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Archive for the ‘homo sapiens’ category: Page 2

Apr 25, 2016

The Importance of Hope

Posted by in categories: biological, health, homo sapiens, life extension

I learn useful life lessons from each patient I meet. Some are positive messages, reminding me of the importance of maintaining balance between family, work, and leisure activities, but more frequently I witness examples of the remarkable resilience of the human spirit when facing the reality and risks of a major surgical procedure and a diagnosis of cancer. Rarely, patients and their family members utter remorseful or simply sad remarks when they are faced with a grim prognosis and the emotions associated with an onrushing date with mortality. These comments invariably involve an inventory of regrets in life, including, “I should have spent more time with my kids,” “I wish I had told my father (or mother, brother, sister, child, or some other person) that I loved them before they died,” and “I have spent my entire life working, I never took time for anything else.” I wince when I hear these openly expressed remonstrations, I recognize that I am hearing painful and heartfelt truths. Not a week goes by that I am not reminded that I do not one day want to look back at my life with a long list of regrets, should have dones, and what ifs.

I was blessed to meet a great teacher in the guise of a patient early in my academic career. He came to my clinic in my first year after completing a Fellowship in Surgical Oncology, my first year as an Assistant Professor of Surgery. My patient was a 69 year-old Baptist Minister from a small town in Mississippi. He was referred to me by his medical oncologist who called me and said, “I don’t think there is anything you can do for him, but he needs to hear that from you because he doesn’t believe me.” This tall, imposing man had colon cancer that had metastasized (spread) to his liver. The malignant tumor in his colon was removed the year before I met him, and he had received chemotherapy to treat several large tumors found in his liver. The chemotherapy had not worked and the tumors grew. At the point I met him, the medical oncologist told him he would live no more than 6 months, and because he was an avid fisherman when not preaching or helping others in his community , the doctor suggested that he go out and enjoy his remaining time by getting in as much fishing as possible. I learned two invaluable lessons from this patient and his family. First, never deny or dismiss hope from a patient or their family, even when from a medical perspective the situation seems hopeless and the patient is incurable. Second, quoting the minister directly, “Some doctors think of themselves as gods with a small ‘g’, but not one of you is God”.

Continue reading “The Importance of Hope” »

Mar 24, 2016

Good News Bad News

Posted by in categories: biological, biotech/medical, health, homo sapiens

One of the things I love most about being a Surgical Oncologist is that I see my patients for years after I have treated them. However, my clinic days are inevitably like the opening scenes from the old Wide World of Sports television program that aired on Saturday afternoons on ABC. I remember watching this show on weekends as a child and teenager. The “thrill of victory”, with images of athletes crossing the finish line in first place, equates to those patients who receive good news during their clinic visit. I tell them I am confident I can perform an operation to remove their cancer; or I confirm that their blood tests and scans show that tumors have not recurred after surgery, chemotherapy, and other treatments; or we pass some major chronologic milestone without evidence of cancer rearing its ugly head again (many patients still believe the 5 year anniversary of being cancer-free equates with being “cured”, if only that were always true). In contrast, the “agony of defeat”, forever seared in my memory in the opening scenes of Wide World of Sports with the ski jumper falling off the end of the jump and bouncing hard off the slope, represents the distress and depression felt by patients and their family members when I deliver bad news.

I would never make it as a professional poker player because I can’t bluff when I’m holding a bad hand or keep from grinning when I have a good one. My patients can tell from my face when I walk into the clinic room what the news is going to be. When all of the blood tests and scans reveal no evidence of cancer recurrence, I walk in smiling and immediately tell all gathered in the room that everything looks great and I see no evidence of any cancer. The remainder of the visit becomes a combination of medical checkup and social enterprise. I inquire about the well-being of their children, grandchildren, parents, other friends and relatives I have met, their pets, their gardening, their recent travels, and sundry snippets of their ongoing lives. Patients frequently bring pictures of children and grandchildren, or travel photos of places they have been since their last visit with me. Often I’m asked for medical advice on conditions totally unrelated to their cancers as they get farther and farther away from that diagnosis. My patients also know about tidbits from my life. They ask about the status of soccer teams that I coached, how my son or daughter were doing in college (both graduated and onto successful careers, thank you), and whether I have progressed from owning a Ferrari lanyard to hold and display my medical badge (I’m a fan of Ferrari F1 racing) to actually owning a Ferrari automobile (I do not).

