It’s pretty wild being alive these days. Lots of big stuff the species is struggling to adapt to and figure out how to exist with.
But also… we got the tablets from Star Trek. And now we have the ship’s computer from Star Trek, and the early makings of the holodeck. And we’re making pigmen senior citizens who would otherwise be dead.
It’s quite something to stop and think about how the problem is becoming less and less about “how do we do the science and the engineering?” And more about “how do we handle how this changes what it is like to be human today?”
They regularly used multiple tablets at a time, stacked like papers. What we have is presumably superior from a technological standpoint. Except their tablets weren’t filled with time-wasting features designed to keep you addicted and distracted.
> And now we have the ship’s computer from Star Trek
No, we definitely do not. If every time they spoke to the ship’s computer it made up answers at the rate LLMs do, they would have either stopped using it or would all be dead.
And you’re ignoring we’re also in the stages of getting the surveillance from 1984 and the social class divide from Brave New World. Those are not good tradeoffs.
> They regularly used multiple tablets at a time, stacked like papers.
If iPads were sold in every store for $1 a piece, we'd be doing that too. This is indeed a technology problem (or at least half-technology, half-economics), we just can't make working tablets cheap enough (and sustainably enough) to support such workflow.
> What we have is presumably superior from a technological standpoint.
The writers were surprisingly prescient about this. Turns out, the secret about paper-based workflow isn't that a sheet of paper can display anything, but that you can have a lot of them, freely arrange them in front of you as you need, pass them around, pin up the wall, etc. Multitasking on a single swab is strictly inferior to that.
EDIT:
>> And now we have the ship’s computer from Star Trek
> No, we definitely do not. If every time they spoke to the ship’s computer it made up answers at the rate LLMs do, they would have either stopped using it or would all be dead.
We definitely do, and this, somewhat unexpectedly, got us to the point of being close to having a basic universal translator as well.
Computers on Star Trek ships weren't built for conversations, and weren't talked with as a regular thing for basic operations, so it wasn't like chatting with LLMs. There wasn't much opportunity to hallucinate - mostly simple queries, translating directly to something you'd consider a "tool call" today. But that's not the actually notable part.
The notable, if underappreciated, part of Star Trek's computers is that they understood natural language and intent. They could handle context and indirect references and all kinds of phrasings. This was the part we didn't know how to solve until few years ago, until LLMs unexpectedly turned out to be the solution. Now, we have this.
(Incidentally, between LLMs and other generative models, we also have all the major building blocks of a holodeck, except for the holographic technology.)
> If iPads were sold in every store for $1 a piece, we'd be doing that too.
Considering how bad Apple is at syncing, that’s just asking for trouble. You’d never know where anything is or what iPad has what or if it’s the current version. Not to mention the charging situation and all the e-waste.
> The notable, if underappreciated, part of Star Trek's computers
Under appreciated by whom? It’s one of their defining features. Are you talking about the real world or the characters?
> is that they understood natural language and intent.
Which LLMs do not. They fake it really well but it’s still an illusion. No understanding is going on, they don’t really know what you mean and don’t know what the right answer is. The ship’s computer on Star Trek could run diagnostics on itself, the ships, strange life forms and even alien pieces of technology. The most advanced LLMs frequently fail at even identifying themselves. I just asked GPT-5 about itself and it replied it’s GPT-4. And if I ask it again in five minutes, it might give me a different answer. When the Star Trek computers behaved inconsistently like that (which was rare, rather than the norm), they would (rightly) be considered to be malfunctioning.
> Which LLMs do not. They fake it really well but it’s still an illusion. No understanding is going on, they don’t really know what you mean and don’t know what the right answer is.
A tree falling in a forest with nobody to hear it: if it makes a "sound", you think "sound" is the vibration of air; if it does not, you think "sound" is the qualia.
"Understanding" likewise.
> The ship’s computer on Star Trek could run diagnostics on itself, the ships, strange life forms and even alien pieces of technology.
1. "Execute self-diagnosis script" doesn't require self-reflection or anything else like that, just following a command. I'd be surprised if any of the big AI labs have failed to create some kind of internal LLM-model-diagnosis script, and I'd be surprised if zero of the staff in each of them has considered making the API to that script reachable from a development version of the model under training. No reason for normal people like thou and I to have access to such scripts.
2. Not that the absence says much. If humans could self-diagnose our minds reliably, we wouldn't need therapists. This is basically "computer, send yourself to the therapist and tell me what the therapist said about you".
> When the Star Trek computers behaved inconsistently like that (which was rare, rather than the norm), they would (rightly) be considered to be malfunctioning.
Those computers (and the ships themselves) went wrong on such a regular basis on the shows, that IRL they'd be the butts of more jokes than the Russian navy.
> Would we? What for? Why would we need reams of iPads on our desks?
To use like we'd use paper.
> Which LLMs do not. They fake it really well but it’s still an illusion. No understanding is going on, they don’t really know what you mean
That is very much up to debate at this point. But for practical purposes in context described here, they do.
> and don’t know what the right answer is.
They're not supposed to. This is LLM use 101 - the model itself is behaving much like a person's inner monologue, or like a person who just speaks their thoughts out loud, without filtering. It's very much not a database lookup.
> I also disagree that was an underappreciated featured of the Star Trek computers, it’s one of their defining features.
What I meant is, people remember and refer to Star Trek's ship computer for its ability to control music, lights or shoot weapons, etc. with voice commands. People noticed the generality, the shamelessness of interaction, lack of structured command language - but rarely I saw anyone paying deeper attention to the latter, enough to realize the subtle magic that made it work on the show. It wasn't just some fuzzy matching allowing for synonyms and filler words, but more human-like understanding of the language.
(Related observation: if you pay attention to sliding doors on Star Trek vs. reality, you eventually realize that Starfleet doesn't just put a 24th century PIR into the door frame; for it to work like it does on the show, the computer has to track approaching people and predict, in real time, whether or not they want to walk through the door, vs, just passing by, or standing next to them, etc. That's another subtle detail that turns into general AI-level challenge.)
> The ship’s computer on Star Trek could run diagnostics on itself, the ships, strange life forms and even strange pieces of technology.
That's obviously tool calls :). I don't get where this assumption comes from, that a computer must be a single, uniform blob of compute? It's probably because people think people are like this, but in fact, even our brains have function-specific hardware components.
(I do imagine the scans involve a lot of machine learning and sensor fusion, though. That's actually how "life signs" can stop being a bullshit shorthand.)
> The most advanced LLMs frequently fail at even identifying themselves.
They'll stop when run with a "who am I?" tool.
> When the Start Trek computers behaved inconsistently like that, they would (rightly) be considered to be malfunctioning. Yet you’re defending this monumental gap as being effectively the same thing. Gene Roddenberry must be spinning in his grave.
All I'm saying is, LLMs solved the "understand natural language" problem, which solves the language and intent recognition part of Star Trek voice interfaces (and obviously a host of other aspects of computer's tasks that require dealing with semantics). Obviously, they're a very new development and have tons of issues that need solving, but I'm claiming the qualitative breakthrough already happened.
Obviously, Star Trek's computer isn't just one big LLM. That would be a stupid design.
How we use paper derives not only from our own practical needs, but also from the intrinsic limitations of paper. Stacks of paper are used because it's not possible to put several pages worth of text onto a single page of paper while maintaining a legible font size. The idiosyncratic way that tablets were used in Star Trek isn't how people would actually do things, it merely reflects the limitations of the writers to imagine all of the practical implications of technology such as they were depicting.
It would be like somebody in the 1800s speculating about motor vehicles, supposing that teams of a dozen or more motor vehicles might be connected using ropes and used to tow a single carriage, because that's how they did it with horses.
> Stacks of paper are used because it's not possible to put several pages worth of text onto a single page of paper while maintaining a legible font size.
Right. And trying to replace a stack of paper with one paper sheet-sized screen is a significant downgrade. Which is why tablets are used primarily for entertainment, not for work.
Having lots of sheets of paper you can spread out around you is an advantage, not a limitation, of the paper-based workflow.
No, a single screen is a massive upgrade over using stacks of paper.
People vastly prefer digital dictionaries over paper dictionaries because you can more quickly find stuff. And that’s with dictionaries in alphabetical order.
Stacks of paper suck, there’s some potential utility in a space ship for all the redundancy around independent tablets you can hand someone. That’s something that regularly happens on the show and kind of makes sense, but is more a visual reference for the audience. Which is where stacks of tablets shine, the viewer can easily follow what their doing even if you can’t see the screen.
It can be true that stacks of paper are better than a single screen in some ways and worse in others. Other people like to be able to spread out multiple sheets of paper in front of them, even if you do not. You are correct that digital search is a huge plus of having a digital interface.
If we’re talking 3-5 pieces of one sided paper for say homework you can spread them out nicely, but scale that to multiple stacks of loose paper and it invariably becomes a mess.
Thus, in practice almost everyone is using multiple screens at work when they can even if printing stuff is trivial.
Your takeaway presumes that all LLM interactions are monolithic, which is the opposite of what was being claimed if you take the other poster's comments about tool use into consideration.
I have no real investment in this conversation though, so your proclamation of winning can stand as far as I'm concerned.
> That's obviously tool calls :). I don't get where this assumption comes from, that a computer must be a single, uniform blob of compute? It's probably because people think people are like this, but in fact, even our brains have function-specific hardware components.
