Even in other sciences this kind of absurdity exists. Let us examine quantum physics. In 1905 in the German journal Annalen der Physik, Albert Einstein, who was then a patent clerk aged 26, wrote an article explaining how certain solids generate electric currents when struck by light, the photoelectric effect. Here Einstein reversed the hundred year old accepted theory that light travels as a wave. His proposition was that light sometimes acts like a stream of particles. In 1923 the French theoretical physicist Louis de Broglie twisted the same argument by saying that electrons could act like waves or particles. New theory of quantum electrodynamics changed this by showing how electrons interact with photons. Interestingly another famous physicist Richard Feynman thought that nobody could understand quantum physics properly. Students were taught that electrons were either waves or particles depending on the experimental apparatus used. They have all agreed now that the particles and the waves are but the extremes of a continuum. In every field of human knowledge clarity is not an alternative to truth.

Let us come back to our question on hand. Is there a biological limit to human life span ? Is it the same for all animals or is it different for man? What are the evidences? I had written earlier about the great English actuary, Benjamin Gompertz, who lived in the early part of the nineteenth century. This man conceived a human life curve and documented it properly, but the whole thing was lost after his death. Recently they have been able to discover the same from Nottingham where he lived. Surprisingly it compared very well with the present data. In 1825 or so Gompertz wrote that human mortality increases with age in a geometric proportion, doubling every eight years, between the ages of twenty and eighty years. Gompertz died before he could prove his hypothesis. Another biologist Raymond Pearl, thought that Gompertz was right, by his experiments on Drosophila in the year 1926, nearly hundred years after Gompertz.

Recently in a study sponsored by the US dept. of Energy, Bruce A Carnes and Jay Olshansky showed that there is a limit for human life span and it is not possible to extend it any further. They have appreciated Gompertz’s phenomenal hypothesis. In a lighter vein Bernard Shaw in his book Doctor’s Dilemma said " Do not try to live for ever you will certainly not succeed." If, as we believe, medical science is able to keep all people alive for ever what will happen to this world ? The truth is that medicine has been and will be able to do exactly what Hippocrates, the father of modern medicine wrote thousands of years ago " cure rarely, comfort mostly, but console always." Medicine should concentrate its efforts to add life to patients’ years and not vice versa. Unfortunately it does not make good business sense. We should tell people that we have increased human life span. If people regularly get themselves checked up they could avoid fatal diseases, detect the latter in their presymptomatic stage for complete cure etc. Like in physics this aspect of medicine is only an opinion and not the truth. Hans Christian von Baeyer, the professor of physics in Virginia, writing a book on Thermodynamics said that clarity is not an alternative to truth.

The truth is that human life span has been fixed over thousands of years of evolution and can not be extended now. Biologically a human being is of no use genetically for the species after the reproductive age. Women after menopause have higher incidence of degenerative diseases. Penile artery is a very good guide to the state of coronary artery patency. As long as a man gets a good erection, it is said, one could roughly estimate his coronary vessel patency. Man is born with only two basic traits, the instinct of self preservation and that of procreation. All others are acquired after birth. What then is the basis of the dubious claim that we have extended human life span. I can not better what Olshansky said about that question. " We now have what could be described as `manufactured survival time’ ."

Allthough I have been writing about this for a long time, this was again brought home to me in the case of patient of mine and a good neighbour, which is worth reporting. This was an elderly lady who lost her husband after a prolonged illness. Both of them had very bad diabetes, hypertension and coronary artery disease. After the husband’s death she was very much depressed and her disabilities worsened significantly. She was in renal failure for sometime. The latter worsened and she was vomiting daily. We have been able to manage symptomatically and try and control her pressure, sugar etc. The relatives wanted her to be taken to a metropolitan city for better care and she landed, very much against her wish, in a five star hospital there.

They started dialysing her daily, her condition kept getting worse day by day. She was in the intensive therapy unit (imagine the cost!). She developed complete heart block while she was being dialysed, but did not have any symptoms. She was in bed with a heart rate of forty per minute. But they wanted to pace her and she had a permanent pace maker put in. Next day she had some chest pain and it was decided to do coronary angiography on her. Thank God , some sense prevailed and they deferred it temporarily. Eventually she died there. Luckily the bill did not give a heart attack to the near and dear ones ! This is where I keep worrying about our system. What was the need to put a permanent pace maker for an old lady in severe renal failure, heart failure, diabetes etc. She was in her terminal stages. How on earth does the coronary anatomy help to keep this lady comfortable? These and many other questions keep begging answers from thinkers in this field.

No one has done any research to show " how longer life by itself is desirable, unless it is accompanied by comparable gains in its intrinsic quality. " Should market forces alone guide our clinical judgement ? Should medical teaching change to accommodate human aspects of patient care in the syllabus? Long life ! - It is a favorite toast. It has its blessings and also its curse.