The Lucky Years: How to Thrive in the Brave New World of Health (34 page)

Earlier I noted how we may have all the drugs we’ll ever need to prevent and fight disease. When it comes to statins, for example, it just may be that their effects on the body can address a surprising number of maladies, including infections as grave and fierce as Ebola.

More than ten years ago, doctors noted striking similarities between
people infected with the Ebola virus and those with bacterial sepsis, an uncontrolled bacterial infection in the blood. Both diseases involve a major dysfunction of the cells that line blood vessels throughout the body, which can lead to severe abnormalities in blood coagulation. The result can be weakness or failure of internal organs, primarily the liver and kidneys, and death is a real possibility. A similar event occurs in people with other types of acute critical illness, such as influenza and pneumonia.

Ebola has a high mortality rate, and especially since the outbreak that swept through Western Africa in 2014 and traveled to America via a few people infected with the virus, scientists have been on a hunt for effective treatments. And they’ve been thinking outside the box in their search for drugs that are relatively easy to access and inexpensive. Enter the possibility of statins, which are among the drugs that can modify or reverse the abnormalities of endothelial function and coagulation. A clinical trial published in the journal
Critical Care
in 2012 showed that early treatment of sepsis patients with a statin decreased the occurrence of organ failure by 83 percent.
²⁹
This is the same complication that often kills people who’ve contracted Ebola.

So could statins and other immunomodulatory drugs similarly prevent organ failure in Ebola patients and spare their lives? Future research will figure this out. While these drugs can’t prevent infection itself, if they can prevent potentially fatal complications like organ failure, they will likely be part of the treatment protocol until an effective preventive measure such as a vaccine against the virus can be developed.

Once again, this goes to show the power of what’s already in our arsenal. The Lucky Years are already here. And even though we’re entering a high-tech era of medicine, the same old ancient secrets to a good, long life are still relevant. Nothing will ever be able to substitute for things like sleep, sex, and touch—and perhaps gnawing on the bark of a willow tree.

All religions, arts, and sciences are branches of the same tree. All these aspirations are directed toward ennobling man’s life, lifting it from the sphere of mere physical existence, and leading the individual toward freedom.

—Albert Einstein

Medicine is a science of uncertainty and an art of probability.

—Sir William Osler

I
f a jeweler tried to sell you a diamond that looked fake, you’d probably find another jeweler because something in your gut would tell you to move on. If you’ve ever bought a car, you likely used your intuition at some point to know which one would be right for you, walking away from candidates you simply had bad feelings about. And if your doctor told you at your next appointment that you need major surgery to remove a mysterious lump in your side, you’d seek a second opinion as soon as possible—not because you don’t trust your doctor, but because your instinct says that’s the best thing to do, period.

Throughout this book, I’ve highlighted the value that technologies will bring to medicine. But along the way I’ve also underscored the power of insight that cannot be quantified by a device, app, medical test, or other technology. Most of us do have an inherent sense of what’s good for us, much in the same way we know the difference between right and wrong. I’m not one to use absolutes that much, but I’m absolutely sure that there will always be an element of art in the practice and execution of medicine no matter how techy we get. And as patients and consumers, we’ll also have to employ a little bit of artful intuition and science in our lives to benefit from any technology. I can’t reiterate the following enough: there’s nothing more powerful than the decidedly unscientific and unadulterated question from doctor to patient, “How do you feel?”

All the technology in the world can’t give you that answer; it must come from a part of you that’s untouchable. When I send patients home with a recommended strategy for their treatment plan, I don’t only want to be able to cure them, which isn’t possible in many cases. I want to make them feel better and live better. I also want them to be comfortable with the decisions they’re making about their health, decisions that stem from science but are couched within their value systems. After all, what matters in life anymore if we can’t feel good and secure?

In this final chapter, I’m going to touch upon a few notes that drive home important points for entering the Lucky Years. At the heart of this message will be the omnipotence of your own intuition and gut instinct as you venture into the Lucky Years. The achievement of wellness is an art, not a true science, that is practiced jointly by you and your physician.

In a widely referenced anecdote, a panel of art experts is brought together to sniff out phony works of art. They are invited into a room where ten or so paintings are on display, each allegedly the work of
the famous Renaissance artist Rembrandt—but some are by imitators. It takes these experts mere seconds to identify the fakes from the real ones. When asked how they can come to their conclusions so quickly, and what makes the forgeries so obviously counterfeit, they cannot articulate their reasoning other than to say something along the lines of “I just know” or “I can
see
it.” And it turns out that their hunches are accurate.

This phenomenon is the core theme in Malcolm Gladwell’s 2005 book
Blink: The Power of Thinking Without Thinking
,
¹
in which he writes:

We live in a world that assumes that the quality of a decision is directly related to the time and effort that went into making it. When doctors are faced with a difficult diagnosis, they order more tests, and when we are uncertain about what we hear, we ask for a second opinion. And what do we tell our children? Haste makes waste. Look before you leap. Stop and
think
. Don’t judge a book by its cover. We believe that we are always better off gathering as much information as possible and spending as much time as possible in deliberation. We only trust conscious decision making. But there are moments, particularly in times of stress, when haste does not make waste, when our snap judgments and first impressions can offer a much better means of making sense of the world. The first task of
Blink
is to convince you of a simple fact: decisions made very quickly can be every bit as good as decisions made cautiously and deliberately.
²

Gladwell opens the book with a story about a fake kouros, a sixth-century BC Greek statue of a larger-than-life-size nude youth carved from marble.