In fairness, half the time the Trek computer does something weird, it only makes sense if there's no memory/process isolation and it's all one uniform blob of compute. Made sense in the 60s where Spock's chess app losing to him was useful evidence that the CCTV recordings had been faked, not so sensible in 2025 when the ship stops being able to navigate due to the excess system demand from the experimental holodeck.
> If iPads were sold in every store for $1 a piece, we'd be doing that too. This is indeed a technology problem (or at least half-technology, half-economics), we just can't make working tablets cheap enough (and sustainably enough) to support such workflow.
The price of a lowend Android tablet can be shockingly low, to the point that physical multitasking is totally practical for an environment as expensive as space travel. The issue is bloat. The UI for a Trek level starship could easily run on 1999 era PC hardware much less powerful than a 2025 postage stamp of an SOC, if we were still coding like it was 1999. But not if it has to run Android Infinity with subpixel AI super resolution, a voice interface, and no less than 70MB of various JavaScript frameworks crammed into a locked Chromium frontend.
I run a Motorola mobile device at work (retail) that would be competitive with 10-15 year old flagship phones. The browser interface is designed for tracking and ease of development and to show off new AI tools. It employs landing pages, phased loading, a bunch of dynamic things. Looking up a SKU number takes 2-5 minutes (MINUTES) to load things I could get in ten milliseconds on a console interface or hundreds of milliseconds in a 1999 World Wide Web e-commerce site.
> There wasn't much opportunity to hallucinate - mostly simple queries,
Depends which Star Trek series you are talking about; early TNG routinely had complex request for new research/analysis/hypothesis generation and evaluation; if it came out today we’d accuse Starfleet of being infected with vibe crewing...
We are also getting a Multipolar order, so a single government Earth is pretty far away, and so too with the 1984 Mega Governments. Surveillance is increasing in developed societies, but there are multiple underdeveloped nations that are currently under siege by their own citizens themselves. Not to mention we're unsure if these developed nations won't suddenly implode or come under fire by their own citizens to invoke mass change.
They are human problems caused or exacerbated by misuse of technology. Mass surveillance and accruement of capital by private entities at this scale is only possible due to automation.
What difference does it make, anyway? The distinction is meaningless when the result is the same.
Imo the distinction is very important in this context because there's a lot of technophobia and cynicism in general discourse, to the point where new developments in technology are often immediately met with extremely pessimistic takes re exploitation.
It's good to remind ourselves from time to time that new developments in technology have both positive and negative potential, and how they're applied is largely due to sociological factors. When we dissociate the issues with "technology" we allow ourselves to see the underlying issues causing potential misuse, making progress at solving those problems possible instead of a knee-jerk negative lashback against anything new.
None of the problems I referenced are “new developments” in technology. The Snowden revelations happened over a decade ago. We know that Facebook hid their discoveries on social media harm, like a tobacco company.
It is patently obvious by now that major developments coming out of big companies will be used to further encroach their dominance at the expense of every one else. It is not a knee-jerk reaction to recognise an obvious pattern and identify probable pathways for abuse. On the contrary, those have to be identified and discussed early if there is any hope of counteracting the problems.
So no, it doesn’t make a difference to distinguish between the technological and human problem when we’re not solving the human problem. It is an excuse which could be applied to anything—technology doesn’t harm by itself, all of it is created by humans. That’s just a variant of “guns don’t kill people, people kill people”. It is important to recognise the role of technology in facilitating and worsening the human problem.
Yes, and in order to identify them, we need to separate the technology from the social context in which it is deployed. That's exactly what I'm saying, glad we agree.
There are a few episodes about holodeck failures due to verbal instructions interpreted incorrectly (notably the Moriarty episode). Ship in a Bottle even has prompt injection when Moriarty figures out he can summon the arch.
Plus, the captains ask tons of questions a computer would know, but only the bridge crew are trusted with.
> Except their tablets weren’t filled with time-wasting features designed to keep you addicted and distracted.
This part I agree with, but is also very easy to fix (use a very old UI system, e.g. direct port of Apple's HyperCard).
On the hardware front, the only thing Trek Padds had that real life can't really do is that Trek's power cells had an energy density on par with "let's say an atomic battery had a way to dial the decay rate up and down at will and were not also a horrifying source of neutron radiation".
> No, we definitely do not. If every time they spoke to the ship’s computer it made up answers at the rate LLMs do, they would have either stopped using it or would all be dead.
“The computer is malfunctioning” has been a plot device in Star Trek since the beginning.
> And you’re ignoring we’re also in the stages of getting the surveillance from 1984 and the social class divide from Brave New World. Those are not good tradeoffs.
Not disagreeing with you at all, but the surveillance on Starfleet vessels and facilities is almost complete and all-encompassing. Real-time location, bodily attributes, eavesdropping, access to all communication and computer data, personal and otherwise, I don't think there's anything that is private in their world! Remember that time The Doctor started a two-way video call with (I think) B'Elanna while she was in the shower? That being said, Starfleet is a paramilitary organisation, perhaps it's less awful in civilian life when one isn't wearing a Comm badge.
I wonder if you and I would consider this degree of invasiveness an acceptable compromise with a life almost completely without illness, any form of capitalism and the opportunity to pursue pretty much any life path we wish, in a society which is largely at peace with itself.
They were listening to people through their wall art.
Leon Theramin had invented a radio-activated passive microphone that was used to listen to people from their furniture [0].
The fact that this was only (as far as we know) used to listen in to embassies is more about the economics of scale rather than imagining new technology that didn't exist at the time.
At that scale at that time it was cheaper to have neighbors name and shame people who complained about the government. But there is little really in 1984 that's about the future of technology in the same way Star Trek or even Brave New Word is.
[0] He had also invented a television in the 1920s, which is mostly just trivia related to this question.
Not "just", the inspiration came from many angles: Stalinist USSR, Nazi Germany, Spanish repression of POUM, Wartime Britain (where the shape of the TVs come from) and multiple other dystopian novels.
People seems to forget that Orwell was a anti-Stalinist socialist.
I don't know too much about POUM, but my understanding was that in Homage to Catalonia he's concerned with the Spanish Communist Party's suppression of POUM. So I think that is consistent with what I said above.
I haven't forgotten that Orwell was an anti-Stalinist socialist. But there weren't any anti-Stalinist socialist states at the time.
Indeed, communist repression of socialist ideas. I think the confusion comes from "surveillance of socialist countries in", where it should have been "Stalinist countries", not "socialist countries".
It really depends on the organ. Kidneys stand out as the most successful organs for transplantation, even in allotransplantation (between humans) so it makes sense that they are working well in xeno as well.
Kidneys are not as vascularized as some other organs (heart or lung) which probably helps a lot.
Heart and lung xenotransplantation are still a ways off and a lot of basic research is still needed to make them work.
My mom worked with eGenesis on pig xenotransplantation, particularly lung.
Here are some links if you'd like to donate to the International Xenotransplantation Association:
A family member needed a kidney transplant in the early 60s. This was in the UK where the first successful transplant was in 1959, so just a few years earlier.
Thanks to a kid on a motorcycle she got a kidney just in the nick of time.
She was in her early 20s and was told she could expect a few years. Because of that she never had kids.
Her donated kidney served her well and she lived a quite normal life. She passed when it finally gave up when she was close to 70.
So those "few years" turned into almost 50.
Interestingly she mentioned she was told to take some strong medicine after the transplant. She got this feeling it wasn't good for her and stopped taking them soon after, without telling the docs of course.
She always wondered if that was the reason it held out so long.
> Interestingly she mentioned she was told to take some strong medicine after the transplant. She got this feeling it wasn't good for her and stopped taking them soon after, without telling the docs of course.
Typically, after a kidney transplant, patients are instructed to take immunosuppressant drugs for the rest of their lives. This is to reduce the risk of the patient's body rejecting the transplanted organ. Your family member was just straight up lucky that her body didn't reject the organ, even without any immunosuppression.
One thing that's fascinating to me is that most immunosuppressant drugs used today hadn't yet been discovered in the early 60s! AFAIK, all they would have had was prednisone, prednisolone, and azathioprine. Back then, a kidney transplant aided by these drugs would have been as new and revolutionary as the Hepatitis C cure or the triple-drug therapy for cystic fibrosis is today.
That was my thought as well when she told me. Then again, when given just a few years perhaps one considers these things a bit differently. The side effects for the drugs you listed does indeed not sound like a lot of fun.
Oh yeah, they suck. Long-term effects of just prednisone can include everything from muscle weakness to reduced bone density to spontaneously developing diabetes. Generally, doctors prescribe these kinds of drugs for longer than a couple months only in situations where the risks of not taking them are worse than the many, many side effects of taking them long-term.
Not a doctor, but I suppose she should’ve eventually told them in the interest of science. Also, pregnancy has a heavy toll so who knows? Maybe it was a good thing she didn’t. We don’t know.
> Not a doctor, but I suppose she should’ve eventually told them in the interest of science.
Glad she had a largely fulfilling life, but also thinking this. As much as it was her choice what to do with her body, it’s probably a good idea to at least tell the healthcare professionals about things like that, even if after the fact.
It's one anecdote. In the hierarch of significance this is below even the "one published paper" level which you certainly should also ignore even if you know enough to interpret the paper.
