Lifeboat Foundation

I learn useful life lessons from each patient I meet. Some are positive messages, reminding me of the importance of maintaining balance between family, work, and leisure activities, but more frequently I witness examples of the remarkable resilience of the human spirit when facing the reality and risks of a major surgical procedure and a diagnosis of cancer. Rarely, patients and their family members utter remorseful or simply sad remarks when they are faced with a grim prognosis and the emotions associated with an onrushing date with mortality. These comments invariably involve an inventory of regrets in life, including, “I should have spent more time with my kids,” “I wish I had told my father (or mother, brother, sister, child, or some other person) that I loved them before they died,” and “I have spent my entire life working, I never took time for anything else.” I wince when I hear these openly expressed remonstrations, I recognize that I am hearing painful and heartfelt truths. Not a week goes by that I am not reminded that I do not one day want to look back at my life with a long list of regrets, should have dones, and what ifs.

I was blessed to meet a great teacher in the guise of a patient early in my academic career. He came to my clinic in my first year after completing a Fellowship in Surgical Oncology, my first year as an Assistant Professor of Surgery. My patient was a 69 year-old Baptist Minister from a small town in Mississippi. He was referred to me by his medical oncologist who called me and said, “I don’t think there is anything you can do for him, but he needs to hear that from you because he doesn’t believe me.” This tall, imposing man had colon cancer that had metastasized (spread) to his liver. The malignant tumor in his colon was removed the year before I met him, and he had received chemotherapy to treat several large tumors found in his liver. The chemotherapy had not worked and the tumors grew. At the point I met him, the medical oncologist told him he would live no more than 6 months, and because he was an avid fisherman when not preaching or helping others in his community , the doctor suggested that he go out and enjoy his remaining time by getting in as much fishing as possible. I learned two invaluable lessons from this patient and his family. First, never deny or dismiss hope from a patient or their family, even when from a medical perspective the situation seems hopeless and the patient is incurable. Second, quoting the minister directly, “Some doctors think of themselves as gods with a small ‘g’, but not one of you is God”.

Continue reading “The Importance of Hope” »

Bioquark, Inc., (http://www.bioquark.com) a company focused on the development of novel biologics for complex regeneration and disease reversion, and Revita Life Sciences, (http://revitalife.co.in) a biotechnology company focused on translational therapeutic applications of autologous stem cells, have announced that they have received IRB approval for a study focusing on a novel combinatorial approach to clinical intervention in the state of brain death in humans.

This first trial, within the portfolio of Bioquark’s Reanima Project (http://www.reanima.tech) is entitled “Non-randomized, Open-labeled, Interventional, Single Group, Proof of Concept Study With Multi-modality Approach in Cases of Brain Death Due to Traumatic Brain Injury Having Diffuse Axonal Injury” (https://clinicaltrials.gov/ct2/show/NCT02742857?term=bioquark&rank=1), will enroll an initial 20 subjects, and be conducted at Anupam Hospital in Rudrapur, Uttarakhand India.

Continue reading “Bioquark Inc. and Revita Life Sciences Receive IRB Approval for First-In-Human Brain Death Study” »

EPFL scientists propose a new way of understanding of how the brain processes unconscious information into our consciousness. According to the model, consciousness arises only in time intervals of up to 400 milliseconds, with gaps of unconsciousness in between.

The driver ahead suddenly stops, and you find yourself stomping on your breaks before you even realize what is going on. We would call this a reflex, but the underlying reality is much more complex, forming a debate that goes back centuries: Is consciousness a constant, uninterrupted stream or a series of discrete bits — like the 24 frames-per-second of a movie reel? Scientists from EPFL and the universities of Ulm and Zurich, now put forward a new model of how the brain processes unconscious information, suggesting that consciousness arises only in intervals up to 400 milliseconds, with no consciousness in between. The work is published in PLOS Biology.

Continuous or discrete?

Continue reading “How the brain produces consciousness in ‘time slices’” »

Humans may need to genetically engineer themselves to withstand the harsh and unpredictable environments encountered during long-term space travel, one researcher says.

New answer for stroke victims.

Hacking the body’s inflammatory immune response via the gut microbiome.

Venus, sometimes called Earth’s twin, is a hauntingly beautiful planet that likely had past microbial life a prominent astrobiologist asserts. If so, we need to go find it. NASA is developing the tech to withstand the high pressures and temperatures to do such a surface search.

I say there’s no excuse; Venus is closer than Mars; and while Mars may have harbored life as did Ceres, finding evidence of past life on Venus and then Mars later this century would mean that life itself evolves pretty readily.

