A.)  You will die waiting.

 B.)   Someone else will die – someone young and healthy. Even if your body is physically capable of accepting their heart you may not be. You may live out the rest of your life ridden with guilt.

 Post a successful transplant- the guilt is mixed in with a sense of euphoria[1]. You have been given a second chance. You are humbled. You probably will undergo a significant change. Perhaps you will be somewhat unrecognizable to those who know and love you- or maybe it won’t be that dramatic.  Maybe for the first time in your life you will crave beers and green peppers.

 On May 29, 1988, Claire Sylvia, a dancer and health nut, received the heart of your run-of-the-mill 18 year old boy. Post-transplant she hungered for a fraternity brother’s feast and romped like a stud. She consumed, in massive quantities, things she detested before. No prior interaction with the donor’s family and a silent operating room. Sylvia was not subconsciously listening to the medical professionals conversing about other patients currently in the hospital[2].  Were these particular taste and behavior modifications mere coincidences?

 Representatives in both the scientific and less-than-scientific communities say “No.”

The un-scientists believe that fragments or the entirety of one’s soul is within the transplanted organ- not yet ready to move on into the afterlife[3]. The scientists dance around a more logical approach in the realm of cellular memory; musing that our tastes, personality, and even histories are all stored within cells throughout our bodies[4]. This theory, in the simplest form, is something our “mystically guided” ancestors established while consuming organs associated with strength, courage, and sexual dexterity[5]. Movies and literature alike have been toying with this possibility since at least 1920[6]. Like science fiction novels of yore, this one has the distinct stench of possibility.

 The science: The mind and body communicate via neuropeptide signals and receptors previously thought only to exist in the brain[7].  This is a continuous two-way-dialogue with each party influencing the functionality of the other. The heart, containing essentially its own nervous system, translates information into neurological impulses and ships it off to the medulla (sometimes even higher up). The impulses ultimately regulate blood vessels and other organs and possibly perceptions, decision making, and other cognitive processes[8]. These peptides are received and sent from essentially any large organ, thus it makes scientific sense to me that an individual receiving a pancreas or liver may also experience memories associated with certain ingestibles from the donor. In line with digestion, Wolfgang Prinz wrote an article in a German journal Geo (which I can not track down) referring to the intestines as the “second brain” giving a whole new meaning to the phrase “Gut feeling.”

 Getting beyond food for thought, the research gets a little dicey. Pearsall et al interviewed a small group of transplant patients attempting to find personality correlates amongst them and their donors[9]. I think their sample size was much too small to make any clinically relevant statements. The same group is currently working on a study enrolling >300 patients. I am eager to hear what they find.

Stepping away from donor-recipient mind-body interactions, it is possible this experience is just a side effect of the immunosuppressant medication given to recipients so their body will not reject the organ. These medications have psychotropic properties that could essentially facilitate in unlocking something from the recipients sub-conscious (taste, personality, what have you) that was previously inaccessible but not attributable to the donor organ.

 There are, however, the unexplainable cases like the following:

 An 8-year-old girl receives a heart transplant. Post transplantation she has the same horrendous nightmare every night depicting in explicit detail the murder of a 10-year-old girl. She is brought to a psychologist, who transcribes the dream and seeks information from the authorities only to learn that the donor was a 10-year-old female murder victim. The recipient’s transcribed nightmare was used to identify and detain the killer.

 I have found this “story” in several potentially legitimate places on the internet but I still do not feel confident that this is in fact truth. If anyone has an idea of where the official documentation of this incident is published I encourage you to comment.

 I’m going to go e-mail Jad Abumrad now and request he do a Radiolab episode on this… he’ll get in touch with the right people then debunk and/or confirm.