It's really good she lived for 50 years with an kidney transplant. But it is a massive stretch to say that she willed herself to last that long.
Totally agree that kidneys are the logical starting point. Lower immunological complexity + less vascularization makes them more forgiving as a test case. The lung, on the other hand… yeah, that's a whole different beast
In star trek they only figured that out in 2024, so we are only a year late.
And honestly, the way us politics are headed, a "bell riots" type event doesn't even seem that implausible. (Learning from it on the other hand does seem implausible)
[For those not into star trek lore, the way star trek became a utopia was first the government put poor people in internment camps, eventually triggering violent riots in 2024, which eventually lead to people learning from their mistakes and a utopia society. https://memory-alpha.fandom.com/wiki/Bell_Riots ]
2024 Bell Riots were the tipping point[0], but there was still World War 3 a few decades later. A global nuclear exchange probably helped a lot in kicking human civilization off the dystopian but locally optimal path it found itself stuck on[1]. Meeting a technologically superior alien race a decade later also helped solidify a different perspective :).
But yeah, I too was disappointed when 2024 came and gone without the Bell Riots - Star Trek came this close to accidentally turning prophetic, as in the months prior things really felt like the Riots are going to happen on the date.
--
[0] - In that timeline, at least. We've already past several important world events that originally happened in Trek timeline, so the show keeps shifting the dates to keep with the overall premise of being imagined future of real humanity.
IIRC the writers now settled on "Romulan temporal agents meddling with timeline, desperate to stop the Federation from forming, and failing because apparently the cosmos really wants UFP to be a thing" as a convenient explanation to push WW3, Eugenics Wars, etc. forward every once in a while.
[1] - How humanity bounced back from that so quickly is something of a mystery to me.
> [1] - How humanity bounced back from that so quickly is something of a mystery to me.
There is always the "it wasn't as bad as in Mad Max/Fallout/..." explanation. Nuclear winter is now understood to be either less severe than predicted back in the 60s, or nonexistent. Nuclear weapons will kill people and destroy cities, but if they aren't aimed at people or cities, but at military installations such as the US nuclear sponge[0], death toll and destruction will be far less severe. Things like the Golden Gate Bridge or the Eiffel Tower might be left standing, as seen in a few Star Trek episodes. Which would also mean that humanity would be in less of a severe turmoil than other nuclear war SciFi might have imagined.
But you are right that the concept was only made popular in the 80s, and a lot of the earlier works were classified or unknown and obscure to the public.
Back to the future 2 called a Chicago cubs World Series win in 2015. It actually happened in 2016.
My favorite fan theory as to why they went to a future of flying cars that’s so different from our own is that it was the events of the first movie (going back there and changing history) that ultimately led us to that different path.
Hoarding land and land speculation is really the root problem.
It's not bad for society if it was used to make building to provide rentable space to industries and business or to provide homes, or quite often both, but it doesn't provide easy money to investors.
Now sitting on land and seeing it appreciate with no hard work from you? That's easy money.
The key words here are "a basic" level of housing. A house in the most exclusive area of town will always be an investment (not necessarily a good one), because it primarily offers exclusion of other poorer members of the society from your surroundings, not habitation for yourself. It can't be affordable by definition.
But a basic level of housing is a human right, because it's a prerequisite for maintaining your humanity, ditto for healthcare.
It's also possible for housing to be neither affordable nor an investment. If there's an expensive area of town, and property tax is 100%, that would be expensive and I don't think people would consider it an investment.
Has no real democracy and the govt is able to plan decades ahead. It seems much better than the typical Western political system to me. But then again gays were only very recently accepted there, right?
> Has no real democracy and the govt is able to plan decades ahead.
I get the sentiment but accuracy is important here. It's a real democracy vs counties where voting is a sham.
But yes, it is widely managed by a single party that was setup by a benevolent dictatorship and the current administration generally does a good job and is voted in with strong support.
So agreed, they can do really interesting things because of their time horizons of control combined with willingness to work for the better of the people.
It can be sort of both. What you need is more housing built at affordable prices. But dont oberbuild. In that situation housing should act as store of value to avoid inflation loss, but not something that you get rich buy borrowing and buying up dozens.
You need socialism to do this efficiently. There isn't room for a profiteer. You need the government to invest (in the for people sense) in allocating land and building housing. Ideally dense housing.
oh we can “figure it out” trivially. There’s no technology or actual resources preventing that from happening.
But the status quo benefits many parties… alas, “people” problems are harder than technical ones. Most humans can be remarkably greedy, and also stupid in large groups.
We've figured that out, but certain members of society decided that extracting wealth through protectionist zoning/building code behavior is much, much more lucrative.
that just moves the figuring out one step to the right. knowing how something will work but not knowing how to get it implemented means the problem is not completely figured out yet.
Exactly. We haven't figured out how to solve the problem, because we still have the problem. Maybe it's unsolvable, and it's just a limitation in our ability to live together in large numbers. Or maybe we need to redirect our spending on (among other things) frightfully expensive experimental medicine and spend the money on things that are a lot cheaper and will help a lot more people.
Really? I think I can agree that the zoning isn't helping, but claiming we have figured it out seems like bold claim. Where _is_ it working? My impression is that housing costs are increasing faster than inflation and wages not only in North America, but also in the UK and EU, which don't have the same kinds of zoning laws.
Aren't Japanese homes super tiny? Even smaller than the already small homes and apartments in Europe? That's one reason. In the US, it seems that people live in bigger places, with higher ceilings.
My understanding was that Japanese housing costs are only good in USD because the yen is devalued. I had the impression that housing is expensive relative to local wages. Is that not true?
America spends a greater percentage of government money on healthcare than many systems with universal healthcare. Medicare, Medicaid, and Veterans Affairs and Military medical spending are about 7% of GDP. Add another 1-3% and you would be ahead of almost everyone.
And that would still be a savings of 7% of GDP.
Not providing universal healthcare is entirely a political cocktail of wasting the money, letting big corporations loot it with tactics like using many partial vials of medicine instead of a full vial, letting the medical professional groups stuff up the pipeline of medical practitioners, and electing members who did all of the above to Congress.
Debt to who? If every country is in debt who is the creditor? Mars?
But you actually said every major country is in debt, so do all the major countries owe money to um...minor countries?
Perhaps it is not the country that is in debt at all, but the government? In which case it must owe money to entities like people and corporations. The government has powers to take money from entities in its jurisdiction and pay its debts, it is called taxation. In fact since the money is issued by the government in the first place, you could consider a token of government debt is actually a token meant to pay your taxes with. By lending money to the government you receive interest, or in other words a discount off your future tax.
All very neat, and why a government being in debt is no reason for it to not be able to pay for things.
In fact you might argue that government debt takes money out of the economy, so keeping inflation down. This means the government can spend more without causing inflation. If a government borrows a dollar and spends that dollar, there is the same amount of dollars circulating. However if it borrows it off someone who is hoarding it, and spends it then you create gdp growth. Magic.
Perhaps it's time to get past puritanical hatred of debt?
Military spending has actually decreased a lot as a % of GDP in the US over time, so old narratives about this have become less true. So the anti-military-spending orgs have to abuse the numbers if they want to keep that narrative going:
Though, a reasonable person can still argue that the many billions we still spend on the military can be better used elsewhere. There’s no need to cook the numbers to make that point.
Healthcare spending is now 4x higher than military in the US (across the whole economy, not just government). So it’s hard to claim the problem is we’re prioritizing the military over healthcare. In my opinion, we have a systemic issue where we get poor value for money across a variety of sectors. Healthcare, education, military, housing, transit…
If you include things directly related to, but not classified as defense spending, like veterans benefits, VA, and the cost of foreign bases; the military is about ~20% of the total US budget.
>> poor value for money across a variety of sectors
Yup this. I went in for a cardiac stress test a few months ago. Less than 30 minutes in a room with a treadmill, an ekg machine and a low-mid level technician. $10k.
> Healthcare spending is now 4x higher than military in the US (across the whole economy, not just government). So it’s hard to claim the problem is we’re prioritizing the military over healthcare.
I don't think that's a hard claim to make in other terms than % of gdp—I can't imagine many americans want to devote that much of our gdp to it when other countries manage a high degree of care with much more efficiency. But we seem to have largely talked ourselves out of democratic control of such matters, somehow, for some reason, repeatedly over the last 70 years or so.
Even if you took all the money from the "rich" the goverment would shut down as usual the next year because the debt they create is way more than the private money available out there.
Insane take. Even if you confiscated ALL the money from all the billionaires (instant 100% wealth tax) and spread it to everyone worldwide, it would be a one time sum of under $2000. And what then?
You can shear a sheep many times but skin him only once.
It seems like billionaires have a knack for making lots of money every year. Why don’t we just take a bit more of it than we do now and invest it into useful projects?
Billionaires generally do not have a knaxj for value creation. What they do generally have is an egregious amount of greed and a total lack of empathy which enables an incredible amount of exploitation.
Then the former billionaires won't have the ability to influence society to pass laws that favours them. We'll finally be able to build a society for everyone.
> We'll finally be able to build a society for everyone.
I assure you this isn't the only blocker and its naive to think that [other_set_of_humans] will not try to consolidate power for themselves after you remove the current set.
