Archives For health

sara jean underwood

The city where I live, the college town/aspiring big city of Columbus, OH, the weather isn’t really known for being nice. And we’ll tell you how much the weather sucks when you ask what it’s like to live here. It will be either our opening line or the caveat we sneak in at the end. Right now, it’s hot and incredibly humid, which makes walking outside feel like stepping into a blast furnace that cooks you in your own juices. This means that if you want to work out, it’s best to get indoors to the treadmill. Unfortunately, some of my wife’s and my mutual friends seem to disagree because lately, they’ve gone granola on us and ascribe to the trend that exercising in hot, humid weather is perfect to sweat out toxins. Ah, yes, the t-word, used as the magical justification for just about every New Age lifestyle trend, much like the word quantum is used as an automatic free pass for them to say whatever they want about science. Now, trust me, I know it sounds compelling to go out there and sweat out all your toxins, but what you’ll really be doing is getting heat stroke and putting your body in danger so for the love of all things cute and fluffy, don’t do it.

Here are the two big problems with this idea. First and foremost, there’s a reason why it feels so miserable to run around in 90+ degree weather and high humidity. Your body needs to transfer heat to the outside environment to cool down and if the temperature is close to, or exceeds your body heat, that transfer is very much inhibited. Sweat doesn’t evaporate cooling you off, it’s just stuck to you and your clothing, keeping you uncomfortably warm. According to research by the people who created the mantra "pain is weakness leaving your body," the U.S. Army, — probably the absolute last institution you could accuse of not knowing enough about fitness and physical training — the optimal ambient temperature during your workout should be about 65° F. It’s not so cold that your body tries to hold on to heat and interferes with your muscles, and not nearly hot enough to get in the way of sweat giving off excess heat efficiently so you could work much harder and train a lot longer than you would otherwise. This is why many gyms have thermostats set to the mid to low 60s, we know it’s good for your body as you’re exercising.

The second big problem is this. What toxins are you trying to sweat out? Chemophobes can get tests to determine what sort of residue can linger in their tissues and hyperventilate about every chemical under the sun on the basis of the results. Whatever chemical name they don’t readily recognize or the nature of which they don’t understand, they call a toxin and proceed to spend a good deal of time and effort "detoxing." For example, formaldehyde is a commonly cited toxin but it actually occurs naturally as a byproduct of your metabolism and is used to help chain together amino acids into proteins. The problem is that if you’re exposed to industrial quantities of it, the excess formaldehyde is converted into formic acid which could cause nerve and kidney damage in sufficient quantities. So where do our New Agey chemophobes go wrong? Well, they assume having a few parts per million of it in our bodies is dangerous and must be the result of pollution, despite the fact that it naturally occurs in our tissues and their concentrations of it are orders of magnitude lower than what it would take to even raise a yellow flag. Dose makes the poison, but the granola crowd assumes that if it can be a poison, it’s just a matter of time before it is.

And so they go out in the blazing heat to sweat out chemicals that aren’t going to harm them just to overheat their bodies to the point of exhaustion, and take how miserable they feel as a detox regimen working as designed. In reality, however, the headaches, weakness, and nausea aren’t toxins leaving the body. They’re your body’s way of telling you "don’t pull this shit on me again, I mean it!" Having less and less discomfort after working out in the heat for a while isn’t a coup for the detox protocol either, it’s your body begrudgingly accepting its fate and getting used to the stress at the expense of overworking the heart and the kidneys. While heat stroke and its milder precursors will generally go away after a brief rest without doing permanent damage, repeated exertions can take their toll in the form of cramps and muscle pain. Really, if the workout in the air-conditioned gym and the miserable routine in the sticky heat won’t actually rid your of all the chemicals that are actually not harmful to you in the amounts everyone carries, why run the risk of heat exhaustion? Why not just keep yourself in shape safely and using real science?

