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The value of life

coffee and tea doodles

value is what we make it

Episode 3 / Season 13 of WNYC’s Radiolab asks, “What is the value of human life?” in a story titled, Worth.

This article questions how much life is actually worth to us. On the street, they put the question to passers-by in the form of, “What would one year of healthy, productive life be worth to you?”

Answers ranged from the ridiculously small ($5 – surely life is worth more than a Venti Frappacuinno at Starbucks) to the absurdly high ($10,000,000 – perhaps it would we worth that to someone with a net worth in the billions, but probably not for the average person.

Is a year worth the salary you make in a year? Apparently non-working spouses (or young children) are worth zero.

Is it the same value for every person? Is a year of my life worth as much as that of a fortune 500 CEO’s. The President? A Nobel Prize winner? A crack dealer?

Read the rest of this entry »

 
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Posted by on December 29, 2014 in Uncategorized

 

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Who isn’t fascinated by Ötzi?

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                       Otzi, the iceman

Radiolab posted a story about one of the most complete, ancient humans ever found. Most interesting is that we have no idea of who this man is. Ancient Pharaohs buried in tombs with slaves and riches have indications of who they were surrounding them. Ötzi was just a man hiking through the mountains who was killed and left with all (?) his belongings where he was for more than 5000 years.

Was he a trader?

A thief?

A hunted man?

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We know very little of the human circumstances that led this man into the mountains to his death by arrow and stone. We only have the forensic evidence he left. He was about 45 years old, he had wounds on this hands, an arrowhead in his shoulder bone, Pollen from both valley and mountain trees (layer as mountain,valley,mountain) in his intestines and la large meal of bread and goat meat in his belly. Genetically, he was lactose intolerant. He is related to people from Sardinia and Corsica and was infected with lyme disease, dental caries and whipworms.

As always, Radiolab gives us a taste of something interesting and leaves us hungry to fill in the gaps. Otzi has been known for twenty+ years now, which has allowed for fairly complete analysis of the body. Find more about him through the wiki site here or the museum in Tyrol devoted entirely to this find here.

 

 
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Posted by on November 23, 2013 in Uncategorized

 

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Devilish Tumors

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     You poor devil

RadioLab recently updated and rebroadcast their Tumors episode (RL link). This includes a story about President Grant’s tumor kept in a cigarbox in museum archives and one about the transmissible facial tumor plaguing Tasmanian Devils. The tumor, known as Devil Facial Tumor Disease (DFTD) is a rare case of an infectious cancer. This is the one that I wanted to think about some more.

What do we know about tumors? How do they arise? Why is cancer so much more prevalent today than ever before? What makes these Tasmanian Devil tumors especially nasty?

What do we know about tumors?

Actually, quite a lot. And many new therapies are very successful – especially those that target very specific kinds of tumors. In 1963 Todero and Green   (http://jcb.rupress.org/content/17/2/299.full.pdf+html) established both a cell line and a precise methodology for growing cells in culture that permitted researchers the ability to recognize specific changes in cells grown in culture – changes such as becoming non-responsive to the presence of other cells that should control cell division.

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                                              30 years of p53 research

Over the years a number of tumor suppressor proteins and proto-oncogenes have been identified. These are the proteins responsible for restraining cell cycle in the event of DNA damage. Among these is p53, the most frequently altered protein in cancer. It was originally identified in 1979 and has since been shown to arrest cell cycling in the event of DNA damage, initiate repair protocols and start a ‘countdown’ to self-destruction (apoptosis).

A number of additional mutations have been defined in proteins that either promote cell cycle progression (proto-oncogenes) or arresting cell cycle progression. Each of these proteins may be mutated in a different way, but the outcome is always the same: cells are pushed through their cycle despite the presence of DNA damage.Image

Beyond this, more processes have been found to contribute to tumor success. Some tumors promote angiogenesis (the growth of new blood vessels) to feed the tumor. Some have mutations that allow them to break off of the main tumor mass and survive in the blood or lymph and migrate to new areas. Some tumors perform tricks to escape recognition by the immune system.

In time, successful tumors may do all of these things. And how can they mutate so quickly and skillfully? It all goes back to p53. When a cell doesn’t slow down and correct errors in its DNA – and when it does not self-destruct when these errors are too damaging, the cell is free to mutate again and again. Each mutation is like a new child that either does better or worse in its environment, with only the successful ones living to spread their genes.

How do they arise?

Tumors arise when DNA damage occurs in just such a way that it escapes notice by the cell and starts to multiply. Actually, we think that a lot of tumors start up, but get weeded out by our immune system again and again. The ones we see are those that were successful enough to evade our defences and grow up. (immune surveillance: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1857231/

Why is cancer so much more prevalent today than ever before?