I am told by patients, family members, and members of my patient care team that I am quite solemn when I walk in a clinic room to deliver bad news. No “light-hearted” chatter or discussion of recent family events or outings occurs. The nervous, hopeful smiles on the faces of the patient and the family members in the room quickly fade as I describe what I am seeing on their blood tests and the scans I have reviewed. Friedrich Nietzsche, the pejorative poster boy of pessimism, is credited with the aphorism, “Hope is the worst of evils, for it prolongs the torments of man.” Thankfully, he was not involved in the care of patients with cancer or other chronic illnesses. A particular patient comes to mind when I remember the importance of dealing with both the highs and the lows of talking with cancer patients.

The patient in question was the wife of an Emeritus Professor of Engineering at a prestigious American university. The Professor knew a thing or two about scientific investigation, statistics, and assessments of probability. Mrs. Professor had a large, grapefruit-sized malignant vascular tumor in the center of her liver called an epithelioid hemangioendothelioma. Quite a mouthful of a name for a rare malignant tumor of the liver. Her tumor was in an unfortunate location in the center of the liver and was wrapped around two of the three veins that drain all of the blood out of the liver into a large blood vessel called the inferior vena cava. The tumor was abutting a portion of the third vein. As a hepatobiliary surgical oncologist, I know I must preserve at least one of these veins to allow blood that flows into the liver to flow back out properly. She had seen surgeons at several other hospitals in the United States and was told that the tumor was inoperable and untreatable. If she was lucky, she might live a year, these doctors told my patient and her husband. The Professor contacted me, and I examined Mrs. Professor and evaluated her prior scans, and then obtained some additional high resolution scans to better understand the appearance of her tumor. I realized that her particular tumor had a very thick fibrous capsule surrounding it. I explained to the patient and her husband that it may be possible to remove the tumor, but that it would be challenging. This lady who had been sullen, withdrawn, and tearful every time I had met with them previously suddenly looked up and said, “If there’s any chance, I’m willing to take it!” I preceded the next week to perform an operation that removed the entire left lobe and a portion of the right lobe of her liver and I was able to gently dissect the tumor capsule free from the third hepatic vein. The operation was successful and the patient recovered well over the next several weeks.

Continue reading “Good News Bad News” »

Mar 7, 2016

The Importance of Hope

Posted by in categories: biological, education, health, homo sapiens, life extension

hope

I learn useful life lessons from each patient I meet. Some are positive messages, reminding me of the importance of maintaining balance between family, work, and leisure activities, but more frequently I witness examples of the remarkable resilience of the human spirit when facing the reality and risks of a major surgical procedure and a diagnosis of cancer. Rarely, patients and their family members utter remorseful or simply sad remarks when they are faced with a grim prognosis and the emotions associated with an onrushing date with mortality. These comments invariably involve an inventory of regrets in life, including, “I should have spent more time with my kids,” “I wish I had told my father (or mother, brother, sister, child, or some other person) that I loved them before they died,” and “I have spent my entire life working, I never took time for anything else.” I wince when I hear these openly expressed remonstrations, I recognize that I am hearing painful and heartfelt truths. Not a week goes by that I am not reminded that I do not one day want to look back at my life with a long list of regrets, should have dones, and what ifs.

I was blessed to meet a great teacher in the guise of a patient early in my academic career. He came to my clinic in my first year after completing a Fellowship in Surgical Oncology, my first year as an Assistant Professor of Surgery. My patient was a 69 year-old Baptist Minister from a small town in Mississippi. He was referred to me by his medical oncologist who called me and said, “I don’t think there is anything you can do for him, but he needs to hear that from you because he doesn’t believe me.” This tall, imposing man had colon cancer that had metastasized (spread) to his liver. The malignant tumor in his colon was removed the year before I met him, and he had received chemotherapy to treat several large tumors found in his liver. The chemotherapy had not worked and the tumors grew. At the point I met him, the medical oncologist told him he would live no more than 6 months, and because he was an avid fisherman when not preaching or helping others in his community , the doctor suggested that he go out and enjoy his remaining time by getting in as much fishing as possible. I learned two invaluable lessons from this patient and his family. First, never deny or dismiss hope from a patient or their family, even when from a medical perspective the situation seems hopeless and the patient is incurable. Second, quoting the minister directly, “Some doctors think of themselves as gods with a small ‘g’, but not one of you is God”.

