
Our unrealistic views of death, through a doctor’s eyes - llambda
http://www.washingtonpost.com/opinions/our-unrealistic-views-of-death-through-a-doctors-eyes/2012/01/31/gIQAeaHpJR_story.html
======
coolestuk
"At a certain stage of life, aggressive medical treatment can become
sanctioned torture. "

I just went through a month with a 90 year old friend whose life ended almost
exactly like the story in that story. He had one lucid 30 mins when I was
there and his family was there (he had been a general physician for almost 50
years). In his brief period when he had the energy to try and communicate
whilst almost totally paralysed, it was clear he was telling the attending
doctor that he wanted them to stop all medication and let him die. His own
family could not face that fact, and said they'd ask him again the following
day (unfortunately the cowardly doctor backed them up on this). He was never
again lucid or strong enough to insist that treatment be stopped. He lived for
another 10 days, struggling to breathe, almost totally paralysed, unable to
control his bowels.

This was a man who when I last went on holiday with him at the age of 85, he
insisted on carrying his own suitcase and refused a wheelchair, even though he
had trouble walking and had blood pressure and angina problems.

I don't blame his family not being able to make that decision (it's so hard to
let go of someone one loves). But his last weeks were undoubtedly torture, and
they know they refused to follow his wishes. It was just terribly sad and an
awful dilemma.

I was really glad of something else I read on HN about 6 months ago, where a
doctor had a brain tumouur (or something like that) and instead of treatment,
he lived out the remainder of his life doing the things he loved. I think that
idea was what meant I could come to terms with the need to respect my friend's
last wishes. I just could not convince his family.

~~~
wpietri
I encourage everybody to talk things like this through with their family.

Last year my mom was diagnosed with a terminal brain tumor. She elected to
pursue treatment vigorously, but brain tumors being what they are, there were
a number of points where she was unable to answer questions about her wishes.

At every one of those points we knew what she wanted because we had discussed
it extensively before. I was incredibly grateful for that. It is bad enough to
have to make complicated, life-or-death decisions for someone you love. I
cannot imagine the horror of trying to do that without a clear understanding
of what they would want.

Please talk with your family about this. Right now if possible. Just forward
your sibling, parent, or child this article and tell them it made you think.
Then tell them what you'd want. Don't just think you'll do it "later"; the
right time will never come on its own.

~~~
lemming
This is great advice, thank you. Despite both of my parents and one of my
siblings having had brushes with cancer (thankfully that resulted in nothing),
this is all too easy to ignore.

------
bradleyland
At first, I was confused by this statement, given the data..

> "...modern medicine may be doing more to complicate the end of life than to
> prolong or improve it"
    
    
        1900  
        65 -> +12  
        85 -> +4
    
        2007  
        65 -> +19  
        85 -> +6
    

The engineer in me said, but we've improved! But then I realized that
evaluating life by measuring in years is like reviewing tech products by
looking at spec sheets.

"But it has more megapixels!? Aren't megapixels what we want?"

Reality is far more subtle.

~~~
SkyMarshal
Gotta consider cost. If the marginal cost per megapixel is a million dollars,
then maybe a few extra aren't so worth it.

~~~
jbjohns
Forget cost. The important question is quality. In cameras, extra megapixels
can mean the sensor sites are so small that they have a harder time
distinguishing electronic noise from actual light, leading to worse pictures.
Likewise, what good is getting me 10 more years if I can't do anything with
them because they're spent in total agony.

------
mistercow
> our culture has come to view death as a medical failure rather than life’s
> natural conclusion.

Death _is_ a medical failure, just like our inability to cure herpes is a
medical failure. That there's no way to overcome the failure yet does not
imply that it is not a failure.

~~~
wpietri
_Death is a medical failure_

No. A thousand times no. Death is part of life. All composite things decay.

Imagine a kindergartener on an ocean beach. They spend hours building a sand
castle. They wail as the tide claims it, feeling the sting of failure. Do you
agree, telling them that they screwed up in their construction?

I say no. The error isn't in the building, it's in expecting the castle to
last through high tide.

For the skeptical, I'd encourage you to watch this documentary:
<http://www.imdb.com/title/tt0307385/> It really solidified my view that the
transitory nature of all things makes them more beautiful, more poignant.

