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Trans Am Clin Climatol Assoc. 2005; 116: 77–89.
PMCID: PMC1473132

How to Live a Long Time:* Facts, Factoids and Descants

It's a special challenge to give an after dinner talk. First of all, most people come to dinners to eat dinner and to enjoy the people they're sitting with, not to be impaled on an oration, so the speaker is at an a priori disadvantage. Second, most after dinner talks are preceded by a cocktail hour and wine with dinner, a gradient not to be trivialized, even in a group as modest in its bibulosity as this one. Yet another caution is suggested by a recent comment by William Germano, who mentions slumped and glassy-eyed audiences listening to scholarly talks, who may actually be wondering how late the dry cleaner stays open or whether the Sopranos is on tonight. Therefore this talk will not be scholarly. In addition, Germano notes that people who doze through talks are often freshly attentive afterward for the question period. Therefore there will be no question period after this talk. Finally, I read somewhere that Warren Harding's political speeches were once described by Senator William McAdoo as “an army of pompous phrases moving across the landscape in search of an idea.” I have taken that as a caution. This talk will, I hope, be devoid of pompous phrases and, more importantly, will not be organized around an idea. I tell you in advance so you won't waste your time searching for one.

All that having been said, the topic I have picked, how to live a long time, has been selected carefully on the basis of admonitions from friends to pick a subject everybody is interested in. This one seems safe enough. Even Woody Allen has expressed himself on it—he has said, “I don't want to achieve immortality through my work. I want to achieve it by not dying.”

I have had more than a glancing interest in this subject for a long time. I was first attracted to it many years ago when I came across a squib in the newspaper to the effect that Leopold Stokowski, then about 90 years old, had been the subject of a complaint to the authorities by a young woman whom he had pinched. Morals aside, I thought the act reflected a certain energy on Stokowski's part, and I found myself led into a rumination about the apparent vigor, and then the differential longevity of symphonic conductors. Stokowski, as it turned out, lived for 95 years, and gave his last concert at the age of 93 at the Vence Festival in France. Toscanini lived to be 90, Sir Thomas Beecham 83, and Eugene Ormandy 86. The more general question that emerged for me had to do with who, in any frame of life, lives a long time, and why. And, if the posit about symphonic conductors was correct, what was it about them or their activities that was operational?

Was it the music? There is some evidence that the right side of the brain is more involved in processing music than the left, and blood flow studies have shown that the same areas of the brain that respond to euphoria-inducing stimuli like food, sex and some drugs also respond to stimulating music. How this might have to do with longevity is admittedly obscure; connections between pleasure and longevity have not been clearly established. In fact, even the nature of pleasure isn't fixed: Italian clinicians recently reported the case of a 68 year-old lawyer who adored classical music and disparaged pop until he got demented, after which his tastes reversed. So there is some plasticity in tastes, which is to say in pleasure, the effect of which on health and longevity is, as I've said, obscure to this point.

In any case, to return to symphonic conductors, the fact that that the sample was small and hardly random didn't deter me much. Maybe it was just the successful ones who lived a long time. Maybe it was the music that did it. Maybe, if symphonic conductors really had preternatural longevity, it had something to do with waving their arms so much. That idea really intrigued me, especially when it occurred to me that the level of central nervous system innervation of the upper extremities had something in common with the level of innervation of the intrathoracic viscera, including notably the heart and coronary arteries. I need to tell you that I took gross anatomy at Johns Hopkins, so I hope you will cut me a little slack here. You can imagine my delight, then, when I discovered that physicians in the 18th and 19th centuries in Europe had observed a correlation between the use of hand bells and asthma. The initial impression I had was that their observation was that hand bell ringing alleviated acute asthmatic paroxysms, and that therefore this became a common prescription. More recently I have learned that hand bell ringing was also associated with the converse, and was thought to trigger asthmatic paroxysms. Either way, it seemed clear to me that I was on to something: the nation was focused on exercising the wrong extremities; all this business about running to enhance life expectancy lacked precision. First of all, it's plain that when people run they also move their arms a lot, so even if running is good for you, you may be able to get the same effect a lot more efficiently. And notice that arm waving is a form of upper body aerobic exercise, so the arms have a claim along that line as well, and, in any case, I found the idea that it might be better to play a little Mozart or Shostakovich and wave your arms in time with it much more congenial. Finally, in the case of symphonic conducting, an enormous amount of cognitive activity is involved, another element that has been linked to longevity.