When I first walked into the examining room, this man was slouched on the examining table in the perfunctory blue and white, open-backed, always unflattering hospital gown. He made eye contact with me briefly, then looked down to the floor. In that momentary meeting of our eyes, I saw no sparkle, no life, no hope in his eyes. He responded to my initial questions with a monotonic and quiet voice. Several times I had to ask him to repeat an answer because his response was so muted. Mid-way through our first visit, the patient’s wife told me he had been very depressed by his diagnosis of untreatable metastatic colon cancer. She reported, despite his occasional side-long warning glances requesting her silence, that while he was eating well, he was spending most of his time sitting in a chair or laying in bed, and that the active, gregarious man with the quick wit and booming voice she had married was gone.

Continue reading “The Importance of Hope” »

Jan 26, 2016

How Technology Changes the Way We Diagnose and Treat Mental Illness

Posted by in categories: biological, biotech/medical, disruptive technology, homo sapiens, neuroscience

As recently as 50 years ago, psychiatry lacked a scientific foundation, the medical community considered mental illness a disorder of the mind, and mental patients were literally written off as “sick in the head.” A fortunate turn in progress has yielded today’s modern imaging devices, which allow neuroscientists and psychiatrists to examine the brain of an individual suffering from a mental disorder and provide the best treatment options. In a recent interview, Columbia University Psychiatry Chair Dr. Jeffrey Lieberman stated that new research into understanding the mind is growing at an accelerated pace.

(iStock)

(iStock)

Lieberman noted that, just as Galileo couldn’t prove heliocentrism until he had a telescope, psychiatry lacked the technological sophistication, tools, and instruments necessary to get an understanding of the brain until the 1950s. It wasn’t until the advent of psychopharmacology and neuroimaging, he said, that researchers could look inside the so-called black box that is the brain.

“(It began with) the CAT scan, magnetic resonance imaging (MRI) systems, positron emission tomography (PET scans) and then molecular genetics. Most recently, the burgeoning discipline of neuroscience and all of the methods within, beginning with molecular biology and progressing to optogenetics, this capacity has given researchers the ability to deconstruct the brain, understand its integral components, its mechanisms of action and how they underpin mental function and behavior,” Lieberman said. “The momentum that has built is almost like Moore’s law with computer chips, (and) you see this increasing power occurring with exponential sort of growth.”

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Apr 29, 2015

Robotic EQ

Posted by in categories: evolution, homo sapiens, robotics/AI

Can an emotional component to artificial intelligence be a benefit?

Robots with passion! Emotional artificial intelligence! These concepts have been in books and movies lately. A recent example of this is the movie Ex Machina. Now, I’m not an AI expert, and cannot speak to the technological challenges of developing an intelligent machine, let alone an emotional one. I do however, know a bit about problem solving, and that does relate to both intelligence and emotions. It is this emotional component of problem solving that leads me to speculate on the potential implications to humanity if powerful AI’s were to have human emotions.

Why the question about emotions? In a roundabout way, it has to do with how we observe and judge intelligence. The popular way to measure intelligence in a computer is the Turing test. If it can fool a person through conversation, into thinking that the computer is a person, then it has human level intelligence. But we know that the Turing test by itself is insufficient to be a true intelligence test. Sounding human during dialog is not the primary method we use to gauge intelligence in other people or in other species. Problem solving seems to be a reliable test of intelligence either through IQ tests that involve problem solving, or through direct real world problem solving.

As an example of problem solving, we judge how intelligent a rat is by how fast it can navigate a maze to get to food. Let’s look at this in regards to the first few steps in problem solving.

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Oct 1, 2014

The Abolition of Medicine as a Goal for Humanity 2.0

Posted by in categories: biological, bionic, biotech/medical, ethics, futurism, genetics, homo sapiens, human trajectories, life extension, philosophy, policy, transhumanism

What follows is my position piece for London’s FutureFest 2013, the website for which no longer exists.

