News From Senior Physiologists

News From Senior Physiologists

As originally published in The Physiologist
Volume 45, Number 5, October 2002, page 474

Letter to Novera Herbert Spector

John Bligh writes: ?What of interest can I say as I embark on my 81st journey round the sun? I think I?m well, I know I?m happy and the garden looks fine, but these are personal matters. I feel a need to say something more, and more seriously.
?The relative leisure of retirement provides an opportunity to reflect upon those early circumstances which helped to shape one. Amongst them is a more than 50-year-old influence upon all that followed. My laboratory life, delayed by those belligerent affairs of states in the 1940s, started at and with the beginning of the antibiotic and synthetic insecticide era. With penicillin to counter some of the more life-threatening pathogenic micro-organisms, and DDT to reduce the impact of diseases spread by insects, there was the promise of longer and healthier lives for all. It was soon realized, however, that while these new medical aids could prevent countless untimely deaths, the beneficiaries could not then be keep alive into old age unless food production could be increased in line with an escalating demand. Without that provision these medical remedies could only cause a shift in the causes of premature death from infections to hunger. That would be inevitable because humans, like virtually all other animal species, tend to breed in excess of replacement needs, and in excess of the number that can be fed adequately and can achieve maturity. A high incidence of premature deaths is the natural way by which a potential exponential rise in numbers is held in check. Considered globally, the sum of human populations is, and always has been, close to that number which the food supply can support, with the premature deaths of the unfeedable ?surplus? progeny. That may not be a pleasant or readily acceptable state of affairs, but it is intellectually inescapable. Thus, while the total sum of humanity is affected by changes in the sum of food production world-wide, medical endeavors can only materially influence populations in those regions where the food supply is plentiful. Thus, a concern I shared with others more than half a century ago, was that if the world?s food supply could be progressively increased, the major medical and public health advances then occurring would turn tragically and painfully sour. On the assumption that I might do something useful, I was thus persuaded to pay more attention to agricultural animal physiology than to human physiology. By good fortune an agricultural revolution did occur, and it was this and not, in most parts of the world, the concurrently occurring medical advances, that enabled world population to increase from 2.5 billion to more than 6 billion in the last 50 years.
?Now, however, there are ominous signs that the upward progression of food production world-wide could be faltering, while the human population continues to increase. If the continuing efforts to make human lives not just safer but also longer lasting, and not to precipitate a human population crash, it is imperative that we ensure that medical advances that tend to prolong lives, are at all times matched by an equally intensive endeavor to increase food supplies. This is not to say that I consider agricultural research more vital to humanity than health-related research, but it is to say that agriculture is the necessary hand-maiden of medicine. Even with a general agreement that is so, it cannot be supposed that both human populations and their food supplies can continue to rise more-or-less exponentially for ever, or indeed, for very much longer. It is more than likely that food production will reach a zenith first, and, may then even start to decline. Hunger and premature deaths will then increase, and in that way the human population will be brought down to that number which can be sustained by the diminished food supply. If we choose that road, which is the natural biological one, it must, at some time, bring misery and premature death to many more millions than already suffer that fate. So if I could start again and choose again, I would still be strongly influenced by an awareness of the need to equate populations and their food supplies in as a humane way as possible, but with the realization now that the only way to avoid the pain and suffering of natural population control, is to exercise control ourselves. This is the subject matter of what, if I can get it published, will probably be my last utterance as an erstwhile physiologist.?

Letters to Karlman Wasserman

Merrill P. Spencer writes: ?Thank you for your greetings and opportunity to tell my friends what I am doing now.
    ?I am the Executive Director of the Institute of Applied Physiology and Medicine as well as Executive Director of the International Cardiac Doppler Society that was organized by myself several years ago. I am also the Medical Director of two sister companies, Spencer Vascular and Spencer Technologies.
    ?We have developed a new modality for transcranial Doppler diagnosis and monitoring called power m-mode Doppler (PMD). The equipment displays two channels of directionally colored power of the Doppler signal along the ultrasound beam, directed through the skull, along with one sample of blood velocities in a selected vessel. The PMD has improved the finding of transcranial ultrasound windows and provides a devinitive signature of microemboli.
    ?I spend most of my time doing clinical research in one of my vascular laboratories and supervising my technical staff. Recently we have used our PMD to diagnose patent foramen ovale and monitor its transcatheter closure with a new closure device.
    ?I am in excellent health and my wife, Joanne, and I travel a lot, mostly to neurology meetings. I do not intend to retire as long as I feel well.?

