A physician’s tribute to Mary Tyler Moore and her physician husband

TV Mega-star Mary Tyler Moore died at age of 80 on January 25.  Of her numerous remarkable careers and achievements I will focus on her Type 1 diabetes and her physician husband, Dr. Robert Levine, a cardiologist.

Mary divorced her second husband, Grant Tinker (who just passed away at age of 90 on 11/30/2016), then NBC chairman, and married Dr. Levine (who is more than 10 years her junior) in 1983.

I recall reading a story in 1980s that Mary had to quit smoking before Dr. Levine would marry her, saying she had no future being a diabetic and smoking even though she was already a mega-TV star.

On the Juvenile Diabetes Research Foundation (JDRF) site, in which she said, “And in getting myself on the right track, I also credit the support and encouragement of my physician and best friend, my husband Robert.”

Mary and husband at Capitol Hill

She also credited the laser photocoagulation surgery which arrested the progress of her diabetic retinopathy and saved her from blindness.  The development of laser photocoagulation technique was supported by JDRF.

Being the JDRF chairman for more than 20 years she raised more than $1 billion for research and along with her physician husband, made frequent visits to lobby Congress on behalf of research.  In fact, JDRF is dubbed as "Mary's Foundation".

She was diagnosed to have type 1 diabetes in her 30s in 1960s.  Having been able to live to the age of 80 without blindness and in relatively good health, one has to give her physician husband credit of asking her to quit smoking and the excellent medical advices and care of more than 30 years.

In a NY Times interview in 1995, Mary said, “I‘ve come to the point in my life where I don’t have to work,” she continued, “I work because I enjoy it.  I only enjoy doing things that frighten me a little bit.  And I am an actress.  I think I am an actress as well as a personality.  And I’ve got to keep the actress in me happy.”

For those who are not too familiar with Mary Tyler Moore’s performance, this YouTube of “Chuckles the Clown’s Funeral” will make you laugh out loud with tears.  Enjoy it and celebrate the life of Mary Tyler Moore.  We’ll miss her.

https://www.youtube.com/watch?v=YmBK5GslDaQ

Mary Tyler Moore and participants at the Juvenile Diabetes Research Foundation's 2005 Children's Congress, held in the nation's capital

Professor Wu Chien-Shiung (吳健雄) was slighted by Nobel Prize in Physics

I was never tired of lamenting Rosalind Franklin and Lise Meitner being snubbed by Nobel Prize Committees.  Rarely did I mention the Chinese American physicist, Professor Chien-Shiung Wu (吳健雄) whose case is even stronger against the gender discrimination of the Nobel Prize.

Prof. Wu Chien-Shiung

Mary Ann Evans used a male pen name, George Eliot, to publish novels to make sure her work would be taken seriously.  The fact that Dr. Wu (吳) Chien (健)-Shiung (雄) even has a ‘male’ name didn’t help. Chien in Chinese (健) means healthy and vigorous whereas Shiung (雄) means male.

We all know that physicists Lee Tsung-Dao (李政道) and Yang Chen Ning (楊振寧) shared the Nobel Prize in Physics for overturning the physical law of parity in 1957.  Professor Wu played a very crucial role and did a very ingenious and difficult experiment to back up the theory.  Nobel Prize allows three to share the prize, and in this case it would be perfectly legitimate for the three Chinese Americans to share.

In the New York Times obituary of Professor Wu Chien-Shiung (2/18/1997), in which I read,

Lee Tsung-Dao

“playwright Clare Boothe Luce [wife of Henry Luce, the founder-publisher of Time, Life and Fortune, an extraordinary lady]said at the time, ‘When Dr. Wu knocked out that principle of parity, she established the principle of parity between men and women.''  Dr. Lee said yesterday, '’C. S. Wu was one of the giants of physics.’ ”

The physical law of parity must be a hot topic in 1950s, at a scientific conference in April, 1956, physicist Richard Feynman (my ‘American idol’) tossed the idea to his colleagues: What if the parity rule were wrong?

