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One of the things I love most about being a Surgical Oncologist is that I see my patients for years after I have treated them. However, my clinic days are inevitably like the opening scenes from the old Wide World of Sports television program that aired on Saturday afternoons on ABC. I remember watching this show on weekends as a child and teenager. The “thrill of victory”, with images of athletes crossing the finish line in first place, equates to those patients who receive good news during their clinic visit. I tell them I am confident I can perform an operation to remove their cancer; or I confirm that their blood tests and scans show that tumors have not recurred after surgery, chemotherapy, and other treatments; or we pass some major chronologic milestone without evidence of cancer rearing its ugly head again (many patients still believe the 5 year anniversary of being cancer-free equates with being “cured”, if only that were always true). In contrast, the “agony of defeat”, forever seared in my memory in the opening scenes of Wide World of Sports with the ski jumper falling off the end of the jump and bouncing hard off the slope, represents the distress and depression felt by patients and their family members when I deliver bad news.

I would never make it as a professional poker player because I can’t bluff when I’m holding a bad hand or keep from grinning when I have a good one. My patients can tell from my face when I walk into the clinic room what the news is going to be. When all of the blood tests and scans reveal no evidence of cancer recurrence, I walk in smiling and immediately tell all gathered in the room that everything looks great and I see no evidence of any cancer. The remainder of the visit becomes a combination of medical checkup and social enterprise. I inquire about the well-being of their children, grandchildren, parents, other friends and relatives I have met, their pets, their gardening, their recent travels, and sundry snippets of their ongoing lives. Patients frequently bring pictures of children and grandchildren, or travel photos of places they have been since their last visit with me. Often I’m asked for medical advice on conditions totally unrelated to their cancers as they get farther and farther away from that diagnosis. My patients also know about tidbits from my life. They ask about the status of soccer teams that I coached, how my son or daughter were doing in college (both graduated and onto successful careers, thank you), and whether I have progressed from owning a Ferrari lanyard to hold and display my medical badge (I’m a fan of Ferrari F1 racing) to actually owning a Ferrari automobile (I do not).

I am told by patients, family members, and members of my patient care team that I am quite solemn when I walk in a clinic room to deliver bad news. No “light-hearted” chatter or discussion of recent family events or outings occurs. The nervous, hopeful smiles on the faces of the patient and the family members in the room quickly fade as I describe what I am seeing on their blood tests and the scans I have reviewed. Friedrich Nietzsche, the pejorative poster boy of pessimism, is credited with the aphorism, “Hope is the worst of evils, for it prolongs the torments of man.” Thankfully, he was not involved in the care of patients with cancer or other chronic illnesses. A particular patient comes to mind when I remember the importance of dealing with both the highs and the lows of talking with cancer patients.

The patient in question was the wife of an Emeritus Professor of Engineering at a prestigious American university. The Professor knew a thing or two about scientific investigation, statistics, and assessments of probability. Mrs. Professor had a large, grapefruit-sized malignant vascular tumor in the center of her liver called an epithelioid hemangioendothelioma. Quite a mouthful of a name for a rare malignant tumor of the liver. Her tumor was in an unfortunate location in the center of the liver and was wrapped around two of the three veins that drain all of the blood out of the liver into a large blood vessel called the inferior vena cava. The tumor was abutting a portion of the third vein. As a hepatobiliary surgical oncologist, I know I must preserve at least one of these veins to allow blood that flows into the liver to flow back out properly. She had seen surgeons at several other hospitals in the United States and was told that the tumor was inoperable and untreatable. If she was lucky, she might live a year, these doctors told my patient and her husband. The Professor contacted me, and I examined Mrs. Professor and evaluated her prior scans, and then obtained some additional high resolution scans to better understand the appearance of her tumor. I realized that her particular tumor had a very thick fibrous capsule surrounding it. I explained to the patient and her husband that it may be possible to remove the tumor, but that it would be challenging. This lady who had been sullen, withdrawn, and tearful every time I had met with them previously suddenly looked up and said, “If there’s any chance, I’m willing to take it!” I preceded the next week to perform an operation that removed the entire left lobe and a portion of the right lobe of her liver and I was able to gently dissect the tumor capsule free from the third hepatic vein. The operation was successful and the patient recovered well over the next several weeks.

