Book Review: Outlive, by Dr. Peter Attia

The time to repair the roof is when the sun is shining – John F. Kennedy

Who doesn’t want to live long? All of us do. But what are we doing about it? Pretty much nothing. Most of us wake up about our health only when something goes wrong, and our daily routine gets affected. But by that time, it is too late.

Outlive, by Dr. Peter Attia takes a deep, hard look at what he calls the science and art of longevity. The author, a doctor and surgeon by profession, quit his medical practice out of disappointment with modern day science and started a practice where he focuses on showing his clients a path to a healthy and long life. The author believes modern day science suffers from severe shortcomings in the way it approaches health and suggests an alternative approach (that he calls Medicine 3.0) that focuses on prevention rather than cure.

To be sure, the lifespans of humans have increased significantly over the last two hundred years, thanks to advancements in medical science. But most of these successes have been achieved by conquering “fast death” – prevention or cure of infectious diseases of various kinds, treatments of injuries, emergency care of accident victims or responses to natural calamities and so on. We have learnt to fix broken bones, wipe out infections, replace damaged organs and decompress serious spine and brain injuries.

But we are markedly less successful in helping patients with chronic conditions. All these issues are caused by metabolic dysfunction, primarily due to a mismatch between our genetic evolution and modern-day lifestyle. Face it - most of us are going to die of what the author calls The Four Horsemen (from the biblical Four Horsemen of Apocalypse) – Type 2 diabetes, heart disease, cancer, or Alzheimer’s (or some variants & combinations of these). This is “slow death” – where medical intervention happens too late in the day, and the treatment is symptomatic, without addressing the root cause. While Fast Death diseases can be cured totally and patient’s condition restored back to where it was before the disease took hold, Slow Death treatment has just one goal today – to stop the patient from dying. The patient never goes back to Being Healthy again.  Most of our final years of life – “The Marginal Decade” – will be just spent battling one or more of these Four Horsemen.

Medicine 3.0

In comes Medicine 3.0 – which focuses on the two components of Longevity viz., Lifespan i.e., how long you live, and Healthspan i.e., how well you live. 

It is an approach that places far greater emphasis on prevention rather than treatment. It considers patient as a unique individual and offers solutions that suit his own specific case. There is no one-size-fits-all formula here, but an advice on how to look at your own individual risk of contracting these ailments and how to prevent them. The author says his goal is to present an actionable operating manual with which, you can potentially increase your lifespan by a decade and healthspan by two. It would be ideal if not only the lifespan is long, but if lifespan & healthspan perfectly overlap. That is what we should be aiming for.

With this background, the book then takes a deep dive into the inner workings of each of the Four Horsemen. How and when do they begin? What forces drive them? How are they sustained – and how can they be delayed or prevented? This part is pure science, and the book goes deep into the molecular biology behind each disease. I found this fascinating, despite the text becoming a bit technical at times. To an extent, this is inevitable given the nature of the topic, and it goes to the credit of the author that he has tried to make the subject as easy as possible for a layman to understand, without either losing the scientific angle or making the content too superficial. One can easily get the drift of what is being said, even if not being able to follow every word literally. 

Having analyzed the four slow killers in-depth, the next part of the book focuses on Solutions.

It starts with a study of Aging itself, which I found very interesting. What exactly does aging means? What happens when we age (grow)? Can the process be slowed down, and how? I had never thought of these things before.

As we grow older, the deterioration in healthspan occurs along three vectors – cognitive, physical and emotional. Medicine 3.0 tackles this through five broad domains – exercise, nutrition, sleep, emotional health, and medication. The book then discusses each of these topics (except medication) in considerable detail. For example, what are different types of exercise, and why do they work? What happens when we sleep and why is sleeping well so important? Is there such a thing as a perfect diet? The book doesn’t simply prescribe solutions (for example, take this diet or do that exercise) but explains the science behind everything and lets the reader decide what is best for her.

The book busts many myths and misunderstandings surrounding all issues Health. Surely, the book will inspire you to do more for your health. At times, it can also scare the hell out you, as you realize how you are going to die! There are plenty of references to latest research in medicine and molecular biology, information about recent and even ongoing clinical trials, survey findings and everything in between. Be clear, this is a science book written for the layman, NOT just a self-improvement motivational book that tells you to eat good food and exercise more. Even for those who studied medicine a few years ago, the book is a wonderful update on the latest happenings in their field.

