Rambodoc at large

A surgeon friend of mine tells me a story.
A young 13-year-old girl is being evaluated for a disease no one is able to catch. The clinically astute doc ordered a special x-ray test (the name of which is immaterial) that ultimately clinched the diagnosis and spared her a major surgery. You can well imagine how relieved and grateful the parents would have been. One can imagine these people sending sweets to the doc’s house on Diwali, and expect him to attend the girl’s marriage in the future.
This story, unfortunately, did not quite go along these lines. The twist in the story came in the x-ray room. During the procedure, the x-ray technician fondled the breasts of the young, innocent girl. She asked him why he was doing so. ‘Just adjusting your clothes’ for the x-ray, said the technician. After the procedure, the kid cried out to her mother, who hushed her up (afraid of a scandal), and only much later told the surgeon what had happened. My friend was deeply, deeply offended. "How dare the swine?" he asked the CEO of the hospital. The CEO promised immediate action. The action was not dismissal, for that could cause problems with the Workers’ Union. No, a three-member committee was appointed to investigate the incident. In the meanwhile, the patient (and her parents) went back home, and soon became well with the medicines prescribed by the surgeon. As the days went by, they chose to forget the unpleasantness. They decided never to go to the hospital again. Courtesy their family doctor, they got another surgeon later. Embarrassment avoided.
Our surgeon got busy again with his patients, but still called up the CEO: “What happened to that technician? Why hasn’t he been sacked?”
Now, the technician had genuflexed to the Committee, saying he had a pregnant wife and a small baby, and that “I can’t afford to lose this job, as I am a poor man”. It was obvious to the Committee that sexually deprived as he was, he just succumbed to some "momentary weakness". The hospital was facing a shortage of trained hands capable of doing certain procedures, and the Committee members agreed within themselves that he wasn’t easy to replace. On top of that, bad press was inevitable should the thing get out. They therefore pronounced the whole thing as a mistake and a misunderstanding, and reassured the parents in writing that “strong action” was “being contemplated”.
Bullshitting over, the world carried on with its business. Only the victim of the pressure-cooked male lust, that little girl, remembered it all. She became a timid woman. She lacked normal responsiveness to men. We don’t know what became of her. Another lost nonentity, another collaterally injured victim of sub-human control, of mindless androgenic aggression. And so much more.

Indians have a few million Gods and Goddesses, and can’t get enough of them, it seems. An infant with both male and female genitalia is being showered unwanted attention in Ball-sore (Orissa), and being thought as a reincarnation of Lord Shiva and Parvati.
To expose the phallacy of this intro, read this news article.
Scientifically speaking, this is old hat. Ambiguous external genitalia is not very rare (may be seen in up to 1% of all births), but true hermaphroditism (where both testicular and ovarian tissue are present) is less common. Contrary to popular notion, the ‘main point’ of the male is not the penis, but the testicles. Similarly, the vagina or the clitoris in the female are not the determining female organs, but the ovary is. External genitalia can be confusing (ambiguous): if the baby’s testicles have not descended at birth, how can one say whether it has a large clitoris or a small penis? I hope you get this answer! If it a large clitoris, the urinary passage is separate, whereas in the male with a small penis, the urine goes through it. However, things become more muddled in the condition known as Hypospadias, where the urinary passage in male babies opens through the scrotum. Now imagine a tiny scrotum without any balls in them, and a small hole through which urine comes out: could it not be confused with the female anatomy?
This is one of several reasons why there is confusion in identifying the gender of some cases.
Apart from the morbid imaginations of the mind, there are some interesting issues here:
* What should the parents do? Surgical reassignment surgery (popularly called sex change operation) is an obvious option. However, whether to make the baby a boy or girl becomes a troublesome issue. Imagine that one (surgically) makes the baby physically a female, and when ‘she’ grows up, she wants to be a boy (because ‘she’ feels like one). What a disaster that would be! For this reason, many experts counsel that the sex change operation should be done when the child grows up and its sexual orientation is clear, along with its choice.
* Imagine again, that the parents of a baby of undetermined sex opt to wait for the child to grow up. How horrible would the child’s growing years be, without it having an idea of what gender it is, and having to cope up with brutal teasing and harassment at home and school!
* Should society officially declare three, and not two, genders: the third being the intersex? Makes you wonder whether these people (we should really coin a word similar to ‘ladies’ and ‘gentlemen’ for them) would visit, after watching a movie, the male toilet or the female!
India being such a reserved country, should we keep away 1% of Parliament seats and 5% of educational seats for the third sex? Should we ban sex determination by preventing doctors from telling the parents what the sex of the baby is? What if the upset parents, upon hearing that they have given birth to a girl, commit murder of the child? (you really have to click that link to understand the irony of this!)
The whole purpose of this article was to engender some discussion by testicling your imagination!

