RIGHT TO DIE

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
 Website: chetyarbrough.blog

The Door

By: Magda Szabo

Narrated by: Sian Thomas

Magda Szabo (Hungarian novelist, 1917-2007, died at age 90)

“The Door” is a story of the human psyche, and religious belief. Every human has a locked door in their consciousness, behind which life’s meaning is hidden.

Often, neither individuals nor acquaintances have a key to that door. Magda Szabo creates characters searching for that key. To some listener/readers, her primary character has the key. Emerence Szeredas is Szabo’s primary character who, some may argue, has keys to other’s doors, as well as her own.

Emerence is a mysterious community caretaker. As Szabo tells her story, listeners find Emerence has lived an eventful life.

She realizes much of life is out of her control but believes that which is under one’s control should be controlled absolutely. Emerence lives in an apartment. Her front door is locked to outsiders–excerpt in a rare circumstance when a fugitive needs to be hidden from the world because of societal transgression. Emerence becomes a place of temporary refuge for societal transgressors in a hidden room in her house.

Emerence cracks the door of her life for a writer who is married and needs help with her household. The writer asks Emerence to become her housekeeper.

The slight opening to the writer of Emerence’s psyche ends in tragedy. Through many years of work and acquaintance with the writer, Emerence reveals personal information about her life. Emerence resists opening her locked door but counsels the writer on how she should live her life. Emerence becomes close to the writer and plans to leave the contents of the house to her when she dies.

Emerence has a stroke. She refuses help from anyone and refuses any food or medical assistance while recovering behind her closed door.

She refuses to allow anyone, including the writer, to come into her apartment. She quits eating and is near death. The apartment begins to stink of pet excrement and rotting food. The writer chooses to organize the community to break down Emerence’s door and force her into a hospital for care. Emerence threatens to kill anyone who tries to knock down her door. In great distress, Emerence wields an axe, inadvertently smashes the door to her apartment, and is unable to stop the community from taking her to the hospital.  

Now that Emerence’s door is broken, both metaphorically and physically, she blames the writer for invading her privacy and denying her the right to die as she chooses.

The writer interferes with Emerence’s fundamental right to control that which she can control. Emerence heatedly explains to the writer that her wish to die behind her door is her choice.

Emerence is saying she has always been in control of her life and if she wishes to die, it is her business, no one else’s.

Emerence is recovering in the hospital. She refuses to talk to the writer. The writer cannot grasp Emerence’s reasoning. The writer feels she saved Emerence’s life. What the writer did not understand is Emerence’s need to be in control of what she can control to give meaning to her life.

Despite Emerence’s physical deterioration, neglect of pets in her house, and the unhealthful condition of her surroundings, in her apartment she had control of her life. Survival in the hospital, the stinking condition of the house, and her physical disability became an embarrassment to Emerence. To Emerence, if she had died in the house, the embarrassment would mean nothing because she would be dead. With survival, Emerence’s locked door would be opened for all to see, a circumstance beyond her control.

Emerence is told by the hospital that she will not be released to return to her apartment. She is to be sent to a convalescent facility. She refuses with anger and physical reaction that ends her life on terms she chooses.

“The Door” appears in Hungary in 1987 and has been translated into French and English. It raises many questions about life, faith, and individual rights. In this age of “right to die”, Szabo’s story has particular relevance.

HUMAN BEHAVIOR

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
 Website: chetyarbrough.blog

Biology and Human Behavior: The Neurological Origins of Individuality, 2nd Edition

By: The Great Courses

     Lecturer: Robert Sapolsky

Robert Sapolsky is an author, American neuroendocrinology researcher, and doctor of neuropsychology, educated at Harvard and acting professor at Stanford.

Sapolsky’s lectures begin with optimism. He infers one can understand the biological origin of human behavior. However, as the lectures progress one becomes skeptical. By the end of Sapolsky’s lectures, the source of human behavior seems too complex for human understanding. In a future age, it may be possible to reduce uncertainty, but determination of the sources of human behavior are likely to remain a probabilistic endeavor.

Sapolsky begins with neurological, physiological, endocrinological, genealogical, and environmental influences on behavior but ends with no definitive origin for human behavior.

This is not to say these lectures are not interesting, but science is far from understanding how any discipline can effectively or accurately identify the sources of dysfunctional human behavior. Cures for psychological maladies remain elusive because of the complexity of their origin.

There is no nerve that can be cut, no drug that can be administered, no gene that can be removed, no environment created that singularly cures abnormal human behavior. Sapolsky is saying the origin of human thought and action begins with genetic history, is influenced in the womb, is subjected to hormonal disruption, lives to be changed by environmental circumstances, and dies either early or late depending on the circumstances of life.

