By Mark Edmundson

A certain part of the American population now lives for nothing so much as it does for good health. There is protracted compulsive exercise, with a keen understanding of exactly how much cardio is necessary to reach maximum benefits. Weight training is crucial, of course, but never so much as to threaten injury. There is care for the diet, which must be rich in the right form of antioxidants, appropriately sparing of meat but not devoid of protein, and jungle-prolific with leafy greens. Wine? Of course there must be wine, and red is the best. Resveratrol is the drug you want to prevent aging, and red wine is where it’s found. But wine must be drunk sparingly, no more than two glasses in an evening. Avoid the third glass, said the 17th-century poet George Herbert, and legions of ascetic sybarites now concur.

Everywhere you go in a certain segment of bourgeois America you see men and women dressed in childish togs trooping off to yoga class or heading to the gym for aerobics or jogging along—six, seven, eight miles, often at a toddler’s pace—in the heat, dust, and traffic of the late afternoon. Then a shower, a change of clothes, and off to the health-food store before it closes to get the right supplements and a quart of blueberries shipped up specially—it’s off season—from Colombia or Peru.

Why all the fuss? Why all the sweat and bother? To feel good, of course. To stay alive, naturally. What other reason could there be?

But the intensity of pursuit makes one pause and speculate a bit. What is this all about, this amazing attentiveness to health? There is a quasi-heroic dedication to all this conscientiousness about food, a saint’s rigorous commitment to the demands of exercise. And the devotees think about their health all the time. Is man the rational animal? More and more what he thinks about—if he is middle class; if he has been to college; if he has read the right books—is how to go on living. He concocts strategies ostensibly for the prolongation of a healthy life.

But on some level one senses—let speculation take full charge here—that what the man or woman oriented to health most wants to do is to live forever. In one of Tom Wolfe’s novels there is a young man perpetually deep in his computer. He wears titanium-framed glasses and a look of enduring intensity. His name is Wismer Stroock. “The Wiz,” says Wolfe, “was only thirty-two, but he had a bony neck and a bony jaw and sunken cheeks and cadaverous cheekbones from getting up every morning, every morning, before dawn and running six miles through the streets of a Dunwoody subdivision called Quail Ridge.” He drinks bottled water and eats purified foods of all descriptions. He is devoted to the purging of the body. He is very pale. He is a young man, Wolfe suggests, not unrepresentative of many in his generation. On some deep level he has decided that it is his goal to live forever. He is never going to die.

One sometimes imagines—and this is all one can do, for who can read the thoughts of another?—that this is the secret goal behind many of our current quests for health. People somehow believe that with the application of current knowledge and the power of the will (plenty of will), they can live eternally.

This ought to be no surprise. Since the beginning of time (or close), men and women have sought immortality. They have sought to live as the gods do—eternally and in bliss. (They have, one might say, invented gods so as to show them an image of eternal life to which they might, with whatever daring, aspire.)

And why should one wish to live eternally? To avoid the pains of death, of course. But if you wish to live as the gods live, at least the Greek gods, you will live for other things too. The Greek gods live for pleasure—they love nothing so much as a delicious tryst with a mortal or with another god. They love to make things—or inspire humans to do so. Athena presides over the creation of the city that bears her name; Apollo makes music and invents mathematics; Diana creates the arts of the hunt and all the woodland crafts; Aphrodite schools gods and mortals in the ways of love. Gods live forever in order to make things, to create where there was nothing, and to enjoy the fruits of their creation.

Why do mortals now wish to live forever? (Let the speculative line play itself out!) It looks to me as though health and well-being are now simply ends in themselves. We want to go on living in order to go on living, and not for much more. The eternal gods embody ideals—love, honor, the humane mastery of nature, skill in music and architecture. They represent the ideal perfection of these pursuits. But in our culture, we have no time for ideal perfections. We are pragmatists. We want to get the job done, not pursue the best. We do not aspire to reach the Platonic transcendent, just do enough to be able to submit a bill. To wish to live for a very long time, even to wish to live forever so as to fulfill ideals—that seems to me to be a noble desire. But we have no ideals. We live for success and prosperity, worship what “works” and denounce what fails. Woody Allen, it seems to me, speaks for many in one of his best-known lines: “I don’t want to achieve immortality through my work. I want to achieve it through not dying.”