This year, another doping scandal has hit the famous cycling event, the Tour de France. Last year, the superstar Floyd Landis was disgraced when he was accused of doping with testosterone. He initially claimed to have the same problem faced by others like the notorious blogger, Dr. Urs Truly, namely, an un-naturally high level of testosterone that is considered impermissible by society.
Doping is, as all of us know, the taking of prohibited substances that can enhance performances in sports. These include blood, blood producing substance Erythropoietin, anabolic steroids, diuretics, and so many more.
The first recorded case of doping was in the eighth century BC when Ancient Greek Olympians ate Ram’s testicles (ouch!), thereby getting a fix of testosterone, presumably. Through the centuries, countless other cases took place, including the historic dethroning of Canadian Ben Johnson who won the 100m sprints in the 1988 Seoul Olympics. Guilty of doping Stanazolol (an anabolic steroid), Johnson was disgraced and replaced by Carl Lewis. And let us not forget that Shane Warne, the legendary Aussie leg spinner lost one year, for doping diuretics.
Why the blog, you wonder?
Because, simply put, I think the world is wrong. I think there is nothing essentially wrong with taking performance-enhancing drugs. In a way, every athlete does try this when he eats loads of proteins and vitamins, which could enhance performance. Anyone can get stimulated by a cup of coffee, for another example. Or feel less pain with a painkiller or a shot of alcohol. There are many agents with potential adverse effects on the consumer’s health that are banned from use. Every sports agency in the world prohibits doping. And every year, great athletes test positive, get disgraced, and fade away, never to be seen or heard again.
What is essentially wrong if performance is enhanced? It may give an unfair advantage to the user, perhaps, though I am not aware of any scientifically conducted trials that prove this. It is, therefore, possible that these drugs are thought to be enhancers, but not actually so. In effect, this means that those great athletes who have been banished from the honor roll of history may not actually have committed any crime at all, beyond breaking a rule. Big effing deal!
Contrary to popular belief, drug intake may actually affect health negatively and cause weakness. Try taking a diuretic, and feel the difference! Left to themselves, once science disproves the notion that additives are of no use, athletes will not use them. Contrarily, once specific drugs are proven to be enhancers, everyone would use them.
There is, in my mind, no other moral locus standi to banning these drugs other than a cry for equal opportunity and egalitarianism, all catchwords for not allowing people to scale the heights possible to mankind. For an interesting article, look here. Look at countries that have sophisticated training centers, psychologists and sports physiologists: don’t their sportsmen do better than Indian and Bangladeshi athletes? Should we bring their preparation down to our level so that there be ‘fair’ competition? When they eat loads of meat and fruits, are the athletes not artificially pumping in iron, proteins, minerals and vitamins? Then why the hypocrisy of disallowing sportsmen from taking drugs that would (at least theoretically) take sports performances to a new level?
Do the top honchos of these Olympic Associations not take Viagra at a big night out (or in)? Why, is that not performance enhancement??
Update (26.07.07): Tour de France leader thrown out

