The Long Game 60: Non-Invasive Health Sensors, Loneliness & Technology, Polygenically Screened Babies

🛩 Electric Planes, Hard Work, Fertility, Brown Noise, The World is Malleable, Ketamine, and Much More!

Hi there, it’s Mehdi Yacoubi, co-founder at Vital, and this is The Long Game Newsletter. To receive it in your inbox each week, subscribe here:

📣 We are hiring at Vital, help us build the future of health optimization.

In this episode, we explore:

  • Rockley Photonics & Non-Invasive Sensors

  • Loneliness: What Robots Can and Can’t do for the Lonely

  • The World Is a Very Malleable Place

  • Hard work

  • Polygenically Screened Babies

Let’s dive in!

🥑 Health

🦾 Rockley Photonics & Non-Invasive Sensors

The future of health optimization and health tracking is bright! I’m, of course, very bullish on the space as we’re working on it at Vital. We believe that in 5—10 years, a sizeable part of society will be optimizing their health in a preventive way.

I describe how this might happen in the thread below:

I read this piece on Rockley Photonics and the future of non-invasive wearables recently.

Rockley Photonics is a silicon photonics firm focused on medical technology that is going public through a SPAC ($SCPE). They have developed a novel, non-invasive multimodal method for biomarker monitoring. Rockley’s method involves many lasers on a single microchip being bounced off a human to measure lactate, alcohol, CGM (glucose), hydration, body temperature, blood pressure, blood oxygen, and heart rate. This technology that Rockley has developed is so compelling, Apple has already paid them $70M in engineering fees. SemiAnalysis believes that Apple watches in 2022 or 2023 will begin integrating this photonic sensing platform.

In short, we’ll get non-invasive sensors for the most important metrics in the near future. This will make it very easy for people to track their health and thus optimize it, and this is great news!

When it comes to helping people optimize their health, we should always remember that data is only one part of the equation. On top of this, there will be a need for solutions helping people interpret the data, get actionable insights from it, and, most importantly, motivate people to stick to their good habits for the long term.

This last part is the most important to me. I’m all for a personalized health system for everyone to reach new levels of performance and longevity. Still, some basics would already give good health to most people (walking, not eating too much, sleeping enough, etc.) Yet, those basics aren’t respected by the majority of society. Overlooking the psychological aspect of optimizing health is a big mistake.

I often talk about longevity here, and you might wonder what’s the link with health optimization. I believe that the gateway to longevity is health optimization. First, people will start tracking & optimizing their health with what we currently have; then, it will be followed by anti-aging therapies that are being developed at the moment.

What I often say is that if you’re bullish on longevity, your best bet for now (on top of investing and learning about the science) is to maintain optimal health and age as slowly as possible to be in the best shape possible for when more radical therapies will be ready.

🌱 Wellness

🤖 Loneliness: What Robots Can and Can’t do for the Lonely

I listened to Noreena Hertz talk about the crisis of loneliness this week. I wanted to learn a little more about it, especially about the technical solutions to this crisis that are starting to pop up.

One might think: why use technology to solve a problem that was caused by technology? I also tend to think this way, but more and more companies are starting to sell robots and other objects and apps to help people suffering from loneliness.

This article from the New Yorker is a great deep-dive on the question.

John Cheever wrote that he could taste his loneliness. Other people have likened theirs to hunger. Virginia said that her loneliness came and went and felt sort of like sadness. And like not having anyone to call. “Well, I do. I have a family, but I don’t want to bother them,” she told me. “They say, ‘Oh, you aren’t bothering!’ But, you know, you don’t want to be a bother.” Her daughter was in Florida. Her older son came by with food sometimes, but he spoke so quietly that Virginia couldn’t always hear him, and then she felt bad for being irritating.

To fix this growing crisis, we are inventing social robots:

Social robots are marketed as emancipatory technology—as instruments of independence for the elderly. There is already a large body of eldertech on offer that claims to address the functional hazards of autonomous living. TrueLoo, an attachment for toilets, can check excretions for signs of dehydration and infection. Other companies have designed wearable G.P.S. devices, to track the wanderings of people with dementia. Social robots, by contrast, attend to the emotional perils of aging alone.

Loneliness specialists like Noreena Hertz explain that although robots can help, they can also worsen the problem. If people completely lose the habits and skills to interact with other human beings, it could get even worse in the future where people could prefer to be in contact with their robot rather than with their friends & family.

This is exactly what is depicted in the exceptional movie Her by Spike Jonze.


