I've had a ton of good luck in this life, an embarrassing amount of it, really, but none of it better than when I found Dr. Harry Lodge to be my internist and persuaded him to write Younger next year with me. It changed my life. I'd had the basic idea, the very basic idea, when my wife, Hillary, and I moved out to Aspen after 25 years of practicing trial law on Wall Street. I'd always wanted to be a ski bum for a bit, and now I could afford it. Such a good idea. But it was always clear that I needed a heavy scientist or doctor as co-author. So once I got serious, we moved back to New York and started looking. I found Harry. Then things got real. It took forever to find him, the stories in the book, and even longer to persuade him to write the book. He was, after all, a rock star in his field, the founder in his late thirties, and head of a twenty-two doctor practice with ties to Columbia Medical School and in tremendous demand. He later became a full professor at Columbia, a rare honor for a practicing doctor, so he was already stretched. But he loved the idea of the book, the idea that profound behavioral change, especially the development of a serious exercise habit, was not a problem for him. could have an astonishing impact on health, wellness, quality of life, and aging. Avoid 70% of normal aging until close to the end. Avoid 50% of the worst diseases and accidents forever. He loved it because he had understood it so well for years, and because it was at the heart of his theories about how to practice internal medicine. he was just about the only internist in new york who paid as much attention to behavioral issues exercise your work life stress your sex life general engagement as to conventional medicine because he believed that those things had more of an impact than conventional medical issues The notion of telling that story to a broader public was a powerful temptation. Also, I had been in the business of persuading people to do stuff for a long, long time, and I leaned on him awfully hard. So I pushed, his natural inclinations pulled, and he finally agreed. Poor bugger. I say poor bugger because doing this book would be like taking on a second full-time job for a guy who was already frantically busy. It could have been a draining horror, but it wasn't. Quite the contrary, it was a joy for both of us. First, we became friends almost at once, close friends before long. That made all the difference. Intellectually, our minds worked similarly. A high level of skepticism and analytical rigor. And we saw the book in almost exactly the same light. Finally, our senses of humor jibed perfectly. In the book, I'm the funny one. In life, it may have been Harry. Beyond that, we discovered we had grown up just two miles, and twenty-five years, apart, on the ocean, north of Boston. In the end, that year turned out to be about the most fun either of us had ever had. At one point the thought was that I could do the lion's share of the work, especially the writing. That turned out to be nonsense. Harry wasn't the kind of guy to delegate that way, especially when it came to something he cared so much about. In the end, we both wrote it. That is, we wound up writing alternate chapters, telling the same story but in very different voices and in very different ways. That doesn't sound very promising, but apparently it had a certain charm. finally the message that you had an unimagined degree of control over your own aging health and quality of life was plenty seductive everyone wants that especially the type a execs and professionals to whom we seem to appeal as of this writing we have sold well over two million copies in some twenty languages and if our mail is a reliable indicator we have changed an awful lot of lives the book became and has remained a cult book for a lot of people especially those over forty The book came out in January 2005. We were on all kinds of national TV shows and so on, and it quickly became a New York Times bestseller. Everyone seemed to like it, and I confess, we liked it too. Harry is the least vain man I've known, but once, when I was trying to persuade him to do a follow-on book, he said, No, we've written one perfect book. That's enough. Wow. One perfect book, huh? Even I, the vain one, might not have said that, but it wasn't totally ridiculous. We did about what we had set out to do. We took what we both believed to be a truly important and deeply underappreciated concept, the notion that behavioral change can have a more profound impact on wellness, quality of life, and aging than anything else, and told it in such a way that a lot of people took it in. It is still the only book on the subject. Interestingly, considering that it went against the grain of traditional medicine, which mostly ignores behavior, no one disagreed. No one in the medical field, no one in other sciences, no one at all, and the popular response could not have been warmer. Here's another nice thing. Despite the fact that the original book was novel and cutting edge, it has stood up remarkably well. Nothing we wrote, nothing Harry predicted or we both recommended, has turned out to be wrong or needed to be amended. In fact, as more research has gone on, the book's conclusions just get stronger. And more important, new studies come out all the time, and the reports on them breathlessly point out that it makes a ton of sense to do this or that, and it's the same exact stuff we wrote fifteen years ago. That is a treat, believe me. And all that credit, let us be clear, goes straight to Harry. Harry had written at one point that some of the minor stuff we wrote might turn out to be wrong, but that the major themes would stand up. Well, it was wrong about that. None of it turned out to be wrong. That's downright eerie. At this point, you may reasonably ask, perhaps with a touch of irritation, if the book is so amazing and you two are such great guys, how come you're writing this new version or revision or whatever it is? Fair question. And the answer is that this is not a revision or re-edit. No changes have been made to the old text, including our ages at the time we wrote it. And nothing's been deleted. There are only additions. Instead of a revision, this is a completion of the original story. Looking back, it's clear there were a couple of glaring omissions in the original book. They're glaring now, but they weren't then. Because back then, There was no science on the subject of cognition and how exercise and emotional connections affected, not even a level of speculation ripe enough to include. So some stuff had to be omitted, but today the omissions are driving us crazy. That's why we did this edition, to put in a little new and incredibly important material. But before we turn to that, it's time to strike a dark note, a terribly dark note. As many of you will have heard, Harry Lodge died three years ago at the age of 58 of a fast-moving prostate cancer. Most prostate cancer is not lethal. This version was very lethal indeed. He had taken good care of himself. He was a passionate follower of the younger next year regimen, and he followed all the regular medical steps for a man his age. When the cancer was discovered, he had superb medical care, obviously, and everything possible was done. He lived longer than he might have, but the end came shockingly fast. His doctors and closest friends knew it was