Raphy’s first memories of Medical College, Trichur were pleasant. But they also included the unpleasant one about the stray dogs. And the attack of epilepsy. It was in his second year, and his grandmother had just died, leaving him an orphan. The grief was unbearable. Nobody could understand it, and that made it worse. Grandmothers were meant to die, weren’t they? Only he seemed to realize that she was the only person who had mattered to him.
He wandered through the wild jungle that was the campus of the college. Some of the places were really desolate. He wanted to be alone. Even his best friend Sivasankaran was not there with him. That was when the pack of stray dogs attacked. Dogs were warm and fuzzy – when they were outnumbered, and among humans. But when they go wild, they can be more dangerous than a pack of wolves. Raphy had no idea that dogs could be so terrifying. He never thought that they would actually attack, till some of them started tearing at his flesh. He remembered screaming. Then strange lights seamed to blink in his head. He felt confused. An elderly figure leapt out of the shadows armed with a stick. It attempted to drive off the dogs, shouting at them to flee. The voice was familiar. What was his grandmother doing here, she is dead … he remembered thinking. Then all was blackness.
When he regained consciousness he was in the ward. Multiple wounds were in bandages, and Sivasankaran was at his side.
“What happened?” He asked.
“You are safe now.” Sivasankaran hovered solicitously. “Some dogs attacked you. Why did you go alone? You passed out from fright” His eyes were accusatory.
“It was an attack of fits that I had. I remember the aura. But who saved me? How did I get here?”
“They said an old woman came into the casualty, dragging you. She had some bites on her as well. They bandaged her wounds. Then she disappeared. She saved your life, I think.”
“Who … who was she?” Lona asked. His voice had turned high pitched.
“Take it easy. Take rest man. God only knows,” said Sivasankaran.
Raphael finished MBBS believing his grandmother watched his every move. It was exceedingly comforting.
He got into research somewhat by accident. He was into curative medicine. He did MD in Internal Medicine after his MBBS, all in Trichur itself. Then he joined back as Physician and Assistant Professor in General Medicine department. Medicine was a hot specialty in those days, and very busy. He saw sixty patients everyday in the OPD.
“Why don’t you do a research project? Even an epidemiological study would be enough.” The unit chief pressed. “Only clinical work is not enough, these days.” He was desperate to utilize the research funds the government had thrust upon him. They were becoming demanding about medical research. The older generation of doctors in India did not even know what that meant – the patient load was so compelling.
Raphy looked at the wizened face of his grandmother in the photograph at his desk. He thought about the ninety-nine year old Veluchettan, his landlord at the lodge where he was staying. Next week was his hundredth birthday. Raphy loved the old man. He started making an impromptu epidemiological study by a questionnaire, on people above hundred years of age that he met in the course of his work.
One day he was seeing patients in the OPD. Most were poor people from Thrissur with various minor complaints. The seriously ill patients were directly sent to the casualty. It was around eleven in the morning and he was seriously contemplating going for a tea break when she appeared. Old – may be sixty or seventy. It was not easy to tell with some of them. Many looked prematurely old, from the sun and from the many sufferings that fate threw their way. She was thin, wrinkled and had grey hair. But she looked neat and graceful and had bindi and chandan on her forehead. There was something wrong with her left eyebrow – a distortion which did not detract from her being pleasing. The cotton sari was cheap but washed. An average old woman. But this one was happy. She had a big happy smile. She looked very familiar. Suddenly he had her placed.
The beggar woman who used the Veranda of the lodge as her nightly quarters, thanks to Veluchettan’s generosity. She was always accompanied by a far younger man in his thirties or forties. A wild eyed, wild haired creature who clung to her as if he was a six year old. But sometimes he became violent and irritable. Then only she could control him. One day, he distinctly remembered the man, walking away terrified (of apparently nothing), eyes wide with fear, hands tightly closed over both ears. He was yelling ‘Bang! Bang!’ giving voice to the imaginary sounds he heard vividly in his head. And the old lady followed him briskly, carrying the bundle containing all their worldly possessions. Her face betrayed nothing but a resigned look, as if it was a routine part of her life. He saw Veluchettan giving her a fifty rupee note. Even the local drunkard Nanu occasionally gave her money.. One day he remembered asking Veluchettan:
“Where is the old woman and son?”
“Oh, she disappears often. Follows him around. He gets restless and wanders off, god knows where. He gets violent if you try to stop him,” said Veluchettan.
“Who is she?” Raphy had asked.
“I don’t know. She doesn’t talk much. I see her only once or twice every few months.”
Now she was sitting in front of him, serene smile in place. He could see the young man sitting outside the room blank faced but sometimes looked fearfully through the open door in his direction.
“Yes, amma, what can I do for you? What is your problem?” He asked.
“Nothing specific. I came for a general check up, doctor,” she answered.
He was surprised at the cultured voice and the chaste language.
“Is there any particular reason for coming now?”
“Oh, it is routine for me, doctor. I always come for regular check up, even before you were working here.”
He took out the stethoscope and proceeded to give a thorough physical. No abnormality. He ordered the usual screening blood tests and sent her for a pap smear.
She was back the next day with the results. All parameters were normal. She was one healthy old woman. He congratulated her.
“What is the secret of your health?” He teased.
“Careful living, healthy food, and no bad habits.” She laughed. “And plenty of exercise also, I guess, walking all over the place.”
