Sunday, June 28, 2009

We Shall All be Healed

Yesterday, Books for Breasts passed the $1000 mark on funds collected, and I still have about 20 books left to give away!

Back in 2004, the Mountain Goats put out an album titled We Shall All be Healed. I suspect they borrowed the phrase from the prayer, "Heal us, Lord, and we shall be healed." I first listened to the album in Laura's bedroom. She was on chemo at the time, and was spending much of the day in bed. The album is mostly about the self-destructive behavior of drug addicts, but there are some lines within it that filled me with neo-religious visions. In one of the songs, John Darnielle sings, "I dreamt of a factory, where they manufactured what I needed, using shiny new machines." He's talking, in the context of the song, about methamphetamines, but I would find myself dreaming of men and women in white lab coats, toiling over test tubes and microscopes, typing data in to computer terminals. These were the invisible soldiers in the war on cancer, and it filled me with the hope that any day I would pick up a newspaper and find that there had been some breakthrough, and Laura's cancer could be healed. I knew of people who'd lived with cancer for ten years and more. If Laura could hold out ten years, I was certain she would beat the disease.

She didn't, alas, make it ten years. And, if she had, I no longer believe the cure is going to be found tomorrow, or the next day. The last five years of research have yeilded important discoveries, the chief and most important of which is that we still have much more to learn.

But, when America was discovered by Europeans, it took them a while to figure out what they'd found. They set up colonies before they really even understood the shape and scope of the continents they'd encountered. I feel like we are in a similar stage in the understanding of cancer: We are still making maps of its boundaries. We are still sending surveyors into its interiors. We do not yet know all there is to know, but we are daily pushing the frontier ahead of us. And, just as we continued to improve the technology to map America--today, I have the ability to look down on the roof of my house from space!--we are only going to increase our understanding of cancer. Even discovering our ignorance, learning, for example, that a drug wipes out cancer in rats but does nothing for people, is progress. As we seek to understand what doesn't work, we gain insights into what will work.

So, on this warm June Sunday morning, I'll give a little prayer of gratitude to those unknown explorers in their lab coats who are seeking a new, cancer-free world. And, I extend a great big, heart-in-my-throat thank you to everyone who's donated this past week. You've done a good thing. You've put your money where your heart is.

The day is coming. We shall all be healed.

Monday, June 22, 2009

Books for Breasts!


Followers of my blogs, and the readers who read the acknowledgement pages of my books, will know that I lost my partner Laura Herrmann to breast cancer in May 2006. I've been interested in cancer research since then and have privately made contributions to cancer related charities, but I've never put out any sort of appeal on my blogs to solicit for this cause, until now.

Last week, I received several cases of my latest book Dragonseed. One of the ongoing themes of Dragonseed is the idea of healing, both from physical and spiritual wounds. Within the book there's a miraculous object called a dragonseed: Eat the seed, and all your injuries will be healed. Even your oldest scars will vanish.

I have some science fiction hoodoo underlying the dragonseed. The technology to create a pill that will both diagnose and cure any illness is pretty far out in our future, if it exists at all. But, the part of this that isn't science fiction or hoodoo is that I believe that technology has the power to work miracles. We have MRI and PET scans that can look into a human body and see it working in minute detail. We have developed surgical tools and techniques that can remove diseased tissues from a human body without doing undo damage to healthy tissues. My father had a heart attack recently, and the doctors had to place stents in his arteries. The incision to perform the operation was small enough to cover with a band-aid. And, right now, there are researchers who are taking apart cancer cells molecule by molecule to understand the genetic engines that drive them to a degree unimaginable only a few decades ago.

We live in an age of miracles because we live in an age of knowledge. Modern computers are finally powerful enough to process all the complex data contained within a human cell. The only barriers remaining between our present understanding a cure for any disease you can name are time and money.

