Spending a lot of time with my mother and grandmother during spring break, I have realized little by little what aging means: my mother is facing her mid life crisis and my grandmother is almost on the verge of becoming senile -- both my future self if I live long enough.
This morning during breakfast, my mom talked about a conversation between a woman who lives in the same apartment building. My mom and her are both housewives, but when my mom used to work as a language teacher, the woman used to ask her why she worked so hard. She asked how much she made with one lesson, and saw no value in keeping oneself busy for so little money. "We can't do anything much. We shouldn't expect too much from ourselves" she used to say. Every time, my mother thought: I'm different.
But now, she is having difficulties accepting the reality, that she was no different in the end. She was just one of the many housewives and the realization kills her with regret, shame and bitter feelings. I can say very little to her that makes her feel better.
On the other hand, my grandma had a very fulfilling life career-wise. But since she is not used to doing the housework (my mother always helped her with that since she was a child) she finds it difficult to do it now. She has also become increasingly forgetful. She still enjoys dressing up and cares a great deal about how she looks, and she also notices small stuff like the small pimple on my forehead (which she insisted was growing: "Are you just going to let it get fatter?") and whatnot, but spending time with her really teaches me what it means to get close to death. I guess it's a process of losing -- losing memories and skills/abilities and precious people you could share your memories with.
I felt slightly emotional as I watched her practice putting on her pearl necklace she had to wear for a funeral. Although we discovered that she could do it when she brought the clasp in front of her, she insisted she could do it with the clasp at the back and kept trying.
Looking at it from the other side though, it's the process of learning again, which rewards her (and those around her) with the joy of reaching a small goal every time she finds a way to overcome her new difficulties.
Life is maybe an endless learning process until the very moment death picks you up.
2014年3月8日土曜日
on death and dying
Death is just a moment when dying ends
-Montaigne
Finished reading On Death and Dying by Dr. Elisabeth Kubler-Ross. It's a study on death and dying -- how each individual patient copes with his last yet greatest ordeal in life. It contains many dialogues between the interviewers (the author with the hospital chaplain) and the patient who found the interviews as a chance to let out their suppressed concerns and emotions as well as to teach the medical professionals and pass something on.
Several things I want to remember (mostly from the last two chapters):
1. Terminally ill patients are aware of the seriousness of their illness whether they are told or not. Those who are not told explicitly know it anyway from the implicit messages or altered behavior of relatives and staff. Those who are told explicitly appreciate it unless they are told coldly and without preparation or follow-up, or in a manner that leaves no hope.
2. Leave hope when telling the truth. No matter the stage of illness or coping mechanisms used, all patients maintain some form of hope until the last moment.
3. We have to take a good hard look at our own attitude towards death and dying before we can sit quietly and without anxiety next to a terminally ill patient. The most important thing is to let him know that we are ready and willing to share some of his concerns.
4. For the patient death itself is not the problem, but dying is feared because of the accompanying sense of hopelessness, helplessness, and isolation.
5. Dying patients has the need ro leave something behind. They want something that will continue to live perhaps after their death and become immortal in a little way.
On a side note, the Japanese translation of the title is 死ぬ瞬間 which literally means "the moment of death". I haven't read the translation so I'm not sure what the translator meant but this book is not about the moment of death; it's about the suffering and eventual acceptance that comes before that moment in life; it's more about dying - the last process of living - than about death itself. But then again, I think there's no such word as "dying" in Japanese. Interesting.
-Montaigne
Finished reading On Death and Dying by Dr. Elisabeth Kubler-Ross. It's a study on death and dying -- how each individual patient copes with his last yet greatest ordeal in life. It contains many dialogues between the interviewers (the author with the hospital chaplain) and the patient who found the interviews as a chance to let out their suppressed concerns and emotions as well as to teach the medical professionals and pass something on.
Several things I want to remember (mostly from the last two chapters):
1. Terminally ill patients are aware of the seriousness of their illness whether they are told or not. Those who are not told explicitly know it anyway from the implicit messages or altered behavior of relatives and staff. Those who are told explicitly appreciate it unless they are told coldly and without preparation or follow-up, or in a manner that leaves no hope.
2. Leave hope when telling the truth. No matter the stage of illness or coping mechanisms used, all patients maintain some form of hope until the last moment.
