Echoes of the Past

 The echoes from the past sometimes bring the cascade of memories tumbling down into the mind’s eye and the play goes on, for a while, lurching us into the sweet confines of the embellished past. The soft cool touch of the winter when a snow blizzard crippled a city and I had to walk a few miles to the hospital as an intern picking up snow from the sidewalk edges and making small snowballs as I walked the distance. I was confined to the hospital for 76 hours on duty because some clever ones called in their absence. Yet those 76 hours shaped my mindset to a certain degree. Mind you, the occupation of that far-off past experience infrequent in its periodicity still reverberates whenever I see anyone ill, especially a young child. The adult always brought out all my desperation to seek an answer while the younger ones tore me up and broke my heart.

 

No, I never became a Pediatrician. I chose instead the hearty and heady concepts in adult cancer medicine. Some call it the field of Medical Oncology. I found Embryology as deeply embedded in that field as Immunology and all together both these fields conversed with Pathology on a constant basis. So began my love for Medicine. To dig deeper into the causal stimulus that initiates the process. To find the switch that turns on the motor of the mechanism when it goes awry. To tailor thought dedicated against that switch or lever or the entire mechanism itself. To heal the body ravaged with the massive army of unwanted deserters parading in single file or in clusters to occupy and destroy the very mechanism that gave birth to them. To deploy an army of knights against the knaves, the looters, the deformers, and the harm lurking within, and vanquish them all.

 

Alas I was never able to find the switch or the lever. The one gene-one disease movement that was heralded at the dawn of Ventnor’s Human Genome Project slowly gave way to a more perplexing theme of catacombs and disabling dead-ends. Oncology became a fishery of finds with the fishing line often catching the occasional sodden leather boot discarded into the open sea. 

 

The chemicals and the biologics against the malady, all weathered against the relentless march, sometime successful and sometime distressfully unrewarding. As we dug deeper into the rabbit hole of the science and mechanics of the cell gone awry, we found a world of tunnels, ladders and chutes that kept whipsawing us back to the beginning. The 100,000 functional genes turned into 25,000 and then got whittled down further as the tinier molecules of the RNA became the disrupters, modulators, expressing over or under the message of the genes. The roll of dice, the chaos theory, exposure, and Heisenberg’s Uncertainty Principle all seem to come and play. The world of Medicine seems to be inextricably linked to the world of Physics, Biochemistry, Quantum Dynamics and to Life itself. The golden weave in the golden ratio within the DNA helix and its interactions with the stray electron became a target of the intelligent minds. Modeling blossomed as an art form within the science, as probability ushered outcomes, and the whole complex turned into a tapestry of minutiae: each invisible path convulsing with another in an intricate dance from the onslaught rigors of the ethereal ions that still keeps us guessing. 

 

Yet in the awe-inspiring days  as a clinician, I learnt about the magnificence of the human spirit. Of the man who would defy time and live a year past his allotted hour only to wander into the undiscovered country after he had seen his beautiful daughter, the apple of his eye, wedded to her beau. As the sun set that evening and the married couple chartered off to their honeymoon, and the twilight spread, he closed his eyes.

 

I have witnessed many a storied tales in real life of men and women, who gather themselves and their emotions and walk through the maze of reconciliation with their personal approaching end, with dignity and grace. It is a reward few get to see. I have witnessed the courage and wisdom in the face of blanketing darkness of adversity and tumult with nary a crack for escape. Yet the spirit lives! 

 

And many more, than I can count, are images imprinted into my mind’s eye of those that got spared from the ravages of this terrible illness called cancer. Some went on to marry and have children and others lived to see their grandchildren. I don’t take any credit for this. I believe they had it in them to be victorious against the scourge. I, on the other hand, only guided them through the murky maze as best I could.

 

The human mind is a powerful weapon against adversities. “Mind over Matter,” does have meaning. It is the form of armor that makes us who we are supposed to be. Perhaps in these days of easy access to all access where humility takes a backseat to the collectivist “drown the other,” mentality. A pause, a hesitation, a momentary reflection of what we are made of, might take us to a better place. Learning that death spares no one and that the short span of life is all we have and with that knowledge, we might relent in our behaviors a bit. That liberty and freedom of thought and action gives joy and hope, while compressing another’s thought, kills that spirit and thus, wisdom. We must all aspire and pour through some history, to advance our scientific thought without prejudice and without being victimized to some construct of right and wrong in the field of science, by those who have a difference of opinion.

 

It is clear to me, that even under the oppressive assault on freedom of thought, should it ever come to pass, that is, if it is not already here full throttle, brave souls will gather to affirm the losing art of liberty and freedom and use that wisdom to fend off all such adversity. Physicians should be allowed to use their knowledge, experience and judgment to dictate the management of a patient. Yet currently we are governed by the confines of guidelines and pecuniary-coded rules that govern. Some drugs are allowed to be prescribed while others are not, science notwithstanding, even though the latter might have a better therapeutic response.  We need to celebrate good individual medical care and not worship at the altar of “one size fits all,” for cost-control purposes.

 

That 76-hour winter still resonates within me. It harkens the days when freedom to actually care for a person was the right thing to do. Ah those days linger on the tongue of my memory like the taste of fine wine. And a reminder still bubbles within me even in these trying times that bravery and courage do exist in each human soul to ask a question. The spirit may be quiet but it is alive!

 

At least that is my hope and prayer.

