Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts

Friday, April 29, 2016

Cryonics, Smallpox, and Pope Pius VII

I remember when heart transplants were front-page international news, not local human interest stories: and when oral polio vaccine replaced injections. I really do not miss the 'good old days.' I remember them, and they weren't.

I also remember when cryonics was 'science fiction stuff,' not a highly-experimental and controversial medical procedure. I probably won't live long enough to see whether it works. But if you're young enough: you might.
  1. Heart Transplant: "a Rebirth of Sorts"
  2. Cryonics: Life, Health, and Decisions
Since I'll be talking about life, death, and medical practices, I'd better start by saying that I'm a Christian: a Catholic.

Like it says in the Apostles Creed, "I believe in ... the resurrection of the body, and the life everlasting." I'll be explaining why I don't see a conflict between that belief and trying to save lives.

I had more to say after discussing the 'cryonics' news item, so this post runs a bit long:

Multiple Surgeries


By the time I started kindergarten, one operation had given me a mildly-functional left hip joint — and another had fixed a complication that may or may not have resulted from the first procedure.

Decades later, I had both hip joints replaced; carpal tunnel surgery done on both wrists: and was in the operating room again when part of my lower digestive tract went bad.

I'd probably have died if the latter had happened in the 'good old days.'

Needing hip joint replacements wasn't a surprise.

Getting a diagnosis of depression and something that's currently pegged as being an autism spectrum disorder — not so much, either, in retrospect.

I'd gradually learned that many folks transition into adolescence without having the light and color drained from their world: metaphorically speaking.

There wasn't much wrong with my vision, apart from extreme nearsightedness. I could still notice that beauty existed, and analyze the phenomenon: but the emotional responses were largely missing.

An array of powerful antidepressants and other pharmaceuticals have been changing that in recent years: which is a very nice change of pace.1

That brings up an interesting question: am I facing the wrath of God because I defied the Almighty by letting doctors keep me alive and somewhat healthy?

I don't think so.

Being Healthy


Let's back up a little, and ask another question — "is being healthy okay?"

Maybe that sounds like a daft question, or maybe not. I've run into a few excessively-sentimental 'lives of Saints' tales that focus on Saints who were very ill.

Saints are noteworthy for their heroic virtue and living in fidelity with God, not for being horribly sick, and that's another topic. (Catechism of the Catholic Church, 828)

Life and health are good things, "precious gifts entrusted to us by God:"
"Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good...."
(Catechism, 2288)
Maintaining health and fitness is important: but it shouldn't be the most important thing in my life. Being healthy is okay, but it's wrong "...to sacrifice everything for it's sake, to idolize physical perfection and success at sports....." (Catechism, 2289)

That seems clear enough. Being healthy is okay. Staying healthy is okay: within reason.

It's okay to help sick people get better, too, and find new ways to cure disease. It's even okay to transplant organs, providing we don't kill or maim one person to help another. (Catechism, 2292-2296)

Even if a disease or injury would eventually kill me, medical treatments — including painkillers — are okay: within reason. (Catechism, 2276-2279)

Using our Brains



(From Correogsk, via Wikimedia Commons, used w/o permission.)

I occasionally run into news about someone who decides that getting medical treatment is immoral. If the person is Christian, the idea often seems to be that we can either use our brains or trust God: not both. Or maybe it's that being sick is divinely ordained punishment.

I trust God and use my brain, or try to; and don't think God gave me bad hips and glitchy neurochemistry as a punishment.

I'd better explain that, or try to.

After the Eden incident, our mental picture of God has been distorted.2 (Catechism of the Catholic Church, 396-401)

Maybe life would be easier if God treated us like Pavlov's dogs, promptly smiting 'sinners' and rewarding good behavior with yummies. But that's not how it works:
"But I say to you, love your enemies, and pray for those who persecute you,

"that you may be children of your heavenly Father, for he makes his sun rise on the bad and the good, and causes rain to fall on the just and the unjust."
(Matthew 5:44-45)
Then there was the way Israel treated his youngest son, Joseph, and Joseph's behavior, that got him sold as a slave and shipped to Egypt. A few years later, he was running the place: and a good thing, too, as it turned out. (Genesis 37:2-28; 45:5-8)

I accept the idea that my continuing existence depends on God. (Catechism, 301)

But I also must accept the idea that God made a world where the creatures in it — including me — play a role in making things happen. (Catechism, 306-308)

Thinking, making decisions based on reason, is part of being human. I can decide to let whim and emotion guide me, or use my brain. Thinking is an option, not a requirement. (Catechism, 154-159, 311, 1730, 1778, 1804, 2339)

My experience has been that thinking before acting is a good idea. (December 6, 2015; March 1, 2015)

Basically, I'm expected to keep myself healthy: within reason. (Catechism, 2288-2289)

Beware Tiny Cows!



(From James Gillray, H. Humphrey, Anti-Vaccine Society; via Wikimedia Commons; used w/o permission.)
"The Cow-Pock—or—the Wonderful Effects of the New Inoculation!"
(James Gillray's warning against the perils of preventing smallpox. (1802))

Concern, reasonable and otherwise, over new medical technology is nothing new.

For example, in 1802 James Gillray warned the British public against a controversial medical technology: inoculation. Meanwhile, the London Fever Hospital opened, "to the great horror of the neighbours." It was the first voluntary fever hospital, and that's yet another topic.

James Gillray probably realized that using cowpox inoculations to prevent smallpox wouldn't really make little tiny cows burst from the nose, face, and assorted other embarrassing spots. He was a cartoonist, satirist, caricaturist, and arguably invented the political/editorial cartoon.