3. We have to take a good hard look at our own attitude towards death and dying before we can sit quietly and without anxiety next to a terminally ill patient. The most important thing is to let him know that we are ready and willing to share some of his concerns.
4. For the patient death itself is not the problem, but dying is feared because of the accompanying sense of hopelessness, helplessness, and isolation.
5. Dying patients has the need ro leave something behind. They want something that will continue to live perhaps after their death and become immortal in a little way.
On a side note, the Japanese translation of the title is 死ぬ瞬間 which literally means "the moment of death". I haven't read the translation so I'm not sure what the translator meant but this book is not about the moment of death; it's about the suffering and eventual acceptance that comes before that moment in life; it's more about dying - the last process of living - than about death itself. But then again, I think there's no such word as "dying" in Japanese. Interesting.
2014年3月1日土曜日
understanding pain
Today I went to a mental hospital to listen to a public lecture on dementia only to doze off until the lecture was over and people started asking questions. My mother had come too, and curiously, we ended up having very different impressions on the director who gave the lecture -- she thought he was overbearing and that he looked down on patients' families; I thought he was humorous and had a deep understanding towards patients (or maybe accepted the fact that he did not understand them fully).
An old man (probably around 80) asked a question about his wife who was taken care of at the hospital but was about to be discharged. He was concerned about her roaming habits and asked if it was a good idea to hang a cell phone around her neck and put a name tag on her shirt, to which the director answered that in the first place, we all had to remember that no one roamed because they liked it. Patients roam around because they are anxious; they don't know where they are, they don't know who they are, and so they roam around. He added that maybe the patient didn't want to have a cell phone hanging around her neck; maybe she didn't want to have a name tag on her shirt; and maybe she didn't want to walk around shouting at the whole world that she had Alzheimer's. Maybe she still wants dignity.
My mother pointed out that the director had an overbearing attitude towards the old man who was desperate. He was clearly worried about how to take care of his wife. It wasn't like he didn't think of her as a human being anymore; he was just... worried. He didn't need a lecture on how to let her live with dignity.
A care worker also asked what she should do when patients asked if they could go home. They asked every day, over and over, and she didn't know what to do. The director said that was normal. They were after all "abducted" and thrown into a hospital. We all had to acknowledge that it is practically impossible to convince the patients that they were better off "here" than back at home. We should never pretend "here" was "home". If we let go and just listened to them and accepted their anger and grief, then the patient would eventually find his own way to convince himself about his own situation.
Again, my mother thought the director was looking down on the care worker who probably already knew all that and was still asking the director for his insight. I could see that my mother had felt exactly the same as how I had felt towards the brain surgeon who talked about brain death and organ transplantation last month.
Maybe the director did look down on families. After all, he was a pro at taking care of patients with mental problems while families were always amateurs struggling to accept the unacceptable -- the process of losing someone they love -- and trying to take care of them while dealing with other problems in life; of course they were not going to be perfect, they were going to be inconsiderate towards the patient at times. But as my mother said, that doesn't mean the doctor can just sit back and give them a lecture like he knows everything.
When I said I didn't really think the director was that high-handed and added that it might have been because I was the same kind of human, I didn't really mean it, but my mother said maybe I was right. "You're too good at everything."
I don't know what she really meant, but I hope I can become a doctor who can understand the pain of both the patient and his family.
An old man (probably around 80) asked a question about his wife who was taken care of at the hospital but was about to be discharged. He was concerned about her roaming habits and asked if it was a good idea to hang a cell phone around her neck and put a name tag on her shirt, to which the director answered that in the first place, we all had to remember that no one roamed because they liked it. Patients roam around because they are anxious; they don't know where they are, they don't know who they are, and so they roam around. He added that maybe the patient didn't want to have a cell phone hanging around her neck; maybe she didn't want to have a name tag on her shirt; and maybe she didn't want to walk around shouting at the whole world that she had Alzheimer's. Maybe she still wants dignity.
My mother pointed out that the director had an overbearing attitude towards the old man who was desperate. He was clearly worried about how to take care of his wife. It wasn't like he didn't think of her as a human being anymore; he was just... worried. He didn't need a lecture on how to let her live with dignity.
