Next Patient-Ailing Earth: A physician's dilemma

This write up was born out of an attempt to prepare a script for a lecture on "Infiltrated Earth drive-management strategies" for students of a national institute of information technology.

The first power point slide shows a patient Mr. Prithvi waiting his turn outside the physician's clinic. Generally most Indian names have a meaning and Prithvi means the Earth. Now I am not sure how Mr. Prithvi appears to you. I am trying to use him as a metaphor for a system under trouble and am just hoping the audience will be able to visualize him as I see him…a virus afflicted system. The Earth to my mind mirrors a similar system on a macrocosmic scale also afflicted by a virus that refuses to coexist in harmony with it.

To begin with let me just portray him in realistic terms as a human Mr Prithvi, who waits his turn outside the physician's clinic.

We often need suspension of value judgments to comprehend or tolerate illustrations of real life that do not portray real life as such. Some of the connoisseurs of art are habituated experts at this sort of a thing but I am apprehensive my present college audience might be a majority who simply like to call a spade a spade and may not wish to enjoy these multiple unreal metaphorical snapshots of an object (in this case Mr. Prithvi).

The ability to suspend our value judgments may be an essential prerequisite to survival in a postmodern world filled with multiple versions of truth. Coming back to Mr. Prithvi…he has a worried look in this first power point slide. Tests have revealed that his system is inoculated with a virus. The next slide shows his eyes. Although I call them his eyes I project an icteric sunset with a few avian silhouettes in flight. Now some people may not like this technique of abstraction although in academic power point meets I find this is generally accepted, as most of the audience in these meets must have habituated themselves to such abstractions. The discussion that follows rests heavily on the ability of my audience to appreciate these abstractions.

Till now Mr. Prithvi is projected in their minds as a jaundiced human but soon he shall be transformed into the Prithvi, a living giant macrocosmic organism that harbors countless Mr. and Ms Prithvis just as Mr. Prithvi Harbors the countless viruses (microcosmic entities) that have inoculated his system at an earlier unknown date.

Approach to system trouble shooting-

The next power point projects just this heading. Many of these seemingly arid slides are actually tremendous vibrant displays of colorful information once the presenter makes sure that he is able to connect to all the skull tops (brains) of the audience and tap the vast treasure house of visual data compressed within them (in short trigger their imagination).

Disease localization-this sub heading appeared below the previous heading magically with a mouse click.

Well …the approach is rather simple…in one word its localization…anatomic and etiologic localization…don't get perturbed by the medical jargon…they are too simple even to pose a rudimentary challenge to our understanding. In simple terms we need to know where the problem is (anatomic localization) and finally why is the problem (etiologic). These are the only two things clinicians are worried about before they can move over to managing the problem. Its akin to solving a computer hardware problem where one needs to decide which component is malfunctioning and if so why.

In the next slide we move into the innards of Mr. Prithvi's system and I project Mr. Prithvi's gigantic macrocosmic form, a satellite image of our planet that hits you when you open google earth for the first time. We are trying to do an ultrasound scan of Mr. Prithvi's liver and as I click my way into the innards of the satellite image, the scanner transforms its macroscopic images into deeper microscopic ones and gradually we confront an area in the liver that looks lush green, forested and slightly forbidding as the sunsets.

As the pathologist continues to scan through the normal lush green tissue she suddenly encounters an abnormal area of bizarre concrete structures, skyscrapers and flyovers interspersed with a scantly amount of green parks. This is it…a big cancerous growth in the liver that is often labeled "city". An interesting feature of the wiki mapia that wasn't there with google Earth, allows all H viruses to post their own tags to various patches of the Earth. One ubiquitous tag is "Land for Sale"; very often visible in most green patches bordering the city. This tells us how and where the tumor is spreading next.  

The H. viruses inside Mr. Prithvi are very much active and thriving in the artificial settings they have created for themselves inside Mr. P's liver. So what next…

The pathologist keeps sliding Mr. P's liver biopsy sideways on the satellite microscope and one can discern vast areas of the Earth's green ravaged by the urban dwellings the virus needs to stay secure from nature. "I don't think one can do much with this amount of spread," she comments. The physician ever happy to get a diagnosis at last rubs his hands in glee, "Aha…just as I had suspected…the anatomic diagnosis is carcinoma liver (that's where Mr. P's problem was all along and the etiology is the H. Virus that inoculated it sometime back (a few million years perhaps as carbon dating tells us?). The virus has mutated over the last few centuries to give rise to this malignant mass and this is why we have the problem.