That may explain what looks like a copy of Nicolas Poussin's "Adoration of the Golden Calf" on the back wall of that inoculation party.

The golden calf incident, described in Exodus 32, happened while Moses was on Mount Sinai. It was a major violation of the Decalogue, and they really should have known better. (Exodus 20:4-6)

Idolatry, putting anything ahead of God in my priorities, divinizing what is not God, is still a very bad idea.3 (Catechism, 2112-2114)

Where was I? Smallpox, inoculations, tiny cows, idolatry. Right.

Vaccination against disease has a long history — I'm putting a resource link list near the end of this post4 — but in the 1700s it was still experimental medicine, and very dangerous.

Science and Silliness


We've lived with, and died from, smallpox for a long time: upwards of three millennia, most likely.

Egypt's Ramses V, Lady Mary Wortley Montagu, and millions whose names are not remembered, suffered from the disease. (February 12, 2014)

Smallpox wasn't always fatal. About two of every three who caught the worst sort didn't die: but were scarred for life.

One of the few advantages to surviving smallpox was that it didn't strike the same person twice. Somewhere along the line, folks also noticed that the disease wasn't as severe for those who caught it from a contaminated break in the skin.

That practical observation led to variolation, deliberately infecting someone so that their bout with smallpox was more survivable, which reduced the smallpox death toll. It was an early step on the road to contemporary medicine.

I don't recall anyone objecting when the United Nations declared that smallpox was extinct on May 8, 1980.

But in the "good old days" when folks like Edward Jenner were developing inoculations against smallpox, it was a different story. Vaccination experiments triggered strong reactions, sensible and otherwise:
"for a man to infect a family in the morning with smallpox and to pray to God in the evening against the disease is blasphemy; that the smallpox is a judgment of God on the sins of people, and that to avert it is but to provoke him more; that inoculation is an encroachment on the prerogatives of Jehovah, whose right it is to wound and smite."
(Contemporary reaction to inoculation experiments by American physician Dr. Zabdiel Boylston, circa 1720)

"Smallpox is a visitation from God; but the cowpox is produced by presumptuous man; the former was what Heaven ordained, the latter is, perhaps, a daring violation our of holy religion."
(A physician's reaction to Dr. Edward Jenner's experiments in developing a vaccine for smallpox, (1796) via Psychological Sciences, Vanderbilt University)
Let's see what other folks said about the newfangled sort of medicine:
"...In contrast, many village priests in Italy, Germany, Switzerland, and England not only urged parishioners to seek the preventative treatment, they became wholesale vaccinators themselves. Pastors in Bohemia charged parents with responsibility 'before God for neglecting the vaccination of their children.' In 1814, the Pope himself endorsed vaccination as 'a precious discovery which ought to be a new motive for human gratitude to Omnipotence.'..."
("Deliberate extinction: Whether to Destroy the Last Smallpox Virus," pp. 19-20, David A. Koplow, Georgetown University Law Center (2004))
That would have been Pius VII who said vaccination was "a precious discovery which ought to be a new motive for human gratitude to Omnipotence."

I'm inclined to think he was right.


1. Heart Transplant: "a Rebirth of Sorts"



(From Lutheran Health Network, via WANE News, used w/o permission.)
(Heart transplant recipient Michael Steadman)
"Heart transplant is a rebirth of sorts for Fort Wayne man"
WANE Staff Reports (April 25, 2016)

"Whether it’s taking a walk in the park, spending time with his grandson, and even performing household chores, Michael Steadman is cherishing every experience.

"Steadman’s heart began to fail three years ago. He got weak, could barely climb the stairs, and was exhausted all the time. Things gradually got worse, and last year doctors told him he’d need a transplant. He expected to be on the waiting list for months – maybe even years – but within 5 days he got the call.

"That was in July of 2015. He’s still on the road to recovery and doing everything he can to stay active and healthy...."
Open heart surgery was newsworthy when I was in high school: and Christiaan Barnard's successful human-to-human heart transplant in 1967 was a major international story. I trust that the donor really was "essentially brain dead" when the doctor cut her heart out.

Louis Washkansky survived the operation and lived for another 18 days: before dying of pneumonia.

I could claim that a wrathful God smote Mr. Washkansky something fearful for being a terrible sinner and mocking God by surviving the operation: but I won't.

I think he caught pneumonia and died because immumosuppresive drugs had shut down his immune system.

Transplant rejection4 is one reason I think learning to grow our own replacement organs is a good idea, and that's almost another topic. (August 29, 2014)

I could also denounce WANE, the transplant team at Lutheran Hospital, and Mr Steadman, for their "encroachment on the prerogatives of Jehovah," as Dr. Zabdiel Boylston put it in the 1700s. But I won't.

I see the WANE headline,"Heart transplant is a rebirth of sorts for Fort Wayne man," as a mildly-poetic way of expressing the idea that getting a new heart restored at least a porton of Mr. Steadman's health.

As I said earlier, organ transplants are okay: providing we don't kill or maim one person to help another. (Catechism, 2296)

Revenge of Frankenstein's Son's Sister's Cousin


That 'rebirth' headline is mild, compared to its 'dead patient returns to life' counterparts I remember from the late 1960s.

They were almost accurate, since a common way to tell if someone was still alive was to check for a pulse.

Surgeons couldn't operate on a beating heart, so the organ had to be stopped — and the patient was "dead." At least in the pulse = life sense.

I'll get back to that.

Oddly enough, I don't remember a rash of horror-heart-transplant movies in the wake of Dr. Barnard's accomplishment.

"Parts: The Clonus Horror," 1979, was close; and considerably more plausible than the 1991 "Body Parts."