smiley death grafitti

It started almost immediately after Sandy Hook. The reliably shrill alt med ignoramus who hasn’t read about a conspiracy theory he didn’t immediately love, Mike Adams, penned a fiery screed accusing psychoactive drugs of creating mass murderers and using a seemingly long list of very grizzly events to support his point. Since he’s Alex Jones’ best buddy and fills in on the Coast to Coast radio show, the meme has spread like wildfire among conspiracy theorists, and even the pundits of World Net Daily — known as World Nut Daily for some very good reasons — are now spouting the dogma of antidepressants turning people into a homicidal frenzy, all so Big Pharma can profit from untested drugs while the government covers up the dark truth. Although that last part there could’ve been from the Sandy Hook Truther conspiracy. It’s kind of hard to keep all of the overlapping conspiracies straight sometimes, though it’s usually a safe bet that there’s some mention of the government covering up something for someone nefarious so the bigwigs of the New World Order can keep their sex slaves and appease their alien overlords.

Here’s the immediate problem with the psychoactive drug-induced mass murders theory. It fails the statistical significance test. Tens of millions of people have taken what’s known as selective serotonin reuptake inhibitors, or SSRIs, to treat mild to severe depression, and social disorders like anxiety and OCD. Virtually all the brand names given by Adams and his friends and fans are from the same family of SSRIs, and we can safely ask why just a few dozen examples of a violent crime out of a population of tens of millions of patients mean that SSRIs turn people into crazed gunmen. After all, if your study population is, say, 20 million and your sample time period goes back decades, having some mass murderers, serial killers, and short tempered violent criminals is pretty much statistically inevitable. Plus, what about the other tens of millions of patients who didn’t commit any crimes? How can you argue for a causative effect between SSRIs and murder when the murderers are so few and far between as to be a tiny blip on the radar? And that’s not to mention that SSRIs don’t have any known side effects that increase one’s aggression.

In fact, patients on SSRIs with the most extreme side effects and conditions are likely to commit suicide, not homicide. A quick reading of the list presented by Adams and company mentions a number of suicides quite prominently, as well as changing the definition of mass murder to "any violent crime in which more then one person died," further weakening their own case. Yes, a lot of gunmen commit suicide after their massacres, true. But the problem is that it’s very difficult to make any definitive causative link between SSRIs and suicide. Considering that patients with an extreme case of depression may commit suicide in spite of the drug rather than because of it, as well as the fact that for patients with a history of abuse and trauma SSRIs might not really do all that much more than a placebo, the connection is very murky. While we can say that gunmen in the headlines today were taking SSRIs and other similar medications, we can make a stronger case that the medications failed to do their job than Adams can that their medication pushed all, or nearly all of them, them towards violence, because the former explanation better fits with the fact that tens of millions of SSRI-using patients aren’t violent, and the relevant scientific work.

So let’s review. Mass murdering gunmen on psychoactive drugs are few and far between even when the criteria for mass murder are loosened to include any crime in which two or more have been killed. The link between SSRIs and violence has been studied and shown not to exist. And while patients on SSRIs with a severe diagnosis are more likely to commit suicide, we could very easily make a sound case that suicides are the result of the medication failing to do its job, not driving someone to a suicidal state, much less to killing themselves after leaving a trail of victims in his wake. But none of this bothers the conspiracy theorists. To them, everything has to be a secret plot by those behind the scenes because this the only way they can imagine the world. If they allowed for random chaos to interfere or simplt incompetence to bring down economies and lose wars, why, the world would be an unpredictable place they couldn’t pretend to navigate like sages in the know observing a chess match. They would have to be ordinary shmoes just trying to make sense of events that all too often simply don’t make sense in the big picture…

beaver talc

A feature piece on the Dr. Oz Show and the man behind it is up at the New Yorker, and as most features on a controversial topic in the New Yorker go, it’s long and none too flattering. In it, he’s described as brilliant, charismatic, but profoundly influenced by his wife’s deeply held beliefs in alt med woo, and seeking ratings and publicity to a fault. He may talk about giving patients every bit of information out there and wash his hands of any claims that in retrospect were found to be with little to no medical merit, but the message is clear. He needs drama, ratings, and to give the audience what it really wants: quick, easy, convenient answers to the big three questions. How can I lose weight? How can I live longer? How can I battle cancer if it sneaks up on me? And as numerous quotes from experts in the article show, he goes overboard with his answers…

