body's systems — a framework for evaluating new treatments and predicting their expected benefit (or lack thereof). The textbook is meant for professionals; I have also made the information more accessible through the Rebellious Aging Podcasts and Rebellious Aging Guidebooks, and am now working to make the textbook information even more accessible through an AI interface.

The second tool is the Japanese Ningen Dock concept of regular tune-ups — similar to the 5,000-mile service of a car — designed to keep the body in peak condition. It's better to detect and correct problems while they are easy to fix. This pairs nicely with our Overflowing Buckets Model, which gives highest priority to the lowest-cost / highest-benefit treatments, and matches higher-cost, experimental treatments to each patient's financial and health goals.