Sapolsky begins his lectures with a lesson in physiology and discussion about cells and the nervous system and how it works.

He explains limbic and autonomic nervous systems. A limbic system is where subcortical structures meet the cerebral cortex. It influences the endocrine system and the autonomic (breathing, heartbeat, and digestive system) functions of the body.

Sapolsky explains how regulation of body function is affected by hormones that come from many organs of the body. These hormones affect brain function (which is also a hormone producing organ) that have a great deal to do with how one acts. The physiology of the nervous system and blood circulatory system carry hormones throughout the body.

Sapolsky goes on to explain evolution of behavior that comes from genetically inheritable social history. What is revelatory is the myth of evolution based solely on a genetic singularity which preserves itself at all costs.

Sapolsky argues preservation of species, not specific gene preservation, is the key to understanding evolution. (This is a partial disagreement with the “selfish gene” postulated by Richard Dawkins.)

The example Sapolsky offers is the Wildebeest herd that plans to cross an alligator infested river.

An early interpretation of that crossing is that a leader of the herd voluntarily steps into the river to sacrifice itself to allow the herd to cross the river while it is being feasted upon by alligators. Sapolsky explains the Wildebeest is not sacrificing itself. Careful observation shows an older Wildebeest is forced into the river by the herd. It is not a voluntary action but a heritable social behavior of the herd to preserve itself.

Sapolsky identifies myths about what causes abnormal human behavior. The idea that testosterone levels are a cause for aggression is untrue. The National Institute of Health found that increased or decreased levels of testosterone have a weak correlation with aggression. Sapolsky notes that testosterone levels vary based on environmental circumstances and interaction with other hormone producing organs. It is not found to be a hormonal cause of aggression.

Sapolsky ends his lectures with “Evolution, Aggression, and Cooperation”. Here is where some may become disappointed with “Biology and Human Behavior”. The disappointment is in feeling there is no way out of the human condition of “everyone for himself”.

Every country of the world is populated with people like the wildebeest. Until the world is one herd, it seems humans are destined to lose their way as a species. The river to cross is the world’s environmental crises. With disparate herds in the world, the alligator in the river (our environment) will eat us all.

LIFE’S LIMITS

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
 Website: chetyarbrough.blog

Biology: The Science of Life

By: The Great Courses

Lecturer: Stephen Nowicki

Stephen Nowicki (Professor of Biology at Duke University.)

Professor Stephen Nowicki offers a 36.5-hour lecture on Biology. From the origin and growth of life to the chemical and neuronal function of living things, Nowicki systematically reveals experimentally tested knowledge of the “…Science of Life”. This brief review only addresses a few of the many fascinating details Nowicki explains.

Science argues the beginning of life began with cells.

Nowicki suggests, cells evolve from the agglomeration of detritus from the “Big Bang”.

The early formation of these cells is missing two ingredients for life. Nowicki explains these early cells evolve from violent volcanic and electrical activity of the “Big Bang”, an environment in which those two missing ingredients are created.

Nowicki explains early non-living cells are bombarded by electrical storms that generate amino acids (organic compounds) and sugar from violent atmospheric conditions that include water.

In the early 1950s, these conditions were tested in laboratory conditions and found to create two essential building blocks of life. Nowicki explains, these building blocks (amino acids and sugars) became part of non-living cells.

Experiments show these non-living cells transformed into prokaryotic and eukaryotic cells.

The eukaryotic cells had a nucleus containing genetic material while prokaryotic cells carried free-floating genetic material without a nucleus. Nowicki then explains the role nucleotides (protein) play in activating genetic material within these cells.

Nowicki notes DNA is present in both prokaryotic and eukaryotic cells, but they need to have a way of being activated. With replication, molecules (chemical compounds) could form.  Nowicki explains living matter originated from the clumping and replication of these molecules.

Nowicki explains ribonucleotides (proteins) were created in the primordial soup of early earth. These ribonucleotides transformed into RNA which activated DNA genetic material and replicated both prokaryotic and eukaryotic cells.

Evolution of species, established by Darwin in the 19th century, appears quite consistent and reminiscent of the primordial process Nowicki outlines.

With that reflection, Nowicki reminds listeners that evolutionary process should not be thought of as a necessarily progressive improvement. Evolution is chancy. It can either preserve or destroy species. Nowicki wanders back in history to explain classification of species as theorized by Linnaeus in the early 18th century.

Carl Linnaeus (1707-1778, Swedish botanist, zoologist, taxonomist, physician.)

A particularly fascinating lecture is given about embryo development. A zygote is a fertilized egg. The zygote begins as a singular cell and splits into two cells.