A care worker also asked what she should do when patients asked if they could go home. They asked every day, over and over, and she didn't know what to do. The director said that was normal. They were after all "abducted" and thrown into a hospital. We all had to acknowledge that it is practically impossible to convince the patients that they were better off "here" than back at home. We should never pretend "here" was "home". If we let go and just listened to them and accepted their anger and grief, then the patient would eventually find his own way to convince himself about his own situation.
Again, my mother thought the director was looking down on the care worker who probably already knew all that and was still asking the director for his insight. I could see that my mother had felt exactly the same as how I had felt towards the brain surgeon who talked about brain death and organ transplantation last month.
Maybe the director did look down on families. After all, he was a pro at taking care of patients with mental problems while families were always amateurs struggling to accept the unacceptable -- the process of losing someone they love -- and trying to take care of them while dealing with other problems in life; of course they were not going to be perfect, they were going to be inconsiderate towards the patient at times. But as my mother said, that doesn't mean the doctor can just sit back and give them a lecture like he knows everything.
When I said I didn't really think the director was that high-handed and added that it might have been because I was the same kind of human, I didn't really mean it, but my mother said maybe I was right. "You're too good at everything."
I don't know what she really meant, but I hope I can become a doctor who can understand the pain of both the patient and his family.
2014年2月21日金曜日
believing in yourself
If you gave up on yourself, if you didn't believe in yourself, who would?
I finished reading Crime and Punishment. I had bought the first volume a decade ago and had never touched it since (except for when I was packing to move) but finally found the time to read it. I didn't think it was especially an impressive book. It wasn't exactly entertaining, nor did I think it would influence the rest of my life; some parts were interesting but I didn't feel like writing an entry about it right after I finished the book.
After a whole day, however, I thought I might as well leave some thoughts here. It was a surprise that the protagonist never actually suffered the pangs of conscience (or at least never clearly admitted it). On the surface, what he finally suffered from was the fact that he couldn't help but confess (which I guess means that he actually did feel remorse for having comitted a murder). He didn't think it was a sin to commit a "crime" in order to achieve a goal that would make a better world. Some people -- people like Napoleon who could endure his crime by strongly believing in himself and his belief -- had the right to violate the law for the better. The protagonist's sin was that he couldn't stick to his own belief. He couldn't believe in himself, and thus had to confess. He was ashamed of himself for that very reason until love saved him...
Everything was depicted pretty dramatically (it was almost like reading a play script); maybe I thought the second volume was better because I got used to the dramatics and could focus more on the content (and also finally saw that every character - some that seemed unnecessary - had his own role).
Speaking of believing in yourself, I was deeply moved last night by Mao Asada's free skating program, especially after witnessing the failure that hit her the night before in her short program. I had always looked up on her for her efforts and perseverance. She always knew that hard work was the only thing that could give you confidence, but often times, it was not enough for her when it came to important games; effort betrayed her over and over, resulting in anger and trauma. Her desire for the olympic medal deprived her of her confidence yet again in her short program -- another defeat to herself.
But she didn't give up -- finally last night, she nailed a perfect program including a triple axel jump she had waited for so long. Maybe she had let go of her pride and expectations; she had lost everything, and was back to the state when she had just loved skating and had nothing to lose but her strong will, now evident in every step, every jump. Asada burst into tears the moment she finished. When interviewed afterwards, she said rather calmly: "I believed in myself that I could do it. It was the program I always had in mind and I'm pleased that I did it." Her words -- her strength -- meant more than a medal.
It was really as if she returned to life under the spell of Rakhmaninov's music, just like the protagonist in the Russian masterpiece found his life once again after his "death".
I finished reading Crime and Punishment. I had bought the first volume a decade ago and had never touched it since (except for when I was packing to move) but finally found the time to read it. I didn't think it was especially an impressive book. It wasn't exactly entertaining, nor did I think it would influence the rest of my life; some parts were interesting but I didn't feel like writing an entry about it right after I finished the book.