Lee approached Wu, who was an expert in beta decay, took up the challenge and  “dropped everything for six months — including sleep, meals, and a long-planned trip to China with her husband — to pursue the parity experiment.”

Yang Chen-Ning

Dr. Wu used radioactive cobalt, beta decay (breaking down) of which will give off electrons.  She used a device that counted the number of electrons shooting out.  [Dr. Wu is known to make major improvements to the Geiger counter]. If the law of conservation of parity were true, equal number of electrons will be giving off in each direction.  But Dr. Wu found out far more electrons flew off in the direction opposite the spin of the nuclei: “Parity Not Conserved”. 

The moment was 2 am January 9, 1957, Wu said, “These are moments of exaltation and ecstasy. A glimpse of this wonder can be the reward of a lifetime” There was an article in New York Times next day, “Shattering of a fundamental concept of nuclear physics”.

This is an earth-moving (驚天動地) discovery, an experiment was not even participated by Lee and Yang, and yet neglected by the Nobel, which at times is not so ‘noble’ as an article in Scientific American implies.  Dr. Wu's name is also mentioned in this article.

Prof. Wu Chien-Shiung

The discover was so stunning that Dr. Isador Rabi [my another ‘American Idol’], a Nobel laureate in physics at Columbia University, said at the time, “In a certain sense, a rather complete theoretical structure has been shattered at the base, and we are not sure how the pieces will be put together.”

During WWII Wu was recruited to work in the Manhattan Project based at Columbia University; her work dealt with the enrichment of uranium.  After the war Columbia U. allowed her to stay, but it took nearly ten years before she could join the faculty.

Wu’s husband, Luke Chia-Liu Yuan, also a noted physicist, is a grandson of Yuan Shi-Kai (袁世凱), the first President of the Republic of China, who once self-proclaimed Emperor of China. If Yuan’s dream of being an Emperor materialized, in a sense Dr. Wu may even become an empress consort.  But Dr. Wu for sure is indeed a Queen of the Science in modern nuclear physics.

Seeing former President Jimmy Carter doing so well is the most gratifying moment of the Presidential inauguration

I cannot talk about the Presidential inauguration without mentioning science/medicine.  After talking about the most gracious moment of the day, seeing former President Jimmy Carter doing so well is the most gratifying moment.

In August 2015, 90 years old then, Carter announced he had metastatic melanoma that spread to the liver and brain.  It must have been detected (as far as the size of brain metastasis is concerned) as it said “four extremely small spots, about two millimeters in size.”

From my readings I never found out where was the primary melanoma, which can be tricky or even disappeared before the metastasis was detected.

Carter underwent surgery to remove the liver tumor in August 2015, followed by stereotactic radiation therapy, which delivers a strong beam of radiation with precision to the four tiny spots in his brain, thus avoiding the “collateral” damage to the nearby healthy brain.

One has to presume Carter might have other “micro-metastasis” in the brain or liver or other organs of the body that cannot be picked up by any image studies.  According to Dr. Keith Flaherty, Director of Termeer Center for Targeted Therapy at Massachusetts General Hospital (MGH), Carter received Pembrolizumab (or Keytrude marked by Merck).

Keytruda (Pembrolizumab) embodies the ingenious immunotherapy, expanding the powerful arsenal against cancer.

Keytruda is an anti-PD-1 monoclonal antibody (the concept of programmed death or PD-1 is beyond the scope of this writing).  Cancer activates brakes to the immune system; thus suppresses our immune system to attack cancer.  Keytrude inhibits the action of those brakes, reverses immune T-cell suppression and induce anti-tumor responses; this is the basic concept of cancer immunotherapy.

Normally activation of PD-1 receptor/pathway leads to programmed death, so it is negative regulation.  Keytrude binds to PD-1 receptor (thus PD-1 ligand cannot bind to it) on immune T cells, thus inhibits programmed cell death-1 (PD-1) activity.  Removing this suppression sets immune T cells free to do its job of attacking the cancer.

