Arts

Book Review

‘The End of Illness’ by David Agus

TODD HIDO

David Agus advocates for ways to achieve better health.

What if there existed a Fountain of Youth, a source of unending health and vitality which could not only extend the lives of those lucky enough to partake of it, but allow them to be lived without the inevitable disease and decay that accompany aging?

The scientific, technological, and medical advances of the last century and a half have transformed life for most into something altogether different from 17th-century philosopher Thomas Hobbes’s description of it as “nasty, brutish, and short.’’ Infectious disease, which used to strike seemingly out of the blue and fell healthy individuals within hours or days, now can usually be treated with antibiotics or even prevented with immunization. Failing organs can be replaced with transplants, and many cancers beaten back with treatments unimaginable even a generation ago.

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David Agus, author of “The End of Illness,’’ is a medical professor at the University of Southern California and director of USC’s Westside Cancer Center. After reading an article in Fortune magazine titled “Why We’re Losing the War on Cancer,’’ Agus began to reexamine his own approach to treating and preventing the illness, later expanding it to disease in general.

In this book, equally descriptive and prescriptive, Agus describes both the good and the bad in our quest to achieve better health. After dispensing with some popular notions of how health is defined, he outlines his proposals for a new model of health, one that focuses on a more systemic view. Demonstrating how it can be used by anyone, Agus then goes on to review some of the cutting-edge medical discoveries he believes will change the way medicine is practiced in the near future.

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One of these is proteomics, the analysis of proteins produced by cells in response to various stimuli in a given individual. While much medical research of the last decades has focused on the genes that encode for the production of proteins, it is only relatively recently that attention is being given to how different genes interact with each other, reducing or increasing the likelihood of disease and its severity. For example, the same abnormality in the CFTR gene, which causes cystic fibrosis, can lead to death from lung failure in a young child but be discovered only incidentally in an asymptomatic adult in his 50s. If it is possible to identify those who will need more aggressive therapy even before they start to display symptoms, it may be possible to keep them healthier for longer, while at the same time being more conservative with those destined for a more benign course.


While exuberant about the promise of such developments, Agus pulls no punches about things that don’t work. We as a nation spend more than $25 billion a year on vitamins and dietary supplements, yet as he points out, almost all of the vitamin studies “done on more than a thousand people in the last few decades . . . have shown an increased risk of cancer.’’ He also advises his readers to be proactive with their doctors, asking them to explain how they keep current, and why they do (or do not) order specific tests. He advocates for simple yet commonsensical measures such as setting specific yearly health goals and keeping track of one’s own medical records, and also discusses some of the pros and cons of genetic and preventive screening.

“The End of Illness’’ will be of interest to anyone struggling to keep track of the latest and often contradictory recommendations about optimizing his or her health. The broadly optimistic overview it provides, tempered with a dose of healthy skepticism, is one that will serve its readers well and help guide them in the right direction, even if reaching “the end of illness’’ ultimately remains as elusive as ever.

Dennis Rosen, a pediatric pulmonologist, can be reached at dennis.rosen@childrens.harvard.edu.
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