Most people are not in it for their fellow man and whoever sold you this idea that billionaires are the only impediment to, or even blocking now, a better society -- lied to you.
By all means get rid of the billionaires, I don't particularly care; just don't be so surprised when it turns out that was just a side quest.
I think there are other avenues here that are probably better spent to make society better.
Everyone in the US misses the 50s, marginal tax rates were crazy high. "Oh, but people had lots of deductions and not many people actually paid the top rates" - yeah, that's exactly the point, it encouraged money to be spread around more. And a whole lot of people prospered, while government revenue was less lopsidedly concentrated too.
Get people away from paycheck-to-paycheck debt loads and you've improved a lot of lives regardless of if those people are egalitarians who will then vote for utopian policies. We know that allowing more and more consolidation ain't the move.
We have 4-5x the normalized GDP per capita compared to the 1950s.
The amount of taxes we collect isn’t the problem. Excessive government spending and inflationary pressures on things like housing is (Which, btw seems to always go up regardless of what political side you want to point fingers at)
While the economic output per person has indeed increased 4-5x, the inflation adjusted median household income has only increased by 50% (1.5x). Government spending is not the issue here.
The things you mentioned are always a problem because even the far left in America is incredibly right-wing.
Re: “how do we handle how this changes what it is like to be human today?” part of your post... I think that came to prominence when cheap, effective birth control became available. I think it was about the first time that the common people could decide to make major alterations in how their bodies function. That debate continue in the current fight about trans rights.
As science and medicine progress, what was once considered solely god-given, or exclusively biologically determined, will be for people to decide for themselves, the decision made between them and their doctors.
I had heart surgery 2 months ago to repair my mitral valve. In the lead-up to that, I had to make a decision what to do if it turned out replacement was needed instead of repair. Choices were metallic valves requiring me to be on warfarin the rest of my life or pig-derived valves. I chose the latter, mostly to avoid warfarin for life, but also because my surgeon was a PhD for work on creating biological-derived valves that didn’t trigger the immune system. Just mind-blowing what can be done. But I’m glad repair and not replacement worked out - and I now have GoreTex fibers attached to my valve.
Pig and cow valves will calcify and fail eventually. But it’s a slow process so you have time to plan and make decisions for replacement. Mechanical values are great until one day the clicking sound stops and you need to get to a hospital ASAP.
Back in the 90’s there were a series of values where the flipping plate shattered-sending shrapnel into the heart and beyond. Typical failure mode is stuck open which is survivable. Stuck closed is very bad.
Size. Pig hearts are the same size as human hearts, cow hearts are larger, so easier to cut up for parts. Chimp hearts are usually smaller.
Also, the risk of transmitting zoonosis is larger in primates than in other mammals, because with humans being primates as well, more viruses/prions/fungi might be infectious to both.
I think Alan Kay deserves the credit for the tablet. We have vague allusions to tablet like things before Kay but it was Kay who really came up with concept.
Does he? It seems to be mostly keyboard operated, and references to any stylus interaction seem to be retconed, let alone direct touch ones.
My search only finds modern claims that he's the true tablet inventor and tablets are touch this and stylus that, but these poison results about any possible original reference of that interaction model having been conceived at the time.
Eh, "figuring out how to deal with it" is the easy part. The hard part is first making it work, and then proving its effectiveness, scaling it and improving it.
Medical advancements in particular are notorious for having a hideously long lead time. This here is an experimental procedure that, if all goes well, will only start becoming commonplace by year 2035. It's not guaranteed to all go well.
You'd think there would be a massive push for new medical technologies that have the potential to save hundreds of thousands of lives, and you'd be wrong. Healthcare is where innovation goes to die. Most companies that attempt to develop this kind of bleeding edge treatment crash and burn either before or shortly after seeing the first results. Just the cost of early testing of a new treatment option is enough to bankrupt many.
> “how do we handle how this changes what it is like to be human today?”
Progress, invention, is part of being human, so this is natural and normal thing that these thing happen. You can stop, marvel, and then go improve upon your own niche.
The “pigmen” as you insensitively refer to them aren’t necessarily seniors. Organ failure affects men of all ages and the patients themselves are not to blame, often they have terrible support structures surrounding them and other factors beyond their control. You can be optimistic and compassionate simultaneously.
And yet while (legitimate) science can universally agree continuing to burn fossil fuels will cause unimaginable chaos for planet earth, half the planet doesn't seem to care about the impending collapse.
So while in my personal vacuum this is awesome, when I stop to consider the situation for 30 seconds I can only think: huh, we might have been able to find a new cure for humanity that isn't going to matter when having "a profession" (like doctor) is no longer relevant to our inevitable hunter/gatherer lifestyle.
Most experts don't predict the collapse of industrialized society. Higher temperatures, rising sea levels, and more energetic weather events will cause damage and make life difficult for decent chunks of the population especially those in less developed areas that are both hotter and more poorly equipped to cope with climate change. But I'm not aware of a consensus or even a plurality among climate scientists that industrialized society is going to collapse even in the more pessimistic predictions.
I'm not sure how Cambridge, Massachusetts, where the company building these pig kidneys is located, becomes a hunter-gatherer society on account of climate change.
Legitimate science doesn't concluded unimaginable chaos from continuing to burn fossil fuels that's what influencers or movies or tiktok reels present because they are part of the attention economy where scaring you is profitable.
Besides hunter/gatherers need medicine men who understand the old ways.
I was just thinking about heart transplants and how they’re treated as commonplace now, but they are nuts when you think about them.
You can hook up the nerve wires and blood pipes from one body into the heart from another body and it works? Just thinking about the simple physical connections would make me nervous. Why isn’t there blood just leaking out in your body? Why isn’t that other heart sliding out of place while you move around?
But presumably the nerves between the brain and heart exist for a reason. What functionality do you lose by not reattaching them? Do things like "heart beating faster when nervous" depend on this nerve signaling, or is it done via other chemical signaling.
Yes, nerves from the brain to the heart can influence heart beat (and other features like heart conduction and blood flow to the heart itself) in response to stress and exercise. Heart transplant recipients lose these features. They make poor marathon runners :)
Heart rate muscle tissue is largely influenced by hormones. The sympathetic system releases noradrenaline to speed up the heart rate, while the parasympathetic system releases acetylcholine to slow it down. But the release of these hormones is controlled by nerves, which are largely severed. So you typically end up with a less "dynamic" heart rate -- resting rate higher and responsiveness to stimuli reduced. These nerve connections can regenerate to some degree but it's individual and rarely close to what they were before.
That is actually wild and I wonder about the practical consequences as well.
So you get into a stressful situation or get a flee or flight response, and your heart is not affected by it, or at least the heart rate, but your cardiovascular system may be needed because in that case the rest of your body is, and presumably you may need much more blood to be pumped out to your organs among other things.
…Do you have a link? I’m not sure if I want to see proof of that, but I’m at the same time curious how you’d manage to do it without disturbing the cat.
The part that always gets me is the lack of nerve reconnection - the heart keeps beating on its own, no nervous system hookup required. It's literally running off internal timing, like a mechanical watch made of cells
It's not exactly the same as a biological heart transplant (I assume), but you might be interested in reading the surgical instruction manual for a SynCardia artificial heart: https://www.accessdata.fda.gov/cdrh_docs/pdf3/P030011c.pdf
In all viscera sympathetic and para- keep balance of muscle function. But in steady state the para- must fire more powerfully because the sympathetic intrinsically dominates a little. So if you cut off both systems, the organ has a sympathetic boost. In heart's case this will make it beat faster, I believe about 20-30 more beats per minute (after some self-compensation). This is easily treated with a beta blocker.
Richard Slayman was a pioneer. He made an amazing decision, to see if it could be done. This was hard work done through eGenesis, and the steps to get to this point is quite interesting.
>> First, the donors were often created on a commercial pig breed whose heart and kidney sizes are too large for human application. Although elimination of growth hormone receptor gene expression could reduce organ sizes, it comes with other undesired biological consequences. Second, the donors were designed for testing in OWMs. They lacked the α-Gal (galactose-α-1,3-galactose) or the α-Gal and Sd(a) (Sia-α2.3-[GalNAc-β1.4]Gal-β1.4-GlcNAc) glycans but expressed the Neu5Gc (N-glycolylneuraminic acid) glycan to match with Neu5Gc expression in OWMs. However, in vitro analysis suggests that a human-compatible porcine donor should ideally have all three glycans eliminated to match with the absence of the three glycans in humans. Although renal grafts derived from the porcine donors lacking these three glycans and carrying various human transgenes have been tested in OWMs, graft survival was short8 or not all human transgenes were expressed. Third, the donors carried porcine endogenous retrovirus (PERV) sequences in their genome, which present a zoonotic risk, as PERV transmission to human cells in culture and their integration into the human genome have been demonstrated.
A bit of medical and historical context seems to invert its interpretation entirely. For example Louis Washkansky, the recipient of the first human transplant (performed by Dr. Christiaan Barnard in 1967 in Cape Town, South Africa) lived for only 18 days before passing away from pneumonia. But nobody considers that historical fact as a negative when thinking about heart transplants these days. In comparison, this statement about the pig kidney is actually very exciting. It means that the xenotransplantation technology is progressing rapidly and will soon become widely available. They seem to have overcome most of the serious difficulties in the process.
