Guts and Smarts

Dare to Be 100
by Walter M. Bortz II, M.D.

Take 99 Steps to 100.

A bestselling expert on aging and geriatric care offers a prescription for achieving longevity and preserving the quality of life. In Dare To Be 100, Walter M. Bortz II, M.D., explains how and why we should all strive to be centenarians with his unique and practical program. Supported by his lifelong research, this program is broken down into the categories of

• Diet (Take a Coffee Break; Beware of Free Radicals)
• Attitude (Be Necessary; Maintain the Creative Spark)
• Renewal (Recharge Yourself; Keep Working)
• Exercise (Keep Your Oxygen Tanks Full; Be Sexy, Be Fit)

The 99 steps in this book offer an effective plan for living long, healthy, and — just as important — fulfilled lives.

Chapter 1

You've got to have guts to grow old
To claim life you've got to be bold
But you have to be smart
As well as have heart
If you want your whole tale to be told.

In 1995 the first of 75 million baby boomers turned fifty. We know this much. What we don't know is, beginning in 2045, how many of them will turn 100. Two principal credentials will have to be presented if most are to make it — guts and smarts. Smarts is the accumulation and use of the cascade of new knowledge that provides the when, what, and how to aim for 100. The when, what, and how involve sorting out and disentangling prior ignorance and misinformation, which has until now prevented full extension of the lifespan. The when is the critical appreciation of the dimension of time in everything you do and are. The what is the simple assigning of life forces to the proper category, knowing what is changeable and what isn't. And the how is the understanding of the way the parts fit together. Our current era is the first in which sufficient knowledge has been accumulated to provide sound answers to these basic questions concerning human life. Having smarts affects each part of your life — the biological, psychological, and social. It affects you individually and collectively as a member of the larger community. It is one of the two basic ingredients of living to be 100.

Smarts When What How

Guts Why

But smarts by themselves aren't enough. Smarts are necessary but insufficient. In order to squeeze all the good out of your life, you also need guts. Guts means having the valor of purpose necessary to pursue the why. The capacity to search steadily for a significance in life represents the highest nobility. The why is finding a meaning for all of the expanded living and also the energy and involvement necessary to make it happen. Nietzsche is quoted in Viktor Frankl's Man's Search for Being: "A person who knows the 'why' of life can put up with almost and 'how.'" For the flame of life to burn brightly for all your days, a steady supply of active participation is essential. If apathy, discontent, and boredom are given room to thrive, your chances of seeing 100 are slim to none. If, however, you muster the guts, nourished by a sense of meaning, then a long vivid life beckons. You need to ensure that each minute of your life is crowded with active participation. It is simply the way nature works, and you need the guts to reach for your natural capacity.

John Gardner suggests that we amend our constitution to read "Life, liberty and the pursuit of meaning." It is the pursuit of meaning that gives life its substance. Without this search we humans are pretty much mindless voyagers on a lonely planet. Yet if we can strive for purpose, then life has a direction. This striving takes guts.

Such heroism does not connote an occasional dash into a burning building or pursuit of other episodic risk of personal safety, but instead reflects a steady, quiet slog across the peaks and valleys of everyday life. Guts and smarts. Courage and intelligence. These are the secrets of the fountain of age, the elixir of a long, bountiful life, the dream of the ancients. Guts and smarts are not mythical, mushy-brained ingredients. They are securely documented, tested, and integrated. They fit precisely into a coherent whole. There is now a sufficient fund of data and experience to allow baby boomers — and, of course, younger generations — to plan their 100th birthday party with calm assurance, prepare the guest list, and muster enough respiratory reserve to blow out all those candles.

But making 100 is not a sure thing. It will not happen effortlessly. It is your job, not someone else's, to see that it happens. As things stand now, the government would hate it, industry would scream, and almost no families would know how to deal with such widespread longevity if we did achieve it. There must be an awful lot of shifting around of old attitudes and social organizations for the boomers and beyond to fit in comfortably as centenarians.

