We are not a soup can

February 9, 2008; Day 478.  Ah, yes, where were we?  Disease states.  So, basically, to state an obvious truism, the biochemical reactions in our bodies are complicated!  Moreover, we are not a soup can.  That is to say, you cannot predict what is going to happen simply by putting all the chemicals we contain into a soup can because we have “architectural pathways” to keep things somewhat organized or separate.  One well-known example is that we have arteries to take blood from the heart and veins to take blood to the heart.  So, oxygenated blood is pumped around to allow oxygen to get “virtually everywhere” in our bodies and the same system picks up carbon dioxide, gathers it together and allows exchange out into the air by exhalation.  Of course, this same system can also be used to pump other relative small molecules throughout the body…alcohol comes to mind as one such example.  If you drink alcohol, it pretty much ends up everywhere throughout your body.  So, the body, rather than being a soup can has various channels that organize and direct chemicals.  But these channels are not “equal-service providers” for all substances.  For instance, if you put grain alcohol on the back of your hand, your skin will pretty much keep it from being absorbed into your body long enough for it to evaporate.  On the other hand, if you put WOOD alcohol on the back of your hand, it (a much more deadly neurotoxin even than grain alcohol) it WILL be absorbed by your skin and course throughout your body.  Enough may cause permanent damage such as blindness or death.  Some chemicals may exhibit gradient properties under certain conditions.  Others may or may not be transferred throughout the body depending on other state conditions within the body, or be transferred at different rates.  Again, to take an obvious example from the world of drinking, if you drink alcohol on an empty stomach, the alcohol will end up throughout your body more quickly than if your stomach is full of rich food.  But this is just one obvious example.  The more general point is that you have hundreds of chemicals coursing through your body at various rates.  Moreover, many of the chemical reactions that take place are also part of more complex systems that involve negative (or more rarely, positive) feedback loops.  These reactions themselves take place at various rates.  For example, drinking a lot of alcohol (a sedative) may actually make you more jumpy or nervous a lot of the time because your body is reacting with chemical that attempt to counter-act the sedative effect (to put a teleological spin on it). 

 

So, now, let’s consider.  We have thousands of chemical reactions going on, in at least partially “protected” places in the body, going on at different rates and part of complex patterns of interacting systems that include feedback loops.  Unfortunately, this complexity means that for many medicines, pharmaceutical companies only know what the first order effects are of a drug.  How do drugs interact with each other?  How does rate of absorption affect the various feedback loop timings?  Although it would be incorrect to say nothing is known about these subjects, it would be fair to say, that a huge amount remains to be discovered.  No-one has anything like an accurate overall picture of how things interact over time and space. 

 

Now, consider these kinds of phenomena at a more microscopic level.  There seems to be an often unstated assumption in genetics that you either “have” a gene or you do “not” have a gene for something and that the effects of genes are independent of where they are on a chromosome.  In many cases, this may indeed be true.  But there is a bias in the method of discovery of cause and effect here.  If genes produce or fail to produce an effect because of variations in the relative gene locations of two or more genes and these locations vary, it may be very difficult to ever discover that these genes are having an effect.  Thus, there may well be diseases that have a “genetic” cause but these diseases are only caused in a small percentage of the population who have the genes because of locational issues.  One person might have genes A, B and C and they are too far apart to cause a significant enough negative chemical interaction while another person could have genes A B and C close together and as a consequence, too much of a “bad” chemical is produced to be dealt with by the normal negative feedback loops that try to “get rid” of this “bad” chemical.  To complicate matters further, it might be that there is a further interaction with environmental chemicals.  A person with genes A B and C far apart might have to be exposed to 1000 times the dosage of a pollutant to cause a problem as the person with genes A B and C close together.  Of course, in this example, having A B and C far apart as “good” is entirely arbitrary.  In other cases, exactly the opposite could be true. 

Zen and the Art of Cat Maintenance

February 8, 2008; day 477.  I go to feed my four cats and also clean the two cans of wet cat food that I typically give them in the morning and again at night.  I put the mostly empty cans in the sink and then turn on the tap to clean extra bits of food out so that they can be put in the recycling without being a temptation for the cats to rummage through the recycling bin.  Now, here’s the interesting part.  If the majority of the stream of water from the tap hits inside the can, it produces a kind of local stable equilibrium.  It kind of “pins” the can down.  If the can shifts slightly, say to the right, there is more pressure on the left and it tends to re-center the can.  On the other hand, if, when I first turn on the water, most of it hits just OUTSIDE the can, it tends to push the can away from the water.  If the can happens to be sitting on a plate, even more complex variations can arise, but more about that later.  Let’s just stick to the simple case.  Here we have a system that can exhibit either a negative feedback loop or a positive feedback loop and which it exhibits depends on where the initial “disturbance” is that triggers the system.  (In the case of the majority of water hitting outside the can, as it travels away from the stream, at first it travels even farther away.  Of course, eventually it is so far away that the water pressure moves it no further, so in this case, it is actually a “self-limiting” positive feedback loop, but let’s focus on the essentials).

 

Now, it strikes me that this provides a good metaphor for many systems in life, at many different levels of scale; for instance, social systems are often like this and so, I would argue are biological systems.  For instance, this may help explain why “allopathic” and “homeopathic” medicine both have their adherents.  Both work, but under slightly different conditions.  If the system is “slightly” off-kilter, a small “kick” in the “wrong” direction may trigger a feedback loop to engage while absent the “kick” the system response is below threshold.  In the same way, if the stream of water hits the empty can slightly off center, the imbalance is not enough to overcome inertia and the can remains in the same place.  A slight tap to *increase* the imbalance of forces generally overcomes this inertia and the can will end up in a more symmetrically places spot relative to the stream than it was before. 