Sree of Sris’ Views poses a problem to us, while handling the divorce case of a couple that are both dentists. 'The wife is asking for divorce on the grounds that the husband did
not reveal the fact that he has 'tuberous sclerosis'. After she gave birth, finding white patches on the baby’s skin, she ran a long list of tests and it was then that the disease was diagnosed”, she says. This is the ground for their divorce case now, she says.
Sree wonders whether premarital screening of the partners for diseases should be mandatory.
So, here is an interesting poser: should we routinely screen for diseases (pre-nup), and if we do, which diseases should be screened, and what are the pros and cons of this?
First see what the world is doing: countries as diverse as China, Taiwan, Italy, Turkey and Brazil are among those states where premarital testing is warranted by law. Most of the rest of the world knows nothing about this, or isn’t too worked up.
You can read an interesting article on this subject here.
Among the tests that can be done are HIV, Hepatitis B, syphilis, other sexually transmitted diseases, German measles (rubella), and a load of others. Physical examination, including vaginal examination of the bride-to-be (and ball-squeezing of the groom to make this non-discriminatory), and urine tests are also done, apart from a detailed history-taking to rule out psychiatric and other problems.
Only if the couple is granted a clean chit of health are the Chinese allowed to marry. In modern days, detailed genetic screening can be done to screen for traits for genetically transmitted diseases (like tuberous sclerosis in Sree’s client), leading to the concern that creation of these designer babies will be a form of eugenics.
Sounds like a good thing, isn’t it? Screen couples for diseases, and thereby prevent new diseases like thalassemia and AIDS from affecting newborn babies. In addition, teach the couple some sex and health education, and parenting, too. Good for the couple, and profitable for the society, right? Wait just a bit there!

There are several glitches in making premarital medical screening mandatory. Like what?
1. The rights of the couple are violated, if the tests are done by fiat, without their consent. In the third world, this means more corruption.
2. The costs: who is going to pay for the tests? In China, the couple pays for the tests. For poor patients, imagine how painfully impossible it would be for them to comply.
3. Test results can sometimes lead to wrong conclusions. There are false positives and false negatives. Chasing more tests to confirm a test for TB, Hepatitis B or HIV, for examples, will cost a lost of money.
4. Privacy violation can stigmatise a person for life: for example, if someone spreads a rumor that a girl tested positive for thalassemia, she would be penalized by her society forever on that count alone, as if thalassemia were a contagious disease!
The solution to this, I think lies with society becoming more smart and enlightened. If people become aware of genetic and transmissible diseases that they want to avoid in a marriage, they must mutually agree to each undergo a battery of tests to that purpose. As genetic testing becomes more sophisticated, and society more aware and affluent, this will surely become more germane an issue in the coming years.

India is once again going through the cycle of deaths and misery from tropical bugs that cause fever in a huge sprawl of urban and rural population. There are some old bugs like malaria and typhoid fever. Others, like Chikunganya, Dengue and Leptospirosis are also old diseases, but less known in India. There are some important issues why these disease lead to such a huge cost on India's health and wealth:

1. Fever is universally treated by GPs with antibiotics. In the instant era, people don't have the patience to wait for five to seven days for the fever to subside. GPs feel it is better to treat with antibiotics just in case. This, of course, is absolutely regressive and unjustifiable, as antibiotics are not exactly harmless, and can cause drug resistance (which is a major problem in hospitals across the globe). As a doc, you do what is right and scientific. If the patient can't be with you in this, let the patient go. However, my experience tells me the reality is different. It is not so much the patient who puts a gun on the doctor's head and extorts a prescription for kill-all antibiotics. It is the weakness of the physician who does not know how to tackle an obscure or atypical fever. Of course, in India, most fevers are probably treated by non-physicians, like quacks or pharmacist-oids.

2. There are no easily available tests that detect viruses, which would make life for the febrile patient (and his doctor) easy.
So one has to rely on clinical patterns, including the flavors of the season. Many docs don't have the time or mindset to sniff out diagnoses that don't hit them between the eyeballs, so they give empirical antibiotics.