probably coming, but it was still all but impossible to accept. Still is. He was so alive, and he had so very much more to do, both in his amazing career and in his private life. It was hard to conceive of his being taken away at that absurdly early stage, but it happened, and a lot of people were absolutely heartbroken. This edition of the book is dedicated to Harry, obviously, and it is beyond fitting. First, because the new chapters, there are only two of them, but they are a big deal, are so well aligned with his interests and character. Harry's friend, the matchless Alan Hamilton, another polymath like Harry, but this time in the field of neuroscience and brain surgery, graciously stepped in and wrote the chapter that finishes the book. But, in a way, it is also Harry's work. Harry's work in the sense that he had a great interest in the impact of behavioral change on energy, mood, resistance to stress, and cognitive effectiveness. Those are Alan's great topics. As you'll see in my chapter, Chapter 21, Harry had written quite a bit on the subject. He would have been delighted to have Alan take up the baton. among other things alan was a passionate admirer of younger next year and had bought cartons of copies for colleagues friends and every single one of his patients and it may be worth noting that harry would almost certainly not have presumed to write the chapter himself because as he once said of nutrition he was only a student of the subject not a master Allen is most assuredly a master. He has taught it and lived it all his life, as a University of Arizona professor in an astonishing four areas and a brain surgeon. He has also thought endlessly about its consequences for individuals and society. He is the perfect guy to complete the original book, as you'll soon see in his chapter. Chapter 22 It is important to say that the idea of creating this new edition and of recruiting Alan Hamilton was Laura York's. Laura was our agent for the first book, but her contributions went way beyond that. She also had a lot to do with its organization. On the extremely rare occasions when Harry and I disagreed about something, she arbitrated with amazing fairness when you realized that she and Harry were falling in love with each other at the same time. It was a hell of a year, as I said before. And the great highlight for Laura and Harry had to be the fact that they fell in love and consecrated their union as soulmates. She is Harry's literary executor. She connected with Alan Hamilton, and she is the one who persuaded him to do his chapter. She also persuaded our publisher to go forward with the project. As ever, she was a key player in the whole business. Alan's chapter contains some remarkable and powerful stuff. For example, he says that behavioral change will have a more profound effect than anything else on what I think of as the executive functions energy, optimism, decisiveness, interest, and most of all, sheer cognitive intelligence. He says that sheer intelligence can be increased by as much as 10%. That's amazing. There will be similar gains in other executive functions. And he says of Alzheimer's, which we were always told we could do nothing about, that the risk of getting it can be reduced by half. And these amazing challenges will come not through conventional medicine, for which we are so grateful, but from serious behavioral change. It is younger next year, taken to a new level. Years ago, a reader wrote to us about Younger Next Year. He told us about the changes he had made and the consequences, and he finished by saying, Life is fun again. We get a ton of wonderful letters, but that one may be my favorite. I hope this new edition will give a significant number of people a reason to read it, or read it again. And I hope that a few of you will be moved to say, Life is fun again. Part 1. Take Charge of Your Body. Chapter 1. The End of the World. So look, you're 53, 58, somewhere in there. Great guy, pretty successful, good energy. You're a serious man in a serious life. And besides that, you're in decent shape, thank God. A solid weekend athlete. Well, fairly solid. Maybe a little overweight, and the bike's been in the garage a while, but you could get back there in a heartbeat. You're type A at work sometimes, but, hey, you get stuff done. You are one of those people who not only had the gifts to do all right, you had the temperament to use them. Good for you. And a couple of months ago, you opened your eyes in the dark and said to yourself, I am going to be sixty years old. I am almost sixty. You're awake the rest of the night. Or you're sitting in the office and some twerp is looking at you strangely, looking through you, sort of, as if you weren't there. When he leaves, it hits you. That guy thinks I'm a short-termer. He thinks this is the departure lounge, the little punk. You go around your desk and sit in the chair where the kid just was. An involuntary sigh. Retire. What the hell will become of me? Last one. You're at a party. A pretty woman goes by. Not that young. Maybe thirty-eight. And she looks through you, too. Just does not see you. As if you were dead. As if you were sixty. Same thing. That night, in the dark again. Sixty. I am going to be sixty years old. In the morning, you suck it up, go to work, do your job, just like the last 30 years. But it's there, man. It's there all the time. I am going to turn 60. What is to become of me? As if I didn't know. But guess what? You don't know. The point of this book is that you do not know, and you have the wrong picture in your head. You know what it meant for your old man and his father, for your mentor and a few billion other guys, but the rules are changing. Right now, and your prospects are different, quite different. Harry, that's Henry S. Lodge, MD, my doctor, co-author, my close friend, is going to give you enough of the new evolutionary biology in his chapters so that you can understand for the first time how your body actually works. It is going to be a revolutionary insight for virtually everybody, believe me. Once you understand it, and once you do some of the things that will seem obvious to you after that, why, you can choose to live like 50 until you're in your 80s. In your 80s, my man. We mean it. You may ski into a tree. That's a different story. Or you may grow a tangerine in your brain pan and be dead in the morning. Fine. But most of us really do not have to age significantly. For decades. It is better than that. Most of us can be functionally younger every year for the next five or even ten years. That sounds like cruel nonsense or hype, but it's true. Limited aspects of biological aging are immutable, like the fact that your maximum heart rate goes down a bit every year, and your skin and hair get weird. But 70% of what you feel as aging is optional. You do not have to go there. No joke. No exaggeration even. There's a new tough game out there. And congratulations, you are eligible to play. You just have to learn how. Here's what you think you know. You turn sixty and your feet are on the slippery slope, the long slide into old age and death, every year a little fatter, slower, weaker, more pain-wracked. You can't hear and you can't see. Your hips go, your knees, and that great friend and amusing companion of your youth curls up and goes to sleep in your lap. Except when you have to take a leak, which is every