🧠 Better Thinking

🌐 The World Is a Very Malleable Place

It’s already been a year that I took the habit of reading a quote from Marc Andreessen every month.

"The world is a very malleable place. If you know what you want, and you go for it with maximum energy and drive and passion, the world will often reconfigure itself around you much more quickly and easily than you would think."

I believe it makes a crucial point: the world is not set in stone; you have the agency to change how things are done.

Simon Sarris brilliantly developed this idea in his recent piece, calling for more agency for children:

Gaining agency is gaining the capacity to do something differently from, or in addition to, the events that simply happen to you. Most famous people go off-script early, usually in more than one way. Carnegie becoming a message boy is one opportunity, asking how to operate the telegraph is another. Da Vinci had plenty of small-time commissions, but he quit them in favor of offering his services to the Duke of Milan. And of course no one has to write a book, or start a company. But imagine instead if Carnegie or Da Vinci were compelled to stay in school for ten more years instead. What would have happened?

By systematizing how children learn and what they need to learn, we are preventing a lot of great things to happen:

Much of the fault for this lies in an attempt at systematizing skill and knowledge transfer so thoroughly that people begin to conceive of it as the task of school, rather than a normal consequence of work. Because of this shift, childhood contains the age where one can intuit very well how the world works while being prevented from acting upon it meaningfully. Instead of an adolescence full of rites of passage, where one attempts to master something and accept responsibility, we have made it full of waiting, and doing work—for school is work—that nearly everyone knows is fake. After a time all children spot this fakeness, and all honest educators note it:

Sarris then goes on to argue that doing must be an essential part of the learning process. I totally agree with him. I remember my years at school as a wasted time for the most part. I met great people and learned important things, but I believe that you can learn much more through engaging in meaningful work.

A few months of building Vital, solving a problem I deeply care about taught me more than I could have ever learned at school. That might be why Thiel Fellows are so successful: giving people the agency to do something might be more important than teaching them things in a systematized way.

⚡️ Startup Stuff

💦 Hard Work

You might have already read it, but I found the recent article of Paul Graham on hard work worth sharing.

The context: a few weeks ago, once again, tech Twitter went crazy because of this tweet.

Like with so many other topics, people create opposed teams and lose the ability to have a nuanced discussion (and potentially disagree respectfully).

Paul Graham managed to capture the important nuance concerning hard work and the eternal work-life balance debate.

There's a faint xor between talent and hard work. It comes partly from popular culture, where it seems to run very deep, and partly from the fact that the outliers are so rare. If great talent and great drive are both rare, then people with both are rare squared. Most people you meet who have a lot of one will have less of the other. But you'll need both if you want to be an outlier yourself. And since you can't really change how much natural talent you have, in practice doing great work, insofar as you can, reduces to working very hard.

Then once that’s clear, it remains to be determined what exactly does it mean to “work hard.”

Once you know the shape of real work, you have to learn how many hours a day to spend on it. You can't solve this problem by simply working every waking hour, because in many kinds of work there's a point beyond which the quality of the result will start to decline.

That limit varies depending on the type of work and the person. I've done several different kinds of work, and the limits were different for each. My limit for the harder types of writing or programming is about five hours a day. Whereas when I was running a startup, I could work all the time. At least for the three years I did it; if I'd kept going much longer, I'd probably have needed to take occasional vacations. 

One idea I liked from the article is that the only way to find your limit is by crossing it.

Cultivate a sensitivity to the quality of the work you're doing, and then you'll notice if it decreases because you're working too hard. Honesty is critical here, in both directions: you have to notice when you're being lazy, but also when you're working too hard.

Finally, here’s a conclusion to this whole debate:

Working hard is not just a dial you turn up to 11. It's a complicated, dynamic system that has to be tuned just right at each point. You have to understand the shape of real work, see clearly what kind you're best suited for, aim as close to the true core of it as you can, accurately judge at each moment both what you're capable of and how you're doing, and put in as many hours each day as you can without harming the quality of the result.

📚 What I Read

💉 Ketamine and the Return of the Party-State

A very interesting story on the Chinese crackdown on Ketamine:

It remains to be seen how long the Communist Party and Chinese state under Xi Jinping can hold out and resist the lure of financialization of the economy. But as China gets richer and its factional lines get drawn across social battles instead of economic ones, we can expect rhetoric about moral regeneration to become more potent. The party’s turn towards encouraging family and child-rearing might well be the first sign of things to come. When all your political capital has been invested in the narrative of national rejuvenation, there’s no easy way out when the low-hanging fruits of the market start to run low.