Ultimately I felt more or less requited when I discovered a paper by Leonard Hayflick citing a MetLife study that involved 437 active and former conductors of major regional and community symphonies. The study started in 1956 and ended in 1975 when 118 of them had died, more than 20% at age 80 or older. The death rate for the entire group was 38% below that of the general population, and for conductors aged 50 to 59, a decade when stress and responsibilities are at their peak, the death rate was 56% less than that of the general population. I was somewhat disconcerted by a nearly simultaneous MetLife study that showed that corporate executives enjoyed longevity similar to that of orchestra conductors, punching a hole in the arm waving theory, though possibly not a definitive hole, since the study did not control for arm waving among the executives.

In any case, the conducting and arm waving thing had me hooked. The next thought, if you'll forgive the expression, was that it might be interesting to compare longevity among baseball players who spent years in positions that involved a lot of throwing, and to compare them with those whose positions called for infrequent throwing. I tried to recruit to this question a bright young man who was taking a fellowship in general medicine with me, and he seemed interested. Accordingly (this was before every statistic in the world was available online, in fact before anything was available online), I provided him with the Encyclopedia of Baseball, thinking he could do the necessary with it. It contained data on everyone who had ever played professional baseball, the teams, the years and the positions played. The task proved too daunting for my young colleague, and it fell by the wayside under the pressure of other responsibilities, but, as evidence the idea wasn't uniquely quirky, in 1988 a group at the University of Alabama published an article on the mortality experience of major league baseball players, in the New England Journal of Medicine. They assembled a cohort that included all players who had played their first games for a major league team in the United States between 1911 and 1915 and who survived at least until 1925. They had a cohort of 985 players to analyze, and successfully acquired follow-up information on 958 of them. Their average age at death was 70.7 years, the average year 1960. Infielders had the lowest overall mortality rate and catchers the highest; the differences were not statistically significant. Grouping all infielders may have blunted the study; it might have been better to compare first basemen, say, who throw relatively little, with pitchers or short stops. But there was an inverse association between standardized mortality ratios for the groups and the length of the player's career; and being a baseball player in fact conferred a slight protective effect against death, with the cohort having only 94% of the deaths expected. It was most interesting to me that the data suggested that players who performed the best lived the longest, a fact that should bring some comfort to the accomplished people in this room. But my arm waving theory was not supported, at least by the gross categories established within the cohort.

I'm not presenting this study to you as one that has great elegance, but the fact that it was done and was published suggests to me at least that no matter how odd the pathways down which curiosity may lead, there is always someone else maundering about the same thing, often, in my case, more productively. In this connection, as many of you know, Dr. Curtis Prout, a member of the Climatological, has studied the life expectancy of college oarsmen, who tend to be very long-lived. He has raised an interesting question about whether environmental and personality factors leading to the choice of a sport may be independent predictors of longevity, and of course this idea has received increasing credence in recent years, not only in athletes.

In any event, I was into this longevity thing, more less as a clinical hobby, filing away odd bits, and some not so odd, that I came across. As one example of how intriguing such a bent can be, a little over 10 years ago it was suggested that left-handed people don't live as long as righties. Based on a study of death certificates in 2 counties in Southern California, Stanley Coren and Diane Halperin reported a 9-year difference, with mean age at death in the right-handed sample 75 years as compared with 66 among left-handers. Further, far more left-handers than right-handers died in accidents, especially while driving. The report, as you can imagine, attracted a fair amount of reaction, most of it negative, the net of which is a modest literature on left-handedness, which associates it variously with autoimmune disorders, autism, epilepsy and so on, echoing suspicions voiced over centuries that there is something sinister about being left-handed. Left-handedness is the only major behavioral polymorphism, and is interesting on its own merits, but probably the most that can be said at the moment is that, if you're left-handed, driving in a society set up for the right-handed requires at least a little extra caution, much like what's required of an American crossing a busy road in London.

An extension of this study about handedness that intersected my idea about baseball players was published by the same authors in Nature in 1988. They analyzed all the players listed in the Baseball Encyclopedia for whom dates of birth and death were known as well as throwing and batting hand. Mean age at death for 1,472 right-handers was 64.6 years, and for 236 left-handers 63.97 years. They managed to find a statistical technique suggesting that this minimal difference was significant. More interestingly, they analyzed data on the cumulative proportion of players surviving at each age, and found that the groups were identical in mortality until age 33, but from then on about 2% more right-handers than left-handers survived at each age. They were unclear about the meaning of this finding, and so am I. Maybe it reflects some permutation of the healthy worker effect, expressed through a differential rate of driving accidents.