half hour. you get petulant your conversation goes stupid your teeth are a bad yellow and your breath isn't so great either you don't have any money or hair and your muscles look like drapery you give up you sit there and wait go to the nursing home get tied to a chair That can certainly happen. In this country it often does. But it's a choice, not a sentence from on high. You can, just as easily, make up your mind and tell your body to live as if you were 50, maybe even younger, for most of the rest of your life. If you're willing to send your body some different signals, you can get off the slippery slope. You can stay on a gently tipped plateau until you're 80 and beyond. There are guys out there skiing slalom races in their late 80s. I've seen it with my own eyes. And other guys that age who are biking in the steep hills outside Barcelona where pro bikers train. Not just crawling along either. Like little old guys but doing it. Going for it. Having a major good time. And there are other old boys who are not interested in athletics but who are still in great shape and having a vigorous old age. So, here's the lesson of the book. You do not have to get old the way you think. You can do all the same things, almost the same way. Bike, ski, make love. Make sense. Roughly the same energy. Roughly the same pleasure. Roughly the same guy. In fact, you're a bit of a mess right now. You can become a radically better guy over the next few years and then level off. No kidding. We are begging you, Harry and I, we are begging you to get off the slippery slope. It will make a fundamental change in the next third of your life. Harry and I want this book to be fun for you. We want you to sail right through it before you realize just how serious we are. But let us have a candid moment. We are deadly serious. The stakes here, the potential changes in the rest of your life, are enormous. Think about the following numbers for a minute. Harry says that over 50% of all illness and injuries in the last third of your life can be eliminated by changing your lifestyle in the way we suggest. Not delayed until you're a little older. Eliminated. Along with all the misery, expense, and lost joy that goes with being seriously sick or badly hurt. You may want to think about that for a minute. You may also want to think about the fact that 70% of premature death is lifestyle-related. Premature means before you're deep in your 80s. Even more important for me is Harry's statement that some 70% of the normal decay associated with aging, the weakness, the sore joints, the lousy balance, the feeling crappy, 70% of that horror can be forestalled almost until the end. That is a huge difference. I had some interludes of normal aging in my life, when my joints hurt so much that regular walking was painful, and I looked for the cutout in the curb so I wouldn't have to step up three inches to get on the sidewalk. Think about that. Think about being so puny that you have to rock just a little to get out of a normal armchair. That stuff happens. It will happen to you. It really, really will. And it doesn't have to. All this sounds extreme, but it is not. Harry will tell you about the emerging science to prove it. It is head-turning. I will tell you about the life, about me skiing like a maniac at 70, long scary bike trips, windsurfing, caring about stuff, doing stuff, about getting functionally younger than I was 10 years ago, about feeling great most of the time. This is not chest-thumping nonsense from some old buffoon. This is the demo tape. Listen, you can turn 60 and get functionally younger every year for the next five or ten years. So, this is serious business. What I bring to the party. A report from the front. My part here is simple. I have lived through my 60s and I have been retired for a while. At 70, I have absorbed and followed the message of this book for a number of years, and I am prepared to tell you the exact truth about the process. Mine is the report from the front. Optimistic? Sure. But honest and unadorned. And here's the good news. I have done pretty well. Not stunningly well. I am not 40. But I am, say, a reasonably healthy 50. And this despite the following truths. I am an indifferent athlete at best. I am hugely self-indulgent. At one point I was 40 pounds overweight. I drink almost every day, and I am hardwired for pleasure. Absolutely hardwired. But once I got it into my head what the stakes were and how modest the commitment was compared to the results, I was there. I did the guy thing that we all know about. I made a job of it. You know the mantra. Suck it up. Be a guy. Do your job. Oh, and show up every day. That's the one thing we all learned how to do in thirty years on the job. Bring that edge to bear on these new commitments and you have it made. Here's another nice thing. The process isn't bad. Some of it, the exercise part, maybe, sounds appalling and you'll think we're kidding. But it isn't, and we're not. i wouldn't have done some of the stuff for a month let alone years if it wasn't fun but mercifully it is slightly addictive as a matter of fact we'll explain it's tough but it's fun and it works what harry brings to the party the truth Harry is the real McCoy. A board-certified internist and a gerontologist, he is, at 46, consistently ranked as one of the best doctors in America in national surveys. He is the head of a cutting-edge 22-doctor practice in Manhattan and on the clinical faculty of Columbia University's College of Physicians and Surgeons. He is also a serious student of recent developments in cellular and evolutionary biology. His is the report on that science, which has not yet made its way into the medical journals and won't for a while, and on what he has learned from his own experience treating patients in their fifties, sixties and beyond for the last fifteen years. The science is heavy, but Harry makes it accessible and persuasive. Okay, sort of accessible. But when you read his chapters, the logic, indeed the near necessity, of embracing his suggestions doesn't sound crazy at all. By the way, the science is sufficiently new that Harry, a profoundly conservative man in this area, warns that some of what he says may turn out to be wrong as research goes forward, but not the basic themes. The revolution he talks about is here, and the science is real. He makes it clear that there are remarkable forces in your body. in your cells all over the place that are constantly at work building you up or tearing you down darwinian forces preservation of the species stuff that have everything to do with who you are and how you live in his chapters we more or less take turns he tells you what they are and how they work He also tells you how to manipulate and redirect them to your own ends, like holding age at bay to a remarkable extent and for a very long time. Not completely and not forever, but a lot more than you can believe right now. What you'll learn is partly what you have always known. There are tides in our lives that carry us forward or back. When you're a kid, the tide is behind you and you go forward, no matter what you do. Stronger, more coordinated, better focused, better able to understand and cope. But at some point, the tide inside your body goes slack and the free ride is over. And then, in an instant, it turns against you. You get a little weaker. Your balance is funny. Your bones