[2] Sylvia C. A Change of Heart. Boston: Little Brown and Company. 1997

[3] Van Praagh J. Spiritual Horizons, Inc. January 25, 2003; [online]: http://www.vanpraagh.com

[4] Carroll, RT. Cellular Memory. 2002. The Skeptics Dictionary. Nov. 12 2002 [Online]: http://skepdic.com/cellular.html

[5] Von Hippel W, Von Hippel FA, Chan N Cheng C. Exploring the use of Viagra in place of animal and plant potency products in traditional Chinese medicine. Environmental Conservation. 2005; 32(3): 235-238

[6] http://en.wikipedia.org/wiki/The_Hands_of_Orlac

[7] Pert CB. The wisdom of the receptors: neuropeptides, the emotions, and bodymind. 1986. Adv Mind Body Med. 2002; 18(1):30-5

[8] McCraty R, Atkinson M, Tomasino D, Bradley RT. The Coherent Heart: Heart-Brain Interactions, Psychophysiological Coherence, and the Emergence of System-Wide Order. Integral Review. 2009; 5(2) http://www.integral-review.org/documents/McCraty%20et%20al,,%20Coherent%20Heart,%20Vol.%205%20No.%202.pdf

[9] Pearsall P, Schwartz GE, Russek LG. Changes in heart transplant recipients that parallel the personalities of their donors. Integr Med. 2000; 2(2):65-72

When she gets them she tells the world to “Fuck off”[1], slaps nurses, loses touch with her equilibrium[2] and reality[3].

What looked like dementia was merely a UTI.

Nothing inspires me to do some research more than real life.

[2] Rhoads J, Clayman A, Nelson S. The relationship of urinary tract infections and falls in a nursing home. Director. 2007; 15(1):22-6

[3] Wells K. UTI May be Cause of Sudden Confusion in Elderly. (online) http://seniors-health-medicare.suite101.com/article.cfm/uti_may_be_cause_of_sudden_confusion_in_elderly

I had my own personal stint with chickenpox when I was four years old. My dad, whom hadn’t previously been exposed to chicken pox, was taking my sister to the father daughter dance. I remember my mom crying. It was her birthday. I was also crying; crying because I had pox on every inch of skin and mucosal membrane. I was terribly itchy. I reeked of oatmeal and was hallucinating ballerinas.

I acquired my chickenpox from a pox party. They were all the rage into the early 90s; the logical explanation being that chicken pox was a childhood disease- exposure would leave your child uncomfortable for a couple weeks with minimal chance of death where as first time exposure as an adult is always severe and comprises 80% of chicken pox related deaths. Also, the vaccine was not available until 1995.

Some parents in Canada thought that swine flu could be squandered in the same way (1). The media informed them that while the virus affected mostly school aged children the risk of death was not high. The parents concluded that swine flu is essentially just like chickenpox. There is a pretty significant flaw in this conclusion.

The difference between parents of children with chickenpox and parents of children with swine flu?

A good portion of parents were exposed to the same old chickenpox when they were children. It is scientifically improbable (impossible) that the parents were exposed to the swine flu as children. While the children are effectively being exposed to swine flu and personally experiencing minor infectious status they may soon be wards of the state.

Maybe they are better off.

(1)  http://www.torontosun.com/news/canada/2009/07/03/10010571-sun.html

Parasites aren’t as easy to acquire in a land where food is scrubbed clean, feces are flushed away to be chemically treated, clean water is in abundance, and hand sanitizer is tucked safely in the purses of neurotic mothers everywhere. The IgE in a well maintained American is much like the imaginative child. Left to the wiles of his own imagination IgE pulls a Don Quixote and makes fast with the windmill. Cat dander becomes comets that must be nuked, peanut butter becomes space gak that must be neutralized, and invisible aliens stationed throughout the body must be enioloated.

Cseriousis, asthma, diabetes, Crohn’s, etc are all diseases instigated by a demiurgic immunoglobulin. If only they made Nintendo DS(s) small enough to derail its “creative” flow.

So what do we do about this dangerously fanciful child? Jasper Lawrence suggests forcing them into the working world. Radiolab did an extensive interview with this entrepenaur in their segment titled “Parasites.”[1] Allergic to the world, Lawrence infected himself with hookworms after reading research articles exploring their IgE suppression properties. Shortly after innoculation, Lawrence could enjoy the outdoors again with only the minimal awkwardness that comes with passing worms every bowel movement. A fair amount of literature supports Lawrence’s personal findings.[2]^,[3] Lawrence was eager to share his success, harvesting the worms from his own feces and sending them all over the world at a reasonable rate. Unfortunately his operation was shut down by the FDA.