In the 1980s, the J. Paul Getty Museum paid around $9 million to acquire one of only twelve kouroi left in the world. It was hailed as one of the most important works of ancient art to enter the United States since World War II. Despite some initial suspicions among museum
officials, the Getty decided to purchase the statue after an exhaustive investigation that lasted more than a year. The probe included testing the statue’s age, consulting sculpture experts in Athens, and background checks into the documentation of the statue’s former owners. In the end, scientists and lawyers hired by the Getty said it was not a fake. In October 1986, satisfied that the kouros was an original, the Getty put it on display. Unfortunately, once the sculpture went up for viewing, longtime art experts took one glance at it and thought it was bogus. The first person to doubt its authenticity was an Italian art historian, Federico Zeri, who said that the statue’s fingernails “seemed wrong to him.” He could not express exactly why they looked wrong, but he had a bad feeling about it based on having seen many similar objects that were real.

A photo of the infamous Getty kouros. The marble sculpture was purchased by the J. Paul Getty Museum in 1985 for $9 million.

When several other art experts experienced the same doubts, the Getty commenced further inquiry into the sculpture’s origin. Much to the Getty’s dismay, the possibility that it was a reproduction became impossible to escape. More research revealed that parts of the sculpture fit into different time periods, and it was determined that a good forgery could pass a core sample test if the statue were soaked in potato mold. The beleaguered statue remains on display today, but its placard reads: “About 530 BC, or modern forgery.” Despite all the technology in the world, neither art historians nor scientists have ever been able to resolve the issue of the kouros’s authenticity completely. The Getty’s curator of antiquities at the height of the controversy, Marion True, believed in the work’s
authenticity at first but then conceded: “Science isn’t the final word. It is flexible and changeable as new evidence becomes available, and as new technology is brought to the question at hand.”
³
How true that statement is, especially in the realm of health and medicine.

Gladwell’s book is largely about “rapid cognition,” or first impressions and instant decisions—and how science and culture don’t appreciate the importance of immediate reactions as much as slower, more deliberate decision processes.

Each of us has the ability to come to snap conclusions. It’s built into our survival mechanisms. In life-threatening situations, we need to be able to make quick decisions based on the available information. A lot of our functioning in fact happens without us having to think consciously. Throughout the day, our brain toggles back and forth between conscious and unconscious thought. It’s as if we have two brains. We have one brain for carefully analyzing and categorizing, and another that can size things up intuitively first and address questions later. Gladwell introduces the concept of “thin-slicing,” which is “the ability of our unconscious to find patterns in situations and behavior based on very narrow slices of experience.” By identifying an underlying pattern, we can even “read” and evaluate complex situations. Which is how art experts can often assess the authenticity of a work of art in an instant, getting an actual physical feeling as they look at a sculpture or painting. Something in their gut tells them this is the real thing or a rip-off.

The reason I’m sharing all this detail about spurious art and the experts who argue over what they see is that the subject of objectivity and artistry—and pattern recognition—is relevant in health. We all establish patterns of behavior, or habits, that play into our health and the path that our health takes. And we all have hunch power: the ability to know instinctively what we should be doing to lead healthy, strong lives. These two characteristics—habits and intuition—are ultimately what make us human and will allow us to capitalize on the Lucky Years. As we encounter a wealth of data and technologies to help us understand our individual contexts, we’ll be equipped to take control of our health
like never before, shape new habits, gain better intuition, and be well prepared for what the future holds.

More than 40 percent of the actions we perform each day are not actual decisions—they are habits.
⁴
So if habits command much of our daily lives, then in the Lucky Years we need to tap our intuition continually, and change ingrained habits, as we encounter new information and have access to technologies that can better our lives. If we stay stuck in old habits that don’t work for us anymore, or worse, harm us, then we won’t be able to enjoy the Lucky Years and all that they can offer.

As we grow older, many habits become background noise that we ignore, and unfortunately, this can have unintended consequences when we end up with a chronic condition we could have prevented. Those who notice and try to stay exceptionally attuned to their habits—ushering in the ones that support wellness and doing away with those that don’t—are typically the ones who stay healthier. The fifty-year-old who looks ten to fifteen years younger and has the heart and brain of a thirty-year-old is the person who has made slight shifts in her habits as time went on. The eighty-year-old who can still live independently and play with his grandchildren has similarly adjusted his habits through the years. These people have honed what’s called their perceptual intuition skills, something we’d all do well to develop.

Malcolm Gladwell isn’t the only one who has popularized the concept of “thinking without thinking.” Perceptual intuition is a popular field of study currently gaining momentum in psychological, educational, and scientific circles, and it’s a powerful factor in achieving better health.
⁵
I’ve already been describing perceptual intuition, which in the simplest terms means being able to use your gut instinct to solve problems and “perceive” certain things. People with well-developed perceptual intuition skills—such as the baseball player who can visualize pitches early, the art collector who can instantly spot a counterfeit painting, the doctor who can look at a patient and know something is wrong—have a great “third eye.” This inner source of intuitive wisdom helps them make quick and, in many cases, accurate or correct decisions.