~~~
jbjohns
I hate this view so much. How are we better off not having people like Tesla,
Newton, Einstein, etc. anymore? They had to give way so we could have
Dragonball Z and reality TV? The notion that we gain something by people dying
is beyond nonsensical.

The only benefit death will bring is when everyone who has this ridiculous
view point is gone and out of the way.

~~~
kls
Well if we want to take it to it's extreme end, death is a certainty. At some
point all nature will decay and the universe and all energy will stop, it will
all be used up. Nature will be used up and gone, barring the supernatural we
will be too, so at that point even if we become naturally immortal we will
die, because nature and more importantly energy will be no more. At this point
Tesla, Newton et. al. will not matter, not a thing will matter, because the
universe will be dead. So if we die in 85 years or x billion of years the
final result is the same. Death is part of life and at some point even our
contributions, no matter how great they are will be of no value. The old
wisdom nothing last forever is true.

~~~
jbjohns
Personally I chose to ignore this point of view as it would imply that
absolutely everything is completely without a point. What's the value in
following such a line of thinking?

~~~
wpietri
Why? Because one eventually realizes that your conclusion here is incorrect.
You have constructed "meaning" as a very particular thing here. There are
other ways to see meaning in the world.

And also because it's true. The best science we have tells us that everything
decays in the end. If you're going to start ignoring facts just because you
don't like them, where do you stop?

~~~
jbjohns
>Because one eventually realizes that your conclusion here is incorrect. You
have constructed "meaning" as a very particular thing here. There are other
ways to see meaning in the world.

But what you're describing sees no meaning in anything ever. Simply because
you can say that eventually the sun will burn out and we'll all die anyway
doesn't mean we shouldn't try to make things as good as we can while we are
here.

>If you're going to start ignoring facts just because you don't like them,
where do you stop?

No, I'm ignoring facts that have no relevance or no useful action to take. If
everything is going to end in a trillion years, what should I do about that
exactly? Does that mean I should try to cure aging _now_?

Do you have a job? Why, the universe will end in some billions of years. Oh,
you want to have as nice a life as you can while you are here? So do I.

~~~
wpietri
You've got me wrong. I agree entirely that we must make the most of what we
have. Which is why I think it's important to face the inevitability of death.
If you aren't realistic about what you have, you can't make the best use of
it.

Which is exactly what this article illustrates. Death comes for us all, and
not facing that yields waste and suffering. Not in some abstract sense,
either. As the author writes, "At a certain stage of life, aggressive medical
treatment can become sanctioned torture." And the amount spent on futile end-
of-life care is staggering.

~~~
jbjohns
I think you have me wrong as well. I'm not for making deteriorating 90-year-
olds suffer in bed for another 10 years to bump some stats. I'm talking about
eliminating aging and natural death.

As things stand today, of course it doesn't make sense to hang on when you're
only going to get a few more years of agony. But more research could be done
in eliminating the effects of aging, etc. We've already lost many great minds
but if we can stop this trend or even slow it down then it's worth persuing.

------
polyfractal
Two poignant quotes from the article really stood out to me:

 _"When their loved one does die, family members can tell themselves, “We did
everything we could for Mom.” In my experience, this is a stronger inclination
than the equally valid (and perhaps more honest) admission that “we sure put
Dad through the wringer those last few months.”"_

 _"A retired nurse once wrote to me: “I am so glad I don’t have to hurt old
people any more.”"_

Makes you stop and think about how we treat end-of-life situations.

~~~
joering2
I think your timing is plausible, given what we can do now and 15 years ago. I
cant remember how astonished I was when I saw this! [1]

25 years to re-print entire human body without cancer cells, tumors, perhaps
without fat and boldness as well? :)

[1] <http://www.youtube.com/watch?v=9RMx31GnNXY>

~~~
barefoot
That TED talk was amazing. Thanks.

~~~
joering2
sure, no problem, although I dont recall when, but I stumbled upon it on HN as
well :)

------
Alex3917
I think the fundamental misunderstanding is that most people think that people
die from diseases, but in reality it's much closer to the other way around;
people get diseases when they are about to die. Even if we had the cure to
every single cancer the average life expectancy would only go up by about 3
years, because most cancer patients would just die from something else anyway.

~~~
JulianMorrison
True but overly defeatist. Fixing one problem would not solve things. Fixing
several problems (cancer, intra-cellular junk, extra-cellular junk, etc etc,
Google "SENS" for a suggested list) would actually cure death from ageing - or
at minimum, would reveal what other problems we would also need to solve.
People get sick because they are damaged, and they are damaged because they
are old, but the damage is in principle something that can be repaired.

