Host Kirti Mutatkar continues KBC (Kirti's Book Club) with Dr. Pankaj Rao to discuss Venki Ramakrishnan's Why We Die - a scientific exploration of aging, death, and the quest for immortality. About the Book Why We Die by Venki Ramakrishnan examines the biological mechanisms behind aging and death from a Nobel laureate's perspective. The book explains complex genetic concepts in accessible terms, covering DNA, cellular aging, environmental factors, and the current scientific understanding of mortality. Rather than philosophical speculation, Ramakrishnan focuses on evidence-based science while addressing the human desire for longevity and the reality of our biological limitations. KBC Reading Radar Brain Fizz Factor: Both - Mental Fireworks (4/4) Bookshelf Worthy: Dr. Pankaj Rao - Shelf Resident/Donate (3/4), Kirti - [not specified] Next Episode: "Sophie's World" by Jostein Gaarder - concluding Season 1 of KBC
Host Kirti Mutatkar continues KBC (Kirti's Book Club) with Dr. Pankaj Rao to discuss Venki Ramakrishnan's Why We Die - a scientific exploration of aging, death, and the quest for immortality.
About the Book
Why We Die by Venki Ramakrishnan examines the biological mechanisms behind aging and death from a Nobel laureate's perspective. The book explains complex genetic concepts in accessible terms, covering DNA, cellular aging, environmental factors, and the current scientific understanding of mortality. Rather than philosophical speculation, Ramakrishnan focuses on evidence-based science while addressing the human desire for longevity and the reality of our biological limitations.
KBC Reading Radar
Brain Fizz Factor: Both - Mental Fireworks (4/4)
Bookshelf Worthy: Dr. Pankaj Rao - Shelf Resident/Donate (3/4), Kirti - [not specified]
Next Episode: "Sophie's World" by Jostein Gaarder - concluding Season 1 of KBC
Kirti Mutatkar: [00:00:00] I am super, super excited today. This is Kirti Mutatkar and welcome to KBC - Kirti's Book Club. And the reason I'm super excited today is I have my brother Dr. Pankaj Rao as a guest on this podcast. And the interesting part is, I am right now in the AFMC House. Usually the commandant of AFMC gets the house.
The house was built in 1845. Right. And to talk about mortality in a house that's more than what, 180 years old?
Dr. Pankaj Rao: Yeah.
Kirti Mutatkar: It's amazing. But before we get started, so give your background, why you decided on the book and what is the book all about?
Dr. Pankaj Rao: This is Dr. Pankaj Rao. I am basically a trained GI surgeon, as you call an abdominal surgeon. And I've specialized in liver transplantation and I have been dealing with issues of [00:01:00] life, issues of death and organ donation. When I saw this book on the shelf, "Why We Die," it just fascinated me. And secondly, it was written by a Nobel laureate who himself is a scientist.
So I thought it may not be just something to do with philosophy and maybe something to do with science. So I just picked up this book and started reading it.
Kirti Mutatkar: So basically you recommended "Why We Die" and usually I had the same feeling, right? So when you pick up a book, and I was thinking it'll be very philosophical, but I think the conversation you and I had, this had more a science thing to it. So what was like I said, being in a house and like such an old house and thinking of mortality and stuff and as we are aging, so you and I are getting old, our parents are getting old and there is a lot of kind of. We are surrounded by, you know, the mortality and the things and what happens. So reading this book, were your ideas changed about mortality?
Dr. Pankaj Rao: At least for [00:02:00] as of now, we understand everyone is going to die one day. So the day a person gets born, he starts aging and then finally has to die. We have still not reached that stage. The science has not evolved that much that we have conquered death, and we think it has an inevitable issue.
And one has to take it in one's own stride. But of course as a living being, it's always been there in the thoughts that one should live forever. Enjoy the goodies of life. Enjoy the life to the fullest. Do whatever you find is interesting and things like that.
Kirti Mutatkar: Right? And didn't you say that just being born, right? So when you really say, when does dying really happen? So from your medical kind of knowledge, when does dying actually start? Doesn't it start at birth in a way?
