The Limits of Exhaustion

By: | June 3, 2016

burnout

Recently I had cause to wonder whether I was experiencing the famous “burnout syndrome”. I had been asked to give a talk to an auditorium full of gifted high school students. As I hurriedly prepared the speech – wondering what one should say to gifted children about their own giftedness – all I wanted to tell them was that being an adult is so hard, I don’t know how anyone who’s not gifted even survives in the world. Just being a person is going to be crazy difficult for all of you, I wanted to say.

And if you set your standards to any kind of reasonable level, every week will look like mission impossible, and you will have to run at it full tilt and try to do all the things. If by some miracle you manage it, you will just have to turn around and line up the hurdles for the next week and do it all again.

When you’re an adult, I wanted to say but didn’t, not ten minutes go by when you don’t think, “Man, I gotta get this stupid thing done or I’m so dead.” And if you’re sick for more than a day, the world breaks. I felt myself morphing into the image of the care-worn woman from the Dust Bowl photograph. It was not going to be a barn-burning performance. Continue reading →

Controlling Cancer with Evolution

By: | June 2, 2016

evolutionIn 2001, Dean Spath was diagnosed with advanced prostate cancer. He had surgery to remove his prostate, and for nearly a decade, Spath appeared to be cancer free. Each year he would visit the doctor to have a blood test and a scan, and each year the tests came back clean. “They thought they got it all,” Spath says. “I was hoping I was cured.” In January 2011, however, a blood test revealed that Spath’s PSA level, a marker of disease progression, was on the rise. By June a malignant spot had appeared on his rib. The cancer was back.

First, Spath underwent eight weeks of radiation. And then he began receiving an injection to suppress testosterone, a hormone that fuels prostate cancer. Next he tried a new kind of immune therapy. But no matter what Spath’s physicians gave him, they couldn’t eradicate the cancer.

Spath is far from alone. All over the world, people with metastatic cancer are fighting a losing battle. Even when oncologists use the most targeted, cutting-edge therapies, patients develop resistance and their cancer comes thundering back.

The problem is that cancer is so monumentally diverse. Tumors begin as a single cell that keeps dividing. The daughters should be perfect clones, but some pick up genetic defects that make them distinct. This genetic diversity allows the tumor to evolve. Resistance is inevitable, says Bert Vogelstein, a cancer geneticist at Johns Hopkins University in Baltimore. “All of the mutations that are responsible for resistance are already present in each metastatic lesion before any treatment is begun,” he says. “It’s a fait accompli.”

But Robert Gatenby, a molecular oncologist at Moffitt Cancer Center in Tampa, Florida, thinks he may have a fix. What if we lower the bar? Instead of trying to cure individuals with incurable cancer, what if we help them live with their disease? Could we stave off resistance and buy more time? Continue reading →

Redux: What is a good death?

By: | June 1, 2016

This post first ran on August 29, 2013.GoodGravestoneMy beloved neighbor Joanne was 87 years old when her son found her dead in the hallway of her old farmhouse on Monday. They’d gone to a funeral together that morning — a younger relative had died of pancreatic cancer — and after lunch he’d dropped her off at home. When he returned later that afternoon, she was gone.

I wasn’t home at the time, so I missed the commotion on our dead-end road, where the Joanne’s family farm occupied the final spot — the anchor to our small, rural neighborhood. When I received the news the next morning, I was so shaken that I hung up the phone in haste, unable to talk through my tears.

Joanne had been seeming a little foggy-headed and newly frail in recent months, but she’d been so resilient over the years that I’d assumed she had several more years in her. Her death came as a shock, and even as I write this I can’t believe it’s real.

I want to comfort myself with the notion that hers was a good death, but I’m not even sure what that means. She’d lived a full life and her decline was sudden, rather than prolonged, like her husband Mack’s had been. Isn’t that what we all want? One day you’re fine, the next you’re gone — no time to linger in the ugly in-between.

Having witnessed a loved one slowly succumb to cancer, I can say with confidence that when my time comes, I’d prefer to be hit by a bus — in an instant, it’s lights out, no prolonged suffering or regret. But most of us don’t get to choose, and even if we try to plan in advance, it’s impossible to anticipate real life.

I’ve been a witness several times to discussions between hospice workers and dying people or their families, and the most striking thing I’ve noticed is how inadequate these theoretical discussions can be. Continue reading →

Guest Post: A Mathy Mechanism for Solving a Problem Like The Donald

By: | May 31, 2016

shutterstock_114656170Over the last several years, Harvard economist Eric Maskin has been delivering a talk asking: “How Should We Elect Presidents?”

Should the candidate with the most votes win? Not necessarily, according to Maskin.

Maskin blames the U.S. system of plurality voting—whereby each voter casts their vote for one candidate and the candidate with the most votes wins, even if that number is short of a majority—for the general election mess of 2000, when the outcome was decided by a divided Supreme Court.

Now, he proposes, plurality voting has abetted presumptive Republican nominee Donald Trump, who made his startling ascent with minority support from his party. “There is something very wrong with plurality voting,” Maskin told me in March, the day after Trump won the Republican primaries in Florida, Illinois, Missouri, and North Carolina—all with only a minority of votes.

