Friday, April 29, 2011

What lies ahead ~ Philosophy of Desire


Fortune and fame are the two imposters that all humans aspire toward. It is a human predicate for survival. It is the DNA directive. It is us, the beings, that read and write and understand and comprehend. It is future. It is thought and action. It is life.

Yet as we go about this evangelical crusade we grow ever weary of our own dictates. Time and age have a tendency to modulate and carve out such reflections into guilt by association or by such other means as we are unable to completely understand. These modulating influences seem to arrive insidiously and in such crafty mechanistic leverage that they modify those inherent callings. Some alter their desires because they have achieved that mantle and having climbed to that loftiest of rarified peaks they cannot see further for the clouds that obscure their vision and others that have fallen short point fingers at those that have. It is a dance of such rhythm and feeling that music is not required. The ebb and flow of desires dictates the slow rhythmic undulating directed flow of the dancers that splinters into confusion, chaos and ultimately conflict and then coheres once again with time.


Such compelling events have writ themselves in history for millennia; from Pharos to Romans, from Ming to the Maoist and from Brits to the Americans. The trailing and leading links of this historical parchment of human existence always seem to collect and disperse like the ant colonies in search of food. 


So why must now be different? Why should this era be any worse or better? Why must man do anything different than he has done before? The answers may lie in shady nooks of numbers and mathematics, yet to be deciphered. But the overarching sense of urgency seems to rest on the rising numbers of mouths to feed and the bodies to clothe in a resource-limited world.  The demands and needs rise geometrically as we struggle to perceive and comprehend what is to come. Do we artificially limit the population (as in China ~ now coming back to haunt) or try inflating resource by integrating technology if that is possible or find new moons to inhabit, or use self-replicating robots of Von Neumann fame with our embedded DNA to drive to the far reaches of our Milky Way Galaxy and populate new worlds?


On this planet, the poor are oppressed by the dictatorial regimes that usurp wealth and control with animalistic brutality. In the land of freedom the achievers are drowned in a sea of regulatory, stifling measures that handcuff them into inaction. And there but for such calumny the pitch and moment of any great enterprise is lost. Both peoples are subjugated into a land of apathy.  The powerful wrest control over both domains; the valleys and the mountaintops. It is all in the manner and the mode.

All previous dynasties and empires have risen and fallen by the swords of their own making. Yet as each fell a new one was ready to replace. There were lands to conquer and wealth to be accumulated, peoples to be subjugated and the all-consuming power to be used for accomplishing such ends. The world has been harvested and each ragged edge of its existence mapped. There are no new discoveries left to the Christopher Columbus of today, save other heavenly bodies. The firewall limits of mechanical discovery for inhabitation on this planet are at a finite end. Yet we must move on. Keep discovering where the eyes cannot see and the mind cannot reach. Salvation to this riddle might lie in that thought that has yet to be born in a child that has yet to be conceived.
Human follies may never end and we may never achieve the ultimate goal of a contended existence, but we must try for we all share the DNA and we are all destined to exist together.


The mountaintop is clouded over to blind, while those in the valleys with the acuity of vision, live and strive to gain that rarified access.  It is the abject desire that controls the future. Those that reside in the valleys become blind to the beauties of their vistas, while those that reside on the mountaintop are blinded by their achievement and the gales of disdain. The valley eyes are focused on the mountaintop enshrouded in the clouds that can only fuel the flames of their imagination because they cannot see the travails of those above. Those above can feel and hear the complaints below but cannot express, while the guilt of achievement in them grows and wanders into and against the very fabric of their own survival. It is only through the actual climb to that mountaintop reality that one becomes aware of these limitations. What both sometime forget is that achievement does need a place of residence –be it valley or mountaintop, to succeed.


So what then must this focal viewpoint of desire to do? Abdicate its universal calling? Deny itself the call of its DNA?  Forgo achievement? Live in the nebulous thought of mediocrity?


The key to success and the answers to all these questions lie within each of us. To aspire for a better future is a healthy and desirous thought, and to imagine the means to create it is its vaunted outcome. Wealth alone does not deem success. Out of poverty has risen many a great minds and many an enterprise of great accomplishment. The juice of success is not squeezed by the free flow of entitlements, but by the raw desire and hard work. It is not in the guilt nor in the blame that success will be breached.  Fortunes come and go just as fame is momentary and fleeting. The human predicate for survival and betterment trumps all else. It is in that ancient of things called intellectual providence where rise and fall is conceived and where life is destined to live with the full knowledge that “If it be not now, yet it will come.”

And so, the show must go on.


It matters not how strait the gate, 
  How charged with punishments the scroll, 
I am the master of my fate:
  I am the captain of my soul... William Ernest Henley (Invictus)

Saturday, April 23, 2011

Dystopian Nightmare v2.5


 A Healthcare Odyssey


His silver hair ruffles from the sudden disquieting breeze that blows through the street stirring up the settled dust. He smoothes his hair instinctively as he closes the door to his 2012 model Porsche designed Hybrid vehicle. There aren’t too many of those around anymore. The door shuts with a distinct muted thud. He admires the preserved state of this antique.

He walks to open the shuttered iron door. A low frequency siren wails from the corner of the office. He uses his thumb on the scanner to quiet it. He turns the light on. It is a single, overhead fluorescent lamp that flickers into existence.


The room is unevenly lit. The books in the closed wall cabinet, line the narrow office space wall on one side. There is a comfortable armchair, a small desk with a caduceus made of ceramic on one side of the table with a blotter and an old-fashioned ink pen in a holder on top on the other side. The opposite wall of this space is filled with photos and a single MD diploma from a little known university hospital dating back to 2010. The office space although narrow is furnished in modern style with clean lines and open spaces.

He picks out a book from his collection and sets it down next to the armchair. It is a compendium of medical differential diagnoses. As he turns the first page, the door opens and a 40-something person walks in.

