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1993-04-08
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SPECIAL ISSUE: MILLENNIUM -- BEYOND THE YEAR 2000 THE CENTURY AHEAD, Page 54Why, You Don't Look a Day Over 100!
Extended life-span, an end to heart disease, a vaccine for AIDS
-- all are on the way. A scenario for health care in the next
100 years:
BY CHRISTINE GORMAN - With reporting by David Gross/Boston and
James Willwerth/Los Angeles
Sources consulted for this story include Dr. Alan DeCherney
and Dr. William Evans of Tufts University and Michael Murphy of
California's Esalen Institute.
Like many other denizens of the late 21st century, Sarah
Higgins spent the first 75 years of her life coming to grips with
the idea that she might live forever -- or what seemed like it.
Despite some close calls, she was as healthy as the average 50-
year-old woman in the late 20th century had been. A freak
infection had destroyed her first heart, but fortunately she had
a spare. It was cloned from a sample of her own tissue that had
been stored away while she was still a teenager.
Naturally, every year her cancer check turned up a few
malignant cells. But thanks to a century of advances in genetic
engineering, that was no more threatening than a common cold.
Her doctor used a computer to analyze the genetic makeup of the
aberrant cells and generate a custom-made virus that would
search out the wayward tissue. Then the virus would infect the
malignant cells, injecting a handful of its own regulatory
genes. These viral snippets would reprogram the microscopic
tumor's DNA, shutting down its unruly growth pattern and
transforming the cancer cells back into healthy ones.
But Sarah was ready for a change. She wanted to have
children. So she strolled into the Reproductive Health Center to
reclaim the ovary that had been carefully removed, frozen and
shelved on her 21st birthday. She called up her fifth and
current husband Abe and asked him if he wanted to have kids.
Since all of Abe's genetic papers were in order and the
couple had already received government clearance to reproduce,
they decided to take the plunge. Technicians at the center
carefully removed a section of Sarah's excised ovary and thawed
it. Over the next several days, they gently washed it with
hormones, coaxing the follicles to generate 10 ripe eggs.
To help the fertilization process along, the center's
microsurgeons drilled little holes in the surface of each egg to
make an easier journey for Abe's sperm. Of course, the procedure
had been a lot more intricate for the lesbian couple who had
shown up earlier that spring. In their case, the nuclei from one
woman's eggs had been carefully cut out and transplanted into
her partner's ova. The resulting fusion created embryos like any
other. But because women bear only X sex chromosomes, the
"fertilized" eggs gave rise exclusively to girls.
After Abe's sperm had successfully penetrated Sarah's
unfrozen eggs, DNA analysis revealed that all the embryos were
healthy. Sarah and Abe decided to implant just one, destined to
be a male. But because Sarah was something of a traditionalist,
she opted to carry the baby herself rather than enlist the
services of either an artificial womb or one of the center's
18-year-old surrogate mothers. A round of hormone therapy
rejuvenated Sarah's uterus, and nine months later Isaac was
born.
Sarah proudly admits that she would not change a thing. "I
didn't want to have children until I was ready," the
septuagenarian says with a laugh. "Now, Abe and I are
emotionally and financially secure. We can offer Isaac all the
advantages that we didn't have ourselves as kids."
Isaac will have advantages that his parents may not even
have imagined. He will probably be enrolled in a nursery school
where one of the most important people on the staff is a
physician, Dr. Horatio Dean. The school's focus is summed up by a
banner proclaiming that HEALTHY HABITS LAST A LIFETIME. Each day
at noon, instead of recess, Dr. Dean gathers together his
charges for a meditation session that the usually rambunctious
youngsters particularly enjoy. "Pediatrics sure has changed
since my grandmother's day," says the young doctor.