“Mehmet was always unique, but now he has morphed into a mega-brand. When he tells people the number of sexual encounters they need each year to improve their lives in a specific way, or how to lose weight in three days—this is simply lunacy. The problem is that he is eloquent and talented, and some of what he says clearly provides a service we need. But how are consumers to know what is real and what is magic? Because Mehmet offers both as if they were one… It all seems to be in the service of putting on a show. And, when you add it up, that seems like something other than medicine. It’s more like medutainment.”

No wonder Oz is so popular. Have trouble with weight loss and yo-yoing back and forth, and no doctor can tell you how to keep weight off? Try the raspberry ketones. Then the green coffee beans. Then the blueberries and almonds. What should I do to add a year to my life? Have sex on a regular basis and aim for 200 orgasms a year. These are not exaggerations. I’m not being snarky or sarcastic whatsoever. These are real, honest to goodness Dr. Oz recommendations, his televised answers to complex medical questions we are only now learning how to even try to research thanks to cloud computing and an explosion in bioinformatics. But instead of doing an expansive study using data from millions of real patients whose data was uploaded into secure data centers for medical research use, Dr. Oz is basically telling his viewers "oh, want an extra year added to your lifespan? Why don’t you go out and get laid? Doctor’s orders!"

It’s simple, it’s nice to hear, and it comes with the most minimal amount of evidence. Yes, we do know that sex adds years to your life but we don’t know how well enough to tell someone how many orgasms he or she should have to live longer. Same goes for all the compounds that Oz touts as the miracle fat buster that Big Pharma doesn’t want you to know about, despite being all too able to extract the active ingredient in pill form, patent it, and make billions selling it. It’s all those pesky FDA requirements that the supplement do a better job than a placebo that just get in the way, unlike for health store chains that sell vitamins formulated in Utah, where a senator with deep ties to the supplement lobby fights to keep vitamin sales totally unregulated. Point is, much of what Oz has to offer the public is either common sense or ridiculous hype and eyeball grabbing manufactroversies for the sake of ratings.

Considering that Oz is indeed a brilliant and accomplished surgeon and researcher, he should really know better than to opt for drama and ratings, telling his viewers what they want to hear instead of admitting that we don’t know a lot of things to which they demand instant answers. In the scientific world, nature doesn’t take the attention span and personal desires of patients into account and it makes you fight to find solutions to complex problems like aging and cancer. For someone to step into the role of "America’s doctor" without acknowledging it and sticking to the facts for which we can have solid evidence, is a gross abuse of trust and a position of immense power. He could’ve used his bully pulpit to dispel countless snake oils and get more people on treadmills and committing to a healthy lifestyle. Instead, he gave common sense a node while sending his fans on the hunt for the latest weight/cancer/age-busting fad. For shame…

[ illustration by Glen Southern ]

lab mouse

While studying what effect cell division has on cancer risk, a team of scientists decided to make mice that that produced excess levels of a protein called BubR1 and got results that seem way too promising at first blush. Not only were the engineered mice a third less likely to develop lung and skin cancers after exposure to potent carcinogens than control animals, but they had twice the endurance, lived 15% longer, and were less than half as likely to develop a fatal cancer. So what’s the catch? Well, there is none. It’s as if an over-expression of BubR1 is a magical elixir of good health and longevity. This doesn’t mean that this protein couldn’t become our most potent weapon against cancer with enough study or that it must have some sort of side-effect, which is entirely possible since too little BubR1 in humans is associated with premature aging and some forms of cancer, but this is a signal to proceed with optimistic caution.