The Professor, having lots of time on his hands, sent an acerbic letter to the physicians at the other hospitals, explaining in detail to them his mathematical analysis of the fallacy of their prognosis when considering an individual patient in terms of a statistical mean. He pointedly informed them that it was impossible to predict if any given individual would fall near the mean or several standard errors away from the mean. In plain language, the Professor was indicating that predicting the length of survival of cancer patients is usually based from data on the life-span of a large number of people diagnosed with the same disease. Some people live for a shorter, possibly even much shorter time than the average, while some live for significantly longer periods than the average survival time. Unfortunately, for the next year when I would encounter these various surgeons at national or international surgery or cancer meetings, I would get some frosty glares and very little conversation.

For the next three years, I saw Mrs. Professor every four months and with each visit I would enter the room smiling and pleased to report that all looked well on the blood tests and the scans. Unfortunately, three and a half years after her operation, the nature of the clinic visit changed. The moment I walked in the door of the room the professor said, “Uh oh!” Mrs. Professor immediately looked crest fallen and asked, “What is wrong?”. I sat down and explained to them that there were new small tumors in her liver and in her lungs. She asked how this could be possible since she felt so well, and I countered that small tumors frequently do not cause symptoms or problems that make the patient aware of their presence. I spent almost an hour answering an array of questions from my patient and the Professor, many of which were different ways of asking me to predict the future and her probable longevity. I repeatedly explained that this was a bad prognostic finding, and that her particular tumor was generally quite resistant to chemotherapy. She stated openly that she had no interest in taking chemotherapy or other treatments that would adversely impact the quality of her life. She then looked at me with tears in her eyes and asked, “Does this mean I won’t see you again?” I immediately replied that I would continue to see her on a regular basis throughout her life and that in my opinion part of the job for all of us in oncology is to support and care for our patients through all phases of the disease, even when our treatments have failed to eradicate the malignancy. I also confirmed that I respected her decision to decline chemotherapy treatment, and that I would assist her at any time. The patient smiled wanly, and reported that she was relieved that my colleagues and I would be available to treat any symptoms and help her should she develop any discomfort or other problems.

I continued to see my patient and the Professor every three months for another year. I arranged for consultation visits with physicians from our Palliative Care Service. Approximately fourteen months after I delivered the bad news that her cancer had recurred, the Professor called me and said that she was fading rapidly and they would likely not return. A month later I received a poignant and personal letter. In it, the professor included the obituary from the local newspaper regarding his wife’s death. It chronicled an impressive array of accomplishments and interests enjoyed over the course of a life lived fully. There was also a small hand painted watercolor card from the patient with a note to me. In it, she thanked me for giving her hope at that initial visit when I told her that it may be possible to remove her liver tumor with an operation. She then wrote something that I will never forget, “When I saw the other doctors, I felt rejected, trashed, and discarded. I felt they were dismissing me because they could not remove my cancer. All my hope was killed.” The note went on to thank me for giving her several additional years of life to enjoy traveling with her husband and spending time with friends and activities that were important to her. I make no apology to Friedrich Nietzsche or his acolytes, for I know that the death of hope is a much greater torment for patients than the presence of hope.

They didn’t teach a course on delivering bad news when I was in medical school, surgical residency, or during my surgical oncology fellowship. I often think of this cartoon by New Yorker cartoonist Matthew Diffee:

Bickles

Delivering and receiving bad news is difficult for everyone involved in cancer care (and any other area of Medicine or life, for that matter): the patient, their family members, their friends, the physicians, and the members of the medical and nursing teams. We can’t have Mr. Bickles deliver the bad news for us and then walk away unscathed. There is an emotional toll taken on all of us. We can deliver bad news with compassion and care, and that should be the goal. Patients have the right to know that they are facing a battle with cancer that they will ultimately lose, but that physicians and other medical professionals will fight alongside them and support them and their family members. Supporting the family members of a cancer patient is too often a forgotten or unspoken component in cancer care, but one which requires mindfulness because all members of the family suffer and need support as they watch the disease progress and change their mother, father, son, daughter…whomever. One thing I learned early in my career is that patients may feel they will be abandoned by the medical profession when we can no longer treat or alter the progression of their cancer. Recall the words written by my patient, “I felt rejected, trashed, and discarded. I felt they were dismissing me because they could not remove my cancer.” Regardless of the outcome, I believe we must fight the battle hand in hand with our patients to the end, providing hope tempered with realistic expectations, discussion of possible symptoms and problems, compassion, and reassurance that we are there to help throughout the process.