PD-1 (or PD-L1, PD-ligand 1) also has synergy with radiation therapy.

Keytrude (approved in Sept 2014) is the 6^th new anti-melanoma agent FDA approved since 2011.  A Wall Street Journal reported (5/19/16) 40% of 655 patients still alive 3 years after taking Keytrude; it used to be 10-20%.

The most famous Sunday School teacher (Carter never retired from this job) announced in his Bible lesson class at Maranatha Baptist Church in his hometown of Plains, Georgia on 12/7/15 that his latest scan showed no sign of cancer, he said, “When I went this week, they didn’t find any cancer at all, so I have good news.”  Glory to God!

Religious Lincoln: Inauguration ceremony is a religious service

You may or may not notice that the entire Presidential Inauguration Ceremony is a religious service and that is the way it should be. To take the religion away from such a solemn service is like taking the soul out of a man. 

The National Prayer (Interfaith) Service at the National Cathedral is about to begin as I am writing, and this service went back to George Washington.  No politicians, including President Trump, will speak here; here we’ll only hear the God’s words.

Lincoln in 1865

Lincoln’s Second Inauguration Address is the sermon of the inauguration ceremony.  It is inscribed on the Walls of majestic Lincoln Memorial.  Among the 702 words there are 266 words quoted from the Scripture; God was mentioned 14 times, quoted the Bible 4 times and invoked prayer 3 times.  No wonder Frederick Douglas said to Lincoln, “that was a sacred effort,” “the best sermon that America ever had.”  I will mention a few examples here:

“Both read the same Bible, and pray to the same God; and each invokes His aid against the other.  It may seem strange that any men should dare to ask a just God’s assistance in wringing their bread from the sweat of other’s men’s face;”

Genesis: 3:19

“In the sweat of the face shalt those eat bread. . .” which means you labor and sweat thus having bread to eat.  Lincoln was talking to the White in the South implying that they eat on the labor and sweat of the slaves.

“but let us judge not that we be not judged.”

Matthew 7:1

“Judge not, that ye be not judged.” (Jesus’s sermon on Mount).  Lincoln quickly followed that we shouldn’t judge others lest we will be judged.

“The Almighty has His purpose. “Woe unto the world because of offences! for it must needs be that offences come; but woe to that man by whom the offence cometh!”

Matthew 18:7

This one is entirely quoted from Matthew 18:7

“. . . as was said three thousand years ago, so it must be said, “The Judgments of the Lord, are true and righteous altogether.”

Psalm 19:9

“The fear of the Lord is clean, enduring forever: the judgments of the Lord are true and righteous altogether.”

Lincoln once told a White House nurse, “They [Psalms] are the best, for I find in them something for every day of the week.”

Trump said he is just a “messenger” in his Inauguration Speech. Lincoln also said, “I am but God’s humble instrument,.” Days before his assassination.

On his way to Washington, D.C. to take his Presidency, Lincoln spoke at N.J. Senate on February 21, 1861,

“I shall be most happy indeed if I shall be a humble instrument in the hands of the Almighty, and of this, his almost chosen people.”

A black minister of Baltimore presented an elegant Bible to Lincoln in September 1864, to which Lincoln commented, “In regard to this Great Book, I have but to say, it is the best gift God has given to man. All the savior gave to the world was communicated through this book.  But for it we could not know right from wrong.”

Lincoln's Bible

Trump swore in as the President, using the Bible his mother gave to him and the Bible Lincoln used.  Obama also twice used the Bible that Lincoln used.  I am hoping Obama started the trend.