“And one more thing, doctor, should I get a mammogram done? I do regular self examination, but still…”
Dr Raphael looked at her with mixture of awe and puzzlement.
“Who are you?” he asked finally.
“Oh, nobody doctor. But I used to be a high school teacher once. But don’t let us talk about all that.”
It was clear she did not want to reveal much about her personal life. She gathered up her bundle and umbrella and got ready to leave.
“And one more thing I wanted to ask you, doctor. What about resveratrol? Is it available in India now?”
Raphael was stumped, “Res … resveratrol? Never heard of it.”
“That is ok, doctor. Thank you for everything.” She rose to leave. Suddenly Raphy felt a twinge, a vague sense that he was reliving something.
“Wait, what is…?” Then he looked again at the scars on her forearm. The scarred and distorted eyebrow clicked into the scheme of things. Could it be…?
“And be careful of the dogs, doctor. They are dangerous.”
Raphy was too stunned to move. By the time he recovered and ran after her, she was nowhere to be seen. The hospital was a maze. That day he went around with an ache, of some loss which he could not quite place.
When he got back to the lodge, he immediately rushed to the nearby internet cafe and googled ‘resveratrol’. Personal laptops and tablets were still luxury that time. He learnt that ‘resveratrol’ was a chemical found in red wine that was supposed to delay ageing. He stayed awake late into the night, studying ageing and the attempts to combat it, fascinated. Then he rushed back to meet the old woman back at the lodge. But she and the man were not seen.
That was the last he saw of her, for a long time.
But that was how he became interested in ageing. And he discovered his life’s calling.
He pursued his old epidemiological survey of centenarians with renewed vigour. These were times when the Indian government began to take a renewed interest in research. It was easy to get a research grant from ICMR. After getting detailed data on more than five hundred men and women who had crossed the magic age of one hundred, he started analyzing it.
To his surprise, he did not find many significant differences when compared with the normal population. The centenarians were seldom overweight. They were seldom smokers. Very few of them had led deliberately austere, careful lives. It seemed as if the magic factor or factors were intrinsic and constitutional. It seemed easy to rush into an early grave by being accident prone, drinking like a fish, smoking like a chimney and eating like a pig. But it seemed remarkably difficult to increase the quota of your time in this world.
He presented his findings before an interested audience of scientists from various fields in a conference in New Delhi – ‘An epidemiological study of centenarians in Kerala’- by Dr Raphael Lonappan Koottookkaren. After fielding a barrage of questions he got down from the podium. He was accosted by a middle-aged man who introduced himself as Brijesh Patel, an anthropologist.
“Your presentation was intriguing. I liked it” He said.
“I want to talk to you. Shall we go for a coffee?”
Dr Raphael had no interest to sit through the next presentation ‘Epidemiological parameters. A statistician’s perspective on analysis’, and he readily agreed. He could not imagine what an anthropologist would want to discuss with him. As far as medical men were concerned, they were from another planet.
After the preliminary introductions and small talk were over, Brijesh Patel briefed him on his work among the tribes in Andaman and Nicobar islands.
“There are six to ten distinct tribal groups in the islands. But there may be up to fifty odd communities which are practically isolated from one another, culturally. Even language may be mutually unintelligible.”
Dr Raphael nodded.
“I have noticed,” continued Dr Patel, “that one of the groups, the Jagatha tribe in Solari islands, have an unusually high number of old people. In fact, most of the members, by their own account, expect to live at least till hundred.”
Dr Raphael found this interesting. Such things were not totally unknown however. The Japanese were long-lived. More interestingly, the Okinawans, inhabitants of the island of Okinawa, a part of Japan, were substantially more long-lived than those in other parts of Japan. When analyzed, these results turn out to be in part due to diet and other environmental factors, and mostly due to racial and genetic reasons.
“The Jagathans attribute their extraordinary longevity to the root of a plant which they call Golgoba. They consume an extract of the plant root every alternate day as part of a religious ritual.”
Patel concluded. Dr Raphael became excited.
“This tree, I mean plant … is it found only on that island?”
“No, Dr Raphael. That is an interesting thing. It is found all over the islands. Rusica Officinalis. The other island tribes avoid it as the root is poisonous. It causes severe vomiting, convulsions and sometimes even death. But the Jagathans have a complex procedure of preparing the extract which neutralizes the poison.”
“Are you interested in coming with me to Solari islands?”
This was another life-changing moment. As though divinely ordained, the two years of his clinical work was just over and he was now eligible for the research sabbatical of two years. He just needed a good research proposal.
Raphy spent two months with the Jagathans and Dr Patel knew their language. They learned to prepare the Golgoba root extract. Return journey was with a large consignment of the root as well as the prepared extract.
He designed a study on laboratory rats. A control group, a group on fifty percent calorie restriction and a group fed on the extract. At that time it was already clear that calorie restriction with optimal nutrition was an established way of increasing life span substantially in laboratory animals. The results were extremely encouraging. By the end of ten months, ten percent of the rats in the first group had died, while all the rats in the calorie restriction and the extract fed group were alive. They were also more active and appeared younger than their same-age colleagues.
Now really excited, Dr Raphael thought he required more expert guidance. He called Dr Albert Gordon Brown, a world renowned authority on pharmacological gerontology.
Dr Brown was in the very modest lab of KUHS at Trichur, the very next week, in person. Raphael was struck by the extreme interest of the great man. And he was overwhelmed with gratitude.