hope

I learn useful life lessons from each patient I meet. Some are positive messages, reminding me of the importance of maintaining balance between family, work, and leisure activities, but more frequently I witness examples of the remarkable resilience of the human spirit when facing the reality and risks of a major surgical procedure and a diagnosis of cancer. Rarely, patients and their family members utter remorseful or simply sad remarks when they are faced with a grim prognosis and the emotions associated with an onrushing date with mortality. These comments invariably involve an inventory of regrets in life, including, “I should have spent more time with my kids,” “I wish I had told my father (or mother, brother, sister, child, or some other person) that I loved them before they died,” and “I have spent my entire life working, I never took time for anything else.” I wince when I hear these openly expressed remonstrations, I recognize that I am hearing painful and heartfelt truths. Not a week goes by that I am not reminded that I do not one day want to look back at my life with a long list of regrets, should have dones, and what ifs.

I was blessed to meet a great teacher in the guise of a patient early in my academic career. He came to my clinic in my first year after completing a Fellowship in Surgical Oncology, my first year as an Assistant Professor of Surgery. My patient was a 69 year-old Baptist Minister from a small town in Mississippi. He was referred to me by his medical oncologist who called me and said, “I don’t think there is anything you can do for him, but he needs to hear that from you because he doesn’t believe me.” This tall, imposing man had colon cancer that had metastasized (spread) to his liver. The malignant tumor in his colon was removed the year before I met him, and he had received chemotherapy to treat several large tumors found in his liver. The chemotherapy had not worked and the tumors grew. At the point I met him, the medical oncologist told him he would live no more than 6 months, and because he was an avid fisherman when not preaching or helping others in his community , the doctor suggested that he go out and enjoy his remaining time by getting in as much fishing as possible. I learned two invaluable lessons from this patient and his family. First, never deny or dismiss hope from a patient or their family, even when from a medical perspective the situation seems hopeless and the patient is incurable. Second, quoting the minister directly, “Some doctors think of themselves as gods with a small ‘g’, but not one of you is God”.

When I first walked into the examining room, this man was slouched on the examining table in the perfunctory blue and white, open-backed, always unflattering hospital gown. He made eye contact with me briefly, then looked down to the floor. In that momentary meeting of our eyes, I saw no sparkle, no life, no hope in his eyes. He responded to my initial questions with a monotonic and quiet voice. Several times I had to ask him to repeat an answer because his response was so muted. Mid-way through our first visit, the patient’s wife told me he had been very depressed by his diagnosis of untreatable metastatic colon cancer. She reported, despite his occasional side-long warning glances requesting her silence, that while he was eating well, he was spending most of his time sitting in a chair or laying in bed, and that the active, gregarious man with the quick wit and booming voice she had married was gone.

After I interviewed and examined the Minister I left the room so he could dress and sit in a chair next to his wife. I reviewed the results of the lab tests and CT scans we had performed on him, and then returned to the examining room. I explained to them that I believed it was possible to perform a difficult operation that would remove approximately 80% of his liver. The operation would be risky, it was possible he would require blood transfusions, and as a worst-case scenario the small amount of remaining liver might not be sufficient to perform necessary functions. If I pushed the surgical envelope too far and removed too much normal liver, following the operation he could develop liver failure leading rapidly to his death. I also stated, assuming he survived a major operation and the recovery period, that I could not predict his long-term outcome or survival. I emphasized that even if the operation was successful, it was possible that the cancer would recur in the remaining liver or in some other organ. I even attempted to raise his spirits a bit by injecting some puerile surgical word play when I said, “This operation will leave you with little more than a sliver of liver, but God willing it will be enough!” At the conclusion of my very direct monologue, he looked up from the floor and once again his eyes met mine. I remember blinking several times in surprise at how different his eyes now appeared. With his eyes bright and twinkling he asked, “Are you saying there is hope?” I replied that I believed there was hope, albeit small and impossible to measure, but hope nonetheless. An unforgettable and immediate transformation occurred in his demeanor and as his wife smiled at me and mouthed the words, “He’s back”; he reverted instantaneously to what I would come to learn was his former garrulous self.