Dr. Pankaj Rao: Yeah, absolutely. The person, the embryo or whatever you call it, starts, the heartbeat [00:03:00] starts, maybe the life starts then, and from day one it starts aging and we begin our journey towards the inevitable. That's death. But yes, one thing is for sure. We live through each and every moment. There are various experiences and that possibly is what life is all about. Enjoy every moment and live through life as it is. And I think that's what is my philosophy about life.
Kirti Mutatkar: So did that change? Did you always have it or... This author said... The only thing I got from the book is that the scientific knowledge of what exactly is aging, how we age, what are the genetic factors behind aging? Can we do something to prevent aging? Can we live a life of eternal youth?
Dr. Pankaj Rao: That's what actually is the aim of every human being. Towards that end, yes, it did [00:04:00] at least incite my curiosity of reading much more about it, and it helped me to understand things in a little better perspective, maybe.
Kirti Mutatkar: Even from being a doctor. Even having gone that, you still found something new?
Dr. Pankaj Rao: Because finally, what I could make out from the book is that human being is a fairly intelligent being, is self-aware. We know the problems, but nature has made us with lots and lots of biases, personal convictions and things like that. Maybe towards that, that also affects our way of how we think. And yes, this all came to forefront when I started reading this book, and it was basically a thought provoking sort of book where I could reflect onto my own behavior, how I would behave, and how I would deal with the situation.
Kirti Mutatkar: That is so true. And when you think of death, right? So one of the things that I like about reading books is you have a certain thought [00:05:00] process, right? And sometimes you read books like this book, which makes you question a little bit that you have to put the book aside and say what this makes, this is a very different concept. So for me, evolution, I would think death is a flaw, but death is actually not a flaw. Death is something that was intentional. That kind of changed my, it reframed the way I think.
Dr. Pankaj Rao: Absolutely. Because if there was no death, there won't have been any evolution. We won't have evolved to this particular stage of whatever evolution we are in, because with each death, with a new generation that comes up, that is a little different from the earlier generation. I don't, I wouldn't call it better, but different. So every generation there is a change and that's how we adopt and adapt to nature. And that's how we live. So without dying, there won't be any evolution and life would just stagnate and [00:06:00] we would stay where we are.
Kirti Mutatkar: So it's needed. So evolution...
Dr. Pankaj Rao: Nature needs it.
Kirti Mutatkar: Nature needs the dying process.
Dr. Pankaj Rao: We are the ones who actually think about future. We got insight into what is going to happen to us, and maybe the intellect has developed to that level that this is how we are.
Kirti Mutatkar: Right. Even knowing that we are going to die is a higher thinking, right? Because we have a thought...
Dr. Pankaj Rao: Absolutely. I do not think that birds or any other animals have that sort of insight where they think that they're going to die. They just live for that particular moment and then they get over it.
Kirti Mutatkar: So the other thing this book talks about is the impact of not just the genetics or the genes that we are born with, but the impact of the environment and what happens around it, and how that then gets adopted and gets passed on. Any thoughts on that?
Dr. Pankaj Rao: Looking at my particular study or maybe my journey [00:07:00] in the field of medicine, I would say that 60 to 70% of what happens to our life, especially our diseases or the way we are, it depends on the genetic makeup of our person. But 30%, yes, the environment does play a role. If we have good food during a younger time. We have food which is nutritious. Definitely we would grow taller, better than we would have been, what the genes would've predicted, maybe we would get some diseases which was not intended by the genes and things like that. So if you say maybe 70-30 is the ratio I would give to genetics and to the environment, this side or that side.
Kirti Mutatkar: Got it. So, but 70% is still genes.
Dr. Pankaj Rao: I would feel strongly that genes do play a role, big role in what we are and how we are.
Kirti Mutatkar: Yeah. And the other thing that I was really fascinated by is how much of the human body is still unknown that we don't know.