The second doubling of a zygote creates four cells separated in a vertical axis with all genetic material present in each cell. Subsequent doubling is separated on a horizontal axis. These new cells do not have all genetic material enclosed. The new cells have a more limited genetic role. There is significance in that axis change because of the location of genetic material in respective cells. With a change in axis, the viability of one cell carrying all the characteristics of its host goes from certainty to doubtful. The specialization of cells removes some of the genetic material that would contain all the characteristics of the life form.

Zygote Evolution

The zygote at four cells is mature. The next doubling becomes an embryo. All four cells have the genetic material of a male’s and female’s contribution. Each multiplication reduces the size of sister cells until they form a mass that surrounds a vacant space within its middle. This vacant space is the blastocyst stage. The blastocyst is made up of an exterior shell, a middle shell, and an inner shell. Each shell becomes the seat of design for what is to be born.

After a Zygote split into 4 cells, it becomes an embryo.

All amassed cells around the blastocyst carry site specific genetic material of life that forms a living thing.

The process of design in a human begins with an intrusion into the blastocyst without breaking its shells. That intrusion (a human gastrula), around the 7th or 8th day, uses the membranes as laboratories within which genetic codes create skin, bone, internal organs, and the digestive system.

Each of the three membranes are the laboratories of creation. The exterior or outer shell for example would become skin, the middle shell would become organs, the inner shell would become the digestive system.

The key to activation of this process is protein. Protein is the messenger of genetic material (DNA and RNA) from cells that create the tissue and organs of the body. Proteins are the elemental particles that activate genetic morphology. Without protein activation, there is no life.

The next exploration of biology by Nowicki is more suited to students of biology. Nowicki makes a valiant effort to explain the chemistry of ADP and ATP phosphates that provide energy needed for growth and maintenance of life. This part of the lecture series becomes too technical.

In general, Nowicki explains growth and maintenance of life requires energy. That energy comes from the hydrolysis of ATP and ADP. Hydrolysis is the chemical breakdown of molecules as they interact with water.

As molecules of ATP and ADP break down, they fuel cells of life to act in specific ways to promote growth and maintenance. Like the importance of protein messengers for activation of genetic material, life cannot exist without the energy provided by ATP and ADP. Nowicki diligently tries to explain the mechanics of this phosphate process but loses this reviewer’s interest.

Next, Nowicki lectures on photosynthesis and how plants use sunlight to synthesize foods from carbon dioxide and water.

The first inkling of cause for plant growth is noted by Jan Baptist van Helmont in the 17th century. Nowicki explains Helmont planted a tree in a tub of soil. He carefully weighed the soil and tree at the time of planting. Over several years, he observed the growth of the tree. At the end of those years, Helmont weighed the soil and tree. He found a small decrease in the soil’s weight and a gigantic increase in the tree’s weight. Helmont speculates the difference is from water added over the years. Though his conclusion is only partly correct, he paved the way for discovery of photosynthesis.

Jan Baptist van Helmont , a Dutch chemist and physician (1580-1644, On the left with his son on the right.)

That synthesis is a more complete explanation of the weight gain noted in Helmont’s experiment. The fundamental point being made by Nowicki is that species growth and demise is based on resource availability. Jan Ingenhousz completes Helmont’s theory with the discovery of photosynthesis.

Jan Ingenhousz (1730-1799, Dutch physiologist.)

Around 1779, A Dutch physician named Jan Ingenhousz found that green plants use sunlight to synthesize food for plants from carbon dioxide and water.

The remaining lectures are about Malthusian limits to life. There are natural and societal actions (meaning acts of war) that affect species survival. For natural calamities, one is reminded of the Black plague in the 14th and 17th centuries, the Spanish flu after WWI., the Irish famine in 19th century, the great Chinese famine during the “Great Leap Forward”, and now Covid19.

And today, the Covid19’ pandemic. (As of August 2022, world-wide deaths are estimated by WHO at over 6,000,000 with the U.S. at 1,032,820, Brazil at 679,536, and India at 526,689. This does not account for undiagnosed deaths from the virus.)

From man’s inhumanity to man, there is the Mongol invasion of Europe in the 13th century, two 20th century World Wars, the holocaust atrocity of WWII that murdered 11,000,000 (6,000,000 of which were Jews), and most recently, an estimated 600,000 dead in the Syrian Civil War.

How many more deaths will there be from Russia’s invasion of Ukraine?

Of course, Nowicki’s attention is on the biology of life. Nowicki explains, the key to balance of nature is biodiversity.  Nowicki notes the unprecedented loss of species in the post 20th century world risks life’s future. Nowicki briefly explains how drug discoveries and loss of genetic material from species extinction affects the balance of nature by diminishing the sources and utility of future medical discoveries.

