“…in this world nothing can be said to be certain, except death and taxes.”

—Benjamin Franklin, among others

The dread of death (and ageing with all its debilities) is a fundamental one, and people have been seeking the elixir of youth for centuries. In modern times, there has been a surge in research on ageing that has, unfortunately, spawned a booming anti-ageing industry, “which has led to widespread marketing of dubious remedies that have a highly tenuous connection with the actual science”, Venki Ramakrishnan says in Why We Die. Because he was alarmed by the hype, he felt it “was an appropriate moment for someone like me… to take a hard, objective look at our current understanding of aging and death”.

Ramakrishnan has spent the better part of his professional life studying protein synthesis in cells. In 2009, he was one of three scientists awarded the Nobel Prize in Chemistry “for studies of the structure and function of the ribosome”, as the Nobel Foundation says on its website. The ribosome is the protein-manufacturing unit of cells. Proteins are the stuff of life; nearly every biological function and process, including ageing, happens through the agency of proteins, and many illnesses linked to old age such as Alzheimer’s disease are caused by malfunctioning proteins.

Although Ramakrishnan did not start his work with the realisation that it was connected to ageing, he has in effect had a ringside seat to the ageing research show and is thus well-placed to enlighten us. This he proceeds to do, with the minimum of jargon and the generous use of commonly understood matters such as electricity supply, traffic jams, and garbage disposal to make complex cellular processes and other concepts easier to grasp. There are diagrams too. The first one is of a cell and its major components whose functioning is depicted using the analogy of a city and its infrastructure (where was this diagram when I studied biology?).

There is much to marvel at in each chapter. (For example, we are told that if human DNA were taken out of a cell’s nucleus, where it resides, and straightened out, it would be about 2 m long, and yet it fits inside a nucleus that is only a few microns in diameter.) And there is so much to learn; Ramakrishnan starts with the basics (cells, DNA, genes) and covers what ageing and death mean at the cellular level, life expectancy and longevity of humans and other species (including trees), stem cells, cloning (remember Dolly the sheep?), caloric restriction and intermittent fasting, the various compounds and chemicals being studied for their anti-ageing properties, cryogenics (for those who believe that humans can be preserved like frozen peas), and so on.

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One of the astonishing things one learns is about DNA. It is well known that the instructions for life are coded in genes, but it was eye-opening to learn that this is not set in stone. The DNA in every cell is under constant assault and can experience some hundred thousand changes, or mutations, just in 24 hours. Everything we do (or do not do), everything that happens to us has a consequence effect that cells have to deal with in real time. Mutations can also occur spontaneously during cell replication, which is regular process, and cells have to deal with issues that crop up during protein synthesis. Therefore, cells are always in damage-control mode to counter the adverse effects of changes. Maybe, we would take better care of ourselves if we realised how much work is involved in keeping us going.

Why We Die by Venki Ramakrishnan
| Photo Credit:
By Special Arrangement

But as we age, a point is reached when the efficacy of the repair processes is impaired and various cells and tissues start accumulating damage. This is when we start to feel our age. Death (natural) occurs when too much damage accumulates in too many cells.

Most chapters end with a small recap and a preview of the next chapter, which is helpful to keep details straight in our head. He introduces us to a wide array of scientists, from the 19th century to the present day, whose work, even if it was not directly connected to ageing, contributed to advances in biology and resulted in the current understanding of ageing and death. It was heartening to read about the contribution of many women scientists.

The penultimate chapter, titled “Crackpots or Prophets”, deals with the unfortunate trend in recent decades of several companies and individuals, including some scientists of repute, touting their products as the next wonder drug/remedy that will “cure” ageing or cheat death. They form part of a growing tribe of “immortality merchants” fuelling a huge anti-ageing industry. Ramakrishnan says: “Today there are more than 700 biotech companies focused on aging and longevity, with a combined market cap of at least $30 billion.”

A Galapagos tortoise is measured during the annual weigh-in photocall at London Zoo on August 26, 2021. This species “holds the record for life span of terrestrial vertebrate animal and can amble along for two centuries”, says Ramakrishnan.
| Photo Credit:
Tolga Akmen/AFP

There seems to be no dearth of funding even when there is little to show for decades of work. Others are peddling nutraceuticals, such as anti-oxidants, whose efficacy is questionable since they do not need to undergo clinical trials or get approvals before being put on the market. This is not much more than a bilking industry as there is no evidence to date that nutraceuticals can slow down ageing or postpone death.

And, as Ramakrishnan discusses in the last chapter, titled “Should we live forever?”, even if it were possible to prolong life indefinitely, should we do so, considering the significant ethical issues and social consequences, overpopulation for one, that would arise?

For those wanting to delve into these and related matters, the book has over 50 pages of notes in which Ramakrishnan has given a detailed chapter-wise and page-wise list of his source material.

For a long time, people could not expect to live beyond their 30s or 40s, and it is only in the past 150 years or so that life expectancy has more than doubled, mainly due to improvements in public health. Maximum lifespan, however, has remained a constant, at around 120 years, with only a handful of people in the world coming near that figure.

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But it is not like there is nothing we can do for ourselves as we grow older. The following tried and tested “treatments” to promote healthy ageing are readily available to all: eating a balanced diet (it turns out Mother was right when she asked you to eat your veggies), getting the right amount of sleep every night, and exercising regularly (your mitochondria will thank you). Sleep is so important biologically that even single-celled organisms, which do not have brains, do it. A recent study found that “one of the ways that a lack of sleep accelerates aging and death is by altering repair mechanisms that prevent the buildup of damage to our cells”. Other things that contribute to longevity: “reducing stress, staying mentally active, and having an optimistic outlook”. These are not as easy a prescription as popping a pill, but they are effective and have no side effects.

Even with all the breakthroughs and advances that have been made in biology and medicine, Ramakrishnan says, no one at the moment is close to developing a drug or treatment to cure ageing or extend lifespan. Ageing and death are inevitable. In spite of this takeaway from the book, reading it was not a grim exercise. On the contrary, Ramakrishnan’s descriptions of internal cellular processes fill one with a sense of awe and wonder at what a miracle life and the human body is. It is remarkable that we manage to make it through a day, considering how fragile DNA is.

As we go about our daily lives, each cell in our bodies is working in tandem with others, like members of a massive orchestra (another analogy used in the book), to carry out the myriad of complicated and interconnected processes needed to sustain life. To even think that we could decipher the biological symphony being played out and tinker with its complex composition seems like hubris.

So be kind to your hard-working cells, and taking heed of the director Baz Luhrmann’s advice in his “wear sunscreen” song, “[e]njoy your body…. It’s the greatest instrument you’ll ever own.”