I think the person you replied to was objecting to the fact that the wording makes it sound like we're using humans as vessels for extending the life of pig organs outside of pigs.
Not necessarily that 6 months is a short period of time.
That's an interesting way to interpret it! I see what you mean, but I still can't see myself interpreting that headline in that way. Does it really give that vibe?
Yeah I re-read it now and don't feel so strongly about it. But I think its the sentence structure:
"This is the longest a pig organ has survived in a living person"
The pig organ is the first thing mentioned, with the living person last.
Whereas:
"This is the longest time a patient has survived after a pig organ transplant."
This puts the patient first, and doesn't give as much of that kind of vibe.
Edit: Actually, that updated sentence may need some adjustment. I assume when organ transplants fail we don't just let people die with them. So maybe that's why the original sentence had such emphasis on the survival of the pig organ...
Seeing as the subject of the sentence is the pig organ, it's saying the organ is the one doing the surviving and only tangentionally mentions the person surviving by calling then living. I (and presumably we) only come to a different interperetation because I have the context that the latter is the important bit. If I give some other similarly structured sentences but without context, how would you interperet these?
- This is the fastest Alice had driven since Bob broke the speed limit.
- This is the oldest tree still standing in the burnt forest.
- This is the most stable chemical additive to our long-lasting concrete.
Without context, to me these examples sound primarily about Alice going fast, the tree being old, and the chemical being stable. But if those appeared in articles about traffic law, natural disasters, and sidewalk design, then these phrasings might be less ambiguous if flipped (as another commentor pointed out).
Well, the pig organ could fail immediately, causing the person to go back on dialysis for 6 months. That person would've also lived for 6 months after a transplant.
> It means that the xenotransplantation technology is progressing rapidly and will soon become widely available
It also validates the platform. If it can last for 6 months, chances are there isn’t some catastrophic failure mode that would keep it from lasting for 6 or 60 years.
The person can go back on dialysis and have the kidney removed if it starts failing. Which is what happened to an earlier recipient of a pig kidney. So it makes sense to phrase it that way.
Transplanted kidneys get rejected by the recipient's immune system eventually, you'd really need to clone the kidney from the individual's DNA to solve the rejection problem. There's also been some success with integrating the DNA from the kidney donor (a human) into the recipient's bone marrow to stop the rejection process, but I hear it can be a brutal procedure in which the original bone marrow must be destroyed using chemotherapy or radiation.
> and really hope it lasts until something like kidney cloning is a thing.
There was another technology under development, colloquially called the 'ghost heart' [1]. It uses a dead heart that's similar to a human's, most likely a pig's heart (I speculate that an unused human heart can also be used). They remove all the cells from the heart using a soap-like substance to obtain a ghostly white colored scaffolding of a heart (probably made of collagen). Then they use the recipient's own stem cells to grow heart muscles, blood vessels, etc on the scaffold. The process to get it to work like a human heart seems complicated, but doable. As you can guess, this heart is fully immunocompatible with the patient and doesn't require immunosuppressants like after a regular transplant. I imagine that this can eventually be replicated for any organ and that the improvement in the patient's quality of life it will bring is unthinkable in the current state of affairs. I'm not sure about the progress and current state of this technology, but several articles do turn up on searching.
Any time I haven’t heard about a tech for ten years I assume it didn’t work. I think I first heard of this stuff around ten years ago. At the time I think they were focused on kidneys. But those have a lot of complex plumbing.
As an outsider, who is either missing a mountain of context, or not so close to the problem they can’t see it, I would assume a better tack would be growing ghost arteries for bypasses and aneurism repair operations. Ghost intestines for reconstruction surgery for people with cancer or massive internal trauma. You’d have a simpler organ to reproduce, but in the artery case you’d likely have to also work turnaround time. Heart failure can be slow, but bypass surgery is often scheduled as either urgent or emergency (I just had a convo with a man who wasn’t allowed to leave the hospital after an angiogram showed he was one stairwell away from a fatal heart attack). But not having to harvest material from the thigh before surgery begins should shorten the surgery and reduce complications. You can have as much artery as you want for the surgery. You could have spares.
The article I cited is from 2022. At that time, the principal scientist had left the academia and was working to commercialize it. So I'm guessing it's still within your decade threshold? Besides, perhaps that threshold should be longer under the current circumstances. One of the greatest medical advancement of the recent times is the mRNA vaccine technology. But it's true origin is in the 1970s. They were solving numerous related problems in the meantime, though it could have been finished sooner had someone invested in it as intensely as they did during the pandemic.
Looking at bibliographies, it seems like a lot of the research for decellularization was 2011, 2013, and a handful after. So they were still working on getting a clean substrate while working on how to fill it back in.
It’s a big problem, but still seems like they’re swinging for the fences when they could save people in the short term while working on organs.
Interesting! I just remembered that there is another team that's working on plant based scaffolds (cellulose scaffolds from leaves like spinach) [1]. This one is from 2017. So I'm guessing that the interest in the technology hasn't waned yet. I also wonder if any biocompatible scaffolds can be 3D printed, rather than having to decellularize the available ones.
It's not entirely impossible that a broadly compatible tissue could be engineered - in a more through version of the same process that yielded those "somewhat human-compatible" pig organs.
That's a part of the reason why this tech is so promising. If we can already target immune incompatibilities to make "elongated pigs" with organs that fit human bodies somewhat, then what are the limits?
Keep in mind the amazing thing is the survival of having the transplant in addition to kidney failure. People have been living up to five years without kidneys by relying on dialysis.
That's rough, I'm sorry for your loss. I've been on dialysis for 5 years now (in-center, I couldn't do home for.. reasons). In the beginning I was considering giving up, but it did finally get somewhat better, and I'm fairly well adjusted now. I mean, it still sucks (especially losing about 5 hours 3 days a week), but I'm able to not think about it when I'm not there, at least.
I've a kidney transplant patient and also have been on dialysis previously.
The pain can come from fluid removal and electrolyte imbalances during the dialysis. The fluid removal is important because if you kidney fails, at some point you stop urinating. The in-clinic dialysis process is also compressing the 24 hour a day function of your kidney into a 3-4 hour process typically every other day. So if you remove fluid and shift electrolyte during a short period of time it can cause cramping and pain.
The situation can be improved by doing treatment over more days or for a longer period. That is where home dialysis comes in. Some people run it at a gentler pace at night. Some may run it for 5 hours 5 days while watching TV or doing something else. They get some flexibility around their schedule.
You can see one of the new home hemodialysis systems here. They are streamlined and less complicated to use than in the past. But for some older people and those with mobility issues they might not be operate it on their own.
I'll note however that I used a different type of dialysis called peritoneal dialysis which uses osmosis action of passing fluids through your peritoneal membrane in your abdomen. No needles involved but it doesn't work for every patient and over time it can stop working. But you end up holding a lot of dialysis fluid at night which can be uncomfortable. But it has less of the complications of fluid removal and electrolyte imbalance issues.
There is actually a project for a implantable artificial kidney but it has slow progress due to funding. This devices operates 24x7 do it could operate at a much gentle pace. Maybe its too ambitious but the lead scientist thinks about $50M would be enough to get it through trials.
I have never experienced it, myself, but have seen several close friends deal with it.
They always come back wiped out, and sick.
Usually, it’s a temporary thing; meant to keep you going, until a full cure (like a transplant) can be effected.
My friend made his decision, because a transplant was not an option. He would need to live like that, for the rest of his life. I have a couple of other acquaintances, that got transplants, and were able to go past dialysis.
I have always wondered what decision I would make facing such a health concern.
> Reaching 12 months would be another milestone and a “fantastic long-term outcome”, he adds.
I am surprised by this being considered a long-term outcome though. Going through the high risk of a kidney transplant, immunosuppression required, risk of using a pig kidney in general, etc seems like a lot if the hope is for 12 months as a long-term unlikelihood.
The alternative is dialysis, which isn't a good patient experience at all. And this is an experimental procedure, testing an early version of the xenotransplant technology. A bad long term outcome would be "the organ ends up rejected within two weeks, and does some damage to the patient while at it".
In a perfect world, this tech would work first try, and the xenotransplant would last for decades. We don't live in a perfect world.
If this proves a workable stopgap, bridging the wait time for the people waiting for donor organs, extending lives of those who don't qualify for organ donations? It might be worth using on those grounds alone. And it's likely that organ longevity could be improved iteratively.
I.e. use an organ to failure, figure out what went wrong and what the host immune system has reacted to, find a way to gene edit around that, get another 6 months of transplant longevity in the next version. Rinse and repeat.
Yes, we don't know what the true limits are - "universal and permanent organ replacement" is very much on the table with this tech. But it's pretty clear: getting all the way there wouldn't be quick or easy. A year of organ lifetime is a damn good start.
I've been on dialysis for 5 years now... which means when I eventually get listed for transplant, I'll be at the top of the list, because nobody survives 5 years...
The rules are very strict, primarily with respect to weight. That is, was (and still am) fat, and that's a no-no. I've lost 120 pounds so far, with at least 10 more to go before I will finally be (possibly) approved!
And this is why this is so exciting. The rules are so strict because kidney supply is extremely limited and they want to maximize the life of the kidney as much as possible.