------
scott_s
Related article from a few months ago, "How Doctors Die":
<https://news.ycombinator.com/item?id=3313570>

~~~
lunarscape
I wish more people read things like this.

"I cannot count the number of times fellow physicians have told me, in words
that vary only slightly, “Promise me if you find me like this that you’ll kill
me.”"

I have a parent who's a medical professional and their response was _exactly_
the same. On a related note I wonder if support for euthanasia is higher among
those who work in medicine.

------
kiba
We shouldn't inflict unnecessary pain and suffering but we must fight death
and continue medical research for the future generation of elders so that they
will be able to see their great-great-great grandchildren and beyond and be
healthy at the same time.

~~~
gnu8
Why?

~~~
sliverstorm
Agreed, where does this "must" come from?

~~~
kiba
Death is wrong.

~~~
gnu8
It's not though, death is natural and inevitable. There are also practical
considerations: if death is eliminated, we must stop reproduction too.

~~~
kiba
_It's not though, death is natural and inevitable_

You committed the naturalistic fallacy. Also, inevitability isn't a
justification for bad things happening.

 _There are also practical considerations: if death is eliminated, we must
stop reproduction too._

I would prioritize existing lives over the yet to be born.

~~~
rayiner
> I would prioritize existing lives over the yet to be born.

From an evolutionary point of view that makes very little sense.

~~~
gnaritas
Evolution has no desire to make sense, it's a blind natural process with no
intent or point of view. From a human point of view, what he said makes
perfect sense.

~~~
loup-vaillant
Plus, that is again a naturalistic fallacy.

------
lizzard
When I am clearly near death I would prefer pain relief and hospice-style care
at home rather than extreme intervention. And yet, as a wheelchair user (on
and off) for the last 20 years and a person in constant pain, I've had people
tell me to my face they'd rather be dead than be "disabled". I would like to
at least mention the importance of listening to people with disabilities on
this issue. Because of societal prejudice against people with disabilities,
often people's judgement is that we would be better off dead than suffering or
impaired. When a disabled person is depressed or suicidal, they are encouraged
to die by fans of the likes of Peter Singer or Kevorkian, rather than treated
for depression, and helped to have the medical and personal care, and societal
infrastructure, that might improve their enjoyment of life.

So, please keep this in mind and perhaps read up on the complexity of the
issues -- from the perspectives of disability rights activists as well as
doctors or the caretakers of people who are extremely ill. Our slogan is
"nothing about us without us" and yet unfortunately, this article is only from
the perspectives of caretakers.

------
rdl
If I were in medicine, I'd sure rather be working on trauma on a healthy
patient population (soldiers, young adults, etc.) than illnesses of the
elderly or already sick -- vastly simpler, sort of like developing new
software (even if it is doing something difficult) vs. working in a complex
legacy system with no documentation and lots of hidden mines.

~~~
Someone
Are you sure you have a realistic view of working on trauma, especially with
soldiers, in the current era? The combination of modern bulletproof helmets
and clothing with the almost immediate availability of good medical care allow
the survival of some horrendously wounded people for whom we can do a lot, but
not, by far, enough. For example, a soldier can loose al his limbs due to a
IED, be burnt over large parts of the rest of his body, and survive.

I think I would rather work with elderly people even if comfort is almost all
we can give them.