3. The bulk of the fault lies with State policies, where civic infrastructure is so pathetic that it fosters all these diseases. It is now known that the bulk of tropical killer diseases like malaria are a direct indicator of poverty and development. In fact, the countries (mainly in Africa and Asia) where people are slaughtered by these germs are morbid examples of State-sponsored massacre. People die because of misguided and corrupt policies. For a simple example, look at the state of drainage in the cities. If that is attended to, one source is taken care of. Do you see that happening? It would take a fevered imagination to imagine the State changing anytime soon, is it not?
UPDATE (16th July 2007): Read about 'Tomato fever' in Kerala

SiCKO is Michael Moore's latest movie that pokes America in the eye and shows its health care system as bad (to cull other adjectives). Moore advocates free universal health care for all.
We have talked about this just recently. What do the pundits say about the movie?
Here is a good review.
For a very favorable review, click this link.
Kenneth Mattox, a world famous cardiac and trauma surgeon, holds forth on the movie:
"First, someone has changed the image of the producer, Michael Moore. Both in the movie and on the publicity talk shows, he is less angry, less hostile, and has 'cleaned up' in speech and appearance since his previous movies and books. He is a producer and was very, very specific in what he wished to create, and he created it. He knew just what he needed to show, what he needed NOT to show, and in what order he needed to show the material."
Mattox asserts that the movie is very superficial and glosses over a potpourri of health care-related issues like education, research, cost of new drugs, etc.
"The producer’s main point throughout the movie and in his final scene was a plea/demand for UNIVERSAL FREE HEALTH CARE FOR ALL (and he tossed in free day care, free college, and free nanny visits to new Mom’s). This is where I totally part ways with his views and motivations. No service is FREE. He visited 5 countries to prove his point about 'free' care – UK, Canada, France, and Cuba and the US. Both access and quality of care in the UK, Canada, France and Cuba, according to what was presented in this movie, are superb. Furthermore, patients and physicians in these countries could not be happier with their respective systems. Based on this movie, the paperwork hassle factor that both docs and patients deal with in the US is nonexistent in these countries. Also, based on this movie, the cost of all these government provided services is not a hardship on anyone or any group. Not a single person interviewed in any of these countries had a remotely negative thing to say about care, quality or even taxes to support the system. Contrarily, ALL interviews in the US were totally negative – not ONE success story was presented. Hence, my greatest criticism of this movie – bias to the point of deception."
So, ladies and gentlemen, here is another way you can damage your cause: by hypertrophy, by exaggeration, by bias to a point where you think you should take Einstein literally: "If the facts don't fit the theory, change the facts". Or words to that effect.
My only submission on this subject is to state the stated: there is no free lunch, there is no free universal health care, there is only freedom. The concept should be easy to understand if you look at free speech as a basic right. Yes, you have the right to speak easy, but do you expect the Government to provide you with a free website, a free newspaper, and a free microphone so that it can shut you up from saying "These greedy capitalist industrialists and monopolies are not giving us our free speech"? And a gazillion words to that effect.
Why should anything else be any different?

Disclaimer: Let's not even talk of the Indian health care scenario!



Here is a post from Cafe Hayek, a site for the relatively unconventional intellectual, about universal health care in France being cruel to patients. The example of the poor patient dying without any care whatsoever in a country that prides itself on a fine and free health care system raises doubts about the 'universality' of their health care.
Even in countries like Canada and UK, where the State is responsible for health care for all (barring tiny exceptions), the long waiting lists and prioritisation protocols leave a lot of patients with sustained suffering. A study that reveals how many people die in such socialised health care systems would be an eye opener. I am not clear about this. Sweden, for example, is another great model of advanced health care that is entirely state sponsored.
At least for some patients, the system short-changes them in favor of an ideal that is questionable in its premise.
Health is considered to be a fundamental human right. This assertion leaves unanswered the poser of who is going to pay for this 'right'.
Just like 'happiness', it is only the pursuit or endeavor which can be a right, not the entire mechanism of healthcare, which needs taxation. Is taxation a fundamental right of the bureaucrats?

