My doctor is a good man. He keeps track of my prescriptions, orders the right labs at the right intervals, and does not visibly flinch—much—when I show up with a typed list of the forty-odd supplements I take daily. But when I mentioned senolytics at my last visit, he gave me the same polite, slightly glazed look my mother used to give when I tried to explain why BASIC was better than FORTRAN. (To be fair, she hadn't asked.)

I am seventy-four years old and will be seventy-five in April. I have been programming computers since 1972, writing professionally since 1990, and managing my own health with increasing seriousness since about 2022, when the phrase "aging gratefully" stopped being a philosophical position and started being a daily engineering problem. I approach my body the way I approach my code: study the documentation, identify the failure points, and patch what you can before the whole thing crashes to desktop.

The Knowledge Gap

Here is a thing nobody prepares you for: at a certain age, you will know more about keeping yourself alive than the person you are paying to help. This is not a criticism of doctors. It is a structural observation. Most physicians were trained in disease management—you get sick, they fix you. The emerging field of longevity optimization, where you try to slow or reverse the mechanisms of aging before they produce symptoms, is not what they studied in medical school. It was not offered in medical school. In many cases, it did not exist when they were in medical school. Especially if the doctor is nearly as old as I am.

I'm so old, I can remember having a doctor who smoked. Cigarettes. In the examining room. While he was examining me.

Meanwhile, I have time. Retirement will do that. I can spend three hours reading about NAD+ precursors on a Tuesday afternoon, cross-referencing the Sinclair lab's findings with the Mayo Clinic's senolytic trials, comparing bioavailability data on liposomal versus standard delivery systems, and then place an order on Amazon before dinner. My doctor cannot do that. He has forty patients to see before lunch. The best he can do is stay current on the prescriptions he writes and trust that I am not actively poisoning myself with the rest.

To his credit, he does trust me. When I bring him my list, he scans it, asks about anything new, checks for interactions with my prescriptions, and moves on. He does not try to talk me out of supplements he has not studied, which I appreciate. He does not pretend to know more than he does, which I appreciate even more. Intellectual honesty in a physician is worth more than a degree from Johns Hopkins, and I say that as someone who has met both kinds.

What Am I Actually Doing?!

The short version: I take six prescription medications and roughly three dozen supplements, divided into morning and evening stacks with a few split between the two. The prescriptions handle blood pressure, cholesterol, fluid retention, pain, and a couple of other things that come with being a seventy-four-year-old man who has not always treated his body like a temple. (Well, maybe I did, but the temple was Dionysus'.) The supplements target everything from cellular energy and mitochondrial function to inflammation, joint repair, liver support, and—this is the part that makes my doctor's eyes glaze—the selective elimination of senescent cells.

That last category is the frontier. Senolytics—compounds like fisetin and the research-grade combination of dasatinib plus quercetin—are being studied at places like the Mayo Clinic with genuinely promising early results in human trials. The idea is simple: as you age, your body accumulates cells that have gone rogue, and if you can periodically clear them out, the remaining healthy cells function better. It is, essentially, garbage collection for the human body. Any programmer will tell you how important garbage collection is! (When it's not done right, that's why you have to restart your computer or phone every few days.)

The catch is that the field is young. The definitive twenty-year longitudinal studies have not been done. The optimal dosing protocols are still being debated. The distinction between "promising early evidence" and "proven therapy" is real, and I am not naive about it.

But the field is young and I am not. That is the whole calculation, right there. If I wait for the gold-standard evidence, I will be dead before it arrives. If I act on the best available science now—cautiously, with my doctor in the loop, monitoring my labs—I might gain a few years that I would not otherwise have had. And a few years, at my age, is not a rounding error. A few years is another grandchild's graduation. Another book. Another sunset over the Sonoran Desert that I would have missed.

The Art of the Educated Guess

People who are uncomfortable with uncertainty tend to fall into one of two camps: they either reject anything that has not been conclusively proven, or they embrace everything that sounds plausible. The first group will tell you supplements are a waste of money. The second group will sell you colloidal silver and magnetic bracelets. Both groups are wrong, and both are wrong for the same reason: they have replaced thinking with a policy.

What I try to do—what I think any informed patient should try to do—is hold each intervention to a standard that is honest about its own uncertainty. CoQ10 has decades of solid evidence behind it, especially for people on statins. Magnesium bisglycinate is well understood. Curcumin with piperine has robust anti-inflammatory data. These are not guesses. These are bets with good odds.

