About the author

A book that grades other people’s products owes you a clear account of the author’s own interests. Here is mine.

No company paid to appear in this book, and none was shown the text before publication.

This book contains no affiliate links, no discount codes, and no sponsored recommendations.

I earn my living practicing medicine. Like any physician, I prescribe, and in my office sometimes administer, medicines discussed in these pages. Now or in the future, I or medical businesses I am involved with may offer tests, treatments, or services discussed here. Nothing in this book was written to promote them, and every one of them is graded by the same standard as everyone else’s. If the evidence is weak, I say so, including for things I may offer myself.

I describe companies only by what they publish about their own services and prices. Mentioning a company is not endorsement, and criticism of a category of treatment is not an accusation against any company that offers it. Where a business is described as an example of a category, I have generally left it unnamed, because the point is the category, not the company.

I have changed my mind in print, and I tell you where. I expect to do it again as the evidence changes.

How to check any author, including me: look for what they sell, look for who funded the study they are quoting, and notice whether they ever say “we do not know.”

My uncle went out one morning to buy breakfast for his family and died in the street. He was fifty. He had no warning that anyone recognized, no diagnosis, no medicine in his cabinet. He was a healthy man until the minute he was not.

I have thought about that morning through nearly thirty years of practicing cardiology, because I now know what nobody knew then. I cannot reconstruct his coronary history from that morning. What cardiology has taught me is that a sudden death can follow a disease process that developed silently over many years. Some risks can be found and treated before symptoms appear. We cannot know which intervention would have changed his ending. We can take prevention seriously without pretending we can.

That is the argument of this book in one paragraph. We speak of people dying of old age, or dying suddenly, as though death arrived from nowhere. Often there were earlier risks: blood pressure that went untreated, cholesterol that remained high, breathing pauses nobody investigated, fragile bone, or years of isolation. Sometimes there were few clues, or good care could not prevent the outcome. Prevention is an opportunity, not a promise that every death was avoidable. The diseases that take most of us are slow. Their slowness is the opportunity.

I had another uncle, a psychiatrist, who taught me the second half. Months before he died he took me to dinner. I was a young doctor then, hot-headed, facing a lawsuit, and ashamed. He told me that if I were sued I should first say “thank God I am alive,” and then fight. If my office fell apart, I should be grateful for my education and my hands, and rebuild. If I lost every dollar, I should be grateful for my health and go back to work. “Everything else,” he said, “is furniture.” I nodded politely. It took me years to understand that he was not consoling me. He was teaching me triage.

So this is a book with two halves, like a heartbeat. The first is about not dying of the boring things: the measurable, preventable, treatable things that modern medicine handles well when it is given the chance. The second is about what the years are for. I have sat with many people at the end of their lives, and not one of them asked to see their lab results.

Between those halves you will find everything my patients ask me about: the scans and blood tests, the hormones, the weight-loss injections, the supplements, the peptides and drips and cold tubs, the clinics that charge the price of a car for a day of testing. I have tried to answer the way I would across my desk, with the short answer first and the evidence graded, so that you can see what is established for a particular use, what remains uncertain, and what a story cannot prove.

You will not need most of what is sold to you. You will need a few numbers, a few habits, a doctor who listens, and a reason to get up in the morning. I wrote this so that you would know which is which.

My uncle did not get another morning. Those of us who are here can ask what deserves attention now.

Ash Emrani, MD

Tarzana, California