These are not insignificant barriers. New technologies are always expensive. And, to be blunt, the world has a limited supply of really smart people, and a nearly unlimited supply of problems for them to solve. For better or worse, money is one of the most important driving forces of where the smart people focus their energies. In the sixties, it was decided we would put a man on the moon. We threw money at the problem, and produced a glut of rocket scientists. In the eighties and nineties, computer technology was fed enormous sums of money by the stock market, and smart people focused their energies on designing hardware and software, and with the result that today my cell phone has more memory than I do. There is a lot of money today flowing into health care, but only a fraction of this money goes to research of any given disease. I'd like to invite you to increase the fraction going to breast cancer research, both due to my personal connection to the cause, and because I think that this is the right moment in history to truly make a difference. I firmly believe this is a disease than can be cured within our lifetime. I don't know if one day we will simply swallow a magic pill and be healed, but I do know that the day will come when we will be able to profile any cancer cell and match it with the appropriate drug to wipe it out.

To help bring this day closer, if only by a minute or two, I'd like to announce my "Books for Breasts" promotion. Anyone who contributes to the Susan G. Komen Breast Cancer Foundation through the "Team Dragon" fundraising page will get a free signed copy of Dragonseed.

You can contribute to the Susan G. Komen Breast Cancer foundation by clicking here. This will take you to my personal fundraising page; just click the button that says "support James." Then, to get your signed copy of Dragonseed, just email me your mailing address to nobodynovelwriter@yahoo.com. I've set aside 50 copies for this cause; if I give them all away by the end of July, I'm pretty sure I can get my hands on another 50.

I've set up a modest goal of raising $300* through this promotion. This means I need to average contributions of $6, which is less than you'd pay for the book on Amazon. However, I'll send you a book for a contribution in any amount, even if it's just a buck. Spend a buck, get a book, save some breasts. Who's with me?
*Okay, I obviously seriously underestimated the generosity of my readers. I hit $300 in under 24 hours. So, I'm going to raise my goal to $1000. Thank you to everyone who's given so far, and everyone who has helped spread the word via blogs and twitter. If I run out of books, I've had some interest from other writers in contributing their books to the cause. I'll keep you posted if it comes to this.

Sunday, June 21, 2009

War on Cancer: An Alternative Approach to Health Care

Health care reform is probably the biggest legislative goal of the Obama presidency. I have no doubt that, by the end of the summer, some sort of expensive and complex bill will get signed into law. But, as with the carbon control bill, my hunch is that what emerges will be toothless and nearly pointless. The money just isn't there for a truly radical reform, and the fact is that the majority of the public is reasonably well served by our existing system and doesn't want the boat rocked. Our existing system covers about 80% of the public. I'm sure that a significant chunk of this 80% is unhappy with their coverage. But if 1 in 4 people with private or employer covered health care want some government program to replace it, then you still have 60% of the population satisfied with what they have. If you're a congressman or senator, and you have the choice of pleasing 40% of the population and disrupting the status quo of 60%, you are probably going to stand by the status quo.

However, I think that there are things that our government could do that would be politically popular, save costs in the long run, and actually accomplish some good. Our government is pretty good at selling wars. We have a war on drugs that has filled our prisons to overflowing. We have a war on terror that leads us to spend hundreds of billions of dollars to fight wars and inconvenience travellers around the world. Attach the word "war" to a cause, and suddenly budgets are no problem.

So, I think it's time that we have a War on Cancer. We are at a unique moment in human history. Since humans first became aware that they were humans, the functions of the human body have remained mysterious to them. Humans have been humans for at least a hundred thousand years. During this time, we've worked under a lot of very bad theories of how the body worked. The last century, however, saw a genuine revolution in our understanding of the body. This revolution pales in comparison to what we will learn in the next hundred years. In the last year of the last century, we mapped the human genome for the first time. Essentially, we finally opened the pages of the owners manual to the human body, and we haven't even had a decade to process all the information inside. Within the human genome, we will find the causes for entire categories of diseases and once we find the causes, we can craft cures.