Having a ready supply of pig kidneys would be fantastic. All the sudden it wouldn't matter as much that you are a bad candidate, you might end up simply cycling through pig kidneys more frequently.
It was unlikely outcome since nobody had lived there long on a pig organ. It is a good milestone since people who live that long, tend to have a good long-term prognosis.
I ran into this guy nere Interlaken 2 days ago! Had a nice long talk at the post office over how he was going to present this in Geneva. I heard that this is result is with little or no rejection drugs as well!
That's genuinely impressive. Six months without dialysis after a xenotransplant is no small milestone, especially considering how many hurdles this field has faced over the years. The level of genetic modification involved shows how far biotech has come. Still, it's hard not to wonder about the long game. Immunosuppression, organ longevity, possible unforeseen complications - all big unknowns
I wonder what the prognosis was right after the operation. The article makes it sound a bit like this outcome was totally unexpected.
Insulin from pigs can be used by humans, right? But maybe there's more to diabetes than just a new pancreas. Interesting development, in any case. Thanks for sharing.
I think the major worry is that the body rejects the transplant. If that happens, things can turn really bad really fast. The body will attack the kidney and completely wreck it. They'd probably need surgery to remove it.
He'd probably need to go on dialysis if that were to happen. How long he'd survive IDK. I think I've read that people survive around 2 years on dialysis.
> Insulin from pigs can be used by humans, right? But maybe there's more to diabetes than just a new pancreas.
It can be. That was the first developed insulin. I believe it's completely synthetic at this point.
Medical history has seen many "miracles." Hopefully, this time, it will become something more people can replicate and learn from, rather than just a flashy headline.
It is fucking wild that we need to resort to putting pig kidneys into humans to squeeze out a few more months of life, while tens of millions of perfectly good human organs are burned or left to rot in the ground each year.
There are talks to breed them smaller for better handling, as they need to live inside the regulated facility. Having a human size animal roaming around is physically complicated to deal with.
Does this mean you can catch pig kidney diseases (they specifically mention turning of a few retroviruses)? I'm assuming pig kidneys are immune to certain human diseases and vice versa. Kind of wild that you have a single organ running an entirely different mammalian OS distro but it is similar enough that it Just Works.
What we really need to work out is how we can incubate humans outside of the womb so we can create brain-dead humans for organ harvesting. Would be both more reliable and more humane than this. Plus you could harvest the heart, liver, etc at the same time. While this is great news, my understanding is that kidneys donors are in larger supply because often family members can give one of theres. This obviously isn't the case for organs like hearts and livers.
I remember interviewing for a bioinformatics role at a certain San Diego company 8 years ago and being told by the staff they were working on humanizing pig kidneys.
I thought it was a fucking insane idea and wanted to leave immediately.
If this becomes commonplace and animals are bred/raised just for their organs, we get into murky ethical territory. (Yes, people already eat the organs for food, that's murky too. But industrial scale organ farming sounds even worse somehow.)
I'm living with heart failure. I have 20-30 years before I'll need a transplant, if I live a perfect lifestyle and keep my other health issues under control. Due to my other health issues, I am not a good candidate for a human heart transplant. It's not that a human heart transplant would fail, but that when I'd be placed against others on the list for a new heart, my other health issues would reduce my priority such that there is always someone with higher priority to receive a heart, up until the point in which I'm no longer healthy enough to receive a transplant. There are far too few human hearts, and far too many people who need one. All that the transplant boards can do is give hearts to those with the greatest momentary need, with the best chance of surviving.
Xenotransplantation is one of the life lines I'm counting on. I'm hoping that, by the time I need it, the issues that we currently have will be worked out. I have zero ethical issues with breeding and eventually culling pigs in order to save human lives. I hope that there will be other, better, breakthroughs by then, but if not, the best I can hope for is that the pigs are raised in a sterile and enriching environment, and that the only bad day they have is their last day.
The ethical reasoning is we don't care about the pigs, millions of lives will be saved by exno kidney transplants. The argument is already very strong that we should pay to donate their kidneys given the scale of death (especially among the poor) kidney disease already causes, so a pig is nothing in comparison
Unfortunately no, after the surgery the pigs are full of ketamine, blood thinners, anticoagulants, vasoconstrictors, and other medications required for surgery and euthanasia and are not fit for human consumption.
Who would eat it these days? The same with e.g. sheepskins. The labor to process them in western countries is so high so they generally just get thrown away.
While I agree that it’s is pretty hard to ethically justify killing a pig for food, but I think I am ok with all that pig killing being used for helping sick humans.
While I don’t think we should be torturing animals or anything, obviously, I think I am humanist enough to where I think the ethical thing is to prioritize human lives or avoiding severe long-term discomfort (as is the case with dialysis).
“Xenotransplantation” is pretty #%^*ing metal.
It’s pretty wild being alive these days. Lots of big stuff the species is struggling to adapt to and figure out how to exist with.
But also… we got the tablets from Star Trek. And now we have the ship’s computer from Star Trek, and the early makings of the holodeck. And we’re making pigmen senior citizens who would otherwise be dead.
It’s quite something to stop and think about how the problem is becoming less and less about “how do we do the science and the engineering?” And more about “how do we handle how this changes what it is like to be human today?”
> But also… we got the tablets from Star Trek.
They regularly used multiple tablets at a time, stacked like papers. What we have is presumably superior from a technological standpoint. Except their tablets weren’t filled with time-wasting features designed to keep you addicted and distracted.
> And now we have the ship’s computer from Star Trek
No, we definitely do not. If every time they spoke to the ship’s computer it made up answers at the rate LLMs do, they would have either stopped using it or would all be dead.
And you’re ignoring we’re also in the stages of getting the surveillance from 1984 and the social class divide from Brave New World. Those are not good tradeoffs.
> They regularly used multiple tablets at a time, stacked like papers.
If iPads were sold in every store for $1 a piece, we'd be doing that too. This is indeed a technology problem (or at least half-technology, half-economics), we just can't make working tablets cheap enough (and sustainably enough) to support such workflow.
> What we have is presumably superior from a technological standpoint.
The writers were surprisingly prescient about this. Turns out, the secret about paper-based workflow isn't that a sheet of paper can display anything, but that you can have a lot of them, freely arrange them in front of you as you need, pass them around, pin up the wall, etc. Multitasking on a single swab is strictly inferior to that.
EDIT:
>> And now we have the ship’s computer from Star Trek
> No, we definitely do not. If every time they spoke to the ship’s computer it made up answers at the rate LLMs do, they would have either stopped using it or would all be dead.
We definitely do, and this, somewhat unexpectedly, got us to the point of being close to having a basic universal translator as well.
Computers on Star Trek ships weren't built for conversations, and weren't talked with as a regular thing for basic operations, so it wasn't like chatting with LLMs. There wasn't much opportunity to hallucinate - mostly simple queries, translating directly to something you'd consider a "tool call" today. But that's not the actually notable part.
The notable, if underappreciated, part of Star Trek's computers is that they understood natural language and intent. They could handle context and indirect references and all kinds of phrasings. This was the part we didn't know how to solve until few years ago, until LLMs unexpectedly turned out to be the solution. Now, we have this.
(Incidentally, between LLMs and other generative models, we also have all the major building blocks of a holodeck, except for the holographic technology.)
> If iPads were sold in every store for $1 a piece, we'd be doing that too.
Considering how bad Apple is at syncing, that’s just asking for trouble. You’d never know where anything is or what iPad has what or if it’s the current version. Not to mention the charging situation and all the e-waste.
> The notable, if underappreciated, part of Star Trek's computers
Under appreciated by whom? It’s one of their defining features. Are you talking about the real world or the characters?
> is that they understood natural language and intent.
Which LLMs do not. They fake it really well but it’s still an illusion. No understanding is going on, they don’t really know what you mean and don’t know what the right answer is. The ship’s computer on Star Trek could run diagnostics on itself, the ships, strange life forms and even alien pieces of technology. The most advanced LLMs frequently fail at even identifying themselves. I just asked GPT-5 about itself and it replied it’s GPT-4. And if I ask it again in five minutes, it might give me a different answer. When the Star Trek computers behaved inconsistently like that (which was rare, rather than the norm), they would (rightly) be considered to be malfunctioning.
> Which LLMs do not. They fake it really well but it’s still an illusion. No understanding is going on, they don’t really know what you mean and don’t know what the right answer is.
A tree falling in a forest with nobody to hear it: if it makes a "sound", you think "sound" is the vibration of air; if it does not, you think "sound" is the qualia.
"Understanding" likewise.
> The ship’s computer on Star Trek could run diagnostics on itself, the ships, strange life forms and even alien pieces of technology.
1. "Execute self-diagnosis script" doesn't require self-reflection or anything else like that, just following a command. I'd be surprised if any of the big AI labs have failed to create some kind of internal LLM-model-diagnosis script, and I'd be surprised if zero of the staff in each of them has considered making the API to that script reachable from a development version of the model under training. No reason for normal people like thou and I to have access to such scripts.
2. Not that the absence says much. If humans could self-diagnose our minds reliably, we wouldn't need therapists. This is basically "computer, send yourself to the therapist and tell me what the therapist said about you".
> When the Star Trek computers behaved inconsistently like that (which was rare, rather than the norm), they would (rightly) be considered to be malfunctioning.
