The Legal Fiction of Brain Death

Hospitals’ brain death policies vary dramatically, study finds: https://t.co/gw8IUMDhw8 pic.twitter.com/2meqBwQ6tu

— Health magazine (@goodhealth) December 29, 2015

Why these disparities? Scientific criteria for brain death may vary from one country to another... I found this out early 2005, this is the reason why I started this blog... Nothing new here, except for one thing: this is no longer taboo...

Burton's Nightmare Before Christmas: Jack's Obsession

7.28.2x: Molecular Biology — Transcription and Transposition

Nice Xmas present...

https://courses.edx.org/certificates/a7acd8f090dd40cb840f6326f7fd8d60

Life Science Limericks And The Slayer Of False

Politically incorrect & Scientifically correct, Bond's bow tie In Tomorrow Never Dies. Who's bad? The Slayer of False. Venter. Craig Venter.

http://illogicalcontraption.blogspot.com.au/2010_04_25_archive.html

Life science limericks: 2015 edition :-) by @megkesh @medcitynews https://t.co/3A0uOnKBWn pic.twitter.com/u0AY5eVmIW

— Eric Topol (@EricTopol) December 24, 2015

May The Cracking Force Be With You

Changing The Law of Gravity In Medicine?

Many thought Mission Massimo Dream Team was crazy. "Crazy" could earn you a Nobel Prize, even if you have no PhD but end up changing medicine...

The Future of Medicine Soon To Hit The Screens: @missionmassimo's #truestory #MayTheForceBeWithYou @leahkam #PWSYN pic.twitter.com/NarlJlkxr2

— CATHERINE COSTE (@cathcoste) December 24, 2015

Saw @missionmassimo Stephen & Sally Damiani & @leahkam in Melbourne today. This #PWSYN thing starts getting real :-) pic.twitter.com/OCAT5mtEf0

— CATHERINE COSTE (@cathcoste) December 24, 2015

In Melbourne with Mission Massimo Dream Team: Leah Kaminsky MD, Sally & Stephen Damiani, Massimo & the twins. Best Xmas present ever!

Beijing Airpocalypse Now

At Beijing Airport, 21 Dec. 2015

Red alert politics (as issued by the Chinese Government): No-More-Red-Alert-Warning. Really? I am in the middle of a pollution peak, this is 5:00 am local time and even at the aiport, I have to wear a mask. Only a few people do, and on the train and in the city I notice that masks worn by most people are a joke.

Even at the Science Museum in Beijing I was wearing this mask. Beijing looks like this is a country at war. What will happen if you don't wear a mask? You'll get runny nose and eyes, even indoors. Happens to me all the time. Would be fun to tell the Chinese police I am an app developer, trying to foresee when the population is going to die due to high levels of pollution, which would be a very interesting information to have for the governement... They could then "divulge" this information to protect the country's productivity. Send unproductive people (retired people for ex.) to highly polluted places, and prevent highly productive people from getting harmed by pollution. Make it happen, thanks to some mHealth app... Productive people could wear an electronic bracelet (like the one prisoners have to wear) and if they happen to be in a polluted zone where they are not supposed to be, they could be stopped by the police.

Information belongs to Chinese officials. An app that does not give real time information but only tells you what the Chinese government wants you to do... My health is government-owned, my destiny is linked to my productivity. Made-in-China mHealth. Dystopian satire? Hardly.

Looks like it could happen... Beijing is the place to be if you are a scifi writer...

"The Patient Will See You Now" Chinese version (actually the book was translated in Chinese), adapted into films? Great potential...

Work In Progress... Please Keep Your Safety Helmet On

Should I close this blog or not? To be or not to be?

Well, imagine Michael Jackson or Mister Spock (yes, I told you, I'm crazy I believe in ghosts) chancing upon this blog... It is old, outdated, not sexy, and I want to write about genomic entertainment. Looks like this blog might not be fit for the task.

So yesterday I decided to close it. Dying Steve Jobs himself told me (end of 2010) that this blog was "stupid".

