Do We Really Have to Die?

“Rage, rage against the dying of the light”

Ten Years into the Future …

The elevator doors opened, and I stepped out and rushed to our mail room. “Here, Mike,” our mail carrier said as he handed me a manila envelope with a government seal on the upper left corner. I thanked him and walked back to the elevator. On the ride up to my apartment, I remembered that the following day was my 90th birthday.

I opened the envelope and as I had hoped, it was the application that I had been expecting. It was from the U.S. Department of Life Extension. In 2025, the Federal Government established Life Extension Clinics that would research and offer a variety of therapies to increase lifespan. The working assumption was that death was a disease that we could conquer through lifestyle and medical interventions.

The initial participants were chosen based on two criteria: first, on the likelihood that they would benefit based on their healthy lifestyles, and second, on their past and projected future contributions to society if given extra years of life. I applied for the program eight months ago. You had to be at least 80 years old to be accepted. Only 20,000 people across America were accepted each year. Because of the large number of applicants, I had a slim (but not zero) chance of qualifying.

The envelope contained a sheaf of documents. Printed in bold 36-point type on the first page was the warning, “Before proceeding, you must look into the retinal scanner below. This will establish your identity as Michael Franzblau. Severe penalties will ensue if you file this application and are not the designated recipient.” I stared into the tiny camera under the text and heard a “click” as it took my picture and identified me.

Why Do We Age?

The second page of the application form explained why we age. Senescence is the medical term for growing old. It occurs because cells damaged by mutations deteriorate and cease to multiply. When you are young, your immune system removes these senescent cells. This gets more difficult as you age, so the senescent cells remain in place. Even though they are deactivated, they can cause damage to healthy cells by emitting proteins that trigger inflammation.

The antiaging treatments and therapies used by the Life Extension Institute included stem cell therapy; 3-D printing of organs to replace those that have failed; nanotechnology for telomere repair, plaque removal and destruction of cancer cells; and AI-based restorative therapies. The Institute was also committed to improving and updating these, with new treatments based on ongoing medical research.

Life-Extending Lifestyle Choices

The next page was a list of lifestyle practices known to prolong life. Acceptance by the Life Extension Institute was restricted to applicants who had committed to these practices for at least a decade, because they were most likely to benefit from the program’s medical therapies.

My personal physician had to certify that I have routinely followed the following life-extending practices in the past decade:

1. At least 30 minutes of high-intensity aerobic activity each day
2. A healthy diet (see below for details of authorized foods)
3. No smoking of tobacco or use of hallucination-inducing drugs
4. Maintenance of an optimal body mass index of 18.5–24.9 kg/m2
5. Modest daily intake of alcohol
6. Maintaining meaningful connections with at least six people
7. Mental well-being such as life satisfaction, absence of negative emotions, optimism, and positive emotions

My answers and those of my doctors had to be signed and notarized. As I was devoted to fitness and health all my life, I knew that I would meet these criteria.

Contributions to Society

The final section of the application was a written essay detailing my contributions to society, if any. The instructions warned that “the applicant will certify to the truth of the statements contained herein. Falsehoods will disqualify the applicant and expose him/her to criminal prosecution.” I had already written the essay, detailing without embellishment the meaningful contributions I have made, first as a scientist and then for decades as a teacher.

In the end, my lifestyle and history of service sufficed to get me accepted into the program.

100 Years Old

It is now ten years since I started treatments at the Life Extension Institute. I will turn 100 tomorrow. However, when I consider how long many species live, especially bacteria and plants, I realize that even long-lived humans have relatively short lifespans.

• Actinobacteria colonies discovered in Siberia are estimated to live for half a million years.
• Glass sponges found in the East China Sea and Southern Ocean are believed to be more than 10,000 years old.
• The “humongous Fungus” in an Oregon forest is thought to be between 2,000 and 8,500 years old.
• The rings of Methuselah, a Great Basin bristlecone pine in the White Mountains of California, show it to be 4,852 years old. It is the oldest known living individual non-clonal tree in the world.
• The oldest terrestrial animal was an Aldabra giant tortoise that lived in India. It died in March 2006 at an estimated age of 255 years. We lag far behind the tortoises in longevity, although hundreds of people have lived to 116. Jeanne Calment (1875–1997) lived to the age of 122 years, 164 days.

Initially, the Life Extension Institute projected that its therapies would extend my life by 15 to 25 years. These predictions seemed optimistic. But now it appears to understate the possibilities. A recent newsletter from the Institute projects lifespans reaching into hundreds of years in the coming decades.