“I will help you, Doctor. I am very much interested in your work. Intriguing. A brilliant line of enquiry, my man!”
Raphael smiled. He wanted to touch his feet. But in international medical circles, it was not done.
“My secretary here will prepare some documents. Please sign them. Cheers to our collaboration.” He raised his glass. Dr Raphael unhesitatingly signed the data and sample sharing agreement. He did not read the fine print. One does not question gods in pedestals.
One month later, disaster struck. An outbreak of murine flu killed off almost all the animals in one stroke. He took immediate steps to restart the entire experiment. “Should he attempt to present or publish the preliminary results of his first experiment?” He promptly called Dr Albert Brown.
“Oh no, Raphael, old boy. Don’t even think about it. You are totally inexperienced in the ways of the research world. None of the big journals are going to take even a second glance at your paper. They will be thrown into the dust bin before you can say kootoo… I mean koottookkaren, heh heh. Wait till you have solid evidence.”
Dr Brown was right about one thing. So inexperienced was Raphael in the devious ways of high powered medical research, that he believed him.
Hardly one year had passed, before an article appeared in the July issue of Current Gerontology. ‘The effect of the root extract of Rusica officinalis on ageing in rats – A preliminary report’ by Dr Albert Gordon Brown. Dr Raphael feverishly searched through the list of half a dozen co-authors. There was no Raphael Lonappan Koottookkaren. No Brijesh Patel. One more year later, another article appeared, this time in the very prestigious Science. ‘Rusica officinalis root extract increases the mean and maximum life span of winstar rats by fifty percent’. Again, there were only Albert Gordon Brown and a few sidekicks. The article ended with:
“Efforts are on to identify the chemical responsible for the effect from the extract, which will herald a revolution in the field of Medicine.”
Brijesh Patel died, shortly thereafter, of a massive heart attack. Raphael felt the loss acutely, for by that time they had become friends. He suspected the betrayal of Albert Brown contributed to his death. He made sure that he attended the World Congress of Gerontology in Amsterdam next year. His aim was not to confront Albert. Such things he considered useless. He was made of stronger intentions. His target was Gerald O’Brain, a bitter rival of Albert Brown, and chief of Gerontology at New York State University.
That was how he became faculty in New York University.
The next forty-six years he was in the USA. He had heard it was a good country to have fun. A place to make money and live the high life. This, he did not do. He was in a desperate race. An athletic contest of intelligence and willpower in exquisite slow motion – to isolate and characterize the responsible chemical in the Jagatha’s extract. Days and nights congealed into months and years of reagents and test tubes. Conferences in scenic locations he spent staring into and fiddling with his laptop. He supervised a generation of research assistants and graduate students. He negotiated and occasionally fought with a succession of grant-awarding committees and government departments. He lobbied against waves of the public and the press who told him that his efforts were not worthwhile. Who wants more aged people, they asked.
Women stayed outside his field of vision. Rosie, one of his secretaries, breached his defences once. While leaving she told him:
“I wish I was a chromatograph in your lab, Raphy.”
She was not spiteful, just sad. He was relieved. The lab work was slacking because of her.
There were no friends, only colleagues.
“Ropimycin – as efficient as fifty percent calorie restriction in laboratory rats,” was published in Nature with Raphael Lon Koo as first author, eight years after isolating the drug. The various studies, safety tests and then the clinical trials were scheduled. He had become a legend. But his opponents were relentless.
“It is no doubt, a significant contribution. But the ultimate value of postponing death is questionable in the greater context of human evolution,” said Albert Gordon Brown, denigrating his own early work in the field.
“Just to spite me.” Thought Raphael. And both of them were in the race for the Nobel Prize. One in Gerontology was due, and Albert’s was the first root extract publication. Albert was ninety-two and Raphael was eighty-six. The Nobel is never awarded posthumously. The winner has to be alive, at least at the time of announcement of the results. This was a different kind of race; to stay alive.
“What we need is respect for life, and dignity. Death is a window to your destiny. Postponing it is futile.” The Pope declared. He was on a cardiac pace maker, without which he would have died twenty years back.
“We are living out a succession of lives. The present one is transient, irrelevant, and futile,” the Dalai Lama said with a beatific expression, the ochre robes glinting in the surrounding snow. “I have great compassion, but not appreciation, for Dr Raphael Lon Koo.” He looked up at his own self-evident halo. The brain implant that took care of his terminal Parkinsonism contributed to its magnetic effect.
“Heralding the Geezer glut- The man behind the wrinkly world vision,” said The Times. The cover showed the Earth crowded with stooped and shrunken men and women.
Meaning, was very important to Dr Raphael Lonappan Koottookkaren. He did not sacrifice his life for the Nobel and glory. Not even to defeat Albert Gordon Brown. The thought that he was doing something worthwhile had sustained him. But what was it that he had achieved for humanity? Fighting off depression, had, for him become a habit. The older he got, the harder it became. Then the lingering pain in his chest, the tests, the pain killers.
Suddenly he felt all alone. And he longed for his roots. And the dream – what did it mean? He wanted to go back to India.