Mice may have a lot of similarities to humans from a genetic standpoint, but they are a different species so what works well in mice may not always work as well in humans. Likewise, if we really wanted to be sure of the results, we’d have to test them on thousands of humans over decades, which is a massive undertaking in logistics alone. And since testing the protein modifications in humans would be such a major effort, the researchers need to know exactly how BubR1 does all the wonderful things it does, breaking down its role by chemical reaction and testing each factor on its own. The work may take decades to complete but if it’s correct, we may have found a way to extend and improve our lives in a humble protein. Combined with other ongoing work, there’s some very real science behind extending human lifespans and modifying our genomes for the better. I just hope we don’t get a little too carried away and treat editorials treating BubR1, gene therapy on a massive scale, and cell reprogramming technology as just around the corner with the necessary healthy skepticism, since the research is by no means complete…

See: Baker, D., et. al. (2012). Increased expression of BubR1 protects against aneuploidy and cancer and extends healthy lifespan Nature Cell Biology DOI: 10.1038/ncb2643

internal view

As we’re starting to test artificially grown organs, scientists are wondering how to make sure that their methods result in viable tissues. One of the first steps was to take organ growth into three dimensions, letting the cells grow on a scaffold and self-organize into the right muscles, valves, and other soft tissue. Usually these scaffolds are derived from existing organs purified of all their old cells and many are designed to break down into naturally occurring chemicals to be flushed out of the body on implantation. But how do you check what the organ can be implanted with the necessary level of precision? Why turn the scaffold into a monitoring device by letting cells grow on a sensor. This way, when the tissues grow, you can monitor the electrical buzz between the cells and track how well they’re developing and working together. But so far, this method had a pretty sever limitation. It could only be done in two dimensions, one less than we need for viable organic structures. So much potential but so problematic to implement.

Well, researchers at MIT decided to tackle this problem and came up with a new biocompatible material that could be arranged into a proper three dimensional scaffold and monitor both the structure and function of an organ. After successfully growing cardiac muscles around a mesh of this electro-sensitive substance, they were able to monitor the effects of a chemical that speeds up heart rate. Using their method, we could obtain a treasure trove of new data about how well a future artificial organ will grow and run it through a battery of tests to make sure it’s fit for clinical use to replace a damaged or failing organ. Even more interesting would be the opportunity for doctors to keep monitoring how the organ is doing and give patients advance warning should a health crisis be imminent. Imagine a future in which your aging and failing vital organs could be replaced with wired versions of themselves and report on how well your body is doing, giving all sorts of useful warnings should something new go wrong. Better yet, the mesh would simply read the behavior of the cells around it and report it back to a system which can make sense of the detected patterns so there’s not delicate, over-engineered instrument sitting inside you.

And all that brings us to another question. Could nanoparticles made from this material hitch a ride through a patient’s bloodstream to the liver, lungs, heart, kidneys, possibly into some key parts of the musculoskeletal system, maybe even the brain itself (though that would be a major challenge in and of itself), and monitor his or her health by listening to the patterns of electrical signals emitted by the organs’ cells. Could be a path to early detection and treatment of cancer strains that grow into tumors when we learn how to track the electrochemical signs of a malicious cell being formed? The possibilities posed by this technology are really quite amazing and come with great potential for new medical markets. Let’s hope there will be a lot of follow up to see if it really would be possible to make us all cyborgs with internal biocompatible sensors that will help us better diagnose what ails us as our bodies accumulate wear and tear. It sounds an awful lot like a science fiction movie, true. But in this case, the technology is very real and we have some very good ideas out there for how to turn it into science fact with the right funding and expertise behind this invention’s spin-off projects.

