#60 - Less Can Be More: Medicine and Longevity

I changed my family doctor a while ago, and the new one happened to be much more reserved when it came to proposing tests, prescribing drugs, and asking questions. Initially, it made me feel undertreated, when in fact, most likely, I did not need any of those additional precautions. This perspective aligns with what Nassim Nicholas Taleb suggests in Antifragile: Things that Gain from Disorder.

If you go to the doctor, you invite him or her to make suggestions and you also expect input, so for both of you, doing nothing doesn’t sound right. This creates a chain of events that often results in overtreatment, and overtreatment, in turn, can lead to unintended negative outcomes. Such interventions are known as iatrogenics.

According to this logic, asking for a regular check-up when you are healthy can potentially be harmful. This idea applies not only to medicine but also to other life domains: good intentions often result in unnecessary actions, which—if not truly needed—may create adverse outcomes.

Taleb’s conclusion is to avoid family doctors and seek medical help only in severe, life-threatening situations. He warns that modern medicine’s overall impact on increasing adult life expectancy may be greatly overestimated.

I don’t necessarily agree with all of Taleb’s comments on modern medicine, but I believe he has a valid point: we should be more cautious before we ask for medical interventions, as we will inevitably receive well-intended input even when it is not needed.

We have become so used to regular check-ups, drugs, and treatments, but what is the real impact of modern preventive medicine on your life?

Can We Extend Our Life Span?

Some data supports Taleb's skepticism. Richard Lewontin, a prominent evolutionary biologist allegedly claimed that the life expectancy of a 60-year-old had increased only marginally—by about four months—over the span of fifty years (Taleb, 2012),. While I haven’t found a verified source for Lewontin’s exact numbers, it’s telling that the WHO’s global data shows that between 2000 and 2021, the life expectancy of a 60-year-old only rose by about eight months. That’s a modest gain, and it suggests that the dramatic increases in life expectancy (from 51 in 1960 to 71 in 2021 ) we often celebrate mainly come from reducing infant and childhood mortality, mitigating violence, and curbing extremely unhealthy habits like heavy smoking.

In other words, medicine has excelled at preventing early death rather than significantly extending the natural human lifespan. The authors of the Sustainable Development Index even suggest that our “natural” upper limit hovers around 85 years, a barrier not easily pushed further by modern treatments and interventions.

If Not My Doctor Than What?

According to Taleb, the best way to lead a long, healthy life is not by adding more tests, treatments, or medical visits, but by following a via negativa approach—improving health by removing harmful elements, such as excessive calories intake, rather than constantly adding remedies.

Taleb’s via negativa approach encourages us to step back and consider what we can remove from our lives to improve health and well-being. Instead of expecting doctors to fix the damage caused by poor diet, sedentary living, or excessive stress, he proposes we focus on cutting out these negatives before they accumulate. Simple but effective steps—such as caloric restrictions, not smoking, or reducing screen time—may yield more substantial long-term benefits than frequent medical visits.

Conclusion

Via Negativa fits well with a minimalistic, conscious lifestyle. With this mindset, we challenge the notion that more pills, more tests, and more procedures are automatically better. Sometimes, it’s what we don’t do that can make all the difference.

Medicine is a good illustration of this thinking, but in truth, it extends to all areas of life. In Poland, we have a saying: "The floor in hell is made of good intentions," which can be linked directly to Via Negativa. A similar proverb in English puts it: "The road to hell is paved with good intentions," reminding us that even well-meaning attempts to add, fix, or improve can backfire. Perhaps the surest path forward is to consider carefully what we choose not to do.

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References and Notes

Taleb, N. N. (2012). Antifragile: Things that Gain from Disorder. Random House.

World Health Organization (WHO). (n.d.). Life expectancy at age 60 (years). Retrieved from https://www.who.int/data/gho/data/indicators/indicator-details/GHO/life-expectancy-at-age-60-(years)

World Bank. (n.d.). Life expectancy at birth (total years). Retrieved from https://data.worldbank.org/indicator/SP.DYN.LE00.IN?view=chart

BBC Future. (2018, October 2). How long did ancient people live? Life span vs. longevity. Retrieved from https://www.bbc.com/future/article/20181002-how-long-did-ancient-people-live-life-span-versus-longevity