Now, to turn to somewhat more rigorous lines of evidence, we've heard for years that the best way to live a long time is to pick long-lived parents, and there is increasing evidence that the pace of aging is to a significant degree genetically determined, but environmental influences and personal behaviors are clearly also of great importance. Scandinavian studies have calculated the heritability of average life expectancy to be 20 to 30%, with environmental differences accounting for at least 70% of variation in age at death among twins. And studies of 7th Day Adventists suggest that optimizing health related behaviors could yield up to 25 years of good health beyond age 60 with a compression of morbidity toward the end of life. The authors of that study suggested that when it comes to aging well there is no such thing as the anti-aging industry's free lunch. I think a better suggestion might be that a really good anti-aging maneuver is no lunch, in light of other studies connecting undereating with extension of life expectancy.

Among very long lived humans the tendency is for them to be quite healthy throughout their long lives, sick for only a short time at the end. This pattern appears to have something to do with the same genes that control longevity; that is, both life trajectory health and longevity are connected at the genetic level. Additional evidence of genetic influence is the fact that longevity in fact does tend to cluster in families, both horizontally within generations, and vertically, across generations. In the centenarian study of Perls and his group, the sibs of centenarians had four times the probability of a control group of surviving to age 91, and had a lifelong reduction in risk for death at various points across the life span of about 50%, even through very old age. In addition, the offspring of centenarians have a markedly reduced prevalence of diseases and conditions associated with aging, especially cardiovascular disease. Centenarians in the Perls study remained functionally independent for most of their lives, with functional impairment still uncommon at a mean age of 92. These individuals experienced very few hospitalizations, had low disease prevalence, low medication use, and nearly 40% were still functioning independently at age 99! This speaks to the comment of George Burns to the effect that there are a lot of things you have to do if you want to live to 100, but the most important is to make sure you make it to 99. Of the centenarians Perls studied, 22% of their mothers and 14% of their fathers survived to age 90 or higher. (The spouses of centenarians, by the way, had average life expectancies).

There are some data connecting a specific region on chromosome 4 to the longevity of centenarians and nonagenerians, and a number of longevity genes have been discovered in yeasts, worms and fruit flies. So apparently there are gerontogenes, or longevity-enabling genes, and the genetic contribution to longevity is being investigated with increasing enthusiasm. The progeroid syndromes, such as Werner's Syndrome, may shed some light on the issues. Werner's is due to genome instability underpinned by loss of function mutations in a gene coding for a helicase that catalyzes DNA unwinding. Werner patients presumably age more quickly than normals because they accumulate DNA damage faster than normal. It is plainly of benefit to unwind your DNA properly. Telomerase may also play an important role, since transfecting Werner cells with a gene for telomerase extends their life span in culture indefinitely. In worms, namely C elegans, mutations in the daf-2 genes can increase life span dramatically. Strong reduction of daf-2 activity causes juvenile worms to enter a quiescent state called dauer, an alternative larval stage that allows them to survive periods of low food availability and during which they become extremely lethargic. Well-fed worms live for about three weeks, but dauer larvae can live for more than two months. Alarmingly, removal of the reproductive system of C elegans causes the worms to live six times as long as normal. The authors who published this report noted in their paper in Science, “We were particularly interested in these animals' ‘quality of life,'” which turned out to mean the worms' level of activity. To cut to the chase, although dauer worms became lethargic, mutants subjected to gonadal ablation were not lethargic and continued to move around on their plates for a very long time, even at six times the usual life expectancy. So their quality of life appeared to be good. Parallels in humans to these observations on gonadally altered worms do not come readily to mind. Variations in life expectancy in Drosophila have also been observed, as I mentioned; the Methuselah mutant lives 35% longer than wild types, apparently also related to daf mutations.

There's been a good deal of research activity, and perhaps even more in the public prints in recent years, with relation to diet and longevity, especially caloric restriction. These effects were first demonstrated in the 1930s, when it was shown that laboratory rats on limited diets live about 40% longer than normal and are resistant to many chronic diseases typical of aging. These studies have been replicated in yeasts, fruit flies, nematodes, fish, spiders and mice, and there are hints that the effect may also hold true for primates. Recent research on the mechanisms underlying these phenomena has shown that the effect of caloric restriction is tied to genetic factors: increasing the activity of a single gene called SIR2 can extend the life span of yeast, and without the gene caloric restriction does not prolong life. SIR2 is also activated in yeast by polyphenols, which also appear to activate analogous genes called SIRT1 in human cells. These polyphenols are found particularly in apples and tea. Several molecules with similar structures have been identified, the most potent of which turns out to be resveratrol, found in grapes and red wine. The SIRT1 activating power of resveratrol suggests a link to the so-called French paradox, the observation that despite eating a delicious high fat diet people in France suffer about 40% less cardiovascular disease than expected. This has been epidemiologically linked to moderate consumption of red wine. However it works, restricting calories boosts the activity of SIR2 proteins and extra SIR2 proteins slow aging. Resveratrol appears to stimulate SIR2, mimicking the effect of caloric restriction and slowing aging.