Let's look at the alternatives:

Something like that?

http://www.explainxkcd.com/wiki/index.php/1613 

Yeah. In my dreams. Data (or numbers) geekery is not my thing (I wish!!), just some kind of a literageek (loving words).

OK. I'm a dinosaur, albeit partially. A mutant dinosaur.

Working with 1.0 tools (took loads of notes during my MITx MOOCs)...

Post-it notes!!! Will make Mister Spock mock me; not rock me.

On the other hand, this tiny flash drive is storing all of the lectures, tests and quizzes (thank you, Awesome Screenshot) from MITx 7.00x, 7.QBWx, 7.28x Part 1 & 2.

 

"Be Yourself, Be Unique, Be A Monster!"

Revamping this blog? Updating it will become more complicated.
A blog with no updates is a dead thing. (Ghoul's Alive!)

I'll ask my friend Dalya, she created this beautiful website for another friend of mine, a paintress. Actually, I connected both one year ago. The result is brilliant: in China they love the paintings and the website.

http://valerie-cabaret.com

Maybe Dalya can design something that will be the right thing for genomic entertainment?... Now I'm dreaming of some kind of a freaky fusion between XKCD and girly design ... Also, would love to do podcasts and interviews, write articles... Genomic entertainment should be entertaining and educational at the same time, and give doctors and patients "tough love" (quoting artist and health care activist Regina Holliday here).

Giving doctors and surgeons tough love. Sounds like some kind of serious comedy material...

Genomic entertainment?
Work In Progress... You can keep your safety helmet on...

Work In Progress

Very old hunter gatherers in the modern medicine era :-) @NewYorker pic.twitter.com/W0Hcs6XC17

— Eric Topol (@EricTopol) 14 Décembre 2015

New Yorker

 This blog I started in 2005 is getting old, too...

Working on something new...

MITx: 7.28.2x Molecular Biology: Transcription and Transposition

Just wrote a course review for @MITxonedX #728x Part 2 #MOOC #biology https://t.co/MNuiyD7B3q @42born2code @duportet pic.twitter.com/D40emDmbyi

— CATHERINE COSTE (@cathcoste) December 16, 2015

Just completed MITx #728x Part II #MOOC #genomics. Total score: 80%. Will write about my experience as #700x #728x part I&II #7QBWx student.

— CATHERINE COSTE (@cathcoste) 14 Décembre 2015

Perseverance trumps talent (it worked for me).

https://www.edx.org/course/molecular-biology-part-2-transcription-mitx-7-28-2x

A sense of humor is essential when learning about transposable elements in #dna #MOOC #728x Part 2 Prof. Tania Baker pic.twitter.com/L8BSt0NoTE

— CATHERINE COSTE (@cathcoste) December 9, 2015

"Retroviral integration was figured out because it was so similar to... transposition of DNA elements." #728x #OnTheShouldersOfGiants

— Mark Schofield (@Hopkins6) 14 Décembre 2015

"Getting to Si, Ja, Oui, Hai, and Da"

Ooops, I'm French: Taz is my middle name :-(

https://hbr.org/2015/12/getting-to-si-ja-oui-hai-and-da

"Bad Timing"

Bad timing :-) @NewYorker pic.twitter.com/k1LXdRi6IC

— Eric Topol (@EricTopol) December 14, 2015

The Emotional Curfew Variable

http://www.theguardian.com/us-news/ng-interactive/2015/oct/02/mass-shootings-america-gun-violence

Steve Jobs was the "son of a Syrian migrant"

Banksy reminds us Steve Jobs was the "son of a Syrian migrant" https://t.co/PhcIXrzlm8 pic.twitter.com/4QImg1trZY

— Boing Boing (@BoingBoing) December 14, 2015

Banksy, via @BoingBoing Dec. 14, 2015 on twitter

The Old Testament Conjecture

Pic.

Pic.

