Saturday, May 6, 2017

An Apparently Controversial Opinion About Cancer

Tomorrow is my 31st birthday, and I'm blessed with incredible health.  Which makes this a fitting time to make a statement that I feel needs to be said about my mortality.  I believe that it is most likely that when I die, it will be due to cancer.  And furthermore, I don't consider this a bad thing.

I went to a doctor for a general checkup last week, and asked to get my genome screened or sequenced in order to assess what hereditary diseases I'm at elevated risk for.  The doctor told me I was about five years early and that it wasn't an affordable or covered service yet, so I guess I'll just have to wait.  When I mentioned that I was fairly confident I'd die of cancer, she was taken aback.  "Why would you say that?" she asked.  Her tone was respectfully professional but without an effort to hide her disapproval that I would prognosticate my own cause of death.  Did she think I was being disrespectful to people with cancer?  Did she think I was being offensive in a general social sense by appearing to mock death?  I'm not entirely sure, but my Mom once gave me a similar reaction when I said the same thing a few years ago, and I recall Julie afterwards chastising me for what she thought was a tasteless thing to say to my mother.  I could imagine that part of the taboo might be that I look like a smug, over-confident prick by announcing that I believe I know what is considered one of life's great unknowables.

I don't understand why my relationship with my mortality reflects badly on me, but I know that it does and I know that not knowing why it does reflects badly on me as well.  If anyone wants to respectfully explain it, I'll listen and I'll probably act on your advice.  But for the record, this isn't a glib, thoughtless statement.

In the US in 2010, roughly 6 million of the 24 million people who died lost their lives to cancer.  Which means that just by sheer chance, I have roughly a 1 in 4 chance of dying of cancer, if I were to have expired in 2010.  So would you.

Additionally, my father died of cancer several years ago.  His sister has fought cancer successfully.  Their mother died of cancer when I was young.  So after he died, in the process of reflecting, it occurred to me: I'm a machine built on the same production line as those people.  And apparently that's a defect that happens to have been seen in that production line.

This by no means rules out the possibility of other deaths.  But consider the next likely causes.


Right alongside cancer is heart disease.  So if I didn't think further, I could make a similar prediction about the likelihood that when I go, it will be due to heart failure.  But diseases aren't random.  My family tree happens to be thin in suffers of heart disease.  Furthermore, risk of heart disease -- like cancer -- is the result of both genetics and lifestyle.  Consider this figure from the American Health Economy:


Heart disease is so prevalent because many people who lived through the last few decades ate poorly, didn't exercise, and smoked.  I've fallen out of the habit of flossing, but I take pretty good care of my body.  At the same time, my career exposes me to more chemicals and radiation sources than most people.  So we start with 25% and then bump it up for the greater likelihood relative to the next likely cause.  We can repeat this process with Lower Respiratory Diseases, just because I don't happen to work in mining or construction and my family has had good fortune with lung health.  Stroke and Alzheimer's are pretty much unchanged.  They're notoriously unpredictable, so I'm at as much a chance as anyone.  For unintentional injury I'm slightly reduced in probability as well.  I'm active, but I wear a helmet and generally exercise caution.  Most importantly, I have prompt access to medical care, which is the biggest factor in predicting mortality of a car crash or a fall.

And then we get to Diabetes.  Which introduces an important new wrinkle.  Now, I'm not going to die of Diabetes, because the genetic version usually manifests in childhood and I don't consume enough sugar to get the dietary version.  But more importantly, that is a disease we're on our way to licking.  I'm not sure we'll ever cure it completely, but like HIV, diabetes is a disease we can treat well enough to let someone live out a natural lifespan.  Justice of the Supreme Court Sonya Sotomayor was told she would probably not make it to 40 when she was initially diagnosed with diabetes at seven.  She is now 58, and is expected to rule on the bench for years to come.  Based on long term projections, even insulin shots will likely become obsolete in my lifetime, as procedures to replace cells like those missing in diabetics appear entirely achievable.