Now what…where do we go from here? As a physician it is not very often that one deals with a patient that is of such gigantic proportions. A patient that is home to this physician and other countless H. viruses that continue to breed in its innards.

All humans are born physicians by virtue of an ownership right on their own systems (bodies) that so very often go wrong and need trouble shooting. Most humans' worldwide are aware of the cancer that is ailing Earth and there have been plenty of solutions proposed from all quarters of our H. virus population. We shall review them in the next few slides.

Viral Clearance  

Ordinarily as physicians we always like to treat the cause but in this particular instance we can't, as we are the cause. However it is interesting to think experimentally what might happen to the Earth if by some quirk it manages to pack off all humans to some outer space theme park. In this slide you can see how the other organisms from the microscopic algae to the Elephant (who have unlike humans never harmed the Earth till date) gradually take over our cities, how the malignant concrete eating into the green is reversed by the green closing in on the cities, as their algal walls crumble under the constriction of wild vines. Yes, viral clearance is a worthwhile solution as any hepatologist battling H viruses with interferon and nucleoside reverse transcriptase inhibitors will tell you although coming across a complete remission once the tumor is advanced may yet be unheard of. One thing is clear however, we H. Viruses are not yet ready to leave, not before we have riddled a few more holes into the ozone layer and the heat begins to get on our nerves along with the oceans rising and also there's this other tiny problem of finding another planet. Space tourism is costly at the moment and most H. viruses will have to wait at Earth till a suitably accessible outer space real estate becomes feasible.

Chemotherapy and radiotherapy are too drastic measures and a violent onslaught on their property may not be appreciated by most H viruses who increasingly seem to prefer peace.

 Tumor cell Apoptosis

The only other solution is natural apoptosis that still hasn't caught on among the cells of H viruses.  Throughout ages they responded to their natural instincts craving more security than they really needed which often was because some of them demonstrated more power than they really had.

Most H viral economies are either modeled around exploiting the Earth's natural resources (variously termed production, development etc) or exploiting each other (labeled competition). H viruses needed to protect themselves from the forces of nature, the Earth's immune system that would attack them from time to time. Over the ages H. viruses have not only successfully silenced the natural forces but have also exploited nature to serve their own ends so much so that they face this peculiar predicament of having to witness the demise of the very natural world they set out to protect themselves from little realizing that it was also a larger part of the place they called home.

As long as development continues even if sustainable it is not going to benefit the Earth although it still may benefit a few more humans. All this development, this economic growth leaves the Earth poorer of its natural resources every day. We need to return to Earth, embrace its trees even as tech park builders chop them off. We need to give up our cars, shift our homes closer to walking distances from our place of work and shopping centers. Our houses need to be less opulent and huge to reduce the natural resource consumption that is necessary to maintain the grandeur. We could eat locally grown

produce instead of the perennial exotic branded fruits lined up in global malls flown across the other end of the globe burning fuel for our round the year consumption.

Can we all arise from our seats in this grand auditorium and come out and seat ourselves in the floor of the large empty hall from where one can also look at the lush flora of this campus and listen to the birds chirp. No I guess not… any way I suspected I was getting carried away in the last bit with the sudden burst of unintended cliché.

For the cancerous growth to stop we may need to go against our natural instincts of self preservation and our overtly powerful response to every fear from nature and return to a non developed closer to Earth existence, of our cave dwelling near animal ancestors. I am sure it won't be acceptable to most of us city-bred humans. I can already hear the protests and voices of disgust. "Here we are working towards developed world status from a measly third world existence. All our lives we have been striving towards our inherited dreams of that nice car and plush house and now that it finally seems to be coming true with the country's GDP peaking at an all time high, you are asking us to give up all our dreams…"

No…I guess this is asking too much from this generation. At present we can only look at means to palliate the Earth as it dies and for ourselves hope that we discover another Earth like planet sooner than Earth's last gasp.