Fifty years ago, if we'd declared a War on Cancer, we probably could have thrown a trillion dollars at it and not produced much in the way of results. Today, we have the technology available to process as much information as we can gather. Curing cancer is now mainly a function of gathering information and designing the tools and software to turn this data into something of practical value. Designing these tools is going to be very, very expensive. We do throw a lot of money at cancer research already. According to various numbers I've been able to google, it looks like the federal government spends upward of 10 billion a year on research. 10 billion isn't a trivial number unless you compare it to the figure being discussed as the cost of Obama's health care plan: 1.6 trillion.

A lot of our health care costs today are driven by the need to pay for new equipment and medicines. Machines for CAT scans, MRI, and PET are outstanding tools for detecting cancers at an early stage. They are also crazy expensive, so getting a scan on one of these machines runs into the thousands of dollars. (Also in this cost is the training of people who can run the machine, and the training of people who can read the results.) The same can be said of building a predator drone and arming it with missiles, along with the training of people to fly them. Senators will throw billions toward weapons without blinking an eye. Why not spend similar amounts of money on medical equipment? If the government picked up the cost of all imaging equipment, and insurance companies were no longer shelling out thousands every time one of these scans was performed, it could provide genuine savings that could be passed on to consumers.

I don't want to put forth the idea that I think curing cancer is going to be easy. To start with, there isn't a single disease that constitutes cancer. Cancer is really 200 different diseases, all with their own challenges.

Still, imagine what could be accomplished if the federal goverment spent as much on a War on Cancer as it does on the War on Terror. Cancer is a far more clear and present danger than terrorism to the average citizen. Cancer kills roughly 1500 people a day: every two days, it's a wide-spread, yet somehow invisible 9-11. Imagine if the US spent as much designing and building a new generation of imaging machines as it spends on designing and building the next generation of weapons.

A cure for cancer is waiting out there in our future. If we can accelerate the research so that we've mastered this disease by 2020 instead of 2050, we could enjoy 30 years of cost savings, assuming we could drive the cost of treating some cancers down to the cost of treating, say, a broken leg.

Perhaps this is just science fiction dreaming. Perhaps there is no cure. But, the War on Drugs can't be won, the War on Poverty hasn't been won, and the War on Terror will never be won. A hopeless cause isn't neccessarily a worthless cause. Politicians like getting behind stuff like this. And, unlike some of these wars, the situation isn't hopeless. We are already seeing declines in deaths from cancer, a few fractions a percent each year. Can we change this so that 10 or 20 or 30% fewer people die each year?

At the risk of overusing a phrase: Yes we can.

Saturday, June 20, 2009

Why I think the carbon bill is doomed.

Observers of politics this week saw two of Obama's biggest legislative initiatives crash and burn. We'll maybe not burn, but at least they crashed. First, house democrats have proven unable to find any compromise on a bill to regulate carbon emissions. This isn't a shock; if you're a democrat from a state that mines coal or pumps oil, it's going to be political suicide to vote for any sustantive measure that will reduce the consumption of oil or coal. The only way to reduce the consumption of these two commodities is to increase their cost, and increase it a lot. When gas doubled from $2 to $4 a gallon, American's bought less gas. SUVs sat on car lots while the Prius built up a long waiting list. The simplest and most direct path to cutting gasoline consumption would be a gas tax of about $2 a gallon that would push todays cost of gas closer to the $5 mark, with a built in clock for raising rates: every year, the tax increases a dime.

No one who wants to be reelected would vote for this, but it would be a simple way of meeting part of the goal. The mechanism for collecting the tax is already in place, so there's no additional beaurocratic costs. And, this proposal might actually cut the deficit instead of increasing it.