The spiritually-resuscitated Minister sat upright, grasped my right hand with both of his hands, and launched into a memorable diatribe. “Never deny someone hope doctor, no matter how hopeless you know the situation to be. Humans need hope, without it comes depression, despair, and death. Why do you think the Jewish defenders at Masada held out against an overwhelming Roman force for so long? Because they had hope, and they had faith. Why do people let you cut them open? Hope. Never deny a human being hope doctor, without it we have no humanity, we are only another animal.” He was a forceful and eloquent speaker. With his Mississippi drawl, he could alternatively be plain spoken or pedantic. He was a well-read and educated man and he loved to display his extensive etymologic armamentarium. Not infrequently after our conversations I would seek out a dictionary to learn the meaning of a word or two. I had no difficulty visualizing him preaching from a pulpit in his Baptist church, like a yo-yo dropping his parishioners to the floor with the fear of eternal damnation, and then pulling them back up into his hands with a message of redemption and salvation.

I walked out of the examination room enthralled and scheduled the operation for the next week. I was amazed by the sudden change I had witnessed in this man’s posture and overall demeanor. As with all who provide care for patients with debilitating and serious medical conditions, I have seen patients lapse into a state of abject, deep despair and complete hopelessness. Like an autumn leaf falling from a tree branch, their spiritual demise leads to a rapid downward spiral of their physical condition. These patients fulfill the expectations of medical practitioners who have told them their survival will be a matter of only weeks or months, in fact I have seen several patients die much more rapidly than I would have predicted when darkness and despair overwhelmed them.

I had the Minister’s “sermon” on my mind throughout his operation. As I expected, the operation was technically difficult. He was a robust, barrel-chested man and had four large tumors in his liver. Two of these were right lobe of the liver only, but the other two extended from the right lobe of his liver into portions of the left lobe of the liver. One of these latter two tumors also extended down to involve two of the three large veins that drain blood from the liver into the large vein, called the inferior vena cava, that carries blood back to the heart. To assure that I had completely removed all of the tumor around these two veins, I removed a portion of the wall of the inferior vena cava and replaced it with a patch from another vein. It was a liver surgery tour-de-force, and at the conclusion of the operation the surgical fellow who performed the operation with me and I quietly congratulated one another on a job well done. Nonetheless, I admit to my own negative sentiments and relative paucity of optimism at the end of the operation. I remarked to the surgical fellow working with me that while the operation had been technically challenging and a great lesson in surgical anatomy, I doubted that we had cured this patient because I was concerned his aggressive cancer would return.

“Never deny someone hope doctor.” If I ever had a crystal ball to predict the future, I obviously dropped it in the mud a long time ago. I was wrong about the Minister. His cancer never returned. He spent only one week in the hospital after his operation and his sliver of liver performed and regenerated beautifully. For the first five years after the operation I saw him every three to six months with lab tests and CT scans to check for return of malignant tumors. For the next six years I saw him only for an annual visit. This man survived and enjoyed life for eleven years after being told that he only had only six months to live. He died as many of us would wish to die, in his sleep from a stroke. He gave his last sermon from the pulpit of his church three days before he died. His cancer never returned to prey upon his mind and hunt down his hope.

After thinking about it, I realize I learned one additional lesson from this patient. He taught me that it was acceptable to express a little clean, righteous anger and then laugh and move on. The Minister and I developed a ritual that was repeated with each of his visits after passage of the initial six months he was told he would live by his medical oncologist. After I reviewed the results of his tests and CT scans and confirmed that all was well and that cancer had not returned, he would smile and say, “Let’s do it!” From the examining room, I would dial the phone number of the medical oncologist in Mississippi who had referred him to me. The Minister admitted to me he was angry that this doctor had needlessly denied him hope. When the medical oncologist came to the phone, I would hand it to the Minister, who would identify himself to the doctor, and then he would say the same exact words, “Hey doc, you want to go fishing?” As a surgeon, I confess I enjoyed witnessing the surgical precision with which the preacher inserted this verbal blade, deftly turning it to maximize the impact of his statement. When I passed the phone to the Minister, he always had an impish, perhaps even devilish grin on his face. Each time after he asked the doctor in Mississippi if he would care to join him for a fishing expedition, he would hand the phone back to me and a look of beatific serenity would come to his face. The ritual was completed when I would take the phone and speak to the doctor in Mississippi. In my first few conversations with this physician, I apologized for my obvious and indecorous breach in professional behavior, but to the credit of this man being regularly taunted by a Baptist Minister who wasn’t entirely forgiving, he would tell me that no apology was necessary and that he believed he deserved and benefited from these brief but poignant verbal reminders. As the years passed, he would be laughing when I put the phone to my ear and tell me that he really enjoyed those calls and that his whole office staff looked forward to this annual event.

