Thursday, September 29, 2005

The future's so bright ...

I really intend to continue from the previous post (fast sum - I was right, but wasn't depressed enough. And it looks like it's going to get a bit worse before it gets better.) But I ran across something that is...

phenomenal. I think that's understating it. I honestly believe it could turn out to be the next Nobel prize in medicine, and it's going to cause a HUGE political battle in an already charged arena.

Link first. The Wistar Institute at the University of Pennsylvania, and in particular the work of Dr. Ellen Heber-Katz, has made a little discovery. Actually she (and her co-workers) made it in 1998. She noticed that the ears of mice which had holes punched in them were healing. The holes were punched, by the way, to identify the set (for control group work) to which these mice belonged. Now those of you with pierced ears are probably going "so what?" - and it wouldn't have surprised most folk to have missed them. But here's the thing. Larger holes, and they not only closed the holes, they formed clean skin which then regrew fur. No scars. No dimples. Healed.

Dr. Heber-Katz then did the thing that distinguishes true genius. She went, "Hmm, that's interesting? I wonder..." She and her staff did a bit more testing. They snipped something - a bit of tail or a toe, I can't quite figure out which was first. And the mice regrew them. Now it's time for a bit of excitement. Wonder what else re-grows? Well, as it happens, the "what else" includes hearts (the whole thing if something can keep pumping while it's growing), spinal cords, legs, eyes, livers... Pretty much everything except a brain. This is pretty darn exciting. I mean, we know lizards and fish and simpler forms can do some of that (though regrowing an eye is pretty spectacular, and growing a spinal column broken mid-back is even more so), but we hadn't found mammals that could do that. But then we get closer to the level that's causing my excitement.

They extracted some cells and injected them into mice that didn't regrow things - let's label them normal. And lo and behold the normal mice have regenerative capabilities as well. [An insertion here - I cannot tell for certain whether they grew what was removed prior to the injection though the implication is the answer is "yes".]

They're doing three general studies right now. First, they're seeing if this regenerative capability leads to longer lives. They're also watching to see if these mice suffer from a greater-than-normal (or even normal) rate of 'growth-failure' diseases. That is, Cancer and other ways in which the cells change and grow uncontrollably. And there's the third study - isolating the molecule (or other particle) that causes this growth. At this time it appears (hence my excitement, but with some caution) that the molecule may be in or applicable to other mammals.

In other words, it is likely - not just possible - that we're on the cusp of a treatment that will make loss of limb and organ be as permanent as getting a cold. Hmmm - liver's gone bad due to overdrinking? Cut it out, stay on dialisys for a couple of months. Congenital heart failure? Artificial heart and bed for a couple of months. Lost a limb in an accident or war? Parapalegic? Muscular Distrophy? Multiple Sclerosis? Gah - the mind boggles. And if it extends lifespan - or even if it just keeps folk "younger" till they die - you'll have people going nuts trying to get the molecule

But there are downsides - potential and actual. Potential is that we don't know what else will grow without bounds - is this a new cancer? Also, it apparently won't do much if anything for brain damage. Potential is that it will work for other mammals but not for us. Potential is cross-species vulnerabilities. Most of these are small, but they need checked. For this reason we won't see it in humans for at least a decade - probably. Thing is it's a BIG thing, and that may cause acceleration toward use. And that takes us to the actual downside. Oh - and we don't know what it'll do to pregnancies.

Politics.

Let's set aside the arguments of who does and does not get it. It's genetic engineering - anathema to very vocal activists on the right and the left. Not only would they refuse it for themselves, they'd try wholeheartedly to deny it to everyone. Whether it's "messing with nature" or "supplanting God" the fear of the change will cause much disruption.

Then there's the longevity politics. Science fiction has handled this discussion a lot so I'll leave it alone for the most part. I'll just point out that if your 'normal' lifespan is 150 years, at what point do you consider someone an "adult", and at what age can or should you retire? And the question of more people being born while the deaths don't happen massively increases population. And socially - if a generation is nominally 25 years, how are folk going to deal with six generations alive at the same time?

I have trouble picturing a transition to a world in which people just regenerate as part of their healing. I can almost picture the world, but lessons and trials during the transition will have much influence. These are interesting times, and I don't think people realize just how interesting they might be.

Wednesday, September 07, 2005

Katrina

Like a lot of folk on blogs, I think it's time to throw my two cents into the arena in regard to the Katrina mess. Let me begin that for the most part it's too early to assign "blame". Heck, for a lot of things what is currently seen as blame may turn out to be outstanding success.