Dr. Pankaj Rao: Yes,
Kirti Mutatkar: Because 2% like very [00:08:00] fraction.
Dr. Pankaj Rao: The max I can give 10%, 90% we still do not know. That's why we have a plethora of medicines. What we call as the modern medicine, the ancient medicine, everything is flourishing around under the sun. But if you ask me the correct way of knowing things is the scientific knowledge and just not going by what the fad is or what one or two people say. So we got to do lots of experiments, got to test it out on proper animals, human beings. And once you're pretty sure that this is going to help us only then we should take it into our system.
Otherwise, just, and 90% of the things absolutely don't work. Even what Venki Ramakrishnan says that lots and lots of research is still going around. People want to live long, people don't want to age. But personally I feel that 90% [00:09:00] is trash and to know which one is good and what is not good. I think just leave it to the science and maybe one day we'll come to some sort of conclusion.
Kirti Mutatkar: Yeah. Yeah, that is so true. And it's, yeah, there is so much unknown. What was fascinating to me is how the human body has thought about everything, right? A DNA or a cell killing itself, not killing itself, and so much unknown out there. So some medicines might work, some medicines might not work. I don't know. It's like, like you said, there's so many myths and so many stories and what works, what does not work is such a subjective thing.
Dr. Pankaj Rao: That's why still the medical sciences are not a black and white science. Two plus two is four in medicine. That's why we have good doctors and bad doctors. Otherwise, any computer would've done the job or any sort of mechanical thing would've professed what the person is going to have and what the person is going to suffer and what the treatment for [00:10:00] that.
Kirti Mutatkar: And based on all this, from your medical knowledge what do you think? Do we, do you think our age, the number of years that we live has increased? Or what are your thoughts?
Dr. Pankaj Rao: If you really look at the subtitle of the book, it says, "New Science of Aging and the Quest for Immortality." The word quest itself means the human beings' desire to live longer. There comes in the philosophical aspects of it and yes, what all a human being is doing now to see that we have some sort of medicines or way of life where we can just keep on prolonging life and achieving immortality. Of course scientists in institutes like Harvard or Stanford or the greatest institutes of the world, they have a complete department where they study aging, the process of aging and how we can stop aging or at least prolong aging.
But yes, there are people with [00:11:00] tons and tons of money who are spending their money to find out if there's really an elixir for life and they can live for long.
Kirti Mutatkar: So do you think there's a miracle drug? Do you think there's a miracle drug or,
Dr. Pankaj Rao: I don't think so because as of today, I don't think maybe another hundred years or maybe we may come out with something. But as of today, there is nothing better than having good sleep, having moderation in your food intake having a nutritious diet, a wholesome diet and exercise. I think nothing beats that. No amount of fast food, no amount of medication, no amount of any addition of some drugs or any particular physical activity to your life is going to prolong life any further
Kirti Mutatkar: Yeah. Do you worry about the miracle drug that everybody talks about, the rapamycin?
Dr. Pankaj Rao: I think there is no such medical drug as of now, which is there, and I don't think it's possible. But of course, yes, the human being's desire is there. So that [00:12:00] brings me to a play, which I had seen a few years back. It also talked about a similar sort of desire of a human being to live to eternity, be immortal.
So he prays, does penance, and the God actually gets so pleased with him that he is being such a good human being. He appears in front of him and says, okay, son, what boon do I give you? What do you want? So this person says, God make me immortal. I just don't want to die. I want to remain young and live forever.
So God says, okay, done. So you are young and live your life the way you want to. So this person, over a period of years and years does whatever he wants to, he becomes a king. He becomes a pauper. He becomes a beggar. He climbs mountains, swims because he knows he is immortal. He does everything that he desires for.
He learns. He recites [00:13:00] poems, music, or whatever he desires for. And then he reaches a point in life where he says, that's enough. And again, he goes back to the same cycle of praying and he desperately prays to the God that please come in front of me and I just want to die. So maybe if really we become immortal, maybe a stage may come in our lives that we say, okay, we are done with it and I just don't wanna live anymore.
