It’s all about the timing – why (and when) I am considering the end-date of my longevity journey.

The New Year is a time for reflection and thinking about the future. Having reached 55 chronologically (although I am still 47 metabolically!), I’ve had my fair share of mid-life crises. There was the weekend warrior period when I took on extreme endurance events, the sports car, skinny jeans… and the inevitable dalliance with tattoos.

While I must point out that I remain tattoo-less, I have been considering a tattoo for some time now: no leaping tiger, no Māori fertility symbol, no heartfelt tribute to a loved one, rather my potential tattoo will be a dated DNR (do not resuscitate) tattoo.

The challenge is, what date do I establish as the point after which I no longer wish to be resuscitated?

What is a DNR tattoo?

Before I explore this, let me point out that a DNR tattoo is completely meaningless in the UK where I live. To comply with a patient’s wishes to forgo resuscitation, doctors require the completion of a dedicated document that forms part of the patient’s medical record and a copy can also be kept on the patient’s person, or with them in a care home or hospital. Even then, it’s not legally binding, as that would require a written, signed and witnessed advance decision (sometimes known as an ADRT or a living will).

The idea of being able to immediately communicate key medical information or treatment wishes regardless of incapacity has been around for decades; back in 1953 MedicAlert pioneered medical jewellery, and in many cases, necklaces and bracelets have proved literal lifesavers for those with severe allergies or life-threatening conditions. The introduction of QR codes means a vast amount of key information can be packed onto jewellery or an RFID tag. But tags and badges and jewellery can be lost, especially if one is involved in an accident.

A tattoo, on the other hand, is permanent – it can’t be lost and is a bold and immediate way to broadcast your wishes. DNR tattoos are on the rise, but when you do a Google image search for them, you’ll see that they are pretty basic and mostly lacking one important piece of information – a date.

Why date your DNR?

If you are philosophically opposed to resuscitation at any point in your life then the date of your need to resuscitate is immaterial. Well, as I see it, you either get tattooed later in life when you’re weighing-up your chances and your finances, or you plan ahead.

The timing of my exit needs consideration; it needs to sit in the Goldilocks zone – not so late that I’ve already started to suffer from the morbidities of later life and not so early that I miss out on the chances to benefit from advances in longevity science.

Let’s first deal with two questions posed by the more adventurous in our field: longevity escape velocity (LEV) and cryonics.

Longevity Escape Velocity

Longevity Escape Velocity (LEV) is the point where for every year we survive, we gain an extra year. This means that as research continues to progress, life expectancy will continually be extended longer than the time that is passing – and I’m fascinated by the concept. The rhetoric of former times has dialled down a lot over recent years; rather than talk of living forever, we speak more of healthspan, and rather than predictions of living to 500, we talk of living to 100 with compressed morbidity of only a few years.

Putting things on ice

Cryogenics is unproven. I was very intrigued to meet Dr Emil Kendziorra who is at the forefront of the industry and openly admits that he doesn’t know if it will ever work. Paying to have my body, or the budget option of just my head or brain, frozen doesn’t appeal to me much.

Imagine if today we were to posses the technology to unfreeze and resuscitate someone from 1852. It would be radical, headline-grabbing and amazing, but after 50 patients the novelty would be wearing a bit thin. Further down the track, in my imaginary post-cryo program, who would be taking on the responsibility of educating a cohort of resuscitated Victorians on how to drive, operate mobile phones, formulate new careers and become financially independent?

For me… well, when it comes to cryo, thanks, but no thanks; with regards to LEV, my mind is very much open, especially given Aubrey de Grey’s prediction that the cost to the end-user will be zero.

Perpetual middle age

Being already 8 years metabolically behind my 55 chronological years am I already pursuing an escape velocity track that means I might just live forever? Might I be able to remain under 50 (metabolically) indefinitely? Hmm, perhaps I’d better push out my DNR date a bit further.

85… staying alive?

80.9 years is the average life expectancy for UK males.

85: that’s the age that my relatives normally pass away. I watched my father decline with dementia and die at 85; my mother is 85 and is following the same dementia trajectory as Dad.

I don’t want my kids forced to witness and manage my decline, and that’s why I want to be in control now; rather than when the point where my potential mental decline means I’m completely in the hands of others.

As old as your oldest vital organ

So far things look cognitively positive for me on a personal level, based on my recent brain scan; at the macro level, we’re seeing the foundations of an eventual cure for cognitive diseases.

I might not get dementia, perhaps I’ll have another chronic condition; my cholesterol is always on the higher-side of acceptable, so perhaps my demise will result from cardiovascular disease. But even here there’s hope; take Cyclarity, for example, a company developing cyclodextrin molecules that remove arterial plaque by clearing the non-degradable oxidised cholesterol that accumulates within cells in the arterial walls.

By the time Cyclarity’s solution has been approved and is in clinical use around the world, I’ll only be in my 60s, and consequently beyond the risk of a traumatic cardiovascular event.

A good time to die?

So, if and when to judge the timing of a good death date?

Well of course that is an individual question that many of us consider, but few address; it’s human nature to carry on and hope for the best. Very probably, this wonderful and emerging longevity industry will have overcome all diseases of aging 30 years from now: when I’m 85 years old.

Genetically we’re currently unable to get past 122 years (Jeanne Calment, 1875–1997), but longevity gene therapies are already making their way along the clinical pipeline, so perhaps mankind will be seeing the emerging reality of LEV, just as we’ve seen the potential of limitless clean energy through the recent nuclear fusion breakthrough.

So the date for my DNR is still a work in progress; for now my skin shall remain tattooless, albeit a little more wrinkly. (On that note, have you read our Advanced aesthetics report?)