“Good morning doctor.” The woman entering the office smiles at him with the greeting..
“Good Morning Vee,” He says and goes back to perusing the book.
“Mr. Stemp will be here shortly, he called yesterday.” She says her face turned away at her tiny desk perched close to the entrance door with its straight-backed chair.
“Thank you Vee.” He replies and no sooner, the door opens and in walks the Mr. Stemp.
“Hello Ms. Vee,” he says and unburdens himself with his issued card and other documents.
“Charlie, how are you!” the doctor shakes the other’s hand. Charlie is Charlie Stemp a 69 year-old man, muscle-bound with strength, who walks with an erect posture filled with pride and dignity..
“Doc you’ve got to help me. I feel fine, but they tell me that I have this heart problem that will take a month or two to confirm and then they will consider treatment.” He shakes his head, “And the problem is…”
“The problem is that in a month you will turn 70 and be ineligible for any treatment. Right?”
“Yeaes.” He exclaims.
“You know Charlie, 70 years is the age limit for any treatment for a chronic condition.”
“Yes. But I am not there yet and I want to nip it in the bud, if I can before then.”
“Ok. Lets see what you have.” The doctor scans the papers one at a time that Charlie has brought with him.

After the doctor completes the physical examination in the side room, he sits back down at his desk with his head bent over the papers in thought. What seems like a long time to Charlie, the doctor finally looks up into his expectant eyes and says, “Maybe I can help you.” Charlie’s face breaks out into a smile.
The doctor looks at the gash on his arm. It is partially healed but the beginnings of infection seem all too likely.
“Charlie, you should have gone to the emergency room for this.”
“No doc. You know they take credits off my health care card every time. Imagine, if I really need the care and no credit left. What am I going to do?”
“This could get infected and besides after next month all your credits are set to expire anyway?”
“I know, but one has to preserve every bit in this world for as long and I figured you can take a look at it. Besides, going to the emergency room is a nightmare. You have to register your name and it can take a whole day to get processed and then wait to be called. There are people lined up against the wall in the hallway and others camping outside the hospital just to get entrance.” He paused, “I don’t have to tell you that they have these mobile vans that carry patients that are not qualified back to their homes without treatment if they are deemed ineligible.” Charlie’s eyes are wide with anxiety.

The doctor opens the thick metal vault next to his desk by placing his thumb on the scan surface. There are no buttons or knobs. The door opens. The doctor pulls out a pad, makes some notation on the electronic pad and has Charlie sign beneath his name. And the treatment is rendered.

“Doc, thank you so much. You know I will pay all your bills as soon as I can earn some credits. Don’t you?”
“Yes Charlie. I know that.”
“Hey doc is that 40 year old antique car out there, yours?”
“Yes Charlie.”
“How would you like two gallons of unleaded gas for it.”
“At the going rate, all I can afford is two gallons a week just to keep it running.”
“I’ve got the gas in a drum at home. It is of no use to me. You can have it.” Charlie offers.
“Thanks Charlie, and I will take off equivalent amount from your owned amount.”
“No doc. This has nothing to do with the bill. Besides you don’t want to get the GS mafia against you, do you?”
“You’re right. Thanks for the offer Charlie”
“It is amazing how far I have fallen doc. Eighteen years ago, I was the poster child of a Biotech firm and its CEO. Seven implants, two ocular, one olfactory, two auditory and two muscle boosting implant devices. GS takes over the firm under some national security pretext and throws me in the trash heap. Now they are just waiting for me to die so they can take out these implants and do some data mining from my experiences. Hell they will have to try harder to rid of me.”
“Charlie, it seems you and I have both out-served our purposes. It is just a matter of time before they look at me too. It seems that once you have outspent your designated budget and out lived your mandate…” the doctor doesn’t finish his thought.
“Well they are not going to psychologically force me to add my name to the rash of 70+ year-olds committing suicide. No! No! I intend to make them miserable with my existence.” Charlie clenches his fist and heads for the door.


After Charlie leaves, the doctor settles into his armchair and his eyes take in the growing traffic outside. The shuttered Hardware Store on the opposite side of the street a stark reminder of the good old days. The shop next to it is a tailoring store with some reasonable business, but it opens only two days a week. Next to that is a shuttered café with the “Moonlight Coffee” sign hanging precariously off the roof overhang. Behind this dilapidation rises the silver megalith. The building almost 100 stories high is the tallest building this side of the Mississippi. It is the GS Headquarters.


GS stands for Geoffery Stoker, a business tycoon aged 45 who inherited it from his father, a wealthy man who became a confidant to the President of the United States. GS enterprises accumulated all its wealth through buying the Nuclear Power plants in the Eastern Seaboard and all the Wind Turbines Farms. GS supplies energy to the entire eastern half of the United States. Mr. Stoker is a very powerful man who wields power through soft toned threats. He has the osmotic desire to absorb all wealth, to fashion the argument as helping others and to mold the facile congress of ideas into a self-propagating financial behemoth. It is no secret that he desires the Western half to add to his collection  He is not driven anywhere. He is flown around town in an electric-state-of-the-art helicopter/mobile. The machine transforms from land-based to flyable state in less than ten minutes, they say. The doctor has heard those tales.

Three hours  and four patients later the sound of muted turbines outside the window, alert him to a black Aviomobile (A flying car – official and very expensive) as it arrives. The gull-wings open and two officials exit the transporter machine and walk towards the entrance door.

The door opens to reveal the two men in silver grey suit, stern features and a no nonsense sense of humor written over their crisp and tanned faces. They are from the Bureau of Finance. The doctor recognizes them from their dress code. A chill runs through his spine.
“Good morning doctor.” The one says in a monotone. “May we review your records today.” A polite statement wrapped in the sternest of tones.
The doctor nods towards his secretary. “Ms. Vee would you please show the gentlemen the logs.”
The door opens and another man walks in and almost immediately turns around and exits the office upon seeing the occupants.
“Mr. Chambers!” Vee cries after him, but the man is already walking down the street. The two men look at each other and then at the secretary.
“May we see Mr. Chambers records also?”
“Sure.” She says and gives then the QD (Quantum Digital) cards. All data is securely stored in a quantum state for encryption purposes. The man scans it into his tablet device. They get up from their chairs from the front of the room and make their way to the doctor.