Both Jesus and Lincoln died on Good Friday, this was not more than a coincidence; God’s only son died for us to clean our sin.  God sent Lincoln to save the Union, thus all Americans.  Walt Whitman used ‘He’ in referring to Lincoln, and Leo Tolstoy said, ‘Lincoln is a Christ in miniature.’  We tend to perceive that Lincoln freed the black from slavery, but in the bigger scheme of things, He saved the Union.  Can nowadays Americans enjoy the prestige and prosperity of this magnitude if the country was divided into two back in 1861?

Moses brought his people to the Promised Land, and he himself did not enter the Promised Land.  Lincoln died five days after Robert Lee’s surrender to Grant, signaling the beginning of the end of the Civil War.  Lincoln didn’t live to see the peace and tranquility.  Once the war ended, the Union saved, his job was done; God called him home!

On the way to Ford Theater on that fateful day—a Good Friday—Lincoln told his wife that after the second term, they should visit Jerusalem to tread the roads trodden by Jesus. 

Some books mentioned this conversation occurred in the carriage ride that afternoon, and one book said it occurred in the theater moments before John Booth’s bullet struck his head.

March 4, 1861 saw no first dance of the First Couple

The first dance of the First Couple (with the First Lady) didn’t occur until after 9:30 pm tonight.  At least there was one; we never saw it on the Union Ball (Lincoln’s Inauguration Ball) March 4, 1861, as Lincoln normally avoided waltz and square dance, his heavy heart was far away at the Fort Sumter, South Carolina.  The Confederate gun fired on Fort Sumter on April 12, 1861, marked the beginning of the Civil War.  Mary Lincoln was whirling in the arms of Senator Stephen Douglas, having a ball in the Union Ball.

Carl Sandburg wrote in his “Abraham Lincoln: The War Years”,

“The Marine Band played ‘Hail to the Chief’ at eleven o’clock.  Lincoln entered leading the grand march, arm in arm with Mayor Berret, followed by Mr. Lincoln arm in arm with Senator Stephen A. Douglas.  Lincoln avoided waltz and square dance, but Mrs. Lincoln and Douglas were partners in a quadrille.  Hundreds of women in crinoline trod the waltz, schottische, polka, mazurka.  Reporters wrote, ‘It was an animated scene.’ Mrs. Lincoln wore a new blue gown, a large blue feather in her hair.  Many said it must be her happiest night of life, the realization of dreams long waited.”

We no longer know who was the designer of Mary Lincoln’s gown (The press seemed to be obsessed with who is the designer nowadays), but I know she got it during her two-week frenzy shopping spree at New York City shortly before they left Springfield, Illinois for Washington, D.C.  She returned to Springfield two days late.  The poor Abe went to the train station and came home alone two days in a row.

In her Team of Rivals (I recall Obama had this book on his desk when first moved into White House), Doris Kearns Goodwin wrote,

“Entranced by her experience in New York, Mary stayed three [some said two] extra days without notifying her husband, who plunged vainly through sleet and snow three nights running to meet her train.”

Lincoln’s inauguration on March 4, 1861

In a moment we’ll no longer have President-Elect, but President Donald Trump. There is no doubt Lincoln is the President that most of the modern Presidents, Republicans or Democrats, want to emulate.  So it is not entirely irrelevant to talk about Lincoln’s inauguration on March 4, 1861.

The NY Times reported that the largest crowd that Washington had ever seen for President Lincoln’s first inauguration in 1861; it was estimated that 7,350 people are in the view of this photo.

“many thousand citizens assembled in the grounds, filling the square and open space, and perching on every tree, fence or stone affording a convenient point from which to see or hear.”

However, Carl Sandburg wrote in “Abraham Lincoln: The War Years” that it was not a big crowd.

“Senator Douglas took a seat, and as he looked over the crowd could have said that he and Lincoln had spoken to larger audiences on the prairies of Illinois. This, however, was a more genteel crowd, and one comment ran that rather than a sea of upturned faces it was a sea of silk hats and white bosoms.”