Venus likely harbored past microbial life, if not on its exposed surface, then in the planet’s potential warm early oceans and hot pools of liquid water, Dirk Schulze-Makuch, a Washington State University astrobiologist now tells me.

Continue reading “Venus Likely Had Past Life; Next Step Is Finding It” »

But function of many of these remains a mystery.

One of the things I love most about being a Surgical Oncologist is that I see my patients for years after I have treated them. However, my clinic days are inevitably like the opening scenes from the old Wide World of Sports television program that aired on Saturday afternoons on ABC. I remember watching this show on weekends as a child and teenager. The “thrill of victory”, with images of athletes crossing the finish line in first place, equates to those patients who receive good news during their clinic visit. I tell them I am confident I can perform an operation to remove their cancer; or I confirm that their blood tests and scans show that tumors have not recurred after surgery, chemotherapy, and other treatments; or we pass some major chronologic milestone without evidence of cancer rearing its ugly head again (many patients still believe the 5 year anniversary of being cancer-free equates with being “cured”, if only that were always true). In contrast, the “agony of defeat”, forever seared in my memory in the opening scenes of Wide World of Sports with the ski jumper falling off the end of the jump and bouncing hard off the slope, represents the distress and depression felt by patients and their family members when I deliver bad news.

I would never make it as a professional poker player because I can’t bluff when I’m holding a bad hand or keep from grinning when I have a good one. My patients can tell from my face when I walk into the clinic room what the news is going to be. When all of the blood tests and scans reveal no evidence of cancer recurrence, I walk in smiling and immediately tell all gathered in the room that everything looks great and I see no evidence of any cancer. The remainder of the visit becomes a combination of medical checkup and social enterprise. I inquire about the well-being of their children, grandchildren, parents, other friends and relatives I have met, their pets, their gardening, their recent travels, and sundry snippets of their ongoing lives. Patients frequently bring pictures of children and grandchildren, or travel photos of places they have been since their last visit with me. Often I’m asked for medical advice on conditions totally unrelated to their cancers as they get farther and farther away from that diagnosis. My patients also know about tidbits from my life. They ask about the status of soccer teams that I coached, how my son or daughter were doing in college (both graduated and onto successful careers, thank you), and whether I have progressed from owning a Ferrari lanyard to hold and display my medical badge (I’m a fan of Ferrari F1 racing) to actually owning a Ferrari automobile (I do not).

I am told by patients, family members, and members of my patient care team that I am quite solemn when I walk in a clinic room to deliver bad news. No “light-hearted” chatter or discussion of recent family events or outings occurs. The nervous, hopeful smiles on the faces of the patient and the family members in the room quickly fade as I describe what I am seeing on their blood tests and the scans I have reviewed. Friedrich Nietzsche, the pejorative poster boy of pessimism, is credited with the aphorism, “Hope is the worst of evils, for it prolongs the torments of man.” Thankfully, he was not involved in the care of patients with cancer or other chronic illnesses. A particular patient comes to mind when I remember the importance of dealing with both the highs and the lows of talking with cancer patients.

The patient in question was the wife of an Emeritus Professor of Engineering at a prestigious American university. The Professor knew a thing or two about scientific investigation, statistics, and assessments of probability. Mrs. Professor had a large, grapefruit-sized malignant vascular tumor in the center of her liver called an epithelioid hemangioendothelioma. Quite a mouthful of a name for a rare malignant tumor of the liver. Her tumor was in an unfortunate location in the center of the liver and was wrapped around two of the three veins that drain all of the blood out of the liver into a large blood vessel called the inferior vena cava. The tumor was abutting a portion of the third vein. As a hepatobiliary surgical oncologist, I know I must preserve at least one of these veins to allow blood that flows into the liver to flow back out properly. She had seen surgeons at several other hospitals in the United States and was told that the tumor was inoperable and untreatable. If she was lucky, she might live a year, these doctors told my patient and her husband. The Professor contacted me, and I examined Mrs. Professor and evaluated her prior scans, and then obtained some additional high resolution scans to better understand the appearance of her tumor. I realized that her particular tumor had a very thick fibrous capsule surrounding it. I explained to the patient and her husband that it may be possible to remove the tumor, but that it would be challenging. This lady who had been sullen, withdrawn, and tearful every time I had met with them previously suddenly looked up and said, “If there’s any chance, I’m willing to take it!” I preceded the next week to perform an operation that removed the entire left lobe and a portion of the right lobe of her liver and I was able to gently dissect the tumor capsule free from the third hepatic vein. The operation was successful and the patient recovered well over the next several weeks.

Continue reading “Good News Bad News” »

A disarmingly simple model of ecology does everything well — except for predicting how rapidly nature can change. Can it become more realistic while still avoiding biology’s messy complexities?