After a whole day, however, I thought I might as well leave some thoughts here. It was a surprise that the protagonist never actually suffered the pangs of conscience (or at least never clearly admitted it). On the surface, what he finally suffered from was the fact that he couldn't help but confess (which I guess means that he actually did feel remorse for having comitted a murder). He didn't think it was a sin to commit a "crime" in order to achieve a goal that would make a better world. Some people -- people like Napoleon who could endure his crime by strongly believing in himself and his belief -- had the right to violate the law for the better. The protagonist's sin was that he couldn't stick to his own belief. He couldn't believe in himself, and thus had to confess. He was ashamed of himself for that very reason until love saved him...
Everything was depicted pretty dramatically (it was almost like reading a play script); maybe I thought the second volume was better because I got used to the dramatics and could focus more on the content (and also finally saw that every character - some that seemed unnecessary - had his own role).
Speaking of believing in yourself, I was deeply moved last night by Mao Asada's free skating program, especially after witnessing the failure that hit her the night before in her short program. I had always looked up on her for her efforts and perseverance. She always knew that hard work was the only thing that could give you confidence, but often times, it was not enough for her when it came to important games; effort betrayed her over and over, resulting in anger and trauma. Her desire for the olympic medal deprived her of her confidence yet again in her short program -- another defeat to herself.
But she didn't give up -- finally last night, she nailed a perfect program including a triple axel jump she had waited for so long. Maybe she had let go of her pride and expectations; she had lost everything, and was back to the state when she had just loved skating and had nothing to lose but her strong will, now evident in every step, every jump. Asada burst into tears the moment she finished. When interviewed afterwards, she said rather calmly: "I believed in myself that I could do it. It was the program I always had in mind and I'm pleased that I did it." Her words -- her strength -- meant more than a medal.
It was really as if she returned to life under the spell of Rakhmaninov's music, just like the protagonist in the Russian masterpiece found his life once again after his "death".
2014年2月11日火曜日
overcoming yourself
Japan has yet to win a medal in the Olympics. Speed skating finished just now and we missed another anticipated medal. The two skaters who had been expected to win the gold medal didn't hide their bitter feelings when interviewed.
It reminded me of what my friend asked me a couple of days ago: Why do you value hard work? Why do you have to be the best? Why can't you be happy with what you already have?
Now, I personally think I've changed over the past year; I have found some happiness, and I don't feel like I need to be the best. I guess, however, that my competitive nature will never change, and obviously, it still shows. To me, it sounded like my friend was trying to tell me that it was foolish to seek happiness in hard work and its expected results. It's ridiculous to compare yourself with others; useless battles just wear you out.
So are all athletes in Sochi fools?
I don't think so. It's simply amazing that all these athletes have trained every single day for more than four years for a single race that's over in a matter of seconds or hours. It's impossible to imagine how hard it is to accept a disappointing result. But at the same time, it's also impossible to imagine how great it is when they win what they want.
I don't think it's just about competing with others. It's not a "useless battle". It's a battle against your other self - your weaker self - and overcoming it through competition. It's about proving something to the world, but more to yourself: that you can do it; that life's worth living.
Finding happiness in small things - fine weather, the smell of a new shampoo, a smile from a stranger - does make your life better. After all, efforts sometimes never pay off; these small things may be the only things that could make you happy if anything can. But hard work and overcoming weakness can probably give you what fine weather can never give. That's for sure. That's why so many atheletes dedicate their lives to the Olympics. And that's why their efforts are often moving, giving us courage to believe in ourselves.
It reminded me of what my friend asked me a couple of days ago: Why do you value hard work? Why do you have to be the best? Why can't you be happy with what you already have?
Now, I personally think I've changed over the past year; I have found some happiness, and I don't feel like I need to be the best. I guess, however, that my competitive nature will never change, and obviously, it still shows. To me, it sounded like my friend was trying to tell me that it was foolish to seek happiness in hard work and its expected results. It's ridiculous to compare yourself with others; useless battles just wear you out.
So are all athletes in Sochi fools?
I don't think so. It's simply amazing that all these athletes have trained every single day for more than four years for a single race that's over in a matter of seconds or hours. It's impossible to imagine how hard it is to accept a disappointing result. But at the same time, it's also impossible to imagine how great it is when they win what they want.
I don't think it's just about competing with others. It's not a "useless battle". It's a battle against your other self - your weaker self - and overcoming it through competition. It's about proving something to the world, but more to yourself: that you can do it; that life's worth living.