Also, if you went into the field, I bet your educators would try to get you
change your opinion. Everybody wants the glamorous job, but most employment is
elsewhere. I have heard this phrased as "all the girls want to work with
children, and all the boys want to work in ambulances; we need to work a bit
to change their minds."

~~~
rdl
Yes. I worked in US military hospitals in Iraq and Afghanistan from 2008-2010,
as well as spending some time in them in 2003-2007. I also spent a fair bit of
time in third world clinics (in North Africa, Middle East, Southwest Asia, and
also Iraq/Afghanistan), where the main care was for sickness or maternity,
including working with NGOs.

The US hospitals also had plenty of local nationals coming in, either due to
trauma, or due to illness. I also got to go out with some teams (i.e. the
"other" people) when they did medical outreach. A few of my friends are Army
SF medics, I lived with an Air Ambulance company for most of 2005, and dated a
(non-US, coalition partner) doctor for a few months. I did combat lifesaver
and some other advanced first aid stuff, and dive medic. I did get to help out
with trauma a fair bit, and I've been first responder at a bunch of traffic
accidents worldwide.

Actually, neuroradiology would be my #1 pick (I hate being around conscious
patients, and even talking to people who talk to conscious patients is bad. A
rad at least talks to other specialists, and a neurorad is going to talk to
specialists (rads, neurosurgeons) who talk to other specialists (surgeons,
oncologists) who talk to normal doctors who talk to patients, so you're pretty
far removed. ER docs are kind of looked down on by other doctors (for
basically being stream of consciousness, get them in, patch them up, pass them
along), but trauma surgeons are well respected. There's clearly a lot of money
in gerontology, and demand for internal medicine (although badly paid, and
often in crappy parts of the country), but I'd hate those things.

However, I'm doing a non-medical startup, and going to med school seems very
unlikely to be in my future.

------
InclinedPlane
These sorts of things strike me as a bit off. One of the problems of being a
doctor, much like being a police officer, is that you tend to get exposed to
the worst experiences. Good folks may have the occasional run-in. With police
but by far the bulk of encounters a police officer has will be with the worst
parts of humanity, again and again. Which can lead them to become jaded,
depressed, etc.

The same sort of dynamics play out with doctors too. People who get better
stop spending time in the hospital, and stop being seen by doctors so often.
This can lead doctors to a false view of late stage medical care. They see
every moment of the pain and suffering, the struggling that turns out to be in
vain, the sheer cost of heroic measures, but they often miss out on seeing the
benefits. The time given back to patients who then spend happy years with
their family away from hospitals and doctors.

------
philwelch
I watched my father die last year, and I'm thankful I did the dignified thing
and let him go when he was obviously at the end. The metaphor of "checkmate"
is quite apt--once you're old enough and you've developed enough problems,
every plausible means of escape from one problem is blocked by the next.

If you don't want to spend your last days being tortured to death in a
hospital, tell someone you love and trust and write up the legal documents
necessary to enforce that decision. It's an incredibly hard decision to make
though, and it's sad that not everyone has someone they can trust to make that
decision. My dad was lucky to have an only child who followed his wishes. I
can't imagine what it would be like to have some hysterical sibling try to
undermine my dad's wishes, but that's what a lot of families go through.

------
jdavid
This is one of the reasons I find it hard to talk to my mother. She is
beholden to grief about her father and is doing everything to prolong the life
of my grandmother even though she can't walk, needs help eating, and
constantly falls asleep. On top of that she hardly knows who is around her.
it's sad.

Watching how my parents have dealt with my aging parents really puts pause on
me and has me thinking about creating a living Will to make my own wishes very
clear.

------
michaelbuckbee
My uncle recently passed away (pancreatic cancer) and the people from Hospice
were all amazing in helping him and the family.

To my mind they embody the different way of handling end of life issues than
standard medical treatment.

------
evo_9
Well worth reading and really considering before people assume 'death' is a
fact of life:

<http://www.nickbostrom.com/fable/dragon.html>

------
srean
I went straight to the HN discussion rather than the WP page and on my way was
thinking to myself, hope some one brings up the issue of "right to die". To my
pleasant surprise that is the central topic of the discussion.

Many have argued for prolonging the life span of humans to the point of
immortality. Its a thought provoking idea to entertain. One comment ponders
rhetorically, wouldn't it be nice to have Einstein and Tesla around.

Not only am I ok with right to die, I absolutely covet it. Not just for myself
but the entire society. I am not so sure about "right to life", though it
might seem such a no-brainer,

Though we use the word "right" they are often privileges and the important
question to think over is who gets to exercise the privileges. That is never
uniform, it always comes down to who has the wherewithal to secure that
privilege. It is this that causes me to worry.

Sure it would be great to have Socrates and Einstein with us if they chose to,
we don't know if they would have. Many assholes would, but more seriously, one
can conjecture that the dictators who were not defeated but died naturally
would probably choose to live. World history would be a lot different. Would
authoritarian regimes live longer ? Difficult to answer.

Then there is the question of ideas. Ideas, both good and bad, they often die
not because better ideas replace them, but because their champions die. I
don't know whether this is an argument in favor of or against prolonging life,
but the need to discuss it will only become more urgent over the years.

------
crag
When we are born, nature promises us nothing except death. It's just that
simple.

It's unfortunate we've surrounded it with so much fear.

Our ideas on death must change. Cause frankly, it's killing us. Death is the
natural order.

I heard a great line from one of the few TV shows i watch, Supernatural;

"Who came first? The chicken or the egg? We're too old to remember. But I know
this, I'll reap god too". - the aspect of Death.

------
luser001
For a book length treatment of this topic, see "How we Die", one of the most
amazing books I've read.

[http://www.amazon.com/How-We-Die-Reflections-
Chapter/dp/0679...](http://www.amazon.com/How-We-Die-Reflections-
Chapter/dp/0679742441)

------
ern
The article seems to be part of a trend where people are made aware of the
value of letting go, rather than engaging in futile medical care.

However, before making end of life decisions, one should be aware that there
is a large and growing hospice industry that benefits from people "giving up"
(sometimes leading to greater suffering, as treatable conditions go
untreated), and weigh one's decisions carefully:
[http://www.businessweek.com/news/2011-12-06/aunt-midge-
not-d...](http://www.businessweek.com/news/2011-12-06/aunt-midge-not-dying-in-
hospice-reveals-14-billion-u-s-market.html)

------
jtothapreston
I think this underestimates our most primal of instincts, survival. Those
people who died at 48 a century ago had no less want or determination to live
longer, than did those who die today at 78. In those times, their options were
extremely limited, so as a culture, our norms prepared them better to accept
death. Nowadays we have many options, and modern medicine has become the
ultimate tool of our survival. Yet another profound ability that separates us
from other animals.

------
charlieok
"According to the Centers for Disease Control and Prevention, a person who
made it to 65 in 1900 could expect to live an average of 12 more years; if she
made it to 85, she could expect to go another fouryears. In 2007, a 65-year-
old American could expect to live, on average, another 19 years; if he made it
to 85, he could expect to go another six years."

I get that gender neutral language like this is the norm these days, but the
way it's used in this particular statement, it isn't helping!

------
lunarscape
This brings to mind the following article, in which doctors place greater
emphasis on quality of life when making decisions themselves: Physicians
Recommend Different Treatments for Patients Than They Choose for Themselves,
Study Finds,
[http://www.sciencedaily.com/releases/2011/04/110411163904.ht...](http://www.sciencedaily.com/releases/2011/04/110411163904.htm)

------
danbmil99
> very few elderly patients are lucky enough to die in their sleep.

That doesn't have to be a matter of luck. If we allowed people the dignity to
choose, while still lucid, to end their life, or to set up a strict set of
conditions upon which their life will end, we could drastically reduce the
suffering involved in death, both for the dying and for their families and
friends.

------
martinklein
My comment on article was deleted by washingtonpost moderator.

[someone] 2/18/2012 9:16 PM GMT+0100 [Implying they removed a feeding tube]

My response:

You didn't feed him? He died of starvation? That could be painful. You should
kill him using exit-bag with helium gas. I'm being serious.

My response was replaced with:

postmoderator responds:

This comment has been deleted by a moderator for violating the site's
discussion policy.

------
rayiner
I think one of the things he mentions, people not living with their elderly
parents, is responsible for a lot of our bizarre attitudes towards old age and
death. How much of the "just a couple of more years" attitude is to help
assuage the guilt of ignoring the person for the last 10-20 years of their
lives?

