Dr. Joana Costa is Longevity and functional medicine physician. Founder of the Costa Longevity Method™. Clinical Director, B-Life Longevity Clinic, Lisbon. President of SPMCLong — Sociedade Portuguesa de Medicina e Ciência da Longevidade.
What is my greatest passion in my work? Reading a person before the diagnosis arrives. I am drawn to the moment when a scattered set of numbers: lipids, inflammation, body composition, lifestyle data, grip strength, suddenly resolves into a single coherent story about how someone is ageing, and why. That resolution is the work. Everything else, the protocols, the supplements, the training, is downstream of it. What I am really passionate about is precision applied to something as unruly as a human life.
What is my greatest fear? That I stop dreaming. Not failure, not being wrong in public, not even losing what I have built. Those are survivable. Dreaming is the engine of my personal evolution; the moment I settle into competence and stop imagining something beyond it. I have seen it happen to brilliant people who were simply never asked to want anything again. I intend to keep asking myself.
What do I love most about my work? That it is never finished, and never abstract. Medicine is the content of my life, not a compartment within it. The science keeps moving, and the person in front of me keeps changing, so the work refuses to become routine. I love the long arc most: watching someone return two years later with a different body, a different trajectory, a different sense of what is still possible for them. Nothing in business has ever given me that.
What is my greatest pitfall? Impatience, and wanting everything at once. I arrive at the answer quickly and then forget that the people around me needed the whole road to get there; and I have never learned to refuse a good idea, so the result is someone permanently overcommitted and rarely finished. I have built an entire practice around long horizons and decades of patience, and I still want the team to understand something by Thursday.
What does the statement “Passion Never Retires” mean to me? It is, in my field, almost a clinical statement. Biology does not distribute purpose according to age, and the people who age best are rarely the ones with the perfect biomarkers, they are the ones with something still unfinished. Retirement as a concept was invented for bodies that were used up by sixty; that is no longer the biology we are working with. My whole practice is built on extending not just lifespan but apetite, ie. the years in which someone still wants something.
What would I like to change about myself? I would like to be better at hard conversations. I can hold a difficult clinical truth with a patient without flinching, but the moment it becomes a partner, a colleague, a negotiation, I find myself smoothing edges that should stay sharp. It is the one skill I am actively, deliberately building, and the one that has cost me most.
What is my greatest professional achievement so far? Becoming respected in my field and within my clients. That sounds modest next to a clinic or a society or a method, but respect was the thing that could not be bought, launched, or accelerated, it had to be earned one careful decision at a time. It means that when I say something about longevity, it carries weight, and that colleagues or clients send me the patients who have problems they don’t have a solution so far. Everything I have built rests on that, not the other way around.
Where would I most like to live and work? All over the world! I come from a small town in the north of Portugal, but from university I studied in New York, London and in Prague, and I miss the thrill of changing countries adapt to new realities. I am not looking for a better city than Lisbon; I am looking for a professional life that is not confined to one. Longevity medicine is being written simultaneously in Boston, in Ibiza, in Dubai, in São Paulo, and I want to be in the rooms where it is argued about, not only the rooms where it is applied.
What is my most distinctive characteristic? I see the whole structure before I can explain it. My mind moves intuitively and very fast. I arrive at the answer, the shape of a programme, the diagnosis, almost immediately, and then I spend the following days building the scaffolding that proves I was right. It makes me quick, occasionally impatient, and difficult to work with if you need me to show every step. It is also, I think, the thing that makes the medicine good.
What is the place outside my home where I get my best ideas? My childhood home, in the countryside. My boxes are still there: diaries, photographs of a girl growing up, the accumulated evidence of who I was before I was anyone’s doctor. It is a nest, and something about being surrounded by my own origins loosens my thinking until ideas simply spill out. It helps enormously that my parents are there to occupy my children while I disappear into my head for a few hours.
Which books have influenced my life and how? Never Lose a Customer Again, Joey Coleman: it taught me that care is choreography. The first hundred days of a relationship decide everything, and I now design a patient’s journey with the same deliberateness I bring to a protocol. The 7 Rules of Power, Jeffrey Pfeffer: an uncomfortable book for someone raised to believe excellence speaks for itself. It doesn’t. Pfeffer made me understand that visibility, networks, and the willingness to ask are not vulgar; they are how good work reaches the people who need it. High Performance Habits, Brendon Burchard: the reminder that sustained performance is a practice. Clarity, energy, courage: things I can build rather than hope for.
“You Only Die Once” — what music would I like to listen to on my last day? Adiós Ayer, José Padilla. A goodbye to yesterday, sung over an Ibizan sunset. It is unhurried, warm and dreamy. If the last thing I hear is that, then I will rest in peace.
Who is my hero or heroine in fiction? Miss Marple. An unremarkable woman in the corner of the room, underestimated by everyone present, who solves what the professionals cannot because she is the only one paying attention to the detail nobody thought mattered. That is, almost exactly, what I do for a living: a patient arrives with twelve complaints and forty abnormal values, and the answer is usually hiding in the thing that was stepped over. I have loved her method since childhood, long before I knew it was a professional description.
Who are my real-life heroes and heroines? My parents. My mother was a teacher; my father founded Trofa Saúde, which became one of the largest private hospital and clinic groups in Portugal. Four children, everything held together, and not a single moment when either of them stopped dreaming. They never taught me ambition as a lecture, they taught it as evidence, by continuing to want things and continuing to reach them, in the same house where the homework got done. What I took from that is the belief that you can do whatever you set your mind to, and I have never once had to argue myself back into it.
Which film would I recommend everyone to watch at least once in their lifetime? The Party, with Peter Sellers. It is a film in which one profoundly out-of-place man dismantles an entire elegant evening simply by refusing to stop being himself. I find it perfect. It’s very funny, very kind, and quietly making the argument that formality is more fragile than sincerity.
What does the statement “I am the storyteller of my own life” mean to me? That the facts of a life are far less determining than the narrative imposed on them. I see it clinically every week: two patients with identical results, one who has decided he is declining and one who has decided he is beginning, they will not end the same way. Authorship is not positive thinking; it is the refusal to accept someone else’s interpretation of your data. My work is largely helping people rewrite a story they were handed.
What role do stories play in my life and work? They are the delivery mechanism for everything I know. No one has ever changed their life because of a reference range; they change it because they recognised themselves in something. So I teach in stories, I write reports as narratives rather than tables, and I build my method around the trajectory of a person rather than the snapshot of a panel. Science gives me the truth. Story is how I get it to land.
Which project am I most looking forward to? The first cohort of the Costa Longevity Method mentorship. For years the method has lived inside my own practice, and this is the moment it leaves my hands and enters other physicians’, which is both the point and the terror of it. What I want from it is not a bigger clinic but a different kind of doctor: one who reads a trajectory instead of a symptom, and who treats the decades ahead as something you can still negotiate with. If we change how medicine is practised, everything else follows.
Who would I like Peter to invite to tell their story? My twin sister, Carolina Costa. She is the founder of the Motherhood Center and of Costa Clinic Medical Concierge, and an expert in paediatric longevity. She works at the opposite end of the same idea I do: I try to extend the good years at the end, she is building them at the beginning. She is also a formidable entrepreneur, which is not a word I use loosely. We studied in the same class from first day of nursery to last day of university. Somehow ended up in opposing specialities and arrived somewhere entirely similar, and I would very much like to hear her tell it.
How can people contact me?
www.drjoanacosta.com
joana@drjoanacosta.com
Instagram: @drjoanacosta
LinkedIn: Dr. Joana Costa