MIT-style #religion #MOOC #biology #728x https://t.co/EOA6k9tXbq + https://t.co/ceSUKxCBPU #BigBangTheory @cp92isa pic.twitter.com/POj5GrB4TA

— CATHERINE COSTE (@cathcoste) December 13, 2015

Normal Gene

Norma Jean? No, Normal Gene :-) #CRISPR https://t.co/SnIjVYBX12 #genomics pic.twitter.com/qgvEn1cwF3

— CATHERINE COSTE (@cathcoste) December 12, 2015

http://starsingers.net/norma-jean

Two of us... And what a conundrum already... Pic

 

The Envelope Pushers

We've all heard about these books. How the future of medicine is in the patients' hands. Great. But this medicine of the future seems to suffer from a transition or procrastination problem.

Yesterday Sir John Burn MD, Professor of Clinical Genetics, Newcastle University (UK), wrote to me:

"There are still many people throughout healthcare who consider genomics as ‘nothing to do with them’. This is an attitude we need to change as the technology's ability to change people’s lives develops. There will come a time when genomics is no longer niche, but will be absorbed into medicine. It will apply to every aspect of pathology and be an integral part of care. Therefore, it is vital for everyone to know and understand its terminology and implications."

 How do we get there? Patients worldwide are starting to realize they can be in charge of their own health, especially in cases where no diagnostic could be achieved, no treatment could be offered.

Australian physician Leah Kaminsky (Melbourne) calls them the envelope pushers. For ex., Angelina Jolie in medical bestseller "The Patient Will See You Now" by Eric Topol MD (San Diego, CA, USA), but equally interesting:

1) Mission Massimo in Australia

Leah told me she is working on the sequel to this book: "Fixing the Code". I absolutely loved "Cracking the Code", this is my favorite book for 2015.

2) Mission Matéo in France

#PWSYN France: boy w/ #leukemia found neither @cellectis (T Cells) nor doctors can help -> #crowdfunded Rx in the US https://t.co/sRUsz4oDe7

— CATHERINE COSTE (@cathcoste) December 11, 2015

Two major differences here: Massimo's story was written by a Doctor, Leah Kaminsky. As she saw Massimo's disease (her patient, she is a pediatrician) was beyond the realm of her competence, she decided to write about the father's story. Massimo's father is actually at the center of the book: he is the envelope pusher, the pioneer. He got a diagnostic for his son where nobody else could. Leah tells about the diagnostic odyssey and reflects on some of the ways that conventional medicine and genomic medicine could find common ground.

I will meet with Leah, Massimo and his parents in Melbourne in a few days. How can we build synergies to take advantage of what pioneer patients have achieved and democratize genomic medicine? Surgeons and doctors should attend congresses about genomics; not only geneticists. And geneticists should attend medical congresses to show what can be done. Robert Darnell PhD at the NY Genome center showed his work about genomic precision medicine at the Academy of Medicine in NY.  See the Genomics and Health Care Conference, two months ago (link to videos). Doctors at the Academy of Medicine had a lot of questions for Darnell, they showed real interest.

The French case is different. Matéo did get a diagnostic, acute leukemia, but there was nothing doctors could do that was helpful. If he does not get a new treatment (CAR-T cells) he will die in a couple of months. French biotech Cellectis was not helpful. It turns out they do have a trial for the new treatment but due to regulation matters, things are being slowed down to such an extent that by the time the new drug trial starts, Matéo will be dead. So the parents looked for solutions, found this innovative treatment in the US and started a crowdfunding action (treatments are 10 times more expensive in the US than in France) to speed things up and save their son's life as no doctors seem to be in charge. The contrast between the media uproar (Matéo is now a star on French TV) and the extreme apathy of French medical establishment is mind boggling. 

While doctors are burying their heads in the sand
Matéo is taking the Future of Medicine in his hands.
Finishing my exams at MIT (genomics). Can't wait to meet with Leah, Massimo and his parents...

"The Barbarian Sublimation"

If I could re-engineer myself with CRISPR, I'd definitely try to achieve this brilliant result...