~~~
arnoldwh
I agree. You try to do everything because you realize you've done so little
during the time you've had.

I guess that's the normal way of being though. It seems like it is every
child's fate to not appreciate their parents enough until it is too late, and
to repeat this same cycle when they have children of their own.

------
ilaksh
This all sounds reasonable to many people.

Unfortunately, the motivation for these kinds of testimonials is not sentiment
or reasonableness. Its profit. Its just not profitable for health insurance
companies to treat old people -- that's where they lose all of their money.

~~~
dennisgorelik
I don't think insurance companies care much one way or another. If people
prefer to prolong their life as long as possible, then insurance companies
would just increase premium payments and pay for these procedures.

------
lizzard
For more on death and disability and "right to die" issues, here's a great
post by Bad Cripple.

[http://badcripple.blogspot.com/2012/02/mainstream-media-
disc...](http://badcripple.blogspot.com/2012/02/mainstream-media-discovers-
christina.html)

------
javajosh
Yes. Now what doctors need is an effective, compassionate way to communicate
the simple fact that we need to let old people die. Here's one way:

A family brings an elderly patient suffering from stroke, diabetes, etc. into
the ER. The patient is in a coma. Before asking them what they want to do,
take the family into the NICU and tell them: we have limited resources, and we
can either save a baby in here, giving him a chance for a healthy productive
life, or we can perform heroic measures on your loved one, almost certainly
doing nothing but prolonging his suffering. What is your choice?