Because we live so much longer. The increase in cancer rates does not come from cancer becoming worse over the years, but comes from the fact that we live long enough to get it

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      We’re getting old … Unfortunately, that means we’re getting cancer too

 

 

What makes these Tasmanian Devil tumors especially nasty?

Transmissible tumors are rare because of the conditions required to allow for them are also very rare. In the case of DFTD the stars aligned in just the right way to allow this to occur.

The first requirement is that a tumor must have evolved sufficiently to be able to spread throughout the body of the initial host and be expressed on the face of this animal.

Second, this tumor was amazing in that it could start growing even in new animals if cells should be transferred from one to another. This may have something to do with the uniformity of the devil population and/or the way that these tumors ‘hide’ cellular markers that would otherwise expose them as bad/ foreign cells. The latter of these explanations is supported by data such as: pnas “reversible epicene tic down-regulation of MHC by devil facial tumor…” Siddle et al vol. 110 no. 13

(my question now is: don’t these devils have NK cells that should eliminate these MHCI-deficient cells?)

 

Perhaps most importantly, these tumors affect animals that are naturally aggressive towards other members of their species in both feeding and sex. Because devils bite one another so often, they provide just the right opportunity for cells to jump from one animal to another.

There is a similar case of a canine transmissible tumor (“tumor cells spread canine cancer” in the scientist, August 10, 2006 by Melissa lee Phillips.) but other than that, these types of tumors are not often seen.

Altogether, this is a fascinating case that illustrates some peculiarities of tumors, DNA damage control and immunology.

The devastating effect of this tumor epidemic is that it has precipitated a dramatic decline in devil numbers now making them endangered of extinction.

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Visit the ‘Save the Tasmanian Devil’ website for more information about their condition. (:  http://www.tassiedevil.com.au/tasdevil.nsf)

 

 
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Posted by on October 27, 2013 in Uncategorized

 

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RadioLab – Speed

flash-crash-dow-popupWhile listening to the latest RadioLab, “Speed” story about automating stock trading, I could immediately remember being in the kitchen, listening to NPR and hearing the updates on the crashing Dow. The flash-crash of May 6, 2010. Stock analysts were going bananas describing an unprecedented drop in the markets that was both incredibly steep and incredibly deep.

I wanted nothing more than to put any money we had into a Dow indexed fund – it was painfully obvious that this was just a computer problem and that it should correct soon (I thought perhaps over the next few weeks). Of course it was impossible to get into my ING sharebuilder account (a great saving device that everyone should have – I started mine as a poor graduate student putting just $50-100 a month into my account).

But the thing that really struck me as I listened was how like biological evolution the race for speed in stock trading is. It was mentioned that speed always wins in the market, the faster you are, the earlier you can act on key information and make easy-money trades to take advantage of

even minute swings in the price of stocks. (OK, an aside: I can’t ignore it, how is this investing? So much of this segment uncovered the truth about so much big money on Wall Street… it’s not about investing, it’s about taking advantage of the system and making money on glitches and technicalities. It’s not clear how this supports – or even has anything to do with entrepreneurial endeavors.)

The race for speed was compared to an arms race where warring parties take every opportunity to turn an advantage over their peers. But what about diminishing returns on these

investments? Can there be an end to this sort of arms race? Despite the apparent cost and distraction of focusing on details like the length of wire between your home office and the NYSE, the game is unavoidable. Why? Because it IS a game. And both game theory and evolution by natural selection can inform us about why these battles go on, and why they can’t end.

In game theory, there is the economic /  trust game referred to as the prisoner’s dilemma. Here, I lifted this description of the game from wikipedia:

“Two members of a criminal gang are arrested and imprisoned. Each prisoner is in solitary confinement with no means of speaking to or exchanging messages with the other. The police admit they don’t have enough evidence to convict the pair on the principal charge. They plan to sentence both to a year in prison on a lesser charge. Simultaneously, the police offer each prisoner a Faustian bargain. If he testifies against his partner, he will go free while the partner will get three years in prison on the main charge. Oh, yes, there is a catch … If both prisoners testify against each other, both will be sentenced to two years in jail.”

The game’s outcomes are presented in this grid, making the dilemma clear:

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Biggest payoff: convince others that you will keep your silence with them, then sing like a canary and go free while your friends rot in jail.

In this game trust is nearly impossible, but it is the only way both prisoners can benefit. But who can be trusted? Life would be so much easier if we could, but experience tells us that there will always be cheaters in games of trust and it’s best to bet on deception.

Why does this remind me of biology?

sun

On the left, all trees ‘agree’ to keep to a set height and no one gets shaded out. On the right, one cheater takes advantage of the others’ trust and grows tall.

