Why We Die: Book Review

Death is the final frontier, the inevitable end. We know that and yet most of us find it difficult to deal with thoughts of dying and of death. With major advances in medical science over the last 100 years or so, doctors and scientists have been able to increase human lifespans, but in the end, we have to accept that human bodies simply aren’t built to last forever. Ultimately, death still wins. Always. For those who might be inclined to ask why, Nobel Prize winner, molecular biologist Venki Ramakrishnan’s recently published book, Why We Die: The New Science of Ageing and the Quest forImmortality has all the answers you could ever hope for.

‘We are living through a revolution in biology. Giant strides are being made in understanding why we age—and why some species live longer than others. Could we eventually cheat disease and death and live for a very long time, possibly many times our current lifespan? Venki Ramakrishnan, recipient of the Nobel Prize in Chemistry and former president of the Royal Society, takes us on a riveting journey to the frontiers of biology, asking whether we must be mortal,’ says the publisher’s note. ‘Covering recent breakthroughs in scientific research, he examines the cutting edge of efforts to extend lifespan by altering our physiology. But might death serve a necessary biological purpose? What are the social and ethical costs of attempting to live forever? Why We Die is a narrative of uncommon insight and beauty from one of our leading public intellectuals,’ it adds.

In the introduction to the book, the author acknowledges that for most of us, the prospect of death is ‘terrifying,’ that we often choose to live in denial rather than confronting this fear, and that humanity has even developed a combination of religious beliefs and coping mechanisms – including the concepts of rebirth, the immortal soul and living on via the legacy we leave behind – that help us deal with the inevitability of death. ‘It is a curious facet of human psychology that even if we accept that we ourselves will be gone, we feel a strong need to be remembered,’ says Ramakrishnan, adding that in the past this need used to manifest itself in the form of tombs and monuments that were built hundreds of years ago and exist even today, and in the modern context, the philanthropy that the rich engage in, perhaps hoping to be remembered via the buildings, foundations and institutions they endow. The idea remains the same – to live as long as possible, even if it is by proxy.

An extension of human beings’ desire to defy the aging process, remain ‘young’ for as long as possible and extend our lives further than ever before is our search for immortality. ‘More than 700 startup companies have invested billions of dollars to tackle aging and this is not counting large, established pharma companies that have programs of their own,’ the author says, noting the rise of gerontology in recent years. With this book, he says, the objective is to take ‘a hard, objective look at our current understanding of aging and death,’ from a molecular biologist’s scientific perspective. The themes he sets out to explore include looking at how our genes govern our lives, the disruption to our cells and tissues caused by the aging process, examining recent advances in anti-aging tech and, eventually, address the fundamental question of why we die.

The author starts with explaining – in very simple terms that anyone can understand – the basic cellular structure of our bodies and how, over time, the accumulation of chemical damage to our cells and molecules diminishes our physical and mental capacity. Eventually, this gets to the point where we are no longer able to function as coherent individuals and, finally, die. Simple? Maybe not. Because, as Ramakrishnan points out, at the time of ‘death,’ most cells in our bodies are still alive. ‘We can donate entire organs and they work just fine in someone else if transplanted quickly enough,’ he says. ‘Still, when we think of death, we are generally thinking about our own: the end of our conscious existence as an individual.’

While considering the process of evolution, whereby human cells gradually deteriorate and ultimately perish, the author also examines other living beings who are endowed with regeneration powers that have not been given to us. Starfish, for example, which can regrow arms that have been cut off. Or hydra, which is able to regenerate tissue and never seems to age at all. Or even jellyfish, which boasts the ability to metamorphose into an earlier stage of its development when faced with injury or stress, thereby living its life all over again! What human being wouldn’t love to have such superpowers? The author, however, notes that while these species might provide some clues to the aging process that may be fascinating from an academic point of view, these clues aren’t likely to be very useful in the human context. We need to look at species that are more closely related to us – mammals, or at least vertebrates – says Ramakrishnan, quoting possible connections with a mammal’s size, heart rate and metabolic rate with its potential lifespan. Interestingly enough, animals who aren’t in a hurry – tortoises, for example, who move slowly, whose hearts beat only once every ten seconds and who can take decades to hit puberty – seem to have relatively longer lifespans as compared to some other species, which seem to be programmed to live fast and die younger.

