Mandatory health care?

Heaven help us if John Edwards becomes president. I think I might actually pull for Hillary.

What a spectacularly bad idea: mandatory preventive care. I don’t even know where to begin. On the surface, it makes some sense. A substantial percentage of our GDP is spent on health care that would not be necessary if folks took better care of themselves. Some part of that would be reduced if diseases were caught early and corrected. To make people go to the doctor would lead to physically healthier lives. But at what (non-monetary) cost?

Stay tuned. I have some time to post for once….

Misunderstanding evolution

I’m not a paleontologist, nor do I know all that much about speciation, but this Yahoo news piece on human evolutionary origins needs a bit more thought…

New discoveries by Maeve Leakey have dated Homo habilis and Homo erectus specimens to the same period that were found within walking distance of each other. The conclusion reached in the news article is that, therefore, the latter is unlikely to have evolved from the former. Sounds logical, right? Two species that live at the same time can’t be descended from each other.

Well, there is absolutely no reason why an older species can’t remain while a younger species develops. Here’s one example of how: suppose that, due to environmental factors, one group of animals gets separated from a larger population. This group then, because it is isolated (for whatever reason) from the other, diverges to the point that it is no longer the same species. Then, at some later point, members of the new group travel back and live among the original population (that, because its environment hasn’t changed, hasn’t “evolved” all that much).

When we, millions of years later, look at fossils from the area where the two groups then lived, it’s easy come to the same conclusion as the folks in the news article. These two groups couldn’t have come from one another because they lived together at the same time. But, at an earlier point, they might not have.

It’s scary how easy it is to come up with explanations for historical discoveries (like those in paleontology) using evolutionary theory. (Is the theory, in fact, falsifiable? I’m not so sure.) But, it’s equally scary how easy it is to grab a hold onto any data that seems contradictory to evolution, and bank on it to boost creationism…

When humanity and homo sapiens clash

I should be studying (as always) before heading off to Latin Mass this afternoon, but I had an odd series of ideas yesterday that need hashing out in words. This is what tends to happen when I have a couple of days off from the ridiculously hectic schedule of medicine….

We’ve spent the past 148 years trying to work out the ramifications of Charles Darwin’s dangerous ideas. If all the living creatures around us are the products of natural selection, then, likely, so are we. The mechanism behind the variation which enables nature to select for the fittest is simple enough: changes in DNA produce changes in proteins that result in changes in function. These changes are almost always deleterious, but at least theoretically, a change in protein structure could enhance efficiency or produce new functions. Over time, as creatures encounter changing environments and compete with each other, various changes in their genetic material are selected for and maintained down the generations. It’s an elegant theory, one that can explain how the vast array of biological life came to be. Yes, it has problems, particularly with explaining large-scale changes and speciation, but I’m not interested–at least not in this essay–in exploring the whole evolution-vs.-creation controversy.

But what about the timescale of evolution? How fast can things biologically change? Organisms with short generation times or error-prone genetic replication systems can evolve remarkably rapidly. Take, for example, the production of antibiotic resistance in bacteria. Or, if we consider viruses to be alive, the champion evolver is the constantly changing HIV virus that stays one step ahead of our immune systems. A bacterial species that doubles in number every couple of hours can adapt genetically to almost any environmental change. But what about us? Our 70+ year life expectancy and long generation times mean that it would take thousands of years to produce the same changes that bacterial populations undergo in a matter of days. Are those changes possible? Sure. They’re even likely.

However, mankind throws a wrench into the mechanism by being creative. We think, ponder, discover, invent at a rate that far surpasses generational genetic changes. While Cro-Magnon Man and I are, on a genetic and biological level, essentially identical, our worlds are radically different, not because of biological evolution, but because of our abilities as sub-creators. Our bodies cannot keep pace with our minds–especially not with the rapidly accelerating rate of technological change over the past hundred years. What ramifications might that have? There are countless possibilities: I’ll focus on a few.

The human body, for all the vast array of diseases to which it is subject, is a finely tuned machine. Left to its own devices, it is fairly good at healing itself and fighting off any number of microscopic and macroscopic invaders. We creators think we can enhance things, though. Sometimes we can, but not without unforeseen consequences. Why is it that there is an epidemic of allergies and autoimmune diseases in the developed world? I pin the blame on two advances: hygiene and immunization. Would I take either of those back? Of course not, but our immune systems, from a biological angle, are intended to combat bacteria, viruses, fungi, parasites, etc. If we have a lower burden of those, I suspect that immune cells have a higher chance of attacking things that they shouldn’t–like things in our own bodies–or are hypersensitive to external things that shouldn’t be a bother–like cat dander. I wouldn’t trade millions of bothersome allergies for millions of deaths from infection, but the principle holds: we’ve short-circuited a slow evolutionary process and have to face the reality that our bodies react to our creations in less than ideal ways.

