Being Mortal, But Moral?

Being Mortal, But Moral?

This post is about death. If you feel its too morbid a topic to talk about and would rather not read anymore please feel free to stop right now. If not lets continue talking.

The average human life is replete with failures, setbacks and rejections. We put on a brave face, tell each other that its all passing clouds and we have to stay positive and get on with living our lives as best as we can. But there is one facet of our life which we cannot change despite all the best intentions, positive thoughts and Facebook memes shared between strangers and acquaintances and that's the great leveler, death.  Now you may wonder why i am talking so freely about something we all avoid talking about, most of us even hesitate to think about and you are right- its only because people like me, who work in the healthcare field are on an ever present acquaintance with death, so much so that it makes a lot of us doctors talk matter of fact way about death to everyone we meet as if we are somehow immune to its effects. And we need that shield of immortality (mentally) to walk into sick rooms all day long, everyday of the year to stand beside people who are sick enough to die soon and treat them without giving thought about catching something from those patients and dying ourselves. If we think that way for even one minute, we wont be good doctors at all, we would just have to retire.

But death comes to doctors too- despite their denials in their own fallibility. And death comes to patients- despite their doctors and their best efforts too.  I have seen so many doctors who give that perfunctory – he/she will be alright soon in the hope that they will be alright and not because they know for a certainty that the patient will be alright. Its a humbling fact to agree to but its the truth. For all the advances we have in diagnostics we can still predict only the amount of damage and disease we discover at that point in a patients body and we cannot with any fair degree of certainty extrapolate the results from the test to predict the date of death. A man who get a 64-slice or 128-slice sonogram and pronounced to be as healthy as a mule heart-wise can still drop dead the next day because the heart muscle may refuse to cooperate with the doctors prediction or the liver refuses to produce clotting factors or the kidney has been abused too much and simply shuts down.  And even the postmortem might not be conclusive for it can only tell about how it happened- a thrombotic event or a coronary occlusion but not about why it happened when it did.

That “why death comes when it comes” is still a whole lot of mystery to everyone. Oh, we have theories to explain it. Modern medicine has all these researches about aging, cellular damage,apoptosis- programmed cell death which is the he simplest and most widely believed reason. It goes something like this - every cell in the body contains DNA, which acquires gene mutations over time. These mutations can sometimes occur in an instant or they can build up slowly over decades and when these mutation reach a certain tip over point- cell death occurs. If enough cells die- the organ dies. If some vital organ dies- the whole organism- the human body in this case dies.  Thats just the scientific explanation of how we die. But the why, still remains unanswered. Death is final, death happens to everyone, we are all on the road to death and we might drop dead tomorrow- you, me and everyone of us.  Accept that and it makes the rest of our life easier to live with. 

And now i come to the moral part of this post. Knowing that we are all going to die soon, despite all our best laid plans and maneuverings and a thousand little things we do to ease our lives in the long run- what if we do not have that long run? What if we were to die tomorrow? Would we still lie, cheat, back-stab, betray and character assassinate if we know that we would no longer be around to reap the benefits  later on? Would we still make long term plans that involve short term evil actions justifying it to our conscience as necessary evil on our way to future success, if we realize we don't have a future at all?  Or would try to live a more moral life remembering that what we do today is not going to change anything to our benefit? Will morality rise if we knew that our days were numbered or would we go the other way? I am curious to know what you think.  So do share your thoughts with me on this question.

P.S. This question about the morality of our actions applies only to the average normal person among us who wont mind cutting a few corners to get ahead in life, regretting the necessity of doing so all the time under their pricking conscience. For the other kind- the born evil kind of people, this question does not apply, for they would go to their graves doing evil to the last minute even if they never benefit from it.  Lately i have been meeting a lot of such evil people who gave me the germ to write this post. And i am curious to know others experiences about such ones.

Dicing With The Devil....Free Verse

Dicing With The Devil

What the world will be

Is not what it is

The world hangs in balance

And time stops still

Quivering and straining

Not a second forward

The world waits

And time awaits

For what comes next

Time has come for all

To stand arm to arm together

For Now is the time to roll the dice

A time to punt all life on a throw

Aces to aces, doubles to win

And death to those who fail to see

For all life has stopped

To stare at the dice

The world hangs in balance

And even time waits on me.