turn out to be frail. You can't remember things. and it begins to look as if before long the tide will be running pretty hard, and it's going to sweep you up on the rocks where the gulls are waiting, and the crabs, to eat your big fat gut and your eyes, take the guck out of your nose and your hair to make a nest, go up there and eat you. Sorry. But the interesting thing is that the tide is not strong. It looks strong because it's so steady, so remorseless, yet it's manageable in the sense that you can turn its relentless power to your own purposes, like using the terrifying force of a wind that is rushing you toward the rocks to sail into the wind and safety. Harry is not a breezy guy. But he's awful smart, and his stuff is worth a close study. All he wants you to do is change the way you live, fundamentally and forever. Me too. Meeting Harry and Getting a New Start I went to Harry because a pretty red-headed skin surgeon named Desiree told me to. She had just taken off half my nose with a local anesthetic, and I was still crazy about her, which requires a certain charm. I had just moved back to New York from Colorado, where I'd gone to be a ski bum for a couple of years when I first retired. I had missed that phase as a kid because I got married at nineteen and had three children before law school. Anyway, I asked Desiree if she could be my doctor and she said no, but she had just the guy. Smart, decent, a terrific person. A wasp, she said, but not a dope, as if that had to be cleared up. He'd been her teacher of something in medical school, and I'd like him. So there I am in Harry's examining room, wary as a cat, because, a confession, I don't like doctors. I don't like the haughty way they say, Hi, Chris, I'm Dr. Smith. I'm Chris, and he's Dr. Smith? What's that all about? And why do I always have to wait an hour to get this abuse? Lawyers don't do that. Doctors, man. And then the stuff they do to you. Harry has lovely manners and is a conspicuously decent guy. I am still wary. We've just been through all this terrible stuff. He's drawn gallons of blood, taken long, dubious looks in my ears and down my throat, asked lots of vaguely scary questions, and stuck his finger up my butt. Finally, it's the old, why don't you put on your things and come into my office and we can talk a minute. You just know he's going to say, I'll listen. I found a little lump up your butt, the size of a pomegranate, actually. Probably nothing, but there is some gangrene, so let's get you booked into the hospital and... I go into his office, and no, he has not found the pomegranate yet. Actually, he says, I am in fairly good shape, overweight, but not bad. The fact that I get regular exercise helps a lot. Harry is tall and oddly shy for a guy running this big practice. He looks at his computer a lot while he's talking to you. You wouldn't say nerdy because he's actually kind of handsome, if you think about it. Well, nerdy might cross your mind. He was an oarsman in college and looks it, but he dresses and carries himself so that I think New England frump, which, of course, is fine by me because I look about the same. I once had a secretary who said, Chris, you wear your clothes as if you hate them. Harry and I were cut from the same rumpled cloth in the same part of the world, the North Shore of Boston. We grew up five miles and twenty-five years apart. He drones on. Numbers, parameters, blah, blah, blah. Then, because I'm interviewing him for the important position of becoming my doctor, I say, so what is it about the practice of medicine that you like most? He stops, but only for a second, as if he'd been waiting to talk about it. What I really like is the notion of long-term relationships with patients and keeping them in good health. Not just curing disease, but promoting health, which is a different thing. I would like to help them have a better life, not just cure them of this and that. Bingo. What do you mean? I ask innocently. Well, I've always been interested in aging as well as internal medicine. I actually got board certified in both, although I'm not sure how separate gerontology is from internal medicine. Then he turns and quietly drops the bomb. What I am sure of is that there is a fundamental revolution at hand in the way people age. He pauses and thinks how to get at it. In the old days, and he goes into the business about the slow, steady curve from 50 to death on the one hand and the new plateau on the other. actually draws the lines in the air with his hand and you could be on the frontier of that change me yeah with your numbers he fools around with the computer yep this is pretty good Uh, you don't smoke, and with these numbers and a more aggressive exercise habit, you could go on about the way you are today until you are, say, 80, maybe 90. In fact, if you do a few things, you can actually be functionally younger. You're already in better shape than most of the men who come in here for the first time, but yes, you could be younger next year in all the ways that matter. Younger next year and for quite a few years to come. I go over and sit in his lap. True? Yeah. You ski. Well, you can ski hard through your 70s. Slow down and eventually go to cross-country at some point in your 80s. Bike. You can do that forever. There will be a certain decline eventually, but basically you can be as athletic, vigorous, and alert as you were at 50 until you're 80 or older. And for the first five or more years, you can be functionally younger. What do I have to do? It's hard to summarize, but there are three things. Did you ever notice how there are always three things? Three things, he says, exercise, nutrition, and commitment. The biggest one, and the biggest change for most people, is exercise. It is the secret to great health. You should exercise hard almost every day of your life, say six days a week, and do strength training. Lift weights two of those six days. Exercise is the great key to aging. This long slide, again the arching curve with his hand in the air, can simply go away or go up for quite a while, and you can be yourself for the rest of your life. I have about 400 questions, but, uncharacteristically, I sit and wait. Harry goes on. Nutrition, too. You should eat the way you know you should eat, but probably don't. If you possibly can, you should get down to your true weight. Your... peak at the screen... 194. You should be... what? What's your normal weight? 175? 