🍄 Psychedelics Open a New Window on the Mechanisms of Perception

Some neuroscientists think psychedelic drugs and the hallucinations they induce could help reveal how the brain generates our perceptions of the world around us — and of ourselves.

Everything became imbued with a sense of vitality and life and vividness. If I picked up a pebble from the beach, it would move. It would glisten and gleam and sparkle and be absolutely captivating,” says neuroscientist Anil Seth. “Somebody looking at me would see me staring at a stone for hours.”

How Will Radical Life Extension Transform Punishment

What happens to life sentences if our lifespan is radically extended? A philosopher talks about future punishment.

Suppose we develop the ability to radically expand the human lifespan, so that people are regularly living for more than 500 years. Would that allow judges to fit punishments to crimes more precisely?

🎙 Podcast Episodes of the Week

A few great episodes this week:

  • History: Supernova in the East

    • The beginning of the series explores Japanese society and how it became so focused on total devotion to the country's cause.

  • Loneliness:  The Crisis of Loneliness

    • Author Noreena Hertz breaks down the world’s loneliness crisis and what it means for the well-being of our minds, bodies, economies, and democratic institutions. This episode defines loneliness and explains how to recognize it, its mental and physical health implications, the shame around admitting you’re lonely, and what we can do to help alleviate the crisis.

🍭 Brain Food

🧬 Welcome Polygenically Screened Babies

We already mentioned polygenically screened babies on The Long Game with the announcement of Orchid a few months ago. I found this piece from Astral Codex Ten to be a good follow-up.

Here’s an excerpt to help you understand how IVF will radically change in the few years to come:

During in vitro fertilization, a woman takes drugs that make her produce lots of eggs. Doctors extract the eggs and fertilize them with sperm from a partner or donor, producing lots of embryos. Hopefully at least one of the embryos looks healthy, and then the doctors implant it in the woman or a surrogate parent.

For a while now, if the process produces enough embryos, doctors have used some simple low-tech genetic tests to choose the healthiest. For example, they might look for Down syndrome or other obvious chromosomal abnormalities, or for very severe monogenic diseases like sickle cell anemia. All of this is routine.

But most interesting traits aren't chromosomal abnormalities or single genes. They're polygenic, ie controlled by the interaction of thousands of genes. You need to record basically the entire genome and have a good idea what all of it is doing before you can predict these. Right now we're at an inflection point where we can sort of do this for a few traits, and some companies are starting to apply this to the embryo selection process.

I often have patients ask me something like: "I have a history of schizophrenia in my family. I'm really concerned my kid might get schizophrenia. What can I do to prevent this?" Right now I don't have a lot of answers, besides just staying generally healthy during pregnancy and making sure the kid has a healthy upbringing. But with polygenic screening, you start to get more options. You can IVF lots of embryos, test all of them for genetic schizophrenia risk, and implant whichever one gets the lowest score.

Of course, society immediately got divided on this. On one side, we reached Gattaca (see quote tweets of this tweet,) and on the other side, we welcome an invention that will enable parents to have healthy kids.

I think we’re at an inflection point right now concerning how people procreate, and we need to discuss these questions before we let the genie out of the bottle and create a society we don’t want to live in.

Optimizing the health of the babies is one thing, but where do we draw the line with things like choosing intelligence, athletic abilities, and more? In this episode with Jamie Metzl, Rogan rightfully noted that we don’t want to live on a planet where everyone is The Rock. The problem is that what parents want and what’s going to create a healthy and diverse society isn’t necessarily aligned.

🎥 What I’m Watching

👶 Spermageddon: The Male Fertility Crisis

I mentioned multiple times the Fertility Crisis on The Long Game. This is a good video to visualize the extent of the problem. 📉

🛩 Electric Planes Are Inevitably Coming

If you’re wondering why cars are switching to electric but not planes, this video is what you need. TL;DR: it’s about the economics, and it might start to make sense for airlines to fly eclectic planes.

🔧 The Tool of the Week

🎧 Brown Noise

I recently discovered Brown Noise, and I must say I really enjoy it while working. I like to alternate between different things I listen to. I also love the Endel x Alan Watts collaboration these days.

🪐 Quote I'm Pondering

“There was nothing left that could conquer Rome, but there was also nothing left that could improve it.”

G.K. Chesterton

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👋 EndNote

Thanks for reading!

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Until next week,

Mehdi Yacoubi

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