Although not all the causes of death listed above will see as much progress as diabetes, it reminds us that we must consider the direction of medicine in order to predict a similar chart for the middle of our new century.  All of these will likely see some improvement.  It's possible some will see a spike due to a modern health risk we aren't aware of right now.  Ultimately, though, as I look at the state of medical research in 2017 and what we know about etiology of disease, I think neurological degeneration, cancer, and heart disease are things that we delay, but may not stave off forever.  Once people don't die of infection or war, these are the things that get you if you survive everything else.  Of these three, my closest pursuer is likely cancer.  Nothing is indestructible, and our bodies like all things will eventually wear out.  But in predicting that I will die of cancer, I am predicting that I will die of it well after 80, perhaps after dealing with it for several active decades.

I consider myself at reduced risk for most of the common causes of death.  I consider myself at elevated risk for one of the leading causes of death.  And I envision a future in which the disease I am most susceptible to is one we can manage very effectively.  So when I say that I believe I am most likely going to die of cancer, it is because I plan my life with the expectation that I'm going to live it very fucking well.  This is how I find comfort with my mortality.  This makes me feel more prepared and in control in the face of something I know I am ultimately powerless against.  One day I will pass away from this Earth.  Hopefully, if I am successful in my endeavors, I will do so contended, proud, and utterly stuffed from the feast of life.  And when this day comes, I think the specific cause listed on the medical report will, as a matter of trivia, be cancer.

And I'm fine with that.

Monday, May 1, 2017

The Fox Hunt

Three weeks ago, Julie and I went camping.  Twice each year, our friend Ann organizes a game in the forest called the Fox Hunt.  It's a bit like hide-and-seek.  Foxes are given a twenty minute head start to go hide in the woods, after which the hunters pursue them.  The foxes attempt to make it back to the base they left from without being tagged, however their trails are marked with surveying flags.

The dogs have gotten really good at camping

The result is surprisingly tense.  Both sides have huge advantages and disadvantages.  The foxes simply have to go into the woods and come back without running right into someone, which seems easy, however the woods we use lie in a valley carved by a stream, which funnels people back towards the middle and makes it hard to circle wide.  Eventually, you've got to come down from the sides to come back.  The hunters, meanwhile, just need to follow a brightly lit trail.  In practice, though, it isn't hard to make the flags deceive.  Foxes lay false trails into dead ends, and when you finally determine that the trail has terminated, you then need to retrace it looking for the fork.  It doesn't take much to slow a pursuing hunter down and then make a move back to base.

Not a morning person :(
I've been doing this each April and each October for about three years or so.  It's a great event.  Julie and I arrive the night before to camp out, and after the game is over, we all hold a big potluck picnic.  It's become an event by which I track the year.  This year was an especially momentous occasion.


Julie broke her leg in a motorcycle accident on April 13 of 2016.  She was in the hospital for two weeks, and when she got out she insisted on driving up to Ojai despite the fact that just getting out of bed was hard.  It was worth it, though.  She got so much out of the fresh air and our friends' reactions.  When they saw Julie out and about despite the leg they all were overjoyed.

A year later, Julie attended on her own two feet.  Not only that, but she caught a fox.  I was with the fox, laying flags.  Typically, foxes have a handler who lays flags so the fox can focus on strategy and isn't relied upon to make a decision regarding how far a distance between flags is allowed (they must be visible from one to the next).  This meant that I was there when Julie emerged to surprise us far out in the brush.  This meant following a trail that cut through brambles, army crawled under sage, and descended from treacherous heights.  I'd assumed that she'd stay near the stream because of her leg.  And yet, she'd tracked us with expert precision along our punishing route, anticipated our heading, and stealthily gotten the drop on us.  I couldn't be more impressed.

It's been a good year.  I hope May is as much fun as April was.


Friday, April 28, 2017

Wishlist

Because I've been asked what I might like for my birthday, I made the following list of ROV parts which would make reasonable presents:




If you purchase anything, please mark it in the sheet as purchased to avoid redundant purchases.