“In 2000, the disaster was Bush winning in Florida when a majority were really in favor of Gore,” he said, adding that maybe the Trump disaster will be enough to incite serious discussion on the topic of voting reform. Because, as he noted, “There will be a next time, if history is any indication.”

Continue reading →

Redux: Gold Stars

By: | May 30, 2016

This post was originally published on May 26, 2014, but it’s still relevant today. ChildFlag_shutterstock_50700037Go ahead and celebrate today’s holiday with a grill and a swill or a trip to some big box store to buy discounted appliances. Unless you’re part of the other one percent — the tiny fraction of Americans who served in the military during the long wars fought since September 11, 2001 — Memorial Day may not feel personal to you.

But if you’re an American, it should. The 6,809 service members killed and 52,010 wounded in nearly thirteen years of war made these sacrifices on your behalf. They gave their lives so that you could go about your way. A growing gap between military and civilian populations has created an easy out for those looking for a reason not to engage in issues of foreign policy and military action. “People say, ‘You volunteered. You knew what you were signing up for,’” one veteran told me recently. That may be true.

Yet there’s a population of innocents who shoulder the burden of military service without ever having made the choice — military kids. These children must accept that their parents’ lives belong to the military first. No matter how dedicated and engaged the parent is, family obligations will always come after military ones. Deployed fathers can’t make it home for their children’s births, mothers or fathers miss a child’s first day of school or graduation. Continue reading →

The Last Word

By: | May 28, 2016

sea pic 4 favignanaMay 23 – 27, 2016

Remember Erik’s argument that cultures have their own keywords/cyphers? Guest Sean Treacy says that the keyword for Italian culture is “bella,” beauty, to such an extent that the beautiful also defines the good.  Think about that a minute.

Every year since he was a kid, Erik’s gone on The Ride up Highway 1, and now that he’s followed the pilgrims to the pilgrimage church in Munich, he thinks he knows what’s been going on.

Jennifer has to deal with chronic pain — oooch, ouch, I’m so sorry, Jenny — and needs to take opioids, which for her though not for movie stars, involves chronic suspicion, guilt, and bureauocracy.

Body-hackers include burners, health nuts, grinders, the mindfulness people, all mixed up in the same Con.  Rose tries to discriminate and unify, gives up.

I go to a meeting about galaxy evolution, hear the phrase, “secular evolution,” wonder whether galaxies evolve irreligiously, find the correct definition, and adjust my life rules accordingly.

_____

photo by Sean Treacy

Science Metaphors (cont.): Secular Evolution

By: | May 27, 2016

HUDFThis is the latest in a series in which science’s metaphors offer the explanations of and guidance for the most cryptic of life’s problems.

A few weeks ago I was at a conference about galaxy evolution.  In the titles of many talks was the puzzling phrase, “secular evolution.”  Secular? as opposed to religious? so secular evolution is galaxy evolution that’s not in the context of religion?  Surely not.   I stopped listening to the talks and googled “secular.”  It’s Latin, meaning “belonging to a certain age,” as opposed to “infinite.”  Not helping.  I opted for the extreme measure of waiting for the coffee break and asking an astronomer.

“Secular evolution” in galaxies turns out to require a little context.  Years ago when I started writing about the origin and evolution of the universe, “galaxy evolution” was a matter of connecting some pretty dicey dots.  Cosmologists looked at nearby galaxies, at more distant galaxies, at the galaxies so far away you nearly couldn’t see them.  And assuming that most distant = farthest back in time = youngest, then those populations of nearby galaxies were grownups, the more distant were adolescents, and the far-away, babies.  Cosmologists arranged the populations into an evolution: galaxies began as little blue messes, spun up into sparkly spirals, collided and merged into unchanging ellipticals.  Galaxy evolution was interesting partly because it showed the universe growing up, that is, the universe that formed those galaxies was aging with them.

But that was populations of galaxies, not individual galaxies themselves – demographics, not myelination and hormones and bones losing calcium.  So what’s secular? Continue reading →

What Makes Something Bodyhacking?

By: | May 26, 2016

cyborg

A few months ago, in a dark club on the always-busy 6th Street in downtown Austin, there was a very odd party going on. To get in, you had to show a thin metal badge with a dancing woman etched into it. Projected onto the wall above the DJ playing house music there was a big counter that read: “Steps: 646873”. Every 15 minutes or so, the number crept up. “Steps: 646934.” The party was an “Interactive Wearables Concert.” Attendees were encouraged to connect their devices so they could add to the total on the wall.

This was the event that kicked off the first ever BodyHackingCon, “A Con as Unique as Its Attendees.” And the attendees certainly were unique. At one table, set back away from the dance floor, a group of men in jeans and t-shirts who could have walked out of any Office Max in any state. The grinders. On the dance floor, people in long leather skirts, zebra print onesies and fancy leather fanny packs. The burners. There were the health hackers, muscled and wearing tight shirts to show it off. Team mindfulness wore flowing pants and a serene look. Continue reading →