The fundamental point of Nowicki’s view is that no species escape the natural biological limits of life. Nature balances life based on resources available. A listener may imply Nowicki believes humanity is threatened as much by ignorance of biology as of “man’s inhumanity to man”.

AMERICAN MALAISE

Audio-book Review
           By Chet Yarbrough

(Blog:awalkingdelight)
 Website: chetyarbrough.blog

The Retreat of Western Liberalism

By: Edward Luce

Narrated by: Julian Eifer

Edward Luce (Author, English journalist, Financial Times columnist and US commentator.)

Edward Luce offers a troubling picture of 21s century America.    His argument depends on one’s definition of “…Western Liberalism”.  If the definition is belief in human individuality and a relaxation of public custom, law, and authority, there is evidence to support Luce’s argument. 

Luce notes the election of Donald Trump is not an American aberration but a symptom of “The Retreat of Western Liberalism”.

The advent of the internet has reinforced a group think driven by belief in alternative facts that create conspiracy theories.  It is a discontent coming from many Americans ignored by rising wealth of a nation controlled by special interests.  Trump taps into that discontent.   

The irony of Trump’s rise is his personal wealth when the American gap between rich and poor is skyrocketing.  Putting that irony aside, Trump suggests America can be “Great Again” by returning to a past.

Trump creates a false hope of re-industrializing America with new jobs. The falseness of Trump’s pitch is that new jobs in America are not being created by industrialization but by technology and human services.  Trump’s appeal is loaded with false representations, amplified by media trolls.  Public custom, law, and authority are undermined by conspiracy theories that convince Americans they have been cheated out of their fair share of America’s wealth.  In truth, they have, and that is why Trump’s false pitch about “Making America Great Again” got him elected.

Trump’s anti-immigrant falsehoods feed conspiracy theories about jobs being taken from poor Americans.  Equal opportunity is a function of rising wealth in the hands of the few.  Public education and health care are unequally distributed in America.  The wealthy can afford higher education and the best health care, the poor cannot. 

Americans are poor because they are being denied equal opportunity, not because of immigration. 

Education and health care are critical for American labor’s adjustment to a changing world.  Private industry and the government have equal responsibility for assisting all Americans, not just those who have benefited from the technological revolution.

Job transition requires re-education and on-job training by employers that offer decent wages and health care. 

Luce’s point is a “rising tide has not lifted all boats”.  The technological revolution offers the same potential for western liberalism as the industrial revolution.  The election of Donald Trump was America’s “wake up” call. 

A large part of America’s population has been left out of the American Dream of western liberalism that came from opportunities provided by the industrial revolution. 

Western liberalism needs to be reinvented by investment in a technological revolution for all Americans, not just those who have benefited from the industrial revolution.  The question is whether private industry and the government are up to the task.  Will western liberalism be reinvented and promoted by ossified industrial leaders and elected representatives?  Most industry leaders and elected representatives are satisfied with the status quo while too many Americans struggle to make mortgage or rent payments.  Luce defines the problem but offers no solution.

CRISPR REVOLUTION

Audio-book Review
           By Chet Yarbrough

(Blog:awalkingdelight)
 Website: chetyarbrough.blog

Editing Humanity (The CRISPR Revolution and the New Era of Genome Editing)

By: Kevin Davies

Narrated by: Kevin Davies

Kevin Davies (Author, Ph.D in molecular genetics, Editor of Nature Genetics.)

The famous philosopher Søren Kierkegaard advised “Life can only be understood backwards; but it must be lived forwards.” 

He Jiankui (Chinese scientist who used CRSPR to modify genes of unborn twin girls.)

Kevin Davies reports the genie is out of the bottle with He Jiankui’s sloppy edit of genes in unborn twins.  Davies suggests science will move forward on gene modification to provide understanding Jiankui’s inept genetic experiment. With that forward movement, Davies implies human extinction will be delayed, extended, or ended by genome experimentation. Proof of Davies conclusion is in Britain’s plan to create a government owned company to investigate genetic diseases and cancer in adults. The pilot project is to sequence the genomes of 200,000 babies according to a May 14th article in “The Economist”.

What remains a danger is that evidence of genomic abnormality is a first step to experiments in changing genetic inheritance at birth. There is a great deal unknown about what some call “dark genetic matter”.

What becomes clear is the potential for great good and great harm in the CRISPR revolution.    