Sunday, April 9, 2017

Here are the Brave Leaders Resisting the March to War

Sadly, as Glenn Greenwald points out, "...nothing unites people behind the leader more quickly, reflexively or reliably than war."  Unfortunately, most Republicans as well as many Democrats -- including Senate minority leader Chuck Schumer and House minority leader Nanci Pelosi -- have stated their support of Trump starting a war with a country allied with another nuclear superpower.  According to FiveThirtyEight.com's Perry Bacon, "Most Senators Support Trump's Syria Airstrike".  He provides a list, stating that only six senators have come out vocally against Trump's strike.  His list is very incomplete, but it's a good place to start.  Here are the leaders who actually learned something from our disastrous wars in Iraq and Afghanistan.  Please lend your support to these individuals and message me we with any I'm missing at andrew@shrad.org.

Senators

Kamala Harris - Senator of California


Chris Murphy - Senator of Connecticut 


Rand Paul - Senator of Kentucky

"...actions often have consequences well beyond the obvious.  It is for this very reason that the Founders wanted a deliberate, thoughtful foreign policy, and when military action was needed, they wanted it debated and authorized by Congress."

Bernie Sanders - Senator of Vermont

“If there’s anything we should’ve learned from the wars in Iraq and Afghanistan, in which the lives of thousands of brave American men and women and hundreds of thousands of Iraqi and Afghan civilians have been lost and trillions of dollars spent, it’s that it’s easier to get into a war than get out of one. I’m deeply concerned that these strikes could lead to the United States once again being dragged back into the quagmire of long-term military engagement in the Middle East. If the last 15 years have shown anything, it’s that such engagements are disastrous for American security, for the American economy and for the American people."

Brian Schatz - Senator of Hawaii

"The Assad regime’s use of chemical weapons is abhorrent, but a military response is not the answer. ... A one-off strike may satisfy our desire to hold Assad accountable but it risks deeper escalation without any sense of direction or objective... The United States must focus on leading a diplomatic effort among our partners and allies in the region to achieve a political solution that results in a post-Assad Syrian government that brings stability to the region."

Tom Udall - Senator of New Mexico

"We're heading rapidly toward another Middle East war with no strategy, no clear time frame or cost, and no authorization from Congress."

House Representatives


Keith Ellison - Representative from Minnesota

Raul Grijalva - Representative from Arizona

Mark Pocan - Representative from Wisconsin  (jointly, as leaders of the progressive caucus)

“In the absence of an imminent threat to the United States, the president must seek Congressional authorization prior to any act of war. ... These unauthorized attacks could pull the United States into a regional war and escalate this unprecedented humanitarian crisis."

"March to war in #Syria without a strategy is both dangerous and ILLEGAL. #Trump cannot go to war against #Assad w/o congressional approval."

Honorable Mention: Tim Kaine, for recognizing Trump's actions as unconstitutional, despite his misguided embrace of military action against Assad

“Assad is a brutal dictator who must be held accountable for his actions. But President Trump has launched a military strike against Syria without a vote of Congress. The Constitution says war must be declared by Congress. I voted for military action against Syria in 2013 when Donald Trump was advocating that America turn its back on Assad's atrocities. Congress will work with the President, but his failure to seek Congressional approval is unlawful.”

Thursday, March 9, 2017

DIY: A Chess set for Jack

I made a new Instructable post.  It's a chess set I made for Jack for Hannukah.



Movie Review of "The Great Wall": Not that bad

I recently saw The Great Wall.  It's honestly an interesting movie, because it is such a specific cultural artifact.  The movie is made to try and impress Americans with the resourcefulness and capability of the Chinese.  The result is meta.  The movie isn't really great, but it shows that Chinese producers, directors, actors, and special effects teams can produce mindless big-budget spectacle just like Hollywood.  And it's impressive in a purely technical way.  Additionally, the film itself is literally about a team of Chinese warriors engaging in a cultural exchange with a greedy European thief searching for treasure in the medieval orient.  Every shot is the fulfillment of stereotypes, both loving and hoke.  The Chinese general explains how her army is strong because of their selflessness and their discipline.  The American brags of his self reliance.

Overall, it's fun.