Fisetin on a burst protocol? That is a bet with interesting odds. The mechanism is plausible, the preclinical data is strong, the early human trials are encouraging, and the downside risk is a flavonoid that, at worst, does nothing. I will take that bet. I will take it because I am seventy-four, not in spite of it.

Gotu kola at four grams a day for cognitive enhancement? That was a bet with bad odds, and I have since dropped it. The evidence was thin, the dose was high, and the capsule count was annoying. Part of being an informed patient is being willing to fire a supplement that is not pulling its weight, the same way you would refactor out a function that looked clever six months ago but turned out to be dead code.

(That said, a supplement would have to make me feel really bad for me to drop it before I've emptied out the bottle. Thanks to my mom for instilling into me a strong sense of poverty consciousness, it's hard for me to throw out a bottle that still has stuff in it. Besides, it's not unreasonable to think it might start working in the next week or two, and I don't want to waste the money. So I give everything a good, long trial before I make a final call on it. And, to be honest, I personally never took a supplement that made me feel ill…but I've had several prescriptions I had to quit because they did. Curse you, Lisinipril!)

What My Doctor Does Not Know

My doctor does not know that rhodiola rosea should be taken in the morning because it is energizing and can interfere with sleep if taken at night. He does not know that prednisone depletes potassium, magnesium, vitamin C, vitamin D, and zinc—or rather, he probably knows it in the abstract but has not connected it to the fact that I am already supplementing all five, which is why my labs keep coming back normal despite being on a moderate steroid dose. He does not know that the Super B Complex I used to take in the evening was actively working against my melatonin and ashwagandha because B vitamins are stimulating. I figured that out on my own and moved it to morning.

He does not know any of this because it is not his job to know it. His job is to prescribe the prednisone and monitor my inflammation markers. My job—and I did not ask for this job, it was thrust upon me by the intersection of aging and curiosity—is to make sure the rest of the stack does not work against the prescriptions, and ideally works with them.

This is, I realize, a privilege. Not everyone has the time, the literacy, or the internet access to do what I do. Not everyone has a doctor who will listen rather than dismiss. And not everyone has the temperament for it. My friend who takes whatever his doctor tells him to take and nothing else is not wrong. He is making a different bet—that the medical establishment, for all its blind spots, is more likely to keep him alive than his own research. That is a reasonable position. It is just not mine.

The Programmer's Approach to Mortality

I have spent fifty-four years debugging systems. You learn certain habits. You learn to read the error messages instead of panicking. You learn that the first fix you try is usually wrong, but it teaches you something. You learn that documentation is often incomplete and sometimes actively misleading, and that the only way to really understand a system is to instrument it and watch what happens.

That is what I am doing with my own body. The supplements are the patches. The lab work is the logging. The doctor is the senior developer I check in with to make sure I have not introduced a regression. And the body itself is the legacy codebase—magnificent in its complexity, maddening in its lack of documentation, and running on hardware that is slowly, inevitably wearing out.

I can't stop the hardware from wearing out. Nobody can, and if someone did, that might cause more problems than it would solve. But I can keep the software patched, monitor the logs, and make informed decisions about which experimental fixes are worth deploying to production. Some of them will turn out to be brilliant. Some will turn out to be gotu kola. The point is not to be right every time. The point is to keep paying attention.

I should clarify something, because people tend to assume it: I am not afraid of dying. I have had seventy-four years to get used to the idea, which is more than enough. I actually have memories of past lives that I have been able to validate to my own satisfaction, so I have reason to believe the show goes on. But even if reincarnation is not the way it works—even if we just go out like a light and that is the end of it—well, that is only scary if you are desperate to cling to whatever it is you think you have. And that desperation is itself an illusion, because none of us ever truly possesses anything but our own will.

So this longevity thing? It is not about preventing my eventual death. My eventual death is not in question. It is a game—a personal challenge, the same kind of challenge that makes me spend forty minutes deciding whether a property should return a List or an IEnumerable. How long can I make this body last? Can I squeeze another decade out of it? Two? Wouldn't it be something if I made it into the Guinness Book of Records as the world's oldest man!

Even if I was already dead and couldn't read it.

Or—if reincarnation is true—I could.

Either way, the alternative is to stop paying attention. To take what you are given and ask no questions and hope for the best. And I have never, in seventy-four years of living, been any good at that.