Regardless of the miraculous effect parasitic therapy may have on those suffering with an autoimmune disease- there are still several individuals who are not tickled pink about the methodology. For those pansies out there who do not want a room mate; mad scientists from RI have bioengineered a magical serum called Etanercept. Etanercept is an injection only medication developed with  the assistance of bacterial plasmids. This injection contain tumor necrosis factors (TNF) antagonists. TNF is a muscle man for all immunoglobulins. It has had great success in the treatment of a wide array of autoimmune diseases[4]^,[5],[6] as well as great success in initiating more scarring and life threatening diseases.[7]^,[8] The “trick” is to not take the medication too often since its not terribly picky about which TNF it is antagonizing. TNF plays a huge role in lysing cells that are misbehaving and thus a depletion in TNF number would ultimately lead to cancer.

I say go for the man behind the muscle.

And embrace a little filth god damnit.

[2] Wilson MS and Maizels RM. Regulation of allergy and autoimmunity in helminth infection. Clin Rev Allergy Immunol. 2004; 26(1):35-50

[3] Chacin-Bonilla L. Relevance of helminthes in the prevention and healing of immune diseases. Invest Clin. 2009; 50(1):1-4

[4] Langley RG, Paller AS, Hebert AA, et al. Patient-reported outcomes in pediatric patients with psoriasis undergoing etanercept treatment: 12-week results from a phase III randomized controlled trial. J Am Acad Dermatol. 2010 Jul7. [Epub ahead of print]

[5] Villiger PM, Caliezi G, Cottin V, et al. Effects of TNF antagonists on sperm characteristics in patients with spondyloarthritis. Ann Rheum Dis. 2010 Jul 7. [Epub ahead of print]

[6] Kanek U, Kishi T, Kikuchi M, et al. Two patients with childhood-onset Behcet’s disease successfully treated by anti-tumor necrosis therapy. Nihon Rinsho Meneki Gakkai Kaishi. 2010; 33(3): 157-61

[7] Kaneko K, Nanki T, Hosoya T, et al. Etanercept-induced necrotizing crescentic glomerulonephritis in two patients with rheumatoid arthritis. Mod Rheumatol. 2010 Jul 9. [Epub ahead of print]

[8] Sacquepee M, Rouleau V, Cantin JF, et al. Active WHO class IV lupus nephritis in a patient treated with etnaercept for a psoriasic arthritis. Nephrol Ther. 2010 July 2. [Epub ahead of print]

 While monthly prevalence graphs of Chlamydia and Gonorrhea from RI consistently give peaks at 16 to 24 years of age it is to be noted that three quarters of the population tested fall within this age group.  Because of this we lack an accurate understanding of the prevalence of STIs in women over the age of 30 and physicians continue to utilize age bias when deciding who to acquire a sexual history from.

 Despite being only one quarter of the tested population; CDC surveillance reports from 1996 to 2008 show that prevalence of Chlamydia and Gonorrhea in women over 30 years of age was consistently 11 and 18% respectively of all reported cases. Imagine the potential perceived prevalence if all women were offered testing.

 Laurence’s article was a valiant attempt to push women onto the front lines of defense regarding their sexual health.  Unfortunately- Rhode Island surveillance indicates that it was a failed attempt in this state. And now elucidation regarding a third prevalent and treatable STI is showing that not only are women over thirty at risk but considerably more so than those previously considered high risk.

And this one isn’t even reportable.

Trichomonas vaginalis in the General Population

 Upon diagnosis with a communicable infection you must report all individuals you have come in contact with as it pertains to the transmission of the disease.

 Yes. Old girlfriends… boyfriends… one night stands…

 While there are several other communicable conditions with non sexual modes of transmission, the overwhelming majority of reportable infections in the state of RI are STIs (mainly Chlamydia if you’re curious.)

 Reporting those who have come into “contact” with you ensures that potential parties will be appropriately tested and treated thus derailing the spread of the disease if only momentarily.

(1) http://www.cdc.gov/ncphi/disss/nndss/phs/infdis2010.htm

(2) http://www.health.ri.gov/disease/communicable/index.php

**Don’t want to “soil” your name with a victim you ponder revisiting? Online service at www.inspot.org allows individuals to send anonymous e-cards to their slew of sexual partners.