Two years before the Minister finally died at the age of 80, the doctor in Mississippi told me that because of this patient, he never answered the question asked to him by patients about their expected longevity with a diagnosis of advanced cancer. Instead, he would inform the patients and their families that he really couldn’t make such a prediction because of marked individual differences in responses to treatment, along with the immeasurable will to live even in individuals no longer receiving treatment for their cancer. Together, he and I learned the importance of leaving no treatment stone unturned; to engage in multidisciplinary management and to consider all options for our patients. Great lessons from a great spiritual teacher, taught to a couple of hard-headed doctors.

“Hey doc, you want to go fishing?”

Interesting Question to ask.


The battle between the FBI and Apple over the unlocking of a terrorist’s iPhone will likely require Congress to create new legislation. That’s because there really aren’t any existing laws which encompass technologies such as these. The battle is between security and privacy, with Silicon Valley fighting for privacy. The debates in Congress will be ugly, uninformed, and emotional. Lawmakers won’t know which side to pick and will flip flop between what lobbyists ask and the public’s fear du jour. And because there is no consensus on what is right or wrong, any decision they make today will likely be changed tomorrow.

This is a prelude of things to come, not only with encryption technologies, but everything from artificial intelligence to drones, robotics, and synthetic biology. Technology is moving faster than our ability to understand it, and there is no consensus on what is ethical. It isn’t just the lawmakers who are not well-informed, the originators of the technologies themselves don’t understand the full ramifications of what they are creating. They may take strong positions today based on their emotions and financial interests, but as they learn more, they too will change their views.

Imagine if there was a terror attack in Silicon Valley — at the headquarters of Facebook or Apple. Do you think that Tim Cook or Mark Zuckerberg would continue to put privacy ahead of national security?

Scientists have redefined the classification of animals due to genetics; 1st time in 300 years. I wonder how the Vets and the Vet Colleges will respond?


The classification system for animals has been hotly debated and frequently changed since it was created 300 years ago, but now researchers have actually found a genetic basis which confirms that part of the system we use today is actually pretty accurate—and they think this part can be defined even more specifically down to the genetic level.

An international team led by Professor Itai YanaAi of the Technion-Israel Institute of Technology Department of Biology made the discovery after using an extraordinarily powerful technique known as CEL-Seq. CEL-Seq monitors individual cells for their gene activity (as detected via mRNA)—and they applied it across 10 different species, with CEL-Seq being applied to 70 embryos per species.

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By Warren Duffie, Office of Naval Research

An exciting new scientific frontier-synthetic biology-took center stage as a celebrated scientist from the Massachusetts Institute of Technology (MIT) recently spoke at the headquarters of the Office of Naval Research (ONR).

As part of a Distinguished Lecture Series celebrating ONR’s 70th anniversary, world-class scientists, researchers and experts from diverse fields will be speaking at ONR in 2016. Dr. Christopher Voigt, an MIT professor of biological engineering, inaugurated the lecture series with a look at the revolutionary potential of synthetic biology.

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I believe that AI holds a lot of promise and many great things; however, we have to correct some very critical issues 1st before compound a huge issue that we have today. And, that is Cyber Security and re-establish trust with our consumers and customers. Without these 2 being fully addressed; you will compound these two challenges with AI plus run the risk of having an IoT that most people will not wish to use due to hackers, bad data, etc. Not to mention lawsuits for Wi-Fi connected robotics that were hacked and injured or worse some innocent person.

I believe need to ensure priorities are in order before we make things worse.


Unexpected convergent consequences…this is what happens when eight different exponential technologies all explode onto the scene at once.

This post (the second of seven) is a look at artificial intelligence. Future posts will look at other tech areas.

http://www.transcendencemovie.com/

Dr. Will Caster: “For 130,000 years, our capacity for reason has remained unchanged. The combined intellect of the neuroscientists, engineers, mathematicians and hackers in this auditorium pales in comparison to even the most basic AI. Once online, a sentient machine will quickly overcome the limits of biology. And in a short time, its analytical power will be greater than the collective intelligence of every person born in the history of the world. So now imagine such an entity with the full range of human emotion. Even self-awareness. Some scientists refer to this as ‘the Singularity’. I call it ’Transcendence’. The path to building such a super-intelligence requires us to unlock the most fundamental secrets of the universe. What is the nature of consciousness? Is there a soul? And if so, where does it reside?”

