The Lucky Years: How to Thrive in the Brave New World of Health (36 page)

In 2011, Yunus addressed the uneven doctor-to-nurse ratio (3:1) by starting a nursing college funded by a for-profit social business that’s poised to break even in 2016. Once the $6 million initial funding for the school is paid back, he’ll go on to build another nursing school and another. The qualification, however, to enter this nursing program is that your mother must be a Grameen Bank borrower. The bank gives the loan to these women who get accepted to the nursing college. They pay it off slowly over their career through salary deductions. And they are guaranteed a job at graduation, which psychologically helps.

I could go on and on about all the innovative things Yunus has done to transform his community—and the world at large. He is the kind of visionary we need today. He has set a terrific example of how we can incentivize people to be accountable for their health and wellness. He’s created a system for turning hope into real, concrete possibilities. I love how he encapsulates his mission: “It’s not about money; it is about creative ideas.” And I’ll add “. . . that can change the world.” I also couldn’t agree more with his belief that “Charity is not the answer to poverty.”

In America, we love incentives. But we also love our entitlements. A question we must all ask is, who or what is driving us to prevent disease?
Sometimes we get such incentives from our children, the wish to conquer a diagnosis, or the mere desire to feel and look better than we do. But it’s hard to inspire people to do something today that will affect them a decade later. There’s just no feedback loop in the health domain; you’re not paid to stay at a healthy weight or avoid artificial sweeteners; you don’t get tax credits for exercising at least three times a week; and you don’t get an extra week of paid vacation if you show that you’re engaged in activities that lower your stress levels and keep you happy.

So where does that leave us? Having to create our own incentives—finishing the “I shall . . .” statement by making commitments to ourselves. And that process begins by knowing who you are and, perhaps more important,
how you feel
.

For every intervention you adopt, you create change. This was articulated beautifully by the late Edward Lorenz: when a butterfly flutters its wings in one part of the world, it can eventually cause a hurricane in another. Lorenz was an MIT meteorologist who tried to explain why it is so hard to make good weather forecasts; he wound up starting a scientific revolution called chaos theory. In the early 1960s, he noticed that small differences in a dynamic system such as the atmosphere could give rise to vast and often unexpected results. These observations ultimately led him to develop what became known as the butterfly effect, a term that grew out of an academic paper he presented in 1972 entitled “Predictability: Does the Flap of a Butterfly’s Wings in Brazil Set Off a Tornado in Texas?”
⁷

The butterfly effect has significant relevance in all matters of health. We are each agents of change in the Lucky Years; we are each butterflies flapping our wings in a space-time continuum on earth. How we live today affects how we are tomorrow. It also impacts the people with whom we interact, our neighbors, the next generation, our children, and their children. It’s easy to cast blame on big business, insurance companies, and the weaknesses in our national health care policies. It’s much
harder to point the finger at citizens and ask for help in creating change. But we must empower people to take charge of their health in ways they haven’t before if we’re ever going to rise above our challenges. The conversation in Washington circles continues to revolve around issues with health insurance policies and health care finance while ducking the most essential policy of all—the one each of us makes with ourselves. We need to be encouraged to sign personal policies that specify the things we will do to support our health and bring down our risks for an early death. And those personal policies are priceless.

In addition to creating our own personal policy to thrive in the Lucky Years, it behooves us to lobby our political leaders to push the idea that prevention is the cure. We all love a good cure. We like watching our government spend money on discovering a remedy for a serious disease, but now that we’ve knocked out a lot of maladies that once factored into our mortality (e.g., smallpox, polio, mumps, rubella), we need to spend more money researching and combating chronic illnesses that usually can be prevented—from diabetes to cancer. Lately, Congress has funneled more money toward understanding diseases and potential treatments at the expense of focusing on prevention. If we have therapies that work to prevent various illnesses, why don’t we promote those? Here’s a thought: California’s tobacco control program cost $2.4 billion to run between 1989 and 2008, but resulted in health expenditure savings of $134 billion (and more important, saved countless lives).
⁸
A very small percentage of our federal money is spent on antitobacco campaigns. In 2012, tobacco companies spent $9.6 billion marketing cigarettes and smokeless tobacco in the United States alone. This amount translates to about $26 million
daily
, or more than $1 million
every hour
.
⁹
Nineteen percent of high schoolers are still smoking today.
¹⁰
That’s 19 percent too many.