 

However, there is also a threshold beyond which such homeopathic measures will no longer work.  In the case of the can, if the majority of the water stream is falling outside the rim of the can, giving it a tap in the wrong direction merely exacerbates the effect of the water stream in pushing it away from the stream. 

 

To be continued.  Soon, I will talk about disease states and the (often implicit) models of interaction that underlie medical thinking.    

Unrelenting Waves of Desire and the Dereliction of Duty

April 25, 2007; Day 186.  Ah, at long last, we have had some beautiful weather bringing springtime leaves and flowers, not to mention golf.  On the way back from the golf course, I see that some lawns are still flooded from the aforementioned deluge.  Our basement, on the other hand, stayed dry through the entire time.  I recommend “Be-Dry”, a company that comes in and makes your basement dry and guarantees their work.  They basically dig a trench around the outside of the basement, put in gravel and a sump pump as well as coating the walls to keep moisture out.  They are headquartered in
Akron, Ohio my home town which probably explains why it actually works.   

 

Speaking of water though, it is so much better than alcohol for the human body.  Nonetheless, as the seasons go on, I find myself in a sequence of venues that used to be associated with drinking alcohol and each time this happens, a weird kind of desire is down there somewhere to repeat my earlier experiences.  Odd, but I don’t see it as such a big threat that it would induce me to drink nerve poison instead of water. 

 

Speaking of healthy things and so on, it turns out that there is a move in the FDA to regulate foods like medicines…well, at least foods that are good for you.  From the naïve perspective that the purpose of the FDA is to protect the American public, it seems a bit odd that they would try to limit your access to say, turmeric because it has anti-inflammatory and anti-cancer properties or orange juice because the vitamin C and folic acid are good for you.  Hmmm.  On the other hand, once you understand that FDA stands for “Federal Drug-company Advocate” it all begins to make sense.  After all, going to the grocery store and getting something healthy is typically cheaper, more convenient, and has fewer side-effects than going to the doctor, getting a prescription, then paying an arm and a leg for a drug.  So, what it really amounts to is unfair competition for the poor, beleaguered international pharmaceutical companies.  While we’re at it, let’s not forget that if your ancestors managed to evolve some sort of protective gene that is in your body, the drug companies are legally able to patent your genes for their profit. Huh?  Yeah, I know.  Sounds impossibly unethical and unfair doesn’t it?   So what else is new?

 

Ah, speaking of corporate malfeasance, are you aware that alcohol companies are targeting young people who find the taste of vodka, whiskey and gin too bitter and biting?  Instead, they have made a large variety of “training drinks” that taste like fruit juice or soda pop.  However, if you are not used to alcohol and you drink enough you can get high and eventually your taste buds can graduate to the harder stuff.  That goodness someone is paying attention to our youth and thinking about their future.

Food, Medicine, and the “Establishment”

January 19, 2007; Day 91.  My mouth feels better and closer to its normal size.  I’m having a fabulous egg-beater omelet this morning, made with shitake mushrooms and a combination of low-fat swiss and non-fat cheddar cheese.  I spice this with a little oregano, thyme and turmeric.  And, needless to say, lots of garlic. Have you heard about turmeric?  It is an anti-inflammatory that also seems to have an effect to slow cancer growth.  Also on this morning’s menu at Chez Truthtable is low-sodium V8 juice, organic sauerkraut and a small slice of bread with cashew butter and honey.  Yum!  It’s worth it not to drink any alcohol just for the increased clarity of taste sensations.  Sauerkraut is also an “anti-cancer” food.  All cruciform vegetables are good in this way, but apparently, the process of making sauerkraut actually changes one of the natural anti-carcinogens into something even more powerful.  I swear I do not knowingly own stock in any sauerkraut companies but it does make a fine side dish. I chose to use garlic and shitake mushrooms because they supposedly have anti-bacterial properties.  I am a little skeptical about that, but so far, keeping an open mind.  Anyway, they taste great.  It turns out that the drug companies and the established “Western” medical profession almost invariably claims no benefits to traditional foods, spices, and herbs that are supposed to have various medicinal properties.  On rare occasions, they admit something is has an effect but claim that the amount of active ingredient is not well controlled in herbal remedies or that the herbs in question might have untoward side-effects (not that this applies to “real” drugs – Haha) . Of course, they might just plain be correct on all counts, but the thing that makes me suspicious is that what does turn out to be effective is invariably something that requires a prescription (= a visit to your doctor) and has a high profit margin.  Personally, I tend to side with traditional Chinese medicine which does not make a sharp distinction between foods and medicines.  I also understand — and this I love — that you paid your doctor as long as you stayed well.  Right.  Doesn’t that make a lot more sense than paying someone whenever you get sick?  It does to me.  No matter how honest, dedicated, forthright and ethical one tries to be, it is not a good situation to have their monetary reward structure antithetical to my health — and then go to them for healthcare.  And, as things have changed over the last couple centuries, this situation has gotten more problematic.  Some of these changes include the current overwhelming concern with currency.  Of course, money has always been important, but from what I can tell from reading about earlier days in
America, it was not all-important as it seems to be now. In addition, the doctor of yore was typically a highly respected member of a local community.  And lastly, drug companies were not the hugely powerful multinational corporations that they are today sponsoring trips and conferences for physicians.

So, I am not against modern medicine or above using some, but I do tend to take it with a grain of salt…or in this case, a substantial amount of saline mouthwash.  And so to work.