Max E. Valentinuzzi writes: ?To cross the 70th mark in acceptable running conditions is quite an accomplishment, even in these days of significant longer life expectancy. To receive a kind letter from a fellow physiologist, Karlman, carrying greetings and warm regards along with a nice invitation to submit a note to The Physiologist, asking questions like what are you doing now?, are you continuing with scientific activities and scientific or other writings?, what are your current interests?, do you have any words of wisdom to pass on to your younger colleagues?, is a stimulating little (or big) fact that tells me what a beautiful and rewarding activity I chose in my life and what wonderful people I got to know.
    ?The three first questions can be readily satisfied: Retired but still active, under a contract with the Universidad Nacional de Tucuman (UNT), as part-time Professor, and under another contract with the Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), as Fellow Investigator. My research activities include a project on cardiovascular mechanics and another one on the psychophysiologic effects of music. I also supervise two doctoral graduate students. Besides, I am writing a textbook on Bioengineering (with a lot of Physiology in it) under a contract with World Scientific Publishers, based at New Jersey and Singapore, while I play piano and record my own cassettes to relax my mind during the intermissions and, on weekends, I travel with my wife to a house (yet unfinished) hidden in Los Zazos-Amaicha, a small 5,000 people peaceful village at about 6,000 feet above sea level, after passing El Infiernillo at more than 9,000 feet, in the Calchaqui Valleys of the Province of Tucuman. The socio-economic debacle of our unbelievably shaken country is then forgotten, gazing at the majestic mountains, always bewitched by the clear nights and their overpowering Via Lactea (the Milky Way), watching placid grazing goats, pigs and burros, talking about simple things with simple, honest wise people.
    ?Some recollections and musings may answer at least partially the last question. It was my father, Max Valentinuzzi, Sr., physician and physicist, who perhaps back in 1941, when I was nine or so, used to take me to his Biophysics Lab at the National Academy of Medicine, in Buenos Aires, and showed me for the first time the beating heart of a frog (I did not suspect how many I was going to use in laboratory exercises), what the galvanic skin response was, teaching me also how to use a Leeds & Northrup Poggendorff potentiometer. One of those days, around 1943, there was a scientific meeting at the Academy?s auditorium. I had to go to the restroom and, while in there, I heard two old gentlemen speaking in English. As I learned thereafter, one of them was Dr. Bernardo Houssay, who won the Nobel Prize of Physiology in 1947. Years later, around 1955, and when I was in the Engineering School at the University of Buenos Aires, my father invited Dr. Bliss, a well-reputed biostatistician from Yale University, I believe, to offer a series of talks. It was in one of those that I met Dr. Houssay for the second time, already crowned by the Nobel halo. By then, I had become a student member of the IEEE and, soon, also a member of the Professional Group on Medical Electronics.
    ?Much water ran under bridge during the 47 years that elapsed ever since. On the personal side, the roads of life made me meet in Houston, TX, Hebbel E. Hoff and Leslie A. Geddes back in 1962, scientists, in-born teachers and friends, who literally changed my whole life, putting in my hands new intellectual elements, giving me a taste for the history of science and the beauties of classical experimental physiology. Soon thereafter, Roger Guillemin became one of my highly respected and dear teachers, one who still honors me with his noble friendship. I still keep a short letter from him thanking me for a note where, more than one year before (1975 or so), I forcasted the Nobel Prize for him. In 1982, Rene Favaloro and his group, due to a number of happy coincidences, came to a close contact with our little and modest laboratory, giving rise to several years of productive collaboration. His traumatic disappearance brought me deep sorrow and pain (1). These are the names that left a deep imprint in me and, very likely, some of it was also transmitted to my students over the years, as some kind of intellectual DNA that shapes up the intellectual progeny, something that so many times Hebbel Hoff and Roger Guillemin used to underline. Other scientific personages very briefly touched my life, as sparks: Kenneth Cole (back in 1976, in Ottawa, Canada), Luis F. Leloir (in 1978-79, in Argentina, also a Nobel winner), Kiichi Sagawa (in Buenos Aires, 1982, and in Baltimore, 1988), Otto Schmidt (at the University of Minnesota, in 1991, with whom I spent almost a whole day), Herman Schwan (in Philadelphia, in 1991). Somehow, those short and improvised conversations were also able to leave longstanding messages and memories. Learning is fortunately a never-ending process.