Coming back to human beings, can a healthy lifestyle – eating clean, getting regular exercise and eliminating stress as far as possible – extend human life? Probably, but perhaps not necessarily. The author writes about Frenchwoman Jeanne Calment, who died at the age of 122. While she regularly rode a bicycle until she was almost a hundred years old, she also smoked till the age of 117 and ate a kilo of chocolate every week, so there goes conventional wisdom on aging and longevity. That said, the author notes that studies say most people who live to a 100 and beyond maintain independent lives until they are in their mid-90s, and manage to stay healthier for longer periods, without suffering from old age-related illnesses for prolonged periods of time. Healthy life choices or nature’s lottery? Probably a bit of both, though nobody can really be entirely sure.

The author, being a molecular biologist himself, discusses the complex issues of human DNA at length and talks about how environmental agents like exposure to radiation or to certain chemicals may damage our genetic blueprint, which may reduce an individual’s life expectancy. ‘DNA repair is so essential to life that it originated billions of years ago, before bacteria and higher organisms diverged. Because DNA damage occurs all the time, any defect in the repair machinery itself is particularly disastrous because it means that damage would accumulate rapidly,’ he says, adding that this has also been linked to certain types of cancers. ‘Generally, the more effectively our bodies can repair our DNA, the more we can resist ageing,’ he adds.

There are chapters that extensively cover factors that cause cell damage within the human body and accelerate the aging process, Ramakrishnan also writes about cutting-edge, metaphysical tech that humanity is experimenting with, which is aimed at extending life beyond the conventional definition of death. Cryonics, for example, where people are frozen immediately after death, with the intent of ‘defrosting’ them at a later point in time, by which a cure has been found for the ailment that caused the individual’s demise in the first place. A macabre bit of science fiction, or reality? Time will tell. In the meanwhile, there are also those – transhumanists – who want to transcend death in a different manner, by letting go of the body but preserving the mind and its concurrent ‘consciousness,’ which many believe is an essential element of life itself. If the brain is alive, and in a state of consciousness, can one life forever? Can this consciousness be downloaded from a preserved brain into a future, yet-to-be-built computer, thereby preserving life indefinitely? The author isn’t too hopeful; ‘there is not a shred of credible evidence that human cryogenics will ever work,’ he says, followed by a deep dive into the complex range of reasons why this won’t work. He also summarily dismisses people like Aubrey de Grey and David Sinclair, who have proposed certain (pseudo-scientific?) measures to defeat the aging process and extend the human lifespan. Ramakrishnan isn’t at all convinced with their theories and doesn’t mince words in saying as much. He is equally dismissive of tech billionaires who believe that aging is ‘just another engineering problem to be solved by hacking the code of life.’ The desire to ‘move fast and break things’ is not very well suited to addressing the issue of aging and extending longevity, he believes.

Can we live forever? Even if that were at all possible, should we even want to live forever? The author has a few words of caution in this context. He refers to global demographic changes, with an increasing proportion of the elderly, the fact that people are having fewer children and that going forward, fewer working people might be supporting a growing number of retirees, many of whom may be on expensive medication for a decade or two. For the elderly, says Ramakrishnan, this would have implications of self-reliance, the need for higher levels of physical fitness, the need to stay active and, hopefully, the desire to remain productive in some ways, which may be a challenge for many. He also, apparently, believes that most people – in areas as diverse as both science and literature – produce their best work when they are still relatively young, and quotes various examples to support this line of thought. ‘Advances in healthy aging would not necessarily make us as creative and imaginative later in life as we are in our younger years,’ the author says, even though he does admit that many film directors, artists and musicians continue to perform at the highest level well into old age.

Finally, can wisdom – acquired over decades of living – offset the cognitive decline that seems to set in with old age? The author says there is no evidence that wisdom continues to increase beyond a certain age (he doesn’t provide a specific number here) and that older people often tend to be conservative, and may be swayed by ‘an appeal to their sense of nostalgia.’ The vast majority of innovation, including social advances, have been driven by young people, says Ramakrishnan. In conclusion, he says ‘I am not sure that if we lived so much longer, we would be any more satisfied. Now that we live twice as long as we did a century ago, we still aren’t content with that entire extra life. Rather, we seem to be even more obsessed with death.’ In his closing remarks, at the end of the book, the author encourages us to ‘enjoy life in all its beauty’ so that when our time comes, ‘we can go into the sunset with good grace.’

A medley of biology, philosophy, history and social discourse, Why We Die is a unique piece of work that is energetic, vivid and full of life. You definitely don’t need to be a molecular biologist to read it, though some parts of the book might be mildly challenging for readers who do not have a scientific background. But overall, the book is for anyone who may be interested in understanding the wonderful ways in which the human body functions at the cellular level, how it gradually declines and why, in the end, we die. A powerful, praiseworthy piece of work, that deserves to find a place on your bookshelf.

Why We Die: The New Science of Ageing and the Quest for Immortality is available on Amazon