Because evolution works the same way. Every organism does everything it can to get ahead. Think of trees in the forest. If only the trees could come to a deal: “None of us will grow above ten feet tall. We can all save energy that way and be better off.” After all, the whole benefit in growing tall is to monopolize the sun and shade out your neighbors. But as soon as one tree breaks the bargain, all bets are off and the arms race begins again.

Amazingly, if the arms race is allowed to go on, a situation much like that depicted on the left occurs. The only difference is that all the trees have expended much more energy and they all stand taller, evening out at the point that physics and environmental conditions become limiting.

 
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Posted by on February 11, 2013 in Education

 

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RadioLab: Source of great conversations

I wasn’t searching for a way to talk about death and the end of life discussions that families must have about it. I was just transporting my son from our home in Paola, KS to his gymnastics class in Lenexa. It’s a thirty minute drive – give or take. Perfect for a good conversation or a couple songs – perfect for a RadioLab Short.

My son is seven and we both like listening to these programs on our drives. I know he’s a little young for much of the material, but it always makes him ask such good questions. It challenges him in his thinking and he gets to see a parent consider and turn over new ideas too.

I wasn’t paying strict attention. I was driving. I was zoning. I was in the audiobook / NPR / Podcast Groove. My eyes on the road, my mind on a walk with the program. We were driving North at about 70 mph and absorbing the program as it pulled us in, bit by bit.

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Doctors who would accept given care options if they were in a state of advanced illness

The Bitter End – a short about how doctors and lay people see end of life care through very, VERY different eyes. To be honest, there was nothing very surprising in the discussion on the radio. Despite the fact that I am not a clinician, my viewpoint of end-of-life care was precisely in line with that of most medical professionals that were surveyed in this report.1 But, that’s a completely reasonable consequence of the proximity of my work to the medical field, having many close friends who are physicians -even my wife in a clinician.

The reality is, people who work in and around hospitals and people who’s impression of hospital care is shaped as much or more by real hospitals than those in TV land, have clear, unromantic ideas about what end of life is like. Also, we have seen more and talked about more situations of ‘heroic’ interventions and know what those outcomes look like.

For instance, my aunt had a heroic intervention by a neurosurgeon following her seizure and fall on the stairs that resulted in a severe head injury, best left to its natural conclusion. Instead, I listened to the doc pat himself on the back for his ability to save her life and turn a sudden trauma with a virtual DOA arrival at the hospital into a yearlong struggle with finding her care as she remained in an unresponsive coma. Oh, and I almost forgot, that meant that we had to actively make the decision to withdraw her feeding tube and fluids so she could die slowly over a number of days in the only legal outlet from this terminal condition. So,… thanks, Mr. Surgeon. Good work.

As I said, I was sort of in the zone and not thinking until we came to a stop at a red light and I suddenly remembered my seven-year-old passenger and thought about what we were listening to.

I don’t believe that there is anything wrong with talking about death – even with children. Death comes to us all in time and we all lose parents and friends and other family. Nevertheless, I thought I might want to take a quick exit before the story went too far. But to turn it off, I had to ask if he had been listening (yes) and would he like to talk about what we heard? (also, yes)

I was relieved when he told me that if I was in the hospital and going to die that he would tell the doctors to give me a ‘sleep shot.’ Then he thought about it … and thought about it some more… And then the waterworks started and he was wailing about how I couldn’t even die, nor his mother, nor his grandmother (Oma) – who would mend his blankie?! No. None of us could ever die. And he would tell the doctors to do anything and everything they could to keep us alive for one more day, one more hour, or minute, or second. And when we died, he wanted to die as well.

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Are you feeling lucky?

I let him cry a bit and brought him back from the brink with some cuddling in the parking lot of the Chinese restaurant we were headed for. Then we had a nice talk about cognitive dissonance before we drowned our sorrows in wonton soup.

Reference

1. http://www.jhu.edu/jhumag/0601web/study.html

End of Life Care: A RadioLab discussion

 
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Posted by on January 17, 2013 in Uncategorized

 

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Listening to House of Dreams

Today the midwest got hit by its first winter storm. At least it was the first storm to hit the Kansas City area. It even had a name, Draco – I didn’t know storms like this were named. Because of this storm, I had a lot of time in the car going to Home Depot and back to pick up some building materials to repair the workshop (which looks like it has been neglected for a decade or more).

All this time in the car means a lot of podcast listening. We heard the latest Radiolab, which contained a great lead-in story about Aleksander Gamme’s solo walk to the South Pole and back.

But, the podcast that really touched me on a personal level was from Freakonomics. It was about a family home and how it can feel like another member of the family, a living part of your memories. This podcast took a turn to talk about how the host, Steven Dubner’s, home had gone from a family centerpiece to a swingers’ retreat. But that’s not what intrigued me.

Instead, I got to thinking about memories and the feeling of ‘family.’

