The Now vs Later Problem

I was reading a book recommended by a friend titled The Road Less Traveled by Dr. M. Scott Peck. The book was published in 1978 but still holds it's relevancy today if even more so than when it was initially published.

The book is studded with gems of quotes and particularly keen insights on the human condition. I wanted to share a particular quote that resonated with me, specifically with it's broad applicability to longevity medicine.

To be organized and efficient, to live wisely, we must daily delay gratification, and keep an eye on the future; yet to live joyously, we must also possess the capacity, when it is not destructive, to live in the present and act spontaneously.

-Dr. M. Scott Peck, The Road Less Traveled  page 64

While Dr. Peck was specifically referring to mental health, this is the same paradox, we must contend with when approaching longevity medicine.

One can easily come up with zany hypotheticals to illustrate this idea. For example:

Would one could choose to follow the most extreme 'longevity protocol' that foregoes all pleasures of the flesh, where they are only awake 30 minutes a day, but it will add 1000 years to their life.

-OR-

Live a life of extreme hedonism to find a life cut short to 30 additional years.

Fortunately, unlike the hypothetical scenarios, this paradox of spontaneity in the present vs discipline for the future plays out in less dramatic fashion. In fact, I would argue that most of the choices for a healthy future also feel quite good in the present.

• Getting in a healthy workout is one of the best parts of my day and is also essential for longevity.

• Now a days, there is little I enjoy more than good sleep which also is key for longterm health.

• I experience great pleasure in being social with friends and maintaining close relationships with my kiddos, both of which are going to be key for both my quality of life and my length of life.

• Cooking healthy food is something I have come to really enjoy on a daily basis, also clearly important for the long term.

• Having a healthy and loving sexual partner brings both the joy and satisfaction of the moment as well as the investment in a life partner.

• Consistently and contentiously refining one's life philosophy leads to frequent sparks of insight and epiphany that most experience as incredibly rewarding in the now as well as critical for maintaining your life trajectory on course in a positive direction.

The real trade offs of short term and long term trade offs happen at the margins. And often fall into one of two categories.

The first category, which I refer to as the 'cake icing category' is easy to resolve with intentional observation. This category consists of transient experiences that bring a spike of pleasure, that is very quickly off set by a much belabored negative experience in both the short term and long term. It is called the 'cake icing category' because that is my favorite example of this trade off in action.

Imagine a big delicious looking cake at a friend's birthday party. Your mouth starts watering in anticipation of the sugary goodness you are about to consume. You are handed the piece with the highest ratio of icing to cake, and icing being your favorite part you indulge rapidly. Within the span of 60 seconds the entire piece is now securely in your digestive track. What a high... Then the sugar rush strikes, followed by the sugar crash, neither of which are particularly pleasant. Then comes the craving for more sweets which you must now manage. On the whole, the entire short term experience of the cake was really a net negative experience. Tie that in to the fact that we know the frequent repetition of such behaviors leads to obesity, insulin resistance, type 2 diabetes, ASCVD, likely cancer, and all the other harbingers of ill health, and with some simple observation, we can see that both the present moment and long term experiences align and tell us not to eat the cake.

Now this is not to say we never eat cake and it's delicious icing... it's to say we move the indulgence to become an infrequent event and try to enjoy the hell out of it while being very mindful of the whole experience.

If find the first category of behaviors relatively easy to reduce or dismiss outright with the help of some mindfulness because of the clear congruency of both short and longterm outcomes.

The second category is where it becomes tricky. This is the category where there are real trade offs in both directions, and the paradox between present and future must be managed. I will give two examples:

The first is alcohol. I personally love the feeling of being slightly intoxicated with alcohol in social settings, and for most of my life alcohol has been my drug of choice. However, I am well aware that alcohol is like radiation exposure in the sense that 'there is no safe minimal dose'. Every dose of alcohol exposes you to health risks and the negative outcomes are dose dependent, escalating precipitously with higher doses and frequency. However, we live in a society where alcohol is widely available and fully integrated into society as a social lubricant. How does one navigate the short term benefits of increased socialization with the known longterm harms of alcohol?

The second example is biking. I love to bike, and living in DC I bike everywhere I can. Given that I am often relegated to biking in the street among cars, I can definitively say that biking is the most dangerous thing I do. If anything is going to kill me in my 30s and 40s, a biking accident is by far the most likely. However, biking also brings benefits. It provides built in exercise to my day, gives the feeling of independence and freedom, as well as protests me from the states of hypertensive urgency I find myself in when encountering traffic and parking in the city.

So what to do about these second category items?

First, realize that they are paradoxes to be managed, not problems to be solved. So know from the get-go that these are going to be ongoing negotiations with decisions that need to be updated regularly when new information becomes available.

Second, define precisely why you are doing the behavior and be specific about what you are getting of that behavior. e.g. "I drink 2-3 cocktails twice a month because it helps me loosen up and become a better salsa dancer, which is a skill I want to learn and is important for me to participate in with my friends group." Awesome, that is specific enough so you can revisit your decision later. Do I still need the 2-3 drinks, or has my salsa dancing skill increased enough that I can cut it back to 1 drink, or perhaps even enjoy myself just as much doing it sober.

Third, be mindful of the consequences. Has my drinking increased without a notable benefits to my socialization? Am I getting shorter with the kiddos? Is my sleep disrupted to frequently to feel refreshed? Has my complete abstention from drinking hurt relationships that I really value?

With time these negotiations become easier and more natural. At first the navigation feel like problems, and most people avoid confronting problems at all cost. But with some practice you will find that the continued framing of and approach to these problems are the gateway to a life well lived where you actually have autonomy and freedom. This is perhaps best captured by another quote by Dr. Peck:

Sooner or later, if they are to be healed, they must learn that the entirety of ones adult life is a series of personal choices, decisions. If they can accept this, totally, then they become free people. To the extent that they do not accept this they will forever feel themselves victims.

-Dr. M. Scott Peck, The Road Less Traveled  page 44