As I finished reading the book, my mind kept going back to my late father-in-law, a healthy man of 75 who had no ailments, never went to a doctor, and took no medicines. Late one evening four years ago, he took his dinner as usual, went to bed and never woke up. To use the language I learnt in the book, his healthspan perfectly overlapped with his lifespan. Blessed are the people who die like this. This is the blessing the book is trying to give you. Take it.

Book Review: Revolutionaries, by Sanjeev Sanyal

 My school going daughter refuses to believe India won freedom through non-violence. “Why would the British leave, unless they were kicked out?” is the simple question which our history books fail to adequately answer. I remember that when I was in school, me and my friends faced the same question. Clearly, some pieces of the jigsaw puzzle were missing. The story was never complete, we never got to see the whole picture.

But here it is. In his latest book "Revolutionaries – The Other Story of how India won its Freedom", Sanjeev Sanyal challenges the conventional narratives and brings to light the revolutionary side of India’s freedom struggle. It is a fascinating book - fast paced, racy and thrilling, but at the same time tragic to the core. It is a story that simply needs to be told. Over and over again.

How did a group of young men and women from different backgrounds and regions come together to form a network of resistance against British rule? How did they plan and execute daring acts of sabotage or assassination? Did they succeed, and if they failed – why did they fail? What happened to them afterwards? More importantly, were these just isolated acts of individual bravado, or part of a larger gameplan to uproot The Empire from Indian soil? These are the questions Sanyal tries to answer.

The book starts somewhere in the late 19^th century. The Uprising of 1857 had been crushed, and Britain had established absolute hegemony over the Indian subcontinent. But the undercurrents of anger and dissatisfaction remained. The author starts with an overview of the political situation at that time, which provides an excellent context to the story that follows. The subsequent chapters then follow a largely chronological order and provide a seamlessly woven narrative of how the revolution unfolded. Or did it? The readers can judge for themselves.

Of course, some aspects of the revolutionary side are well known, such as the story of Veer Savarkar & the Cellular Jail, the travails of Netaji Subhas Chandra Bose or the daredevilry of Shahid Bhagat Singh or Chandra Shekhar Azad. But what about the rest? What about the extraordinary life of Pandurang Khankhoje (I bet you have never heard of him)? The dedication and commitment of Sachindra Nath Sanyal. About Barin Ghosh. The heart wrenching love story of Ullaskar Dutt & Lila. The untold side of Jallianwala Bagh. The role of Japan in India’s freedom struggle. The Naval Mutiny. And a lot, lot more. There are countless stories of exceptional bravery and courage. But also, of shocking treachery and deceit. Of frightening cruelty and cunning. They are all strung together like beads in a chain. I am sure you know nothing of this, and after reading the book, you will wonder why no one told you this before. Sanyal has done us Indians a favor, and we should be eternally grateful to him for the same.

Sanyal’s simple and easy-going style makes reading the book a breeze. His personal visits to the places mentioned, and how they stand today adds the author’s personal touch to the gripping events those places witnessed a hundred years ago.

Interestingly, the book doesn’t end with India winning freedom. The author goes one step beyond the event – what happened to the revolutionaries who survived to see India win freedom? Did the country do justice to them? In fact, have we really got freedom, or the slave mentality still exists? Clearly, Sanyal has gone much farther than what an ordinary history book would normally take us to. And this makes it much more complete. For, if you study the past, you can understand the present better. The present is nothing but a continuation of the past.

Having read "The Ocean of Churn" earlier, I was keen to read the “Revolutionaries” as well. And the book did not disappoint, far bettering even my elevated expectations. Don’t miss it. 

Thank you, Mr. Sanyal.

Dekho Apna Megh! - Part 2

 In the previous post (click here), I described my visit to the capital city Shillong. In this post, I write about the other places I visited during the visit – mainly, Mawlynnong, the Krang Shuri waterfalls, Dawki and Cherrapunjee.

In Mawlynnong, our first port of call was a visit to a “Living Root Bridge”. The living root bridges of Meghalaya are a unique and remarkable feature of the state's landscape. These bridges, found in the dense forests of the region, are made entirely of living trees and roots, and are woven together over time to form sturdy, naturally grown bridges.

A "Living Root Bridge" - Unique and spectacular.