~~~
wpietri
Having recently been an advocate for an elderly patient with severe medical
problems, I can say with confidence that this is a terrible idea twice over.
Not only would it not work well, but it's also so lacking in compassion as to
be horrific.

The time to educate people on these choices is years before you have to make
them. The solution isn't to take people thrust into tragedy and threaten to
kill babies if they don't do the "right" thing. It's to change our culture
such that people consider these hard choices much earlier and life, and feel
comfortable discussing these issues with their families.

~~~
javajosh
What I'm trying to get at is that doctors need some sort of tools to help
explain the situation to their patients and their patient's families. It
doesn't have to be my suggestion, but some way of making the twin points that:
a) prolonging life at any cost is not compassionate to the patient, and b)
prolonging life at any cost is not compassionate to people who actually can be
healed to go live a happy remainder of their life.

------
joelrunyon
_Honest Question_

If we all lived forever, where would we put all the people?

~~~
orangecat
Space. Maybe silicon.

------
jdavid
Ray Kurzweil should read this article.

------
ThaddeusQuay2
This reminds me of Percy Bridgman, whose work with high pressure got him a
Nobel Prize in physics, and which led to the creation of synthetic diamonds at
GE.

"Bridgman committed suicide by gunshot [at age 79] after living with
metastatic cancer for some time. His suicide note read in part, "It isn't
decent for society to make a man do this thing himself. Probably this is the
last day I will be able to do it myself." Bridgman's words have been quoted by
many on both sides of the assisted suicide debate."

<http://en.wikipedia.org/wiki/Percy_Williams_Bridgman#Death>

[http://en.wikipedia.org/wiki/Synthetic_diamond#GE_diamond_pr...](http://en.wikipedia.org/wiki/Synthetic_diamond#GE_diamond_project)

EDIT: I forgot to end with: Mr. SENS, FTW.

<http://en.wikipedia.org/wiki/Aubrey_de_Grey>

------
berntb
I haven't studied medicin, but have a smattering of chemistry so I follow the
subject a bit.

The article miss the probably most interesting aspect.

In fifteen years, there will almost certainly be organs grown from stem cells,
which allows transplants without immunity problems.

What would happen to the first example in the article when the hearth and
kidneys are replaced? When growth factors and (more or less) young stem cells
start repairing the brain damage and the Parkinsons?

It might take twenty years. It will still be in time for most people on HN
when you grow old.

Anyway, it is probably only of academic interest to me (old health problems
will probably get me).

~~~
polyfractal
Edit: _I don't think everyone should be downvoting the parent. It's a logical
statement from someone outside the field - you see "organs grown in XYZ lab!"
all the time in the press._

As a biologist, I can tell you that home-grown organs are waaay more than 15
years away.

Currently, we can grow skin pretty well. Mostly because skin likes to grow and
is _very_ simple in structure. We are making progress on growing liver tissue,
again because liver cells are particularly robust and the liver is not a
strongly organized tissue. It is (mostly) a big blog of heterogeneous cells
that does not require complicated geometry and organization.

Anything past those two are wishful thoughts. I'm not discounting the advances
that we have made in growing organs. We've done some very cool work, but it is
certainly a long way away. Once the basic science is established, it will
still take a long time to get widespread medical approval.

Re: "repairing" the brain makes growing an organ look trivial. The difference
is like building a house vs repairing CERN's LHC.

