Up@dawn 2.0

Friday, July 28, 2017

Dying: A Memoir

Years ago, a palliative care doctor told me that what he knew of a patient’s personality often had little to do with how he or she coped with dying. Generous people could become ungenerous, and brave people could become frightened. Angry people could become gentle, and controlling people could become Zen. Dying, in other words — like combat, like becoming a parent, like any transformative life event — doesn’t always reveal or intensify aspects of our character. It sometimes coaxes out new ones.

For a long time, the writer Cory Taylor took, by her own admission, “a fairly leisurely approach to life.” That changed in 2005, just before her 50th birthday, when doctors removed a mole on the back of her leg. Melanoma, Stage 4. She wrote the novel she’d always meant to write, then another. Then she wrote “Dying: A Memoir.”

The book rings louder in my imagination the more time I spend apart from it, a kind of reverse Doppler effect. “Dying” is bracing and beautiful, possessed of an extraordinary intellectual and moral rigor. Every medical student should read it. Every human should read it. My own copy is so aggressively underlined it looks like a composition notebook.

“Dying” is short, but as dense as dark matter. There is an electrifying matter-of-factness to it, one that normalizes death, which is part of Taylor’s goal. She deplores the “monstrous silence” surrounding the subject of mortality. “If cancer teaches you one thing,” she writes, “it is that we are dying in our droves, all the time. Just go into the oncology department of any major hospital and sit in the packed waiting room...” (nyt, continues)

Debunking "What the Health"

There’s a sensational new documentary out on Netflix that seems to have a lot of people talking about going vegan.

In the spirit of so many food documentaries and diet books that have come before, What the Health promises us there is one healthy way to eat. And it involves cutting all animal products from our diet.

Meat, fish, poultry, and dairy are fattening us up, giving us cancer and diabetes, and poisoning us with toxins, Kip Andersen, the film’s co-director and star, tells us.

Reflecting on a youth spent inhaling hot dogs and cold cuts, he asks, “Was this like I had essentially been smoking my whole childhood?”

No, Kip, not really... (continues)
Q. It seems that many people who are not elite athletes are now hyper-focused on protein consumption. How much protein does the average adult need to consume daily?

A. The recommended intake for a healthy adult is 46 grams of protein a day for women and 56 grams for men. And while protein malnutrition is a problem for millions of people around the globe, for the average adult in developed countries, we are eating far more protein than we actually need.

Most American adults eat about 100 grams of protein per day, or roughly twice the recommended amount. Even on a vegan diet people can easily get 60 to 80 grams of protein throughout the day from foods like beans, legumes, nuts, broccoli and whole grains.

The Hartman Group, a consumer research firm that has been conducting a study of American food culture over the past 25 years and counting, has found that nearly 60 percent of Americans are now actively trying to increase their protein intake. Many are avoiding sugar and simple carbohydrates and turning to protein-rich foods, snacks and supplements. The firm calls protein “the new low-fat” or “the new low-carb,” even “the new everything when it comes to diet and energy.”

“Soccer moms feel they can’t be anywhere without protein,” says Melissa Abbott, the firm’s vice president for culinary insights. “Really it’s that we’ve been eating so many highly processed carbs for so long. Now it’s like you try nuts, or you try an egg again, or fat even” to feel full and help you “get through the day.”

In her research, Ms. Abbott said she always seems to be finding beef jerky in gym bags and purses, and protein bars in laptop bags or glove compartments. Many consumers, she notes, say they are afraid that without enough protein they will “crash,” similar to the fear of crashing, or “bonking,” among those who are elite athletes.

But most of us are getting more than enough protein. And few seem to be aware that there may be long-term risks of consuming too much protein, including a potential increased risk of kidney damage. To learn more, read “Can You Get Too Much Protein?”

Saturday, July 22, 2017

Gene editing, techno-optimists

Gene editing threatens to homogenize society, says Atul Gawande. Aberrant yet valuable characteristics are under threat. Think of George Church's narcolepsy... more »

Biology and its discontents. Techno-optimists come in all stripes — scientists, seekers, grifters, con artists. They share a zeal for augmenting their bodies... more »

The Gene Machine: How Genetic Technologies Are Changing the Way We Have Kids—and the Kids We Have
by Bonnie Rochman
Scientific American/Farrar, Straus and Giroux, 272 pp., $26.00
DNA Is Not Destiny: The Remarkable, Completely Misunderstood Relationship Between You and Your Genes
by Steven J. Heine
Norton, 344 pp., $26.95
A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution
by Jennifer A. Doudna and Samuel H. Sternberg
Houghton Mifflin Harcourt, 281 pp., $28.00Graeme Mitchell/Redux

In recent years, two new genetic technologies have started a scientific and medical revolution. One, relatively well known, is the ability to easily decode the information in our genes. The other, which is only dimly understood by the general public, is our newfound capacity to modify genes at will. These innovations give us the power to predict certain risks to our health, eliminate deadly diseases, and ultimately transform ourselves and the whole of nature. This development raises complex and urgent questions about the kind of society we want and who we really are. A brave new world is just around the corner, and we had better be ready for it or things could go horribly wrong.

The revolution began in benign but spectacular fashion. In June 2000, President Bill Clinton and Prime Minister Tony Blair announced the completion of the first draft of the human genome. According to a White House press statement, this achievement would “lead to new ways to prevent, diagnose, treat, and cure disease.” Many scientists were skeptical, but the public (who footed much of the $3 billion bill) probably found this highly practical justification more acceptable than the mere desire to know, which was in fact a large part of the motivation of many of the scientists involved.