CRISPR-This is an acronym for clustered regularly interspaced short palindromic repeats. It is a tech tool that reads DNA sequences that are fragmentary and not normal. In identifying what appears abnormal, the fragments can be manipulated to repeat what is believed to be the correct DNA sequence.                                                                                        

With the discovery of base pairing and the DNA double helix by Watson, Crick, and the (often-unrecognized) assistance of Rosaland Franklin, the basis for genome editing became possible. 

Beyond the syllabus: The discovery of the double helix. Erwin Chargaff (1951): Rule of Base pairing. Rosalind Franklin & Maurice Wilkins (1953): X-ray diffraction pattern of DNA. James Watson & Francis Crick (1953): Molecular structure of DNA.
Davies notes the key to editing genes are the replication errors between DNA strands.  Those spaces are indicative of disease risk that can be modified with CRISPR, a genome editing technique.

Davies offers a picture of Jiankui’s life.  He was educated at the University of Science and Technology of China and received a Ph.D. from the Department of Physics and Astronomy at Rice University in Texas.  From a humble life in China, Jiankui climbs a genetic mountain to arrive at a cliff of science.  One might characterize it as a cliff because a misstep in gene editing may injure or kill a patient and ruin a practitioner’s professional reputation.  Jiankui became a living example of a practitioner’s misstep. Jiankui is serving 3 years in prison and has been fined the equivalent of over $430,000 American dollars.  Davies notes the fate of the prenatal female twins is unknown.

Some would argue there are too many unknowns when genes are modified. As noted by Robert Plomin in “Blueprint”, the interconnection of DNA strands is complex.

Plomin notes the results of DNA modification are a matter of probability, not certainty.  Clearly identifying defective genes and modifying their code to eradicate disease or mental dysfunction is presently beyond current science understanding.

Adding to the uncertainty of results is the potential for creating a radical human cohort that defies societal norms, e.g., the creation of a destructive or superior race of humans.  An infrastructure would have to be formed to make decisions about the course of human civilization.  That infrastructure creates potential for radical authoritarian control of humanity by a select group of minders.

On the other hand, DNA modification holds the potential for eradicating disease.  The idea of eliminating HIV, and other viral diseases holds great promise for the future of humanity.  The cost and benefit will only be realized through experiment.  In one sense, it is like the experiments that doctors have taken since the beginning of medical treatment.  Heart disease and cancer treatments have become better over years of trial and error.

DNA modification is extensively used in agriculture to increase field productivity by reducing disease in plants and hardening resistance to blight.

DNA modification opens doors to regeneration when threatened by species extinction.

The light at the end of this tunnel may be a train or a new day. 

Davies’s underlying point is that CRSPR is here and will not go away.  Experiment will continue whether condoned by government or not.  All species on earth have a finite life. 

DNA modification is a fact, not just an idea.  It is here and will be used.  Science is grappling with rules to mitigate its potential downside while trying to insure its upside.  In the end, human survival will be decided by nature and the politics of control.

DNA

Audio-book Review
           By Chet Yarbrough

(Blog:awalkingdelight)
 Website: chetyarbrough.blog

Blueprint (How DNA Makes Us Who We Are)

By: Robert Plomin

Narrated by: Robert Plomin

Robert Plomin (Author, American Psychologist and behavioral geneticist.)

As a psychologist and clinical geneticist, Robert Plomin seems well suited to explain how understanding of DNA has the potential of mitigating (possibly curing) many human psychological maladies. 

The scientific community notes that 70% of human variability is based on genetic differences among people. 

With a perfect picture of a person’s DNA, there is potential for reducing human mental disorders.  However, Plomin’s argument seems weakened by his research and experience.

Plomin has spent a great deal of his life researching DNA and genetic inheritance. 

What “Blueprint” reveals is how much progress has been made but, at the same time, how far science must advance to clearly understand what the other 30% of human experience has to do with who we are, how we think, and why we act as we do. 

Plomin acknowledges there are different patterns of genetic inheritance.  These patterns show susceptible psychological maladies and other genetic anomalies that cause Huntington disease, Marfan syndrome, cystic fibrosis, sickle cell disease, hemophilia, and others.  The inheritance patterns suggest those diseases are probabilities, not certainties. 

Plomin acknowledges DNA analysis remains too complex for precise understanding of the correlation between cause and effect.  Without precise understanding of genetic manipulation there will be unintended consequence, ranging from disability to death.  Further, there is the ethics of gene splicing that implies creation of a utopian society. 

Who would have the right to determine another’s role in society?  Whether as a philosopher king envisioned in Plato’s “…Republic”, or an Aryan race envisioned by Hitler, genetic manipulation opens a door to predetermined roles for human beings.  Who will make these decisions?  Is a planned society a good thing?  Does a human being want to be classified as a worker, a leader, a thinker, a doer because someone suggests society needs those classifications?

