Merchants of Immortality

Mariner Books

Excerpt

Prologue
The Never-Ending Life

Several years ago, while spending a weekend in the country with my family,
I stepped out onto the porch of the cabin where we were staying one night
and looked up into the sky. It was unusually clear for a summer night in the
Catskills, and every familiar jot and scrawl of the firmament was writ large—
the Polestar, Little Bear, filaments of the Milky Way strewn like pulled
cotton right down the middle of the dome, the entire landscape "apparelled in
celestial light," as Wordsworth put it in his "Ode: Intimations of Immortality."
A field of tall grass and wildflowers sloped down from the porch, and
hundreds of fireflies blinked on and off in the middle distance, so that the
line where our earthly, mortal light yielded to the celestial became beautifully
blurred in the darkness. As I stood at the rail, I could hear the uniquely
peaceful sound of untroubled sleep behind me in the cabin— my wife and
two children. I scanned the dark sky for a shooting star. I even had a wish
ready.
Since I didn"t happen to see a shooting star that night, I don"t
think it will betray any cosmic confidences to reveal what my wish would
have been, especially since it was so predictable. I wished for long, healthy,
productive lives for my family, especially my children. In doing so, I know I
was indulging a desire as ancient as our fascination with the heavens, a
longing as timeless and fierce as the biological instinct to protect one"s
brood. A desire so old, in fact, that it is not only about nature, but a part of
human nature, at least for the only species of life on earth known to be
aware of its own mortality. And as an amateur student of aging, I also knew,
as I stood at that porch rail, that my Darwinian warranty was about to run out.
In strictly evolutionary terms, I"d just about outlived my biological usefulness
to the species and would not much longer enjoy the built-in genetic
protections crafted by eons of natural selection. Indeed, those two cherubs
sleeping inside were the agents of my inevitable demise. Evolution protected
me long enough for me (and my wife) to have children, but became
biologically (and, in a sense, lethally) indifferent to us once we reached a
certain age. From paramecia to primates, from the single-celled denizens of
pond scum to poet laureates, natural selection stops caring about us once
we have lived long enough to reproduce. Evolution in that sense is a strange
ship: it moves ever forward through dark waters, keeping the species alive,
even as it throws each and every member of the species overboard. I was
nearing fifty years of age. My primary care physician had retired and I"d been
forced to switch to a new doctor. His name—no joke—was Dr. Faust. And so
this midsummer night"s wish of mine, stripped of its conflicted humility and
its faux altruism, revealed itself to be transparently self-referential. And here
I"m tempted to add "like most of the wishes of my generation." Because what
I was really saying was: Let us all live a long time, we"re not quite ready
to . . . to . . . I couldn"t bring myself to utter the D word, even in a
conversation with myself. I was content to reiterate the ancient ritual of
submitting a time-honored petition to indifferent gods on dark, starry nights.
In the same way, I feel that an entire generation—a generation
new to mortality, you might say—has been poised to file that same petition
as a kind of generational class-action suit against the laws of nature. Many
of us have been similarly poised at the railing of middle age, in the twilight of
something more permanent than a summer night, launching that same
fervent petition on behalf of our parents, our children, and, of course,
ourselves. I am speaking in part of the baby boomers, 75 million strong in
the United States alone, as well as our similarly entitled post–World War II
siblings spread throughout the developed world. This is a generation, it goes
without saying, that thinks of its petitions as somewhat special, a
generation that is perhaps a little more insistent about answered prayers.
Or so it appears superficially. If you think beyond the
demographic clichés, however, it"s hard to believe with much conviction that
the baby boomers are any more concerned about their mortality than
previous generations and previous cultures. Can we possibly experience
more feral emotions than the hunters and gatherers of 10,000 years ago,
whose very mortality attached to the success of finding their next meal? Can