Back then, the body was treated like a machine. Illness was
seen as a structural breakdown, and doctors specialized in
repairing or replacing increasingly specific parts of the
internal mechanism. But the 21st century's emphasis on
prevention has changed all that. Physicians heal whole
individuals instead of just treating subsystems. Study after
study has proved that relatively simple alterations in
life-style dramatically improve both the length and quality of
life -- provided the changes are made early enough.
The most important aspect of pediatrics, 21st century
doctors know, is to educate children toward good health. By
weaning them on pureed broccoli, parents train their offspring
to love cancer-fighting crucifers. When boys and girls get
vaccinated against aids, they learn to use condoms as well.
Pediatricians teach children how to boost their biochemical
defenses against aging and disease, based on what researchers
have discovered about the interplay between thought, emotions,
hormones and the immune system. As a result, the foundation for
21st century medicine is now education, diet, exercise and
meditation.
Dr. Dean checks the armbands on the biceps of his nursery
school wards. Each monitor is composed of tiny optic sensors
that measure the levels of thousands of different fats,
proteins, carbohydrates and other molecules in the capillaries
just under the skin. Then the devices transmit all this
information to the central computer screen at the front of the
room. The pediatrician can discern at a glance whether his
charges are exhibiting optimal health.
The sensors count and evaluate, for example, all 24
varieties of cholesterol that have been discovered since the
late 20th century. They keep tabs on normal molecules of oxygen
as well as the renegade radicals that wreak havoc on individual
cells and cause the body to age. No less important, the sensors
constantly test the strength of the body's own cancer-fighting
forces in the immune system.
During the meditative session, the children regulate their
breathing and fall into a trance. As Dr. Dean watches his
computer screen, the levels of carbon dioxide and other wastes
in their blood begin to drop. Blood pressure falls. Among the
more advanced students, a surge of naturally induced
biochemical relaxants sweeps through the blood vessels and
permeates the body. Interferon levels begin to soar.
Neurotransmitters in the brain return to normal. This is the
effect that Dean and hundreds of other physicians before him
have worked so hard to achieve. By harnessing the powers of the
mind, the body is healing itself.
After meditation comes recess, during which the children,
still attached to their sensors, race around the playground.
Dr. Dean watches their endorphin levels rise and nods in
approval. Exercise physiologists had long ago determined that
the combination of yoga, Tai Chi and low-impact dodge ball
produced the best results. The regular release of natural
opiates ensures that the children will not succumb to the
poisoning effects of depressive or worrying thoughts -- and that
excess aggression will be defused. Their immune function and
cardiovascular systems remain at peak level. "Yes, this class
is coming along beautifully," Dr. Dean congratulates himself.
"None of them will suffer from the old scourges."
The exercise period in the middle of the day is calculated
to blunt any hunger signals emanating from the children's
stomachs. Back in the 20th century, scientists had learned that
decreasing total caloric intake by 30% increased laboratory
animals' potential life-spans by as much as 50%. When
epidemiologists proved that the same equation held for humans
too, lunch was banned. The sale of saturated fat was
criminalized soon afterward, although a sympathetic doctor
could still get you a prescription for a gram or two.
Nonetheless, grease dealers face mandatory prison terms. And
thanks to the ubiquitous armband monitors, fat abusers are
quickly caught. "But that is only fair," Dr. Dean thinks. "Dying
before 150 is inexcusable and results only from poor planning."
And yet, even in the 21st century, not all patients are
created equal. Only the very wealthy can afford the hefty
dollar price tag commanded by medical centers that clone and
maintain such major organs as the heart. Preventive medicine,
with its populist roots, has actually served to widen the gap
between haves and have-nots. A case in point is the continuing
AIDS epidemic. Developing a vaccine against the virus took much
longer than anyone had anticipated. In the meantime, only the
most privileged sections of global society could afford the
extensive public health campaigns that kept the infection in
check. By the time a vaccine was available, the killer virus
had decimated thousands of communities in Africa, urban America
and Asia. And so, although many people have benefited from 21st
century medicine, a large portion of humanity must still pin
its hopes on the future.