With relation to caloric restriction and survival, by the way, a retrospective review of 208 patients admitted to the Mayo Clinic with anorexia nervosa showed no difference in survival from the expected mortality of a population-based cohort.

Numerous mechanisms have been suggested without great clarification to this point, but it does appear that life lengthening through caloric restriction is not primarily related to retardation of disease processes, but rather to slowing of primary aging processes, and this is related to restriction of calories rather than specific nutrients. Modification of the insulin/IGF-1 system appears to be important.

On the other hand, specific nutrients may impact disease processes themselves. For example, lycopenes, the main carotenoids found in tomatoes and tomato-based products, it has been suggested, reduce the risk of cardiovascular disease, colorectal adenomas, colon cancer and prostate cancer. In one extraordinarily creative study of the effect of lycopene, the authors investigated the question of whether increased ingestion of lycopene-rich food is reflected in increasing concentrations in body tissues. They fed tomato lycopene to 75 volunteers undergoing elective hemorrhoidectomy, and demonstrated an increase in tissue concentrations. Inventiveness appears to be alive and well in nutrition research. It may be of some importance to notice that other studies have suggested that lycopenes from fresh and unprocessed tomatoes are poorly absorbed, and that absorption is much better from processed foods such as tomato paste and tomato sauce. One study suggested that pizza intake had the potential to reduce cardiovascular risk, presumably because of the tomato sauce component, and despite the cheese.

A number of other foodstuffs have been thought to enhance health prospects, including nuts, for their resveratrol content, organo-sulfur compounds in garlic and onions, and various carotenes. Cocoa, flavanol rich, is thought to be good for you; the makers of Mars Bars are working hard on this. So are blueberries, high in antioxidants, as are raspberries, cranberries and strawberries, which, by the way, appear to impair angiogenesis.

One study from Rome considered alcohol consumption and its effect on longevity. The study suggested that drinking 4 to 7 drinks per day, roughly 63 grams of alcohol, a dose some might think heroic, led to a two-year edge in life expectancy, but drinking more than 10 drinks was negatively associated with longevity. These drinks were 97% wine, primarily red, high in resveratrol content. Other studies have suggested that 250 to 500 cc. of red wine a day is associated with a diminished risk of macular degeneration, Alzheimer's disease and cognitive deficits.

On another tack, what about relations among social factors, individual characteristics, and longevity? One interesting effort has been made through studies of wild baboon populations. Baboons probably represent the highest point in monkey sociality, and have the largest neocortex of any old world monkey, the neocortex being the brain region with which sociality has the strongest correlation. One study examined the relation between sociality among baboon females and reproductive fitness. It shouldn't come as a surprise that females who are significantly more social, as measured primarily by the amount of time that other baboons spend grooming them, tend to have more than the average number of surviving infants 12 months later. In other words, in evolutionary terms, at least, sociality is good for us; it enhances the longevity or survival prospects of the group. There may be something for us to ponder with regard to human populations in the fact that, within the intricate sociality of baboon communities, one element of survival appears to be a cognitive capacity to understand the social intentions of others. I say there may be a link with individual longevity there: I don't know what it is.

Several studies along similar lines have found that social networks among humans are important predictors of longevity, including participation in formal organizations, contact with friends or relatives, and so forth. In one study of African American women aged 55 to 96, those who were extremely isolated in a social sense were more than three times as likely to die within a five-year period of observation, an impact unaffected by the use of community senior services. A search for the effects on longevity of living as a recluse or a hermit produced no results, I imagine because follow-up would be difficult, but on the other hand a number of additional papers about socialization in humans turned up. One suggested that providing social support may be more beneficial than receiving it. Mortality was significantly reduced for individuals reported to be providers of support to friends, relatives and neighbors, and emotional support for spouses.