    ?Personal life is interwoven with social, political, economic and scientific events. There is no way to separate them out. My generation was initiated with the vacuum tube, saw the transistor birth, the development of the operational amplifier, the integrated circuits, the microprocessor and the personal computer. Point to point communications were superseded by the satellites, the web, and the cellular phones, while the SPUTNIK in October 1957 and later on the female dog astronaut Laika left us speechless. Amazement after amazement came as an overwhelming waterfall: cardiac pacemakers, implantable defibrillators, open heart surgery, cardiac transplantation, myoelectric prostheses, implants of different types ...so many and so revolutionary that our life styles, ways of thinking and philosophical attitudes have been profoundly changed. In science and technology and in biomedical knowledge, mankind has advanced more in the XXth Century than in all the previous centuries.
    ?Interdisciplinary studies have become the most productive concept. Historically, and for a long period of time (Middle Age, Modern Times), knowledge was thought as a unified set with science being considered a relatively smaller portion called Natural Philosophy (as opposed to the higher Theologic and Human Philosophy). Our current PhD?s or Doctor of Philosophy degrees stem in these old ideas. Disciplines and more focalized specialties showed up much later. Sciences seem to come together once more, but the attitude now is more positive and constructive, so much that isolation within a single scientific and technical compartment denying the influences and contributions from the outside may mean self-extinction. The Theory of Creativity, introduced by Arthur Koestler (2) very clearly holds that mental collisions, facilitated by inter- and multi-disciplinary activities, favor the understanding of problems, discovery, inventivity and the generation of fresh knowledge.
    ?In 1944, Erwin Schroedinger, Nobel laureate and cofounder of Quantic Mechanics, published a small and famous book, What is Life? It became later on a hallmark for the development of the current Molecular Biology (3). It was an attractor for other physicists who were brought to the area of Biology starting up a revolutionary movement with transcendent contributions from Computer Science, Physics, Electronics, Mathematics, and Telecommunications. The Human Genome Project (4) dramatically exemplifies the projections and still unforeseen reach of this fascinating and apparent melange. The emerging virtual surgery (5) seems to cross the borders of science fiction while cellular engineering, artificial organs and biomaterials are opening new roads to explore with huge practical possibilities. No doubt, the barely started XXIst New Century is the dawn of a brilliant New Physiology (6,7).
    ?However, and despite the tremendous scientific and technological progress, the true and cruel huge problem of mankind is still open: inequality, as manifested by deep and growing socio-economic differences that lead to insufficient education, malnutrition and endemic diseases, to an insensitive affluent minority and an enormous suffering majority (8). The recent Twin Towers tragedy in New York City followed by the retaliation against Afghanistan, both paying an unmeasurable toll in human lives and destruction, sowing nothing but hatred for the future, flag bluntly a human problem of still unsuspected magnitude and consequences. No one is left out.
    The XXth Century started with about 1,000 million inhabitants; the New XXIst Century is beginning with about 6,000 million people, and we know that before 2050 the number will climb up to may be 12,000 millions. Besides, in less than 30 years there will be severe limitations in the availability of fresh potable water. Science in general, technology, physiology and bioengineering in particular: what could they do or offer to solve or alleviate the pressures emerging from such demands? Certainly, more and better weapons and more powerful armies are not the proper and sensible way. Perhaps, we had better remember that before anything else, we are simply men and women, that being is much better than having and that independently of how much richness, or power, or knowledge, or worldly glories we might collect and store, the really important and significant fact is and will be how much we love and how much we have loved. And the scientific endeavor calls for a lot of love.?

