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The story is set in 2158 A.D., after the invention of a medicine called Anti-Gerasone, which is inexpensive and widely available. Anti-Gerasone halts the aging process and prevents people from dying of old age as long as they keep taking it; as a result, America now suffers from severe overpopulation and shortages of food and resources. Will people need to leave earth for better living conditions elsewhere and take "the big trip up yonder" or is that just a euphemism for something else?
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