Health should manifest itself as a means to an end. We want to be healthy so we can get something practical done—or better still, something divine, something celestial. But now, since we do not know what we are doing here, do not know what we want or need, health has become an end in itself. People pursue health for its own sake. Why do you want to live? we ask the compulsive exerciser. The answer is not So that I can finish the work; so that I can make the discovery; so that I can find enduring love. The answer now—implicit, but to me, alas, unmistakable—is that I want to live simply to go on living. With the disappearance of tenable ideals, life, simple life, has become the great goal.

Francis Fukuyama glances at this matter in a passage from The End of History and the Last Man.“In America today, we feel entitled to criticize another person’s smoking habits, but not his or her religious beliefs or moral behavior. For Americans, the health of their bodies—what they eat and drink, the exercise they get, the shape they are in—has become a far greater obsession than the moral questions that tormented their forebears.”

*****

All of the energy that once went into the pursuit of the ideal is now dormant, for almost no one can believe in ideals anymore. A quest for artistic perfection? Absurd. A search for true and absolute knowledge? A joke. A life’s dedication to compassion and lovingkindness? You must be kidding. So what is to be done with the power of human will that might once have sought after these things? It is redirected to more quotidian business. People now pursue a means—staying alive—as though it were an end in itself. Epic measures of energy invest a rank banality, for in truth there is no sustaining meaning to be had, no triumph to be achieved, simply in the maintenance of biological life.

Yet to my eye we go at that maintenance as if it were all important, as if life maintenance were capable of producing the sense of achievement and consequence that the creation of a perfect piece of art could produce. This is why exercise crazes and diet books and supplement hawkers and all the rest are so absurd. We treat all these things as ideals in themselves, overvalue them ridiculously. It is as though a man bought a car and spent all his time tuning it, getting the tire pressure right, vacuuming the interior, and checking the fluids, but the car stays parked in the driveway. The journey never begins. How could it? The man has no idea where to go. Just so, we tune our bodies, prepare for long life, maybe eternal life, though of what to do with that life, what makes it worth living, we no longer have any idea. So we turn living itself into the goal, just as the poor man knocks himself out maintaining an automobile that will never take him even a hundred yards away from where he lives.

The struggle to sustain life can feel like a real struggle. It can feel like an epic task. (Ask anyone who has tried.) The writers of all the health books can make the choice between asparagus or candy corn feel like an engrossing struggle. The exercise guru can make his regimen feel like a battle. But on some level we know that these equations are false. We know that you cannot substitute having an enviable waistline and low cholesterol for living a life rammed with meaning, but we do not know what meaning is or how we might recover a sense of it.

There is nothing at all wrong with a tough physical regimen. Plato understood that a philosopher must be an individual perpetually in training. He must keep himself (or herself) nearly as tough and strong as warriors do. Plato’s philosopher eats a simple diet; exercises regularly; owns no property; has no family; never touches gold or silver (he has these things in his makeup already, Plato says). But all of this training is not an end in itself. It is done to put the thinker in the position to think. It’s necessary to remove as many external distractions as one possibly can. One cannot be overwhelmed by the merely circumstantial. But the philosopher does not strive forever. When he thinks, he touches on eternal truths (if he thinks well), and this gives him all the commerce with the eternal that he needs for an entirely joyful life. And he eats and drinks as he does in order to be in a position to do what he believes he’s been set on earth to do, cultivate wisdom. He does not eat and drink in a given way primarily to be healthy, feel good, and prolong life.