Trichur had changed considerably. In fact, it had grown into a big city. The six lane roads thronged with gleaming vehicles. He could recognize none of the cars by their brand and make. That, he had stopped noticing for many decades now. Once, he could identify a Honda Maxima or a Mastodon Elba easily two hundred metres away. He had maintained an active interest in cars even as a young man at the University of New York. He bought a brand new Chevrolet – when he was made full professor at the age of fifty-two. Yes, a young man of fifty-two. He smiled as he realized that he remembered himself as a young man at that age. But then, he was eighty-six now. He reflected, with some surprise, that he did not feel that old. Sure, he could not walk that fast (he had forgotten about running), there was a peculiar creak in his knees when he climbed the stairs. His still thick hair was completely white and his perfect set of teeth was permanent implants. His face was lined with wrinkles, though not as much as in a white man of similar age. Thanks to the dark coffee-coloured skin, he thought, with some pride in his ancestry.
But his mind was remarkably young and clear. At least that is what he felt. He felt the same as he was at thirty-five. Or at twenty-five, for that matter. Was it an illusion? Could it be that it was the eternal self; the spirit? These thoughts were itself a sign of age; he smiled to himself. It was a forced smile, which failed to lift the depression that seemed to press over his chest like a weight. A perpetual block of nagging pain seemed to have accumulated over the years. Or just after The Diagnosis? He couldn’t be sure.
A few young girls passed by in micro-minis that was the rage now in India. Hair dyed blue, violet, beige. The multicoloured hairdo was the in-thing now all over the world. He tried to remember when it started. 2030? 2040? No. Not that recent. He realized that he was no longer interested in the march of trends in women’s fashion. That was a difference. At a younger age, he definitely was; and in the people sporting them. Now he had no interest at all in teen-aged or even women in their thirties. Why was that? Nobody reminded him of his daughters, for he had none. Never had a wife or children. But for some unknown, obscure evolutionary reason, his mind reacted in a grandfatherly way to youngsters now. He still felt vaguely interested in ‘young’ women in their sixties and seventies. But he certainly did not chase them nowadays, like before. Like the dog that ran after every passing car, what will he do if he was suddenly successful in catching one? That would be embarrassing.
Old age is definitely not the period to return to the town of your childhood after spending an entire life-time in some other country. The massive change baffled, depressed and angered him. Trichur was a quiet town. Now it was an unrecognizable metropolis, teeming with cars and people. Looming skyscrapers blocked out the sun, while a speeding locomotive silently whizzed overhead on the elevated rails that worked on the magnetic levitation system. The air was thick with copter-cars whirring on their way. Every corner and by lane he had explored on foot and on bicycle – now were changed beyond recognition. His eyes searched in vain for familiar geographical landmarks. The heart of the city still contained the Vadakkunnathan temple, surrounded by the large courtyard, now a garden. The temple itself was dark, dwarfed, ancient and mysterious. Timeless and forbidding – yet for him was familiar and comforting. His old Medical School was still there at Mulangunnathukavu, and that was where he was going. The young Assistant Professor had called and said he will pick him up in five minutes.
Meanwhile a silvery streak announced the young academic’s arrival. The automatic door opened for him. The man apologized for being late.
“The traffic is horrible. And there was an alert against flying. Smog-containment measures, sir.” He informed contritely.
“But you are still late.” He said a little irritably. But he regretted his outburst when saw the young man’s face. These days he found it difficult to control his anger and frustration. It was not due to old age alone.
The metallic silver aero car raced smoothly along the vast eight lane stretch to the Kerala University of Health Sciences at Mulangunnathukavu. He knew it was fifteen kilometres from the town. He had travelled along the same route by bus hundreds of times when he was an eager medical student there. It was sixty … no, more than sixty years ago. Ages ago. It felt like a millennium had passed. But the memories were as fresh as if it were yesterday. Yet, when he looked out of the windows, the view was totally strange. He could not recognize a single landmark, not even the trees. Trees? There was not a single tree left, other than a few carefully cultivated ones on the gardens of sprawling buildings. The inexorable march of time had effaced and re-painted his once comfortingly familiar world. It was now a disconcerting restless changeling. The whole world marched, rushed and hurtled madly. He was tired of the unending series of monstrous buildings lining the road. He took his eyes off the path, leaned back in his chair, rested his head on the soft cushion and watched the young scientist handling the aero car expertly with his left hand on a touch screen control panel. His right hand held a slender joystick. The steering wheels of his younger days were a distant memory.
“You are from the Genomic Chemistry department, isn’t it? Dr Ganapathy had invited me…,” Dr Raphael enquired.
“Oh, no sir. I am Gyanesh from the department of Bioethics. We are organizing the symposium. It is after all on ‘The ethics of anti-aging therapy’. He turned and smiled reverentially.
He smiled back and leaned backward in his seat. The air conditioner kept the car at just the right temperature. Lately he was intolerant to the cold. But this was very cosy.
He was warm and floating effortlessly. It must be the warmed pool at his New York suburban villa. He had just dived off at the deep end and was at the very bottom. The warm water engulfed him in a soft embrace. He let the water carry him. The weightlessness was exhilarating. He did not want to rise up out of that ever. But after sometime the carbon dioxide built up in his body and the yearning … for air! Leisurely he rose up paddling slowly and steadily rose up effortlessly. He was calm, but his need for fresh air increased every second. He could see the sun’s light filtered through the surface of the water. The air-water interface scattered the light into a beautiful sheet of dazzling silver. He raised his hand expecting to break through the water surface. But his hands encountered an unexpected barrier. It was transparent, crystal clear. But it was unyielding. He pushed against it and the initial perplexity gave way to desperation. He tried to go around it, but it was everywhere, like a glass ceiling. His lungs seemed to be bursting. Air! Air! He pushed, again, with all his might. As he struggled for his life, he saw a fleeting visage in the mirrored interface between air and water. It was an old woman. Was it his grandmother? No. the scarred and deformed brow… The face was very serious. Of course, it should be – he was dying, drowning … he wanted air. Air!