The Beast in the Lair

 The Beast in the lair of my memory needs to expose its scales and fangs…

 

The technological force that metes out our daily rewards and retributions on the basis of opinion creates a cemetery filled with thoughts and ideas. There are many tombs in this cemetery: some small and incipient and some large and life changing, all imprinted upon a canvas, where a potential beautiful painting might have been, but remains bare. The general morosity that creeps in its steady pace, continues to cut and shred the past into colorful confetti, to be hauled away to the closest recycling plant somewhere far away. The present is all and All must follow the rules set forth. Over time the excess in life pits us into a delectable pantry of sweets that force us into a slumber of peaceful acquiescence and blind obedience. 

 

In a zero-sum game, as one power grows, the other must diminish. And so, it is with the law of diminishing returns as you have more, so you have less. All the collections, possessions and consumptions remit a steady tick of an emptiness within. While, hubris springs eternal, the tall reach of that mind yearns for more and in so doing empties itself into the drivel of conformity that runs like overflowing muddy rivers from a past storm. Does incivility rise with wealth? I believe it does. For if it didn’t why would so many wealthy behave with such disdain and aloofness against those with little? Yet in this big and giant cauldron where the rhapsody of the bohemians swirls and chugs, coughing from the strain of the daily toil, why are so many busy articulating the virtuous words as the expensive wine swirls in their fine crystal glasses while their deeds are rancid with exploitation?

 

But then, there is the second law of thermodynamics, which suggests that there is a natural tendency of any isolated system to degenerate into a more disordered state. When we confine thoughts and ideas into a forced system of compliance and conformity without discourse or objectivity, the powerful become more powerful and the weaker lose their foothold in their daily lives. But as all things in life, such isolated systems decay and entropy always seeks its rewards. As Shakespeare eloquently put it, “if it be not now, yet it will come.”

 

Our todays are drowned in words. And actions are a one-way street. We live in a sea of how many likes we get, nowadays. The larger the dimension of these unwitting “thumbs up” emoji, the better our sense of selves feel for the moment. And yet there is a sinister crawl of this insidious flatter. A flattery that corrals and cajoles and lulls one to the delicious inebriated sleep. And one day, the “likes” falter and diminish, anger visits and snitchers snitch and your currents run awry, restricted to an observer and no longer able to say what you think. You wonder. Then a trail of words emerge and advise you for you consent to limit your words because they are deemed as “misinformation.” Misinformation? You think. What in heavens is that. All you wanted was to share a story that you deemed as being righteous and true, but others found it not to their liking. The hammer comes down and you are lost in the lurch of truth and denial. No debate. And, you begin to question motives.

 

I remember a one-time fellow acquaintance, I met on a flight to phoenix once who claimed that the earth was flat. Even though from the 37,000 feet vantage from his window-seat, one could see the slight curvature of the earth. Yet he maintained that truly that was a visual aberration. I argued with him over the next four hours and by the end of the flight he was quite shaken in his belief. Arguments are a mechanism for arriving at the truth. All of science is doubt. If there is none, there is no science. Nothing is settled in science as Newton-lovers found out that even the electron that buzzes around in a cloud-like manner follows the Heisenberg uncertainty principle. That matter and velocity create energy and vice versa. From nothing, something and vice versa.

 

Yet today as the sun rises and will set, words implying thoughts and intent contrary to the ideology of a few are considered “misinformation.” Why is that? Why not argue and debate? Why not hash it out in the public square, rather than preemptively censor and restrict? Why? Perhaps this is the inverse of Wittgenstein’s Tractatus: “Whereof one cannot speak, thereof one must be silent.” It should read, “Whereof one be forced into silence, thereof one must speak.”

 

Does … malice often lend a certain cunning to stupidity when bureaucracy is at the helm? A question that pervades the mind only to come up short. Because that question cannot be answered, since conformity is the honored sequence in the linearity of today’s time pieces. What flows from here must reach there without a pebble in its path. For such a question might, just might lead to another censorship without an answer?

 

I await the mail…

 

SCIENTISM and NEWSPEAK

 

With the ever-widening gyre of despair, some unfortunate souls resort to opioids to minimize their grief or succumb to suicide. While another ever-deepening well of scientism propounds an ever-alarming restriction on the liberties and freedoms of the many creating a chasm between what is and what perhaps is envisioned. This “degrading mass of animated dust” quoting Lord Byron, has descended into a nightmare of ever-shimmering mirages amidst a barren desert of singular dark-thought. What should be, seems to supplant what is by the force of the word rather than heed to deed.

 

Man is allowed his moment of thought: his quiet, his peace. Yet that seems to linger at the outskirts of this dystopian neighborhood of “do this and fear that.” We are barraged with a daily dose of “cases” and “hospitalizations” and “deaths.” As if the value of life, is in the fear and entrenchment behind closed doors and not in the pursuit of one’s ideals.