In preparing to write this book, I asked a few friends and colleagues what they’d do differently if they could write a letter to their much younger selves. All of them wished they’d avoided the conditions they grapple with today. They would have told their younger selves to establish better habits sooner and to have the foresight to know what
was coming down the pipeline in their health life. Granted, most of us would love a glimpse into our future and future health. That’s not possible. But prevention is, and it’s especially possible in the Lucky Years. When we were young, we planned our educations, careers, and even our retirements. We didn’t plan our future health. Now that we can more easily do that, it’s imperative. It’s essential. And all that’s asked of us is that we start to flap our wings.

As the Savage in Huxley’s
Brave New World
says, “All right then . . . I’m claiming the right to be unhappy. Not to mention the right to grow old and ugly and impotent; the right to have syphilis and cancer; the right to have too little to eat; the right to be lousy; the right to live in constant apprehension of what may happen tomorrow; the right to catch typhoid; the right to be tortured by unspeakable pains of every kind.”
¹¹
After that statement comes a long silence, and then the Savage says, “I claim them all.”

The Lucky Years are here and we all must adapt to take advantage. As the Savage says, it is our right to do nothing, but we also have the ability, the technology, and the wisdom to do the opposite. And that requires action. I imagine the last person to buy the older model of a smartphone days before the surprise launch of the new model feels buyer’s remorse every time he sees a friend with the new one. A friend called me recently to discuss getting an elective surgical procedure to correct one of the changes that happens with aging. In discussing with him whether this made sense or not (for the record, I was against the procedure), I told him that in the near future we may be able to awaken his own quiescent stem cells and allow him to go back in time, but having the surgical procedure now may preclude this. His sentiment quickly changed. He put his faith in the Lucky Years rather than resort to a temporary fix. I hope by focusing on prevention today, there will be no remorse and we can all benefit and enjoy what the Lucky Years have to offer.

I
thank my patients for allowing me to be involved with their care and their lives. They demonstrate to me daily how the Lucky Years are benefiting all of us. At the same time, I continually realize that the current progress isn’t enough. We still need more advances to alleviate suffering, but I am more confident and optimistic than ever that the breakthroughs will arrive.

It is not just a privilege, but it is also a responsibility to strive to educate about health. I have never been on this path alone and have many to thank. This book reflects the culmination of not just my lifetime work in science and medicine, but also my ongoing collaboration with many individuals and teams of people. First, I thank my collaborator Kristin Loberg. Kristin and I have been working together for six years now, and I still get excited every time we speak. She is an amazing partner, an insightful thinker, a remarkably talented writer, and a good friend. I would like to thank her family, Lawrence, Colin, and Teddy, for allowing me to spend the precious time with her over the past years.

To Robert Barnett, who has expertly and caringly represented, protected, and guided me through this process. Your mentorship, friendship, and wisdom have meant so much to me. David Povich, thank you for being a guiding light to me. You have both been extraordinary in looking after me.

I have been with the same publishing house for the three books I have written, and I couldn’t imagine a better and more supportive environment. I wish to thank the crew at Simon & Schuster, led by Priscilla Painton, whose support, faith, and skill made this book possible. I can easily state that Priscilla’s exquisite editorial leadership made this
a much better, clearer, and focused book. Thanks also to her fantastic colleagues, including Marie Florio, Allison Har-zvi, Larry Hughes, Sophia Jimenez, Jessica Chin, Kristen Lemire, Richard Rhorer, Jackie Seow, Dana Trocker, and the fantastic boss Jonathan Karp. Thank you for putting up with me (I know it isn’t easy) and your continued support. To Steve Bennett and AuthorBytes, thanks for the creative and dynamic website management.