See: Tian, B., et al. (2012). Macroporous nanowire nanoelectronic scaffolds for synthetic tissues Nature Materials DOI: 10.1038/nmat3404

oscar pistorius

Apparently, so I hear at least, the summer Olympics are currently going on in London. Obviously, I haven’t been watching any of the events when not working, or had them on in the background while writing posts and switching up the template, or stay glued to them at the gym. No, not at all. Why, a public admission of a binge on Olympic sports would surely wreak havoc on my nerd cred. But I digress. Aside from the profiles of the U.S. women’s gymnastics team and tributes to Michael Phelps, which I’m told have been airing incessantly, another huge story at London 2012 is Oscar Pistorius’ historic attempt to use his Cheetah Blades in competition alongside athletes using their biological legs. After years of IOC’s suspicious glances at his artificial legs, he was finally cleared to compete, and despite coming in last in his final race, he did qualify for a semi-final, something that a good deal of perfectly able-bodied athletes couldn’t manage to do.

So all in all, he did quite well and managed to show that our technology is making life without seemingly crucial limbs quite manageable, so much so that Pistorius can professionally peruse track and field, a sport that generally requires its competitors to have a pair of working legs. So what about the future? As Bob Costas asked, will we see an Olympics in which athletes use technology to gain an advantage rather than overcome a physical limitation? I would say that we will and we won’t. Follow me on this train of logic. Today’s athletes train with technology, medicine, and under the tutelage of experts armed with knowledge that was considered science fiction just a generation or two ago. They all benefit from new medicine, better training methods, better nutrition, and sage advice, so in many ways, technology is already providing an advantage to modern athletes. We just assume it as a given.

But there are some limits involved as well. Recall the controversy that ended the super swim suit era, a time when arming a professional swimmer with a high tech suit would guarantee that world records would be shattered right and left. The problem was that the competition came down to who had the better suit to help eke out a small but decisive advantage, not who was the better athlete, and the sport’s authorities decided that enough was enough. So were some sort of new suit of implant give Olympians of the future a slight edge, it would most likely be swiftly banned since it would violate the spirit of fair play. On the flip side, implants that would make someone superhuman are going to remain more fiction than fact due the complex medical and ethical issues involved. If anything, future athletes will simply reap the benefits of overall better science and technology that will guide their training rather than try to become super powered cyborgs.

Simply put, if you want to make the competition fair and reward those who trained the best, had the most focus, and executed better, not those who had a nifty truck up their sleeve, you’ll have to make sure that none of the athletes are relying on a gimmick or a gadget to win gold. This is why the IOC was so wary of letting Pistorius race. It didn’t want to be seen as giving a competitor an unfair advantage or tipping the playing field in an athlete’s favor by not doing its due diligence. After all, it’s part of their job. Lucky for everyone, they did their homework well, and came to an evidence-backed, fair result. Pistorius got to race, the Cheetah Blades were shown to be excellent substitutes for parts of biological legs rather than techno-wizardry that could enable someone to cheat, and the door to wider acceptance of advanced prosthetics was cracked open. Maybe Pistorius didn’t capture a medal, but he’s certainly going to leave London with a big win.

[ photo illustration by Oakley ]

Once upon a time, I was talking to a friend about some of the more popular utopian sci-fi worlds, particularly, the world of the Jetsons in which we were predicted to have primitive robot maids, apartments in the sky, vacations on a lunar base or a city on Mars, and 30 hour work weeks for even the most workaholic nations. As we discussed the likelihood of all this happening in the near future, she brought up a point about George Jetson I didn’t even bother to consider. If he was a real person who lived the way all residents of his future do, he should weigh a ton, literally. His lifestyle isn’t even sedentary, it’s stationary! Everywhere he goes there are moving walkways, escalators, elevators, hover-pods, and so on and do forth. The man only needs to lift a finger to eat and that’s actually not always the case. And considering his near-constant immobility and certain morbid obesity, he, as well as every other typical resident of the future, would contribute to private and public healthcare budgets that would soar into the hundreds and hundreds of trillions, dying between two years and two decades early.