Allergies and autoimmunity are physical examples of what happens when we meddle with our biological selves, but what about the costs of modern technological society on a more abstract level? I have, as usual, more questions than answers. Is our modern plague of depression, anxiety, and mental illness the result of, quite simply, not having to deal daily with what our ancestors bravely faced: death or survival? Are we consumed with ourselves because we’re insulated from stark reality? Do we fear death more, and as a result quixotically seek physical immortality, because we can push the reality of our mortality out of our minds for extended periods of time? Are we losing belief in God because we surround ourselves with our own creations? Has our incredible store of knowledge about things led to a paradoxical loss of understanding of ourselves?

The problem is the same whether you believe that we are the special creations of God or the result of millions of years of evolution–or both. It is undeniable: we biologically cannot adapt at the same pace at which modern human society is changing. Genetics won’t allow it. We’re cavemen in modern garb (with apologies to Geico). Does that mean I want to turn back the clock and return to the Stone Age? Far from it. Modern medicine and science have changed our lives for the better. But we ought to step back and think about why we react as we do to modernity. Look beyond the technology that surrounds us to the fact of death. Look past the anxiety that can consume us and accept that, despite appearances to the contrary, we really can’t control everything. We have just postponed and disguised the inevitable by our creations. Know thyself, not just the world around.

Quote of the day

All things were made to lead us to God. As a matter of fact, though, most things turn us away from him. The only puzzle to be solved is to make the things which turn us away from God become means to lead us to him. … It is we, by the bad use we make of things, who render them blockades between him and us. There is therefore no other problem than to transform these very same things, the things that make up our daily lives, from obstacles into means. And it is there, then, that our temporal activities, our work in the world, become the very material, we might say, for our practice of the spiritual life–means for going towards God. At that moment, we shall have caught on to the unity of our life. A day that can be spent in the most total banality, taken up by the purely human aspects of work, and bringing me in the evening only a kind of frightful void–it is up to me to transfigure it by a miracle of the heart and to invest it with a kind of incorruptible substance.

- Jean Cardinal Daniélou, The Scandal of Truth

Just when I thought it was safe to cut back…

…I get linked by Eric Scheske in the National Catholic Register as a “Southern blog.”

Well, that it is, but much more the blog of a Catholic convert biochemist turned medical student who just happens to be from the South. Welcome to all who might be visiting, and I’ll attempt to write a little bit more. But no promises as I’ve been putting in 80 hour weeks here lately, and studying in my “free time”.

Making a difference

Thanks to all of you who prayed for me during the past few weeks as I’ve transitioned from research to something much more concrete. I was petrified at first, but I’m now at peace.

I gradually realized something over my first week in my return to my old career. Advances in medicine require two types of people: those who study molecular biology in the abstract, and those who take care of patients. Both are necessary for new cures to become available, but it is extraordinarily difficult to be both. On the one hand, doing basic research has great potential for finding new discoveries. It’s necessary, and without it, we would still be living in a world where we were beholden to the vagaries of disease. We can treat much more than we could 30, 50, 100 years ago. But, on the other hand, the day-to-day life of a researcher is often sheer drudgery. Experiments may not work; “positive results” may not occur for months a time. Science for its own sake is critical to progress in medicine, but it takes a special person to do it.

I may not be that person. I’m glad that I have the training in basic research to be able to understand new advances as they come, but to help just one sick person in the short term is more rewarding–to me–than the illusive potential to help many people over the long term. So, when on Thursday I met with someone before surgery, assisted (ever so slightly) in a five hour operation to remove a deadly tumor, and monitored that same person before discharge the next day, well on the road to recovery, I discovered the allure of clinical medicine.

My fear, and my new request for prayer, is that I am falling in love with a specific type of medicine that would require long hours and would provide the temptation to make God, Church, and family second, third, and fourth. We shall see.

The wager

“Yes, but you have to wager,” said Blaise Pascal in response to agnosticism. In the end, death intervenes, and not deciding on God’s existence is ultimately tantamount to choosing against Him. Choose for belief, and at best you gain salvation; choose against, and at best you gain nothing at all. Of course, if the probability of God’s existence is precisely zero, then all bets are off, but you’d have to be rather myopic to make that claim, which you cannot prove. No, when all is said and done, you have to wager.

The same goes for the current debate on embryonic stem cell research. A wild jump, you say, to go from discussing Pascal’s wager on belief to public policy? Not so, because at the core of our endless arguments on stem cells is a dilemma which requires a wager and has no definitive materialist answer. Is the human embryo a human life? If we were simply studying the embryo, observing its development, awestruck at the formation of a human being from one cell, then yes, contrary to Pascal’s conclusion about God, you could abstain from a wager. No action has been committed against the embryo; it is allowed to develop naturally.