The devil is on the other side

Watching me throw

Fire and brimstone, he reeks so sulfur

I clamp my nose and play my game

Even the devil cant beat me

For today I ride reckless

Trusting my luck.

For am I not the dearly beloved

Of her Highness Lady Luck?

Elusive no more, there she is,

Whispering sweetly in my ears

On, forth, roll that dice,

For todays the day you beat that devil

Smiling at her, I do as she bids

Hands clasped behind my back

Leaning at my ease.

I ride my luck and throw that dice

The world, the world, the entire world

On one throw of my wrist,

One whim of my luck

The dice falls and spins around

It bounces and rattles

And the world awaits.

Quick, take a peek, I close my eyes,

Tell me, do we live, to fight again?

Yes we will, the cheering starts

Fortune favors me,

Goddess Luck in love

And the world is saved by a thread (again).

P.S: I rarely write verse, unless mentally disturbed/distracted. So when I was recently too high strung/anxious and looking to work that extra energy off somehow, I wrote this free verse on how it would be to play a game with the Old ‘Un himself. Of course, I would back my luck any day. Even against him. But with the fate of the world in balance? Do I dare? Would you? Tell me….

Genes, Clones and the Quest for Immortality

Genes, Clones and the Quest for Immortality

I happened to have a cup of coffee at the canteen with a friend from anesthesia, for I have a habit of hanging out with people from different specialties every day, in the hope of keeping up with the latest news. Medicine is so fragmented with specialties and sub-specialties that it’s difficult to stay current (however much you read) with what’s happening in everything unless you get a distilled synopsis from different specialists on what’s the latest treatments going on in their field. And that’s how I wound up talking to my anesthetist friend this morning about the recent news in Lancet of people retaining memory of what was happening to them under anesthesia and the resultant post traumatic stressful effects causing unexplained depression years later. As usual with such talks the topic veered around to the basics- what really is anesthesia? Is it a deep sleep or near death? Both descriptions are not enough so the truth lies somewhere in-between, as no one including anesthetists, can say what exactly happens when a human mind loses its consciousness. As the stages of anesthesia get deeper and deeper the human mind goes to a level of near death where its kept hovering by the drugs being given and when the mind recovers from general anesthesia it is as near an experience as regaining life from the brink of death and a far more different experience than just waking up from deep sleep.

And that turned my mind to the intriguing question of immortality. Throughout human history we have wondered whether we can extend our lives, if not to become truly immortal. A lot of legends and myths run on the quest for immortality from the garden of Eden to the fountain of youth to the cup of life. But leaving aside myths and allegories, when we see it on a purely scientific basis are we finally at a stage where death is not commonplace (and accepted easily) anymore? With our current scientific and medical advances, are we at a stage where we can cheat death, so to say. When we intentionally take a person to the brink of death and bring him back are we not we already at a point of controlling death

To simplify it further, what is death to you? To answer my own question when we talk of death we mean a simple thing - stopping of breathing and stopping of the heartbeat. Like when someone suffers a heart attack and stops breathing and the heart goes silent. But with a machine called the ventilator to give artificial breathing we can even restore the breathing of someone who has stopped breathing on their own. And even if our heart stops working on its own, with a machine called the heart-lung machine to hook us up to, we can restore blood circulation to our body till a donor heart is found and transplanted and that can keep us going for a pretty long time. So can we say that as we have got our breath back and our new heart has started pumping, we have gone beyond accepting death as finality?

And that brings us next to loss of consciousness in brain death or coma- when a persons brain stops working due to lack of oxygen supply to the brain. As everyone knows if we starve the brain for more than 5-7 mins without oxygen the brain cells start dying and all our memories are erased with those cell deaths. But recent research has shown that there is even more damage when the brain starts getting oxygen back after an absence - called reperfusion injury and caused by the toxic gas oxygen and its free radicals which damages the mitochondria, a small sac-like thing inside each cell which is responsible for making use of oxygen to produce energy for running the cell. If we can somehow prevent the oxygen free radicals (by anti-oxidants at cell level?) from damaging the brain cells then we can revive a brain dead patient and restore him to the living as good as new with perfect memory. That’s a kind of an immortality too isn’t it? Waking the mentally dead? Like in the movie The Mummy?