Alcohol is both tonic and poison. For long years the medical literature has been saying one thing or the other on the impact of alcohol in the body. A recent article has now assessed the health effects of beer, making some interesting observations. "In conclusion, short-term beer consumption ............ positively affects plasma lipid levels, plasma antioxidant and anticoagulant activities." Here is an easy-to-grasp overview of the health risks and benefits of alcohol. In brief, one can, first, say that red wine (which contains resveratrol, is good for you. Second, drinking benefits are inversely proportional to the volume of alcohol consumed. Third, daily alcohol consumption (in moderation, of course) is better than once or twice-a-week drinking. Four, folic acid may offset the detrimental effects of alcohol by reducing the level of homocysteine in the blood. Homocysteine is now known to be bad for the heart. According to some references, beer, being a source of vitamins, has benefits as part of a balanced diet (I know, laugh your beer-belly out at this one!), dieting (100 calories in a can of light beer), and halts the decline in mental functions with age. I know of some urologists who advise beer drinking to flush out small stones in the ureter. These folks also advise female patients to drink cranberry juice for preventing urinary infections, but I digress.
As to the esthetics of the palate, I am not qualified to comment. Most beers have tasted to me like the urine of a pregnant, jaundiced cow, and I have never dared waste precious foreign currency in fair lands by buying the ale in lieu of wine or spirits.
So, should a teetotaler start drinking to enjoy a better heart? This would be akin to a normal man taking Viagra to have better sex, or smoking cigars to save himself from Alzheimer's disease. I personally think that in order to live longer one should eat very little food, drink good wines, lead a boring life, laugh a lot, and have long walks, or long bouts of sex, whichever is cheaper and more easily available!!

Morbid obesity means excess body weight that causes many diseases and reduces longevity.

It is objectively defined as a BMI of 40 or more. BMI is Body Mass Index.

It is measured as follows:

BMI = Weight (in kg)
Height(m)2
BMI effectively gives us an objective parameter to measure an individual’s state of obesity, relative to his height. If the BMI is more than 40 kg/m2, the condition is known as morbid obesity. In such a state the patient is prone to develop diabetes, hypertension, obstructive sleep apnea, arthritis, gallstones, reflux disease, hernias, cancers, etc. The average longevity of such a clinically severe obese person is cut short by 10-14 years. Indians have a higher proportion of body fat and less bone mass compared to Caucasian and African races. For this reason, the BMI parameters for defining obesity are a little less. For example, in India, a BMI of 37.5 would be the yardstick to call a person morbidly obese. In India, around 15 percent of the population is overweight or obese. Around 5 million people are morbidly obese.
Scientific studies have shown that in this group of patients, supervised weight loss programs using diet and exercise have a failure rate of 95% when it comes to assessing sustained weight loss. Drugs achieve a weight reduction of only 10% at most, and the benefits cease as soon as the drug is withdrawn. In addition, there are side effects of these. The only proven method of weight loss in morbidly obese individuals is Bariatric surgery. This surgery may be of two different types: restrictive (where the capacity of the stomach to store food is restricted), and malabsorptive (where the digestion of fats is hampered). The most common operations are Laparoscopic Gastric Bypass (LGB), Laparoscopic Adjustable Gastric Banding (LAGB), and Sleeve Gastrectomy.
Benefits of the surgery include 70% weight loss in two to six months that is sustained in life, cure of diabetes in 85% of patients, cure of hypertension in around 60%, and cure of snoring in around 90%.
In Kolkata, this kind of surgery is available at Wockhardt Hospitals.

Remember Thomas Edison? Wrongly thought to be the inventor of the electric lamp, but actually the creator of the electric grid? Or Graham Bell, who rang in the first telephone? These men created products that changed civilisation. These, amongst some others, were disruptive technologies: technologies so outrageous that they are considered daring, provocative, and extraordinary. Today, we are on the threshold of possibilities so outlandish that science fiction sounds pretty ho-hum.
Nothing exemplifies this as fundamentally as the field of ‘disruptive’ medicine and, arguably, nobody in the field of medicine understands the future of this ‘outrageous’ medicine as well as Richard Satava. ‘Rick’ Satava is a Professor of Surgery at Washington University Medical Center, Seattle and has written several books and articles on futuristic ‘disruptive’ medicine. Apart from being a surgeon of world repute, Satava was part of the team that developed the first robotic and Virtual Reality systems, before joining DARPA (Defence Advanced Research Projects Agency), the brain bank of the US military. He is soon to take over as the Chief Scientist of theUS Army Medical Research and Command. It is here that he will be funding and overseeing more outrageous medical research. So, what earth shaking developments are afoot in the world of medicine?