Meghalaya has several such bridges which are made from the roots of the rubber (“ficus elastica”) trees. The tribal people of Meghalaya have been weaving these roots for centuries to create bridges that can support the weight of several people at once. Living root bridges are not only a fascinating engineering feat, but also an important part of the local culture and tradition. Visiting these is a unique and unforgettable experience. The bridges are located in some of the state's most beautiful and remote areas and are a testament to the ingenuity, creativity, and resilience of the local communities. They are a fascinating example of nature's ability to provide sustainable solutions to the challenges of modern life.

Mawlynnong is also famously known as the "Asia's Cleanest Village”. The village is home to around 500 people of the Khasi tribe. The villagers take pride in their cleanliness and have made it a priority to keep their village spotless. The village is a hub for eco-tourism and offers visitors the opportunity to experience traditional village life while also learning about sustainable living practices. For those having more time, almost every household offers a “homestay” option where visitors can spend a few days. Mawlynnong has received numerous awards and accolades, including the "Best Village Tourism Award" from the Ministry of Tourism, Government of India, and has been featured in several international travel magazines and documentaries.

A street view in Mawlynnong village

We took a stroll at the village, looked around the natural beauty, dined and shopped at the local shops. I tried to speak to a few villagers but found them reluctant to engage in a conversation.

The next day, we headed to Krang Shuri. The Krang Shuri Waterfalls are located on the Eastern side of Meghalaya, roughly between Jowai and Dawki. It’s a pity many tour operators skip these falls, as the location is out of the way from the main tourist circuits of Shillong – Cherrapunjee – Dawki. But these falls are perhaps the most beautiful and spectacular waterfalls in the state and are a “must-visit” site for anyone traveling to Meghalaya. The falls are surrounded by lush green forests, and the sound of the cascading water creates a serene and peaceful ambiance. You get life jackets on rent if you want to take a dip in the (chilling cold!) water. There are changing rooms for tourists. Apart from the view of the waterfall from below, one can go on top of the waterbed from where the stream comes. Tourists can also enjoy boating and watch the scenery around. A visit to Meghalaya is incomplete without visiting Krang Shuri.

The mesmerizing beauty of Krang Shuri is not to be missed

From Krang Shuri, we came to the border town of Dawki, situated on the banks of the Umngot River. The river is known for its crystal-clear waters, so transparent that boats appear to be floating on air. The best time of the day to visit Dawki is around noon, when the sun is overhead and sun rays penetrate right down to the bottom of the river. Visitors can take a boat ride on the river, spend time on its banks filled with picturesque rocks and enjoy the spectacular views of the surrounding hills. Visitors to Dawki can also visit the India – Bangladesh border and snatch a bargain from the garment vendors who walk over from the other side!

Take a boat ride in the Umngot River 

A word of caution here – the roads around Dawki were in bad shape when we visited. Further, they have heavy truck traffic, so visitors should base their time calculations keeping adequate margin in mind. The distances look short on a map, but it takes much longer to reach your destination! Luckily for us, we visited Dawki on a Sunday, when the truckers have a holiday and traffic was far less.

After Dawki, we visited Cherrapunjee, which has now been renamed Sohra. The place is famous for being one of the wettest places on earth. Cherrapunjee is also known for its beautiful waterfalls, bridges and limestone caves. The most popular tourist attraction in the region is the Nohkalikai Falls, which is the fourth highest waterfall in India. The waterfall is located just a few kilometers from the town and is surrounded by lush green forests. The water here falls from a height of about 1100 feet and creates a spectacular sight. Visitors can take a short hike to the viewpoint to get a closer look at the falls and to enjoy the picturesque views of the surrounding hills.

The Nohkalikai Falls is another beauty that will leave you spellbound.

Another important place to visit is the Mawsmai Caves. Mawsmai caves are a network of limestone caves located just a few kilometers from Cherrapunjee. The caves are popular among adventure seekers and cave enthusiasts as they offer an exciting and challenging experience. Visitors can explore the caves and see the interesting rock formations, underground streams, and limestone formations. Besides these, we also visited the Seven Sisters Waterfall, the Eco Park and a few other viewing points in and around Cherrapunjee.

Overall, I spent six days in Meghalaya. It was an unforgettable experience! 

It is said that if humans were meant to be in one place, we would have had roots, not feet. What are you waiting for? Pack up your bags and leave.