During the 2000s, Clinton’s vision was slowly put into practice, beginning with the development of tests for genetic diseases. As these tests have become widespread, ethical concerns have begun to surface. Bonnie Rochman’s The Gene Machine shows how genetic testing is changing the lives of prospective parents and explores the dilemmas many people now face when deciding whether to have a child who might have a particular disease. Some of these technologies are relatively straightforward, such as the new blood test for Down syndrome or the Dor Yeshorim genetic database for Jews, which enables people to avoid partners with whom they might have a child affected by the lethal Tay-Sachs disease (particularly prevalent in Ashkenazis). But both of these apparently anodyne processes turn out to raise important ethical issues... (nyrb, continues)

Monday, June 26, 2017

The Symptoms of Dying

You and I, one day we’ll die from the same thing. We’ll call it different names: cancer, diabetes, heart failure, stroke.

One organ will fail, then another. Or maybe all at once. We’ll become more similar to each other than to people who continue living with your original diagnosis or mine.

Dying has its own biology and symptoms. It’s a diagnosis in itself. While the weeks and days leading up to death can vary from person to person, the hours before death are similar across the vast majority of human afflictions.

Some symptoms, like the death rattle, air hunger and terminal agitation, appear agonizing, but aren’t usually uncomfortable for the dying person. They are well-treated with medications. With hospice availability increasing worldwide, it is rare to die in pain... (continues)

Tuesday, May 30, 2017

Web MD

“You can’t list your iPhone as your primary-care physician.”

“You can’t list your iPhone as your primary-care physician.”

Monday, May 22, 2017

Siddhartha Mukherjee & Sam Harris on the moral complexity of genetics

In this episode of the Waking Up podcast, Sam Harris speaks with Siddhartha Mukherjee about the human desire to understand and manipulate heredity, the genius of Gregor Mendel, the ethics of altering our genes, the future of genetic medicine, patent issues in genetic research, controversies about race and intelligence, and other topics. Listen here.

Thursday, May 18, 2017

Better dead than "upgraded"?

“[Many people] are happy to follow the advice of their smartphones or to take whatever drug the doctor prescribes, but when they hear of upgraded superhumans, they say: 'I hope, I will be dead before that happens” 

“No clear line separates healing from upgrading. Medicine almost always begins by saving people from falling below the norm, but the same tools and know-how can then be used to surpass the norm.” 

― Yuval Noah HarariHomo Deus: A Brief History of Tomorrow
Bill Gates recommenmds Homo Deus, by Yuval Noah Harari. "I recommended Harari’s previous book Sapiens in last summer’s reading list, and this provocative follow-up is just as challenging, readable, and thought-provoking. Homo Deus argues that the principles that have organized society will undergo a huge shift in the 21st century, with major consequences for life as we know it. So far, the things that have shaped society—what we measure ourselves by—have been either religious rules about how to live a good life, or more earthly goals like getting rid of sickness, hunger, and war. What would the world be like if we actually achieved those things? I don’t agree with everything Harari has to say, but he has written a smart look at what may be ahead for humanity."

Read Bill Gates' full review of HOMO DEUS here

Thursday, May 4, 2017

Be healthy and happy, Bioethics class of '17!

Image result for the end is near cartoons
Keep in touch. Let me know how I can help you reach your goals!

Brave New World Final Blog Post: The Beauty and Negativity of Adversity

Pop warner coaches always tell their players that you grow when it is tough. Living the easy life and becoming complacent with our current situation provides little opportunity to mentally or physically grow. Even Arnold Schwarzenegger loved pain, because pain meant growth. However when life becomes too difficult, surviving is the only thing one can be focused on. It is not ideal to be focused on surviving and ignore the pleasure of life.

What is the perfect balance in our lives where it is not overly difficult but neither overly plush? Do we even have control over that balance?

Sometimes in life we are dealt a bad hand. No body can accurately predict when misfortune strikes. You are laid off, get into a car accident, or a flood destroys your home, what happens next? Most people will tell you to pick up the pieces and move on, that the experience will only make you stronger. It is true that these experiences will help you grow as a person, but if you become overburdened with unfortunate events it becomes difficult to not give up. Some might resort to alcohol, drugs, or even suicide. Who is to blame them though,

However, with modern technology and progressive policy it become easier to weather tough times. If you are laid off, there is a safety net to prevent you from starving and losing everything you have. Cars on constantly being improved on to be more safe so that if you get into a car accident you chance of death or serious injury is diminished. Even in cases of serious injury from a car accident, modern medical practices offer a better prognosis of your injuries than in the past.

In first-world countries you have more opportunity thus control over how difficult your life is. Living in a country that is more economically stable gives its inhabits a higher quality of life. Certain diseases are no longer existent and food for the most part is plentiful. Instead of worrying about how difficult life is we may be worry about how easy life is becoming. Will we becomes less motivated if our standard of living becomes too high, or will a higher standard of living provide new opportunities that were not previously achievable?

In Brave New World, life is relatively easy. Commodities are readily accessible, everyone is programmed to be complacent with their life, and if one experiences too much stress a drug called soma is taken to escape reality. Nothing is wrong with enjoying the newest item, accepting your situation for as it is, or consuming alcohol or dope when life becomes stressful. This scenario however was created with lots of influence an oversight. In a naturally progressing society, a life without adversity may not be possible.

Our standard of living 200 years ago does not compare to the standard of living today. Our ancestors may scoff at our problems today, to us however they are of no small matter. If we were to see the problems that future generations face, we may scoff at them. To some degree difficult is relative and here to stay, manifesting in different forms. However, wether we can or can not eliminate difficulty in the future, we should try to embrace adversity now.

If life gives you lemons makes lemonade.

Sorry for the late post Dr. Phil, wrongly assumed that the final blog post would be due on the exam date and not earlier.