“Doctor, we find that there was an overuse of four medications prescribed by you to four different individuals for a diagnosis of Asthma. One medication for Arthiritis and one that you prescribed today for a 69 year and 11 month old man with heart failure. These are deviations from standards established by the Office of Health and Management. OHM does not take this lightly. The current penalty for these deviations is a loss of your privileges for one month and a fine of 10,000 Globes (Globes is the global currency now in use across the world).” He pauses for a moment and there is a discernable glee in his voice although it maintains its official monotonous boom. “We also find based on the electronic logs that you vary your time spent with each patient. Some are under the mandatory 45 minutes and others are well over 60 minutes. These violations will reduce your this month’s expected total credit down to 5000 Globes and next month to 1000 Globes.” His face pale and set in its official haughty demeanor remains impassive.

The doctor slumps in the chair, for he knows there is no appeal because the decision is made on a computer algorithm and the data input. How can he convince a non-human insensitive, uncaring, thoughtless, bureaucratic software algorithm designed by heartless human beings the art of medicine.
“And furthermore we find an additional breach of conduct. You sent a patient aged 70 years to the Emergency Room for treatment.” You are aware that patients over 70 must not be sent to the Emergency Room?”
“Yes, I know. But that man was gasping for air. What was I to do?”
“Send him home doctor.” The man replied in his distinctive monotone.
“We have recorded that on your file in the database and the OHM will make a subsequent determination on that in the next 24 hours.” They have not sat down during this conversation and just as they are about to leave, the other one who has not spoken a word, opines, “I will buy your car if you need more credits.”  With that they are gone. Vee looks at the doctor in disbelief. She has tears streaming from her eyes. “I am sorry doctor, it is my fault. I should have flagged their charts.”
“Its not your fault Vee.”


The doctor closes his eyes and within minutes the landscape changes, Outside he can see the Hardware store bustling with activity and the patrons sitting outside in front of the café being tended to by the waitresses wearing white aprons and bright smiles. 


The lampposts have signs of a rally for global integration and free healthcare for all. The rally is planned for 5 PM at the University square. There are people walking in the street in animated discussion. One says to the other, “This GS guy is really a man for the poor people. He wants to help everyone. They say he donated millions of dollars to build a wind farm to give poor people free electricity.”
The other man looks at him and nods his head in agreement. “And I heard that he wants a level playing field for everyone.”
“Yeah. He should run for President” The other one agrees. Cars stream by of all makes and models. Life is brimming with hope.

The doctor wakes up from his short dream and finds two officers of the law standing beside Vee as she cries in anguish, “Please don’t do this. I am a single mother. My child needs me.”  “Don’t worry about your child, Miss, she will be placed in safe custody of the State while you are serving your time.”
The man looks at the doctor, “Doctor, you are requested to come to the local office of the OHM at noon tomorrow.” And they leave.

It is time to leave medicine, he thinks. He has worked for almost fifty years helping the poor and the rich alike. His motivation has always been the health of the patient, something he has ascribed to since the desire of medicine consumed his soul. Now that desire seems to ooze away from the pores of his being. He feels the insidious pressure on his temples. The weight of this burden seems too heavy to carry. It is time.

There is a loud noise that shakes the bed and I sit up sweating from my nightmare. It is still 2011. I look outside from my bedroom door and the street is quiet in the wee hours of the morning. The street lamplight grows weak as the day breaks. The chirping birds dance about the branches of the fully blossomed trees, singing melodies that just sound good. The breeze is building as the sun rises steadily to command its post and soon it will be time for the school busses to roll-by picking up little children and transfer them to their schools and cars driven by their owners looking forward to their days work and the wonder of new spirits ahead that will foster a better future for those little children. The day yawns and spreads its misty golden hue and I close the window gently so as not to awaken anyone in the house. I steal my way down to the kitchen to enjoy the first cup of freshly brewed coffee. The dream of a better future is still alive.


Monday, April 18, 2011

Leonardo's Temple Part II

Part I of Leonardo's Temple published on January 2010 here: http://jedismedicine.blogspot.com/2010/01/leonardos-temple.html


The summer was coming, actually racing to cover the rigid branches of the recently thawed trees with green. The cool breeze slanting the smoke from atop the chimneys as it dissipated into thin air. There was an air of expectation as I walked to the mailbox to retrieve the mail. A curious brown envelope caught my eye. I opened it and there in folded over twice was a crumpled lined paper as if someone had rejected the idea of mailing it and then changed their mind. I unfolded the paper.

“Dear Sir,” it began in a handwriting that gave away the tremulous shake of the hand holding the pen that wrote.
“If you are the gentleman, and I pray that you are, that once visited my house, located off the Beech Road and gave me the pleasure of your warm company, then I am ever so grateful that this paper has reached your hands. I would be ever so grateful if you could visit with me again, below is my new address.” The paragraph ended there and then below the space in the same handwriting but with different ink was a more cryptic message that did not make sense.
“It is 10^3, seven left of 8979. It would be three streets right of the Phi highway and four houses removed from the first lamppost.”

The letter was unsigned and flipping over the envelope, there was no return address. The postmark was partially erased over the dark background of the postage stamp. All I could think were words like clever, curious and confusing.

So the house on Beech Road, I remembered very well, that was the “Leonardo’s Temple.” That was the house of the eccentric but very intelligent mathematician, whose name I could not remember, who had divided his land using the “Golden Phi” and raised crops for himself. I remembered his frail features and toughened arms and hands from tilling his land. I had not driven by there lately so I figured that would be the next step. The curiosity in me was building and the need to solve this riddle rising exponentially.
That afternoon I drove past the location, hoping to find the little house nestled amidst the fertile land of colored fields.