In a study from Columbia University, the impact of marital closeness on survival was examined in 305 older couples. Closeness was defined as naming one's spouse as a confidant or as a source of emotional support, versus not naming, or being named by the spouse on at least one of the two dimensions, versus not being named. Husbands who were named by their wives as confidants or supports, but did not name them, were least likely to have died after six years. Compared with them, husbands who were not named by their wives as a confidant or source of social support, or did not name their wives, were from 3.3 to 4.7 times more likely to be dead. The results among wives showed a similar pattern, but a weaker one.

Two wonderfully quirky studies bear in a way on social status. In one, it was hypothesized that there would be a gradient in life expectancy of British peers to the effect that Dukes would live longer than Marquises, Marquises longer than Earls, and so on down through Viscounts, Barons and Baronets. Data were looked at for more than 9,000 male peers from Burke's Peerage and Baronetage, and no gradient in life span was found by social position, consistent with other observations to the effect that gradients in health status weaken or disappear at the top of the economic hierarchy.

The other, from UC San Diego, examined the power of symbols on mortality. The study considered survival among individuals with “positive” initials, for example ACE or VIP, on the one hand, and those with “negative” initials, such as PIG or DIE, on the other. They found that males with positive initials lived 4.48 years longer, whereas males with negative initials died 2.8 years younger, than matched controls. The effects were similar but smaller for females. Positive initials were associated with shifts away from causes of death with obvious psychological components, such as suicides and accidents, whereas negative initials were associated with shifts toward these causes.

Studies of personal histories have illuminated some personality factors that may bear on longevity. One important investigation is the Nun Study, organized by David Snowden in 1986. In this longitudinal study of aging and dementia, he was looking at a convent community of nuns aged 74 to 106, retired from careers in a variety of sites, many of them as teachers. They tended not to drink or smoke, had similar diets, income, and quality of health care and had an active social network. Snowden examined short biographical notes written at an average age of 22, on entry into the order. These suggested that positive emotions in early life were associated with longevity, with a difference of nearly 7 years between the highest and lowest quartiles of positive emotion sentences. That is, positive emotional content in early life autobiographies was strongly associated with longevity six decades later. There was some sense that positive response patterns, or more rapid return to a positive outlook after negative events, serves to dampen the physiologic sequelae of emotional arousal, such as heart rate and blood pressure changes, and presumably also hormonal responses. In a word it's best to be cheery, or at least positive.

Further to the effect of optimism and pessimism as risk factors for disease, Peterson and his group studied questionnaires filled out by 99 Harvard graduates in the classes of 1942 to '44, when they were about 25 years of age, and then determined physical health from ages 30 to 60 as measured by examination by physicians. Pessimistic explanatory style, the belief that bad events are caused by stable, global or internal personal factors, predicted poor health at ages 45 through 60 even when physical and mental health at age 25 were controlled for, across an array of diseases ranging from gout to diabetes, kidney stones to hypertension. The correlations increased across the life span, from age 30 to 60.

With regard to the impact of cognitive activity on optimism, health, and possibly life expectancy, there is good reason to believe, as Guy McKhann and Marilyn Albert have pointed out, that the phrase “use it or lose it” applies. Maintaining one's mental abilities is made easier through a variety of activities, including reading, doing crossword puzzles, learning ballroom dancing, using a computer and going to lectures or concerts. Studies have shown that in rats an enriched environment that includes exercise, toys, mirrors, tunnels and interaction with other rats strengthens connections between cells in the hippocampus and even increases the rate at which new cells are born. The idea of rat fraternization may be counterintuitive, but somewhere here there may be a link with the academic parable expressed in prior talks by Dick Johns on how to swim with sharks. Fraternization with rats, has, I think, a weaker set of academic projections, but I pass it along for what it's worth.

All of the foregoing, relating to clinical, biological, sociologic and epidemiologic studies, is one way of coming at the problem of how to live a long time. Another tack would be to consider the reflections of philosophers and other savants as a window into what might be thought of as a philosophy of longevity. There are two I'll mention briefly. The first, one of the great iron men of baseball, had quite a little to say on the subject. You will recall that Satchel Paige, the philosopher in question, was widely viewed as one of the great natural pitching talents in the game, and was still pitching when many thought he was in his 60s, although dating Satchel's birth had proven to be something of a challenge. Nevertheless, it was clear he was well along, and far older than most active pitchers, when his reflections were written down by someone.

Satchel's wisdom emerged as a series of brief aphorisms, which I present to you with admiration of their incisiveness and depth. You will see that he anticipated in summary form much of the content of this talk.