Life inevitably brings losses. The longer you live, the more there will be. The losses themselves are not the principal threat, however. A lack of resilience is. How you confront and adapt to losses is a major ingredient in daring to be 100. There are many pitfalls along the way, disincentives, wrong information, stereotypes, prejudices, and asynchronies. There are many excuses for not wanting to be 100, but they are wrong-headed. The reason all of us should want to live a century are much stronger than the reasons not to. To wish for less than your full potential is dispiriting. We are born for one purpose, and that is to live. When you are ready to die, you must be able to say "Yes, I have lived." Don't spend so much time worrying about whether there is life after death. Worry instead about the life before death.

Smarts — The When

The first element of developing the smarts necessary for a long life is the new appreciation of the time dimension of your life. How far is it from womb to tomb? An 83-year-old friend of mine told me how he had been more or less looking idly out the window each day for the undertaker to pull up. Then — "Eureka!" — he miraculously recognized that "it wasn't time yet." But until this moment he had lacked the clarity of information to know what stage of life he was living, or put another way, what time it was in his life.

In all likelihood, until now, all of your estimates of your lifetime have been wrong. How do you know what time it is in your life? Usually you set your life clock by your parents' and grandparents' experience. If they died young or old, you more or less projected that prophecy onto your own life. My maternal grandparents died in their 50s and 60s of cancer and diabetes, which was pretty much what was expected of them in the 1920s. My paternal grandparents, however, lived into their early 70s, and I recall my parents and all of their friends feeling that Dad's folks were extremely old, outliving their allotted times. They were in overtime.

I am sure that my parents set their life clocks according to my paternal grandparents, making midnight for them around 70 years of age. Dad died at 74, just about on cue. But my mother lived to 95, the last survivor of twelve children, and a widow for twenty-two years. She was confused and awkward about her age, despite the fact that she was healthy until she died. She had lived way past her midnight. On birthdays and Christmases in our house, she was upset that my kids — her grandkids — did not turn cartwheels when they found her check for five dollars in her card. Despite my continued efforts to encourage her to play a role in our family, she was uncomfortable and out of synch. She often told us to "act your age," but the problem was that she didn't know how to act her age.

Mother lived to 95, not because she paid any heed to the advice of her physician husband and son. She took perverse pride in disregarding everything we ever said to her. She was at least thirty pounds overweight her whole post-me life. Mother lived to 95 because she was designed to live this long and longer. We all are.

When my mother was a little girl, the average life expectancy was only 45 years of age. No wonder she felt awfully old near her end. But there is now a virtual consensus that the maximum human lifespan is around 120 years, or one million hours. This does not mean, of course, that all of us will live that long. But at least two people have — Shigecko Isumi was recorded by the Guiness Book of World Records as the oldest documented life — 120 years, 237 days (but on February 21, 1996, Jean Calment of Arles, France, turned 121). By merely asserting that some of us can live this long creates a noble vision. It is like being President of the United States. Our Constitution asserts that any one of us can be, but very few will. However, the very possibility stretches our imaginations and encourages a sense of participation.

Virtually all biological processes conform to a bell-shaped curve, which is to say that no feature of nature operates in such a way that allows that everyone is the same height or weight, or that all leaves fall off a tree or a shrub on the same day, and so on. In just such a way, natural life expectancy should conform to a bell-shaped curve, the extreme end of which is 120 years. If 120 is the far edge of the curve, where is the center? The answer is 100, meaning that 100 years of age is the median. Ken Manton of Duke University is the leading age demographer in our country. In a recent article in the International Journal of Forecasting, he calculated that if the current health habits of the past few years continue, in the year 2080 the average life expectancy in America will be 100 for men and 103 for women. Using data supplied by the Census Bureau, Paul Siegel and Cynthia Taeuber predicted that "If the average rates of decrease in death rates continue to prevail in the coming years, in 2050 the average life expectancy will be 100." If this is the case, there will be 19 million centenarians.

These sturdy predictions by leading experts should be heartening for my oldest grandchild, Kellen's, buddies. There years ago I gave a very important public address — to his first grade class. Before I started, I passed out papers and asked these bright kids to answer a few basic questions. First I asked how long they would like to live. All but five answered at least 100. One said "forever." The lowest number was 87. Then I asked how long they thought they were going to live. Two answered less than 80, six answered 80 to 90, four answered 90 to 100, the other ten answered 100 plus, one 125, another 254.

A year or so ago, the Alliance for Aging Research conducted a man-on-the-street survey and asked essentially the same questions. Two thirds of the people, this time adults, also said they wished they could be 100 if — and this is the important if — they could stay healthy.