Case in point - the tens or hundreds of thousands stuck in New Orleans during the hurricane. That is, the alleged "failed" evacuation. They had an evacuation of at least 80%, some estimates as high as 90%. That on a short-notice evacuation. You don't think that's impressive? OK, try this. Go to an apartment building and pull the fire alarm. Now find out how many residents didn't get out. Unless the place has special supervision, you're likely to discover a lot more stay-behinds than you'd expect. Some will be folk who couldn't get out - sick, bedridden, elderly, that sort of thing - and some will be people who thought "it's just a drill, if it were real I'd smell smoke". Now remember that New Orleans had a voluntary evacutation last year for a hurricane and Nothing Happened. (Actually, there was some damage, but relatively speaking it was insignificant.) The normally planned time to evacuate the city was 72 hours, and the order didn't go in till 48 hours. So with that in mind, the evacuation was FANTASTIC.

But. But there have been some things that deserve blame. Not many, but some that stand out as errors.

The Mayor of New Orleans dawdled. It's quite apparent he was one of those who felt it wasn't really going to be bad, regardless of what the weathermen said. It required the combined insistence of the governor and the president to get him to declare an emergency and order an evacutation. And because it was so short notice he didn't follow the plan but played catch-as-catch can.

A funny thing, but I've not yet found a true "error" in the governor's actions. There are some questionable items, but at the same time there are mitigating circumstances. What's most amusing at this level is the blame redirection program from the current administration that's trying to point all sorts of blame (that may or may not be deserved by anyone) at her. My favorite is the repeated claim that she never issued a "state of emergency", when it's in black and white documentation and specifically referenced by the White House statements on the 27th of August.

At the federal level, I'm really only seeing three "blame" events. Two are from the DHS - one in planning and preparation, one in the response.

The planning and preparation failure is quite simple - in 2002 there was a mandate that all the responders would have common communications, and it was DHS's responsibility to see it was done. Frankly, an amazing number of tragic events in the Katrina episode can be traced to this lack.

In response, the only blameworthy action is that DHS was slow off the mark. One of the most critical declarations in the process of responding to an emergency at the federal level is the sole responsibility of the Secretary of the DHS, and that's to declare an event as an "Incident of National Significance." Once that's declared a huge number of federal and NGO assets move without further need of notification. It's like pulling that rock holding up the avalanche, frankly. All the prerequisites for an INS declaration were in place the 27th of August - the governors of the states involved had declared an emergency beyond their ability to cope, the president had responded with an order of Federal Emergency Assistance, the governors had put their respective National Guards on standby... That was the 27th of August. On the 29th of August, Katrina made landfall. By that afternoon the levees had been breached and New Orleans was flooding, and Biloxi and Gulfport were reporting estimates of 90% of their structures being irreparably damaged. And here's where that condemnation occurs. Michael Chertoff, Secretary of the Department of Homeland Security, did not issue the INS till the late afternoon of August 30, approximatey 24 hours after the levees broke, and almost 36 hours after Katrina made landfall. "Ask of me anything but time," said Napoleon (paraphrased), and the SecDHS wasted at least a day and a half - given the prerequisites in place, perhaps as much as three full days.

And yes, I'm going to tag President Bush with some blame. Not, however, for setting up the disaster with the cuts or with delays or anything like that. In the cuts, he was doing what most of the folk who voted for him said they wanted. And in administrative terms he did everything in a timely fashion - he was, for example, critical in helping convince the Mayor of New Orleans to issue a mandatory evacuation notice. No, where he failed was in being a leader.

See, in times of emergency leaders lead. Sure, it's important they not merely be posturing figureheads but actually ensure that Things Get Done. But a good part of leadership is, indeed, "posturing". And that's where the president failed in his duty. This was such a major emergency coming on that he issued several Federal Emergency statements. He pleaded with at least one mayor to begin a mandatory evacutation. He did all that right, but at the same time it was all behind the scenes. And in leadership and politics, what isn't seen didn't happen.

What the public at large saw was a man who thought his vacation was more important that preparing for the emergency. He stayed on his ranch as the storm reached Cat 5. He played guitar and cut cake at a birthday party as the storm turned and raced for New Orleans. The day after it hit he finally said, "I'm cutting my vacation short and returning to Washington," then ruined his recovery by adding one more word, "tomorrow."

Appearances, all, matter. And if it's able to be handled tomorrow, it's not an emergency. If I think it's an emergency and you say you'll be there tomorrow, then to me you've said you do NOT think it's an emergency. Now let's be completely honest here. The President couldn't actually DO anything more in DC than he did at his ranch. And he did a lot. But he sent a terrible message - a message that in his eyes and therefore inevitably in the eyes of his subordinates this was not an emergency, it was just a rough period to be dealt with later.

Frankly, I cannot help but wonder if the DHS error was caused by Chertoff's impressions of the importance President Bush was giving the matter. After all, he held regular electronic meetings with the president, but that's just once a day and he was in DC, not Texas. So if you really wanted to push it you could assign Chertoff's blame to Bush. Me, I don't want to go that far - it's not the first time Chertoff's been a little slow off the mark, and those times didn't involve the president's behavior. However, Bush appeared to minimize the importance, and DHS dawdled the "go" order.

The folk doing rescue are doing heroic things. But I can't help thinking how much better they might have been if they'd been able to start a day earlier.