“Any problem, Sir? Sir?” Gyanesh’s cry woke him with a start. He must have cried out in his sleep. The damn dream again. This was a recurring dream ever since … ever since… The Diagnosis.
“Are you all right?” Gyanesh repeated.
“No, No… Nothing…” He replied.
“We have reached sir. This is the administrative office.” The young Assistant Professor gestured with his hand, and took it off the joystick casually. Actually, steering the vehicle wasn’t necessary. The computer navigation system automatically negotiated the traffic, once the destination was fed into the global positioning system.
“Shall we go to the auditorium straight? Or do you want to go to the guest house and rest for a while? Sir?”
He shook his head and peered outside. An intense wave of nostalgia overtook him. Joy mingled with a sweet pain. Ecstasy, that comes to you when you meet an old friend with whom you have shared some of the moments when life was carefree. It was mixed up with a curious pain of the inevitable loss. Ineffable sadness at the passage of time, youth and good memories. He felt the acute transience of existence.
He saw tall buildings, ten, twelve stories high, bisected by shining four lane roads marked by intersections with decorated fountains. Aero cars and zoom bikes meandered to and fro. Well-tended landscaped gardens dotted the huge campus. What a change! He had spent twelve years of his life – undergrad, MD residency and as a fledgling physician – Here. At that time it was only a few scattered single-storey buildings in a forested woodland. He could not believe the change. Was he really that old? Not really. Nowadays centenarians had become common. But his time was surely running down fast.
“This is the auditorium? It is huge.” He looked up at the large structure stretching enormously in all directions, as the aero car silently slowed down to a halt.
“Of course sir, almost all the faculty and students from all the universities in this part of the country are here. Then there is the public, the activists and press people. You are a celebrity, didn’t you know?”
He faintly heard a commotion in the distance. He looked at Gyanesh.
“Err … a few trouble makers, sir. They are protesting against your research. Don’t worry. They won’t reach here. The Police won’t let them. Unfortunately, there has been a lot of opposition to your work here.” Gyanesh said, almost apologetically.
He groaned inwardly. Protest, controversy, the limelight. And the presence of non-scientists and the public at the meet … ‘Ethics of blah blah blah’. He felt mildly nauseated, but he faintly looked forward to it. It was his alma mater, after all.
A lanky middle-aged man with neat trimmed moustache and beard was waiting, as he alighted.
“Welcome, Dr Raphael. I am Ganapathy, chief of Genomic Chemistry and Gerontology.”
“I know you. Science, Jan 2042- ‘The role of TGAT sequences in telomere shortening’. Good work,” Dr Raphael replied.
Dr Ganapathy simpered with pride. “Thank you.” He said.
He was ushered into the podium and the entire crowd got up and applauded. He smiled at everyone and shook hands with others on the dais. The dean and director were among them. Dr Ganapathy rose up to introduce the chief guest. The small mike – a wireless one inch gadget in the breast pocket amplified his voice over the entire gathering.
“Dear colleagues and my dear friends… I feel honoured to introduce our illustrious guest – Dr Raphael Lonappan Koottookkaran. I am acutely aware that he needs no introduction, especially for us people of Trichur metro city. He was one among us, once. He was from this city and trained in this very institution. Then he grew wings and flew away to the University of New York. I saw some in the audience stare surprised at my mention of his full name. He is known all over the world now as Dr Raphael Lon Koo – the man who gave respectability and new direction to the science of Biogerontolgy. The man, who gave Ropimycin to the world. As many of you know, it is undergoing clinical trials at five centres scattered over the globe. If it passes these trials, it will be the first drug capable of actually increasing both average and maximum human life span, by extrapolation from animal studies, even up to fifty to seventy percent.”
There was an audible collective gasp from the audience.
“Really?” someone shouted.
“Now that I have got your attention…” Dr Ganapathy continued, “Let me tell you that we will be listening to a man who is expecting a call from Stockholm at any moment.” Here he paused for effect. “The Nobel Prize, ladies and gentlemen, is not only a possibility, but expected. Now let us listen to – the path-breaking visionary, the man who found the key humankind has searched for in vain for millennia – the secret of eternal life! Please, Professor Raphael Lon Koo…” Ganapathy finished dramatically, and motioned for Dr Raphael to take the stage.
Dr Raphael stepped forward, deftly pocketing the minute mike that Dr Ganapathy handed over.
“Dear friends,” he began, looking at the audience with a practiced eye. They easily took in all the four corners of the spacious auditorium in a sweeping glance.
“I thank Dr Ganapathy for all the kind words, and you for all the adulation. I must admit, that hearing my full name in all its ugliness gave me a nasty start!”
The audience tittered appreciatively.
“I changed my name was not to disown my origins, I assure you. I am proud of my Indian heritage. But my name was not fitting into the boxes in the application forms, and computer slots. I was tired of the Americans always mispronouncing it horribly. That is why I changed my name to Raphael Lon Koo. It also had a nice Korean or Chinese ring to it. In the formative years of my life, I regret to say, the Orientals were more respected in scientific circles, than Indians. Now of course, all that has dramatically changed.”