America now is full of people who have made of the self’s quest for longevity an epic quest. And it is full of people who seem to be running almost precisely in the reverse gear. They are getting fatter and fatter, shorter- and shorter-winded. They eat what they like and they seem to like everything that is amok with salt and sugar and fat. The well-conditioned thin are made furious by the fatties—the abstemious being singularly disposed to fury. Why do we have to pay their hospital bills? Can’t they take responsibility for themselves? They know what they should be eating and what not. Why don’t they get in line and get in shape? As the (rather plump) late-night host Jay Leno seems never to tire of asking: “How fat are we getting?” The tubby are a health disaster and an aesthetic outrage to boot. Who can bear to look at them? Who can bear to be around them? At least they should stay indoors so we don’t have to be appalled.

To which the fat might righteously reply: What for? Why bother? Is there a reason to get in shape and get in focus? What exactly does life offer at this point that would make such activities worth anyone’s while? There are no mutually respected ideals to work toward (unless you are perverse enough to count making a great deal of money as an ideal) so it makes perfect sense to let it all go. The fat, perhaps, are sad. Maybe—let speculation continue—the world as it is appalls them and so they protest it in the way that is most ready to hand. They won’t play. They won’t participate. If the only reason to go on living is to go on living, then why bother with that?

At least you’ll feel better, says the well-conditioned skinny. On the contrary, comes the reply, the bursts of pleasure that food and drink reliably deliver far exceed the meager little hum of satisfaction that comes from being “in shape.” Ask Falstaff. Didn’t he have a better time of it than the scrawny, scheming, starveling of a prince, Hal? Surely fat Jack thought that he did. So what if he had not seen his privates for lo a decade and more. Let us have capons and sack. Or, to cite another Shakespearean high-liver: “Dost thou think, because thou art virtuous, there shall be no more cakes and ale?” There will be cakes and there will be ale. “Yes, by Saint Anne, and ginger will be hot i’ th’ mouth, too,” as Feste assures us. Falstaff is a merry nihilist; the prince a tight, resentful one: Which do you prefer?

The healthy—or those who aspire to be—can’t really understand the unfit. Why don’t they diet and exercise and read articles about the joys of vegetable soup? In behalf of the corpulent, one might say simply this: Maybe they have the courage of their lack of convictions. They cannot believe in anything—if they did they’d find a way to thin-up in behalf of their cause. Nonbelief may bring them to despair, but at least they don’t hide their despair in futile projects like trying to stay alive in order to keep on living (in muted despair).

In the absence of true human purpose one can only say this: Health—health can be sickening.

Raymond Johnson, a 26-year-old man from Charleston, SC has breast cancer, something that rarely afflicts men. Mr. Johnson, who is employed laying tile was unable to afford health insurance.

Susan Appelbaum, an angel working in disguise as a patient advocate at the Charleston Cancer Center, tried to help Raymond and a state program that providing Medicaid for breast cancer patients. Mr. Johnson was denied the coverage because he’s a man and the program is only for women.

The SC Department of Health and Human Services has asked the federal government for help. But Raymond Johnson needs the treatment NOW. From WCIV ABC-TV news in South Carolina:

“Each treatment is probably roughly around 10 grand,” said Susan Appelbaum, the patient advocate for Raymond Johnson. She says, Raymond still needs several more chemotherapy treatments.

“Right now I’m stuck with these bills and I’m trying to find a way,” said Raymond, who just underwent his second round of chemotherapy at Roper Saint Francis Hospital.

Breast cancer in men may be rare, but it does happen. Statistics show one in 100 men will get it, roughly 2,100 cases a year.

Susan Appelbaum hasn’t given up.

“He’s young. He’s working and he’s worried this could be financially devastating to him.”

She is now contacting lawmakers, trying to get the medicaid program changed. Raymond Johnson calls her his new best friend.

“I don’t know where I’d be without her,” he said.

Best wishes to Raymond Johnson. May he live long and thrive. The only thing he did wrong was not being born in Canada. Ms. Appelbaum is a fine human being for not letting him slip through the cracks of our horrible healthcare system in this country. I do hope this story has a happy ending.

By Zoë Corbyn of Nature magazine

The placenta has long been thought of as a passive organ that simply enables a fetus to take up nutrients from its mother. But new research in mice shows that when calories are restricted, the placenta steps up to the plate-actively sacrificing itself to protect the fetal brain from damage.