Maybe studios figured folks had had their fill of Frankenstein spinoffs5 by then, or maybe I didn't notice 'I Have an Ax-Killer's Heart' titles.

Anyway, that's movies; and heart transplants are now so routine that they're generally human-interest local stories.

My guess is that someone, somewhere, is preaching that the road to Hell is paved with transplanted hearts. That's a disturbing image, now that I think about it. Never mind.


2. Cryonics: Life, Health, and Decisions



(From iStock, via BBC, used w/o permission.)
("What would it be like to know that everyone you had ever met was long gone?"
(BBC))
"If cryonics suddenly worked, we'd need to face the fallout"
Rachel Nuwer, BBC Future (April 25, 2016)

"Right now, in three facilities in the US and Russia, there are around 300 people teetering on the cusp of oblivion. They exist in a state of deep cooling called cryopreservation, and entered their chilly slumber after their hearts had stopped beating. Before undergoing true cell death, the tissues of their brains were suspended using an ice-free process called vitrification. All are legally deceased, but if they could they speak, they would likely argue that their remains do not constitute dead bodies at all. Instead, in a sense, they are just unconscious.

"No-one knows if it's possible to revive these people, but more and more of the living seem to believe that uncertainty is better than the alternative. Around 1,250 people who are still legally alive are on cryonics waiting lists, and new facilities are opening in Oregon, Australia and Europe soon.

" 'We have a saying in cryonics: being frozen is the second worst thing that can happen to you,' says Dennis Kowalski, president of the Cryonics Institute in Michigan, the largest cryonics organization in the world. 'There's no guarantee you'll be able to be brought back, but there is a guarantee that if you get buried or cremated, you'll never find out.'..."
Rachel Nuwer's article mercifully avoids the "I freeze people to cheat death" and "Bringing the dead back to life" exuberance of some 'science news' coverage.

I'd have a problem with cryonics, heart surgery, and emergency rooms, if I thought being very sick or seriously injured was the same as being dead — or that folks who aren't healthy are better off dead. I don't.

Recapping what I said earlier, I see life and health as gifts from God. Taking reasonable care of them is a responsibility. (Catechism, 2288)

That's reasonable care. "Over-zealous" treatment isn't required. Common sense is:
"Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of 'over-zealous' treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected. "
(Catechism, 2278)

Legally Dead: For Now



(From iStock, via BBC, used w/o permission.)
("The bodies preserved today are considered legally dead, but our descendants might not see it that way"
(BBC))
"...To the uninitiated, cryonics might seem the stuff of 'Vanilla Sky,' 'Demolition Man,' and other purely science fiction works. But many researchers believe that it is a credible field of inquiry, and cryobiologists are slowly chipping away at the possibility of revival. Most recently, a team succeeded at thawing a previously vitrified rabbit brain. Even after several weeks of storage, the synapses that are thought to be crucial for brain function were intact. The rabbit was still dead, though – the researchers did not attempt to resuscitate the animal afterwards.

"While a thawed out rabbit brain does not a fully revitalised person make, some believe that cryogenic revival might someday be as commonplace as treating a case of the flu or mending a broken arm. 'This is really not so earth-shattering or philosophically weird as you might think,' says Aubrey de Grey, co-founder and chief science officer at the Sens Research Foundation in California, a non-profit organisation dedicated to changing the way we research and treat age-related ill health. 'It's just medicine – another form of healthcare that helps people who are seriously sick. Once you get your head around that, it's much less scary.'..."
(Rachel NuwerRachel Nuwer, BBC)
Cryonics "is not part of normal medical practice," as a Wikipedia page put it.

Quite a few scientists are skeptical about whether or not 'reviving' someone who has been frozen is possible. They've got a point.

We don't know for sure whether the human brain has to be continually active to preserve memory. If it does: getting stored at around -196°C would pretty well erase the person's memories. I wouldn't like that.

The last I heard, someone must be legally dead to be frozen. That makes sense from a criminal-liability viewpoint: but means that if and when folks get taken out of cold storage, medicos will have a really sick patient on their hands.

I'm not convinced that cryonics works, or that it doesn't. I'll get back to why I don't see an ethical problem if it does. Practical issues, yes: ethical, not so much. I'll get back to that, too, in this post's Afterword.

Death, Saving Lives, and Safety Coffins


We've been learning a great deal recently, which has helped save lives: and made defining "death" trickier.

I am convinced that "legally dead" or "medically dead" and "dead" are not the same thing.

If having a pulse meant being alive, and not having a pulse meant being dead, all recovering heart transplant patients are walking corpses that had no heart at all, let alone a pulse, for several minutes.

I think Mr. Steadman would not agree, and I think he's right.

I'll admit to having a personal bias about hasty assessments of death.

My father's father was on a construction site when a crane collapsed, killing many of the workers: including, apparently, my grandfather. An alert medic noticed that one of the mangled "corpses" was bleeding, which saved my grandfather's life.

His days as a construction worker were over, but he developed other skills, and that's yet again another topic.

I'd like to think that most folks buried these days were dead before getting embalmed/cremated and interred.

Which reminds me: I've heard that cremation was on the 'don't do this' list for Catholics. The rule wasn't as random as in might seem, and reasons for the prohibition are implicit in the Catechism's discussion of options:
"Autopsies can be morally permitted for legal inquests or scientific research. The free gift of organs after death is legitimate and can be meritorious.

"The Church permits cremation, provided that it does not demonstrate a denial of faith in the resurrection of the body.93"
(Catechism, 2301)
I've talked about autopsies and cremation before. (August 28, 2015; September 25, 2009)

I'm forgetting something. Safety coffins: that's it.