We just saw that President Obama and First Lady, Michelle, waiting outside for the incoming President and First Lady to have a tea at White House.  In Lincoln’s days, it was President Buchanan went to pick up Lincoln who was staying at Willard’s Hotel (now InterContinental Hotel), two blocks from the White House.

I do not know what Obama said to Trump at the “tea party”; I do know what Buchana, with the Civil War looming, said to Lincoln, when they rode back to the Executive Mansion (President Theodore Roosevelt officially gave the White House its current name in 1901) after the inauguration,

“If you are as happy, my dear sir, on entering this house as I am leaving it and returning home, you are the happiest man in this country.”

A great, great American jewel, world jewel”: The press is against me!

As we all know that Donald Trump won the Presidential election, running a campaign against Democrats, Republicans and the press.  Trump was not the original; Linus in Peanuts lamented “The press is against me!” many years ago.

In addition to the many books and ebook I received from my daughters and good friend for Christmas gifts, I also receive a one-year gift subscription of the New York Times (digital version).  I have been exploring its rich resources that have more than 13 million articles since 1851, or shall I say since “the beginning of the Times”.

There has been a tremendous surge of the digital subscriptions to the New York Times since the election of Donald Trump.  The number is top 10,000 a day, in contrast to 600 a day previously.  The theory is that people wish to support someone or something that can stand up President Donald Trump (in less than a day he will be). 

I began to read New York Times (“a great, great American jewel, world jewel,” as Trump would say) in 1972 when I began my residency training in New Jersey.  For many years I subscribed the Times after moving to Waynesburg in 1975, at which time the print papers would come a day or two late, and that was long before the digital age.

The New York Times currently has more than 2.5 million subscribers, including the 1.1 million Sunday print papers; the daily print papers have since shrunk to about 600,000 now. With the success of the digital subscriptions, it looks like this great American institution will survive to years to come.

We are not born with antibodies; they are produced in response to foreign invasions

While reading articles about monoclonal antibodies in New York Times, I came across “New method of creating antibodies hailed as a research aid”, published on 12/8/1989, in which there was a paragraph:

“A human is born with about 100 million different antibodies, ready to meet an invasion. Although antibodies can be extracted from human tissue, they do not survive outside the body under laboratory conditions.”

The author of the article, Sandra Blakeslee, a respectable NY Times science writer.  She is Northwestern U. and U.C. Berkeley educated with a major in political science.

I think this statement is not quite correct; a human is not born with about 100 million antibodies, instead a human is capable for producing “100 million” (or more precisely, limitless) different antibodies.  An antibody is produced by B lymphocyte in response to an invasion by foreign agent, such as virus or bacteria or any toxin. Antibody will seek the foreign invader and mark it for destruction.  So we’re not born with antibodies; it was produced in response to foreign invasion.

Antibodies are proteins, which are encoded by genes; one gene one protein.  The human genome contains fewer than 50,000 genes, and yet we seem to have capability to make unlimited diverse antibodies as the need arises.  If each antibody were coded by a separate and distinct gene, a B cell’s genome would have to carry an enormous and improbably large number of antibody genes. And we know that is not the case; it is a fact.

This puzzle was solved by Susumu Tonegawa who was awarded a Nobel Prize in Medicine in 1987.  It turns out that our immune system has evolved a unique genetic mechanism: Various segments of an antibody gene can be cut and paste/fused before the codes (nucleotides sequence) are transcribed into messenger RNA, which are then translated into a different language—sequence of amino acids of a protein, or antibody in this case.

Susumu Tonegawa wrote an article of “The molecules of the immune system” in 10/1/1985 Scientific American, two years before he was awarded the Nobel Prize in Medicine.  The diagram below is taken from the article.

ASSEMBLY OF AN ANTIBODY GENE from scattered fragments is done in two stages, shown for a kappa light chain. First randomly selected V and J segments are fused by enzymes that delete all the DNA lying between them. Here the gene segments labeled V3, V4 and J1 are deleted, bringing together V2 and J2.  Next the entire length of DNA from the start of V2 to the end of the C gene is transcribed into RNA. Standard RNA-splicing enzymes, which take part in the expression of many genes, excise all the RNA from the end of h to the start of C. The resulting sequence of messenger RNA is translated into protein.