165, I guess. Maybe less. I rode a little in college at 155 and weighed about that until I was in my 40s. Okay, if you could get back to 170 someday, that would be great. But don't stew about it. It's much more important to exercise, regardless of what you weigh, and then learn to eat rationally from here on out. Quit eating the things that you know are rotten for you, like fast food and lots of fats and simple carbs, and eat less of everything. He says dieting is dumb and doesn't work, but that my weight would drift down over time if I exercised the way I should and quit eating junk. How about jeans? I thought this was all decided at birth and I could just sit back and take my beating. No, Harry says emphatically. That is a profound misunderstanding and a lousy excuse. Jeans are maybe 20% of it. The rest is up to you. Booze? He looks back at the screen again. Social drinker. He quotes me from the questionnaire. Two drinks a night. Then those lovely manners cut in, and he does not lean across the desk and shout, liar. He just does the familiar thing about how a glass or two of wine is good, but more than that is a negative. A lot more can be a real negative, obviously. Commitment, he shrugs, as if to say this next part is harder to talk about. What I mean is, you have to be involved with other people, and you have to care about something. Goals, charities, people, family, job, hobbies. Especially after retirement, you have to dig in and take hold or things can take some bad turns. He stops, stuck for a minute, struggling a little. It's specific to you, and it's awfully hard to generalize, but there have to be people and causes you care about. Doesn't seem to matter much what the causes are. They don't have to be important to society or make money, as long as they're important and interesting to you. There have to be people you care about and a reason to keep yourself alive. If not, a little smile. You'll die. "'That's it?'I ask. "'In a nutshell, yeah.' "'Okay. I'm ready to go. How much exercise? What do I eat?' "'But that's the rest of the book. You're going to like it. It's going to save your life.'" Chapter 2 How's Your Wife? Before Harry gets his turn to talk, let me ask you a funny question. How's your wife? Or your lover or close pal? Whoever you got. Whoever's got you. How's she doing with the idea of your aging? Of your retirement? Is she basically life-affirming or has she had about enough? Is she on your side or on your case? Does she like you? Do you like her? What do you think of each other, anyway? Now that you're getting older. Okay, here's the real question. Is your union strong enough so it can be made into the foundation for the very different life that's coming at you both, at about a hundred miles an hour? Can you use the old stones, use the old beams, use the old love? Are you in this thing together? Here's why I ask. It's too damn hard to do this thing alone, that's why. And it's a real help if you happen to have someone who loves you and whom you love. That may come as a little surprise to you. Some guys have a wistful way of thinking, boy, if I could get the hell out of here and get my mitts on young Susie Q, then, by God, my life would begin. Or if I could just go out there and mess around for a while, just a few years. Well, maybe, but I've got to tell you, I don't think so. I was single for a long, long time, and I actually loved it. Had a fine, dangerous time. Excellent. Just like the movies. But that was then, and this is now. I happen to know that this next phase, turning 60 or 70 and retiring, is a lot easier if you have a partner. And if your partner has you. Look, if you don't have someone, or if your relationship is an absolute horror, fine. This book is certainly not intended just for married folk. There are other ways. Friends will do the job. Just one close friend does miracles. Networks of like-minded souls, too, especially if you're tied together by a passion for something. The great trick is to be connected, so that you go into this next phase with some support. We were designed to function in packs. Strays get the sniffles, especially with winter coming on. Later, Harry is going to tell you some wild stuff about how mammals are actually hardwired to function in groups, how we have this separate brain for it. Weird but true. The disposition to work in pairs and groups runs deep in our bodies and our minds, and we cannot get away from it. So let's go back to my question. How's your wife? Or your partner? Or your one close friend? And to our excellent advice, if you happen to have a decent relationship, don't piss it away in the vortex of change that's bearing down on you in retirement. You're going to need it. It's worth mentioning this little point because a surprising number of men do exactly the wrong thing. A lot of relationships that have lasted thirty years or more suddenly implode when the players reach their fifties and sixties. People give up, just when those relationships could be turning into something pretty damn good, perhaps because of the stress of retirement or the pressure of suddenly spending so much time together. who knows but it happens and it's not always a great idea because this is a time when you need some serious company and some serious roots a time when a lot of roots are being pulled out and things are getting a little scary i am an optimistic chap and you should be too Much the best approach to life. But let us have another candid moment. Turning 60 can be awful damn bad if you don't watch out. And even if you do, think about it. Some people actually die in their 60s. Not hit by cars or fallen off their bikes, just die of semi-natural causes, like heart failure and cancer of the this and that. It is highly unlikely that you will die, of course. I understand that, especially if you do the stuff that Harry and I talk about. But death is out there somewhere, and it can make you moody. You keep hearing the waterfall in the distance, and you wonder all the time, what's that noise, as if you didn't know. Scary. Very, very scary. One of the basic rules of this book is, be a guy, suck it up, do your job. Great advice, but it can be hard, and it's nice to have company. Preferably, someone you know pretty well. You're going over the falls alone, babe, but it's nice to have company for as long as you can. Especially when you're lying there, listening to that cataract in the night. We are pack animals. Snuggle up. Plan and scheme and get ready. Harry and I talk a lot in this book about retirement, even though there's a good chance you haven't retired yet and won't for a while. We do so because it is such a huge deal and it makes plenty of sense to get ready for it as early as possible. To simplify our storytelling chores, we talk as if everybody's on the edge of retirement right now, or already retired. If you've got a lot of time to go, great. Our modest suggestion is to do something that no one does in this country. Think about it. Plan and scheme and get ready. Build new networks of friends and commitments that will be there when the job ends. Think just a tiny bit about building a new you and a new relationship with your partner, if you happen to have one. If you're planning on working part-time or at something new, and a lot of you are going to be doing that, get your lines out. Use your connections right now. Figure out what you're going to do and how to do it while you're still a player. Retirement can be a fascinating and life-enhancing experience, one of the most interesting and important things that will ever happen to you. But it ain't easy. and it's dumb to sail into it without giving it some serious thought. Okay, back to the story. One of the basic reasons not to be alone as you head into your 60s is that retirement is so tricky in this nation. Science has given you another 30 years. Hell, 40 for some. But not the dear old firm. They want you out tomorrow, and they're going to get what they want. With a terrible suddenness. From one day to the next. You'll go from being a critically important element in a complex social organism, a member of the pack, to being a guy on the street with a lot of shattered connections. Maybe you're a consultant or you go to the office a bit, but it doesn't matter, you're history. They'll mourn you like crazy for about thirty seconds and