I'd like to think that what's euphemistically called "unintentional live burial doesn't happen: but in 2005 funeral director John Matarese noticed that the "corpse" in a body bag wasn't quite dead yet, and called paramedics. Dashed thoughtful of him, I think.

Quite a few patents for safety coffins date from the 18th and 19th century.

Cholera epidemics — I've mentioned how much I don't miss the 'good old days' — and a natural skittishness about examining possibly-contagious corpses encouraged not-unreasonable fears of waking up in a cozy little coffin.

"Dead," But He's Better Now


A recovery team pulled a limp, obviously-lifeless body out of the Red River in Fargo, North Dakota, back in 1987. Young Alvaro Garza Jr. was limp as a noodle when a recovery team fished him out from a hole in the ice.

He had no pulse, and was quite obviously "dead." That's what happens when you spend 45 minutes under the river's surface.

Usually.

His core body temperature went down to 77 degrees Fahrenheit — which probably saved his life. That, the mammalian diving reflex, having a hospital with a heart-lung machine nearby, and a family who wanted him to be alive. My opinion.

Folks at St. Luke's hooked Alvaro Garza Jr. into the machine, which let them "take his blood and warm it up and put it right back in his body," as St. Luke's/MeritCare's Roberta Young, RN, put it. 20 years later, Mr. Garza had four kids of his own: and a healthy respect for water.

Afterword


As I said last month, I follow the Man who is God: who died in my place; descended to the abode of the dead; rose from the tomb; and lives today and forever. (Matthew 28:1-10; Mark 16:1-11; 1 Peter 4:6; Catechism, 631-635, 638-655)

Jesus died. Our Lord had been killed by an execution squad which included Roman soldiers. They surely knew the difference between a dead body and someone who had fainted, or was pretending to be dead.

About three decades back, JAMA (The Journal of the American Medical Association, a peer-reviewed medical journal covering all aspects of the biomedical sciences) published an analysis of what our Lord went through.

It isn't an easy read, but worth the effort. My opinion:
I've been over that before. (April 5, 2015)

Health and Faith


When my lower digestive tract went into failure mode, my wife, a devout life-long Catholic, poured me into the family van and drove me to an emergency room.

I am quite sure she did not do that because she denied the Resurrection, or wanted to encroach "on the prerogatives of Jehovah, whose right it is to wound and smite," as Dr. Zabdiel Boylston put it.

I am reasonably confident that her goal was what it appeared to be: restoring my health.

Restoring and maintaining health is a good idea, within reason. (Catechism, 2278, 2288)

Getting back to the cryonics, ethics, assumptions, and all that — I very strongly suspect that whether or not getting put in cold storage is right depends at least in part on a person's motive.

If the individual thinks surviving until a cure for some disease is developed will prove that God doesn't exist — don't laugh, I've heard goofier arguments on several issues. I also don't see that as a good reason.

Someone wanting to survive until a cure for some disease is developed: that, to me, seems reasonable. I suppose someone out there thinks we're supposed to sit on our hands and let God smite us something fierce, but I'm not of that opinion.

Basically, I don't see cryonics as wrong, ethically.

If it works, it's simply another method for stabilizing a patient until adequate medical care is available. If I'm going to denounce cryonics on ethical grounds, I might as well denounce ambulances: because they defy God by getting folks to a hospital while they're still alive.

We may learn that cryonics doesn't work, and that folks who signed up to be frozen are really dead: as well as legally deceased. But right now, we do not know. I'm inclined to see it as a highly experimental medical procedure: dangerous, but potentially life-saving.

I think what Dr. Barnard wrote about Mr. Washkansky, the first heart transplant patient to survive more than two weeks after the operation, is relevant to questions about cryonics:
"...Washkansky could either wait for certain death or risk transplant surgery with an 80 percent chance of surviving. He chose the surgery. As Barnard later wrote, 'For a dying man it is not a difficult decision because he knows he is at the end. If a lion chases you to the bank of a river filled with crocodiles, you will leap into the water convinced you have a chance to swim to the other side. But you would never accept such odds if there were no lion.'..."
(Christiaan Barnard, People and Discoveries, A Science Odyssey; NPR)

The Disturbing Case of Lal Bihari


Lal Bihari was dead, officially, from 1975 to 1994. His uncle had bribed an official to register Bihari's death: putting the uncle in line to inherit some land.

Bihari eventually sorted the legal mess out, learned that at least a hundred other "dead" folks were in his position, and formed the Uttar Pradesh Association of Dead People.

Lal Biharie and his fellow-dead-people were victims of fraud: and in danger of being really, as well as legally, dead if they made too much of a fuss. I hope folks in that part of the world sort the mess out, but I won't claim that 'it can't happen here.'

Over the half-century or so that I've been paying attention, quite few definitions of brain death, clinical death, and legal death have been popping up.

"Brain death," the complete cessation of brain activity, might be a useful definition of death: if it was consistently applied.

It's not, so "brain death" in one place can mean that the whole brain, right down to the brainstem, has shut down.

Somewhere else, a patient with an active brainstem can be breathing on his or her own — and be "brain dead" because at least part of the higher brain functions are offline at the moment.

I don't think it helps that in my country organ harvesting can't start, legally, until a doctor signs off on "brain death." Cheerful thought.

Waking Up in the Future: Practical Considerations


I grew up when quite a few folks still thought human ingenuity would solve all our problems: or at least make "the future" a magical place to live.

I've seen that silly optimism change to what I think is an equally-silly fear that the future will be just simply awful: and then we'll all die.

As it is, I like living in "the future" — when polio is no longer a health threat in my part of the world, and smallpox is an extinct disease.

The World Health Organization released a Global Polio Eradication Initiative Strategic Plan progress report in 2012. This will take time, but I think we can end polio, too.