Kirti Mutatkar: Don't want to. Yeah, because when you think about even, I think he says it because we know it's finite, the number of years that we have on earth, because it's finite. We feel like we have a sense of purpose and we feel like there is, we wanna do something and when that sense of that it becomes infinite or we live years and years. I wonder if that sense of purpose goes away.
Dr. Pankaj Rao: That I'm not too sure about it, but yes. If any of you have read about Viktor Frankl, [00:14:00] he is a psychiatrist. He says that a person lives only because he's got a purpose in life. The day he loses the purpose, he just perishes and he dies.
So maybe that's one motivation, I don't know if it's really true. But yes, everybody does have a desire to do something in life.
Kirti Mutatkar: Maybe
Dr. Pankaj Rao: It may not translate into it, but yes, he's got a purpose.
Kirti Mutatkar: I would believe in that. Because if you don't have a sense of purpose, then it feels what's the point of living?
Dr. Pankaj Rao: You are not happy or maybe you are depressed. But longevity, I'm not too sure if it's directly connected to the lifespan.
Kirti Mutatkar: Right? Because you find people who are in mental institutions and have gone through depression live long years. Right. So one of the things, I was thinking about this as I was reading it. I have a background in biology so I related to a few things or I had to even look up. So I did a lot of kind of reading around it. Do you feel, since this [00:15:00] podcast we release it and after that we would want people to join in for a discussion with you and I and others. Do you, how do you think of somebody who might say, oh my God, I don't know anything in biology. Should I pick up this book?
Dr. Pankaj Rao: Absolutely. So though it's a very, very complex sort of subject, talking about genetics, because the less and less you know about it, it becomes more and more complex. You cannot simplify it any further. But I would give full marks to Dr. Ramakrishnan. He has done a great job of it. He has actually cut it down to the basic necessities, what one should know to incite our thought process and start thinking about what life is, what aging is and what death is. I think as far as that goes, I think full marks to the author.
Kirti Mutatkar: Right. I do think, because when you are reading it, sometimes if you have the background and he's explaining what a DNA is, double strand, and this, [00:16:00] you think I know that, right? But that's because maybe you and I might know that, but somebody explaining the basics, explaining what mRNA is and all that. So he does a really good job by doing that. Like a laymen person.
Dr. Pankaj Rao: Of course. Even for me, even having known so much about biology still, I had to go back and refresh my memory, refresh my whatever I knew about genetics. I had to go back to my books. And that way it did give me a better way of understanding what he actually tries to say.
Kirti Mutatkar: Right. So when I think of like, the rating for my books, right? So I have like a rating from one to four. So I say one is like a flat soda and four is like a high, like the fizz factor, which is like really gets your brain charged. What do you think about that?
Dr. Pankaj Rao: Yeah. I would give this book four because yes. I read it very fast, but in other places I went extremely deliberately about it. I used to close the [00:17:00] book, think for a while, reflect and then go ahead again. So I would give four and that maybe because of my background of biology and I deal with death, I deal with aging. Maybe that could be the reason, but definitely I like this book.
Kirti Mutatkar: Even me, I had the same thing. Even without having your background I felt the same way that it gets you thinking, right? It gets you thinking, including, I think I was thinking about when I was pregnant and the exposure that you have and what that impacts on the genes. When I was reading about DNA and telomerase and all that stuff, it gets you thinking, definitely gets you thinking.
Dr. Pankaj Rao: Absolutely. Because, can we change the genetic makeup of a person? Can we modify it? Can we alter it? Suppose we know that somebody's got a gene that is going to give him a cancer at later stage in his life. Can we do some sort of engineering and maybe modify it? Will it affect some other part of his body still? I think we are in a [00:18:00] nascent stage. We are just evolving. We are learning. And maybe the day is not very far, I can tell you, where what we call as precision medicine, we would actually genetically map a human being and devise medicine as well as maybe treat a person because we would know his genetic makeup
Kirti Mutatkar: The other thing I kind of talk about from this book is, or when I discuss books, is to see, so usually when you look at books, right? You have a book, you read it. You like it maybe, but you donate it, it's in the donating pile. Or you have a book that sits right next to your bed and you kind of revisit it over and over again or give it to other people. So where would you, in that scale from one to four, where would that go for you?