Listening to “Blueprint” leaves little doubt that understanding DNA is important.  What is in doubt is how that understanding is used.  Humanity has survived an estimated five or six million years.  To date, human survival has been based on random modifications of DNA and life experience. 

Maybe genetics offer the next stage in human survival, but abandoning natural selection carries risks based on human thought and action rather than natural selection.  Should science open Pandora’s box?

OOPS

Audio-book Review
           By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

Complications (A Surgeon’s Notes on the Imperfect Science)

By: Atul Gawande

Narrated by Robert Petkoff

Several years ago, “Being Mortal” was reviewed with appreciation of what the author had to say about a doctor’s responsibility for improving the quality of life for the elderly and terminally ill.  Atul Gawande reinforces the double meaning of “Being Mortal” in his “Complications…Notes on the Imperfect Science”. 

Gawande explains doctors are not superhuman beings.  They are well-educated mortals that practice medicine with the intent of making the right decisions through attentive communication with patients. 

Knowledge from teachers and practitioners is helpful but it is through practice on patients that doctors become proficient for those needing help.  Gawande’s reflective words “practice on patients” are frightening to one who’s life is threatened by injury or disease.

Gawande notes decisions are not based on omniscience but on a doctor’s education and experience. 

Gawande offers notes on the imperfect science of medicine.  He explains why even the most conscientious physicians, let alone bad practitioners, make mistakes.  To become a skilled physician, as with any skill, requires practice.  The monumental difference is medical practice directly affects human lives.  Other professional practices are indirect.

The compounding difficulty of the science of medicine is that even the most experienced physicians make mistakes.  It may be because of missed diagnosis or motivations inherent in human nature (the drive for wealth, power, or prestige) but it is always at the expense of a patient.

Gawande reflects on the intuitive nature of medicine by telling the story of the fire captain that tells fellow fire fighters to leave a building when he senses the building is going to collapse (an anecdote also told in “Thinking Fast and Slow”).  An experienced doctor often must rely on the same sense and can be perfectly right or catastrophically wrong. 

Gawande tells the story of a young woman who is diagnosed with cellulitis in a leg that is swollen and inflamed.  The attending physician asks Gawande to look at the patient to confirm the diagnosis. 

Gawande questions the patient about how she might have acquired the infection.  He suspects it may be from a rare flesh-eating virus even though all the symptoms are consistent with cellulitis which can be easily treated with antibiotics.  Gawande suggests a biopsy and the diagnosis is changed.  It is found to be to the rare flesh-eating virus.  It is Gawande’s intuition that leads to treatment that successfully saves the young woman’s life.

A medical patient listening to Gawande appreciates his candor but fears the truth of human fallibility of a profession one relies upon. 

Most realize all humans make mistakes.  What is disconcerting is the lack of disclosure by many physicians and the doubt raised by Gawande in some doctor’s veracity in seeking what is best for their patients. 

Gawande explains some organizational methods used to minimize mistakes and modify future medical practices.  However, public disclosure of those mistakes (particularly regarding specific doctors and hospitals) is largely undisclosed. 

Gawande is challenging his profession to do better.  To that, the public should be grateful.

BRAIN FUNCTION

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

The Secrets of Consciousness

By: Essays in Scientific American

Narrated by: Coleen Marlo

A lot of ground is covered in “The Secrets of Consciousness” but for many who are interested in the subject, little new is revealed. 

Many articles and books have been written about the easy and hard part of the theory of consciousness. 

The easy part is knowledge of the physical characteristics and mechanics of brain function–the “how and where” of information that is stored and transmitted by the brain. 

The hard part remains the explanation of what consciousness means, particularly the “whys”. Why are living things aware of themselves, others, and the world from information transmission within a brain.  Why do humans get angry?  Why do we love?  Why do we hate?  Why are we sad or happy?  Is everything in the universe conscious?

(It is somewhat surprising that “A Thousand Brains” theory is not revealed in “The Secrets…” but it may be timing of publication. Or it may be scientist’s discounting of an engineer’s qualification for understanding consciousness.)

Consciousness is explained as an all-encompassing part of nature.  There is an avenue for consciousness in A.I., once the mechanics of consciousness are fully understood. The focus of first chapters are on scientific experiments showing all living things exhibit consciousness through their actions. 

For example, bees show consciousness by seeing red and in choosing the site of their nests with an ability to consciously navigate the world.

Following chapters explain parts of the brain and the mechanics of brain function.  They explore the complexity and interconnections of the brain and how different parts of the brain have specific functions.  This is the easy part of understanding consciousness because it is something that can be physically measured through brain scans and experiments that correlate actions with brain stimuli.  