About adjusting to 'the future,' it helps that I didn't expect the world I am growing old in to be exactly like the world my grandfather lived in. I lived through the intervening years, learning new skills as needed: and enjoy learning about new technology.

If I'd — this couldn't have happened, we didn't have the technology, and still don't — been frozen in my mid-20s, and taken out of storage this year: that would be a different experience. I wouldn't mind learning that the Cold War was over: and wouldn't miss disco.

My guess is that I'd learn how to use today's information technology differently: most likely skipping right past learning how to use BASIC, QBasic, and DOS. Also, I wouldn't have gotten practice being patient while a dial-up modem made connections.

What sort of job I'd be qualified for: that, I'm not at all sure about.

The biggest adjustment, I think, would be getting used to a world without my parents. I would have missed the last few decades of their lives. On the whole, I'm glad to have experienced that.

Something that I'd wonder about, if I signed up for being frozen, is who would pay the bill if I survived the process. Cryonics organizations charge for their services up front, including storage and maintenance costs: so that's not an issue. Not in the short run, at least.

But let's assume that I was dying of something, arranged to be frozen, and woke up in the 31st century. Any financial arrangements I'd made could easily have failed in the millennium that passed.

One of my top concerns would be learning how I'd be expected to compensate folks for keeping me alive.

In a way, I'd probably rather wake up after several thousand years. That way my memories and experiences might be a mildly-valuable resource for antiquarian scholars.

And now for something completely different.

"Reanimated Abomination of Science?"


That's Rudolf Selnikov in the jar: what's left of him, that is. He was "in need of medical attention" — it's quite complicated, actually, like most of the Girl Genius comic series, and mostly irrelevant to this post.6

Selnikov looks happy in that panel because he's realized that being (officially) "dead" frees him from political infighting; and, as he put it, "...twisted and ruthless as you people are, throwing in with you is a step up."

Several panels back, Selnikov asked why he was "still alive." Given the willing suspension of disbelief required for the story — that question makes sense.

He'd been seriously injured, but "dead" only in a legal sense. His head was essentially intact, so his medical status in the story was a bit like an accident victim who was unconscious when taken to the emergency room.

We can't grow a new body for someone. Today, that sort of medical technology does not exist: although scientists have successfully grown a mouse thymus, and a few other non-human spare parts. (August 29, 2014)

Interestingly, I don't remember folks going ballistic over the first heart transplants. Maybe that's because I'd stopped listening to radio preachers by then, or maybe they were too busy having conniptions over just about everything else going on during the '60s.

By now, swapping out someone's heart is still a major medical procedure: but I think most folks have gotten used to the idea that not having a pulse does not necessarily mean being dead.

I also think the Sens Research Foundation's Aubrey de Grey, quoted in that BBC Future article, made sense, talking about cryonics:
"...'It's just medicine – another form of healthcare that helps people who are seriously sick. Once you get your head around that, it's much less scary.'..."
(Rachel NuwerRachel Nuwer, BBC)
More, mostly about faith and reason, science and religion:

1 I've been over this before:
2 I've talked about God, love, anger, and getting a grip, before:
3 I don't hope to convince zealots — but owning pictures and carvings isn't "idolatry," and the Catholic Church says to worship only God:
4 Life, death, and medicine; background:
5 Just when you thought it was safe to go back to the movies:
  • Frankenstein
    (1910)
  • Frankenstein
    (1931)
  • Bride of Frankenstein
    (1935)
  • Son of Frankenstein
    (1939)
  • The Ghost of Frankenstein
    (1942)
  • Frankenstein Meets the Wolf Man
    (1943)
  • Abbott and Costello Meet Frankenstein
    (1948)
  • I Was a Teenage Frankenstein
    (1957)
  • Frankenstein Meets the Space Monster
    (1965)
  • Frankenstein
    (1992)
  • Frankenstein
    (2004)
  • Frankenstein
    (2007)
  • Frankenstein
    (2015)
  • More Frankenstein films
  • Still more Frankenstein films
6 Selnikov is a minor character in the Girl Genius comic series.

Friday, October 16, 2015

Pig Organs, Ancient Immigrants

We're years away from safe pig-to-human organ transplants: but scientists using CRISPR gene editing tech are working toward that goal.

Other scientists are discovering a chapter of humanity's family history: Eurasian immigrants returning to Africa, when the Shang dynasty and Egyptian Empire collapsed.
  1. CRISPR Genetic Tech: Pigs as Organ Transplant Donors?
  2. Returning Home: Back to Africa, 3,000 Years Ago

Tech, Old and New


There's no such thing as "safe" tech. Not in the 'absolutely nothing can go wrong' sense.

Over the last million years or so, we've learned to cook without killing ourselves, and incinerated cities at irregular intervals before developing less flammable buildings and more effective fire suppression tech. (May 9, 2014; April 27, 2014)

But my guess is that we'll still need first responders or their equivalent a million years from now. We're smart, but accidents happen. And sometimes we get careless: or deliberately cause trouble. (February 1, 2015)

We've used tech like string for so long that it seems 'natural.' Newer tech, like steam engines and neurosynaptic cores, not so much. (August 15, 2014)

Tales like "Frankenstein; or, The Modern Prometheus" (1818) and "The Island of Doctor Moreau" (1896) were more fiction than science — but arguably more thoughtful than "Island of Lost Souls" (1932) and "Frankenstein Meets the Space Monster (1965).

More recently, a pinch of science and hogsheads of imagination produced films like "Carnosaur 3: Primal Species" (1996) and "Splice" (2009). I'm pretty sure most folks realize that direct-to-video movies are entertainment, not edutainment.