Medicine is a very ancient practice. In fact, it is so ancient that it may have become obsolete. Medicine aims to restore the mind and body to their natural state relative to an individual’s stage in the life cycle. The idea has been to live as well as possible but also die well when the time came. The sense of what is ‘natural’ was tied to statistically normal ways of living in particular cultures. Past conceptions of health dictated future medical practice. In this respect, medical practitioners may have been wise but they certainly were not progressive.

However, this began to change in the mid-19th century when the great medical experimenter, Claude Bernard, began to champion the idea that medicine should be about the indefinite delaying, if not outright overcoming, of death. Bernard saw organisms as perpetual motion machines in an endless struggle to bring order to an environment that always threatens to consume them. That ‘order’ consists in sustaining the conditions needed to maintain an organism’s indefinite existence. Toward this end, Bernard enthusiastically used animals as living laboratories for testing his various hypotheses.

Historians identify Bernard’s sensibility with the advent of ‘modern medicine’, an increasingly high-tech and aspirational enterprise, dedicated to extending the full panoply of human capacities indefinitely. On this view, scientific training trumps practitioner experience, radically invasive and reconstructive procedures become the norm, and death on a physician’s watch is taken to be the ultimate failure. Humanity 2.0 takes this way of thinking to the next level, which involves the abolition of medicine itself. But what exactly would that mean – and what would replace it?

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Sep 18, 2014

Why Superintelligence May Not Help Us Think about Existential Risks — or Transhumanism

Posted by in categories: alien life, biological, cyborgs, defense, disruptive technology, ethics, existential risks, futurism, homo sapiens, human trajectories, internet, military, philosophy, policy, posthumanism, science, singularity, transhumanism

Among transhumanists, Nick Bostrom is well-known for promoting the idea of ‘existential risks’, potential harms which, were they come to pass, would annihilate the human condition altogether. Their probability may be relatively small, but the expected magnitude of their effects are so great, so Bostrom claims, that it is rational to devote some significant resources to safeguarding against them. (Indeed, there are now institutes for the study of existential risks on both sides of the Atlantic.) Moreover, because existential risks are intimately tied to the advancement of science and technology, their probability is likely to grow in the coming years.

Contrary to expectations, Bostrom is much less concerned with ecological suicide from humanity’s excessive carbon emissions than with the emergence of a superior brand of artificial intelligence – a ‘superintelligence’. This creature would be a human artefact, or at least descended from one. However, its self-programming capacity would have run amok in positive feedback, resulting in a maniacal, even self-destructive mission to rearrange the world in the image of its objectives. Such a superintelligence may appear to be quite ruthless in its dealings with humans, but that would only reflect the obstacles that we place, perhaps unwittingly, in the way of the realization of its objectives. Thus, this being would not conform to the science fiction stereotype of robots deliberately revolting against creators who are now seen as their inferiors.

I must confess that I find this conceptualisation of ‘existential risk’ rather un-transhumanist in spirit. Bostrom treats risk as a threat rather than as an opportunity. His risk horizon is precautionary rather than proactionary: He focuses on preventing the worst consequences rather than considering the prospects that are opened up by whatever radical changes might be inflicted by the superintelligence. This may be because in Bostrom’s key thought experiment, the superintelligence turns out to be the ultimate paper-clip collecting machine that ends up subsuming the entire planet to its task, destroying humanity along the way, almost as an afterthought.

But is this really a good starting point for thinking about existential risk? Much more likely than total human annihilation is that a substantial portion of humanity – but not everyone – is eliminated. (Certainly this captures the worst case scenarios surrounding climate change.) The Cold War remains the gold standard for this line of thought. In the US, the RAND Corporation’s chief analyst, Herman Kahn — the model for Stanley Kubrick’s Dr Strangelove – routinely, if not casually, tossed off scenarios of how, say, a US-USSR nuclear confrontation would serve to increase the tolerance for human biological diversity, due to the resulting proliferation of genetic mutations. Put in more general terms, a severe social disruption provides a unique opportunity for pursuing ideals that might otherwise be thwarted by a ‘business as usual’ policy orientation.