The first aphorism is Avoid fried foods, which anger the blood. With this aphorism he anticipated an enormous body of work on diet as an important factor in health, and on saturated fats and serum lipids in particular. In addition, though, the concept of angry blood itself is worth pausing over. In an allegorical sense he is telling us that diet, blood and emotion are all mixed up somehow, that it's better to keep a cool head and calm blood, and that in fact it may be not only what you eat, but, in a wider sense, what you swallow. The key thing appears to be not to ingest things with maleficent potential, including things that make you angry, and so when Satchel talks about fried foods, he's really talking about avoiding all manner of things, foods or not, that tend to get one's blood up, warning us that these things should not be swallowed, physically or metaphorically.

His second aphorism is If your stomach disputes you, lie down and pacify it with cooling thoughts. We notice here that the philosopher is advising us to attend to visceral signals as indices of our own responses to what's going on around us. He is suggesting that, at the slightest hint of adversity, for example in disputatious meetings, the key thing is to lie down immediately. I think this one has enormous potential utility. I, at least, can think of a number of discussions that would have been vastly improved in direction if not in quality if I had taken off my shoes and lay down instantly when my viscera began to send signals suggesting the need for cool thoughts.

The third aphorism is Keep the juices flowing by jangling around gently as you move. Satchel is once again right on here. Keeping the juices flowing is vital, as we all know, to the perfusion of everything that's important. I have reflected on this to some extent, and have made some informal observations, and it is my opinion that he's right—a lot more jangling is needed. For many of us it doesn't seem so much to be a juice quantum problem, but a need for attention to juice flow, which is to say jangling. So trying to jangle better has some utility; for one thing, if your own juices are flowing well, you are likely to be miles ahead of everyone else. In fact, in circumstances requiring the herding of academic cats, for example, at the slightest sign that anyone else's juices are also flowing, it might not be a bad idea to take off your shoes and lie down. I suspect you would be pleasantly surprised at how quickly everyone else comes around.

Satchel's fourth aphorism is Go very light on the vices, such as carrying on in society; the social ramble ain't restful. Now, it's plain that most of the people in this room don't have a lot of time for social rambling, or for carrying on in society, whatever that is. Both of them sound very tiring and distracting. Besides, going light on the vices can only add to the dignity that goes with being an accomplished academic, and in addition is likely to allow for more effective jangling. All in all, this one seems less applicable to the people in this room than some of the others.

Satchel's next aphorism is Avoid running at all times. I myself warm to this aphorism, since this has been a guiding precept of mine for a long time. In offering this advice, he is referring to the importance of dignity and its effect on others. It is entirely possible that maintaining a stately mode will make everyone else think that you have an agenda and understand it. Establishing this fiction is an extremely powerful thing to do. It is probably life-lengthening to cultivate looking like one is not even thinking of running, even though the impulse may be overpowering. If seized by the impulse to run, a good plan is to slow down, fix the source of the impulse with a steady gaze, and, with any luck, thus transfer the running impulse to someone else.

Satchel's final aphorism is Don't look back—something may be gaining on you. This aphorism isn't famous for no reason. Everybody with any sense knows that things are trying to gain on you all the time; looking back is a notoriously unproductive maneuver, even though it may appear to be an effective way to protect your hind quarters. In light of the number of things that may be chasing you, it may be better if you don't focus on them, but keep your eyes straight ahead and try to pick out the things you shouldn't look back at before they happen. With practice you can actually confine your attention to the important business of rank ordering what to ignore.

Are Satchel's aphorisms likely related to things importantly involved in living a long time? I believe that that is profoundly the case, and that his wisdom offers a framework on which to put the emerging body of research on longevity, some of which I have tried to describe.

Finally, the other philosophic note with which I would leave you has to do with the paradigm of the hedgehog and the fox, raised in our time especially by Isaiah Berlin, but probably introduced in the 7th century B.C. by Archilochus of Thasos. The hedgehog, you will recall, was characterized by Berlin as knowing one big thing, the fox many things. We might paraphrase that, as Robert Proctor has, in this way: the hedgehog always returns to one great and effective strategy, while the fox devises many different ways to achieve an end. The difference, Proctor says, translates roughly to dogged persistence versus creative flexibility. Both are needed, both echo Satchel Paige's wonderful aphorisms, and the combination certainly sounds like a reasonably effective way to beat the rap, and to live a long time.

Footnotes

*After Dinner Remarks, American Clinical and Climatological Association, Sea Island, Georgia, October 23, 2004


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