The place was walled off with a giant terracotta cement wall with a small gate that was locked. What was beyond was not visible. Life continued to hum on the road There were no sounds emanating from within and no written messages on the wall or the gate for any visitors. Strange. A cell call to the municipality revealed that the property was now owned by a F.I. Corporation.

Back at the house with little but that riddle in hand, I stared at the piece of wrinkled paper. Never being good at riddle solving, I placed the paper on the table and went for a bike ride with the thought that the answer would come to me, if I let it percolate in my mind.

Days of daily deliberations went by and the folded paper found different places to perch upon. The answer remained hidden in some small corner of the mathematical intellect that I did not possess. The windmills of my mind kept waiting for the breeze.
A month passed and getting more and more restless at the inability to solve the mystery, I called upon a friend who had been trained in the field of mathematics and numbers. To me he was a whiz.

“Lets look at this logically.” He wrinkled his nose and the frown lines of his forehead seem to envelop his entire persona. For a long moment he became all nose and forehead, lost in the depth of his thought. He pulled out his calculator and manipulated the numbers, and after each iteration, shook his head. Finally he gave up. “I haven’t a clue.” He said. Sometimes the letdowns are tragic and other times just plain confusing. This was neither, just a thorn in side of my mental being.

Three Saturday nights later when the moon was in its full glory painting silver, the tree limbs and the rose bushes, I sat at the dining room table eating the garlic-roasted artichoke. Looking at the leaves in their Golden Phi arrangement, it suddenly dawned upon me that the letter had mentioned the Phi highway. Maybe there was the clue.
I rushed off the chair and dug up the wrinkled, now almost teetering at the brink of falling apart note, and reread the code.


I looked for my laptop, turned it on and punched in the number 8979 to Google correlates. None came up. I opened a mathematical program and did the same and found the Pi. 3.1415926535 8979323846 2643383279 And there lodged between 6535 and 3238 were the 8979 but they were eleven digits to the right. So multiplying that number with 10^3 or 1000 yielded a number 3141. 59265368979 now exactly seven digits to the left are the 3141. Could that be the house number? I wondered. At least something was happening, the event horizon was collapsing and the black hole emitting light. Maybe all was not lost. I just might be able to solve this mystery. What did “It would be three streets right of the Phi highway and four houses removed from the first lamppost.” Mean. The three streets right of Phi highway and four houses from the first lamppost is 3, Phi, 4,1. Or 3141 again. But placing Phi in there was interesting. Phi =1.618 and so multiplying or adding or dividing all the numbers did not make sense. I thought of substituting the 1.618 with the alphabets and that turned in “AFAH” That did not have nay reference to streets or initials representing anything on the Internet. So I looked at the initial numbers 8979 and the alphabet correlate was “HIGI” looking on the Internet revealed a street named “HIGI.” Now I was really cooking. So looking for the 3141 HIGI Street turned out an address about twenty miles away from my home. The curiosity was too much. The adrenaline from this mental exercise was too much. Not to be able to see this place tonight was out of the question.


Driving there under the moonlit night brought with it an eerie sense of calm. It took a half an hour through some winding roads and quiet neighborhoods. It was 7:57 PM by my watch as I drove up to the gated entry. The fourth house after the first lamppost and there it was. I did not know what to do. Should I press my luck now or wait till the morning. After all the man was elderly and I did not want to inconvenience him. But then the curiosity had exploded within and cast myriad of colored mysteries. I pressed the bell at the gate. There was no answer. I pressed it a second time and again to no avail. No answer. Social courtesy demanded me to back away and I did. Stepping back into the car with thoughts of at least the mystery may have been solved, if indeed it was and this was the right address. Maybe the right thing to do was to come back during the daytime. Having resolved to this thought, I drove back home.


The next afternoon while the sun was declining on its well-traveled path towards the horizon and the shadows lengthened to hide parts of nature, I arrived back at the address. The environment was completely different than I had imagined. The gate was small and the posts were smaller than I had realized. The transmogrification of this simple home in my mind had been replete with images of castle hidden behind the winding road that lead inwards  from the gate. No such thing. It was a modest ranch set two to three hundred feet back with trees lining the paved entryway on both sides. I rang the bell and the after a momentary delay, the gate opened, each side sliding to the side.  I got back in the car and drove in.


The man who stood at the door awaiting my ingress was the same figure, I had seen a few years ago. The long grey hair was now tied in a ponytail, and he wore a long dark coat for protection against the cool breeze that intermittently ruffled the leaves.

He had weathered some more as far as I could see. “I knew you would find me.” He said, his voice raspy from age, low in pitch and dull in timber.
“It took me a while to figure it out.”
“I knew the right person would know the answer.”
“You sent it to others?”
“I sent it to ten people who had ever visited me because I did not know which one was you.”
“Oh.”
“Only one could or would take the time to figure it out.”
“Yes, but it took a while.”
“Come on in, we need to talk. I have a request to make.”
He led the way into the dark hallway, “You must be curious, why I am living here?”
“Oh yes that and about a whole bunch of other things.”
“I figured.”

The story he related was fascinating in content and replete with minor details that I could actually relive his memory in my own mind. Some people have the gift of storytelling. And he had it. Two years ago due to the drought, he was unable to water the fields around his house with city water. So he arranged to have well water pump placed on his property. The firm that inserted the pipe (well) and the attached pump left after their work had been completed. That evening he had turned it on to make sure of the pump’s functional reliability. He described the initial spray of water from the sprinklers as casting a rainbow effect from the diminishing sunlight, ceased quickly. Alarmed he went out to investigate and found oil seeping out from the sprinkler heads.