He paused and then continued. “I don’t want to bore you to death (ha, ha) with a long lecture on longevity. I just want to give you a general overview, not of the technical details, as most of you are not biologists, and stick myself to the social and philosophical issues, as I see it.
Humans are mortal. All complex animals are. Death is as inevitable as life. The earthworm, the fish. The elephant, the blue whale. The chimpanzee, the human. Fleeting existence followed by certain death. But as far as we can see, human beings are the only animals that are aware of their inherent mortality. We brood over it, while other animals are not bothered. The Bible was correct after all. Eating the apple from the ‘Tree of Knowledge’ – or ‘awareness’, brought with it, the scourge of death (or its awareness).
Mankind from time immemorial has searched in vain, as Ganapathy said, for the magical elixir of life. As public health measures and curative medicine have improved longevity has increased steadily in most countries. But by the beginning of the twenty-first century, the effect had begun to plateau, in the developed countries. We were hitting a fundamental limit or barrier. Around hundred to a hundred and twenty was the maximum age possible for humans. We needed to flex our scientific and technological muscles substantially in order to break through this natural barrier. All common diseases are now age-related: Coronary heart disease, diabetes, most cancers. Strokes, dementia, and chronic lung disease. By reversing or slowing ageing, we can hope to mitigate the suffering due to these diseases also. Ropimycin is the most promising and the only one.
The quest for immortality is not such a dangerous idea. In fact the success of human beings is partly due to our extreme natural longevity.
Long- lived humans brought experience, expertise and education. Our need for more knowledge, more expertise, and more foresight – is only increasing. So long life is not a curse, but a blessing.”
Dr Raphael stopped, surveyed the audience and sat down. He reached for the glass of ice water that was in front of him at the table. A regimented, few seconds of applause followed.
Ganapathy, in the role of a moderator, rose from his seat, and said:
“Anybody wants to offer a counter point or alternate view of what Professor Raphael presented here?”
A bald old gentleman with wispy hair at the sides and prominent grey walrus moustache rose and approached the podium.
“Ah, Professor Rao, Head of Geriatric Medicine. Please come forward,” Dr Ganapathy said, with characteristic enthusiasm.
Dr Rao appeared to be a very serious man. With no hint of a smile, he started in a morose baritone.
“I am very much flattered to share a stage with the most eminent researcher, Professor Lon Koo. I am Nageshwara Rao, from Geriatrics. I care for hundreds of old people, day in and day out. Old people are wise, I agree, though not uniformly. I wouldn’t say they are a burden (for I am also old enough to join them), but they need care. There should be enough young men and women in the population to keep the show moving forward, otherwise civilization will stagnate. Population will surge, and the proportion of older people will become a dead weight, dragging everybody down.
Anti-ageing research, in my opinion, is bound to fail, after a point. A car, or anything, say a computer, or a washing machine, deteriorates over a period of time. Initially, your Tata Excelsior is brand new, and rides like a charm. After one or two years to around seven years occasional problems crop up, different ones for different vehicles. But eventually all of them get the same problems – wear, rust, and overuse. Multiple defects add up, till the car becomes useless. Similarly, old age is the effect of incremental wear and tear, oxidative damage and accumulated genomic degradation. It is an inevitable process. We will not be able to alter it significantly. That is my take on this.”
After Dr Rao stepped down, Dr Raphael took the stage. There was certain weariness in him. These arguments were by no means new.
“Thank you Professor Rao. The demographic one is serious and genuine. That definitely merits further discussion. But humans are not cars. We are not built, we have come into being. We are self-repairing machines. If ageing is wear and tear why do different species age at different rates? A man easily lives till eighty. What about progeria? A genetic defect that causes accelerated ageing? They rapidly age, get coronary artery disease and diabetes at ten years of age and die very early. Ageing is a species-specific programmed process that can be targeted pharmacologically. Your argument on this aspect is plain wrong.”
Raphael concluded, and sat down. He panted slightly. The pain in his stomach radiated to his back. He was surprised at his own emotional reaction. Dr Rao appeared slightly crushed, but spoke up bravely from the audience, after collecting the pocket mike from the attendant.
“But, Professor, why should such a program evolve in the first place? Isn’t it against the principle of natural selection? Individual survival is paramount in natural selection.”
Dr Raphael smiled. “Well, Dr Rao, I won’t go into the technical details here, as this symposium is not about that. But you have to remember that evolution is not about individual survival alone, but adapting rapidly to changing conditions. Variation within a population is an essential for that. Ageing and natural death facilitates this process. I will stop with this.” He looked at Dr Ganapathy. Ganapathy took the cue and said:
“We will accept that, and move on to other topics. Does anybody have a fresh or novel outlook on the matter?”
A thirty-something man with slick hair neatly combed back in an immaculately creased shirt stood up. Dr Raphael looked at the unconventional round collar thick across the neck and thought: ‘Ah, a clergyman! I was wondering where all of them went’. In his younger days, all of them were in long distinctive cassocks which seemed to have gone out of fashion with the dinosaurs. Religion, on the other hand, had not, contrary to his expectations. The priest cleared his throat and said.
“I am a research scholar in theology but I did a Masters in evolutionary biology.”