References
l. Valentinuzzi ME. (2001) ?An honorable death?? PACE, Musings Section, June.
2. Koestler, A. The Act of Creation. Pan Books Limited, 3rd printing 1978, 1st edition 1964, Great Britain, 491 pp.
3. Schroedinger, E. What is Life?, Cambridge University, reprinted 1998, 184 pp.
4. ?Human Genome: Rival Genome Sequencers Celebrate a Milestone Together.? Science. 30 June 2000, vo1 288, pp. 2294-5.
5. Borst, C. ?Operating on a Beating Heart.? Scientific American. October 2000, pp 46-51.
6. Valentinuzzi, M.E. ?Bioengineering: Looking into the 21st Century. IEEE/EMBS Mag, 18(1):16-7,20, Jan/Febr 1999.
7. Valentinuzzi, M.E., Arias, N.E. ?Human psychophysiological perception of musical scales and nontraditional music.? IEEE/Eng Medicine & Biol Mag. March-April, 18(2): 54-60, 1999.
8. Valentinuzzi, M.E. ?Hippocrates Oath.? IEEE Technology and Society, 15(3):46-7, 1996.

John Severinghaus writes: ?My family threw a party this May for my 80th birthday, with about 130 guests at the Marin Art and Garden Center ?extravagant but fun.
    ?High altitude research is over for me. I had to abandon a trekking group at 4,300 meters near the Kangshung face of Everest in Tibet a few years ago?severe ventilatory drive, not pulmonary or cerebral edema.
    ?Our most recent work showed that angiogenesis-induced capillary breakdown probably underlies high altitude cerebral edema (HACE). Feng Ping Xu and I found vascular endothelial growth factor (VEGF), the angiogenesis signature, in hypoxic rat brain, and Marlowe Eldridge and I found VEGF in human nasal washes during rapid ascent to altitude. Nosebleed is common at altitude.The International Society for Oxygen Transport to Tissue is now about 30 years old and thriving.
    ?When pulse oximeters became available in 1985, I began a program of testing their accuracy at low saturation, as part of my interest in high altitude and its problems. I had generated an accurate simple equation of the oxygen dissociation curve, and applied it to a method to predict arterial oxygen saturation from end tidal mass spectrometer analysis of Pco2 and Po2. This permitted me and my group to safely briefly expose healthy volunteers to saturations as low as 40% for 15-30 seconds and then sample arterial blood oxygen saturation. This turned into a service for manufacturers needing data to submit to FDA, and continues at an accelerating rate. We have been testing one to three new instruments on six to 12 volunteers each month in the anesthesia Hypoxia Research Lab at UCSF. I manipulate inspired oxygen, watching the computed estimated saturation on an old analog meter, which is more useful than a rapidly changing digital numerical display.
    ?Several years ago, Tom Hornbein, chief of Anesthesia at the University of Washington, Seattle, alerted me to a serious problem with care of a dear friend of his at our Marin General Hospital. After I reported the second hand information at a District Board Meeting, I was unanimously elected by the board to serve out a term when one member resigned for ill health, and then in November 2000 I was re-elected by 62% of Marin County voters responding to numerous charges against the corporate board that leased the hospital in 1985, illegally, it became apparent. We now await court action of the District?s lawsuit to invalidate that lease and recover public control of medical and nursing policies. I learned this morning that I will face nine other candidates for the three seats this November.
    ?I lecture on altitude pathophysiology, regulation of respiration and acid base balance to each year?s group of CVRI fellows and anesthesia residents. Our lab has been moved at least five times since I retired, and will move again in a few weeks to a hopefully more permanent location in Moffitt Hospital, taking over a three bed unoccupied patient room. That human study lab is shared with many other Anesthesia Department investigators.
    ?While I have abandoned the large national anesthesia and physiology meetings, I delight in subspecialty groups like ISOTT and the Anesthesia History Association which celebrated Ralph Waters? appointment 75 years ago this May to the world?s first academic anesthesia department in Madison, my home town, where my father?s office was next door to Waters? office. Most current academicians trace their roots to him. Last year Elinor and I attended the Scandanavian Anaesthesia Society far north of the arctic circle in Troms? Norway?a large metropolitan agricultural and industrial city in addition to its fishing traditions. We?ve been regulars at those meetings for 40 years, rotating between the five Scandanavian countries. My lecture in Troms?reported the discovery, 220 years late, of the lost letter from Swedish pharmacist Carl Wilhelm Scheele to Antoine Lavoisier of his discovery of oxygen two years before Priestley. Popular lecture to that Nordic audience!
    ?Forty-four years ago this week Elinor and I bought this house in Ross where I now spend more time gardening than either politicking or researching. Dahlias and roses are at their peak now?no aphids in August! Our four children remain single keeping us from aging into grandparenthood. Ed builds medical and electronic devices, Jean head-hunts for the packaging industry, Wendy writes and edits, and Jeffrey, the youngest is just now extracting trapped methane from Greenland glacier ice dated to 11,500 years ago to understand how the ice ages came to such a sudden end.
    ?In December 2000, I broke my back when my ladder slid off our Sequoia (Christmas light fixing), but I?m very lucky?fully healed, no residual pain or limits. Elinor continues to join me in most meeting travel, and has graciously continued to feed me even for lunch most of the time.?

Letter to David Bohr

Horace Davenport writes: ?I am grateful for having the opportunity to be a physiologist. I have enjoyed learning and teaching physiology, and my research has given me more reward than frustration. I am also grateful for the knowledge that my teaching and research have done some good in the world and that my historical writing has amused and enlightened some of my colleagues. All this is a bit sententious. Physiology has been fun.?

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