What are you talking about? In the Trek-verse, leaps like that happen every week.Medical knowledge, even in the trek-inspired future, doesn't make leaps like that in a 80 year span.
Seeing people being active right up to the top end of their expected lifespan may seem strange to us in 2009, yes. But a hundred years ago, it would have been just as bizarre to think of spending the last twenty years of your life in a convalescent home, taking a dozen pills twice a day just so you could get up and do nothing the next day. Heaven only knows what the general perception of the elderly will be in the 23rd or 24th centuries.
Are you saying that if you were the head of SI you would have no problem sending someone who looks...ahem...as healthy as the way McCoy did in Encounter at Farpoint, on a mission into enemy territory like he was some kind of commando

I find it hard to believe that with all of SI within Uhura's grasp, that the best person for a massively important mission into enemy territory, was a man with next to no knowledge about said enemy who also happened to be 132

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