“OO! A biologist-theologian!” exclaimed Raphael. “The church is surely getting progressive!”
The young priest smiled and continued.
“Sir, Professor, conventional evolutionary theory cannot explain programmed ageing and natural death. Neither can it explain altruism and co-operation. Life anyway, is transient. What is the point of prolonging it? We want new life to be created.”
Dr Raphael stared at the priest. Will he say the same thing when he was ninety? May be he would. Raphael himself was not sure whether he wanted to live much any longer. Was his life’s work worth nothing?
With an effort, he continued:
“At least you agree, father, that evolution happened and is happening. The mechanism of evolution, I concur is still not fully understood. But as I said I believe that ageing, death, altruism and co-operation are all evolved traits. The explanations are complex. Evolvability is the key factor here, rather than individual survival.”
Next person to come forward was a young master’s student who said her main interest was in ‘exobiology’. Dr Raphael looked at the green and magenta hair, pink contact lenses in the eyes and the skin-tight ‘Super woman’ dress. She looked properly extraterrestrial, he thought.
“But no ETs were ever discovered. At least till now. Are you one?”
He could not resist that. The young woman was unfazed.
“The reason, I believe, doctor, is research similar to what you are doing, which should be banned, in my opinion. There are undoubtedly millions of advanced civilizations elsewhere in the universe!”
“And why they are not visiting us, contacting us?” Raphael felt slightly fascinated by this line of thinking.
“They are stuck in a rut, all of them. They live the same life, disgustingly satisfied with their lot, millennia after millennia. They have all discovered the secret to prolong life indefinitely early in their technological development. And they never produce restless young ones that think differently.”
‘You are a restless young one!’ Thought Raphael, astonished. This was a totally new idea against anti-ageing research. He had never heard in his long life a similar argument against his efforts.
“Congratulations, Young lady. I like that! It is a good one.” He said simply. The girl literally glowed with happiness and pride.
Then a demographer raised his hand. After that a student, a member of the public, a pharmacologist… Almost two hours of lively discussion followed. All were against his efforts.
A student shouted from the back:
“You want a planet of old, rigid geezers to control, the world? What is the use of your expensive efforts when millions in Africa don’t have enough to eat and have no homes to go to?” The faint sounds of protests that he heard when he arrived reverberated in his ears. He suddenly felt defeated. The whole world opinion mirrored the ones he heard here. Maybe he had hoped his countrymen would have a more charitable view. He felt very tired. And that gnawing pain in the upper abdomen spread to his lower chest and back. Burning … burning … piercing, again. In spite of the quite high dose of methoxyphene he was already taking… He leaned forward and whispered in Ganapathy’s ear. Ganapathy rose and brought an end to the proceedings with a vote of thanks and the traditional presentation of the memento to the chief guest – A golden chalice -‘The holy grail’.
Gyanesh drove him to the guest house in his aero car. Dr Raphael found the room very comfortable. India was not the same as when he had left it. He liked the bottle of scotch carelessly but deliberately kept on the dining table. After bidding good bye to Gyanesh, he reached into his pocket, took out two tablets of methoxyphene and popped them into his mouth. Then he poured four fingers of the whisky into a glass and added four ice cubes from the refrigerator. Then he plopped tiredly onto the reclining couch and sipped the amber fluid. ‘I shouldn’t be taking this, considering my…,’ he thought, whatever was left of his residual clinical sense raising it’s shrivelled head. ‘Won’t make any difference now.’ He thought. A grey fog of depression closed around him. It was almost comforting. His eyes grew heavy with sleep.
The warm pool again. Nice, and comforting. Relaxing in the water was his favourite pastime. He had dived deep and was coming up slowly for air. He encountered the invisible but unyielding barrier again. Hunger … for air. Bursting lungs. Push, Push! The face with the eyebrow scar looked on, serious and unhelpful, as if it was unhappy that she could not do anything. Or was it disapproving? Dr Raphael awoke with a start, panting in fear. Sweat bedewed his brow. He did not sleep that well after that.
By six in the evening, he got dressed for the dinner with Gyanesh and Ganapathy and a few others that included the medical school dean, and the dean in charge of research. He waited for Gyanesh to pick him up.
He was back in the spacious room at ten O’clock. The only good point about the dinner was that he got to eat real chicken after a long time. In America, it was always E-chicken or engineered chicken. It was cloned factory-produced mass of muscle fibres and assorted tissues. Then there was E-beef and E-pork. Killing of live animals was increasingly frowned upon. The presence of that reporter from Indiahotnews.com had irritated Dr Raphael. Why did he leave India? What was the inspiration for his line of research? Why did he choose gerontology? What about his famous rivalry with fabled Albert Gordon Brown? Will he beat Dr Raphael to the Nobel Prize? Does he really think that worthless research like this warrants the Nobel?
As he lay down on his couch once more, he had the tiny music plug into his left ear. A bewitching tune from his college days burst forth into his temporal lobes. A sea of memories came flooding in.
Dr Raphael woke with a start. An unpleasant feeling of suffocation filled his mind, an aftertaste from the dream. The old woman’s face was very vivid this time. Why she after all these years? He wondered. He had practically forgotten her till the dreams started. The same damn dream, again. He looked at the digital time display glowing on the wall – 3:30 am. He could not go back to sleep again. The pain was again gnawing at his belly.
By eight he was up and ready. He had one more person to see. He was clear where he wanted to go, when Gyanesh come by in his aero car.