~~~
joering2
interesting. can you explain bit more why repairing brain would be that
complicated (asked by someone that never touched biology [me])

side note: your Cloudera job post has cudazi tags visible.

~~~
polyfractal
Sure. With a lot of organs, the function is a relatively mundane process. The
heart pumps. The liver filters. The skin grows and dies and grows some more.
This simplifies things a bit.

The challenge is to get all the right cells in the right places. Heart cells
need to be arranged specifically so that the heart can pump. Wikipedia has a
good animated gif of how the conduction wave flows through the heart [1].

Fortunately, this is a surmountable challenge. You can throw progenitor cells
into a pre-built scaffold and they tend to organize like they should. This is
because most organs in your body are built of relatively interchangeable
parts. E.g. Most of your heart is the same kind of muscle cell.

The brain is a bit different. First, the type of damage is very dependent on
the disease state. Have we lost entire neurons? What regions are affected? Are
our neurons de-mylenating?

Second, your brain is unique to you. Sure, we both share stereotyped
architecture: we both have a hippocampus, a cerebral cortex, a cerebellum, etc
etc. The structure inside each region is pretty stereotyped too - we both have
cortical bundles in our neocortex.

But when you drill down to the cellular level, we are very, very different.
Each neuron I possess in my brain has a unique (and dynamic) synaptic arbor
that connects to thousands of other, unique neurons.

If I suffer a stroke and a portion of my brain dies, you can't simply throw
more neurons in to compensate. Effectively, neurons are not interchangeable
parts like heart muscle cells. You need to coax those neurons to:

A) live in relatively hostile environment

B) synapse to appropriate neuronal populations

C) weight those synapses correctly.

[1]<http://en.wikipedia.org/wiki/File:ECG_Principle_fast.gif>

Side note: Thanks for the heads-up on the Cloudera post - I just migrated
themes and servers last night :)

~~~
loup-vaillant
(I'm a programmer, I know little about biology)

Another way to look at it is the information theoretic perspective: when organ
X is damaged? what information do you need to grow it back? If X is anything
but the brain (and maybe part of the spine), the information you need can
almost always be picked from somewhere else (Stem cells plus standard human
anatomy). We can't do that now, but in principle it should work.

But if you lose part of your brain, then it's a tougher challenge, because
your personal memories, skills and more are stored in it. The only way to
recover _that_ would be to use the redundancy your brain _might_ feature.
Otherwise, it's lost. Sometimes, you cannot recover a code from a burned piece
of paper.

Now, if your brain just suffers a terminal illness, but the information is
still there, then healing you may be as difficult as copying your whole soul
into a computer, synapse per synapse. (Or it may not: we do have way to slow
down —not heal— Parkinson, for instance.)

~~~
stan_rogers
That's exactly the sort of thing I'm coping with right now. The best currently
available treatments can only mask and slow the progression of symptoms; the
only really effective therapy at the moment is to try to build redundancy into
the system at a rate approaching the loss of "primary storage". That includes
nutrition, aerobic exercise (which, admittedly, looks a little bit silly when
performed by someone who has difficulty controlling his limbs and maintaining
posture) and keeping the ol' mind as active as it can be. That's hard, too --
it is very easy to let frustration overcome you and decide to lie down and
die. But as long as there's a life worth living after the grunt work, it's
something I'll keep on doing.

That said, I'm not holding on to life for its own sake. At some point I will
either become incapable of any real physical activity OR too stupid to live.
I've gotten a little taste of both when I've needed to get a baseline
reassessment of my condition (which is not a typical presentation of anything,
but seems to be more like Parkinson's than anything else on the menu). It's a
bit of a race, really. I'm hoping that stupid wins, and that when it happens I
do something so spectacularly stupid on the way out that it will make the news
the world over (and perhaps win me a Darwin award).

------
Craiggybear
I think just because you _can_ do something to prolong someone's life, there
used to be a time when a good doctor knew this didn't automatically mean you
_should_.

I know my grandparents didn't fear or refuse to believe in death in the same
way as people do now (and they had seen a _lot_ of it). I hope I'm strong
enough and happy enough with myself that I will gladly relinquish my hold on
the reins of life when its properly time to do so, and not fear it or be sad.

------
hendrix
There is no such thing as 'aging' in the traditional sense. As explained by
Aubrey De Grey Sens' founder "the set of accumulated side effects from
metabolism that eventually kills us"
[http://en.wikipedia.org/wiki/Strategies_for_Engineered_Negli...](http://en.wikipedia.org/wiki/Strategies_for_Engineered_Negligible_Senescence)
sens.org

It might not work but it is a _much_ better use of our tax dollars than
blowing up brown people in the middle east.

------
taf2
i knew at 31 i should start feeling old... so 47 is the end, that means i have
16 good years left in me... here's to enjoying it and making something great
of it... cheers!

------
delinquentme
TLDR:

We all are afraid of death and the reason humans invented religion was to cope
with this fear.

If you're going to downvote...

Instead say something so we can discuss!