A NEW AGE

Satava starts off, “A glimpse of what the future might become was given by Alvin Toffler in his 1976 book ‘The Third Wave’, in which he described the three different ‘ages’ – the Agriculture Age, the Industrial Age, and the Information Age. There appears to be a new age emerging – tentatively called the Biointelligence Age.” But one thought the Information Age is the future? He says, “The Information Era is here and is getting over. Over the past 20 years, there have been no new discoveries. The cell phone, computer, etc. are fundamentally the same as they were 20-30 years ago, the only difference being their level of sophistication and add-on features like small size, Internet access, cameras, etc."
The Biointelligence age features a slew of radical technologies that are set to change the entire way of treating health and disease issues. We examine some of the main issues here.

THE IMPOSSIBLE FUSION OF LIFE AND MACHINE

Scientists have implanted sensors and radio transmitters in bees and cockroaches to control them. The cockroach can be controlled with a joystick, allowing a possibility for cameras to be implanted in the creature for use in the detection of earthquakes and tsunamis. Bees fitted with sensors for biological weapons can transmit the information to the military. This is the beginning of the man-made fusion of living and non-living.
In man, brain implants are promising enormous hope for patients of paralysis, epilepsy and Parkinson’s disease. John Donoghue, a neuroscientist who also owns a biotech company called Cyberkinetics in California has begun implanting the Braingate device in the heads of patients that allow them to mechanically move an attached robotic arm with the power of electrical impulses generated by thought. The brain’s electrical impulses generated from thinking of an action go to a robot that then interprets these signals and performs an appropriate action.
How realistic is it to expect intelligent machines to perform radical functions in place of diseased body parts? Says Ray Kurtzweil, a global authority on science and future technology, “The latest generation of the implant for Parkinson’s disease (a slowly paralysing nerve disorder) is not an experiment, and it is an FDA approved therapy”. Rameez Naam says in his book ‘More Than Human’, “In Lisbon, Portugal, there is a group of blind men and women who can now see. In place of eyeglasses, they wear cameras connected to electrodes implanted in the visual parts of their brains. Some of them were blind for twenty years or more before the surgery. The same research that gives them sight could beam images from one person’s mind into another. “
Aubrey de Grey, a world-renowned scientist at the Department of Genetics, University of Cambridge, says, “There are non-biological organs such as cochlear implants already, and rapid progress is being made on more advanced things like artificial hearts. What will be more dramatic is when we start to be able to make machines that can replace some parts of the brain. For well-understood parts like the hippocampus (the part of the brain that stores memory), this may be only a couple of decades away. At that time we may wonder if ‘non-living’ is really the right word - non-biological, yes, but performing a living, cognitive function.”
de Grey looks even farther: “If we end up being able to replace the hippocampus with a machine that works just as well, there's no reason why we couldn't replace it with something that does more than the natural one. One additional function could be to use it as a knowledge base, an inbuilt Internet. In the more distant future we will probably understand the cerebral cortex well enough to start replacing parts of it too, and that is possible.”



