******************************

                “At Death’s End”, written by James Blish (1921-1975), was published in the May 1954 issue of Astounding Science Fiction magazine. Surprisingly, this short story is still only accessible in hard copy, within the original Astounding Science Fiction edition. Apart from a brief review by Robert W. Franson, who introduced me to this work, there is today surprisingly little literary analysis devoted to “At Death’s End” – even though it offers a fascinating glimpse into how a science-fiction writer from an earlier era perceived the prospects for indefinite human longevity, from the vantage point of the scientific knowledge available at the time. The world portrayed by Blish is, in some respects, surprisingly like our own. In others, however, it overlooks the complexity of the treatments that would be necessary to achieve actual radical life extension.

                The future (shortly after 2000) that Blish depicts is one where national governments are obsessed with “security” and “defense” – much like the United States today. It appears that the Cold War is still underway in this world (and it could be said that it has been resurrected in ours as well); however, space travel and space colonies are also prominent. The protagonist, Colonel Paige Russell, is himself a spacefarer who begins the story by journeying to the headquarters of pharmaceutical firm Jno. Pfitzner & Sons, Inc., to bring back soil samples from Ganymede and Callisto. In the midst of a society where an entrenched military-industrial complex has taken hold (even to the point of top positions – such as head of the FBI – becoming hereditary), a fundamentalist religious revival has also emerged, though the religionists often use machines to preach in their stead. This development, too, bears striking similarities to the rise of televangelism and the fundamentalist “religious right” in the United States during the late 1970s and 1980s. The overall society depicted by Blish is more permeated with religion than our own, as the alternative to the preachy fundamentalist religiosity of the Believers is portrayed as being a more subdued but still inextricable personal faith. Paige claims,

I’ve no religion of my own, but I think that when the experts talk about ‘faith’ they mean something different than the shouting kind, the kind the Believers have. […] Real faith is so much a part of the world you live in that you seldom notice it, and it isn’t always religious in the formal sense. Mathematics is based on faith, for instance, for those who know it. (17-18)

Even many religious individuals today would disagree with the notion that mathematics is based on faith – and certainly the many atheists and agnostics who are fond of mathematics and of the scientific method would rightly recognize that these logic-based and evidence-based approaches are as far from faith as one can get. And yet Blish intends Paige’s position to be the level-headed, sensible, rational one, compared to the alternative – showing that Blish did not foresee the extent to which skepticism of religious faith would become a widespread, though still a minority, position.

                Blish’s extrapolation of medical progress is remarkably prescient in certain respects. Paige learns of the history of medicine from Anne Abbott, the daughter of Pfitzner’s leading researcher:

In between 1940 and 1960, a big change came in in Western medicine. Before 1940 – in the early part of the century – the infectious diseases were major killers. By 1960 they were all but knocked out of the running. […] In the 1950s, for instance, malaria was the world’s greatest killer. Now it’s as rare as diphtheria. We still have both diseases with us – but how long has it been since you heard of a case of either? […] Life insurance companies, and other people who kept records, began to be alarmed at the way the degenerative diseases were coming to the fore. Those are such ailments as hardening of the arteries, coronary heart disease, the rheumatic diseases, and almost all the many forms of cancer – diseases where one or another body mechanism suddenly goes haywire, without any visible cause. (20-21)

The shift from infectious diseases being the primary killers, to the vast majority of people dying from the degenerative diseases of “old age”, is precisely what happened during the latter half of the twentieth century, throughout the world. The top killers in the early 20^th century were infectious diseases that have been virtually wiped out today, as this chart from the Carolina Population Center shows. (For more details, see “Mortality and Cause of Death, 1900 v. 2010” by Rebeca Tippett.) Additional major progress is evident in the 54% absolute decline in mortality from all causes during the time period between 1900 and 2010.

                Blish was foresighted enough to attempt a conceptual decoupling of chronological and biological age. Anne Abbott explains to Paige that “Old age is just the age; it’s not a thing in itself, it’s just the time of life when most degenerative diseases strike” (21). She recounts that “When the actuaries first began to notice that the degenerative diseases were on the rise, they thought that it was just a sort of side-effect of the decline of the infectious diseases. They thought that cancer was increasing because more people were living long enough to come down with it” (21). Anne then proceeds to discuss findings that some cancers are caused by viruses – which is actually the case for a minority of cancers (approximately 17.8% of cancers in 2002, as estimated by the World Health Organization). In the world portrayed by Blish, a rising incidence of degenerative diseases caused by viral infections led the National Health Service to fund research efforts by companies like Pfitzner, in an effort to address the threat.