Tonegawa in 2013--still at MIT

I wrote a post in my blog on 5/31/2007 (“How does our body manage to make a vast array of diverse antibodies?”  There are some interesting stories.  There was a twist of fate that he was forced to move to the Basal Institute of Immunology in Switzerland in 1972.  By ‘kicking him out of the United States’, the U.S. Immigration Service may unwittingly helped advance of science.

Most of his work was published in the Proceedings of the National Academy of Sciences between 1976-1978.  He so dominated in this field that he was a single Nobel Prize in Medicine winner in 1987.  With few exceptions the Nobel Prizes in sciences were shared by two or three laureates.

It was Salvador Luria (like Enrico Fermi, my another Italian American idol) who recruited Susumu Tonegawa to MIT in 1981, adding another Nobel laureate to its long list in 1987—a windfall to MIT.

“How does our body manage to make a vast array of diverse antibodies?”

http://doctorjytsai.blogspot.com/2007/05/how-does-our-body-manage-to-make-vast.html

College football is no less exciting and hilarious than NFL games

(All the photo credits are to New York Times)

The persevering Clemson Tigers just beat the seemingly invincible and unconquerable Alabama Crimson Tide 35 to 31 with one second left in the 4Q in the National Championship game; what a touchdown, what a game. 

Alabama led Clemson by 24-14 going into 4Q when the high drama unfolded.  Ripping open the illustrious Alabama’s defense, Clemson took the first lead 28-24 with 4:38 left before reaching the “promise land”.  Yet the game is not over until the “fat lady sings”.

Alabama took back the lead in no time (31-28), leaving 2:07 for Clemson to create a miracle, a miracle they made.  The Clemson quarterback Watson completed six of his eight passes for 50 yards, reaching the climax of the game with that seemingly easy 2-yard touchdown throw with one second left.  The ecstasy of the victory.

The pomp and circumstance at the beginning of the game, the excitement and the expectation is what America all about and is why America is great all along. To console Alabama Crimson Tide of the agony of the defeat; it takes two to tango, there is no loser for the game like this.

I hate to paraphrase what Will Durant said of Thomas Cromwell [who was sent to the Tower of London by Henry VIII] that Alabama Crimson Tide “won every battle except the last” and at the last second (not minute or hour).  But, please take comfort in knowing that there was no loser for a great game like this—a game no one can script. Crimson Tide has built such an intimidating reputation over the years, it is always “Alabama Crimson Tide vs the world”, and Clemson Tigers had honor and privilege to be the representative of the “world” that happened to succeed this year.  We will see the Tide rolling back in big time next season, and that will “make America great again.”

The art and skill of fetching water from a well

The house in which I grew up in Xia-Tan (下潭) had no running water, so we had to fetch water either from the water pump or the well next to it, located in the elemental school (the only school in the village) across the road.

I reminisced about my childhood story with the family during the holidays in Michigan.  When talking about fetching the water from well, I vividly remember the trick of twisting or jerking the bucket when it reached the bottom of the well, so that it could turn and sink into water; I was very proud of the skill.

While reading Lin-Yutang’s “From Pagan to Christian”, I came across this passage, in which he obviously had the same experience and even called this skill an “art”.

“We were a family of six brothers and two sisters, and we boys used to take turns drawing water from the family well.  There was fun in learning the art of swinging the bucket when it reached the bottom of the well so that it would overturn and catch the water.”

I recall there was a water pump in front of Janice’s dorm in the Harvard Yard.  It brought back the memory of my childhood when I first saw it.  My left thumb was once partially crushed operating the pump.  The water pump was kept it in the Yard for “historical” reason; like Lin Yutang, I must have lived through the history.