 

Interestingly where some proof exists, it is quietly squashed under the guise of harmful speech. Studies of agents undertaken previously, that have proven promise over the virus that plagues humanity today, are discredited as untruths by statistical fiat of the modern-day science. The purpose it seems is to propound the benefits of the latest and greatest and by virtue of that greatness, exponentially more expensive drugs, craft them as the panacea. Many such expensive drugs are currently in vogue, yet prevention, the hallmark of good medical care is always peeking through the curtains but never allowed to be on stage. Hydroxychloroquine ( Read: https://trialsitenews.com/italian-government-agency-declares-use-of-hydroxychloroquine-for-off-label-against-covid-19-legal-revolt-of-the-doctors/ ) and Ivermectin, two such preventative medicines with costs ranging in a few dollars are placed under the banner of quackery in favor of the more expensive medicines that are needed when the plague has broken through the barriers of immunity in a frail individual. So, it seems the call is “to go forth and not get infected, but if you do and based on the past pandemics, we know, you will, we and our experts have the potential to reduce harm to you and possible save your life, at great financial cost only to the State, not to you. And don’t listen to the quackery of some clinicians who advocate prevention with available cheaper medication, that is just nonsense!”. “Prevention,” they say, “is possible only by means of isolation, distancing from others and wearing a mask.” Yet, based on years of data and in at least 10 randomized control trials on masks, have yielded no benefits against a 120nm virus. And countless data on Economic Shutdown shows actual, quantified and verified harm to the public in general and to the individual in particular, which seems not to have ruffled any feathers on the headdress of the chiefs. 

Read:  https://rcm.imrpress.com/EN/10.31083/j.rcm.2020.04.264)

Also Read: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05773-w

 

A new and much hoped-for prevention has arrived on the market. It is a vaccine. The clouds seemed to have parted. If herd immunity is listening, we might be at the verge of achieving it soon. But there are questions being raised in small circles: a few sudden deaths in elderly folk mostly those over the age of 80 years: 24 in Norway and 161 in the US, immediately post vaccination, based on the VAERS data from the CDC are disconcerting. (Read: https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/vaers/index.html ) There are concerns of hypotheticals noted in the laboratory during previous such mRNA vaccine preparations, related to Antibody Dependent Enhancement (ADE) issues in post vaccinated individuals who are infected within the vulnerable period where no antibody production has taken place within the body, with serious consequences.  (Read: https://www.biologicsconsulting.com/regulatory-perspectives/antibody-dependent-enhancement-risk-for-sars-cov-2-vaccine-developers/?gclid=CjwKCAiAr6-ABhAfEiwADO4sfVQBXxxoyEG22JBBb1M3isYtT5vv8iJc1LvSq7qdPIEyw5MUMF4LyhoC7qkQAvD_BwE ) This, remains to be elucidated further. Vaccinations will certainly get us to the promised land of HIT (Herd Immunity Threshold) but as we progress at this rapid pace, some are already raising banners of you must still isolate, distance and mask up for protection in  spite of being vaccinated. Huh? 

 

Meanwhile, the pandemic soldiers on with a daily dose of the graphics and the loud calls for isolation and distancing so that the very nerve of a commoner is rattled as he or she suspiciously views a friend as a potential enemy, deciphering every move as a threat against self. Did the person sneeze into the crook of their elbow, did he talk too loud and aerosolize his spittle, when must he have washed his hands or did he, did he rub his eyes just now, or touch the mask of protection and move it above his nose just then? Such questions lurk in the central program within the decision-making neural tracts of the frontal lobes of the brain in some individuals. Some Governors advocate citizens to “snitch” on others if they do not follow these important mandates. Ah, what a grim place in soon to be history we have arrived at. All else is clouded. (Read: https://www.washingtontimes.com/news/2020/apr/22/americans-are-asked-to-snitch-on-each-other-during/ )

 

Amidst all this manufactured mayhem, there is some good news. Even with news media suppression of simpler mechanisms of controlling this virus with cheaper drugs, some truth steals its resolve and reveals itself. Studies of two available drugs: Ivermectin, (Read: https://www.covid19treatmentguidelines.nih.gov/statement-on-ivermectin ) an anthelmintic agent used against parasites and viral infections in animals also controls COVID and a new study called COLCORONA shows the benefits against the SARS-Cov2 (COVID-19) of a readily available drug Colchicine routinely used for gout. Both reduce infection,

the viral load, and prevent hospitalization from potential viral related severe illness. ( Read: https://www.globenewswire.com/news-release/2021/01/23/2163109/0/en/Colchicine-reduces-the-risk-of-COVID-19-related-complications.html ).

 

Beneath the virtual surface, the all-knowing  and all-seeing eyes of the programmers continue to monitor the human behavioral deeds via the tiny camera-holes in the computers, phones and other assortment of carefully created devices, sold at below cost, with algorithms of multi-lined codes deciphering the mood of the general public in their homes and outside, on a moment by moment basis while simultaneously nudging a change in that behavior through catch-phrases and repetition more in line with the narrative. The Artificial Intelligence codes created by the internal human bias, however, continues to marshal such moves and ascribe to the skeptics the term, “harmful intent.” 

 

Censorship arrived at this party at about the same time as the pandemic did. Voicing concerns now is considered harmful speech. Skepticism is considered a dire threat to humanity and any written word not in conformity with the narrative is grounds for shadow-banning or outright censorship.

 

The world has changed and those at the top are making hay while their sun shines. At every turn of the screw new fear mongering is delivered to unravel the minds of the easily deluded. New mandates are ordered under the guise of public good on a daily basis.  All contrary thoughts and opinions are masked-over as darkness while evil descends like the nightfall of a moonless night.