then get on with their lives. Geez, I miss old Billy. Can I have the rest of his lunch? Of course you can, old boy. Here, I'll just take a little bite on the way. As if you were dead. That's hard. All that support. That whole network of colleagues and friends and enemies. The great flywheel of your life. Things to do. Things to be proud of or to fear. Places you fit in. Places you don't. All gone in an instant. And not much around in this society, with its nutty insistence on the nuclear family and faceless cities and no roots to take up the slack. We should change the way we've organized society so that we make better use of the next third of our lives. We should foster commitments and communities that will last a lifetime. And I believe we will. Because it's so obvious. But not in time for you. American society has been rushing down this weird, atomizing, isolating track for a hundred years now, making us into rounder, smoother pieces for the global economy we're all so nuts about. And it's not going to stop on a dime, even though it should. So you're on your own. Guys in this country think that's okay. We think we're cowboys and individualists who just happen to drop in to work for a while before we head on down the road. dropped in for you know thirty years but still the same independent guys we were way back then we think we have this inalienable core of individuality and solitary strength for the flinty eyed ride into the sunset at the end of the movie Like Alan Ladd riding off at the end of Shane. Guess what, partner? That was a movie. When the time comes for you to get on your horse and mosey off into retirement, you'll have a lump in your throat the size of Canton, Ohio, where you probably should have stayed in the first place, and you'll be scared. The lucky ones will be saying, what will we do now? I can answer that for you. For good or ill, you will invent a whole new life in a weird new world, the two of you, if there are two of you. You're going to build a new homestead, and it will have to last a lot longer than the rolling of the credits. In the old days, men could more or less count on dying a few years into retirement, but not you. You will probably last for twenty years, maybe thirty, almost a third of your life. So, the new spread better be pretty strong, pretty cozy, and homesteading is mostly couples' work. If you happen to be blessed with a relationship that can bear some weight, or if you can retool and reinvent what you've got so that it can take the strain, then the great likelihood is that you two are going to be each other's primary resource for a long damn time, perhaps the rest of your lives. Primary company, primary joint venturer, primary encourager or dissuader, the works. For an awful lot of us, it's going to be a huge part of the social structure for a while. The best relationship in the world cannot and should not be a substitute for everything you got out of your job. That's nuts. But it's going to be a primary resource, almost for sure. So start the emotional negotiations early. You are real partners now, whatever it's been like in the past. Talk as openly as you can and figure out who's interested in doing what, who can bear what loads, and do new stuff together. Think, for example, about the heavy exercise program that Harry and I will be touting in the rest of the book. If there's a chance in the world of doing that together, or even some of it, it is way more fun and way easier. You may think, why hell, she doesn't care about that kind of thing, or she couldn't keep up. Maybe that's right, or maybe not. Give you an example, close to home. When my wife Hillary and I met, the gag was that she never went outdoors, except to go to clubs, and only wore black. We moved to Colorado, and she shrugged off that persona like Superman changing in a phone booth. In a heartbeat, she was skiing, hiking, biking, and Lord knows what. Not a real athlete by any means, neither am I, but into it. And when we came back east and I got into what I call Harry's Rules, she was offish at first, but then she got into that too, and we went at it neck and neck. All right, not quite neck and neck. I'm a touch crazier and still a little stronger than she is, despite her slight age advantage, but we do a lot of it together. A couple of days a week, say, and I cannot tell you how much better that is. Think about it. Six o'clock in the morning, dark out, time to struggle off to that wretched gym. It's so much easier if there are two of you. you go out together you do it together you come home together soaked in sweat in the freezing air to the coffee and the paper and you both feel great pump each other up nice or this summer at the lake in new hampshire where i've always done a bit of rowing this summer hilary suddenly got into it we're off side by side she in her alden ocean skull and me in my little river white hole at dawn usually with the loons laughing at us in still water before it gets hot i often go farther but not always mostly we do it together and i can't tell you how nice that is biking these days same deal no one would have predicted that ten years ago so don't be too sure that your partner won't get into the exercise stuff she may fool you Also, in the next third, there are important things that she'll be better at than you are. Making new pals, maybe. Keeping the children and grandchildren in your life, where you can do one another some good. Pursuing connections and commitments and networking for both of you. Those are critical areas where she may do the heavy lifting. Hang on tight. in a way marriage in the next third is easier it's like farm couples in olden times less divorce and less angst because both players husband and wife had such important roles keeping the farm going same here You both have such important roles keeping your new lives going that, intuitively, you're going to show each other more respect, pay more attention, simply care more about each other than you have in the past. And by the way, that nutcase testosterone flood ebbs a bit. That helps. Another candid moment. Some older men are suddenly tempted to take a sideways glance at their wives and think, hey. There's been some mistake here. There is an old person in my bed. I've got to get out of here. As if you were so great-looking, you know, with your little belly there and your stinky teeth. But never mind, it happens. There's a convention in our society that men age better than women. Not when they're dying, of course, which happens five years earlier for men. We don't look that much cuter when we're dead. But guys forget about that. Think they're Paul Newman, gonna live forever. So never mind that there's an old man in her bed, you've got to get out of here. It is our presumptuous view that that is rather a cheesy sentiment. Probably a projection of your own fears about what's happening to you more than anything else, and not a good basis for action. We are not going to say anything in this book about divorce, young wives and all that. Too idiosyncratic, too personal. But we do have an idea. Instead of sitting there in silent, mounting gloom, thinking about what's wrong with each other, how about embracing each other's vitality? How about a timely, resounding yes to each other at this critical moment, when you can both use it? How about taking stock of what's best and strongest about each other and