But unconsidered optimism about progress gave way to equally-unconsidered pessimism during my youth. I think we don't live in a perfect world, but doomsday predictions and fashionable melancholia seem silly. (July 5, 2015)

Think!


Thinking is not a sin. Really.

We've got brains, and are expected to use them. Part of our job is learning about the universe, and using that knowledge. Ethics matter in science and tech, just like everything else we do. (Catechism of the Catholic Church, 154-159, 2292-2296)

A scientist occasionally embraces the notion that smart folks are "beyond good and evil." I suspect that attitude contributes to real-life horrors like Ilya Ivanovich Ivanov's 1920s attempts to breed a human-ape hybrid; and experiments like the ones performed at Auschwitz, Dachau, Tuskegee, and Willowbrook.

Then there was Johann Conrad Dippel, who wrote that he'd invented an elixir that'd keep him alive until he was 135 years old. He died a few months short of his 61st birthday.

Like I said, we've got brains. But we have free will, so using our brains is an option: not a requirement. (Catechism, 1730-1738)

We've also got feelings, emotions. That's okay. It's part of being human. Emotions happen. They're not good or bad by themselves. (Catechism, 1762-1770)

I think it's easier in the short term to act on impulse, letting my endocrine system run my life. But I'm human: so in the long run, I'm better off if I think before I act. (Catechism, 1778, 1804, 2339)

That takes more effort, and can be inconvenient: but I've found that using my brain makes sense.

That's why I don't assume that CRISPR and other biotechnology is a worry-free solution to all our ills — or something that will destroy us all.

Whether we use technology to help or harm ourselves and others is up to us. Blaming our tools doesn't make sense. Neither, I think, does yearning for the 'good old days' of cholera pandemics and frequent famines. (March 27, 2015; January 9, 2015)

We'll probably need new rules to deal with CRISPR and other new tech: but the underlying principles don't change. Loving neighbors — and seeing everybody as neighbors — still makes sense. (Matthew 22:36-40, 5:43-44; Mark 12:28-31; Luke 10:25-27, 29-37; Catechism, 1825)


1. CRISPR Genetic Tech: Pigs as Organ Transplant Donors?



(From Science Photo Library, Mauro Fermariello; via BBC News, used w/o permission.)
" 'GM could make pig organs for humans' "
Michelle Roberts, BBC News (October 12, 2015)

"A gene-editing method could one day make pig organs suitable for use in people, scientists say.

"Prof George Church and colleagues used a technique called Crispr to alter the DNA of pig cells to create a better match for humans.

"The early work, in the journal Science, aims to address concerns about rejection and infection by viruses embedded in pig DNA.

"If successful, it could be an answer to the shortage of human donor organs...."
The Science article says that around 122,500 folks in the United States are waiting for organ transplants.

Organ and tissue transplants have a long history.

It's been about 22 centuries since Sushruta did the first recorded skin graft. Theodor Kocher did human thyroid transplant in 1883. Work by Peter Medawar and others in the 1940s and 50s identified the immune responses that usually killed transplant patients.

The human immune system is very good at identifying organic stuff in our bodies that doesn't belong there. The problem with transplants is that the immune system generally identifies a new organ or tissue as a threat: and attacks it as if it was a parasite or pathogen.

In 1972, researchers at Sandoz developed ciclosporin, the first immunosuppressive strong enough to keep transplant patients alive.

That's the good news. The not-so-good news is that we don't have enough spare hearts, kidneys, livers, lungs, and other organs, to go around.

Legal and social attitudes toward organ suppliers vary from country to country.

Moldova, for example, outlawed international adoption: apparently because the country's rulers were squeamish about kids being broken down for parts.1 Other nations are a bit more open to folks with flexible ethics.

I'm a Catholic, so I must think that organ transplants are a good idea — if the benefits outweigh the risks, and someone isn't maimed or killed in the process. (Catechism, 2296)

Genetic Technology and Vocabulary



(From Science Photo Library, via BBC News, used w/o permission.)
"...Crispr is a relatively new scientific tool that lets scientists snip and play around with the code of life - DNA.

"Prof Church, from Harvard University, used it to inactivate a retrovirus present in the pig cell line.

"This porcine endogenous retrovirus is potentially risky because it can infect human cells - at least in the lab.

"In tests on early pig embryos, Prof Church was able to eliminate all 62 copies of porcine endogenous retroviruses from the pig cells using Crispr.

"Next, he checked if the modified pig cells would still easily pass the retrovirus on to human cells. They did not, although there was still a small amount of transmission.

"Prof Church says the discovery holds great promise for using animal organs in people - what doctors call xenotransplantation...."
(Michelle Roberts, BBC News)
Vocabulary time. Feel free to take a coffee break, go for a walk, or skip down to Synthetic Organisms, like Chickens.

Xenotransplantation is transplanting organs or tissue between individuals of different species.

CRISPRs, clustered regularly interspaced short palindromic repeats, "are segments of prokaryotic DNA containing short repetitions of base sequences." (Wikipedia)

Prokaryotes are critters without membrane-enclosed cell nuclei. We're eukaryotes, since our cells have a membrane around the nucleus. Not our red blood cells, though, and that's another topic. Topics. (June 19, 2015)

Bacteria have been using CRISPRs for a very long time. We didn't notice them until 1987. Researchers recently spotted bacterial CRISPRs from bacteriophages and extrachromosomal DNA.

We've known about horizontal gene transfer since 1951, and that's yet more topics. (August 28, 2015)

A retrovirus inserts DNA code into its host's DNA. Scientists picked up their trail in the early 20th century. They're used for gene therapy these days — something that didn't exist until 1972, and wasn't tried with humans until 1989.