 

Something evil this way comes… 

COMMUNICATION

The squeeze and push of information flow are like water through a tube. The limits of throughput are based on the diameter of the tube. Remember the two open cans and a string tied in the middle as a means of communication between friends. It was a thrill of youth to be able to remain in “touch.” Even though the information passed between the two parties was negligible with a high degree of information error rate that Claude Shannon called “entropy rate.” Now however we are embarked on a magical carpet of multi-lane-highway-in-the-sky form of communication’ satellites receive and transmit at a pace unfathomable a few years ago. The fidelity of the transmission is unquestioned, yet the human problem exists to continue the dogma of the entropy rate viable: both through misinterpretation, disinformation and through limiting the throughput.

While the “bit” remains the universal currency of information shuttling between pairs of one to one, one to many, and many to one, the deterministic reconstruct of the original intent remains a problem sometime, due to the embedded selected entropy within.  The fundamental transmission of intelligence is therefore bogged down both by entropy and throttled down by limits imposed via the control levers.

Is information accurate?

Is information true?

Is information, disinformation or misinformation?

These perplexing questions rattle the un-caged minds of many. The fidelity once lost takes great pains to regain its ground. With functional distortions of the throughput aside, the prevention of dissemination of intelligence through control of those levers weigh heavily on society.

Communication is a dialog, a two-way street to enhance intellect. The flow of information generates questions and greases the levers of thought. Absent that, the mind roasts in its own mental construct, which hardens and ossifies into the grotesque. Society degrades and asymmetry of information propels a few and harms the many.

Somethings are worth pondering over.

GODSPEED!

 

I have seen the human Spirit. I have seen it soar to heights and drown in despair. I have seen people fight for their lives, past hope, past reason, and past assumed the last syllable of their recorded time and live to tell a tale. And I have seen despair dredge a muddy hole to bury its depressed spirit in ankle-deep waters without a current as it sucks out the last vestiges of hope. I have seen a young man live months past his borrowed time with cancer and another die of fear and desperation of a minor illness. 

 

I have seen them both in myself, the success of accomplishment, and the vicissitude of abject despair. I know both intimately and have reconciled them to be the two faces of the same coin.

 

Life is fleeting moments of hopefulness and hopelessness. Each with its own complement of visions. You strike a match and see the flame as it burns the wood to a crisp. It is a fleeting warmth of the bursting glow and soon the charred remains all in a single moment of reflection.

 

What the human spirit mostly seeks, is to be. To be! In being, it accomplishes its most ardent task of satisfaction. Its goal in life. It is not Hamlet’s morose, wallowing wanton lust for despair in the “not to be.” No. Life is a march for accomplishments. To help others. To be kind. To Innovate. To create. To live! The human spirit does not define itself with loss. It defines itself through success. It does not ache for victimhood but in the conquering of it. The Spirit always finds when one door closes, it looks for another to open and goes to find that new promise.

 

And yet these days, that triumph of a spirit is constantly and deliberately being rendered moot. Shackled to the reins of a galloping authority, it is being dragged and ground in the grist of other’s desires. Discrete disincentives to level desire with feeding troughs of entitlements; the “mother’s milk” of dependency. The force of such a narrative is strong and easily overwhelms those that spend less on thought and reason and more on meaningless distractions of how others live their lives. 

 

Submission to the demands follows via platitudes of self-preservation and safety, while liberty and freedom are torn asunder. Masks, distance, limited groups, no access to the religion of belonging, no thought unless approved by the groupthink machinery of corrupt ideology, no words, except those approved by the mobilized mob of ‘journalism.’ And no critical thinking encouraged among children, lest they begin to think for themselves and unravel this imposition of soft-tyranny. The constant peddling of untruths to mask the ultimate aim of command and control of the human spirit.

 

What happened to humanity?

 

Actually nothing. The triumph of the human soul lives and is gathering steam. The pendulum rises and always falls back to the center. Triumph of the human spirit still lives in the cracks and fissures of these blockading “impervious” walls of virtue-signaling and political correctness. These walls cannot stand and will crumble under the weight of their own lies and take down those that built them.

 

The human Spirit strives against the impossible. It strives against hardships. It has remained unbeaten and unsullied through history.

 

Earnest Shackleton defied the odds in 1909 to go to the South Pole where all longitudes merge, but with ailing men in his encampment was forced to surrender to Nature and not meet his goal. He wrote, ““Men go out into the void spaces of the world for various reasons. Some are actuated simply by a love of adventure, some have a keen thirst for scientific knowledge, and others again are drawn away from the trodden paths by the ‘lure of little voices,’ the mysterious fascination of the unknown. We had seen God in his splendors, heard the text that Nature renders.  We had reached the naked soul of men.”  

 

A hundred years later, Henry Worsley in 2009 and then again in 2015 with

a “combination of eating, bending, driving, tying, pushing, bracing, draining, swearing, pausing and despairing, made two treks to the South Pole unaided and against all odds, and succeeded in both endeavors. A Triumph of the Spirit! The Spirit lived.

 

That spirit lives in all of us. The odds only make that Spirit more defiant and more resolute. So, in the scheme of life, we must not let our currents run awry and lose the name of action. Live on! We do not need to “weep, past hope, past cure, past help.” We just need to embody the indefatigable and indomitable Spirit of Worsley and others like him and move on to new heights and prepare for new challenges.

 

God Speed!

