Promise of miracles in the age of uncertainty
From Griffith REVIEW Edition 4: Making Perfect Bodies
© Copyright Griffith University & the author.
Written by Robyn Williams
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Robyn Williams' biography and other articles by this writer
Planets full of bronzed healthy clean-imbed individuals merrily prancing through their lives meant
that the only doctors still in business were the psychiatrists, simply because no one had discovered
a cure for the universe as a whole – or rather the one that did exist had been abolished by the
medical doctors.
Douglas Adams, The Hitchhiker's Guide to the Galaxy
They made me bionic in 1988. I still don't know why. A machine, round and smooth as a flattened pebble, sits under the skin of my right breast, just below the collarbone. Its wire travels through the blood vessel to a chamber of my heart. By now, I'm told, the wire is well encased with cardiac tissue and cannot be removed. The machine itself, a pacemaker, has outlived its allotted lifespan and continues mysteriously to do something in there, like one of those spacecraft launched when you were adolescent, still surviving somehow in deep space, beeping away regardless into your middle age.
I know why they said they'd put the thing inside me. I had three cardiac arrests on the evening of May 31, 1988. The second arrest had me flat-ined, dead, for 47 seconds. The third required an injection of adrenalin. What I don't know is what the pacemaker does. Apparently, for me, nothing.
Every few years I go to have it checked. I'm supposed to go every six months but never have the time. At the clinic they sometimes find my file is missing – it's been so long – and they must rediscover what contraption I've got by placing a sensor over it. This reads the signals and tells both the model and what it's up to. I'm usually informed the pacemaker is still in order and to come back in less than a year. Underwhelmed, I go away. Forget.
ISN'T IT A LITTLE ODD TO HAVE A SOPHISTICATED GADGET in one's chest for all that time and yet no one can give a plain explanation of what it's doing? I suspect I was given this proud invention of modern cardiology as a kind of insurance policy. I don't need it and yet, because I've got it and am registered as a kosher cardiac case, everyone now has to perform the protocols of care and maintenance. It is hard to become an "unpatient". Though I try.
A more interesting question is why I died in the first place. The first arrest came late on the Tuesday afternoon as I chaired a meeting of trustees at the Australian Museum. I felt faint and nauseous and then the floor and walls of the old boardroom began to warp and ripple. I woke up cold and wet and was told I'd been thrashing like an epileptic Russian prince. An ambulance had been called.
At nearby Sydney Hospital I was laid on a bed. A young intern took my history. I couldn't resist making the odd wry joke. The doctor seemed vague about what was wrong with me but gave me a potassium pill, then left. By this time my friend and colleague Norman Swan had arrived. Norman, a doctor trained in Scotland as a specialist pediatrician, has kept more ABC staff alive and functional than anyone else in history. As I swallowed the potassium pill a ceiling of darkness came down. In the absence of the intern it was Norman who jumped on my chest and brought me back from oblivion. When I came to I said, "Does this make me a no-onger-iving national treasure?" and promptly died again.
A second pill then had a similar effect. But why? Why was I carking?
The explanation I was offered was silly. "It's a virus." So, which virus? How come? Why should it exacerbate heart block? This is a common syndrome involving an indirect electrical pulse travelling through the heart muscle to initiate contraction. A bug had stymied a bit of my circuitry and the vagal nerve sending instructions south had been compromised in the process. You sure? This to a phalanx of medicos. Well, no, they weren't.
An alternative explanation (applying Ockham's Razor) came from a chance reading of Time magazine and a list of substances banned for athletes at the forthcoming Olympic Games. You mustn't take diuretics. Why not? Risk of cardiac arrest.
I had been on a diuretic for a year or two for mild hypertension. They make you pee more. This leaches your salts. Potassium! In a town like Sydney, built on sandstone and with the softest of waters, over 40 per cent of those taking this particular diuretic are asking for trouble (despite the claimed compensatory factors included in the drug). I was pissing away my electrolytes, the ones you need to stay alive.
How could I have such spectacular symptoms, like dropping dead, and yet not be offered a neat scientific account of what was going on? This was 1988, but still about 20 years since men had first walked on the moon. Was the body still such a black box to the men in white? Are we still in the age of medical uncertainty?
I SPEND MY WORKING WEEKS TALKING TO THE LEADING SCIENTISTS of the world. They are the toreadors of discovery, the matadors of revealed truth. Their arguments with each other in public forum, watched and applauded by thousands, are the finest detail of apparent certainty. Their predictions are about a world in which babies are designed, cancers cured, organs farmed, drugs sent by nanorobot to the deepest crannies of your tiniest organs, remote surgery, replacement limbs and botoxed beauties aged 95.
Yet the doctor in the high street cannot fix your bad back. Or tell you why it's gone bung.
The Promise of Miracles exists in The Age of Uncertainty. As everyday people we grizzle about getting no quality time from GPs, get cross about hospital waiting lists, accept the inevitable decline of weary bodies. And yet. And yet, we take seriously claims about clones (even Raelian ones!), buying genes for Harvard
or genes for Olympic gold, eternal life and instant beauty. Millions are spent on alternative quackery while people complain about scientists playing God. Society is spooked. Some societies take refuge in
the Dark Ages.
SCIENCE IS FURIOUS WITH THIS DISJUNCTION BETWEEN REALITY and remote possibility. Yet science is itself partly to blame.
My fax machine is now the enemy. Every day it pours out spam, breakthroughs unlimited, answers to everything. Without shame. Every day there's a helpful Debbie or Karen on the phone from the WishfulThinking PR company asking whether I've received their message and how soon I'd like to drop what I'm doing and join their uninhibited quest to make (even more) famous astounding Professor Marvel or Wonderdrug Panacea or Triumphal New Technique. The company needs sales, the university needs profile, the scientist needs to vanquish competitors. Debbie and Karen have never heard any of my programs. But they call me Robyn immediately as if we're in mid-tryst.
Over a year ago I received a call from medical researchers at the University of Newcastle. They had discovered that melanoma could be destroyed by injecting an infusion containing common cold virus. I drove north to see them. We recorded an interview. And where, I asked at the end, had they published their finding, which leading professional journal? In fact, they hadn't. But they had set up a company. I did not broadcast the interview (but waited until a year later when it had been published).
Every day our media are awash with claims of breakthrough. Little is said about the painstaking, deliberate, unpredictable, costly, lengthy process required to make even the most promising treatment into an acceptable part of medical practice. No wonder the ordinary citizen is bewildered.
Meanwhile these same media, full of disconnected factoids, take some of this "news", stretch it, discard the mundane, and look for Dr Frankenstein. And they find him, surrounded by shiny-machines-that-go-PING! ensconced in the well-guarded laboratory of a mighty multinational enterprise.
If the first villain of public disquiet with scientific "progress" is marketing, then the second is its near cousin, the market itself. Nearly every major advance in biotechnology, especially those that are gene-based, appears to the dyspeptic public mind to be in the interests of making money for some large corporation. Genes are patented, drugs are promoted (shamelessly), fortunes are made (and lost). Even Craig Venter, daddy of the private Human Genome Project, turns out to have used his own DNA to do the sequencing.