“Dr Sivasankaran Pillai ? Retired Surgeon? I know him. I will take you to his house,” said Gyanesh.
“You are my genie, from the bottle,” smiled Raphael.
Ten minutes later, Raphael was in the front porch of a picturesque suburban villa and bid a grateful goodbye to Gyanesh. The ring of the door bell brought a wizened old man to the door. If he did not know who he was, he wouldn’t have recognized him.
“Who is this?” He peered intently, scanning his face.
“Siva the egg-head, I presume?” Raphael enquired. Oh the nick names of those times!
“Raphael! – Koothi Lonappan!” the man had placed him.
While having a pleasant drink in the drawing room they reminisced about their medical school days. They were best friends once. Most of their contemporaries were no more.
“Ropimycin is taking a long time coming. It is too late for most of us,” Sivasankaran said, only half -joking.
“Even for me,” agreed Raphael.
“I didn’t see you even once after you left.”
“I didn’t come back, to tell you the truth.”
“And you were obviously too busy to keep contact also.” The voice was non-complaining. “Any particular reason, for your return?”
“To die?” smiled Dr Raphael.
“We are due, I agree,” Sivasankaran smiled. “But don’t talk morbid like this. Enjoy while it lasts. I mean while you last,” Siva raised his glass of vodka as a toast.
“No, I am not joking.”
Raphael took out the compucard and inserted it into the I-projector placed on a side table. Automatically the lights in the room dimmed and the wall opposite filled with images. It was the MRI and nuclear quantum scans of a human’s whole body. Dr Sivasankaran peered at it intently. After a few minutes he straightened up.
“It is carcinoma – body of the pancreas, and scattered lung and liver metastasis. Whose quanta scan is this?”
“Mine” said Raphael.
Siva turned and grasped his friend’s hand.
“I am sorry.”
“Oh don’t be. We all have to go someday. Look at the superior mesenteric artery. It is quite close. At any moment it can burst.”
Sivasankaran got up, and enveloped Raphael in a tight hug. Two old men who were old friends. They bid goodbye for the last time. Finally Raphael disengaged the other man gently.
“I want to spend my last few days here. With you.”
“Sure, buddy. You are welcome. Anyway, I am alone here. Children all gone – flown the nest.”
“Long gone – up,” Sivasankaran pointed to the heavens with his finger and smiled.
“You are lucky,” Said Raphael.
“Because she is dead? She was rather tiresome, but…” Laughed Sivasankaran.
“No, because you had one. And you have children, grandchildren. You have a legacy.”
“I thought a big scientific breakthrough is a huge legacy, dammit. What is it with you?”
Raphael smiled, pondered for a moment before changing the topic.
“I want to visit this lady, if possible. Can you help me?” Siva looked at him quizzically.
Raphael ordered the compucard in a gentle voice:
“The saved news item from two days back. Amminiamma.”
The projected image changed. Now it showed a photo of an incredibly old woman. Dr Raphael had recognized instantly as the beggar woman from his youth who had saved his life and triggered his life’s passion. There was a bold headline under the photograph.
‘One hundred and fifteen year old lady celebrates birthday.’
Half an hour later, they were in a clean but bare room in the government old age home at Patturaickal. A tiny, skeletally thin woman lay on the bed. She was nearly bald, and had a hundred wrinkles per square inch of face. But the eyes looked clear and alert, and peered out like twin jewels placed in wrinkled brown paper. Raphael went forward and grasped her hand and looked at her face intently, putting his face close. She looked uncomprehendingly at him, but smiled nevertheless. She turned and smiled at Dr Sivasankaran also.
“She smiles at everybody. Has a touch of dementia,” the caretaker said, fondly. “She is very ill, the poor dear. Doctor said the end is near.”
“You are happy? Are you happy? Raphael asked, instinctively raising voice for the old woman’s benefit.
“Happy to die. Amminiamma is happy to die.”
A slow drawl. The smile was still in place.
“How old are you?” Dr Raphael enquired.
“Very old. Amminiamma has lived for a long time. Very happy for long life.”
“Why very happy for that?”
“My son. He died. Very happy.” She seemed to go into trance.
“Why?” Dr Raphael shouted.
“He died first,” said Amminiamma, completely contented.
Unknown to Raphael, the old woman died hardly an hour later. They were her last visitors, in that old age home.
Back in his old friend’s house Dr Raphael Lon Koo retired to bed early that day. He promptly fell into a deep sleep. Usually he lay awake for a long time.
He was in the warm pool at his suburban villa in New York. He had dived and was at the bottom of the deep end. Slowly he rose gently moving his hands and legs. He could see the sun’s rays refracted on the surface, making it a silvery screen. As he was about to break into the surface, he remembered the invisible barrier and began to panic. The choking sensation, the terrible fear and suffocation. He could see the familiar face. But it was smiling now. He anticipated the feeling of impending doom. But to his surprise his hand broke through the water surface effortlessly and he emerged into the light. And air! Greedily he inhaled breath after breath of sweet air.
The next morning Dr Sivasankaran found Dr Raphael Lonappan Koottokkaran dead in his bed. He had apparently passed away in his sleep. Dr Sivasankaran had come to wake him to tell him about the cyber shout that had reached him in the morning through I-megaphone news alert service:
‘Nobel prize in Medicine for scientist of Indian Origin – Dr. Raphael Lon Koo’