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 What Would Joe Do?
Peggy Aycinena
Peggy Aycinena
Peggy Aycinena is a freelance journalist and Editor of EDA Confidential at www.aycinena.com. She can be reached at peggy at aycinena dot com.

Glioblastoma: SynBio, AI, Medical Science, 11th Commandment, and the Future of Thought

 
September 27th, 2017 by Peggy Aycinena


During a recent reunion of immediate family members in North Carolina
, we received devastating news that a nephew out in California, a husband and father of three, had just been diagnosed with a glioblastoma, one of the most horrifically aggressive types of cancer.

Back in North Carolina, the reunion group included a nursing administrator, an MD specializing in genetics, a computer scientist expert in AI and ML, two bio-pharma research chemists – one an expert in CAD tools for protein synthesis and the other with expertise in targeted chemo therapies for oncology – as well as a couple of electrical engineers thrown in for good measure.

In other words, it was a custom-built conference for discussing cell physiology, brain function, clinical protocols, targeted therapies, genetic mutation, and the emerging science and software of semiconductor-based artificial intelligence and neuromorphic computing.

What the conference attendees wanted was to give hope to the nephew in California, despite the brutal reality of the current state of the art of treatments for virulently malignant brain tumors. However, after many hours of discussion in North Carolina the group concluded that the situation in California was dire, even hopeless, given what is currently known about glioblastoma.

The group also concluded that given the promise of synthetic biology, the growing understanding of tissue specificity in the human body, and the increasingly wide-spread use of standard protocols for brain tumor therapies, it is possible within the foreseeable future that new strategies will emerge which will include the ability to grow fresh, healthy brain cells to replace the ones ravaged by cancer.

The theory: While life-saving new tissue growth is underway in the lab utilizing genetic mapping, a concurrent strategic use of artificial means of intelligence – those based on semiconductor technology – will carry the load the brain normally handles, directing physiological function and preserving established memories associated with the diseased tissue.

Not unlike the use of an artificial heart during heart surgery, which allows surgeons to muck around in, and repair, the silenced muscle tissue of the real heart – artificial semiconductor intelligence might capture the data stored in the real brain tissue of the afflicted individual long enough for new, fresh brain tissue to be generated, implanted, and then re-populated with the skills and memories that had resided there prior to a tumor driving the system off the rails.

The problem with the brain: It’s a big mass of messy, gooey grayness – not clearly labeled like the big organs in the abdomen where the liver’s red, the intestines yellow, and the gall bladder green. With the brain, it’s just not easy to know which part of the gray goo does what and when – albeit, the mapping of brain is moving along at a rapid clip.

When tumors invade the gray matter, or are removed in a gross surgical procedure, it’s hard to know what damage is being done. Brain surgeons literally wake the patient, while removing a mass, just long enough to determine what skills have been lost so far. The cutting stops when the damage is no longer tolerable.

As one of the electrical engineers at the North Carolina conference offered: “Cutting apart the brain to understand how it works is like cutting apart an SoC to understand how it works. If one was attempting to understand which part of the device did what, chopping it up wouldn’t be informative at all.

“You’d just get a bunch of dis-aggregated transistors that offered very little info about what was going on here, there, or yonder. Instead, you need the system on the chip to be intact if you want to probe and test and fully understand regional functionality.”

Meanwhile, the research chemists at the conference offered their own predictions: Targeted therapies will really hit their stride when you can get individualized chemical agents in place that match the exact genetic profile of the offending cancer cells, which are themselves probably unique to the patient’s brain-cell genetic profile.

But getting those agents into the brain is hellatiously difficult, given the very effective barrier that nature has encased the brain within. And once in the brain, who knows what collateral damage will ensue as the chemotherapy agent rampages throughout that blood rich organ.

Since standard protocols today for glioblastoma include removing the tumor, followed by highly assertive chemo and radiation, a whole lot of collateral damage is the well-known outcome of the current state of the art for treating cancer of the brain, damage both the nursing administrator and the doctor acknowledged having seen in clinical settings.

And so the conference in North Carolina drew to a close, ending with a mix of hope for the future of brain tumor therapy, and a gritty sense of the reality of the here and now.

Back in California, that reality unfolded this week. Things progressed as predicted: The nephew had the tumor removed, and hence his life has been extended for a period of time. Early results of the surgery suggest he has lost the use of his right arm and leg, and now has limited speech abilities.

Nonetheless, he is still among us and able to provide comfort to his family who are thrilled just to know he is alive. He seems to feel the same. Next comes the bilateral horrors of chemo and radiation.

Which brings us to my father.

My father’s father’s family hails from North Carolina. Not a cheerleader among them, they were a hardy breed of Quakers residing in the Piedmont region for three generations in the 18th century, before moving on to Tennessee in the early part of the 19th. The Quaker thing stuck with the family well into the 20th century: My father was raised in the Quaker tradition.

Despite a childhood spent enduring silent meetings, and some pretty strict social codes, he survived to tell the merry tale and used his upbringing to synthesize his beloved 11th Commandment: Thou shalt live. No matter the pain, suffering, the sorrow or loss, the difficulties, disappointments or despair, Thou shalt live.

My father came to his 11th Commandment the hard way. Losing his father at the age of 5, and his childhood to the depression when the farm was taken by the Bank of Italy, serving in World War II as a medical officer in the Pacific, then surviving Hepatitis and Polio – and all of that before he was even 30.

Forty years later, after a long career in medicine, he contracted bladder cancer, which metastasized into liver cancer, lived for several years with a urostomy, and finally died at the age of 78.

Yet throughout all of that, he followed his own 11th Commandment: Thou shalt live. No matter the pain, suffering, loss or despair, Thou shalt live. And he did, until nature took its course.

And that’s exactly what the nephew is doing this week here in California. He is fully aware of his prognosis, the pain and suffering of this week’s surgery, and the agonies of next month’s chemo and radiation. Yet somehow he is finding the strength to live on, for the sake of his family, his wife, his children, and the community that loves them all.

And it’s that strength of character, that faith in the profound goodness of life, that the conference attendees in North Carolina could not take into account in predicting the outcome of this week’s surgery, or the future of cancer therapies.

Neither the science of tissue regeneration nor targeted chemo, protein synthesis or genetic mapping, can account for this will to live, or the magic of computer science, artificial intelligence or machine learning.

None of these disciplines, however visionary or inspiring, can quantize the strength of the human spirit. That phenomenal ability to survive, to show profoundly indescribable loyalty to family and friends, a fierce intention to obey the 11th Commandment.

Ironically, it’s the North Carolina Quakers of the 18th century, not the 21st-century visitors to that beautiful state, who probably best understood the mystery of what our family has witnessed this week. The nephew today is broken in body, but strong in the face of his certain fate. ‘Thou shalt live’ is dramatically and poignantly his rule and watchword.

The 11th Commandment is more than a legacy idea that my father left behind. It is a truth that exceeds all science. It is, and always will be, that by which we define the courage of our humanity, yesterday, today, and far off into the future.


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