It turned out as he put it that the firm had placed the underground well pipe deeper and next to his house and unbeknownst to him, some 25 feet below, trapped between two geologically subducted plates was a cloistered fairly large amount of light crude oil. The amount based on geological survey later showed a million plus barrels. He exhibited no emotions about that quantity.

He had signed a contract to turn over his property to a multinational oil company for a very reasonable price and moved into his new home. “Sometimes life plays strange tricks. The gesture was a little too late for me. But it has provided me with abundant comfort, I must say.” He said quietly.

“Wow!” is all I could say. “Wow!”
“Have a seat while I get us some soup and vegetables.”
“Great! I said. I remember that delicious soup we had at your other place.”
With the food consumed, we sat in stilled silence for a while. Nothing uncomfortable, I simply luxuriated in the bursting joy of my taste buds. We had discussed simpler mathematics that I could understand. I asked him about the “Phi” highway. “Oh that was based on 1.618 which translates to the Interstate 16R that parallels the street. It was an additional clue in case you needed it. But you managed without it.” Not showing it but definitely feeling the puffed pride of this accomplishment, I settled in my chair and enjoyed the minor compliment.


“I have a request to make.” He hesitatingly began.
“Yes, you said so before. Sure, I’d be glad to help out.”
“Well, it is kind of personal and I hope you don’t mind the imposition.”
“No,” I said, “not at all.”
“You see, I have only one living relative and he does not know of my new found wealth. I have prepared some papers for him and I want you to keep them for safekeeping. There is a stringent requirement that no one opens the package before the right time.” He paused and observed my reaction, finding none he continued, “When I am gone, you will receive a notification to open the package. Only you may open it. The name and address of my relative will be in the papers. Please dispatch them accordingly. For this trouble, I’d like to compensate you with one thousand dollars.”
It hit me like a ton of bricks. “No absolutely not.” I said.
“So you will not do it?”
“No, I mean, I’ll do it for nothing and I do not need any compensation. I mean this is nothing and it’s the least I can do for your kindness and kinship.”
“I insist upon it and that is a part of the request.” He said with some firmness.
“If that is a precondition then I accept.” I said not wanting to prolong the form and substance of this conversation.

He got up from the wooden straight-backed chair that I recognized came from his previous dwelling and went to extract the package from a different room. Meanwhile, I let my eyes roam the walls of the room. The photograph of his wife was prominently displayed. Whatever his settlement was did not seem to show in the modest limits of pomp displayed in this room. The Golden Phi was still there in the form of a beautifully colored image of the artichokes in his former dwelling. On the mantelpiece was a crucifix that I had failed to see before. He caught my eye on it as he walked into the room.

“Ah! you have caught my former agnostic heel.” After my wife passed away, religion and I became distant to each other. Now in the twilight of my winter, I find great comfort knowing that life is more than mathematics and religion now fills that void that mathematics could never fill. The utility of time made it so, that I felt fulfilled. It is in the perception that life is lived and there I was lurking at the periphery of life and mathematics while the emptiness at the core remained.”
“Good for you.” I said, not knowing how to respond.


We talked for a while as he unpackaged his heart with stories from the past. The afternoon sun now well past its post seemed to have quietly slipped below the horizon casting darker shadows from the trees outside, into the room.

We parted company and I asked if I could visit with him again and he politely declined. His words carried a personal plan that he did not want disturbed and my revisit might disturb the yang of his thinking. I left him standing in the cooled air of the evening. The dark shadows of his brow concealing his eyes made him a fragment of a man he once might have been. I remember his receding image in the rear view mirror and his effort to raise his hand in farewell.

Time has passed. Five years or more and I have not received any further communication from him or anyone. It is five in the evening as I turn into my driveway stopping to pick up the mail from the mailbox in front of the house. The mail is bundled together in an elastic band. I place it in the passenger seat and drive up the driveway. The autumnal sun is breaking through the nooks and crannies created by the house and the trees alongside it and bathing nature in a blush of gold. I remove the elastic band and rifling through the mail, I find a plain white envelope with no return address. I unseal the envelope and there is a handwritten note.


“Dear Friend,
As per our agreement please open the package today.
I thank you for your kindness and kinship.”

The letter is not signed. I know it is from him. The written words and their shaky up and down-strokes are trademarks I remember well. I walk into the bedroom and extract his package from the safe where it has resided for the past few years. I open it. It is time to fulfill a promise. The twenty or so pages are stapled together. It is his last will and testament and it addresses me as the beneficiary of his estate!

My brain is scrambled. My thoughts are not of my own. My hands tremulous as if controlled by another, slowly flip the pages. It seems I have an inheritance. My wife stands in the doorway her eyes narrowed together by the furrows in the middle trying to decipher the blank-stare in my eyes. She does not know yet, but she will. My legs grow weary and lose the action of the muscles and I slide against the wall down to the floor. My wife rushes to my side.
Life is about to change.


Friday, April 8, 2011

Radiation and Humanity



Entropy is the natural state of the universe. All things suffer and decay with time. The landscapes change, the rocks are molded by the rain and wind, the green grass undergoes desertification and living beings die. Elements also undergo their natural recession. All radioactive elements undergo decay on a time clock, each to its own drumbeat. 
Carbon-14 Cycle
Carbon Dating

For instance the Carbon-14, which is used extensively in dating natural materials has a half-life of 5736 years, which coincides with the human civilization. Each nuclear decay of this element ticks back 5736 years and configuring that loss, dates the material under study. That is how geologists are able to date various artifacts of history and the geological layers of rock formations, the Burgess Shale, 
Burgess Shale

the age of King Tutankhamen, other mummies and even Lucy (Australopithicus afarensis circa 2.7-4 million years).
Lucy

History is replete with serendipitous expressions of discovery. Radioactivity falls in that category. In 1896 a Frenchman named Henri Becquerel discovered the radioactive emissions from Uranium while looking for phosphorescence in various elements. Ernst Rutherford first employed the term radioactivity in 1899 when he discovered the alpha and beta emissions from Uranium. In 1898 Nobel Laureates Marie Curie her husband Pierre and Henri Becquerel realized the complex nature of radioactive decay.
Henri Becquerel discovery of radiation