'Designer babies' aren't here yet, but we're close. I see problems and opportunities in the emerging tech, which are — Yet again more topics. (January 23, 2015)

Synthetic Organisms, like Chickens


If this research leads to practical pig-to-human organ transplants, I'm pretty sure that editorial cartoons will lampoon the new tech, and those who benefit from it.

Folks with religious, ethical, or aesthetic objections to pigs will most likely protest. But I don't see a problem.

Getting a pig's heart might be an 'image' problem for a politician or movie star — but doesn't involve the ethical issues involved in human-pig and human-safflower hybrids. (August 28, 2015; February 14, 2014)

It's not that I think artificial organisms offend a hypersensitive God.

Unless you're a hunter, the odds are pretty good that you've never eaten food that didn't come from a modified critter. Synthetic organisms like chickens, dogs, and macaroni wheat, have been with us for a very long time. (March 6, 2015)

I'm inclined to give 'primitive' folks credit for more competence than some academics. A footnote says that Jacob's deal with Laban, in Genesis 30:31-43, illustrates a 'simple' belief that visual stimuli affect DNA.

My guess is that Laban made the mistake of letting someone with a shepherd's practical understanding of heredity control the flock's breeding: and that the rods mentioned in Genesis 30:27-38 were a misdirect. Laban isn't shown as the brightest lamp in the camp.

Paul used grafting, artificially combining parts from different plants, as a metaphor in Romans 11:19-24. But I don't think that passage condemns the practice.

People aren't sheep or olive trees, though, which gets me back to human-animal hybrids.

Remembering Who We Are


"Instruction Dignitas Personae on Certain Bioethical Questions" (2008), 33., specifically addresses reprogramming human somatic cells with another animal's oocytes.

Combining DNA from a human and a pig or safflower is possible, but "...such procedures represent an offense against the dignity of human beings on account of the admixture of human and animal genetic elements capable of disrupting the specific identity of man...."1

Science and technology are not a problem. Studying this universe and making new tools are part of being human. It's what we're supposed to do. (Catechism, 2292-2295)

But we're also supposed to remember who we are. We're made in the image of God, with a dignity that must be recognized. Respect for the dignity of the human person is why social justice is so important, and that's still another topic. (Catechism, 1700, 1701-1706, 1928-1942)

I accept what the Church says about mixing human and other DNA. I am also certain that two millennia from now the Church will still say that humanity is made in the image of God — with the dignity and responsibilities that implies.

Since we're rapidly discovering more about horizontal gene transfer and other previously-unknown aspects of genetics, I suspect that rules about DNA will be reviewed within the next century: probably sooner. (August 28, 2015)

I had something in mind there. Let's see: pigs; politicians; Laban; respect. Right.

Ethical Landmines


These scientists have been using CRISPR to modify porcine DNA: removing code that would harm a human organ recipient.

Pigs are popular biomedical research lab animals because they're a lot like us in terms of size, biological processes, and anatomy. (Wikipedia)

Porcine organs aren't exactly like a human's: but apparently many are close enough to work for transplants.

And raising pigs as donors doesn't have nearly as many ethical landmines as raising humans for the same purpose. (February 13, 2015)


2. Returning Home: Back to Africa, 3,000 Years Ago



(From Kathryn and John Arthur, via BBC News, used w/o permission.)
("The remains were found in this cave in the highlands of Ethiopia"
(BBC News))
"Ancient DNA reveals 'into Africa' migration"
Rebecca Morelle, BBC News (October 8, 2015)

"An ancient African genome has been sequenced for the first time.

"Researchers extracted DNA from a 4,500-year-old skull that was discovered in the highlands of Ethiopia.

"A comparison with genetic material from today's Africans reveals how our ancient ancestors mixed and moved around the continents.

"The findings, published in the journal Science, suggests that about 3,000 years ago there was a huge wave of migration from Eurasia into Africa.

"This has left a genetic legacy, and the scientists believe up to 25% of the DNA of modern Africans can be traced back to this event...."
As I've said before, folks move around. A lot. (July 11, 2014)

Details of that massive migration are being debated, but I'm not surprised that it happened.

Between 1200 and 1150 BC, more or less, something dreadful happened around the eastern Mediterranean.

Nearly every city between Pylos and Gaza was destroyed. Mycenaean kingdoms and the empires of Egypt and the Hittites collapsed.

We don't know what went wrong.

The Hekla 3 eruption may or may not have caused two decades of globally reduced sunlight around that time. Or a Bond event may have triggered the Late Bronze Age collapse.

As I've said before, Earth's climate changes. We're starting to sort out some of the periodic fluctuations, like Bond events. They're disruptive, but not necessarily devastating.

Barbarians and Frost Fairs


The Little Ice Age, about five centuries back, didn't do much besides force China to change agricultural practices in Jiangxi Province, popularize ice skating and make events like the River Thames frost fairs possible in Europe.

But we didn't have the social and political issues plaguing the Roman Empire, a thousand years before that, when barbarians moved east and south. We had really bad weather during 535–536.

My ancestors may have been among the barbarians who took over Roman land — or more likely were among the folks pushing them south. The barbarians eventually started building Gothic cathedrals and steam engines, and I'm wandering off-topic again.

Another Bond event, the 4.2 kiloyear event, wreaked havoc. So did the 5.9 and 8.2 kiloyear events. I've discussed this year's climate talks and King Cnut before. (July 3, 2015)

Getting back to the Late Bronze Age collapseIronworking, a new technology, may have disrupted traditional economic and military systems. Infantry equipped with mass-produced bronze weapons may have made military chariots obsolete.