Don’t just take my word for it. A recent study shows that a sedentary lifestyle costs two years of your life and at least every twenty minutes, you’ll need to get up and walk around to mitigate the ill effects of sitting still. No matter if you put in an hour a day three to five days per week at the gym as doctors recommend, a job in which you sit at a desk, or wheel, or a machine, all day is going to be detrimental to your health. Trouble is, it’s not as if you can just excuse yourself from the typical hour long meeting or an intense assignment to go stretch. This is simply not how white collar jobs are designed. So what about blue collar workers who get to stand most of their day and move around on a regular basis? Why don’t we re-finagle our cubicles and offices to allow more mobility and require less time that our rear ends press down into our seat cushions? Well, there’s a problem with that too because standing too long and too much causes joint pain. So we’re back to the 20 minute break schedule that’s downright impossible for most workers, from mail room interns to CEOs if we want to live just a few years longer. Guess that’s another argument for why cubicles are pure evil and humans don’t belong in them and why we shouldn’t be standing in the same few spots on an assembly line year in, year out…

It doesn’t matter how fit or young or healthy you are, when you get a bad case of food poisoning, you will quite clearly be reminded of the fact that you’re a mere mortal. And then the hospital bill will remind you that getting sick in the United States is a rather expensive affair. Back in January of this year, a tainted pizza picked a fight with my stomach and until I got to the emergency room, it was winning. After a shot of something to stop what were the most immediate and painful symptoms, and two quick blood tests, I was sent home to recover for a few days. So how much did three hours at a hospital, one of which was spent waiting for treatment, cost? Just a little over $4,000 with the hospital charging about $3,000 of it and the doctor asking for the remainder. Lucky me though, I can buy insurance so I’m only on the hook for… oh, $2,000 because that’s my deductible. I could try and get better insurance, but even for a healthy non-smoker under 30, a $1,000 deductible is the smallest you’re likely to get and it will cost as much as it would to lease a new economy car. But remember, we’re lucky to have the medical system that we do, otherwise, we’d have to ensure socialistic rationing nightmares.

Certainly, paying between $2,000 and $4,000 for an emergency room visit is worth it not have any government agencies involved in deciding what care you should receive. The decision will be made by a case manager at an insurance company who will determine what care to authorize based on your plan, and if your doctor dares to prescribe a pill that’s too expensive for their tastes, they’ll simply refuse to cover it for you. And certainly, it is their right as private parties not to cover you, and we certainly couldn’t expect the public to pick up the tab for random freeloaders who think they have the right to get sick and expect medical care. If they don’t want to have medical debt or need treatment, they shouldn’t get sick in the first place because you can prevent getting sick from anything as long as you really put your mind to it, right? So say a college student living mostly on loans is driven to the ER with food poisoning after eating something shady to save a few bucks on food and winds up with a $4,000 medical bill. Can we, with a straight face, insist that this is fair to everyone involved? Do we just say that the student can sue whoever sold her the food that sent her to the hospital and that some very basic, straightforward treatment should really cost thousands and thousands of dollars?

Suing the place that sold the questionable food is an expensive and lengthy ordeal that’s hardly guaranteed to work out in the end, and the health inspector is likely to only give the establishment a slap on the wrist unless there’s a huge flood of lawsuits coming their way and the kitchen is literally crawling with roaches. Meanwhile, the student is looking at incurring medical debts that could stick around for years unless she’s under a terrific plan through her parents. Sure there’s a maze of forms from charities and government funds that she may try to navigate to get more of her care covered but they take a healthcare professional to fill out properly and to be frank, having someone jump through so many hoops for what should be a very simple and inexpensive round of treatment is ridiculous. The healthcare system in the United States can only be described as dysfunctional because it’s guided by conflicting principles, confusing regulations, and its pricing and cost structures are the definition of absurdity. On the one hand, we say that we need to help those who are sick since many of those who are, didn’t decide that today would be a perfect day to get into a traffic accident, or be diagnosed with life- threatening illnesses, or even have food poisoning. And yet, we’re constantly afraid of "freeloaders" who dare to expect the hospital’s resources to be used to help them when they get sick and have no insurance.

