I hope the "Don't Die" guys die

Bryan Johnson, for those of you who don’t know, is the longevity erection billionaire guy.

Okay, that probably didn’t make much sense. Let me elaborate: Bryan Johnson is a billionaire (tech, naturally) who wants to live forever — or at least not die anytime soon — and measures his progress towards that goal, in part, by reporting on his nighttime erections.

Once rich and chubby and depressed, Johnson is now, at forty-seven, rich and ripped and determined to live forever. He spends a quarter of a million dollars a year in that pursuit. His regimen has included restricting calories to 1,977 a day, undergoing high-frequency stimulation of his abdomen to simulate the effect of twenty thousand sit-ups, and stimulating his penis with shock waves for some doubtless excellent reason.

Johnson leads a movement called Don’t Die, whose adherents hope that they, too, can reprogram their bodies and minds. Open-sourcing himself, he publishes his biomarkers online, everything from body-mass index to a total duration of nighttime erections (three hours and thirty-six minutes at one recent climacteric).

Johnson is perhaps the brightest star in a constellation of rich men obsessed with longevity. The New Yorker profiled one of them, Peter Diamandis.

Diamandis’s network, known to its constituents as the Peterverse, is largely peopled by slim, graying, well-off men who finger their Oura rings like horcruxes. America’s richest now live a dozen years longer than its poorest, and they intend to widen their lead; Jeff Bezos, Yuri Milner, and Sam Altman have all funded anti-aging research. Joel Huizenga, the C.E.O. of Egaceutical, a startup whose “water-based drink” aims to reverse cellular age, told me, “We don’t work in mice. We work in billionaires.”

I rarely read about a group of people I so viscerally hate, besides Republicans, so it should come as no surprise that these people are, largely, Republican or Republican-friendly. When Trump won for the second time, Johnson wrote on Twitter, “Congratulations @realDonaldTrump on becoming the 47th President of the U.S. I am with you and @RobertKennedyJr in making America the healthiest, most vibrant, and strongest nation in the world.” (Johnson was more measured in his praise last month, saying, “Whether RFK is the solution or not, what we’re doing is not working, so I’m open to change, and I’m open to a variety of possibilities. It’s not to say that everything he’s doing is correct, but I do support the idea that we definitely need to change.”) Diamandis apparently includes Elon Musk and Peter Thiel in his friend circle, and he claims he was asked by them to lead NASA during the first Trump administration (he refused, claiming it was too slow and bureaucratic for his liking).

Longevity is, variously, a business proposition, a science, and a religion. It is also inextricably bound with “AI” and the idea of the “Singularity”. The idea is that we’re in a time of very rapid technological change. We might even be approaching the “Singularity”, in which artificial intelligences reaches a point where it can advance science and technology without our help, giving rise to “superintelligence”. In the telling of the longevity bros, the Singularity would be mostly a good thing. According to Diamandis, “I think there is a single tide that floats all boats. A.I. will feed the hungry, solve the climate crisis, and get us to space.” Johnson is less sure about the ultimate outcome, but he agrees that "AI is improving at a rate that is unfathomable to our minds”.

The point of longevity research is, as Johnson says, to not die. If, in the next 10 or 20 years, we reach the Singularity, then technological progress and AI will likely allow us to live forever thereafter. The tough part, for aging tech billionaires, is getting there. (”Dave Blundin, [Diamandis’s] partner in an A.I. venture fund, told me, “When you’re Peter’s age, you’re right on the longevity cusp. That’s the tragedy of the whole Peter story—he could live forever, or he could miss by a year and not live any longer at all. It’ll be close.””)

Longevity is a largely selfish field. The purported benefits accrue, at least at the moment, only to those who can afford the “treatments”. Diamandis founded “Fountain Life”, a longevity clinic where an annual membership costs $21,500. Other clinics charge 10 times as much. These clinics also offer a la carte treatments like “therapeutic plasma exchange, in which plasma is filtered from your blood and replaced with albumin and antibodies from healthy donors”. T.P.E., which Diamandis has done 5 times, retails for $10,000. The article above pegged Bryan Johnson’s annual spending on anti-aging at $250k; other reports have it as high as $2 million per year. The money goes towards a suite of medications and supplements (upwards of 100 per day) and an army of 30 doctors. The Chief Medical Officer of Fountain Life quipped, “I like to say about these men, ‘They spent their health getting their wealth, and now they have to spend their wealth getting their health back.’”

That doesn’t stop longevity’s proponents from depicting it in a more altruistic light.

Implicit in this narrative is the belief that technocrats aren’t hogging resources for vanity projects; they’re fixing the world. One X-Prize Healthspan donor, Daniel Krizek, a biotech-fund manager who plans to invest a billion dollars in longevity, espouses the values of effective altruism. That principle, popular in Silicon Valley, holds that philanthropists should save the most lives they can, including the billions of future lives that might be enabled by a particular action. “You could put a trillion dollars into Africa and feed the continent forever,” Krizek told me, “but I believe it’s better to spend the trillion on going to space, because all the scientific advances that come from that will save many more lives in the future.” Bryan Johnson’s movement aligns with this belief: his ultimate goal is “species maximization—trying to get life in this part of the galaxy to flourish.”

“Effective altruism” has long been an excuse for rich people to spend money on themselves. The weak link in Krizek’s argument is not that scientific research and technology might ultimately save more lives than food banks; it’s that privately funded scientific research, with privatized gains, devoted to problems that concern a vanishingly small segment of the population, will have that outcome.

