Gaza. Pause and think

  On October 7, I was walking on a sunny Ashdod beach when the rockets struck.  Like everyone in Israel, I was shocked, humiliated, and outraged.  On that day, while Hamas fighters were still killing people, Netanyahu declared "We are at War."  He added that he directed the army to "fight back on a scale and intensity that the enemy has so far not experienced.”  Initially, I welcomed his statement, but in the days that followed, I began to have doubts.  It was difficult to express these doubts while in Israel, and more difficult to do so now that I am back in Oaxaca.  In the eyes of many Israelis, it is inappropriate for me, an outsider, to discuss security matters.  However, perhaps I am allowed to ask questions.  I'll present them in reverse order.

1.  Does the conduct of this war by the IDF, an army that prides itself in innovative thinking and technical knowhow, meet your expectations?

2.  Is the cost of the war, 100 Israeli soldiers, 20,000 Gazan civilians and counting, acceptable to you?

3.  Will a war achieve permanent security for Israel?

4.  Will the war insure the release of all the hostages?

5.  Were you presented with alternatives solutions to war?

If the answer to some of these question is not a clear 'Yes!', ask yourself  'Why?' 

It could be evidence of a leadership failure to think.

I know that Israel's political and military leaders are smart and have good intention, so I will venture to guess some causes for their failure.

a.  Shock.  It is hard to think under attack

b.  They accepted and joined the national urge for revenge.  

c.   A deep personal burden of guilt may cloud rational thinking and drive one to strong violent action.

I am afraid that unless the current leaders are dismissed now, the underperformance will continue.  It is the Israeli voters turn to pause and think.

P.S.  I am often asked  "Then, what do you propose?"  All I wish to say is that I have heard many anecdotes of action that could have been taken or  action that should have been avoided, to prevent the massacre.  Those hypothetical actions are an indication that there are other options.  

Outlive, by Peter Attia MD. Book review.

Outlive aims to teach us how to live a longer healthy life.  I like the book because it fits my goals.  I am not afraid of death, but for as long as possible I wish to remain active. To achieve this goal, I need to be strong both mentally and physically.  I have been listening to Peter Attia for several years. He is an MD (and engineer,) smart, charismatic, and his explanations fit my way of thinking  (1).  The book is well organized, although, to my taste, it could be shorter by reducing the number of anecdotes.

As I was reading, I realized that the correct audience are my three middle-aged children.  They are old enough to be aware of aging, yet still have enough time to implement the advice in the book.  Perhaps this review will motivate them to read it.

The book is organized around Objective, Information, Strategy, and Tactics. 

Objective

Delay death, and get the most out of our extra years. The rest of our lives becomes a time to relish rather than to dread.

Information 

Aging is a process of deterioration of both mind and body. Eventually, the deterioration leads to illness and death.  The four main causes of death in western society are heart diseases , cancer, neurodegenerative disease (Alzheimer),  and Type 2 diabetes.  Attia named them the four horsemen [of the apocalypse.]  The book dedicates at least one chapter to each horseman, describing its causes and treatments.  The common thread in these chronic illnesses is that they are a result of a mismatch between the modern environment and our genetic makeup. 

Strategy

Today's medical practice does a good job of tackling acute disease, yet it is not equipped to handle chronic diseases.  To increase our healthspan, we need to develop a new style of medicine, which Attia names Medicine 3.0.   Since chronic illness starts to develop many years before it is recognized and treated, Version 3.0 focuses on early detection and early prevention.  It uses data to provide individuals with advice which minimizes the risk of intervention, while maximizing the reward (years of health).

Tactics

If we want to outlive our life expectancy and live it better, we will have to work.

The tactics entail five tools:  Exercise, nutrition, sleep, emotional health, and exogenous molecules (a fancy name for drugs and supplements).  Attia aims to provide general principles for these tools, rather than exact recipes, though in many cases he does provide detailed advice.

Exercise

Exercise is, by far, our most effective tool.  It is more potent than any known medication.  It can offset many adverse lifestyle factors.  Exercise reduces our risk of illness and death from any of the horsemen.  In addition, to be able to execute the activities we wish to do in our last years, we need to build some reserve now.  That includes both aerobic fitness and strength. 

We want to be able to walk uphill with our grand (or grand-grand) children, as well as pick them up when we desire.  Strong muscles also help avoid accidental falls, and the resulting bone fractures.  Interestingly, grip strength has a very high correlation to reduced mortality risk.  

          Attia provides some advice on how, how much, and how often to exercise.