we summon more urban angst than the average citizen of ancient Rome, who
could expect to live only about twenty or twenty-five years? Can we
honestly argue that we feel a more exalted fear of death than the soldiers of
the greatest generation, teenage boys like my father, huddled in foxholes,
dodging bullets? I have a hard time convincing myself that this is so. What
makes this particular moment so unusual in the age-old posting of these
timeless wishes is that they might actually be answered in an altogether
different way, with altogether unexpected consequences, in the not-too-
distant future. Perhaps I was looking in the wrong place for my shooting
star, because in a sense the truly meteoric agency capable of delivering on
these wishes may be found not in the world of cosmology but biology; the
high priests of our secular age, the molecular biologists, have begun to
address mortality in a way no group, no generation, and no society has ever
dreamed of before.
They may not succeed, of course, and the purpose of this book is
not to conflate promising science with the wishful thinking of an entire
generation. It is enough to note that in the last decade the most skilled,
ambitious, and indeed arrogant of our sciences has lined up to tackle
the "problem" of aging (and its faithful sidekick, death) in a way
fundamentally different from that of any previous era of medical intervention.
This is happening at the very same time that an enormous demographic
bulge in our population is burying parents and picking out gray hairs in the
mirror. If nothing else, these trends make for a fascinating convergence of
social desire and scientific ambition; of deeply personal psychological needs
(and fears) and the shamelessly public promissory notes that issue from the
lips of biologists, businesspeople, and other incurable optimists; of the
inevitable decline of the human body (or soma) and the almost alchemical,
regenerative capabilities of bland cells in plastic dishes; of the highest
intellectual aspiration for basic knowledge that contemporary civilization can
muster, alongside the most common and infinite capacity for greed and
personal advantage that has ever sullied the name of human nature. Looking
at this intersection from one perspective, nothing less is at stake than a
partial or nearly total repeal of mortality; from another perspective, we might
be witnessing a postmodern, molecular version of the Fountain of Youth tale,
a spectacle of promise and hubris and failure that will make the Ponce de
León story look like bad summer stock.
Medicine, especially in the last century, has consistently helped
prolong life (or, if you prefer, forestall death), to the point where more people
Prologue 3 in developed societies are living to a greater age than ever before
in human history. Because we"ve done such a spectacular job of minimizing
the agents of premature death—diseases, accidents, poor hygiene, injuries,
not to mention predation, starvation, and exposure—we are living so long
that aging itself has only recently emerged as a subdiscipline of medicine. In
a sense, we didn"t even know aging existed as a biological phenomenon until
we started living well beyond reproductive age, which is really all that
evolution is interested in protecting. Now that we know aging exists as a
separate, degradative phenomenon, and are beginning to understand it, we
naturally want to see if we can tinker with the process. That is what we do,
and that is what I have set out here to chronicle: an account of some of the
people who have begun to revolutionize medicine"s assault on aging, and
the type of science they are doing. Inevitably, my encounters have also led to
a cultural contemplation of what it might mean to us, as individuals and as a
society, to repeal, even partially, the laws of mortality.
For most of the recorded past, humans could expect to live on
average about twenty years (although that number is deceptively low
because of the high incidence of infant and childhood mortality). A century
ago, Americans born in 1900 could expect to live roughly forty-nine years.
Some lived longer, of course, but many still perished at a very young age.
Civilization —in the form of antiseptic medicine, sanitation and public
hygiene, vaccination and other measures—has dramatically increased the
amount of time we can expect to spend on earth. Indeed, as a prominent
gerontologist, Leonard Hayflick, puts it, "Aging is an artifact of civilization."

