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Comment by simianparrot | Hacker News Reader

It’s not. We never fix anything in medicine: We treat and prevent. Removing the appendix prevents or treats acute appendicitis, but it also has a tradeoff in terms of removing a gut biome reservoir.

This isn’t me dismissing the incredible improvements to our way of life modern medicine has brought. In essence it’s given everyone access to the same potential standard of living as was reserved for kings and nobility in the past — and then some.

But you can’t fully fix aging. You can’t infinitely improve standard of living.

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What is your end goal with this opinion? Just getting everyone to stop looking, because "you can't"?

It's okay if you want to die, but I think I draw the line at demanding others want it too.

I'm a resident doctor and profoundly disagree. And I fail to see how you define words so that "fixing" and "treating" are not at least overlapping, if not similar.

Not if you throw your hands up and never try!

Aging isn't even recognized as a disease yet, and it well should be. Once it gets at least the same kind of focus cancer or heart disease does now? Then we'll talk about how it's "impossible to fix".

Aging is a disease in the same way children are parasites. Fix one, fix the other.

That’s a naive take on what senescence is. Look it up. You can stop it, but be prepared to then have to figure out how to deal with all the side effects it prevents. And then you can fix those but be prepared to deal with those side effects. And so on. My point isn’t to stop researching and understanding and even treating, but it’s that life is a balance of tradeoffs. Looking at it as if energy is a universal currency that can be traded for every other function is a fundamental misinterpretation of everything we understand about biology.

There is no physical or biological constraint that says "senescence absolutely has to happen".

In some species, it doesn't seem to happen at all. In others, it happens extremely slowly. Clearly, there are massive longevity gains left on the table - ones we'll never pick up if we keep whining about "life" being "a balance of tradeoffs".

And in those species there's other constraints that weigh up for it. I'm not sure which ones you're thinking of, but in every single one I know of there's other tradeoffs. And if there's some without them, I'm pretty sure we just haven't discovered them yet.

I find it peculiar that you interpret my statements as "whining". I specifically wrote:

> My point isn’t to stop researching and understanding and even treating, but it’s that life is a balance of tradeoffs

What's whiny about that? Modern medicine has for a while been in a position of treating symptoms of symptoms of symptoms, often of its own making. That doesn't mean we should stop treating symptoms! But it means we have to look at the bigger picture and stop thinking everything is a "problem" to be "fixed", and work harder to understand why things work the way they do, and what the costs of altering them truly are. Sometimes fixing one thing isn't worth the tradeoffs in other areas.

There is no "fairness enforcement" in life, and biology is no exception. The closest we get is conservation laws, and those do not forbid living healthily well into your 500s.

You're out looking for "tradeoffs" that may not be there, or may not be worth caring about. There is no "balance of tradeoffs" in everything. There isn't an Authority on Biology that says "if you get good X then you must take bad Y to keep things fair for everyone". There are just shitty local minima you get stuck in unless you manage to climb your way out.

Do you want to get 50% less cancer, or to live to 120? The answer is "yes". You can have both. Nothing forbids you from having both. Is it easy to get both? No. It's not easy to get even one of those. But nature barely even tried. Humans can do better than that.

> But nature barely even tried. Humans can do better than that.

~3.8 billion years of evolution "barely even tried"? There's hubris and then there's _hubris_. But to repeat myself: I am not saying we shouldn't try. I'm saying we should expect no free lunch, and that the concept of tradeoffs for every alteration is a much healthier mental framework to work off of because _so far_ that's been the one consistent truth in all of biology.

And tell me - for those "~3.8 billion years of evolution", what was the optimization target?

What was natural selection selecting for, exactly? Longevity? Happiness? Quality of life?

Hahahahaha hahaha hahah ha no.

There is no "fairness" in biology, and natural selection isn't your friend. It's aligned with your interests sometimes - but if evolution could make humans reproduce much more effectively by making them live half as long and ten times as miserable? It would. There's just one primary metric that evolution cares about, and it totally would throw your well-being under the bus for it.

Evolution doesn't care much about whether humans live long and happy lives. Only humans themselves care about that. There are a lot of optimizations possible there, and humans have to be the ones to find them.

If you think evolution was optimising for longevity, then you really haven't thought it through.

For 3.8 billion years, organisms just needed to survive long enough to reproduce. Cancer, heart disease, and other age-related diseases only became significant killers in the last few hundred years. That's nowhere near enough time for evolution to address them. And even then, age-related diseases don't directly influence people's chance of reproducing and passing on their genes.

Conversely, evolution has had millions of years to work on fighting infectious diseases, which have been bigger killers for most of our history.

And evolution eventually led to mammals with complex brain plasticity and an almost _unreasonably_ long and fragile childhood that allowed in-generation transmission of lessons and knowledge bypassing the traditional, heavily trial and error -based approach of just gene transmission and instinctual knowledge.

I think evolution did a damn fine job. And yes there's surely more we don't know than we know or understand, which might change the future just as much as bacteriology has, but let's also be humble and learn from what came before. Both things are possible.

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