Dr. Pankaj Rao: See for me, I read this book and I made my small [00:19:00] little notes about it and maybe now I'm done with it. So I feel that I won't keep it with me and I won't revisit it later maybe a few months later or maybe years later. I think I would rather donate it to somebody and that's what I would do.
Kirti Mutatkar: So maybe like two or three maybe? Your rating would be around
Dr. Pankaj Rao: Yeah, maybe around three. Maybe around three.
Kirti Mutatkar: You recommend it, you want...
Dr. Pankaj Rao: I recommend, definitely. I would recommend people to read it, but it's not something that I would revisit it again and again and go and read about it again. Maybe that is because it's a technical book and once you know the technical aspects of it, then maybe you lose interest. If it was philosophy or some thought process, then maybe I would have revisited it, that would've made this book even more better. But anyway, that's not possibly the aim of this book. The aim of this book is to remain technical and give facts as they are, as we know today,
Kirti Mutatkar: Which was [00:20:00] good.
Dr. Pankaj Rao: I think he has left that bit untouched. And he being a scientist, I think that he has done his job of just portraying what is known to us. What is actually evident to us, what we already know as far as science goes. And he has not actually gone too much into the philosophical aspects of it or prediction about the future, what would happen in the future. But he just told us in basic things as to what we know as of now in simple terms, so that a lay person knows about it and doesn't get carried away by all the jargon, advertisements or people talking all that on the social media and the tabloids and things like that.
So maybe that's his aim and he achieved that aim.
Kirti Mutatkar: That's true. So I would recommend I, I think people, if they get intimidated by the science behind it to read, and even if you don't finish the book, would love to have them join in that roundtable discussion. Because [00:21:00] some of those things as you discuss with each other, right? Different people have different perspectives and we can talk through that.
Dr. Pankaj Rao: Maybe next level would be after reading this book as human beings, we can discuss the other aspects which are not mentioned in the book. We talk about the philosophy, whether it's really right to do the ethical aspects, whether one should be making such drugs, which will make a person immortal, whether the science should really crave or strive towards making all this. Maybe that's a different issue and that can be discussed with the others.
Kirti Mutatkar: Yeah. That'll be a fascinating, that'll be an interesting, yeah, that'll be...
Dr. Pankaj Rao: As to why people do it, as to whether it should be done at all or not, and things like that that can be discussed.
Kirti Mutatkar: That'll be a good discussion to have. So I would, we would encourage people to join in. Even if you feel you read the book and you think it's too technical, I would go through it and read it, finish it. But if you don't, you can also join the discussion. I think it'll be a fascinating discussion. [00:22:00] Is there anything else that I missed?
Dr. Pankaj Rao: I think you've fairly comprehensively covered all aspects of it. And what I would say is for a lay person, I think just go read this book and then just you will get an understanding as to what is aging and why you should not be believing in those wonder drugs, those supplements that you take and live a simple life of having a limited diet, balanced diet, sleep well, moderate exercise, and live a happy and a healthy life.
Kirti Mutatkar: That's well said. Because yeah, that, I think that serves the book, serves that purpose. So thank you for recommending the book. Thank you for joining the podcast and this is my first podcast in India. And to do it from where we are right now, the historic place, the AFMC House, this is very, very exciting. It [00:23:00] feels like in the middle of Pune, which is a city in India, we are sitting surrounded by... In the middle of the city, but it feels like a very resort kind of living. So honored to be here and really excited that you are a guest on my first season of my podcast series. Thank you.
Dr. Pankaj Rao: Yeah, thank you so much Kirti, have a great day.
Kirti Mutatkar: Thanks.
Dr. Pankaj Rao: Thank you.