Excerpts-

• From the cover Chapter 1
  
  The Long Game
  
  From Fast Death to Slow Death
  
  There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in. —Bishop Desmond Tutu
  
  I’ll never forget the first patient whom I ever saw die. It was early in my second year of medical school, and I was spending a Saturday evening volunteering at the hospital, which is something the school encouraged us to do. But we were only supposed to observe, because by that point we knew just enough to be dangerous.
  
  At some point, a woman in her midthirties came into the ER complaining of shortness of breath. She was Black, from East Palo Alto, a persistent pocket of poverty in that very wealthy town. While the nurses snapped a set of EKG leads on her and fitted an oxygen mask over her nose and mouth, I sat at her side, trying to distract her with small talk. What’s your name? Do you have kids? How long have you been feeling this way?
  
  All of a sudden, her face tightened with fear and she began gasping for breath. Then her eyes rolled back and she lost consciousness.
  
  Within seconds, nurses and doctors flooded into the ER bay and began running a “code” on her, snaking a breathing tube down her airway and injecting her full of potent drugs in a last-ditch effort at resuscitation. Meanwhile, one of the residents began doing chest compressions on her prone body. Every couple of minutes, everyone would step back as the attending physician slapped defibrillation paddles on her chest, and her body would twitch with the immense jolt of electricity. Everything was precisely choreographed; they knew the drill.
  
  I shrank into a corner, trying to stay out of the way, but the resident doing CPR caught my eye and said, “Hey, man, can you come over here and relieve me? Just pump with the same force and rhythm as I am now, oaky?”
  
  So I began doing compressions for the first time in my life on someone who was not a mannequin. But nothing worked. She died, right there on the table, as I was still pounding on her chest. Just a few minutes earlier, I’d been asking about her family. A nurse pulled the sheet up over her face and everyone scattered as quickly as they had arrived.
  
  This was not a rare occurrence for anyone else in the room, but I was freaked out, horrified. What the hell just happened?
  
  I would see many other patients die, but that woman’s death haunted me for years. I now suspect that she probably died because of a massive pulmonary embolism, but I kept wondering, what was really wrong with her? What was going on before she made her way to the ER? And would things have turned out differently if she had had better access to medical care? Could her sad fate have been changed?
  
  Later, as a medical resident at Johns Hopkins, I would learn that death comes at two speeds: fast and slow. In inner-city Baltimore, fast death ruled the streets, meted out by guns, knives, and speeding automobiles. As perverse as it sounds, the violence of the city was a “feature” of the training program. While I chose Hopkins because of its excellence in liver and pancreatic cancer surgery, the fact that it averaged more than ten penetrating trauma cases per day, mostly gunshot or stabbing wounds, meant that my colleagues and I would have ample opportunity to develop our surgical skills repairing bodies that were too often young, black, poor, and male.
  
  If trauma dominated the nighttime, our days belonged to patients with vascular disease, GI disease, and especially cancer. The difference was that these patients’...

Reviews-

• 

  February 20, 2023
  This rigorous debut by physician Attia dispenses guidance on living longer while staying healthier. “The odds are overwhelming that you will die as a result of... heart disease, cancer, neurodegenerative disease, or type 2 diabetes,” he writes, outlining strategies to stave off these four “chronic diseases of aging.” The author’s medical philosophy emphasizes prevention over treatment, recognizes that what works for one person might not work for the next, evaluates “risk versus reward versus cost” on a case-by-case basis, and prioritizes maintaining one’s “healthspan.” He strikes the delicate balance between providing scientific background and keeping his explanations accessible, as when he relates that long-distance running and biking help fend off neurodegenerative disease because they cause the body to generate a molecule that bolsters the health of brain structures implicated in storing memories. Attia’s acknowledgement that diets aren’t one-size-fits-all is a welcome departure from the overgeneralizations of similar volumes, and he provides recommendations on modulating protein, fat, and carbohydrate intake depending on one’s age, sex, and activity levels. The familiar suggestions to reduce stress, eat healthier, and exercise are elevated by the depth of detail and lucid prose that Attia brings to the table. This stands a notch above other fare aimed at boosting health and longevity.

• A physician with a popular longevity podcast, "The Drive," offers an encyclopedic guide to preventing disorders that diminish quality of life and cause premature death. He's a good narrator, though with these extensively illustrated stories and a huge amount of medical information, his pacing might sound slow to some. But his voice is clear, and he sounds confident and full of dedication to his mission. His focus is on diseases that diminish our healthy years and make late life unbearable--preventable or treatable killers such as heart disease, cancer, Alzheimer's disease, and Type 2 diabetes. With downloadable charts and graphs, this is a well-organized, must-hear collection of the latest research for anyone who wants to maximize their healthy years and live longer. T.W. © AudioFile 2023, Portland, Maine

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