recommitting to each other's vitality? Not a bad idea. Having said that, there are limits to what your partner can do for you. you won't believe it if you're in your forties and still full of yourself but there is a real risk that you will try to put too much reliance on the relationship in the early stages of retirement men even great guys like you and me are a bit dumb about preparing for retirement as i said we go into denial and stay there so when the day does come an embarrassing number of us turn with something like tears in our eyes and expect our partners to take up the whole burden of keeping us interested loved hated amused sorry gents they can't they cannot and should not bear that burden Let's say they're nuts about you, which may or may not be true, after the rotten way you've behaved the last thirty years, but even if they are, they cannot shoulder that huge load and shouldn't have to. You're going to have to work at connecting and committing to other people, other groups, to make your life work. You are going to have to exercise your charm, your persuasiveness, your ability to get excited about stuff and bring others along, attributes developed over a lifetime, just as you have to exercise your physical body. The more broadly and variously you can manage to connect and engage with others during or in anticipation of retirement, the better off you'll be. But that's all subtext for now. The black letter rule for this particular chapter is this. Get in touch with your wife or significant other or best pal, if you just happen to have one. Recalibrate, restructure, and strengthen your deal, whatever it is, and head into the next third as full partners, homesteaders in tough, sometimes hostile new country. You'll have much better luck and more fun doing it together. Start with this book. Ask your partner to read it and talk it over. Use Harry's insights into evolutionary biology to trick your bodies and minds into staying strong for the next 30 years. You're a couple of kids in an old western, and you're going to knock over the Darwinian casino together. Live on the loot forever. She'll be waiting with the horses down by the river, or you will be, and you're both going to ride for your lives. It's a romantic story, surprising after all these years, and you're in it together. Chapter 3 The New Science of Aging When I had been in practice as a general internist for ten years, I sat down and took stock. What I saw changed my life, the way I practiced medicine, and ultimately led to writing this book with Chris. Things were going well. I loved my job, I loved my patients, and had wonderful colleagues. But the patients who had been with me from the beginning were coming into their late 50s, 60s, and 70s, and things were happening. Some had become friends as well as patients, but most I saw only occasionally, once a year for their physicals and from time to time as problems came up. Their annual checkups were like time-lapse photography, and in those jerky pictures, I saw people I cared about getting old at an alarming clip. Many were sedentary, but even those who were moderately active were becoming increasingly overweight, out of shape, and apathetic. and some were getting seriously sick. They were having strokes, heart attacks, liver problems, cancers, and bad injuries. A number had died, and the timing didn't seem to make sense. One of the hardest things about medicine is delivering bad news. We'll need to do some more tests. This looks suspicious. Why don't you sit down so we can talk? all the euphemisms we use to say that life has suddenly and irreversibly taken a bad turn. I became increasingly aware that most of these conversations were happening long before they should have, and for reasons that were clear and avoidable. It wasn't that I had missed a diagnosis or failed to spot something on an x-ray. I had done what doctors do well in this country, which is to treat people when they come in with a disease. My patients had had good medical care, but not, I began to think, great health care. For most, their declines, their illnesses, were 30-year problems of lifestyle, not disease. I, like most doctors in America, had been doing the wrong job well. Modern medicine doesn't concern itself with lifestyle problems. Doctors don't treat them, medical schools don't teach them, and insurers don't pay to solve them. I began to think that this was indefensible. I had always spent time on these issues, but I hadn't made them a primary focus. And far too many of my patients, including some very smart and able people, were having lousy lives. Some were dying. I had some further thoughts at that 10-year review. Most modern medicine is what lawyers and bankers call transactional, a one-shot deal. You blow out your knee, you have a heart attack, and you see a specialist. A short, intensive period of repair or cure follows, and the parties go their separate ways, probably forever. I realized that my practice was entirely different. I was likely to have long relationships with people, 20, 30 years. That's one of the best things about being an internist. but that privileged long-term look into patients'lives has put me on a different footing from that of the specialists. I am on notice of how my patients are living and of how they are dying. I am on notice that the normal American way of life, and especially the American way of retirement, is dangerous and sometimes lethal. I am on notice that no matter how great our medical care, we all need great health care, too, and very few of us get it. It is inexplicable that our society, plagued by soaring medical costs and epidemics of obesity, heart disease, and cancer, cares so little about these things. The simple fact is that we know perfectly well what to do. Some 70% of premature death and aging is lifestyle-related. Heart attacks, strokes, the common cancers, diabetes, most falls, fractures, and serious injuries, and many more illnesses are primarily caused by the way we live. If we had the will to do it, we could eliminate more than half of all disease in men and women over 50. Not delay it, eliminate it. That is a readily attainable goal, but we're not moving toward it. Instead, we've made these problems invisible by making them part of the normal landscape of aging. As in, oh, that's a normal part of growing older. Normal aging isn't normal. The more I looked at the science, the more it became clear that such ailments and deterioration are not a normal part of growing old. They are an outrage. an outrage that we have simply gotten used to because we set the bar so shamefully low. A lot of people unconsciously assume that they will get old and die. One phrase, almost one word, and certainly one seamless concept. that when they get old and infirm, they will die soon after, so a deteriorating quality of life doesn't matter. That is a deeply mistaken idea and a dangerous premise for planning your life. In fact, you will probably get old and live. You can get decrepit if you like, but you're not likely to die. You're likely to live like that for a long, long time. Most Americans today will live into their mid-80s, whether they're in great shape or shuffling around on walkers. And that number is rising over time, too, so you may well live into your 90s, whether you like it or not. Which is good reason to make the last third of your life terrific, and not a dreary