Link to picture (Korea)

Not so sure all the cool genome editing tools in the world can be helpful for this, though:

https://www.facebook.com/interestingengineering

"Outdated Science Is My Worst Ennemy."

http://www.yourbest100.com/people/top-100-influential-people

Catherine Coste, author of this blog. Pic: Hello Tomorrow, Paris, June 2015

I used to work with surgeons and doctors as a marketing assistant. I earned myself four MITx EdX certificates (MOOCs) to learn about genomics and quantitative medicine. If a marketing assistant can do it, physicians can do it!

The patients will want it...

Inspiring @statnews profile of Fred Zhang, the 34 yr old groundbreaking scientist behind optogenetics & CRISPR https://t.co/aEhk7HNfhE

— Atul Gawande (@Atul_Gawande) December 9, 2015

What happiness looks like

What happiness looks like. Myosin molecules drag endorphins into brain's parietal cortex = feelings of happiness! pic.twitter.com/hpC68Z12eE

— Carol Duncan (@carolduncan) December 11, 2015

What happiness sounds like:

@DmitryBaranovsk Something was missing from that gif. pic.twitter.com/Y80Ep7ictr

— Alex Moyler (@thealexmoyler) November 12, 2015

The Pharma-Hollywood Congruence

http://bigbangtheory.wikia.com/wiki/The_Locomotion_Interruption

Bernadette: "OK. One more time. We throw chemotherapies blindly at cancer patients, which means we do not care about their genomic profile. The reason for this: whole genome sequencing is not yet a blockbuster."

Penny: "Why would we throw pills at the problem if it doesn't work?"

Bernadette: "Think of them as blockbusters, not as pills. In 'Big Pharma', B stands for Blockbuster: the one and only drug that will cover management's salaries and a whole variety of expenses like gourmet buffet dinners, posh golf clubs, nice congress venues worldwide, entertainment for the physicians. Last but not least, your salary and mine."

Penny: "Yeah, but those blockbusters you are talking about... Can they cure people?"

Bernadette: "Sometimes they can do that. The only thing that is 100% of the time true is that they are so damn expensive."

Penny: "Do people get a refund if the treatment doesn't work for them?"

Bernadette: "Now I need you to think very carefully. Criticizing a blockbuster can get you in real trouble. What would you like better? A well-paid job or death threats?"

Penny: "Got it. Big Pharma is just another Hollywood, with drugs instead of movies. This new job means I will pursue a new career in acting. Blockbuster? I'm all for it."

Bernadette: "Excellent. You are making the right choice."

Overclocking Medicine

https://www.reddit.com/r/futurama/comments/3pea6t/bender_reads_some_awesome_books_when_he_is
 

http://mashable.com/2013/02/08/watson-six/#oXHyvSCRSGqm

"This is Futurama. Books are only for overclocked robots."

The Doctor-&-Patient "Nerdvana Annihilation" Topology

My favorite musical is "New West Side Story", which is an adaptation of "The Creative Destruction of Medicine" by cardiologist Eric Topol MD, but there's kind of a fly in the ointment...

Ever seen that old musical in New New York, Matilda?

Lyrics from "Naughty" -- Matilda The Musical

Stupidity, gory?? Paternalistic medicine??!! Yuck.

This nerdvana thing drives me crazy...

So Sheldon Cooper gave me a hot beverage to comfort me...

He also told me IBM's Watson might help...

http://www.robofed.eu

Watson?!? WTF???!!! 
 

Oh, I see... So they did change their story after all... "The Rockstar Patient Will See You Now"

"A.I. + Rockstar; Doctor + Amy Wong.
What could possibly go wrong?"

http://rosiecoleman.deviantart.com/art/fry-n-bender-193472434

http://www.cc.com/video-collections/l7sdzn/futurama-why-not-zoidberg-/6xblvr

"I'm a Doctor. I thrive in a competitive environment.  I got selected for med school through competition. I've studied anatomy and organs for 15 years but I spend most of my time hating my colleagues."

"Doctor-&-Patient 'Nerdvana Annihilation'? Paternalistic medicine can kiss your shiny metal ass, Bender!"