Continue reading “Why Superintelligence May Not Help Us Think about Existential Risks -- or Transhumanism” »

Jul 20, 2014

Humans Aren’t the Pinnacle of Evolution and Consciousness—We’re Only a Rung on the Ladder

Posted by in categories: biological, DNA, evolution, homo sapiens, posthumanism, transhumanism

Written By: — Singularity Hub
http://cdn.singularityhub.com/wp-content/uploads/2014/07/universe-comes-to-know-itself-1.jpg
In his latest video, host of National Geographic’s Brain Games and techno-poet, Jason Silva, explores the universe’s tendency to self-organize. Biology, he says, seems to have agency and directionality toward greater complexity, and humans are the peak.

“It’s like human beings seem to be the cutting edge,” Silva says. “The evolutionary pinnacle of self-awareness becoming aware of its becoming.”

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Jun 19, 2014

Amazing People with Real Superpowers

Posted by in categories: evolution, geopolitics, homo sapiens

Brent Swancer — Mysterious Universe

monk-featured
The world of comics and movies is full of superheroes and characters with abilities that transcend what is possible for the typical person. We enjoy these stories because we can escape our reality and imagine what it would be like to have amazing powers of our own. Yet, a gifted few in this world don’t have to imagine because like the superheroes in comics and movies, they too have extraordinary powers beyond normal humans.

Here we will look at a selection of real world people with remarkable powers and abilities that surpass those of us mere mortals.

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May 10, 2014

What to make of the film ‘Transcendence’? Show it in classrooms.

Posted by in categories: 3D printing, augmented reality, bionic, computing, cyborgs, disruptive technology, existential risks, fun, futurism, homo sapiens, human trajectories, innovation, nanotechnology, philosophy, posthumanism, privacy, robotics/AI, science, singularity, transhumanism

transcendence
I recently saw the film Transcendence with a close friend. If you can get beyond Johnny Depp’s siliconised mugging of Marlon Brando and Rebecca Hall’s waddling through corridors of quantum computers, Transcendence provides much to think about. Even though Christopher Nolan of Inception fame was involved in the film’s production, the pyrotechnics are relatively subdued – at least by today’s standards. While this fact alone seems to have disappointed some viewers, it nevertheless enables you to focus on the dialogue and plot. The film is never boring, even though nothing about it is particularly brilliant. However, the film stays with you, and that’s a good sign. Mark Kermode at the Guardian was one of the few reviewers who did the film justice.

The main character, played by Depp, is ‘Will Caster’ (aka Ray Kurzweil, but perhaps also an allusion to Hans Castorp in Thomas Mann’s The Magic Mountain). Caster is an artificial intelligence researcher based at Berkeley who, with his wife Evelyn Caster (played by Hall), are trying to devise an algorithm capable of integrating all of earth’s knowledge to solve all of its its problems. (Caster calls this ‘transcendence’ but admits in the film that he means ‘singularity’.) They are part of a network of researchers doing similar things. Although British actors like Hall and the key colleague Paul Bettany (sporting a strange Euro-English accent) are main players in this film, the film itself appears to transpire entirely within the borders of the United States. This is a bit curious, since a running assumption of the film is that if you suspect a malevolent consciousness uploaded to the internet, then you should shut the whole thing down. But in this film at least, ‘the whole thing’ is limited to American cyberspace.

Before turning to two more general issues concerning the film, which I believe may have led both critics and viewers to leave unsatisfied, let me draw attention to a couple of nice touches. First, the leader of the ‘Revolutionary Independence from Technology’ (RIFT), whose actions propel the film’s plot, explains that she used to be an advanced AI researcher who defected upon witnessing the endless screams of a Rhesus monkey while its entire brain was being digitally uploaded. Once I suspended my disbelief in the occurrence of such an event, I appreciate it as a clever plot device for showing how one might quickly convert from being radically pro- to anti-AI, perhaps presaging future real-world targets for animal rights activists. Second, I liked the way in which quantum computing was highlighted and represented in the film. Again, what we see is entirely speculative, yet it highlights the promise that one day it may be possible to read nature as pure information that can be assembled according to need to produce what one wants, thereby rendering our nanotechnology capacities virtually limitless. 3D printing may be seen as a toy version of this dream.

Now on to the two more general issues, which viewers might find as faults, but I think are better treated as what the Greeks called aporias (i.e. open questions):

Continue reading “What to make of the film 'Transcendence'? Show it in classrooms.” »

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