Finding happiness in small things - fine weather, the smell of a new shampoo, a smile from a stranger - does make your life better. After all, efforts sometimes never pay off; these small things may be the only things that could make you happy if anything can. But hard work and overcoming weakness can probably give you what fine weather can never give. That's for sure. That's why so many atheletes dedicate their lives to the Olympics. And that's why their efforts are often moving, giving us courage to believe in ourselves.
2014年2月8日土曜日
recycling
Human recycling. I think that's what organ transplant is in the end. The concept of brain death only emerged when human recycling started. Before that, no one was dead unless their heart stopped beating. Human recycling is wonderful as it saves many lives, but at the same time, it is not the most natural phenomenon on earth and I totally understand that there are many families who have difficulties accepting the fact that a patient's brain death means their death. And if that is why Japan has such a low transplant rate, I think we just have to accept it. But maybe I'm wrong.
Japan is said to have the best skill when it comes to organ transplant and yet we have the worst transplant rate among developed countries. The US still provides 5% of their transplant organs to foreign patients, and the majority goes to Japanese patients who come with hundreds and millions of dollars.
Today, a brain surgeon came to talk to us about organ transplant. It was his 123rd time to give the talk, and he said he was here to give us some "correct knowledge". He seemed to have some very strong feelings towards doctors who didn't present the option of organ transplant to the patients' families, and towards journalists who critisized that families were often unfairly "urged" to consent under some kind of pressure. These people were being the obstacles in preventing the growth of transplant industry in Japan.
According to him, doctors never "urged" families. A doctor's job is to tell the family that the patient will soon be dead and ask if they would consent to organ donation. I think the point the surgeon wanted to make was that we should all accept that it was natural to be asked about organ donation at times of death -- it is out-of-date to regard this type of "request" as insensitive "exploitation". After all, we're living the age of human recycling.
I do understand at a very logical level, but I was not convinced at all on an emotional level (maybe because he spoke so fast and came on pretty strong). I personally think many families will more or less feel that they are "urged", as some journalists (and lawyers) point out. If you dissent, it's literally the same as being asked if you would save someone's life and saying no. The surgeon said doctors were the same as waiters at Mc Donalds -- they offer cheese burgers and chicken nuggets for customers to choose, while we offer the chance of saving a life or not saving a life, for families to choose. I don't think it's the same at all.
He also said the Japanese were too emotional when it came to the definition of death. Being brain dead means being dead in the context of organ transplant, just like red means stop in the context of traffic lights. I don't think it's the same at all. It's easy to accept the latter; it's much much harder to accept death.
A doctor's job is to save patients -- not only those who are right in front of them, but also those who they haven't met. As the surgeon insisted strongly, Japanese doctors do need to learn to bring this subject up in front of families. However, I think it's also important to realize that some families will, in fact, feel urged or even forced to consent. We have to know that it's not the same as offering burgers and nuggets. And we should acknowledge that we are asking families to think about saving someone they don't even know, when all they can think about is the fact that they are about to lose someone they love. It's obviously important we reassure that families who decide not to consent will not be blamed for "killing" anyone.
Japan is said to have the best skill when it comes to organ transplant and yet we have the worst transplant rate among developed countries. The US still provides 5% of their transplant organs to foreign patients, and the majority goes to Japanese patients who come with hundreds and millions of dollars.
Today, a brain surgeon came to talk to us about organ transplant. It was his 123rd time to give the talk, and he said he was here to give us some "correct knowledge". He seemed to have some very strong feelings towards doctors who didn't present the option of organ transplant to the patients' families, and towards journalists who critisized that families were often unfairly "urged" to consent under some kind of pressure. These people were being the obstacles in preventing the growth of transplant industry in Japan.
According to him, doctors never "urged" families. A doctor's job is to tell the family that the patient will soon be dead and ask if they would consent to organ donation. I think the point the surgeon wanted to make was that we should all accept that it was natural to be asked about organ donation at times of death -- it is out-of-date to regard this type of "request" as insensitive "exploitation". After all, we're living the age of human recycling.