RISKS and MITIGATION STRATEGIES

   

I am often asked about risks. As an Oncologist, one has to understand the potential risks of how many ways cancer can manifest and the associated management with all its various interactions with the human body. The riddle is a complex one. It oozes with a myriad of signs and symptoms that need a solution. So, Risk management becomes a big part of cancer care. And the oft-repeated Hippocratic injunction which was actually mentioned and should be attributed to an English physician Thomas Sydenham In, 1860 reminds us, and remains the guardrail of protection for the patient, “Primum Non-Nocere!” (Above All Do No Harm).

Overall mortality increases with time

RISK

Risk, therefore, is nothing more than a manifestation of a known and unknown hazard. In our daily lives, we encounter hazards that we consciously and unconsciously avoid. Mostly these are known, and always from the lens of our view, filtered possibilities. If an AI chip was embedded in the human cortex or one was wearing a virtual display, the probabilities of such risks based on computed hazards would constantly be displayed in the field of view. But then we would be cyborgs, all of us. For instance, a 0-1% chance of tripping on a low table while negotiating a room in daylight increases to a probability to 90% in the dark. The only mitigation strategy is the known layout of the room and the frequency of negotiating that room, which reduces the risk. So, a known hazard can be mitigated better through knowledge and understanding. Our brains are such marvelous organs that subconsciously plot out the probabilities and the net result from the behind the eyeball calculations comes up with “nah not going there, too risky.”

SMOKING

Allow me to dwell on a few risky things that humans are wont to. Smoking for instance is a well-known risk to cause disease. The manifestation of that disease can be in the form of emphysema and heart disease all the way to the development of Cancer. The risks increase with the number of cigarettes and the number of years smoked. For instance, it is a known axiom that a 20-pack year history of smoking (1-pack smoked per day for 20 years or 2 -packs for 10 years) has a much higher risk of developing lung cancer than a non-smoker. On the obverse side, 80-90% of lung cancer deaths have smoking as the main causal factor. Male smokers are 23 times more likely to develop lung cancer, while women are 13-times more likely, compared to never-smokers. Genes are at play in that variance.

Why the risk in smoking, one might ask? The answer is in the 7000 chemicals contained in the cigarette smoke. Almost 69 Polycyclic aromatic hydrocarbons or PAHs (aromatic amines, benzene and the like) and their reactive intermediates are implicated in the cancer development process. https://www.ncbi.nlm.nih.gov/books/NBK294309/ From a basic science point of view, these aromatic amines and their carbo-carbons have an affinity for the nucleophilic sites present on the DNA. These DNA adducts once gaining the piggy-backed ride are critical in causing mutation and damage to the protective mismatch repair enzymes (these enzymes rewrite the wrong of the DNA sequence during replication). A study by Ding et. al found 1,013 nonsynonymous somatic mutations in 163 of the 188 tumors were identified, including 915 point mutations, 12 dinucleotide mutations, 29 insertions, and 57 deletions due to smoking. https://pubmed.ncbi.nlm.nih.gov/19064552/ A more recent study found after analyzing the entire Exome of 188 smoking related lung cancer cases that there was a 12.0 events per megabase! (So much harm from a puff of smoke). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557932/

So, the data from this smoking hazard is brutally strong, yet people still smoke! Their rationale is based on a self-served motive of “let me enjoy a smoke.” Unfortunately, the “later” happens as the future becomes the present in most enjoying that smoke. Risk mitigation should always be balanced when thrill-seeking or immediate desire fulfillment, in the present with some concern for the future.

Why do people ignore warnings is because of “Risk Appetite” and “Risk Tolerance?” In the business world, the definitions are quite simple, and they bleed well into our daily realities too:

RISK APPETITE AND TOLERANCE in Business & Life

 

Risk appetite is the level of risk that an organization is willing to accept while pursuing its objectives, and before any action is determined to be necessary in order to reduce the risk.

 

Risk tolerance on the other hand, reflects the acceptable variation in outcomes related to specific performance measures linked to objectives the person seeks to achieve.

 

People make choices with an asymmetry of information and thus lack the ability to process and manage decisions properly.  Risk appetite is where one is willing to reach the maximum limit of their personal level of tolerance and Risk tolerance is where one is willing to accept a certain level of harm from potential hazards in lieu of maximizing the potential of benefit. Between appetite and tolerance, there are a set of guardrails in the decision-making process. These guardrails guide an individual between the lanes of harm and the potential of reward. Between failure and success, between error and trial and between riding a bicycle and watching with desire and between what might have been to what is, lies the path of life. Similarly, when it comes to business innovations the risks are always being closely scrutinized to minimize harm while maximizing the potential future benefits. In simplistic terms, a mountain is a known hazard, and flying into it is mission failure and thus a risk. The problem of an unknown or unquantified hazard gives us all shivers and makes those ills appear unsurmountable until someone brave enough ventures further than the mind’s eye into the thicket and proceeds to create new guardrails for success. Thus, is born the term Risk Arbitrage in investment deals where an investor may profit from the difference in the trading price of the target stock, and the acquirer’s valuation of the stock. Although this seems as a win-win situation, the caveat is when the deals falls short or the valuation is negotiated down below the valuation price. A savvy investor might buy a stock for its price appreciation but hedge his bets with a put option to protect on the downside should the stock price go south. Essentially trading stocks is a chess game much like in life but more as a high roller derby, prying to maximize profits and minimize losses.