How does Carbon-14 do that? The sun is the source of radiation energy. As the cosmic rays collide with the Nitrogen-14 they liberate a proton and a Neutron. The Carbon captures the released Neutron to become Carbon-14. This is embedded in plant and animal life and gets buried in the soil ultimately decaying back to its Nitrogen form as its half-life clock ticks down the years. This instability expressed in the form of radioactive decay is related to the configuration of the Neutrons and Protons in the nucleus of the atom. It is balance that the atom tries to achieve between Neutrons (N) and the Protons (Z) by causing the radioactive decay and emission of particles.  Thus release or capture of Neutrons is an attempt to achieve a nuclear balance. We, humans, exploit that imbalance to read time.

Radioactive Decay
“The common decay products are named after the first three letters of the Greek alphabet—alpha (a), beta (b), and gamma (g). In an alpha decay, a helium nucleus escapes from a nucleus. Alpha emission reduces the number of protons by two and also the number of neutrons in the nucleus by two. Beta decay can proceed either by emission of an electron, and an antineutrino or by emission of their antiparticles, a positron and a neutrino. Beta decay changes the number of protons and the number of neutrons in the nucleus by converting one into the other. Inverse beta decay involves the capture of an electron by a nucleus. In a gamma decay a high energy photon leaves the nucleus and allows the nucleus to achieve a more stable, lower energy configuration. Spontaneous fission of a large-mass nucleus into smaller-mass products is also a form of radioactivity.”



Uranium in Pitchblende


Interestingly a naturally found element in the soil is none other than uranium. In 1789 Martin Heinrich Klaproth discovered the silvery element after dissolving pitchblende in nitric acid and named it after the planet Uranus. The most common isotope of Uranium found in the earth is U-238. Although U-238 is fissile (breaks into smaller components) with high-energy neutrons, it however does not lend itself to a “chain-reaction.” U-238 can also capture its own Neutron and after two beta-decays convert into Plutonium-239. Pu-239 is highly fissile and used militarily and in commercial use for energy production in Nuclear Reactors. The military grade Uranium has to have between 3-5% of U-235 which has a lower half-life and is inherently more unstable and therefore given easily to fission. A “Depleted uranium is one that has less than 0.3% U-235 and therefore considered less fissile and is extremely dense. The DU is used in weaponry. The half-life of U-238 is an impressive 4.468 billion years.
Uranium

Atom and its components

All radioactive elements are inherently unstable. The stability of the Element comes from when Neutrons (N) and the Protons (Z) are balanced. For example if the element has 6 Neutrons and 6 Protons, its nucleus is inherently stable. However any discrepancy between the two leads to radioactivity through decay by virtue of expulsion of the excess Proton/Neutron/Electron to achieve parity. 


The emissions are in the form of “Alpha decay”. “Beta decay” or “Gamma decay.” Alpha decay occurs in heavy elements with 52 or greater Protons. The emitted particles are therefore heavy (Helium nucleus) and have limited penetrance beyond a thin layer of material. 


The only way they can cause harm to humans and animals is if these are ingested and their radioactive decay occurs within embedded tissue causing genetic effects on the nearby cells. Beta decay occurs with smaller particles that can penetrate deeper. 
Particle penetration


So external exposure to humans can lead to damage to the subsurface of the skin (subcutaneous layers). The penetration stops there due to material density. This occurs with all unstable elements. 
Beta Decay

Nuclear Power Plants

Gamma particles are essentially electromagnetic radiation of the photons/electrons. The energy of the gamma particles determines the depth of penetration of the tissues. The expulsive emission from the nucleus if approximated with another unstable radioactive element that can capture the emission can lead to a contained fissile reaction with release of energy. Therein lies the mystery of the Nuclear Power Plant. The Nuclear Energy containment is nothing more than a sustained and contained nuclear reaction. Since the U-238 is inelastic and does not afford itself to a “chain-reaction” this very containment results in a sustained energy release and a contained fissile reaction.
Three Mile Island


What happens in an Nuclear Plant accident is if the fissile reaction becomes uncontained and it continues leading to a core meltdown resulting in escape of the radioactive material into the water used to cool the reactor and therefore expelled in the steam as in the TMI accident or contaminating the soil and underground water supply as in Chernobyl and Fukushima Daiichi disasters with release of radioactive byproducts of fission: iodine-131, cesium-134, cesium-137 and tellurium-132. Unfortunately the containment of the radioactivity is not linear, which means that distance does not necessarily diminish the radioactive intensity. 25 years after the Chernobyl Nuclear disaster the fall out continues to haunt humans with Leukemia and cancer related diseases. 
Chernobyl aftermath


The radiation levels at Chernobyl at the time of accident were 200 times that found at Hiroshima and Nagasaki and based on atmospheric radioactivity monitoring in Scotland for a brief period following the accident the radioactivity level rose to 10,000 times normal values.
Hiroshima mushroom cloud


We call them disasters because of the effects on humans, animals and plants. Biological life forms live in a radioactive world. Radioactivity is in the atmosphere (cosmic radiation/solar radiation), in the soil and in the plants. Animals and humans who consume the plants and animals contain a minute fraction of these radioactive elements within their tissues. We are therefore constantly bombarded with radioactivity in our daily lives. 