CHANGING LIFE’S BUILDING BLOCKS

Conventional medicine looks at organ systems and deals with disease at the macro level. The dizzyingly fast developments in nanotechnology and genetic engineering are set to make this obsolete, if experts are to be believed.
Nanotechnology deals with molecules at the scale of a few nanometers, and banks heavily on the creation of an atomic ‘assembler device’ or molecular machine: a concept of scientist Eric Drexler that pertains to a group of molecules arranged to perform the functions of a machine or even a computer. Says Kurtzweil, “The golden era will be in about twenty years from now. The real Holy Grail of nanotechnology are nanobots, blood cell-size devices that can go inside the body and keep us healthy from inside.” Molecular machines can clear out clots in arteries, go into cells and correct abnormalities, and kill germs or cancer. Kurtzweil reiterates, “If that sounds very futuristic, let me point out that we’re doing sophisticated tasks already with blood cell-size devices in animal experiments.
One scientist cured Type 1 diabetes in rats with a nano-engineered capsule that has seven nanometer pores. It lets insulin out in a controlled fashion and blocks insulin antibodies. This is what is feasible today. MIT has a project of a sub-cellular nano-engineered device that is capable of detecting specifically the antigens that exist only on certain types of cancer cells. When it detects these antigens, it latches onto the cell, and burrows inside the cell, where it releases a toxin that destroys the cancer cell. This is a sophisticated nano-engineered device in that it is created at the molecular level. So that’s what is feasible already.”

CHANGING GENES OR SPECIES?

The era of transgenic animals is upon us already. Michael Crichton’s latest book 'Next’ deals with apes that speak Dutch and French, because of experiments in crossbreeding with humans.
Genetic engineering can prevent inherited disorders, but more radical is transgenic genetic engineering. Satava cites the example of rhodopsins (color detecting eye pigments). Man has four rhodopsins for vision of which he uses only two. The pit viper snake has one of the same rhodopsins that is unused by humans, and which gives the snake the ability to seek its prey in infrared. He asks, “ Should we genetically engineer our children to give them such abilities, so they can see in the dark? Should they have abilities that others do not have, giving them an enormous advantage? Moreover, who will decide which children can be ‘enhanced’? Are we on a threshold of designing our children to a point where there will be a whole class of enhanced individuals?”
Troubling questions, these! The ethical issues of genetic engineering are being debated fiercely in scientific and political circles, with more questions than answers.
With the establishment of ‘intelligent’ prostheses that function even better than a normal body part (as in amputees who can climb mountains or play), and with all possible organs (except the brain) being replaceable with biosynthetic ones, it is possible to conceive of an ‘enhanced’ man with 95% of his body replaced by artificial ones. “Would such a man be ‘humanoid’ or human?” asks Satava.
Talking of humanoids, a parallel development has been the creation of intelligent robots that help impaired patients. Satava remarks, “Advanced programs such as fuzzy logic can help the robot or computer to learn from tasks. This meets the definition of ‘thinking’. There are machines with life-like robotic faces which can answer verbal questions and attempt to make facial expressions that show six specific emotions”. Robotics is expected to be a $50 billion industry by 2025, with countries like South Korea set to become leaders in domestic multifunctional robots (with a target of one domestic droid for every home by 2013). Companies like Microsoft are working on the same lines. With such research, a thinking and emoting robot is not going to be mere science fiction. It is already reality in research!

WILL MAN HIBERNATE AND REJUVENATE?

American scientists have new insights into the phenomenon of hibernation, with stunning implications for medical care. Animals like the Arctic ground squirrel can turn their entire system off, effectively living with minimal heart rate, breathing, and circulation, owing to a molecule that blocks energy generation in the hypothalamus of the brain. Scientists have been able to create a block in mice such that they are put into a state of suspended animation for about 6 hours – no respiration, heart rate, blood pressure, ECG, EEG, and even no activity on functional MRI of the brain. After 6 hours, they are awakened and they behave normally. Satava points out “while this is an early experiment, it points to the possibility of using these molecules or drugs for anesthesia. If successful, in surgery a patient could be put to ‘sleep’ with no heartbeat, no bleeding when incised (bloodless surgery), unaware of pain and unable to move. When the surgery is over, he can be awakened.”
Drexler confirms, “It is possible to discover a drug that causes biostasis (putting life in pause). A method of producing reversible biostasis could help astronauts on long space voyages to save food and avoid boredom. In medicine, biostasis would provide a deep anesthesia giving physicians more time to work. When emergencies occur far from medical help, a good biostasis procedure would provide a sort of universal first-aid treatment: it would stabilize a patient's condition and prevent molecular machines from running amok and damaging tissues. 