 

RISK IN AVIATION

 

In the aviation world where many of us travelers partake in, we all realize the risky nature of flying in a large aluminum tube filled with hundreds of fellow human beings, but we are willing to use the option because it is the fastest way from here to there, by suspending the disbelief of potential harm. Aviation is a risky enterprise to some extent. Managing an aircraft especially with dependence on automation has some risks. Several harrowing airline disasters litter the historical landscape: from the Tenerife disaster between KLM and PanAm Airways to Japan Airline 123 to Air India flight 182 and more recently the Malasian Airlines flight 17,  wherein each disaster hundreds perished due to human error. Although these disaster claim headlines, the risks of such occurrences are miniscule in the scheme of things.  The United States Aviation Regulations Part 121 (governs Commercial Airlines) shows that from 1983 -2000 the fatality rate was 0.03 per 100,000 flight hours. And this risk has declined to 0.006 accidents per 100,000 flight hours. That is equivalent to ONE fatal accident for every 16,300,000 flight hours based on the National Transportation Safety Board (NTSB). In comparison, the General Aviation Aircraft fatality rate is much higher at 0.84/100,000 flight hours. Consider that risk against driving a car. The fatality risk is 23 per 100,000 hours of driving. So, it is more dangerous to drive to the airport than to take the flight to one’s destination. Risks are everywhere where the eye can see. We walk through a field of risks each day and through each night. We negotiate the path of observing and quantifying the myriads of risks consciously or unconsciously in our passage through time. Humans have the gift of such wondrous abilities. Animals too have such potential: A deer knows the risk from an approaching lion in the wild as a duck does from a steely-eyed alligator in the lake. The flight from risk and towards safety is every life’s reach.

RISK IN COVID times & the March to Madness

 

And that brings me to the current debacle that has unfolded across the world. SARS COV2 or COVID19 as it is called has the attention of 7.3 billion people on it. Answers come in a slow drip as the steeled doors are locked and the key has gone missing. Many theories abound about this 80-140 nanometer (0.00003937 inches) virus. We find an inordinate amount of human intervention as mitigation strategies. Shutdown and lockdowns and Restricted Outdoor activity and restaurant closures and bar closures including other forms of commerce that feed the household each day. There is a plethora of graphs of the increasing cases on a daily basis. Not to mention that the case largesse (called “Casedemic” by some) is based on flawed scientific methodology. The vaunted PCR test, it turns out gives false-positive results at an alarming rate when the thermal Cycle threshold is raised above 27. And yet most tests are being performed at 35 as they finger the non-infectious RNA remanents and falsely posit them as True COVID cases. The real numbers remain cloaked in mystery as the mountain of erroneous data gets compiled and disseminated for consumption. The mortality numbers below give a vivid picture of reality.

 

The other side of this midnight, however, shows a different viewpoint. Infection fatality rates have ranged from 0.00% to 1.63% and corrected values ranged from 0.00% to 1.31%.

When reviewed across 32 different locations, the median infection fatality rate (IFR) was 0.27% (corrected 0.24%). Most studies were done in pandemic epicenters with high death tolls. Median corrected IFR was 0.10% in locations with COVID-19 population mortality rate less than the global average (<73 deaths per million as of July 12, 2020), 0.27% in locations with 73-500 COVID-19 deaths per million, and 0.90% in locations exceeding 500 COVID-19 deaths per million. Among people <70 years old, infection fatality rates ranged from 0.00% to 0.57% ( or up to 99.43% risk) with median of 0.05% (or 99.95% risk) across the different locations (corrected median of 0.04%). When one looks at the excess mortality on an average year and compares with the past years, it was an increased blip. That blip, however, has to be taken with a grain of salt, since all deaths occurring, whether, Heart failure, COPD, Diabetes, Cancer, Accidents on the road or at home and those related to Opioid abuse and other vicissitudes of life during this period of such heightened alertness are being recorded as COVID deaths.

The true Death Rate is somewhat circumspect, at best as well. Knowing the foregoing it brings us to the question of real risk. It is unfortunate that the term “science” is being used to propel one’s career through fear-mongering. Given the tumult of politics for advantage, a chance of tenure as a professor, or gaining a governmental position of power, or increasing one’s own heightened narcissistic recognition by the peers, the projected asymmetry of information is loathed, to give us real risks that can be comprehended and easily used by the populace for risk mitigation. In spite of the fraction of fractions of the risks from death from this virus, the drama continues to unfold on television and social media as an Armageddon and a “Dark Winter.” There are calls for “The Great Reset” and for a “New Normal” on a daily basis. And each of these terms has widely nefarious interests of the few against the many. “Wear a mask,” “Stay home,” “Don’t question the science’” are the clarion calls of the day. One wonders as to the motive and reasoning and reminded of Feynman’s words that “science is (and has always been) a culture of doubt.” But then questioning any of the unfolding quasi-science is considered tantamount to heresy. The harm from shutdowns and lockdowns is in thousands of lives that the “experts” and Governors of some states refuse to acknowledge. There is this new-found sickly power and control over others that would have Tantalus lusting.

 

COVID Protections?