I have visited the Institute every six months for the latest treatments. Some were preventative and others remedial. To date, I have four 3-D-printed organs in my body: my heart, spleen, kidneys and one lung. Even my eyes have been replaced. I can still remember the thrill of seeing a new world, crisp and clear, after the operation.

Over the decades, many of my family members and friends have died. Fortunately, all of my children and their offspring qualified for treatments at the Institute and are still alive. Eventually, the remaining friends from my pre-treatment life died. The Institute had anticipated this situation and helped me meet and befriend other “Long Livers.” We have become a nationwide support community with strong bonds. It’s very comforting to have someone to talk with who understands your experience because they are living through it.

Biomedical Advances That Extend Our Life

Scientists tell us that the lifespan of a cell is limited by the number of times a chromosome can divide. Unless it becomes cancerous, the typical human fetal cell will divide no more than 70 times before experiencing senescence. Unfortunately, cancer cells have no limit on how many times they can divide.

In 2017 the Journal of the American Medical Association published a study that found that after six decades of gains, life expectancy for young and middle-aged Americans had decreased since 2014. While some of the causes were societal, such as drug overdoses and suicide, others were health related. While the average life expectancy in the U.S. is 78, the authors noted that healthy life expectancy is about ten years less. The Life Extension Institute is committed to biomedical advances in a number of therapies that redress this problem.

TELOMERASE: Telomeres are protective caps at the end of chromosomes. As a healthy cell divides, the telomeres shorten and the DNA shrinks. The continuous reduction of a telomere’s length functions as a “molecular clock” that counts down the end of cell growth. This causes ageing as the reduced cell population contributes to weakness, illness, and organ failure. Smoking, alcohol and air pollution speed up the toxins entering the body and reduce the length of telomeres, also accelerating ageing.

The enzyme telomerase counteracts the telomere shrinking process. It can offset cellular ageing by lengthening the telomeres, adding back lost DNA. This adds “time” to the molecular clock countdown. The application of telomerase, however, can also cause an increased risk of cancer.

NANOTECHNOLOGY: Ultra- small “nanoparticles” can be designed to repair damage to our bodies at a cellular level. One example is the delivery of telomerase and other drugs (called nanorods) to specific sites in the body. Magnetic nanoparticles can also attach to cancer cells circulating in the bloodstream and prevent the formation of tumors.

3-D PRINTING: Some companies are already developing transplantable lungs, as well as bioprinting organs such as heart, liver, and kidneys, Researchers are also testing “bio-inks” as a way of creating vital organs, bones, cartilage, skin and even corneas to replace diseased, damaged or dying tissues.

The process takes stem cells from the recipient to create a bio-ink that “prints” an organic object. The bio-ink may be cellulose-based, collagen-based, fibrin-based, or even synthetic-based. The bio-ink forms a microstructure that copies the cell’s environment. To ensure biocompatibility, the printing process and bio-ink must be carefully selected so as not to trigger an immune response.

STEM CELL THERAPY: Stem cells are divided into 2 main forms: embryonic stem cells and adult stem cells. Stem cells are able to develop into many different cell types. These can range from muscle cells to brain cells. Stem cells are the major actors in regenerative medicine. Researchers believe that stem cell-based therapies may one day be used to treat serious illnesses such as neurodegenerative disorders, heart disease and diabetes.

ARTIFICIAL INTELLIGENCE: Longevity medicine is a new field that incorporates AI, basic research, and medicine. The Hong Kong- based company Deep Longevity is developing artificial intelligence systems to track the rate of aging at the molecular, cellular, tissue, organ, system, physiological, and psychological levels. It is also developing systems for the emerging field of longevity medicine that will help physicians make better decisions on therapies that could slow down or even reverse the aging process.

March 5, 2090

It’s hard for me to believe that I am the living patriarch of 7 generations. But the last 10 years have been very difficult. I struggled to find a purpose and the will to go on living. The certainty of death, which made each moment precious before I reached 80, is no longer a comfort. I can live as long as I want. Yet I may soon choose to end my life.

Long Livers are fortunate that society has accepted our presence. We have successfully run for public office, with a third of the House and Senate seats currently occupied by us. I believe this was the result of our commitment to make longevity medicine available to everyone, not just we few lucky people selected by the Institute.

Still, I am both tired of living and curious about what lies beyond. Many religions believe in the immortality of the soul, and that the purpose of our life on Earth is to repair our faults and do some good. I look forward to discovering whether this is true.