I am also indebted to my team at the USC Westside Cancer Center and the Center for Applied Molecular Medicine, who enable me to wear multiple hats—to be a physician, teacher, and researcher—and find the time to write. I want to thank particularly my fantastic assistant Wendy Piatt, and former assistant Autumn Beemer, and the clinic team of Olga Castellanos, Shelly Danowsky, Adam Feldman, Angel Jones, Bill Loadvine, Kelly La Mont, Michael Rice, Cindy Richards, Kelly Santoro, Rachel Twomey, Julianne Yu, and Mitchell Gross, all under the inspirational leadership of Lisa Flashner. Thank you for your loyalty and friendship and the caring you give to the patients we are honored to treat. To the research team including lab chief Shannon Mumenthaler, Jonathan Katz, Dan Ruderman, Paul Macklin, Kian Kani, and Yvonne Suarez, and the rest of the dedicated scientists. Thank you for pushing my thinking forward and your work in figuring out better ways to understand and treat disease. To my science mentors, collaborators, and friends Andrea Armani, Anthony Atala, Anna Barker, Paul Davies, Scott Fraser, Sam Gambhir, Murray Gell-Mann, Inderbir Gill, Dana Goldman, Danny Hillis, Cliff Hudis, Carl Kesselman, Parag Mallick, Franziska Michor, Vincent Miller, Larry Norton, Carmen Puliafito, Michael Quick, Chris Rose, Howard Scher, P. K. Shah, Jeff Trent, and Yannis Yortsos.

I have the privilege of seeing the breaking health and technology information daily through my involvement with CBS News. Many of the ideas discussed in
The Lucky Years
originated from stories I initially did with
CBS This Morning
. To the outstanding leadership at CBS News, including Chris Licht, Lulu Chiang, Jon LaPook, and David Rhodes, who empower me to educate and inform; and to Susan Schackman
and Leigh Ann Winick who collaborate with me on every story and are excellent at distilling the essence and truth from science news. An extremely difficult task! The anchor team of Gayle King, Norah O’Donnell, and Charlie Rose is an absolute pleasure to talk with at 4:00 a.m. and 5:00 a.m. Los Angeles time. Your collective passion to understand and enlighten comes through every day. I am lucky to be a part of such a program.

To my friends Dominick Anfuso, Marc Benioff, Glenn Boghosian, Yael Braun, Jerry Breslauer, Eli Broad, Sharon Brous, Bill Campbell, Steve, Jean and Stacey Case, Robert Day, Michael Dell, John Doerr, Bryce Duffy, Larry Ellison, Bob Evans, Sandy Gleysteen, Darryl Goldman, Jimmy (Taboo) Gomez, Al Gore, Brad Grey, Davis Guggenheim, Yoshiki Hayashi, Uri Herscher, Walter Isaacson, Peter Jacobs (and the CAA team), Ashton Kutcher, Jimmy Linn, Dan Loeb, Max Nikias, Fabian Oberfeld, Howard Owens, Chemi and Shimon Peres, Amy Powell, Robin Quivers, Bruce Ramer, Linda Ramone, Ed Razek, Shari Redstone, Sumner Redstone, Joe Schoendorf, Dov Seidman, Greg Simon, Bonnie Solow, Steven Spielberg, Tom Staggs, Elle and Paul Stephens, Gregorio Stephenson, Howard Stern, Meir Teper, Yossi Vardi, Jay Walker, David Weissman, Will.i.am, and Neil Young: your mentorship, friendship, and advice are appreciated beyond measure. To my personal exercise team of Heidi Kling, Anne Van Valkenburg, and Nereida Vital, thank you for helping me to practice what I preach.

Lastly, to my family for their unwavering support and love; thank you to my beautiful and inspiring wife, Amy, and our two fantastic children Sydney and Miles, and our goofy and loyal dog, Sadie. To my mother, Sandy, and father, Zalman, who have been role models and inspired me from day one in Baltimore. And to the rest of the Povich and Agus gang, I thank you and love you.

Lastly, to the readers, thank you for believing in
The Lucky Years
 . . .