Many years ago on our visit to Taiwan, I did bring Jo and Sean to see that house in the village; I regret not to bring them to demonstrate the skill/art of fetching water from the well.

We moved from Xia-Tan (下潭) to Po-Tzu (朴子) half way through my fifth grade, I wrote a story about this in 2007.

http://doctorjytsai.blogspot.com/2007/04/comparing-with-young-abe-lincoln.html

Cyclosporine brought the liver transplants out of dark age: The stories related to Professor Jean Borel, Dr. Thomas Starzl and Dr. Chao-Long Chen (陳肇隆醫師院士)

My interest in history in general evolved from the interest in medicine in particular that began right after my residency training.  Recently I have been reading about the developments of liver transplant and monoclonal antibody.  Speaking of liver transplant, one cannot escape the story of cyclosporine.

In a 7/30/1981 New York Times report showing a stunning success of liver transplant, using cyclosporine (or cyclosporine A) to overcome the rejection of the transplant organ.  This report was based on a New England Journal of Medicine article of the same date.

In the NEJM article as well as NY Times article, Dr. Thomas Starzl reported 10 of the 12 persons survived one year after surgery or 83% (two died on the operating table).  The survival rate was 32% among the 170 liver transplants that he performed over the 17 years period before using cyclosporine.

Dr. Starzl performed the first liver transplant in a 3-year-old boy with biliary atresia in 1963; the boy bled to death on table.  He did five more cases of liver transplants in 1964; all died of hemorrhage or infection within 23 days of transplants.  This was followed by four years of moratorium.  Dr. Starzl began to use cyclosporine at University of Colorado before he moved to University of Pittsburgh January 1981.

The success of cyclosporine lies in the fact that it suppresses the body’s natural immunity so that it will not attack the transplant organ and yet it doesn’t hamper the body’s ability to fight off infections.

Cyclosporine was first used in 22 kidney transplants (survival rate of 85%) before it was used in liver transplant.  Dr. Roy Calne of Cambridge University was the first to use cyclosporine in liver transplant.  The development of cyclosporine was not all rosy and smooth, at one time Sandoz threatened to discontinue the project because of the toxicity to kidney.  Dr. Calne flew to Basel [where Sandoz based] and successfully appealed the decision, allowing an experimental supply to continue.  Dr. Starzl and Dr. Calne shared the 2012 Lasker Award.

Speaking of cyclosporine, it would be remiss of me not to mention Dr. Chao-Long Chen (陳肇隆醫師院士), the father of liver transplant in Asia/Taiwan.  After completing the liver transplant training with Dr. Starzl in 1983, he returned to Taiwan, at which time cyclosporine, not yet approved by FDA, was still an experimental drug.

Realizing there cannot be a success of liver transplant without cyclosporine, Dr. Chen, armed with a recommendation letter from Dr. Starzl, flew to Basel, Switzerland (where Sandoz is based) to apply for the use of the then experimental cyclosporine and was granted for the supply for five patients.

Dr. Chen had a photo taken with Dr. Borel then and again had a photo taken with him in October 2016, 33 years and more than 1,500 liver transplants later, when Dr. Chen was invited to give a talk at the prestigious 15^th Borel-Stӓhelin Lecture, named in honor of Dr. Jean Borel.  Dr. Chen was the first non-European/American doctor to be granted for this honor.

In the late 1960s Sandoz discovered two strains of fungi in soil samples.  The fungi produced substance that they hope can be developed into antibiotic.  It was a fateful twist that Professor Jean Borel of Sandoz who discovered the substance can suppress body’s immune system in 1970-73 and eventually cyclosporine came into being.