However, gas is only a fraction of the problem with carbon. The big problem (assuming you view carbon as a problem) is coal. My electric bill averages about $80 a month. I'm not sure that most people appreciate how inexspensive that figure is compared to all the benefits I derive from it: Cool air in summer, hot water year round, information at my finger tips 24 hours a day, the freedom to read at night, the ability to pop corn in three minutes flat, and a giant box full of food that stays cold all year round. Electricity is modernity, and in the US, electricity is coal. If you want American's to conserve electricity, you need to raise the cost, and raise it a lot. The challenge that faces most alternative power sources aren't technological, but economic: Coal is simply cheaper than its competitors, and will remain so in the US and China for a long time, since both these countries are sitting on huge deposits of coal.

The direct path to making coal less attractive than its competition is to tax it at a substantial rate. If my electric bill doubled next year, I'd be forced to change some of my habits. For instance, I routinely wash my clothes with warm water. I could save a few bucks a month just by only using cold. I could save even more by using a clothesline to dry some select items of clothing... towels and blue jeans take a lot of energy to dry, for instance. Also, I could turn off my computer the 20 hours a day I'm not using it. When I replace my refrigerator, I'd select one with the lowest energy star rating. LED light bulbs might suddenly seem cost effective.

But, again, the direct path isn't being discussed in congress. Nor should it. I think most American's recognize the economic costs of a direct tax. If you double their gas bill, they will drive to stores less often and spend less money when they get there. Double their electric bills, and they'll again be cutting back in other areas. The effects ripple through the economy as stores and restaurants cut staff. It's economic suicide to double our energy costs directly.

So, the bill that congress has to craft is one that doubles our costs while making the blame fall elsewhere. They want us to come out of this angry at Exxon and Duke Power, not them. But, even if they manage to shift the blame, they can't ignore the political consequences that will fall on them if the recession deepens and unemployment goes even higher. So, I think that the eventual outcome with be that they pass a bill too long for anyone to read that actually does nothing at all. For instance, it's not difficult to pass a law saying that our carbon emissions must be cut in half by 2050, then leave all the paths to that goal vague, toothless, and slated to kick in years from now. I think that when Obama runs again, he'll have a climate bill he can point to as an accomplishment... I just don't think it will actually accomplish anything.

I started by saying that two initiatives crashed and burned this week. The second was health care. I'm going to save my thoughts on this for my next post. Unlike our energy policy, I think there's a smart, politically popular path available to the goal of controlling health care costs. Stay tuned.

Tuesday, June 16, 2009

A Cure for Cancer

Veronica Gray, Simon Gray, Me, Andy Herrmann, Jessica Herrmann, James Herrman, and the top of Maggie's head (in stroller).
June 13 Susan G. Koman Race for the Cure in Raleigh.
Saturday I took part in the Susan G. Koman Race for the Cure. I did the 5k fun run (though I walked it) with Laura's kids, her brother Andy, and her sister-in-law Jessica.
I've never used my blog to solicit money, except, of course, to encourage people to buy my books. I figure the world is full of good causes, and people will naturally support the things that matter most to them, whether it's Boy Scouts, the local library, NPR, March of Dimes, or whatever. People don't need me to tell them how to be charitable.
On the other hand, I have no problem advocating for other things I feel strongly about. I don't mind making the case for atheism and libertarianism. So, here's my brief pitch for why I think that it's worth sending some of your charitable dollars to organizations actively engaged in the search for a cure for cancer: Unlike certain problems, cancer actually has a solution. Poverty, for instance, has proven time and again to be able to sustain itself as a problem no matter how much money is thrown at it. Similarly, if you give money to Girl Scouts or NPR, more power to you, these are terrific organisations. But, fifty years from now, these organizations are still going to be asking for money. I'm not convinced that will be the case with cancer charities.
Cancer isn't a philosophical problem that can be debated for centuries without ever arriving at a conclusion. It's a defect in the normal function of the cells of the human body. There are specific, identifiable steps that the cells must go through in order for cancer to grow. Fifty years ago, we didn't have the tools we need to track each of these steps. Today, we have instruments available to model the cells in tremendous detail, to the point that we can generate computer models of individual protein strands within the cell. We are in the early stages of a revolution in our understanding of the human body. The information contained in any cell was too complex to fully model only a few years ago. Now, we can carry around terrabytes of data on devices small enough to slip into a pocket. We finally have the tools to truly understand everything that is going on inside a cell.
I don't want anyone to think that I'm underestimating the difficulties that still lie ahead. For one thing, "cancer" isn't one disorder. Even specific types of cancer like breast cancer turn out to be composed of lots of different sub-types, growing in responses to different triggers, following different paths of progression. Cancer isn't a single problem to be solved, but hundreds, if not thousands, of interrelated and overlapping problems.
Still, it is fundamentally a physical problem, and the physical world may be complex, but it's not infinitely complex. Our bodies can be understood, and they can be manipulated. There is a cure out there in our future, and once we cure one type of cancer, the others will follow, and one day we will fear cancer no more than we fear smallpox or polio.
All that stands between us and a cure now is time. There are unknown number of man-hours of study and research between us and a cure. But, the old adage tells us that time is money, and the reverse is also true: Money is time. The more money that's made available for research, the more people will be employed in the research, and the faster those man-hours will accumulate.
So, if you are someone who likes putting your charitable dollars toward problems that have solutions, consider making a contribution to a program searching for a cure for cancer.

