In this chapter Taleb applies the ideas seen in former chapters to describe how can we improve our lives and health.
Following the general concepts described in the former chapter on medicine, Taleb questions the famous argument that now we live longer thanks to progress, technology and medicine. Taleb rightly observes that this is true only in the case of lethal diseases in which iatrogenics is not relevant -after all you are going to die anyway, so why don’t we try some surgery?
In his delightfully ironic style, Taleb defends the via negativa in medicine, avoiding bad stuff -including non critical surgery, with statements like “telling people not to smoke seems to be the greatest contribution of medicine in the last sixty years”.
I find specially relevant his proposal of substituting the pursuit of happiness for the avoidance of unhappiness. I’d say that this is one of the best reccommendations to live a happy life I’ve evern seen.
So, for Taleb being healthy is mostly a substractive activity:
“If true wealth consists in worriless sleeping, clear conscience, reciprocal gratitude, absence of envy, good appetite, muscle strength, physical energy, frequent laughs, no meals alone, no gym class, some physical labor (or hobby), good bowel movements, no meeting rooms, and periodic surprises, then it is largely subtractive (elimination of iatrogenics).”
Another very interesting topic in this chapter is his apology of fasting. For Taleb, religions has a not so obvious function of limiting iatrogenics by substituting dangerous medical practices with harmless one (going to church to pray for your health instead of going to the doctor) and he finds specially relevant the idea of fasting to have a better health. He argues for the wisdom of fasting based on the idea that human bodies were not designed to always eat at certain times similar amounts of food, but to fast for some days untill some food was found and then gorging on it until it was finished. We are not merely vegetarian, or carnivores, or paleo, but we adapt to whatever the environment bring us. Non-linearity is also relevant when considering food intake.
In a similar way, Taleb questions the idea that breakfast is the most important food intake of the day, and we must eat a lot and observes how humans were not designed by nature to eat food first thing in the morning: one eats after some exertion because one spends some energy and need to recover it.
Taleb finishes this chapter with his classical no-nonsense approach observing how living longer is not such an amazing purpose in life. We should care more about the quality of life, and, like the ancients, avoiding a dishonourable death.