Those computers (and the ships themselves) went wrong on such a regular basis on the shows, that IRL they'd be the butts of more jokes than the Russian navy.
> Would we? What for? Why would we need reams of iPads on our desks?
To use like we'd use paper.
> Which LLMs do not. They fake it really well but it’s still an illusion. No understanding is going on, they don’t really know what you mean
That is very much up to debate at this point. But for practical purposes in context described here, they do.
> and don’t know what the right answer is.
They're not supposed to. This is LLM use 101 - the model itself is behaving much like a person's inner monologue, or like a person who just speaks their thoughts out loud, without filtering. It's very much not a database lookup.
> I also disagree that was an underappreciated featured of the Star Trek computers, it’s one of their defining features.
What I meant is, people remember and refer to Star Trek's ship computer for its ability to control music, lights or shoot weapons, etc. with voice commands. People noticed the generality, the shamelessness of interaction, lack of structured command language - but rarely I saw anyone paying deeper attention to the latter, enough to realize the subtle magic that made it work on the show. It wasn't just some fuzzy matching allowing for synonyms and filler words, but more human-like understanding of the language.
(Related observation: if you pay attention to sliding doors on Star Trek vs. reality, you eventually realize that Starfleet doesn't just put a 24th century PIR into the door frame; for it to work like it does on the show, the computer has to track approaching people and predict, in real time, whether or not they want to walk through the door, vs, just passing by, or standing next to them, etc. That's another subtle detail that turns into general AI-level challenge.)
> The ship’s computer on Star Trek could run diagnostics on itself, the ships, strange life forms and even strange pieces of technology.
That's obviously tool calls :). I don't get where this assumption comes from, that a computer must be a single, uniform blob of compute? It's probably because people think people are like this, but in fact, even our brains have function-specific hardware components.
(I do imagine the scans involve a lot of machine learning and sensor fusion, though. That's actually how "life signs" can stop being a bullshit shorthand.)
> The most advanced LLMs frequently fail at even identifying themselves.
They'll stop when run with a "who am I?" tool.
> When the Start Trek computers behaved inconsistently like that, they would (rightly) be considered to be malfunctioning. Yet you’re defending this monumental gap as being effectively the same thing. Gene Roddenberry must be spinning in his grave.
All I'm saying is, LLMs solved the "understand natural language" problem, which solves the language and intent recognition part of Star Trek voice interfaces (and obviously a host of other aspects of computer's tasks that require dealing with semantics). Obviously, they're a very new development and have tons of issues that need solving, but I'm claiming the qualitative breakthrough already happened.
Obviously, Star Trek's computer isn't just one big LLM. That would be a stupid design.
> To use like we'd use paper.
How we use paper derives not only from our own practical needs, but also from the intrinsic limitations of paper. Stacks of paper are used because it's not possible to put several pages worth of text onto a single page of paper while maintaining a legible font size. The idiosyncratic way that tablets were used in Star Trek isn't how people would actually do things, it merely reflects the limitations of the writers to imagine all of the practical implications of technology such as they were depicting. It would be like somebody in the 1800s speculating about motor vehicles, supposing that teams of a dozen or more motor vehicles might be connected using ropes and used to tow a single carriage, because that's how they did it with horses.
> To use like we'd use horses.
> Stacks of paper are used because it's not possible to put several pages worth of text onto a single page of paper while maintaining a legible font size.
Right. And trying to replace a stack of paper with one paper sheet-sized screen is a significant downgrade. Which is why tablets are used primarily for entertainment, not for work.
Having lots of sheets of paper you can spread out around you is an advantage, not a limitation, of the paper-based workflow.
No, a single screen is a massive upgrade over using stacks of paper.
People vastly prefer digital dictionaries over paper dictionaries because you can more quickly find stuff. And that’s with dictionaries in alphabetical order.
Stacks of paper suck, there’s some potential utility in a space ship for all the redundancy around independent tablets you can hand someone. That’s something that regularly happens on the show and kind of makes sense, but is more a visual reference for the audience. Which is where stacks of tablets shine, the viewer can easily follow what their doing even if you can’t see the screen.
It can be true that stacks of paper are better than a single screen in some ways and worse in others. Other people like to be able to spread out multiple sheets of paper in front of them, even if you do not. You are correct that digital search is a huge plus of having a digital interface.
If we’re talking 3-5 pieces of one sided paper for say homework you can spread them out nicely, but scale that to multiple stacks of loose paper and it invariably becomes a mess.
Thus, in practice almost everyone is using multiple screens at work when they can even if printing stuff is trivial.
> They're not supposed to. This is LLM use 101
> (…)
> Obviously, Star Trek's computer isn't just one big LLM. That would be a stupid design.
Or, in other words, we don’t have Star Trek’s computer like originally claimed, and our current closest solution isn’t the way to get it.
Your takeaway presumes that all LLM interactions are monolithic, which is the opposite of what was being claimed if you take the other poster's comments about tool use into consideration. I have no real investment in this conversation though, so your proclamation of winning can stand as far as I'm concerned.
> Or, in other words, we don’t have Star Trek’s computer like originally claimed, and our current closest solution isn’t the way to get it.
My computer can both run an LLM (albeit a bad one, only has 16 GB of RAM) and also run other things at the same time.
> That's obviously tool calls :). I don't get where this assumption comes from, that a computer must be a single, uniform blob of compute? It's probably because people think people are like this, but in fact, even our brains have function-specific hardware components.
In fairness, half the time the Trek computer does something weird, it only makes sense if there's no memory/process isolation and it's all one uniform blob of compute. Made sense in the 60s where Spock's chess app losing to him was useful evidence that the CCTV recordings had been faked, not so sensible in 2025 when the ship stops being able to navigate due to the excess system demand from the experimental holodeck.
> If iPads were sold in every store for $1 a piece, we'd be doing that too. This is indeed a technology problem (or at least half-technology, half-economics), we just can't make working tablets cheap enough (and sustainably enough) to support such workflow.
The price of a lowend Android tablet can be shockingly low, to the point that physical multitasking is totally practical for an environment as expensive as space travel. The issue is bloat. The UI for a Trek level starship could easily run on 1999 era PC hardware much less powerful than a 2025 postage stamp of an SOC, if we were still coding like it was 1999. But not if it has to run Android Infinity with subpixel AI super resolution, a voice interface, and no less than 70MB of various JavaScript frameworks crammed into a locked Chromium frontend.
I run a Motorola mobile device at work (retail) that would be competitive with 10-15 year old flagship phones. The browser interface is designed for tracking and ease of development and to show off new AI tools. It employs landing pages, phased loading, a bunch of dynamic things. Looking up a SKU number takes 2-5 minutes (MINUTES) to load things I could get in ten milliseconds on a console interface or hundreds of milliseconds in a 1999 World Wide Web e-commerce site.
> There wasn't much opportunity to hallucinate - mostly simple queries,
Depends which Star Trek series you are talking about; early TNG routinely had complex request for new research/analysis/hypothesis generation and evaluation; if it came out today we’d accuse Starfleet of being infected with vibe crewing...
We are also getting a Multipolar order, so a single government Earth is pretty far away, and so too with the 1984 Mega Governments. Surveillance is increasing in developed societies, but there are multiple underdeveloped nations that are currently under siege by their own citizens themselves. Not to mention we're unsure if these developed nations won't suddenly implode or come under fire by their own citizens to invoke mass change.
It wasn’t a tablet but there was a TNG episode about a time wasting game that nearly took over the minds of the entire crew.
https://en.wikipedia.org/wiki/The_Game_(Star_Trek:_The_Next_...
They foresaw tiktok and their ilk way in advance.
>Except their tablets weren’t filled with time-wasting features designed to keep you addicted and distracted.
>And you’re ignoring we’re also in the stages of getting the surveillance from 1984 and the social class divide from Brave New World.
Those are more human problems than technological problems.
They are human problems caused or exacerbated by misuse of technology. Mass surveillance and accruement of capital by private entities at this scale is only possible due to automation.
What difference does it make, anyway? The distinction is meaningless when the result is the same.
https://youtu.be/lBS9AHilxg0?t=36
Imo the distinction is very important in this context because there's a lot of technophobia and cynicism in general discourse, to the point where new developments in technology are often immediately met with extremely pessimistic takes re exploitation.
It's good to remind ourselves from time to time that new developments in technology have both positive and negative potential, and how they're applied is largely due to sociological factors. When we dissociate the issues with "technology" we allow ourselves to see the underlying issues causing potential misuse, making progress at solving those problems possible instead of a knee-jerk negative lashback against anything new.
None of the problems I referenced are “new developments” in technology. The Snowden revelations happened over a decade ago. We know that Facebook hid their discoveries on social media harm, like a tobacco company.
It is patently obvious by now that major developments coming out of big companies will be used to further encroach their dominance at the expense of every one else. It is not a knee-jerk reaction to recognise an obvious pattern and identify probable pathways for abuse. On the contrary, those have to be identified and discussed early if there is any hope of counteracting the problems.
So no, it doesn’t make a difference to distinguish between the technological and human problem when we’re not solving the human problem. It is an excuse which could be applied to anything—technology doesn’t harm by itself, all of it is created by humans. That’s just a variant of “guns don’t kill people, people kill people”. It is important to recognise the role of technology in facilitating and worsening the human problem.