panoply of obesity, sore joints, and apathy. Normal aging is intolerable and avoidable. You can skip most of it and grow old, not just gracefully, but with real joy. This was my epiphany. I thought, I cannot, as a doctor, sit here and watch people I care for and care about go down a road that is leading them to an awful place without doing something. It's not enough to wait for the car to crash and then do a good job of treating the injured and dying. If 70% of the serious illness I see is preventable, then it's my job to prevent it. The good news on this front is that you don't need to wait for a presidential commission or a national health initiative to do something. This fight can be led, fought, and won, one person at a time. Starting with you. As I've looked at the steady stream of people coming in for their first visit over the ten years since that epiphany, I've been struck by just how many of them suffer the downright bad health that seems to be the American lot these days. Not just older people, either. The horrendous effects of idleness and a rotten diet show younger and younger. With each new patient, I have the same talk I had with Chris, and if the patient is at all responsive, a new collaboration begins. The great news is that most people get it, and a lot of them have gone down the path toward getting younger. Change on the cellular level We are in the midst of a revolution in the science of aging. It is part of a larger revolution in our understanding of how our bodies work at the cellular level, and it has opened the door to healthy aging. The science behind this revolution is vast and extraordinary, covering fields as diverse as cell physiology, protein structure, biochemistry, evolutionary biology, exercise physiology, anthropology, experimental psychology, ecology, and comparative neuroanatomy. Definitive conclusions from this research are still emerging, but the basic lines are clear enough that men and women from 40 to 90 should act on them now. If they do, they can live radically better, happier, healthier lives than their parents, grandparents, or anyone else in all of biological time. Let's back up. Ten years ago, the basic science of health was unknown territory, the huge blank space on the map. But we've finally learned enough from studying disease to understand health. As it turns out, health is biologically more complicated than disease. In disease, the train has gone off the tracks, and the law of physics takes over. The crash is terrifying and destructive, but the science is simple. Health is the reverse. It has carefully designed control mechanisms to keep the train on the tracks. The science of those mechanisms, the blueprint for our bodies, is phenomenally complex. Luckily for us, the controls are simple to operate. You need to understand only two basics. Background points about the evolution of your biology to take control of your health. The first is that the human body is not a neatly integrated design package. The wonderful but wacky biological commune you call your body was cobbled together by nature from parts that evolved in different species millions, even billions, of years apart. Your opposable thumb, wiggling down there at the end of your arm, and a couple of extra pounds of brain are the only parts of you that are distinctly human. everything else is from another species. And don't think chimps here. We are talking bacteria, dinosaurs, birds, worms, gazelles, lions. The list goes on for pages. Your body, created with great optimism and fanfare by your parents in 1950 or 1930 or whenever, is mostly made up of cells whose basic structure and operation are not known. were developed by bacteria billions of years ago. The messages that run these cells are not the conscious thoughts that gave rise to the Renaissance or constitutional government. They are not thoughts at all. They are primitive electrical and chemical impulses that predate the dawn of consciousness by many eons. The second point is that you can control your deeply primitive cells with your miraculous, renaissance-creating brain, but not in the way you would expect. You have to talk to your body in code and follow certain immutable rules. We're here to give you the code and explain the rules. Not our rules, by the way. Nature's rules. And you can't get around them. Some good news, with a catch. You inherited a biological fortune. You have a stunningly good body, whether you think so or not, and a truly amazing brain. As a matter of fact, you actually have three separate truly amazing brains, from three very different stages of evolution, all working together. In simple terms, you have a physical brain, an emotional brain, and a thinking brain. Although they are chemically and anatomically distinct—neurosurgeons can separate them like sections of an orange—and have different purposes, all three are densely wired together to get you through your day. But here's the catch. Your body and brains are perfect for their natural purposes, but none of them was designed for modern life—fast food, TV, or retirement. They were designed for life in nature, where only the fittest survived. Most of your body parts have as little business in a mall as a saber-toothed tiger. Left to your own devices, your body and brains will consistently and without fail misinterpret the signals of the 21st century. Decay is optional. There's a critical distinction between aging and decay that you need to keep in mind from here on in. Aging is inevitable, but it's biologically programmed to be a slow process. Most of what we call aging, and most of what we dread about getting older, is actually decay. That's critically important because we are stuck with real aging, but decay is optional. Which means that most of functional aging is optional as well. There is an immutable biology of aging, and you can't do anything about it. Hair gets gray, gravity takes its toll, and movies go to half price. Your maximum heart rate declines steadily over time, regardless of how active you are. That's big. Your skin degenerates, too, regardless of lifestyle. So you will look old no matter what. But you do not have to act old or feel old. That's what counts. We haven't figured out a way to last forever. But aging can be a slow, minimal, and surprisingly graceful process. And even on the appearances front, there is a huge difference between a great-looking, healthy, older person and one who has let go. Nature balances growth with decay by setting your body up with an innate tendency toward decay. The signals are not powerful, but they are continuous, they never stop, and they get a little stronger each year. Chris refers to this as the relentless tide, which is a good metaphor. Whatever you call it, in our 40s and 50s, our bodies switch into a default-to-decay mode, and the free ride of youth is over. In the absence of signals to grow, your body and brain decay, and you age. We may not like that arrangement today, but we are certainly not going to change it. What we can do, with surprising ease, is override those default signals, swim against the tide, and change decay back into growth. So how do we keep ourselves from decaying? By changing the signals we send to our bodies. The keys to overriding the decay code… We hope you enjoyed this preview. To continue listening to this audiobook on Google Play Books, use the link in the video description.