And the confusion goes even deeper. We get riled up at the idea of governments deciding who gets care and who doesn’t, but seem perfectly fine with insurance companies who try to make a profit by not covering care in the role of the "Death Panels," a role they’ve occupied for years. Why? Because it’s less direct? Because it’s a more digestible idea we can hinge on money rather than think about its ethics? And why does basic care cost so much? We know that waste is a big part of the problem as are fraud and litigation, but between all of those things combined, we still have more than a trillion dollars worth of medical care left unexplained. Even the fact that Americans have been eating themselves to death for the past two decades and the same punditry that preaches personal responsibility in healthcare grabs their torches and pitchforks when someone suggests a few more salads to the 66% of the country that needs to lose weight to live a longer life, doesn’t account for all of it. And this is the real problem with every major healthcare bill considered since the 1990s. Instead of trying to sort out our philosophical contradictions and to get to the bottom of why medical care is so expensive in the United States, it offers little more than overcomplicated band aids. As healthcare costs grow, politicians either twiddle their thumbs or regurgitate stale, predictable talking points. But hey, they get medical care paid by our taxes. Why should they care about this? It’s not like they’ll have to pay $2,000 after eating a bad pizza.

We’re not talking about healthcare being free of course, that’s impossible because someone will always have to pay the doctors and cover the cost of operating the hospital and its equipment. But at the same time, what a libertarian would describe as a "free market solution" doesn’t apply here because when you need emergency medical help, you don’t have time to shop around to find the right hospital. I know of no one who makes totally rational, logical decisions when he or she is really sick and even if he or she did, emergency room visits tend to be equally expensive wherever you go. Likewise, it seems crudely selfish to declare that anyone not happy with the runaway costs of healthcare in the U.S. is a freeloading socialist whiner who expects to be taken care of by everyone else. The issue is not black and white, and no "illegals and welfare queens" is not the answer to every question about the cost of medical care out there. And until we can actually put all the facts and all the options on the table, and consider them without radical partisan insipidity, we’ll have a healthcare system that functions despite its best efforts to collapse under its own weight, trudging onwards with no guidance and an impassioned, tangled mess of contradictory principles instead of a standard or goal.

[ illustration by Denis Zilber ]

wired cyborg girl

If you think we’re in data overload now, just wait until the numbers of so-called wired patients swells. A profile of one such patient appears in MIT Technology Review, and foretells of a future in which patients track over a few thousand biomarkers to identify the onset of chronic diseases, have their genomes scanned in, out, back and forward again, then sideways and inside out, and everything about them is being constantly tested. Now, from the side it would certainly seem like this constant prodding and measuring would seem like hell and the patients who’ll want to sign up for something like this will be hypochondriacs. But would that really be case? If you want to be a wired, hyper-analyzed patient today, you have to be extremely proactive, have roughly $50,000 or more per year to cover the costs of testing, and supervise the tests yourself. In the future, things could work quite differently and various nano sensors working their way around your bloodstream until being flushed out by the body to make room for another wave, would silently collect your vitals and only alert you if where’s a real emergency or if something’s really off. This sort of passive scanning wouldn’t require dedication to a battery of tests and instead, give the patients peace of mind. If something’s actually wrong, they’ll know it quickly.

Usually the faster you catch an illness, the faster it can be treated and the greater your chances of beating the disease, especially when it comes to potentially terminal but difficult to detect conditions like certain cancers. Having a little nanobot army patrolling your body for disease and keeping track of how things are working has the potential to detect these dangerous conditions before they start doing real harm and guide doctors’ future smart medications to newly arisen tumors for biopsies and treatment. Keeping track of such things as weight and cholesterol could allow the patients to take better care of themselves too, knowing when they can afford a caloric splurge and when they better moderate their diet habits for the sake of their hearts and waistlines. The hoped for result? Patients living longer, healthier, fuller lives, doctors who know what’s going on with patients so they can make more accurate diagnoses and recommend more effective treatments, and yes, savings for health insurance companies and their customers by reducing the number of claims generated by conditions that have become chronic and require constant medical care and supervision. Of course the testing would be an ongoing expense but it would be a lot cheaper to cover ongoing personal tests than decades of claims for those suffering from diabetes, hypertension, heart disease, and other chronic maladies.