Saturday, June 06, 2009

I believe in matter

A few months after Laura died of cancer, I went the Bodyworks exhibit, where corpses were preserved with plastic. Peeled and posed, they show the inner workings of the body, the muscles, bones and nerves. I spent a long time studying a lung riddled with cancer. I could see the tiny knots of tissue that had ended Laura’s life. Looking at the tumors I felt peace, and optimism. Laura’s death hadn’t been the act of a capricious god, nor some failure of spirit or karma. The tumors that killed her were physical, not some concept or idea. They were growths of tissue and nothing more. They were matter.

And matter is wonderful.

The beauty of matter is that it can be understood. It obeys rules. The secrets of matter unfold daily before the collective study of mankind.

I believe our most urgent problems have their solutions in the material world. Our understanding of steel and oil gave us the internal combustion engines that power our comfortable modern lives. Our study of plants and soil have led to bountiful harvests undreamed of by earlier generations. We live longer lives due to our understanding of diseases, and our ability to better engineer the delivery of clean water and dispose of our waste.

It’s true that every advance brings new challenges. Longer life spans lead to a growing population that strains our resources. Increasing crop production has come at the expense of natural habitats, and fertilizers and pesticides can poison our streams and fields. But we know of these problems because of our continued study of the physical world. We’ll solve these problems by deepening our understanding. We’re building new materials from the atom up to capture the energy of the sun. The age when power comes to our homes via copper wires, or to our cars as flammable liquids, is near an end. In our lifetimes, our roofs will become power plants and a new generation of batteries will propel us along the highway. Our growing knowledge of genetics will give us crops that feed more people with less harm to the environment.

And, yes, I believe that one day the tumors that killed Laura will no longer threaten anyone. Cancer is caused by a few stray genetic switches that get flipped and turn ordinary cells into voracious growth machines. One day, we’ll design the key to turn these switches off.

All of these problems are complex, but none are infinitely complex. Our understanding of matter has given us the power to process unimaginable amounts of information in the etchings on a silicon wafer or the magnetic alignment of atoms on a steel disk. As we learn about matter, we can build increasingly powerful tools to study and manipulate it. We are nowhere near the final boundaries of our understanding.

I'm James Maxey, and I believe in matter.

___

Note: I've written this post with the goal of submitting it as a "This I Believe" essay on NPR. These are limited to 500 words, though the real limit is actually a time one, I think. I'm pretty sure the essay can't be more than three minutes long when read aloud. I feel like there's a lot of stuff I'm not saying in this essay, many points I'd like to expand on. But, I'm putting it up here to see if anyone has any comments on its relative effectiveness or clarity. If there's anything that confuses you, or any obvious typos you note, I'd love to hear about it. My goal is to submit this to NPR next week.

Thanks!