 Which brings me to cloning. If you don’t know the word, it means taking a single cell from someone and making a completely new person with it. It’s been done with rats, with sheep and with cattle. But not with humans- till now. Or at least not legally (or atleast not as far I have heard- but who knows what’s happening in North Korea?). But the major problem with cloning is, even if you clone yourself, you only get a physical being who looks like you but without your memories or your thoughts or experiences. So unless we find some way to download our memories onto a supercomputer for restoring back to our new bodies which are cloned again, our memories which make up our self-awareness maybe lost forever. So even if our bodies are immortal our minds may not be, which is not what we claim by true immortality is it?

 And human cloning also raises certain hard ethical questions. As they say in warfare- no perfect plan survives contact with the real world, similarly cloning ourselves for immortality is a fine concept but there are lots of armchair theorists (of the Hollywood scriptwriter style) who suggest that cloning will lead to a new form of slavery where instead of just personal cloning, commercial cloning will become available for a price. It’s just a matter of time before some celebrities start selling their clones (or just their cells) for a huge price. So if you ever fancied an Hollywood celebrity you can buy as perfect a physical copy of her as you want and keep at home. Why stop at ogling the kingfisher calendar girls? You can buy the whole damn set, the clones of the girls and keep them at home. This is just an extreme example but you never know about the future and the possible real world applications of scientific discoveries, do you? The Internet was invented as a military communications system to survive a nuclear first strike, look at what it has turned into now.

There is a popular joke in cloning called the taj mahal paradox which states that if cloning had been around in shahjehans time, we would never had the taj mahal because shahjehan would have cloned his wife Mumtaz for the first time at 20 years of age and by the time he turned forty (twenty years later) he would have had a new 20 year old Mumtaz to play around with for another twenty years (you cannot accelerate physical growth- so it still takes time), and if he cloned her again and again he can have a new 20 year old mumtaz maybe every ten years or every five years or whenever he wanted- a like replacement for like. And you think he could have got around to building anything leave alone had time to think? So there goes the Taj, once you have cloning.

So what if we don’t want to replace our entire selves? But just do patch work repairs of worn out organs? Isn’t that possible with stem cells you ask? Yes. We can do the new organs for old thing pretty soon. Organ replacements are of two types. The first is building up a entirely new organ from the ground up (using your own stem cells) and the second is stripping an anonymous donor organ off its original cells (leaving just the supporting framework behind) and replacing them with your personal cells which means the organ you get fits you perfectly as if it’s yours. The second type of cell replacement technology is currently available but the other type of growing a new and entirely your own organ is still not available with our current science. But we should get there soon. With the speed of research in stem cell technology, in just a few more years we can have tailor made organs from our own cells. And then we can just replace damaged parts and retain our own overall body and mind. Not real immortality, but something halfway to it.

And finally we should realize that there are some true immortals walking around among us. Or leastwise people who get as close to immortality as possible- the long lived ones, the genetically fortunate ones with robust immune systems- whom nothing kills easily. Forget all the claptrap of the dietary recommendations- people who live long eat the Mediterranean diet with lots of olive oil, the French diet with lots of red wine, the Japanese diet with lots of fish liver oil. Everything is just a myth. There are people among us, walking around unrecognized amidst us, who could eat toxic nuclear waste and survive somehow. They can and do smoke continuously, eat whatever they want, never exercise, have unprotected sex with any number and rarely die of anything except old age. These people are from the deep end of the genetic pool, the blessed original genes of the homo sapiens species with the minimal number of harmful mutations and recessive genes. Their natural immune systems would put any billion dollar defense system to shame. Anything and everything which attacks their body is cleared up without a fuss.  Their immune system eats up bacteria and viruses and allergens and cancer cells with rarely a sweat. And if you are the type of person who goes down with pneumonia when someone sneezes in a room full of people, the best gift you can give your next generation is to marry as far from your own genetic pool as possible. When it comes to genes, the bigger the diversity of your gene pool the better. If you are an Asian marry a Caucasian, if you are a Caucasian marry a Mongoloid, if you are a Mongoloid marry an African. Diversify your genetic alleles to give them the best chance to survive.

And for those not born with fortunate genes, the only way for immortality is to hope science catches up with science fiction soon. Or to find that fountain of youth in Eldorado. Or Amrut from Indralok.

P.s. Pics courtesy Google Images