I do understand at a very logical level, but I was not convinced at all on an emotional level (maybe because he spoke so fast and came on pretty strong). I personally think many families will more or less feel that they are "urged", as some journalists (and lawyers) point out. If you dissent, it's literally the same as being asked if you would save someone's life and saying no. The surgeon said doctors were the same as waiters at Mc Donalds -- they offer cheese burgers and chicken nuggets for customers to choose, while we offer the chance of saving a life or not saving a life, for families to choose. I don't think it's the same at all.
He also said the Japanese were too emotional when it came to the definition of death. Being brain dead means being dead in the context of organ transplant, just like red means stop in the context of traffic lights. I don't think it's the same at all. It's easy to accept the latter; it's much much harder to accept death.
A doctor's job is to save patients -- not only those who are right in front of them, but also those who they haven't met. As the surgeon insisted strongly, Japanese doctors do need to learn to bring this subject up in front of families. However, I think it's also important to realize that some families will, in fact, feel urged or even forced to consent. We have to know that it's not the same as offering burgers and nuggets. And we should acknowledge that we are asking families to think about saving someone they don't even know, when all they can think about is the fact that they are about to lose someone they love. It's obviously important we reassure that families who decide not to consent will not be blamed for "killing" anyone.
2014年2月2日日曜日
dream cells
In exchange for making each of us original, genes are unfair. Michael Jackson was born black when he wanted to be white. So technology and plastic surgery helped him get what his genes couldn't. Once when he was still alive, I heard someone joke that he had a set of noses and ears in his closet and would pick one every morning to wear for the day. What if we could do something similar with our organs?
Tissue engineering (or regenerative medicine) seems to be a huge trend these days. In the future, human bodies might be repairable like cars. If your kidney fails, you get a new one made from your own somatic cell. If you need a new liver, you will never have to wait for a doner. If your son is born with a heart disease, you will never have to hope (even for a second) that another child will be brain dead so that he can provide a new heart for your son. One day, you may never have to watch your loved ones die. At least, no nation would have to pay billions of money for dialysis, and therefore, the money can be used to enhance our lives in other ways. It's a technology no one could ever have imagined 100 years ago; it's full of dreams. It's exciting.
And yet, I wonder if we're really heading the right way.
A young Japanese researcher recently published her discovery of a revolutional way of making stems cells from somatic cells by merely exposing them to low-pH (the link is below**). When she first submitted her paper, however, the editor told her that she had mocked the long history of cellular biology. The reason is obvious -- the editor had been soaked in preconception he had formed over many years of editing and researching; he could not believe, or accept that a cell could be reprogrammed with such a simple method.
Steve Jobs said in his famous speech that death was nature's best invention. I agree. Altertion of generations is essential to the progress of human society. The only way the old can give way to the new is to die, or get a new brain with no preconception -- every couple decades, you get a set of new organs along with a new brain for your birthday. Except then, it's not really you. It's just a human with the same set of genes as you. So rather than getting a new brain in a "100 year old" body (with organs of various ages), you might as well be born as a different being with a different set of genes. Then it's called evolution.
Either way, you don't really want a brand new brain. The realistic scenario is probably that you get a set of new neurons that would work along with your old ones so that you can still be you. By the time you reach seventy, you have a brain that still works like when you were twenty (with a lot of unwanted preconception but also with more wisdom) and since you have a twenty year old ovary (and uterus) you have two more babies. But we would never have enough food to feed that many humans, so we would have to set a law saying no more babies after age fifty. And maybe no more organ repairment after age eighty.
Of course, I say all this because I am not in fear of death at this moment. I respect the wishes of people who are dying or suffering from illness. How could I ever blame humans of their ego in such a situation? It's indeed unfair that some people get to live a healthy life up till hundred while some die before reaching twenty. Genes are unfair. Life is unfair. And tissue engineering has the possibility to grant all dreams of people who wish to live a long fulfilling life just like everyone else.
*In case anyone's wondering, it is apparently possible to treat genetic diseases by tissue engineering. As far as I understand, the very basic idea is that you make iPS cells and replace the abnormal genes (that's causing the disease) with normal ones and then transplant them. You can read more about it in papers like:
Science. 2007 Dec 21;318(5858):1920-3
Treatment of sickle cell anemia mouse model with iPS cells generated from autologous skin.