But no one has found a drug able to stop the entire metabolism the way anesthetics stop consciousness - that is, in a way that can be reversed by simply washing the drug out of the patient's tissues. Nonetheless, reversible biostasis will be possible when repair machines become available.”
With much research involving other areas like human cloning, prolonging longevity of man, and tissue synthesis modern science is helping evolve a new breed of professional: the scientific ethicist.

No, I am not going to wear my bariatric surgeon cap and ask you to go under the knife to lose weight. Instead, why don’t you do what you are normally so good (or un-good) at? Use the Web to lose your weight! Ah, you must be thinking, just surf into some sites while slurping the chilled Coke (and making love to the chips, some cookies and a couple of laddoos to round it all off) and kick-start the magical melting machine! Er, I mean, to cut a long story short, no.
You can use your computer to help you in the process a lot better. How so?
Log on to a site like Fatsecret and explore. First do the free registration bit and then go! Fatsecret is not your typical site that promises you a one-week loss of a ton of lard and then tries to sell you diets. It just provides you a space where you can speak up and share your thoughts and experiences, at the same time becoming part of a community that believes in “United We Fall”, at least in terms of weight! I learn from a guy called Jiga, who has come into the nineties from a weight of a hundred kilos, that he gets his diet to work by eating every two hours to keep his metabolism going. In addition, he repeats some old pearls like “one bad meal does not deserve another”. You also get a variety of diet-friendly recipes for each meal. I read this laughably simple recipe for breakfast, called “low-fat yoghurt with banana”, where the directions are “chop banana and mix with yoghurt (dahi)”. But if you add, me-says, some chopped almonds and berries or papaya bits, you are in serious business! However, it is not merely the revision of various diets that matters, but a sharing of the psyche: one feels part of a community of people helping each other to lose weight. You could also imagine this site as a publisher interested in your personal weight loss (or gain) story and doing this for free!
Like exercise, dieting is good for some time before it gets boring and depressing. Don’t you feel that it would be so much better if you had a group with whom you could diet or exercise, so that when you feel down, there are others who pep you up? Fatsecret lets you do that. Find friends who will diet with you and share the experience. It may just work! There are lots of other sites that use innovative approaches that help you do better in your weight loss attempts. Traineo is another free site that works you out by setting up four motivators of your choice and sends weekly updates to them on your weight loss progress. This, surely, should be motivating!
If you like to go for the gimmicky stuff to spend money on to motivate you to use ‘em, try a Geek-a-Cycle that costs around $350 and exercise while you work at your desk.
There is actually some serious tech that helps you optimise those morning saunters in the park. Get a Nike with iPod. Check it out here and type ‘nike’ in the search bar. You will also gets loads of accessories that will certainly help you lose money, if not weight! The Nike with iPod is basically a wireless sensor that fits in your Nike shoe and sends the workout data (like how many kilometers you walked, your speed, calories burned, etc.) to your iPod nano, which you are using in the meanwhile to listen to your music. When you come home, sync your iPod to your computer (on the iTunes application) and get the records of your exercise. And, before you ask, it only works with the Nano, and not with your video iPods. On a daily basis, you can use this as a target-driven exercise program, and even compete with others online. Just sync your iPod at the Nike site and enrich yourself with the online community’s running and walking targets and experiences. You can also learn which rock ‘Powernumbers’ are celeb favorites that might just charge you up as you run. In case you didn’t get on to the hitch, it is that you have to buy the thing. The iPod sports kit (the sensor, stupid!) is cheap at Rs.1995 (around $29), but this goes only with the Nike + shoes. And them cushioned things cost only an arm and a leg! Want to buy it? As the company says, ‘Just Do It’! As for me, well, no thanks, I prefer to wait for it as a birthday gift, some day, some year!
I am indebted to Lifehacker for this article, and for lots more!