One question you might be asking is, given the large sums of money being mentioned — tens of thousands, millions, billions —, does any of this “work”? Will Diamandis be on the right side of the “longevity cusp”? Will Bryan Johnson avoid death?

There is legitimate scientific research being done on longevity, but, in my reading, that seems to have hardly any overlap with what people in the “Peterverse” or Bryanverse are doing. Furthermore, the gains to lifespan that real scientists expect are far smaller than what Johnson and Diamandis anticipate. (Johnson has published YouTube videos about living to 120+; Diamandis believes he can add “decades of health” to (rich) people’s lives.).

Let’s take one example. Bryan Johnson took a drug called rapamycin for 5 years. Rapamycin is an anti-inflammatory, and it seems to extend the lifespan of some organisms (worms, mice, etc.). Real scientists believe it can make you feel better (one longevity researcher, Matt Kaeberlein, used it for treatment of his frozen shoulder.) The anti-aging community seized on these studies, and many longevity hackers, including Johnson, added it to their daily drug cocktails. Yet there is no rigorous research showing that rapamycin extends human life.

More recently, Johnson discontinued rapamycin. He cited several studies, including one which purportedly showed that while rapamycin might slow tumor growth, it also “inhibits natural killer cells” of tumors. Despite testing “various rapamycin protocols” on himself, he found none of them seemed to work, and he suffered several negative side effects, including elevated levels of glucose and increased resting heart rate.

I watched a YouTube video of Kaeberlein (who is, again, a real scientist) dissecting Johnson’s statement on rapamycin. Some of the science went over my head, but the gist is that Johnson grossly overstates the case against rapamycin, and likely misrepresents thee studies he cites. For example, many of these studies were conducted on organ transplant patients, not people like Johnson. Johnson also claims he suffered specific side effects from rapamycin, despite the fact that he’s taking dozens, if not hundreds, of drugs and supplements, so isolating the causal effect of a single drug is impossible.

We see in this example some problems with the longevity community.

First, the most prominent voices aren’t scientists or doctors. Diamandis, funnily enough, went to medical school, and did so poorly he was offered a medical degree after the dean had him promise he wouldn’t practice medicine. Johnson is a tech billionaire who made his money in payments processing. Both men rely on teams of medical advisors and scientists, but the rich guy is ultimately calling the shots. It’s no surprise they end up misunderstanding or misrepresenting scientific literature.

Second, there is no real scientific method. These hackers are experimenting on themselves. The group of individuals receiving these treatments is small and unrepresentative, and there are no randomized controlled experiments, which are the gold standard of evidence in medical settings. It is impossible to know whether Johnson is extending his lifespan, and, if so, which particular drug (or combination of drugs) is causing that effect. The New Yorker writes,

According to Dr. Michael Roizen of the Cleveland Clinic, you can make a thirty-two-year difference in your life span by implementing the no-brainer stuff (sleep, diet, exercise, etc.), but you can gain only four years by taking supplements.

Nonetheless, biohackers regularly tweak their “stack” of drugs and supplements, seeking minute advantages. The hope of “combinatorics” is that interventions enhance one another.

What Johnson offers in his YouTube videos is just that — hope. There is little rigorous evidence supporting the claim that his drug protocol slows or reverses again, and collecting that evidence would require decades of observation.

A third problem is that it’s tough to tell whether longevity hackers are actually impartial voices. Diamandis owns or has invested in several longevity-focused companies. When he touts their “advances”, is that as a scientist, or as an investor? Johnson sells the same supplements that he takes daily. Is he altruistically allowing everyone to extend their lives in the same way he has, or is he also trying to make a buck?

Another aspect of longevity hacking that rankles me is that these people take from science without giving much back. The research on rapamycin in worms and mice was funded by the government. The research on rapamycin causing harmful side effects was also funded by the government. Johnson cites these studies and they seem important to his decision making, but he contributes absolutely nothing to scientific literature in return. Imagine if he devoted his millions to something broadly beneficial, instead of narrow and selfish?

But the final issue, hinted at above, is that all of this money might just be going to waste. Supplements and medical interventions, of the type discussed above, may not improve human lifespan that much, for people who have already optimized their diet and exercise regimen. (Johnson’s own doctor says “We have not achieved any remarkable results. In Bryan, we have achieved small, reasonable results, and it’s to be expected.”) Many of the wonder supplements, like rapamycin, haven’t panned out, and combinations of drugs might not have the same effects as each drug in isolation. Moreover, as one longevity influencer mentions, “For life span, every pathway has to be delayed. If you delay changes in ninety per cent of the pathways, you’re still going to die—and probably right on schedule.”

For the sake of humanity, I am hoping this happens. I hope the Don’t Die guys die. They claim to imagine a world in which abundance prevails, in which AI and technology have slaked our material wants, and we can live lives devoted to leisure and knowledge. But we all know what’s actually going to happen if longevity research works. The benefits will be reserved for the richest humans, and they will take it upon themselves to rule us until the end of time. (Recently, Vladimir Putin and Xi Jinping were overheard talking about using organ transplants to live until 150.)

The world in which “Don’t Die” happens is a world where we have to read Trump’s pronouncements, Bezos’s “free markets” op-eds, and Altman’s Dyson sphere bullshit forever — or at least not until they die, but until we do.