Researchers at Cambridge University, UK, examined what happened to 10 fetuses from 8 mice when their pregnant mothers were deprived of food for 24 hours-as might happen in the wild — about mid-way through gestation. This point in pregnancy is critical in the development of the hypothalamus, the part of the brain that controls primal urges, including maternal instincts.

Behavioural neuroscientists Kevin Broad and Barry Keverne found that the placenta responded by breaking down its own tissues, recycling proteins inside its cells to provide a steady supply of nutrients to the developing hypothalamus despite the mother’s interrupted food intake. Their study is published today in the Proceedings of the National Academy of Sciences.

“We didn’t know before that this protection of the fetus goes on,” says Keverne. “I expected the lack of food to affect the fetal brain and the placenta equally, but instead we see the placenta acting as an interface to make sure the fetuses’ particular stage of brain development is protected.”

Imprint of starvation

As well as causing placental breakdown, the enforced starvation had effects on the expression of some ‘imprinted genes’ in the placenta. Such genes, unique to mammals, are inherited by the fetus in the normal way but their expression is subject to ‘epigenetic’ chemical tweaks by the mother through the placenta. By silencing either the paternal or maternal copy of the gene, she is able to shape her offspring’s genetic destiny during pregnancy.

One of the affected genes was Peg3, which regulates the number of neurons that produce oxytocin, a hormone that is important for maternal care, milk production and giving birth. Peg3 expression in the placenta is normally closely tied with expression of the gene in the fetus’s brain. After the mother had gone 24 hours without food, the researchers measured a 35% decrease in Peg3 expression in the placenta. But Peg3 expression in the fetal hypothalamus actually increased.

The researchers say that as with nutrient supply, the fetus appears to be protected from the consequences of the mother’s starvation - in this case downregulation of a gene that threatens to impair the next generation’s mothering ability and therefore reproductive success.

The main message is that the fetal hypothalamus and placenta “are not independent tissues”, says Keverne. “They have evolved together in such a way that built into the system is a genetic flexibility enabling the next generation to be primed to become good mothers.”

The researchers didn’t study whether the genetic changes in the placenta caused by lack of food then feed back to the mother-to-be, reducing her maternal instincts. But Michael Skinner, an expert in reproductive biology at Washington State University in Pullman, thinks that is possible and would like to see more work in this direction. The placenta, he points out, communicates with the mother’s own hypothalamus. “The hormones being produced by the placenta are going to shift the mother’s programming,” he says. “Whether that will turn around and influence the brain of the mother is all speculation, but if [the starvation] was long enough it might.”

Keverne stresses that the findings in mice cannot necessarily be extrapolated to humans-in whom such starvation studies can’t be done ethically.

But he wonders whether measuring the expression levels of neural genes in the placenta once a baby is born might provide a window into the brain function of that baby. His experiment also showed changes in expression of over 200 non-imprinted genes in the placenta on food-deprivation. Forty-one of those genes have been associated with neurological disorders, and two have been identified as markers for schizophrenia.

“The brain was rescued by the placenta in this case,” he says. “But presumably if the perturbation had been more serious it would have affected the fetus’s hypothalamus, which you could pick up by looking at the placenta.”

Alexis St Martin was one of the 19th century’s most important scientific guinea pigs. In 1822, the illiterate young French-Canadian was working as a ‘voyageur’ for John Jacob Astor’s fur-trading company in northern Michigan. He was hanging out with a bunch of rowdies in the company store when a shotgun accidentally went off and he was hit below his left nipple. The injury was serious and likely to be fatal – his half-digested breakfast was pouring out of the wound from his perforated stomach, along with bits of the stomach itself – but a US army surgeon called William Beaumont was nevertheless sent for. Beaumont was pessimistic, but he cleaned the wound as best he could and was amazed the next day to find his patient still alive. It was touch and go for almost a year: St Martin survived, though with a gastric fistula about two and a half inches in circumference. It was now possible for Beaumont to peer into St Martin’s stomach, to insert his forefinger into it, to introduce muslin bags containing bits of food and to retrieve them whenever he wanted. Human digestion had become visible.