Hold on a second though, doctors would say, over-testing is not a panacea. How much good will we do many patients by keeping them anxious and doing test after test on them? After all, when you really set out to find an anomaly in the human body, biology won’t disappoint. How much time and money should a patient invest in a potentially dead end, examining and reexamining something harmless? All of this is certainly true, but doctor- driven objections to wired patients aren’t so much objections to the testing itself as much as they are a strong argument for guided measurements by automatic systems certified to keep track of a patient’s vitals without a constant necessity to perform test after test after test at a doctor’s office, silently analyzing biomarkers unless very real concerns emerge. You don’t think of your firewall and antivirus every time you use your computer and unless there’s a virus actively trying to infect your computer or some piece of malware trying to broadcast what its found on your hard drive through the web, you wouldn’t want it in the way. But would you really want to turn it off completely with the idea that the more you scan your computer and find cryptically named files, processes, and filders you can’t readily identify, the more paranoid you’ll become that your machine has been infected so you’ll spend a lot of money buying more and more tools to scan and re-scan harmless data?

Again, the goal here is balance and automation. Those utterly paranoid about their health will always exist, as will those who’ll misinterpret an elevated or low, but still perfectly safe, level of whatever in their blood or stool or urine. Nothing can be done about them. But the vast majority of people who should be wired with a swarm of medical nanobots in the future would be more than content with simply knowing that should any dangerous disease or condition start rearing its ugly head, they’ll be alerted and sent to the doctor promptly, with a much higher chance of being effectively treated and cured. Who wouldn’t want to be told when his or her behavior is trending into health-endangering territory? Obviously we can’t make acting on the information compulsory but we have to at least inform the patients, and sometimes, just a little information would make all the difference and just a few tests carried out in time can save someone. If technologies on the horizon will let us to improve and save millions of lives, why dismiss them as burdensome and excessive just because there will be some hypochondriacs who’ll will get carried away with them in their search for an illness they’re sure plagues them, as if they don’t get carried away with anything today? If we want to improve medical care and lower the cost of healthcare, we need to enable wired patients and get systems that will help them stay healthy to market.

Quick, how do you tell if someone is alive? Either check for a pulse or if the person is still breathing. But there seems to be a very, very serious possibility that checking one’s pulse wouldn’t tell you anything because a lot of perfectly normal and seemingly healthy humans will walk around without a heartbeat thanks to an artificial heart which does away with a pulse, reduces wear and tear to a bear minimum, and was designed not as an experimental, last resort bridge to an organ transplant, but as a substitute for one. By sheer accident, a duo of doctors discovered that a well-tested and long proven heart assist device could take on the job of a heart in a few extreme cases and set off to create a mechanical vital organ in which function overtakes natural form. The video below is a terrific introduction to the concept, but be warned that it features pretty graphic surgery and is definitely not for the squeamish, the faint of heart, or those whose knees get wobbly at the sight of blood…

Also, make sure to read the Pop Sci feature story on the subject which gives an even more detailed account of the doctors behind the research and the questions they had to answer along the way. One of the important things to note is that their idea may not seem all that extreme or groundbreaking when we get into the details, just a combination of devices that have been used for decades with great success. But what makes it such a major accomplishment is that no one seemed to have thought of creating a no-beat artificial heart because of the laser-like focus on the fact that our own heart beats and therefore, that beat must be important to the body at large. In reality, the heart seems to beat only to take in the nutrients it needs to keep beating and as long as there’s a steady flow of blood to the rest of the organs, we’re no worse off for it. And that’s what a breakthrough is really all about. Realizing that we can try something seemingly too simple to work just to see what happens and find that the conventional wisdom is wrong via the scientific method. Even more importantly, this story is a great example of how failure can be beneficial as the failure to treat two patients lead to an artificial organ that could save millions of people suffering from organ failure or those who would otherwise die in the OR.