Radiation and the Human DNA

Our genetic makeup is designed to withstand this onslaught through a mechanism of DNA Mismatch repair mechanism. Overwhelming that mechanism leads to either cell death (apoptosis) or disease. For instance it is believed that the human DNA takes about 10,000 hits daily. In human cells, both normal metabolic activities and environmental factors such as Ultra Violet (UV) light and radiation can cause DNA damage, resulting in as many as 1 million individual molecular disruptions per cell per day. DNA damages in frequently dividing cells, because they give rise to mutations, are a prominent cause of cancer. 
DNA damage and repair


In contrast, DNA damages in infrequently dividing cells are likely a prominent cause of aging due to the slow reactive damage inflicted upon these cells. (These hits are random based on radioactive decays from the soil and inherently assimilated natural radioactive substances incorporated in various tissues of our body and via solar radiation). It is true that the incorporated radioactive materials in the body have a long half-life i.e. their propensity to decay is extremely slow and therefore emissions of alpha, beta or gamma particles is rare. But it is there, maybe not constant but forever the bell that has the potential to toll. In the event of such disasters where there is a dramatic increase in the radioactivity in the environment the body can be overwhelmed with the onslaught and that can lead to human cellular framework disintegration and chaos.

The cancer cell is wayward cell that has lost all constraints and restraints programmed into it. This loss of restraint and constraint from normal function and form leads to unrestricted growth.
DNA single/double strand damage


Lets dig a little deeper into the cellular DNA both in the nucleus and the mitochondria. Imagine the DNA with its double helix held together by the phosphate sugars and linked together by extremely loose water-soluble hydroxyl (OH) bonds. Now imagine a stray bullet (in this case an escaped electron) dislodging one of those (OH) bonds and in so doing ricochets and hits the corresponding Nucleic acid. This attack leads to a compromised connection between the Nucleic acids Adenine with Thymine and Guanine with Cytosine and also disrupts the Nucleic Acid. 



DNA repair Ligase

DNA Repair Mechanisms

The repair mechanism using default methods substitutes another Nucleic Acid and changes the entire message that that portion of the DNA represents. Now suppose that the damage occurred in the DNA where the gene was coding the antiproliferative (non-growth) activity of the cell, but with this dislodgement and disruption via change of the Nucleic Acid that code now no longer suppresses the growth activity. The cell is given the go-ahead signal to multiply without restriction and cancer results. That is akin to taking the foot of the brakes and jamming down the accelerator in the car. This disruptive action can also result in another portion of the DNA relegated to the Chromosome 9 in the long arm at position 21 which can lead to heart disease. So modulation of the DNA not only affects cancer formation it can lead to other disease as well. A disruption of an Alpha-1-Antitrypsin enzyme produced in the lung suddenly stops being produced due to the disrupted gene code by an accidental damage from a wayward electron can lad to Emphysema. The list goes on and on. The “out-of-nowhere” disease emergence, during the aging process in humans, has a causal basis in the environs and within us.

The energetic electron can also by virtue of affecting the hydroxyl (OH) group release nascent “free radicals” which essentially means that an electron was stripped out of the oxygen’s outer shell rendering it nascent and making it look for a source to feed itself on other easily derived electrons through disrupting cellular makeup. This frenzied feeding by the nascent oxygen to satisfy its appetite, leads to similar disruption of the proteins, DNA, RNA and all building blocks of the human cellular mechanism and can lead to aforementioned cell death or disease.

Inside mitochondria, reactive oxygen species (ROS), or free radicals, byproducts of the constant production of adenosine triphosphate (ATP) via oxidative phosphorylation, create a highly oxidative environment that is known to damage Mitochondrial DNA (mtDNA). Superoxide Desmutase is a critical enzyme that counters such activity in the cellular machinery and is present in both the mitochondria and cytoplasm of eukaryotic cells.

Radiation Poisoning

Acute Radiation Poisoning is a phenomenon when the body is espoused to a large amount of radioactivity. The former Soviet KGB agent Alexander Litvinenko was deliberately poisoned by polonium-210 and died soon thereafter. 
Alexander Litveninko


It is estimated that 1Gy would enable such an event. This acute illness occurs as a result of damage to the fast-replicating cells such as those found in the skin (radiation burns), in the gastrointestinal tract (Nausea, vomiting and diarrhea), blood cells (Low white counts and platelet counts leading to infections and bleeding), Immune surveillance, tracheal burns and oral cavity (mouth) sores and bleeding.

I-131 and Graves Disease

The chronic nature of radiation damage is essentially a torrid affair between the radiation damage to the cellular DNA and the months and years it takes to create the cancerous tumor. The most common forms of cancer related disease include the Leukemias, Lymphomas and solid tumors such as Thyroid cancer. Thyroid cancer occurs by virtue of the I-131 finding a safe haven in the thyroid, since the thyroid gland is the pooled reservoir of all iodine in the body. I-131 emits 14 gammas and 6 beta decays and that is how it is used in the treatment of Graves Disease (Hyperthyroidism). 
Graves Disease (Hyperthyroidism)


The beta decay causes 90% of the tissue damage to the thyroid gland leading to a hypothyroid state.  Excess of the I-131 exposure when ingested through water or fish/animal food as in a nuclear fallout the I-131 after saturating the thyroid follicles finds other organs to bio-accumulate within like bone, liver, lung and kidneys where it creates cellular disruptive mischief.
Enlarged Thyroid & normal

Radiation as Therapy for Cancer

So if radiation is so bad for us then why do we use radiation therapy as a treatment? Before human knowledge had achieved its current state of understanding, self-made ”therapists” were touting the benefits of radioactive fluid lavages and enemas as panacea for all disease. It was another Nobel Laureate Hermann Joseph Muller who in 1927 discovered the genetic mutational effect caused by radioactivity. Only when the dangers became predictably known with this “therapy” did the FDA outlaw the practice. It is now known that bioaccumulated uranium in the tissues leads to Binucleated cells with micronuclei, Inhibition of cell cycle kinetics and proliferation; Sister chromatid induction, tumorigenic phenotype. Knowing the affinity of radiation to disrupt the cellular function and knowledge about the acceleration of the electron/photons via the electromagnetic wave came to reveal the benefits of radiation as a treatment methodology for cancer.