Luddite: “Dr. Caster.”

Dr. Will Caster: “Yes, sir? You have a question?”

As recently as 50 years ago, psychiatry lacked a scientific foundation, the medical community considered mental illness a disorder of the mind, and mental patients were literally written off as “sick in the head.” A fortunate turn in progress has yielded today’s modern imaging devices, which allow neuroscientists and psychiatrists to examine the brain of an individual suffering from a mental disorder and provide the best treatment options. In a recent interview, Columbia University Psychiatry Chair Dr. Jeffrey Lieberman stated that new research into understanding the mind is growing at an accelerated pace.

(iStock)
(iStock)

Lieberman noted that, just as Galileo couldn’t prove heliocentrism until he had a telescope, psychiatry lacked the technological sophistication, tools, and instruments necessary to get an understanding of the brain until the 1950s. It wasn’t until the advent of psychopharmacology and neuroimaging, he said, that researchers could look inside the so-called black box that is the brain.

“(It began with) the CAT scan, magnetic resonance imaging (MRI) systems, positron emission tomography (PET scans) and then molecular genetics. Most recently, the burgeoning discipline of neuroscience and all of the methods within, beginning with molecular biology and progressing to optogenetics, this capacity has given researchers the ability to deconstruct the brain, understand its integral components, its mechanisms of action and how they underpin mental function and behavior,” Lieberman said. “The momentum that has built is almost like Moore’s law with computer chips, (and) you see this increasing power occurring with exponential sort of growth.”

Specifically, the use of MRIs and PET scans has allowed researchers to study the actual functional activity of different circuits and regions of the brain, Lieberman noted. Further, PET scans provided a look at the chemistry of the brain, which has allowed for the development of more sophisticated pathological theories. These measures, he said, were used to develop treatments while also allowing measurement of the effectiveness of both medication-based therapies and psychotherapies.

As an example, Lieberman cited the use of imaging in the treatment of post-traumatic stress disorder (PTSD). The disorder, a hyperarousal that chronically persists even in the absence of threatening stimulation, is treated through a method called desensitization. Over time, researchers have been able to fine-tune the desensitization therapies and treatments by accessing electronic images of the brain, which can show if there’s been a reduction in the activation of the affected amygdala.

Lieberman noted that despite progress in this area, technology has not replaced interaction with the individual patient; however, as technology continues to evolve, he expects the diagnoses of mental disorders to be refined.

“By the use of different technologies including genetics (and) imaging, including electrophysiological assessments, which are kind of EEG based, what we’ll have is one test that can confirm conditions that were previously defined by clinical description of systems,” Lieberman said. “I think, of all the disciplines that will do this, genetics will be the most informative.”

Just as genetics is currently used to diagnose cancer using anatomy and histology, Lieberman said the expanding field is helping researchers distinguish mental illness in individuals with certain genetic mutations. He expects that in the future, doctors will use “biochips” to routinely screen patients and provide a targeted therapy against the gene or gene product. These chips will have panels of genes known to be potentially associated with the risk for mental illness.

“Someone used the analogy of saying the way we treat depression now is as if you needed to put coolant into your car. Instead of putting it into the radiator, you just dump it on the engine,” he said. “So genetics will probably be the most powerful method to really tailor to the individual and use this technique of precision and personalized medicine.”

Lieberman also sees additional promise in magnetic stimulation, deep brain stimulation through the surgical implanting of electrodes, and optogenetics. Though he has plenty of optimism for these treatments and other potential treatments for mental illness, much of their continued growth may hinge on government policy and budgets. Recent coverage of gun violence in the United States, and a public call for better means by which to screen individuals for mental health inflictions, may be an unfortunate catalyst in moving funding forward in this research arena. A recent article from the UK’s Telegraph discusses Google’s newfound interest in this research, with former US Head of the National Institute of Mental Health now in a position at Google Life Sciences.

“Science, technology and healthcare are doing very well, but when it comes to the governmental process, I think we’re in trouble,” he said. “A welcome development in this regard is President Obama’s Human Brain Initiative, which if you look at the description of it, (is) basically to develop new tools in neurotechnology that can really move forward in a powerful way of being able to measure the function of the brain. Not by single cells or single circuits, but by thousands or tens of thousands of cells and multiple circuits simultaneously. That’s what we need.”