Let us look at some issues as dictated under the guise of “evidence’ by “experts” and their collaborators: The Media. Stay Indoors and Wear masks. On the former , there are ample data sets that prove that most transmissions occur in an enclosed environment. This is attributable to limited air movement and poor ventilation. The aerosolized viral particles, after the fluid medium of transmission, dries out, are free to find another human refuge through contact (and by contact, I mean hand to mouth or nostrils or eyes) or direct inhalation in the vicinity. How far do the aerosolized particles go is dependent on the breath, the sneeze, or a cough, where the expulsive force can be as much as 60 miles per hour at the exit point. So, to force indoor activity is tantamount to a forced infection among the household. This was confirmed when Governors of five States sent convalescing COVID patients into Nursing Homes and caused the harm of thousands of deaths among the vulnerable population (all of these politicians still evade the harm they caused and point fingers at others. On the subject of masks, there are more questions. The current scientific data suggests, COVID19 has a 80-140 nanometer size and the N95 mask protects against particulate matter in the 300-nanometer range 95% of the time. So, for all practical reasons, the 140nm particle is free to glide through the N95 mask with impunity. The Surgical mask however restricts particles of 100nm size. But reuse of such masks is not recommended since degradation from use (saliva, breath, sneeze, cough) is common and these masks are not meant to be used for hours at an end for protection. Doing so causes the exhaled breath biological particulate matter to stagnate on the inside and touching the masks as most people do will do the same on the outside of the mask. Meanwhile,  the colorful cloth masks whether from Rodeo Drive or Walmart are absolutely useless to prevent transmission of the virus, period.

WHAT TO DO?

So, what to do? It goes back to the time tested hygienic preventative measures. If you are sick isolate yourself in the interest of others or till you have recovered. Wash hands before eating. Do not put fingers in your mouth, nostrils or touch your eyes and go outdoors where the breezes and sun act as natural disinfectants. Improve your overall health by exercising and eating a better diet, not smoking and reduced drinking also help. Besides better therapeutics against the COVID are available to prevent harm to us humans against this virus. Stay tuned for success.

Perhaps we as scientists must seek the truth rather than strive for the next richer rung of the ladder. Perhaps we should stick to facts and the truth rather than made up pseudoscientific talking points. And perhaps, this ask is a bridge too far. The journalists continue the farce of asking the meaningless non-science questions to pursue a narrative that fits in the 10-second television segment and their intent, and continues to evade ones that are on everyone else’s lips. Stifled by the “Woke” and the politically correct crowd, the pre-determined pursuit of falsehoods continues, and the gyre widens and widens, while the center teeters on losing control. What is left, is critical thinking and reason, logic and understanding, to bring us back from the abyss of this wild and risky ride. What we should fight for is real science, our cherished liberties, and freedoms and the way of life now being actively usurped by the virtue signaling, snake oil-carpetbaggers littering the landscape.

It is time to get REAL…!

https://www.ncbi.nlm.nih.gov/books/NBK294309/

2020 - The Year the Music Died

 

The promise of a new decade began in earnest. On December 31st, 2019, the bells were ringing, the crystal ball slowly dropped ready to crown the year in perfect unison to the cheer of the crowd as the countdown pulled it down to its vaunted perch. The glow and excitement, the singing, hollering, crowd infused, and drunk with the hope of a brighter future to come were filled with hope and dreams. What innovations may evolve, what dreams may come true, what happiness and loves would flourish, what friendships would evolve, all thoughts were buried in that one moment of joyous celebration.

 

But that was many moons ago.

 

An 80-160 nanometer RNA monster cloaked in a protein shell was dreamt up in the confines of four walls, glass partitions, and a bright white sterile confines of the Wuhan laboratory in China. Perhaps the escape from this “Alcatraz” was an unfortunate hiss of the loss of a positive pressure environment of a Biosafety lab, or perhaps it was inadvertent contamination, and a minor infraction led to the runaway uncontained debacle.

 

The physical drama would soon be broadcast across the globe.

 

Soon began the dance and drama of containment. It first sparked in Wuhan, Hubei Province of China. All of China was immediately cut off from the Province. Containment processes ensued and video information of forced encampment of citizenry spread far and wide. Street spraying, a 10-day make-shift-hospital, and images of overrun hospital emergency rooms started happening in that far away land from the western shores. Amused by the goings-on in these distant shores, a cadre of pontiffs began to swell here and elsewhere. These self-appointed experts in the western lands began to sing. The song was initially quite conciliatory and harmonizing evoking feelings of nothing can hurt us. Some false prophets claimed to keep the borders open to all travelers from China. No, they cried, this is paranoia, nothing can harm us. All were in a state of a temporary kumbaya.

 

Then the change came. The psyche preprogrammed from the earlier visuals began to play…

 

A spark in the state of Washington ignited the fuel of concern. The monster was here! Soon the spread would come. And it came. Another spark ignited in the densely populated skyscraping land on the eastern shores of the United States and all hell broke loose.

 

In that sinister spread, something else emerged.

 

The call for a strict discipline to conform to the call of “Science.” Sprouting in the midst were a few who took that call seriously and started invoking the term at every street corner of the social media where a gathering of eyeballs was glued to their feed. Charts and Graphs were everywhere. The exponential rise of the infections was teased statistically and the exponent kept on getting higher to make the graphs worse and worse. Amid these trying times images of inundated tired and overworked doctors, nurses, and healthcare workers gowned and masked emerged and broadcast across the world. Italians, Spaniards, French, Danish, and Americans.

 

The deluge of the suddenly ill grew.