Given this data, we now know how to set our watches and clocks and calendars. Midnight on the 31st of December comes at 120 years of age. For a 30-year-old that means he or she is only at three o'clock, or in March of the year. A 60-year-old is at six o'clock, or in June. Not until older ages does winter set in. Knowing how to "time" lifetimes is surely one of the most powerful tools we can use to live a fulfilled life. It is a key component of smarts. The when of life.

The physicists teach us that there are really only three basic components of the universe: matter, energy, and time. We mortals can have some input into the first two of these, matter and energy, but time is beyond our control. No one has yet found out how to alter time. This is clear. What isn't clear is our ability to know which aspects of our lives are controlled by the effects of time, over which we have no influence, and which are due to the interaction of energy and matter, which we can actively confront. The distinction between these two aspects is one of the great benefits of being able to comprehend the true time boundaries of our lives.

Until now, we have understood only two times of life, youth and adulthood. Youth and adulthood were and are extremely well studied and understood. There are innumerable texts describing in abundant detail what being a child and an adult are all about. Being a child means growth, learning, developing, maturing. Adulthood means childbearing and-rearing, the time of work. What comes next? The answer for most people, until relatively recently, is that they die. But when you realize that there are as many people alive over 65 years of age in the world today as in all previous history put together, you get the idea that the opportunity to grow old — to live into a new third age of life — has only rarely existed before. Now it is common and becoming more so, as 15 percent of women and 4 percent of men now live into their nineties. The most rapidly growing segment of the American population is the centenarians, not because of any great medical breakthroughs, but simply because they, like my mother, are fulfilling their natural biological heritage.

Having the smarts to understand the true time dimension of life can be powerfully shaping. With this knowledge, you can redesign your life. Such a positive act helps offset what psychologist Martin Seligman calls "the helpless-hopeless" syndrome. Numerous examples exist that indicate that for many people death seems to occur on cue. Voodoo death and the pointing of the bone are vivid evidences of negative predictions. There are, as well, positive examples in which people die at lower than predicted rates in periods immediately before important holidays or celebratory events. For example, elderly Chinese die at lower than expected rates in the period preceding the Moon Festival and higher rates immediately thereafter.

With a foreshortened lifespan expectation, how can you logically plan the last of your new life? How can you see and know the whole when only the first part has been studied? How can you understand a novel, a mystery, a movie, a ball-game if you leave part of the way through? Now that we see the last part, we can understand the whole.

As children we presume that most of our life will be spent going to school. As young adults we presume that most of our life will be spent with children in the house. As working people we presume that most of our life will be spent working. All wrong. Life is made up of these segments, but the huge post-working segment is unaccounted for. Is it possible that this last segment is the longest of all? What is the job description of this new-found lifetime? It is a gift of found time.

Lack of sensitivity to this time dimension of life leads naturally to an assertion of immediate self-gratification — the newborn baby has no patience. If there is no sense of tomorrow, we naturally want it all today. If life is going to last 40, 60, or 80 years, we need to get it all done in that span.

What if it were possible to know exactly how long we were going to live? What if our birth certificate had an expiration date stamped on it? The lifestyle of the inner city toughs is predicated on having no life calendar. Each day has no future. Logic is irrelevant — all because of lack of identification and appreciation of a sense of lifetime. If gang members knew with confidence that they could and would live to be 100, their mad pursuit of consumption and immediate gratification and glory would erode. Length of life has consistently been shown to relate to intelligence in general. And length of life should logically be expected to relate very highly to intelligence about how long a person might live!

The point is, we can play an active role in determining our lifespan, as long as we understand that it is mutable and not fixed. Having established reliably our true lifetime potential is one of the most precious intellectual gifts our species will ever receive. But of equal or even greater importance is the nature of the new longer life, the what and the how.

Copyright © 1996 by Walter M. Bortz II, M.D.

About the Author

Walter M. Bortz II, M.D., the author of We Live Too Short and Die Too Long and more than 100 scientific articles, is a member of the teaching faculty at Stanford University Medical School and a practicing physician at the Palo Alto Medical Foundation. Past president of the American Geriatric Society, former co-chair of the AMA-ANA Task Force on Aging, and participant in one marathon yearly, he also serves on the editorial board of Runner's World magazine.