But, we aren’t merely observing; we are destroying. Once that decisive step has been taken, then we must wager. Either that destruction is blameless, or it is murder. There is no question as to the embryo’s innocence; the best argument for abortion, the violinist argument, falls apart since we’re not destroying an embryo because it’s infringing upon the mother’s rights. The intentional killing of an innocent life is murder; therefore, unless my reasoning is terribly mistaken, the creation of stem cells by disaggregating a human embryo’s cells is one of two things: if a human being, then murder, if not, then no big deal.

But how do you decide between those two options? You cannot turn to science. Any embryology textbook shows what a seamless process embryonic development is from the moment of fertilization until birth. Unless impeded by faults determined by the interplay between its own genetics and the environment provided by its mother’s womb (otherwise known as miscarriage), it will be born 40 weeks or so after it was but a single cell. Markers such as the heart beginning to beat, or the first neuron firing, or development of a recognizably human face, are mere symbols devoid of any real meaning. Since at this moment, it would be terribly difficult to select an embryo that could not develop into a human being and would be intrinsically miscarried, then use its cells, we still must wager.

Science cannot tell you whether a human embryo is a human being at the stage in which it would be dismembered to create stem cells. If anything, the evidence points firmly toward its humanity. But, we deeply want to cure crippling, deadly diseases like Alzheimer’s and Parkinsonism. We would do almost anything if we could make the lame walk. However, if we were told tomorrow that the cure to Alzheimer’s disease was present within the brains of a family with a newly discovered genetic variant, but we would have to kill them to get it, we would all recoil in horror. Why do we not flinch at the production of stem cells? I suppose it’s because a “blob of cells” simply doesn’t look human. In the end, though, looks aren’t everything, and you have to wager. You cannot claim ignorance; what you may be supporting has the possibility of being murder. Is it worth the lebensraum?

Stem cell research in NC

My bishop today asked North Carolina Catholics to contact their legislators regarding a bill supporting embryonic stem cell research that is making its way through the State House.

Here’s my contribution:

Dear Representative X,

As one of your constituents, I recently discovered that the State House is considering the “Stem Cell Research Health and Wellness Act,” HB 1837, which has been recently sent to the Appropriations Committee on which you serve. I would like to point out two areas in particular for your consideration as your committee considers this bill: the failure of this bill to adequately address ethical concerns about embryonic stem cell research, and the lack of support for other kinds of stem cell research which avoid the insurmountable ethical problems with embryonic research.

The bill as currently written would make it state policy that embryonic stem cell research could be conducted only on cells derived from “excess” embryos donated after in vitro fertilization treatment. On its surface, this appears to be an admirable solution. However, it does not address the primary ethical concern that many of your constituents have with such research: that it destroys a human embryo. Whether created for the purpose of stem cell research or for in vitro fertilization does not change the basic fact that embryos are destroyed to produced embryonic stem cells. If you consider an embryo to be a human life, this can never be condoned, even if miraculous treatments be generated as a result.

Our legislature could, however, endorse and fund research designed to circumvent this problem. Researchers at Wake Forest University School of Medicine, for example, have derived cells with many of the properties of embryonic stem cells from amniotic fluid. With the support of our state, these scientists and many others like them may generate ways to produce cells with many, if not all, of the benefits of embryonic stem cells without destroying embryos in the process. In addition, adult-derived stem cell research shows great promise in medical therapeutics. By focusing on areas of research that do not contain ethical pitfalls, we would set an example for the rest of the country to follow.

I acknowledge that my requests may sound like pleas to limit the creativity of scientists. But, as a molecular biologist by training, I have come to understand that what we can pursue must be tempered by what we ought to pursue. Embryonic stem cell research may be a panacea for all I know, but to save lives at the expense of countless others is a cure that we cannot risk. This policy debate turns on whether a human embryo is a human life. That is something that science cannot answer, so we should err on the side of caution.

If you’re in North Carolina, please go write your state representatives. It doesn’t take much time, and it just might make a difference.

Sorry for the delay

As indicated in my previous post, things are changing around here. Posts will be few and far between, but I don’t quite feel like shutting the blog down. So, keep your feed readers running!

Could use some prayers

It’s rather unlike me to ask for a personal favor on this blog, but I’m in need of some prayers.

In less than a month, I’ll be making a radical career shift. It’s been planned all along, but it’s just now hitting me how difficult it is going to be. I have to refresh my memory on a huge amount of information that I laid aside several years ago, and it is scaring me to death. Until I started reading over stuff, I didn’t realize how much I had forgotten. It ain’t like riding a bike…

Anyway, please keep me in your prayers. Sorry to be so vague; drop me a line if you want specifics…