Linear Accelerators

Linear Accelerators were developed to accelerate electrons and then through focused beams these electrons/photons were directed at the source in this case a tumor to destroy the tumor without affecting the normal tissues. R. Wideroe built the first linear accelerator in 1928, accelerating positive ions to about 50 keV. This ability improved over time from the Cobalt-60 that was a byproduct created in the Nuclear Reactors and used for cancer therapy. Unfortunately it cast a large damaging penumbra effect on normal non-cancerous tissues and with innovation lead to the focused IMRT (Intensity Modulated Radiation Therapy) and IGRT (Image Guided Radiation Therapy) therapies available today. Now high-energy accelerators SLAC (3-km long at Stanford University, CA) are capable of harnessing more energetic photons/electrons (Energies up to 50GeV) to deliver precise doses to the embedded tumors. Meanwhile newer modalities like Proton Beam therapy that use massive particles such as protons or alpha particles to deposit the bulk of their energy in the tumor bed are being used in cancer care. (This maximal accumulated dose before rapid decline is called the Bragg Peak. 
Bragg Peak


Using Bragg peak helps direct the radiation energy precisely to the tumor without exposing the normal intervening tissue).


Boron Neutron Capture Therapy (BNCT) is under development, In BNCT; boron is synthesized into compounds that are selectively taken up by cancerous cells in the brain and not by healthy ones. It is being utilized in Brain tumors like Glioblastoma Multiformi with greater success.
BNCT

Do we need protection against radioactivity? The answer is: Absolutely (as much as possible). Are we safe from all radioactivity? The answer here is no! We are as mentioned, constantly exposed to radioactivity be it in the form of cosmic rays or diagnostic X-Rays we do get it in our daily lives. Flying for instant at 35,000 feet in an airliner exposes one to a higher level of cosmic radiation then at the sea level due to some protection afforded by the Ozone layer and other particulate matter suspended in the atmosphere. So we cannot exist without some exposure, but we certainly ought to be cognizant of sources of radiation that we can knowingly avoid.

Radon and Lung Cancer

Another little known source but highly toxic to humans is the Radon (Rn86) present in the soil. Radon is an odorless gas when present in the soil can accumulate in closed, unventilated spaces like the basements and in the attics. A way to detect that is to vacuum the spaces and use a Geiger counter to determine the background radioactivity. If there is increased radioactivity determined then appropriate ventilation should be considered such as attic fans and basement windows. “Air the house periodically.” Radon has been estimated to cause about 30,000 cases of lung cancer per year.

Radiation Hazards

Examples of naturally occurring radioactive hazards include the following:

Radiation source
Comments
mSv/yr
mrem/yr
Natural sources



indoor radon
due to seepage of 222Rn from ground
2.0
200
radionuclides in body
primarily 40K and 238U progeny
0.39
39
terrestrial radiation
due to gamma-ray emitters in ground
0.28
28
cosmic rays
roughly doubles for 2000 m gain in elevation
0.27
27
cosmogenic
especially 14C
0.01
1
total (rounded)

3.0
300




Medical sources



Diagnostic x-rays
excludes dental examinations
0.39
39
Medical treatments
radionuclides used in diagnosis (only)
0.14
14
total

0.53
53




Other



consumer products
primarily drinking water, building materials
0.1
10
occupational
averaged over entire US population
0.01
1
nuclear fuel cycle
does not include potential reactor accidents
0.0005
0.05




TOTAL (rounded)

3.6
360

Hamlet says to Horatio: “There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.”

The last question worth asking is what will happen to Japan’s West Coast after the March 11, 2011 Earthquake near Tahoka and the ensuing Tsunami caused the Fukushima Daiichi nuclear meltdown with ongoing aftershocks near Honshu. If Chernobyl history is a reference point then a 40-year ecological disaster remains in effect. The 100 km area around ground zero will remain radioactive making it uninhabitable for humans. Modern techniques of ion exchange from the soil and ground water may speed the process and help the ecology recover faster maybe. The coastline of the Northeastern Japan has changed for this and the next generation of Japanese forever.

Our lives are lived in the fear of death, since death taunts us at every step of the way. Human lives are lived in the quiet desperation of that and other imagined fear. Understanding, avoiding and preventing are the steps to a fruitful life. Engaging life and its predicates with an open mind and enjoying every valuable moment is a life well lived. The anatomy of that conjugate thought is an aspiration devoutly to be wished.


References:

Lodish H, Berk A, Matsudaira P, Kaiser CA, Krieger M, Scott MP, Zipursky SL, Darnell J. (2004). Molecular Biology of the Cell, p963. WH Freeman: New York, NY. 5th ed

Campisi J, d'Adda di Fagagna F (2007). "Cellular senescence: when bad things happen to good cells.". Rev Mol Cell Biol. 8 (9): 729–40

Best,BP (2009). "Nuclear DNA damage as a direct cause of aging" (PDF). Rejuvenation Research 12 (3): 199–208

S. Craft, A. W. Abu-Qare, M. M. Flaherty, M. C. Garofolo, H. L. Rincavage, M. B. Abou-Donia (2004). "Depleted and natural uranium: chemistry and toxicological effects". Journal of Toxicology and Environmental Health Part B: Critical Reviews 7 (4): 297–317.

Proton beam therapy" W P Levin, H Kooy, J S Loeffler and T F DeLaney British Journal of Cancer (2005) 93, 849–854

Zamenhof, R.G., Murray, B.W., Brownell, G.L., Wellum, G.R., Tolpin, E.I., "Boron Neutron Capture Therapy for the Treatment of Cerebral Gliomas. 1: Theoretical Evaluation of the efficacy of Various neutron Beams," Med. Phys., 2: 47-60, (1975).

Barth, R.F., Solloway, A.H., Fairchild, R.G., "Boron Neutron Capture Therapy of Cancer", Cancer Res., 50:1061-1070, (1990)

http://www.lbl.gov/abc/wallchart/guide.html