Nutrition

Nutrition is a fuzzy science.  The experiments are not clear, and the effects are not large.  Bad nutrition habits can make us ill, but as long as we avoid the Standard American Diet (SAD), all other diet religions provide about the same benefit.  Instead of a diet, Attia recommends these simple rules:   "Don’t eat too many calories, or too few; consume sufficient protein and essential fats; obtain the vitamins and minerals you need; and avoid pathogens and toxins" 

All macronutrients and their qualities are discussed.  Special attention is placed on consuming sufficient protein.  For active people, sufficient daily quantity is 2.2 grams per Kg of body weight.  That's nearly three times the medical advice. 

Sleep

High quality sleep is essential to our health.  Attia provides advice on how to achieve it. 

Emotional health

“Why would you want to live longer if you’re so unhappy?”

A lot of this chapter is devoted to Attia's long road from child abuse to therapy, but the lesson may apply to any of us.  Emotional health will affect our physical health and longevity.

[In a separate but related reference, I learned that chronic stress causes a faster rate of telomere shortening, and therefor accelerates aging.  Stress relief methods such as meditation, are highly recommended (2)]  

Medication and supplementation

The book does not dedicate a chapter to this tool.  Attia prescribes medication to patients who do not respond to the other tools.

Notes:

1.  The theory behind this book seems solid to me.  However, over the years I realized that Attia is a bit fanatic about ideas he believes are true, and more than a bit obsessive in his activities.   In the book he claims that he has reformed these tendencies.  Nonetheless, if any of the ideas or suggestions in the book seem wrong to you, feel free to further investigate and or reject them. 

2.  The Stress Prescription, by Elissa Epel, Penguin books 2022.

Purple

Two old men ride slowly into town.  They are covered in dust after the long mountain trail.  The street is abandoned.  On both sides, they see broken walls and fallen columns, remnants of formerly monumental edifices.  The loose cobblestones crumble under their tires, and the sound echoes against the bare walls. Although they see no one, they can feel eyes watching them from the shadows.  Night is looming, and with it,  danger.  At the central square, they dismount.  They hear the rumble of distant thunder, They look up.  Stars are visible in the darkening sky; It is not a storm.  The sound grows nearer and louder. The sonorous throb of large drums reverberates within their body, and is now accompanied by slow-cadence music.  A large group of men, wearing hooded dark robes, enter the square. They step in unison carrying a long and heavy wooden float. On the float, effigies of mythological figures in various postures of torture or death. Dozens of men shoulder the float, yet the strain is visible on their young faces. The two riders observe in silence. Torches are lit to illuminate the procession. Behind the float march several men playing funeral music on tubas and other wind instruments. The large drums are towed on trolleys and mark the solem beat.  These are followed by more hooded men dispensing smoking incense from swinging censers.  Out of the smoke, emerges another float.  This one smaller, carried by dimunitive pre-teen girls.  The girls are overpowered by the weight on their shoulders.  A few of them stumble to the ground, and are briskly pulled up by the adult attendants surrounding them.

OK, OK. Enough of this post-apocalyptic movie.

Kobi and I arrived in Antigua, Guatemala, unaware that it was the night before Passion Sunday.  The ruins are the remnants of an eighteenth century earthquake which almost destroyed the city.  The procession is an old tradition, and attracts many visitors.  (We were lucky to find a room.)  The little girls were not being tortured.  Their mothers were there, discreetly sharing the load.

On Sunday morning, more luck.  A flight delay, allowed me to stay in town for the main event.  The sidewalks bloomed with Mayan women wearing colorful woven outfits.  Along the procession route, locals applied the finishing touches to decorative carpets formed by flowers and colored sand.  These will be obliterated as the procession passes over them.  At last, The large float entered the city.  It was carried by two hundred men, wearing purple, the color of Lent.  On it, effigies of Jesus enacted scenes of the crucifiction.  A squad of Roman soldiers marched in front, and the bass drums and tubas followed.  Virgin Mary on a smaller platform came next, carried by veiled women in black dress. Since the procession started earlier at a nearby village, and would wind its way through the city until evening, thousands of curcuruchas (carriers), all in purple, stood in readiness to carry the load for one block. Each carrier wore a badge, designating his turn as well as his position under the float. (That's how I know their number)

The spectators were still choking the city streets when I had to squeeze my way out, barely making it to the airport taxi.

Dances with Lions

                            Happy Lunar New Year

We celebrated the New Year in a village not far from Oaxaca.  The restaurant owner is Vietnamese, the food was Thai, (I had beef eggplant)  and the friends from Mexico, Canada, and even Turkey.

Short but excellent dancing (with lions):   https://vimeo.com/791974714