When I was a kid, I had some wonderful ‘golden years.’ I don’t know how else to describe them. Our family was close – both geographically and emotionally. We celebrated holidays together, had group birthday parties (because otherwise there would be too many) and vacationed together. These vacations were all coordinated by my grandparents, who rented a beach house in Rehoboth, DE every summer and had everyone down.

We spent the days on the beach and the nights playing cards together around the dinner table. Playing cards was my favorite part. We mostly played a version of solitaire, which oxymoronically, combined the games of innumerable players into one raucous mess. We also played Hearts a lot and would delight in not just winning, but pounding one poor victim mercilessly through the night (usually a younger, weak player).

Then, in 1994, my grandmother died and shockwaves went through our family. I think we all knew that she was the one who coordinated things, but none of us knew just how central she was. When she was gone, the family fractured and drifted apart.

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Hermann Hesse

Years later, I think some things have improved, but we will never be the close unit we once were. Perhaps it was inevitable. As families grow, there are simply more people and the family unit refocuses. I’m reminded of the Hermann Hesse novel, The Journey to the East.

This novel has a story, but the story is not what is important. What is important is “The League’s” spiritual journey. From the Wiki page, “Although at first fun and enlightening, the Journey runs into a crisis in a deep mountain gorge called Morbio Inferiore when Leo, apparently a simple servant, disappears, causing the group to plummet into anxiety and argument.”

Leo, the servant was really the leader. Only no one knew this until he was gone.

I never thought of her as a servant, but I never knew how much a leader she was.

 
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Posted by on December 21, 2012 in Personal Life

 

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RadioLab’s Inheritance Podcast

Screen Shot 2012-11-30 at 9.41.46 AMMy son and I just listened to a completely engrossing podcast on inheritance from RadioLab. The episode had three stories about different aspects of inheritance and genetic control. The first didn’t capture my interest nearly as much as the next two, so I won’t discuss it here.

The second story proposed and interesting idea of Lamarckean inheritance based on the extraordinary record-keeping of a far-north town in Sweden. In this town, the church kept amazingly detailed records about births, deaths, disease, health and even crop production year to year. When all these data were analyzed, researchers found a strong correlation between the availability of food to men in the village and the health and wellbeing of that man’s children. What might seem unintuitive is that contrary to what you might think, the children of men who suffered through years of starvation when they were ~9-12 years old fared the best. If dad ate well, your health prognosis was poor. If dad ate poorly, your prognosis was better. The effect even seemed to trace down two generations.

The explanation for this was that at this time in a man’s life he is making the cells that will go on to make sperm. Somehow, these cells can receive genetic imprinting that improves the fitness of the offspring.

Let me stop here. I have to say, I think this is entirely unconvincing. I can think of at least one simpler explanation for these data. Further, I can easily imagine how if it was possible to turn on these beneficial changes, evolution would make this the norm rather than the exception.

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Example data. A) Population lifespan following feast years, 100% survival. B) Population lifespan following famine years, 50% survival.

Consider a population of 100 kids in the target age group during a year of ‘feast.’ 100% of these kids survive and have children. These children have an average lifespan of 50yrs. Given the same group during a year of ‘famine.’ 50% of the kids survive and have children. The children live to an average age of 75 yrs. It appears that the famine during the elder generation improved the fitness of the younger.

But, if we examine the ‘feast’ population again, we might see that they can be broken up into two natural groups, one with a 75yr lifespan (the healthier 50%) and one with a 25yr lifespan (the less healthy). If the famine year selectively kills the weaker kids, then we are simply selecting our way to better health rather than causing it.

Because this is published research I expect that this simple answer was excluded somehow and I hope to find the original work to see that, but the burden of proof rests on the group proposing the more complex explanation.

I’ll see if I can research this a little and write again later, but I wanted to comment right away because I thought that it was an interesting example of how numbers can sometimes lead you astray if you’re not careful.

Oh, and very quickly, the last story…

The last story was about a woman who had adopted a baby girl, Destiny, from a mother who was addicted to drugs and couldn’t support the child. Amazingly, the next three years after that, the same mother gave birth to three more addicted babies that were all adopted by the same family. Because of her frustration about how this woman was so casually bringing more children into the world, one a year, each addicted to heroin et al. at the time of birth, the adoptive mother tried to pass a law to somehow prevent this from happening. When that failed, she worked directly to set up a fund to pay addicted women to undergo surgical sterilization or get long term birth control.

Many saw this as eugenics in action. Personally, I see no convincing connection to eugenics whatsoever based on the fact that the procedure was voluntary and based on a behavior rather than an innate characteristic of the women. Nevertheless, the conversation went places I never expected – mostly because I thought Jad and Robert would not get drawn into such ridiculous speculations and extensions of logic as they did. It was still good listening though.

I highly recommend checking out this episode.

 
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Posted by on November 30, 2012 in Uncategorized

 

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