                Incidentally, Blish also foresaw the rise in major government expenditures on medical research. Anne explains that “the result of [the first world congress on degenerative diseases] was that the United States Department of Health, Welfare and Security somehow got a billion-dollar appropriation for a real mass attack on the degenerative diseases” (22). Of course, in our world, major scientific conventions on degenerative diseases – both governmental and private – are far more routine. Indeed, a small but dynamic private organization – the SENS Research Foundation – has itself hosted six world-class conferences on rejuvenation biotechnology to date. In the United States, billions of dollars each year are indeed spent on research into degenerative diseases. The budget of the National Institute on Aging exceeds $1 billion annually (it amounts to $1,170,880,000 for Fiscal Year 2015). Unfortunately, in practice, even this level of funding – from both private and governmental sources – has thus far proven wholly insufficient to comprehensively reverse biological senescence and defeat all degenerative diseases.

                In Blish’s imagined future, the battle against senescence could be won far more easily than in our present. Pfitzner’s key project is a sweeping solution to all lifespan-limiting ailments – a broad-range “antitoxin against the aging toxin of humans” (36). In this world, Paige, who later becomes trained in Pfitzner’s research techniques, can pronounce that “We know that the aging toxin exists in all animals; we know it’s a single, specific substance, quite distinct from the ones that cause the degenerative diseases, and that it can be neutralized. […] So what you’re looking for now is not an antibiotic – an anti-life drug – but an anti-agathic, an anti-death drug” (36). If only it were that simple! Today, even the most ambitious engineering-based approach toward defeating senescence, Dr. Aubrey de Grey’s SENS program, recognizes not one but seven distinct types of aging-related damage that accumulate in the organism. Dr. de Grey’s strategy of periodically reversing the damage is more straightforward than the alternative approach of re-engineering the tremendously complex metabolic processes of the body that malfunction over time, and which are still quite incompletely understood. In Blish’s world, a single company, working covertly, with relatively modest funding (compared to the funds available to research organizations in our world), can develop an “anti-agathic” drug that does for senescence what antibiotics did for deadly infectious disease.

                Without spoiling the ending, I will only mention that it is friendly to the prospects of radical life extension and portrays it in a positive light – one additional reason for recommending that “At Death’s End” be included within the canon of proto-transhumanist and life-extensionist literary works. Furthermore, the viability of indefinite life extension in Blish’s vision is closely intertwined with humanity’s future as a spacefaring species – another progress-friendly position. Blish comes across as a thoughtful, scientifically literate (for his era) writer, who extrapolated the world-changing trends of his time to arrive at a tense, conflict-ridden, but still eminently hopeful vision for the future, where the best of human intellect and aspiration are able to overcome the perils of militarism, fundamentalism, decay, and death.

              The author of “At Death’s End” himself succumbed to death at the age of 54, on July 30, 1975. He did not live to see the world of 2000 and compare it to his prognosis. Unfortunately, Blish seems to have disregarded the tremendous harms of tobacco smoke and was even employed by the Tobacco Institute from 1962 to 1968. A genealogical profile lists Blish’s cause of death as “Recurrent cancer per smoking, metastasized.” This brilliant, forward-thinking mind unfortunately could not escape one of the most common collective delusions of his time – the fascination with and normalization of one of the least healthy habits imaginable, one that is the most statistically likely to lower life expectancy (by about 10 years). This is quite sad, as it would have been fascinating to learn how Blish’s projections for the future would have been affected by additional decades of his experience of societal and technological changes. One of the major trends in longevity improvement over the past several decades has been a major decline in the smoking rate, which decreased to an all-time low in the United States in 2013 (the latest year for which statistics are currently available). Surely, to come closer to death’s end, as many humans as possible should abandon what are now known to be obviously life-shortening habits.

              While an anti-agathic drug is not in our future, James Blish’s vision of the defeat of senescence can still serve to inspire those who endeavor to solve this colossal problem in our world, during our lifetimes. Let us hope that, through the efforts of longevity researchers and through increases in funding and public attitudinal support for their projects, we will arrive at death’s end before death ends us.