Dr. Chen’s lecture at University Hospital Zurich on October 11, 2016 was “Perspectives on Liver Transplantation, Innovation, Education and Beyond”

(I gave a talk of liver transplant to the Taiwanese American community, this is the Power Point)

Dr. Starzl spoke at Dr. Borel’s retirement banquet in 1999; this is how Dr. Starzl began,

“THANK YOU, ladies and gentlemen, and especially Jean Borel. I am honored to be here, and especially by the chance to speak. More than a retirement banquet, we celebrate tonight and tomorrow the descent of a hero from Mt. Olympus. How you, Jean Borel, managed to scale such heights, and returned unscathed is a question to which I will return in a moment. But first, I want to say something about what your journey meant to me personally, and eventually to everyone else in this room, and in the world.”

After talking about the dismal outcome of liver transplants of 17 years prior to the era of cyclosporine came around, Dr. Starzl said,

“At the darkest and most unexpected moment, a mounted torch-bearer appeared in the distance. The torch was cyclosporine; the bearer was Jean Borel, and the horse was the Sandoz Corporation. How the next steps were taken by Roy Caine and his English colleagues is the material of legends. Suffice it to say, both the patients and those who cared for them were liberated from a terrible bondage. There have been improvements in treatment since then, and there will be more. None, in my opinion, will compare in magnitude to those that occurred between 1978 and 1980 as the result of Jean Borel's initiative.”

Professor Borel’s first love was art and that “allowed him to exercise the imagination and creativity of the artist in the pursuit of science. The result was vision.”

Dr. Starzl closed his remark very appropriately at a retirement banquet,

“As for Jean Borel, don't count him out.  There are pictures to be painted, music to be composed, and words to be written.  And there is still plenty of time.”

Cyclosporine brought the  liver transplants out of dark age.  Dr. Thomas Starzl felt he owed his career to Professor Borel’s ingenious and creative work on cyclosporine; this feeling, I think, must be shared by Dr. Chao-Long Chen.

Why I am switching from Print Book Reading to eReading?

In a NY Times Book Review (12/15/16), it takes the form of interviewing with the author, Steve Johnson.  One of the questions is:

Do you like reading on paper or electronic?

I always prefer electronic when I am doing research because I have an elaborate system that I’ve been tinkering with over the years for digitally capturing and storing important quotes from anything I read. There are a number of studies showing that readers have better recall when they read in print, but the problem with print is that it’s not searchable. On my computer today, I can find quotes from books that I read almost 20 years ago in a matter of seconds. And those searches are constantly surprising me with interesting connections or long-forgotten threads.

I wrote the following on a post talking about print books and eBooks at Sermo [a physician-only online site] on 2/21/11,

“Browsing in the libraries or bookstores or holding a book in hands is a joy in life, and that is why I am still resisting eReaders. But, I know in the bottom of my heart, its onslaught is inexorable and irresistible; for me to fall for it is when, not if. Rumor had it that my daughters are conspiring to get me an eReader whether I like it or not. They’re confident that I may hook on NOOKcolor, or the Kindle and may kindle my interest of reading other stuff; but my eyes are on iPad; more versatile, . . . .”

That was 2011, now more than half of my book readings are digital (laptops, iPads, Kindle Fire HD 6 and 8, iPhone, iMac, etc.)  The main reason of switching over is exactly like what Steve Johnson said, “I have an elaborate system that I’ve been tinkering with over the years for digitally capturing and storing important quotes from anything I read.”

I myself do have an elaborate system, using FileMaker file.  I constantly look for a better way so I can retrieve the info (data) I store at a click years from now.  One of the Christmas “loots” I got from the family is a Classic Quotes tote of “I cannot live without books” (by Thomas Jefferson).  Shall I say “I cannot live without FileMaker”?

While writing a letter-to-the-editor in 2010, I wanted to use a quote from Mark Twain that I recall reading it in a book about American language by H.L. Mencken 20-30 years ago.  I had to check the book out from Waynesburg University and spent more time locating the quote than that I wrote the letter.  If it were stored in my FileMaker file, I could get it at a click.

http://doctorjytsai.blogspot.com/2010/11/or-may-not-be-as-easy-as-you-thought.html