Illiteracy became common, which may help explain why tales of the Trojan War are a mix of fact and imagination. It was - - -

- - - the End of Civilization As They Knew It


Quite a bit changed after the Late Bronze Age collapse.

Egypt's Twenty-second and Twenty-third dynasties were immigrant families. New smelting tech made iron tools and weapons affordable, King Wu of Zhou founded the Zhou dynasty, and Saul became the first king of of a united Israel.

Folks on the Aegean peninsula re-learned writing from the Phoenicians, and formed self-governing communities which would give us Plato, Socrates, and the Peloponnesian War, although not in that order.

The Roman Republic eventually took over 'all of the above,' became the Roman Empire, which dissolved about fifteen centuries back, that brings me back to today — and I see I've gotten off-topic yet again.

With Kaskians, Phrygians and Arameans roaming and raiding where the Hittite Empire had been; and great cities like Hattusa, Mycenae, and Ugarit in ruins; it's no surprise that many farmers moved back to Africa.

The University of Cambridge's Dr. Andrea Manica says that about a quarter of the folks living in East Africa back then were immigrants: mostly from western Eurasia.

Discovering a Complex Family History



(From Kathryn and John Arthur, via BBC News, used w/o permission.)
("The researchers uncovered a rock cairn before finding the buried remains underneath"
(BBC News)
"...Ancient genomes have been sequenced from around the world, but Africa has proved difficult because hot and humid conditions can destroy fragile DNA.

"However, the 4,500-year-old remains of this hunter gatherer, known as Mota man, were found in a cave and were well preserved.

"Importantly, a bone that is situated just below the ear, called the petrous, was intact.

"Dr Manica, speaking to Science in Action on the BBC World Service, said: 'The petrous bone is really hard and does a really good job of preventing bacteria getting in and degrading this DNA.

"What we were able to get is some very high quality undamaged DNA from which we could reconstruct the whole genome of the individual.

" 'We have the complete blueprint, every single gene, every single bit of information that made this individual that lived 4,500 years ago in Ethiopia.'..."
(Rebecca Morelle, BBC News)
Filling in humanity's family history by studying our genomes is new. We're discovering that it's complicated, which may upset some folks. I'm not one of them, partly because I know a bit about my recent ancestors. And that's — another topic. (October 31, 2014; July 11, 2014; July 6, 2014)

Mota man's DNA was "purely African." His ancestors had stayed in humanity's homeland, when many of mine moved out some 60,000 years back.

Like I said earlier, we're learning that a whole lot of folks returned around the time Troy fell and Western civilization collapsed, again, roughly three thousand years ago. Can't say that I blame them, considering the chaos and destruction sweeping their world.

Anyway, the returnees started doing what almost everyone does: "interbreeding" with local families. I don't particularly like that term, but it's better than "miscegenation," and I've been over that before. (February 6, 2015; December 12, 2014; October 31, 2014)

Honestly, how many folks really want to emulate the Hapsburgs? (December 12, 2014)

Not surprisingly, the highest percentage of  Eurasian DNA — including genetic code picked up from Neanderthal ancestors — is in northeastern Africa. Dr. Manica says that percentages run from 20% in Ethiopia to 5%, roughly, in western and southern Africa.

I'm guessing that we'll see reasonable discussion of the data and analysis. There'll also, I suspect, be complaints from folks who don't like the idea of 'foreigners' in their family tree.

Burial and Reasonable Respect


Burial isn't a universal custom, but folks around the world show respect for the dead: usually.2

Archaeology has come a long way since the days when amateur treasure-hunters mining barrows and tombs extracted gold and jewels: disturbing valuable evidence in the process.

Heinrich Schliemann's eagerness to discover Troy may have resulted in his obliterating evidence that he was right.

Fossils generally aren't as shiny as jewelry, which may be why paleontology's history has had relatively few incidents like the Bone Wars.

Even hoaxes like the Piltdown Man and Archaeoraptor were comparatively low-key affairs, and I'm drifting off-topic. Again. (October 31, 2014; August 8, 2014)

We have learned a great deal from studying burial sites like the Dinaledi Chamber and Denisova Cave. (September 18, 2015; July 11, 2014)

However —

'Mota man' has been dead for four and a half millennia. His descendants may still be living in or near Ethiopia, but it's possible — even likely — that no one will claim his remains.

I hope that his bones will be treated with respect.

This isn't superstitious fear that ghosts will wreak vengeance on those who disturb a grave. That sort of thing is okay for movies of the 'Revenge of the Mummy Returns' variety: but I'm a Catholic. Superstition is a bad idea, and against the rules. (Catechism, 2110-2111, 2138)

However, respect for others doesn't stop when they die. Bodies "must be treated with respect and charity," which does not mean that autopsies are wrong. (Catechism, 2300-2301)

I've rambled on about death, resurrection, burial and cremation before. (September 25, 2009)

The remains of 'Mota man' may end up in a museum, and may be placed on display. I'm not sure what I think of that.

Decades back, I saw an Egyptian mummy in a Minnesota museum: what was left of some government official, I think. I remember feeling a bit sad, wondering what he would think of being above ground and far from home.

More of my take on genes, people, and all that:

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Marian Apparition: Champion, Wisconsin

Background:Posts in this blog: In the news:

What's That Doing in a Nice Catholic Blog?

From time to time, a service that I use will display links to - odd - services and retailers.

I block a few of the more obvious dubious advertisers.

For example: psychic anything, numerology, mediums, and related practices are on the no-no list for Catholics. It has to do with the Church's stand on divination. I try to block those ads.

Sometime regrettable advertisements get through, anyway.

Bottom line? What that service displays reflects the local culture's norms, - not Catholic teaching.