 

A make-shift hospital in New York (The Jacob Javits Center) was built, while a large Navy ship coasted and anchored near Manhattan to take on any excess patients sickened from the virus. But no ambulances of the ill came around to fill those excess beds. Yet the calls from the political leaders grew, claiming lack of this and that. Meanwhile some politicians exacerbated the deaths in their states by sending virus-infected idviduals into the Nursing Homes where the vulnerable population of the aged was resident. Men and women dressed in white coats appeared on television to new-found fame advocating for more of everything in packages and less of everything related to liberty and freedom. Whereas protecting the elderly and vulnerable was need, mandates for all to acquiesce to the mandates was the want.

 

The organ of innovation resolved to create.

The Public-Private enterprise emerged, and all the levers moved, the gears switched, and the mechanics of the newly crafted Rube-Goldberg machine produced. Innovation occurred at the whoosh of the breeze. Mountains of innovations were suddenly at hand to be deployed and used.

 

The carpetbaggers were never too far behind.

The newly appointed tele-evangelical scientists clamored for more. More masks, more gowns, more of everything. And more was created in a short flash of time. In that whole drama was a desire to create more testing. Machines were built and logistics created to distribute the emergent technology across the country and thence to the rest of the world. 

 

Testing was the new norm. People lined up in their cars to get a swab inserted in their nostrils to discover if the virus had entered their body’s realm. Many were proclaimed positive through the magic of the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) tests. The positive tests grew and call for a shutdown and lockdowns from the ignorant leaders who relied on their pseudo-scientific health advisors (some with degrees in sociology, others in social service, and yet others in computer science). In all this drama a white knight emerged. He took on the mantle as a spokesperson with his impeccable credentials in bureaucracy. He seemed to waffle a bit, initially taking his cue from a non-physician head of the World Health Organization. He first implied that there was no risk to the United States from the virus, and then changed it to a serious threat. He also maintained the mask-wearing was useless as a protective mechanism against the virus in line with the WHO and then suggested that masks should be worn at all times. He then stated that vaccines would put an end to the “pandemic” and then stated that even after the vaccination distancing and masks should continue to be worn. The cases grew as the PCR machines chugged along falsely giving positive results as they churned out 35-40 thermal-cycles determining non-infectious fragments of the viral RNA.

The decline of the laughter and joy became evident.

Meanwhile, where once children played in the yards, swirled around in merry-go-rounds, swung from the swings, swished down the playground slides were silent at homes, tied to the outside world through the medium of social media. The creators of the social media were hard at work broadcasting pseudo-science and virtue signaling, warping the young and flourishing minds with their version of the “new norm.”

 

Children more susceptible to such subtle and nuanced broadcasts without the link of companionship to other children started a new and sustained epidemic within society. Depression. Teen and adult suicides increased. The fragmentation of the family unit began to show deeper cracks as the finances took a hit.

 

The toll on commerce grew exponentially.

Companies were shut down since workers needed to be “protected” and adults lost their jobs since companies could no longer bring in the revenues from unsold products that filled their inventories.  Adults could not bring in the paycheck to pay for their family’s needs. A disruption of the cohesive family networks suddenly started fragmenting the fabric of society had a loose thread that slowly began to unravel. The politicians meanwhile jockeyed for position to control and used the “pandemic” to their advantage. The floodgates of the sham however would soon open. The deluge would soon follow. And all of the worlds would dearly pay.

A few groups started rioting and destroying commercial and private properties to send political messages across the land. These were considered "peaceful protests" as homes and property burnt to the ground. Something sinister was at play.

 

Masks became the in thing.

The cloth and surgical masks, it turned out, do not, and never did protect against viral infections. The former has a 90+% chance of failure and the latter about 45+% of failing to protect. The N95 masks do help but if used for more than 2 hours at a time, harm the individual wearing it from a whole host of harm of rebreathing exhaled air, acidity in the mouth, periodontal disease, and the consequences resulting from that; coronary artery disease, intestinal illnesses, and change in the microbiome of the mouth and the GI tract resulting in a decline in the robustness of the immune system. 

 

Where once was joy, depression ensued. Where once was music, a daily broadcast of “cases” and “death counts” played, plucking the detuned strings of society. Dissonance followed. Further jarring the fragile mental framework of a society teetering on the edge of its stable psychological limits. 

 

11 months later, cars still drive on roads, albeit much fewer. Aircraft still dot the skies but are few and far between. The car industry and the airline industry are in shambles. Their Earnings per share declining faster than a lead bullet speeding down a well. Malls are shuttering as brick and mortar retail shops have few to none consumers strolling around looking for things to buy to warm up their families with joy and some happiness. Meanwhile, a few mega-companies like Google, Facebook, Apple, Amazon, etc. capturing personal data of the citizens are selling information to evaluate and control the habit of the population at large while making large sums of money for themselves, earning billions of dollars an hour from the decimated smaller businesses that lie flailing for their last breaths.

 

The once glorious, happy, and harmonious world has become a shell of its past. The music seems to have died in the soul of this and other nations. The schools are forcibly closed by governmental mandates for absolutely no reason, yet the term "Science" is proclaimed to be behind all such decrees. Experts are clamoring for placing more restrictions on citizens, made to socially distance to limit interaction, and mask-wearing is enforced to further limiting any and all social human interaction. Some are being bullied by authorities, others handcuffed and processed. This goes on as the same politicians enforcing the mandates are also releasing convicted criminals from the prisons under the guise of the virus.

 

A plague is upon us and it is not the virus!