Next, there are explanations of how experiments with brain stimuli offers potential for reading one’s mind without verbal communication. 

It opens the door for a consciousness meter that may allow some level of predictability and mind control.  In a positive sense, stimulus experiments might hold a key to reawakening consciousness in comatose patients.  The negative sense is the potential for brain washing a non-conforming human being.

Section 4 of these “Scientific American” articles is about “Altered States of Reality”. 

A particularly bizarre and threatening chapter suggests someone who sleepwalks can murder another person without being legally guilty of murder.

The last two sections of articles deal with psychoactive drugs, spiritual belief, and their effects on brain function.  A listener might view these articles as incentive to experiment with consciousness in two fundamentally different ways. One is with the use of psychedelic’s. The other is to join a monastery or convent.

The last article deals with the end of life. It reveals a possible explanation of why some see a white light just before dying.

Science argues the end of life is the end of consciousness. There is nothing after death–no heaven, no hell, just nothingness.

As an introduction to consciousness, this compendium is interesting.  However, after completion, the hard part of consciousness remains a secret.

AUTISM

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

Uniquely Human

By: Barry M. Prizant PhD

Narrated by P.J. Ochlan

Barry M. Prizant, Phd. (Author, adjunt professor at Brown University, authority on autism disorders.)

Many are familiar with the existence of a neurodevelopment disorder called autism.  In a 2015 “Global Burden of Disease Study”, it is estimated that 1-2 people per 1,000 may be diagnosed with an autism spectrum disorder. 

Prizant notes it affects more males than females and has a wide range of exhibited symptoms.

“Uniquely Human” is an excellent introduction to autism.  Prizant explains how symptoms are manifested, and how parents, teachers, and the public can help those within and outside the autistic spectrum. 

Autism is believed to be caused by a combination of genetic and environmental factors.  Faulty synaptic connections in an autistic person’s brain affects their way of thinking and acting.

Prizant notes the importance of listening to a person on the autistic spectrum and asking questions to understand their thought and action. 

Prizant becomes an investigator by asking parents, teachers, and acquaintances of their experience with a particular autistic person.  By questioning, Prizant can find why an autistic person acts or reacts in a particular way. 

Prizant explains that a person on the spectrum is no different than any human being. An autistic person is thinking and acting based on facts they perceive and how they interpret those facts. 

If something is thought of as a threat, all people act in similar ways.  The principal difference is that one on the autistic spectrum may be interpreting information differently and reacting in accordance with their unique perception.    

When one realizes how information is being interpreted by someone on the spectrum, it is possible to work on reactions that seem wrong for the circumstances.  Prizant goes through several examples.  Being fearful of a boat ride, a particular corner of a street, or meeting strangers may make one who is on the spectrum act out.  With understanding of an autistic’s perception, one can desensitize and change behavior through explanation, environment change, or avoidance. 

In the case of the boat ride for the autistic child, Prizant suggests explaining the safety measures to be taken, adding a comfort toy on the trip, and showing that many friends will be on the boat.  In the case of a scary corner, Prizant discovers that a white building at the corner reminds the autistic person of a trip to the doctor when he was ill and in pain. Explaining to the frightened child that all white buildings are not the same abates fear of the corner. With more careful understanding of an autistic person’s perception, the object of fear can be addressed directly.  Being afraid of strangers is true of many people whether on the spectrum or not.  Knowing there is fear means one can address that fear by gradually introducing friends that do not have to be feared.

The difficult realization in Prizant’s book is that there are so many commonly understood social conventions assumed by people that are not comprehended by those on the autistic spectrum.  Social conventions are often poorly defined or not taught. 

Social conventions like not saying what you think when it embarrasses a person in front of other people comes from experience, not teaching.  This is just one example of how difficult it is for an autistic person to cope with life because societal norms are not precisely defined.  Those not on the spectrum, take societal norms for granted based on their experience.  Prizant notes a person on the autistic spectrum experiences life differently.  They may be completely unaware of social conventions.

Prizant offers tools for understanding and working with all human beings, not just those on the autistic spectrum.  Whether one is autistic or not, it is important to listen, investigate, and understand why people think and act the way they do.  It might be because that person is on the autism spectrum.  That does not mean those who are not on the spectrum may also interpret facts in a way that is inconsistent with most people’s understanding.

Many experiences early in one’s life have consequences later in life. A child remembers a father’s or mother’s rebuke as an eternal judgement when the reality may have been to protect a child from harm.  The shadow is created and remains with the child for the rest of his/her life.

Understanding human beings can only come from listening and questioning what a person thinks and why they act the way they do.  Easy to say, but time consuming and unlikely to be done in this increasingly fast-paced world.

