🧑‍⚕️🩺 AI and the Leap to Medicine 3.0: A Recipe for Longevity and Vitality

All doctors, upon graduation, take the Hippocratic oath in honor of Hippocrates. Hippocrates is considered the father of medicine. His main contribution was the idea that diseases are caused by nature, not by gods, as was believed at the time.

Ahhh, nothing is more effective than a good bloodletting.

At this time, “doctors” did what they could with what they knew. But often, they did more harm than good. Life expectancy was between 30 and 40 years. One in two children died before reaching 15 years.

Thanks to 21 historical societies that kept data on their demographics, we know that infant mortality in ancient times was around 50%.

Until the scientific method arrived.

Medicine 2.0

When we began to form hypotheses and conduct experiments to validate or refute those hypotheses, we started to make real progress in medicine.

Gradually, inventions arrived that changed the course of history. The microscope allowed us, for the first time, to see face to face the organisms that were killing us. Antibiotics gave us a powerful weapon against them. And later, vaccines allowed us to eradicate diseases that, in other times, killed a significant fraction of the population.

In just a few decades, we doubled life expectancy.

Source

Thanks to medicine 2.0, we tamed “rapid death.”

If I ask you, how do you think you will die? No one thinks they will die from pneumonia, avian flu, cholera, or tuberculosis. These are diseases that are completely treatable under medicine 2.0.

But once we defeated rapid death, a new group appeared: “slow deaths”:

• Cardiovascular diseases (heart attacks)

• Cerebrovascular diseases (strokes)

• Cancers (you know them)

• Neurodegenerative diseases (Alzheimer's and Parkinson's, among others).

Together, they are responsible for almost 60% of deaths worldwide.

Source

The problem with “slow deaths” is that they are caused by diseases that take years to develop. When a person dies from a sudden heart attack, we are witnessing the end of a disease that has been growing slowly for 30 or 40 years.

Medicine 2.0 has been very effective against rapid deaths, but not so much against slow ones. In part, because it tries to use the same set of tools that work for one but not the other. Medicine 2.0 intervenes when the disease is “visible”: you treat a bone when you break it, or you have surgery for appendicitis when the pain is unbearable.

What's the problem?

This approach does not work with “slow deaths.” Medicine 2.0 intervenes only when you have your first heart attack, or when you have diabetes, or when you develop the first signs of dementia, or when you are diagnosed with advanced cancer. And when those diseases are “visible,” it is already too late.

Despite how far we have come in treating “rapid deaths,” we have not been very good with their “slow” counterpart.

While the mortality rate has dramatically decreased in recent centuries, if we exclude deaths from infectious diseases, then progress “flattens.” We have not managed to defeat “slow deaths” in the last 200 years.

For them, we need a different mindset.

Medicine 3.0

This graph is useful for understanding the concept of medicine 3.0.

On the horizontal axis, we have longevity, or “how many years we live.” On the vertical axis, we have vitality, a subjective measure of “how well we live” in terms of health.

Without medical intervention, our vitality declines as the years go by. In our last decades, we continue “living” but we no longer have the vitality to do the things we enjoy, likely caused by one of the diseases previously described.

Medicine 2.0 manages to extend a few years of life in that last period (the curve that moves to the right at the end). That is, it is good at giving us more longevity, but at a stage in life when we no longer have vitality. We all know a relative who was diagnosed with cancer and lived their last years/decades without much vital energy due to chemotherapy.

The goal of medicine 3.0 is to extend longevity while also maintaining vitality. To achieve this, it understands that the diseases that will kill us today are “slow” and, therefore, develop from our early years of life, and focuses on early prevention.

And What Does This Have to Do with AI?

You might be wondering how medicine 3.0 increases both our longevity and our vitality.

And the answer may not please you.

It does not achieve this through technological fantasies of biohacking or miraculous supplements, but mainly through highly rigorous, detailed, and personalized monitoring and treatment of our nutrition, sleep, exercise, and mental health.

Yes, how boring.

But this is precisely an area where AI can be an ally.

Take, for example, this blood test I received after my annual preventive check-up.

我爱学习新的语言。" 这句话在英文中是 \- (That's how I felt trying to read it)

But today I have at my disposal a robot that has read practically everything on the internet.

Uff, everything is in order. Thanks also for the biology lesson.

And this is the result of a model that has not been specifically trained to provide medical answers.

Can you imagine a model that has been trained on the best medical research papers, on databases with patient histories and their diagnoses, and that has been supervised by a body of expert doctors to provide correct answers?

Well, that AI already exists. It’s called Med-Palm 2 and it’s from Google.

It understands the image (X-ray), shares what it understands, and provides recommendations.

As is common, to evaluate the ability of this model, they gave it a difficult test (the exam to become a licensed doctor in the USA). What was the result? It scored 86.5%, the result that expert doctors achieve.

The results in the exam of different language models.

Additionally, they compared its answers with those of experienced doctors and then asked a committee of doctors to choose which answer they preferred. Overall, Med-Palm 2 performed better.

Percentage of answers preferred by the expert committee. Med-Palm 2 beats doctors in 8 out of 9 categories.

Here is the study.

Medicine 3.0 + AI

In the future (or should I say present?), AI will be our coach for Medicine 3.0.

It will have access to our health data (sleep, heart rate, oxygenation, VO2 Max, weight) and will periodically prescribe more specialized tests (biochemical, hormonal, lipid profiles, blood counts, etc.).

With that information, it will be able to guide us in the right direction on each of the important elements of Medicine 3.0:

1. Exercise: it will ensure that we are doing enough exercise. Additionally, it will monitor that we are doing the correct type of exercise. I don’t want to go into details, but medicine 3.0 recommends a mix of gentle cardio exercise (zone 2), hard cardio (VO2 Max), strength (weights), and balance.

2. Nutrition: it will prepare a weekly menu tailored to our needs. Moreover, it will adjust it according to our caloric needs and goals (gaining or losing weight).

3. Sleep: it will alert us when we are not maintaining good sleep habits and will find patterns of poor sleep nights to identify the things that disrupt our sleep.

4. Supplements: it will understand what type of supplementation we will need to achieve certain goals: sleep better, improve our physical performance, treat a symptom.

5. Mental Health: in this area, I think we are still far behind, but there are some cases where researchers have used AI systems to monitor and treat symptoms of mental illnesses.

6. Preventive Medicine: this point is the most important. It will tell us when it is advisable to undergo new tests and see a doctor to monitor our health.

On the doctors' side, they will have a powerful AI ally, which has access to all the information in the world in an organized manner and has infinitely superior image recognition capabilities.

Not only that, but they will also have more informed patients and more information about their current health status.

Win-win.

PD 1: just as ChatGPT said in the photo analyzing my blood test, the first thing is always to consult with your doctor. This essay seeks to explore interesting and curious ideas about the future of medicine, but by no means is it intended for us to stop relying on doctors and medicine. On the contrary, I see how this type of technology can make doctors' work even more effective.

PD 2: this technology is still being tested. In fact, some doctors have reported serious errors in diagnoses made by ChatGPT. As I said before, health is the most important thing, so we should always seek a doctor's opinion. In my case, after receiving my test results, I had a session with a preventive medicine doctor to review the results.

PD 3: if you are interested in learning more about the science and art of longevity and vitality, I recommend reading the book Outlive by Peter Attia.