[davidw]

I had a good friend over for dinner recently, and learned that he had recently suffered a heart attack. Not a really bad one, but there aren't exactly 'good' ones either. Pretty scary, as he's still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on.

[tomhoward]

still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on.

This is the problem. In the absence of proper diagnostics, people look at popularly touted risk factors like age, alcohol/smoking/drugs, exercise, diet, etc. But these are highly generalised factors that don't take into account: genetic/congenital/epigenetic conditions, stress/emotional issues, environmental factors, and other factors that are difficult to understand by themselves, because the human body is so complex.

The only way to truly determine the extent to which someone's health really is perfect is with detailed individual diagnostics.

As I said in the initial comment, we're only just getting started in developing adequate approaches to diagnosis that may become widely accessible, but I think it's the key to preventing unexpected attacks in your friend and Dustin's friend.

[carbocation]

Not to be a downer, but I suspect that we are decades away from meaningful diagnostics that would get you anywhere close to being able to declare someone in "perfect health". In fact, I will say that we are 20 years away, and we always will be.[1] For someone who believes that "perfect health" is of little meaning in an adaptive evolutionary framework, this isn't a big issue, but it could be disquieting to some.

Let's say you sequence everyone's genome and can do it for $0 per person. Even if you could, having a genome sequence gets you only so far. We don't know what many genes do; even less so do we know what changes in their structure or in their regulatory elements may do. We have useful, powerful ideas coming from evolutionary biology, but these won't be enough to let one feel confident about health claims.

And this says nothing about infectious, environmental, and behavioral components to risk.

[1] = I know that the fusion "20 years away and always will be" actually refers to the fact that if insufficiently funded it will always be 20 years away. But most people don't know that part of the reference, so I will ignore it at will.

[tomhoward]

Optimal is perhaps a more useful term.

I'm more optimistic than you about how soon we might see major advances.

The emerging field of epigenetics seems very promising.

[carbocation]

I hope I didn't come off as pessimistic in the general case with regard to medical advances! We see important medical advances every year. I was referring to the notion of being able to verify "perfect health".

[marshallp]

I'll have to disagree with you on that. Genetics is the wrong approach to dealing with all this and was a wild goose chase. Regenerative medicine is the correct approach, the body has all the mechanisms already to regrow itself, after all, it did grow in the first. Regrowing the body and keeping it from being a cancerous growth is the actual challenge. Noninvasive surgery like radiosurgery, focused ultrasound, and photoacoustic surgery is the correct approach along with floating growth factors. This is not really biological engineering but electromechanical engineering and well within grasp. A proper effort would get this done within a year.

[jackylee0424]

We're in a culture of productivity. Here, a person in "good health" is like describing him a proper-functioning working machine.