IGNORANCE IS NOT BLISS

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

Half Lives

By: Lucy Jane Santos

Narrated by : Deirdre Whelen

Lucy Jane Santos (Author, Freelance writer and Historian.)

              Lucy Jane Santos recounts the perilous history of radioactivity in “Half Lives”.  Her history is not scintillating but offers a lesson in skepticism.  Her focus is the “on again, off again” love affair with radon by scientists, doctors, charlatans, and beauty product entrepreneurs.  The lesson is relevant in some ways to the Covid19 controversy of this century.

Santos recounts the discovery of radium in the late 19th century and shows how it evolved into the discovery of radiology that revolutionized surgical practice and diagnosis

A brighter part of Santos story is the discovery of X-rays (a type of radiation) and the value it gave to diagnosis and repair of internal injuries by providing interior pictures of the human body.  The idea came from an accidental discovery by Wilhelm Roentgen in 1895.  While testing whether electrons could pass through glass, Roentgen found a green light appeared on black paper which then projected onto a nearby fluorescent screen.  These electrons are the essence of what became known as radiation.

Wilhem Roentgen (Scientist who discovered x-rays, received Nobel Prize in Physics 1901)

Marie Curie, a chemist and physicist, discovered two new periodic table’ elements, radon, and polonium in developing a theory of radioactivity.  Like Roentgen’s Xray discovery of the dispersal of electrons, Curie found photons may be released from atoms to trans mutate into different elements on the periodic table.  Curie received two Nobel Prizes, one in conjunction with her husband Pierre and a physicist named Henri Becquerel, and another on her own.  She is the first woman to receive a Nobel Prize and only one of four people who have ever been awarded two Nobel Prizes. (The other three were men—Linus Pauling, John Bardeen, and Frederick Sanger.)

Marie Curie (Scientist, chemist, and physicist, received 2 Nobel Prizes, died at the age of 66.

Santos suggests Curie’s death from radiation poisoning is a myth.  She bases that conclusion on an exhumation of Curie’s body to relocate it in France.  In the exhumation, no radiation was found in her remains.

These are two positives’ Santos notes in her history of radioactivity.  With the discoveries of Roentgen and Curie, radiation is used for diagnosis, surgical care, and treatment for physical injuries and cancer. 

However, radioactivity discoveries are misused by many who ignore the negatives of radiation.  Prominent businesspeople, some of which are outright charlatans, suggest radiation will cure numerous diseases, can be used as a luminous paint without concern for its impact on health, and should be mixed in elixirs or emoluments for skin repair and beauty treatments.  The quest for money, power, and prestige seduces the public into using radiation treatments for unproven, often harmful health and beauty benefits.

Radioactivity’s early history reveals shortened lives of many who believed radon was a miracle cure.  Maybe the most famous is Eben McBurney Byers, a wealthy American socialite, athlete, and industrialist who died in 1932.  He was 52 years old.

Byers, at the suggestion of his doctor began drinking a non-prescription liquid called Radithor (radium infused water).  The irony of his doctor’s suggestion is that a person who identified himself as a doctor was actually a college drop-out who manufactured and sold Radithor to Byers and other un-suspecting victims.

Upon autopsy, it is found that radium does not dissipate in the body but accumulates in organs and bones.  Byers is said to have ingested over 1400 bottles in 3 years. His brain became abscessed with holes forming in his skull. He died on March 31, 1932.

Santos notes the dials of watches were painted to glow in the dark, particularly important during WWI when soldiers needed to coordinate their movements.  It was found that the radiated dials were harmful to painters of the dials, but manufacturers denied the correlation until challenged by evidence of many who were physically disfigured or died from their work.

Radium Girls (Women hired to paint watch dials with radium)

Famous beauty product producers in England and France in the 1920s and 30s were promotors of cosmetics infused with Radon.  One wonders how many of these misinformed practices are not a proximate cause of cancer increase in the world.

The cosmetic industry grew exponentially after WWI.  Radon mixing in emoluments were touted for their ability to increase blood flow to the skin to brighten one’s appearance. 

Santos’s story is a warning to humanity.  Be skeptical of cures that purport to be safe and beneficial, and review facts available from reputable sources.  Today’s vaccination for Covid19 is a case in point.  The facts are that over 650,000 Americans have died from Covid19.  Those who have received the “jab” are less likely to die if they are infected by the virus.  The virus is transmitted from person to person and can be mitigated by wearing a mask.  Consider the source of those who promote or deny those facts.  When facts are distorted by politics, we only have ourselves to blame.  Humans need to be skeptical but not ignorant.