"Life Extension" corrupted into medicine
Posted: Tue Feb 14, 2023 6:49 pm
I've been annoyed by the frequency with which "life extension" or "anti-aging" has ceased to point towards radical mechanism investigation and principled interventions like the ones Aubrey De Grey and John Wentworth have proposed. Instead, it's mostly tinkering around the edges with interventions optimized to palliate subclinical metabolic syndrome, e.g. metformin. But now I think I see how this works and what well-intentioned people might hope to get out of it - it's a way to use speculative bubble dynamics to get more old-fashioned medicine.
Medicine has jargonized (in the Frankfurt School sense) metabolic syndrome as part of aging. In other words, what was previously a contingent condition is now baked into the basic ontology as though it were simply the way of things unconditionally. (Related: Nutrition and Physical Degeneration by Weston Price.) This is part of a larger trend in medicine to give up on curing nonacute conditions. Nonacute vitamin deficiencies are largely ignored, specific physical movements or precise dietary interventions are not considered as part of a treatment plan.
When I was diagnosed with "silent GERD," I was handed an info sheet with a panoply of poorly thought out suggestions, plus a few goods ones. When I looked up a review article on Google Scholar, I found a review of the evidential strength for these. The review usefully pointed out that the somewhat scattershot dietary suggestions were based on poor evidence, but didn't really engage with the idea that a mechanistic understanding might help. It also claimed ideologically that since proton pump inhibitors (a pretty nasty class of drug that interferes with stomach acidity and thus digestion) empirically "work" to alleviate this particular condition, that's what "evidence"-based medicine should recommend.
Anatomy of a Bubble describes a process in which initially high-integrity players acting based on a first-principles causal decision theory converge on an obvious good idea. Then early imitators use this as the seed for a speculative bubble, and late imitators join the scene once there's visibly a lot of momentum. At each stage the idea is modified to appeal to a larger audience, to keep the bubble going.
It seems like something like that already played out with conventional western medicine (possibly aside from a few acute subfields, it's mostly grift now on the margin - I've mostly had to solve my medical problems myself and then negotiate with gatekeepers, including problems as simple as gout!). The same process is playing out with anti-aging / life-extension, but it's currently only at the stage where "solve aging" has been watered down to serious interventions to cure the lifestyle diseases of civilization, which is a big part of what medicine's job *used* to be. Naturally this isn't stable.
Medicine has jargonized (in the Frankfurt School sense) metabolic syndrome as part of aging. In other words, what was previously a contingent condition is now baked into the basic ontology as though it were simply the way of things unconditionally. (Related: Nutrition and Physical Degeneration by Weston Price.) This is part of a larger trend in medicine to give up on curing nonacute conditions. Nonacute vitamin deficiencies are largely ignored, specific physical movements or precise dietary interventions are not considered as part of a treatment plan.
When I was diagnosed with "silent GERD," I was handed an info sheet with a panoply of poorly thought out suggestions, plus a few goods ones. When I looked up a review article on Google Scholar, I found a review of the evidential strength for these. The review usefully pointed out that the somewhat scattershot dietary suggestions were based on poor evidence, but didn't really engage with the idea that a mechanistic understanding might help. It also claimed ideologically that since proton pump inhibitors (a pretty nasty class of drug that interferes with stomach acidity and thus digestion) empirically "work" to alleviate this particular condition, that's what "evidence"-based medicine should recommend.
Anatomy of a Bubble describes a process in which initially high-integrity players acting based on a first-principles causal decision theory converge on an obvious good idea. Then early imitators use this as the seed for a speculative bubble, and late imitators join the scene once there's visibly a lot of momentum. At each stage the idea is modified to appeal to a larger audience, to keep the bubble going.
It seems like something like that already played out with conventional western medicine (possibly aside from a few acute subfields, it's mostly grift now on the margin - I've mostly had to solve my medical problems myself and then negotiate with gatekeepers, including problems as simple as gout!). The same process is playing out with anti-aging / life-extension, but it's currently only at the stage where "solve aging" has been watered down to serious interventions to cure the lifestyle diseases of civilization, which is a big part of what medicine's job *used* to be. Naturally this isn't stable.