Some of these thoughts were on my mind on a sunny day in December
2000, when I headed north from San Francisco in a rented car. It was a
professional pilgrimage, in that I was setting out to talk to Hayflick, a
scientist well known within the biological community (indeed, almost
infamous) and yet virtually unknown outside it. In 1961, Hayflick achieved a
rarely attained degree of academic celebrity when he discovered that
normal human cells grown in the laboratory have a finite lifetime—that is,
they are programmed to divide a more-or-less fixed number of times (known
now as the "Hayflick limit") and then simply stop replicating and senesce.
Senescence is a word groaning with metaphoric throw weight in the context
of human gerontology; cellular senescence begins a process of biological
lassitude and decay that ultimately leads to cell death. Hayflick"s discovery
brought together a powerful mix of scientific interests: aging, life span, the
biology of cells, immortality. It put the biology of aging—and therefore the
biology of life and death—squarely in the crosshairs of the biologist"s
microscope.
Hayflick had sent me meticulous instructions on how to reach his
home—a map marked with arrows, annotated directions of key crossroads,
even aesthetic admonishments ("Go slow on Highway 1 for safety and to
observe the beauty! Careful around blind curves . . ."). As I headed north on
Highway 101 and cut across Mendocino County toward the Pacific Ocean,
it was hard not to notice the everyday auguries of aging and mortality that
color the way in which we view the world, even from a car window. Outside
Guerneville, the road curved past—deferred to, actually —a number of
towering redwoods crowding the asphalt. Some of those massive and long-
lived creatures have lorded over this landscape for centuries (and yet they
represent a lesson in complexity and paradox as well as longevity, for as
Hayflick has pointed out in one of his books, only a tiny fraction of their
cells are actually alive, the rest inanimate pulp). At another point, within
spitting distance of the Russian River, several birds that I took to be
buzzards—high-shouldered, glowering gatekeepers of the afterlife —perched
on a wire, waiting, their patience seemingly informed by the knowledge that
they never have to wait too long. Even when you weren"t exactly looking for
them, the signs and symbols of life and death were everywhere, just as they
are every waking day, gentle but persistent reminders that mostly blend into
the background of our busy days.
That"s what made this a personal pilgrimage, too. At the time, I
had just turned forty-nine and was about to trip an important threshold on
my own actuarial odometer. My parents, both in their seventies, were alive
and in reasonably good health. I had a daughter who had just turned five, a
son soon to turn three. Those little details would normally be irrelevant
intrusions in a scientific narrative; in this one, however, they form a kind of
background matte to the portrait of science that occupies the foreground. It is
our children, especially, whose lives may well be altered by this new science.
Even without being crassly self-interested, it is impossible not to think
about the science possibly to come in very personal terms.
In conversations with Hayflick and other scientists over the next
few days and in subsequent months, I heard outlined, in sketchy but
tantalizing Prologue 5 detail, a medical future so bold in its ambitions, so
profound in its potential impact, that if even a tenth of the promises pan out,
it will fundamentally change how we think about life and what it means to be
human. There was talk of genes that, when properly manipulated, might
significantly extend life span. There was talk of stem cell therapy, a
celebrated new technology that holds the hope of replacing aging or failing
or diseased organs and other body parts. I even talked to several people
whose cells were being used to clone them, in an attempt to create a short-
lived, utilitarian embryo that could be harvested for stem cells and, perhaps,
immunologically compatible cells and organs. In almost every instance, a
biotechnology company had been formed, or was in the works, with dreams
of commercializing a technology that would extend life or regenerate human
tissues and cells. Indeed, the catchphrase of the day was "regenerative
medicine," referring to a discipline that had its own meetings, its own
funding and supportive foundations, its own ambitious agenda, and its own
little swarm of bioethicists and journalists flitting around like gnats, trying to
figure out what was going on and what it all meant. And it was happening
very fast: on the ride to Hayflick"s home, the news on the radio had been
dominated by the still-unresolved Florida vote count in the 2000 presidential
election. I think it is safe to say that no one, during those weeks of
uncertainty, could have predicted that the new president"s first major
televised address to the nation would focus on, of all things, embryonic stem
cells.<



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Excerpted from Merchants of Immortalityby Stephen S. Hall Copyright © 2005 by Stephen S. Hall. Excerpted by permission.
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