Hanna J, Wernig M, Markoulaki S, Sun CW, Meissner A, Cassady JP, Beard C, Brambrink T, Wu LC, Townes TM, Jaenisch R.
http://www.ncbi.nlm.nih.gov/pubmed/18063756?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
**Nature 505, 641–647 (30 January 2014) doi:10.1038/nature12968
Received 10 March 2013 Accepted 20 December 2013 Published online 29 January 2014
Stimulus-triggered fate conversion of somatic cells into pluripotency
Haruko Obokata, Teruhiko Wakayama, Yoshiki Sasai, Koji Kojima, Martin P. Vacanti, Hitoshi Niwa, Masayuki Yamato & Charles A. Vacanti
http://www.nature.com/nature/journal/v505/n7485/full/nature12968.html
(update: this paper is now being considered of retraction by some co-authors for various reasons)
Tissue engineering (or regenerative medicine) seems to be a huge trend these days. In the future, human bodies might be repairable like cars. If your kidney fails, you get a new one made from your own somatic cell. If you need a new liver, you will never have to wait for a doner. If your son is born with a heart disease, you will never have to hope (even for a second) that another child will be brain dead so that he can provide a new heart for your son. One day, you may never have to watch your loved ones die. At least, no nation would have to pay billions of money for dialysis, and therefore, the money can be used to enhance our lives in other ways. It's a technology no one could ever have imagined 100 years ago; it's full of dreams. It's exciting.
And yet, I wonder if we're really heading the right way.
A young Japanese researcher recently published her discovery of a revolutional way of making stems cells from somatic cells by merely exposing them to low-pH (the link is below**). When she first submitted her paper, however, the editor told her that she had mocked the long history of cellular biology. The reason is obvious -- the editor had been soaked in preconception he had formed over many years of editing and researching; he could not believe, or accept that a cell could be reprogrammed with such a simple method.
Steve Jobs said in his famous speech that death was nature's best invention. I agree. Altertion of generations is essential to the progress of human society. The only way the old can give way to the new is to die, or get a new brain with no preconception -- every couple decades, you get a set of new organs along with a new brain for your birthday. Except then, it's not really you. It's just a human with the same set of genes as you. So rather than getting a new brain in a "100 year old" body (with organs of various ages), you might as well be born as a different being with a different set of genes. Then it's called evolution.
Either way, you don't really want a brand new brain. The realistic scenario is probably that you get a set of new neurons that would work along with your old ones so that you can still be you. By the time you reach seventy, you have a brain that still works like when you were twenty (with a lot of unwanted preconception but also with more wisdom) and since you have a twenty year old ovary (and uterus) you have two more babies. But we would never have enough food to feed that many humans, so we would have to set a law saying no more babies after age fifty. And maybe no more organ repairment after age eighty.
Of course, I say all this because I am not in fear of death at this moment. I respect the wishes of people who are dying or suffering from illness. How could I ever blame humans of their ego in such a situation? It's indeed unfair that some people get to live a healthy life up till hundred while some die before reaching twenty. Genes are unfair. Life is unfair. And tissue engineering has the possibility to grant all dreams of people who wish to live a long fulfilling life just like everyone else.
*In case anyone's wondering, it is apparently possible to treat genetic diseases by tissue engineering. As far as I understand, the very basic idea is that you make iPS cells and replace the abnormal genes (that's causing the disease) with normal ones and then transplant them. You can read more about it in papers like:
Science. 2007 Dec 21;318(5858):1920-3
Treatment of sickle cell anemia mouse model with iPS cells generated from autologous skin.
Hanna J, Wernig M, Markoulaki S, Sun CW, Meissner A, Cassady JP, Beard C, Brambrink T, Wu LC, Townes TM, Jaenisch R.
http://www.ncbi.nlm.nih.gov/pubmed/18063756?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
**Nature 505, 641–647 (30 January 2014) doi:10.1038/nature12968
Received 10 March 2013 Accepted 20 December 2013 Published online 29 January 2014
Stimulus-triggered fate conversion of somatic cells into pluripotency
Haruko Obokata, Teruhiko Wakayama, Yoshiki Sasai, Koji Kojima, Martin P. Vacanti, Hitoshi Niwa, Masayuki Yamato & Charles A. Vacanti
http://www.nature.com/nature/journal/v505/n7485/full/nature12968.html
(update: this paper is now being considered of retraction by some co-authors for various reasons)
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