Yes, and in order to identify them, we need to separate the technology from the social context in which it is deployed. That's exactly what I'm saying, glad we agree.
There are a few episodes about holodeck failures due to verbal instructions interpreted incorrectly (notably the Moriarty episode). Ship in a Bottle even has prompt injection when Moriarty figures out he can summon the arch.
Plus, the captains ask tons of questions a computer would know, but only the bridge crew are trusted with.
> Except their tablets weren’t filled with time-wasting features designed to keep you addicted and distracted.
This part I agree with, but is also very easy to fix (use a very old UI system, e.g. direct port of Apple's HyperCard).
On the hardware front, the only thing Trek Padds had that real life can't really do is that Trek's power cells had an energy density on par with "let's say an atomic battery had a way to dial the decay rate up and down at will and were not also a horrifying source of neutron radiation".
> No, we definitely do not. If every time they spoke to the ship’s computer it made up answers at the rate LLMs do, they would have either stopped using it or would all be dead.
“The computer is malfunctioning” has been a plot device in Star Trek since the beginning.
> And you’re ignoring we’re also in the stages of getting the surveillance from 1984 and the social class divide from Brave New World. Those are not good tradeoffs.
Not disagreeing with you at all, but the surveillance on Starfleet vessels and facilities is almost complete and all-encompassing. Real-time location, bodily attributes, eavesdropping, access to all communication and computer data, personal and otherwise, I don't think there's anything that is private in their world! Remember that time The Doctor started a two-way video call with (I think) B'Elanna while she was in the shower? That being said, Starfleet is a paramilitary organisation, perhaps it's less awful in civilian life when one isn't wearing a Comm badge.
I wonder if you and I would consider this degree of invasiveness an acceptable compromise with a life almost completely without illness, any form of capitalism and the opportunity to pursue pretty much any life path we wish, in a society which is largely at peace with itself.
People keep forgetting that the surveillance of 1984 was just the surveillance of socialist countries in the 1940s.
The states were listening to people through their TVs in the 1940s?
They were listening to people through their wall art.
Leon Theramin had invented a radio-activated passive microphone that was used to listen to people from their furniture [0].
The fact that this was only (as far as we know) used to listen in to embassies is more about the economics of scale rather than imagining new technology that didn't exist at the time.
At that scale at that time it was cheaper to have neighbors name and shame people who complained about the government. But there is little really in 1984 that's about the future of technology in the same way Star Trek or even Brave New Word is.
[0] He had also invented a television in the 1920s, which is mostly just trivia related to this question.
Not "just", the inspiration came from many angles: Stalinist USSR, Nazi Germany, Spanish repression of POUM, Wartime Britain (where the shape of the TVs come from) and multiple other dystopian novels.
People seems to forget that Orwell was a anti-Stalinist socialist.
I don't know too much about POUM, but my understanding was that in Homage to Catalonia he's concerned with the Spanish Communist Party's suppression of POUM. So I think that is consistent with what I said above.
I haven't forgotten that Orwell was an anti-Stalinist socialist. But there weren't any anti-Stalinist socialist states at the time.
Indeed, communist repression of socialist ideas. I think the confusion comes from "surveillance of socialist countries in", where it should have been "Stalinist countries", not "socialist countries".
The stacks of tablets were because of DRM (a cybersecurity method to manage the threats of data exfiltration, “Digital Romulan Management”)
The class divide might rather be likened to The Time Machine
It really depends on the organ. Kidneys stand out as the most successful organs for transplantation, even in allotransplantation (between humans) so it makes sense that they are working well in xeno as well.
Kidneys are not as vascularized as some other organs (heart or lung) which probably helps a lot.
Heart and lung xenotransplantation are still a ways off and a lot of basic research is still needed to make them work.
My mom worked with eGenesis on pig xenotransplantation, particularly lung.
Here are some links if you'd like to donate to the International Xenotransplantation Association:
https://donate.tts.org/agnes/
https://tts.org/74-ixa/889-ixa-in-memoriam-agnes-marie-azimz...
A family member needed a kidney transplant in the early 60s. This was in the UK where the first successful transplant was in 1959, so just a few years earlier.
Thanks to a kid on a motorcycle she got a kidney just in the nick of time.
She was in her early 20s and was told she could expect a few years. Because of that she never had kids.
Her donated kidney served her well and she lived a quite normal life. She passed when it finally gave up when she was close to 70.
So those "few years" turned into almost 50.
Interestingly she mentioned she was told to take some strong medicine after the transplant. She got this feeling it wasn't good for her and stopped taking them soon after, without telling the docs of course.
She always wondered if that was the reason it held out so long.
> Interestingly she mentioned she was told to take some strong medicine after the transplant. She got this feeling it wasn't good for her and stopped taking them soon after, without telling the docs of course.
Typically, after a kidney transplant, patients are instructed to take immunosuppressant drugs for the rest of their lives. This is to reduce the risk of the patient's body rejecting the transplanted organ. Your family member was just straight up lucky that her body didn't reject the organ, even without any immunosuppression.
One thing that's fascinating to me is that most immunosuppressant drugs used today hadn't yet been discovered in the early 60s! AFAIK, all they would have had was prednisone, prednisolone, and azathioprine. Back then, a kidney transplant aided by these drugs would have been as new and revolutionary as the Hepatitis C cure or the triple-drug therapy for cystic fibrosis is today.
> Your family member was just straight up lucky
That was my thought as well when she told me. Then again, when given just a few years perhaps one considers these things a bit differently. The side effects for the drugs you listed does indeed not sound like a lot of fun.
Oh yeah, they suck. Long-term effects of just prednisone can include everything from muscle weakness to reduced bone density to spontaneously developing diabetes. Generally, doctors prescribe these kinds of drugs for longer than a couple months only in situations where the risks of not taking them are worse than the many, many side effects of taking them long-term.
Not a doctor, but I suppose she should’ve eventually told them in the interest of science. Also, pregnancy has a heavy toll so who knows? Maybe it was a good thing she didn’t. We don’t know.
> Not a doctor, but I suppose she should’ve eventually told them in the interest of science.
Glad she had a largely fulfilling life, but also thinking this. As much as it was her choice what to do with her body, it’s probably a good idea to at least tell the healthcare professionals about things like that, even if after the fact.
> it’s probably a good idea to at least tell the healthcare professionals
No, the pipeline to handle this feedback is completely missing from modern medical practices.
There is not really any way for a doctor to make use of this information to advance medical research.
Maybe what we need is more motorcycles.
They do help a lot[1], especially without helmets[2].
[1]: https://www.health.harvard.edu/blog/motorcycle-rallies-and-o...
[2]: https://pubmed.ncbi.nlm.nih.gov/33334475/
Maybe organ donation should be an opt out process.
Amazing story. Thanks for sharing. It shows how resilience and intuition matter.
I don't think it shows much.
It's one anecdote. In the hierarch of significance this is below even the "one published paper" level which you certainly should also ignore even if you know enough to interpret the paper.
It's really good she lived for 50 years with an kidney transplant. But it is a massive stretch to say that she willed herself to last that long.
Totally agree that kidneys are the logical starting point. Lower immunological complexity + less vascularization makes them more forgiving as a test case. The lung, on the other hand… yeah, that's a whole different beast
>...that's a whole different beast
...so's the donor! (I'll see myself out...)
There have already been a couple of attempted heart xenotransplants? Lawrence Faucette being the most recent patient that I've read about.
yep, but they didn't last as long. six weeks max I think?
Pigs are already helping out with lung transplantation[0]. It's a ways off from where this kidney trial is, but very promising.
[0] https://www.theguardian.com/science/2025/aug/25/surgeons-tra...
Meanwhile we can’t figure out how to provide a basic level of housing and healthcare to everyone.
In star trek they only figured that out in 2024, so we are only a year late.
And honestly, the way us politics are headed, a "bell riots" type event doesn't even seem that implausible. (Learning from it on the other hand does seem implausible)
[For those not into star trek lore, the way star trek became a utopia was first the government put poor people in internment camps, eventually triggering violent riots in 2024, which eventually lead to people learning from their mistakes and a utopia society. https://memory-alpha.fandom.com/wiki/Bell_Riots ]
So we’re getting close in the US government is putting certain types of poor people in internment camps.
"Close"? It seems many Americans still live in a fantasy. Unless y'all start looking into your history, you're bound to repeat it.
I think we already ticked that box
the school to prison pipeline is talked about a lot.
2024 Bell Riots were the tipping point[0], but there was still World War 3 a few decades later. A global nuclear exchange probably helped a lot in kicking human civilization off the dystopian but locally optimal path it found itself stuck on[1]. Meeting a technologically superior alien race a decade later also helped solidify a different perspective :).
But yeah, I too was disappointed when 2024 came and gone without the Bell Riots - Star Trek came this close to accidentally turning prophetic, as in the months prior things really felt like the Riots are going to happen on the date.
--
[0] - In that timeline, at least. We've already past several important world events that originally happened in Trek timeline, so the show keeps shifting the dates to keep with the overall premise of being imagined future of real humanity.
IIRC the writers now settled on "Romulan temporal agents meddling with timeline, desperate to stop the Federation from forming, and failing because apparently the cosmos really wants UFP to be a thing" as a convenient explanation to push WW3, Eugenics Wars, etc. forward every once in a while.
[1] - How humanity bounced back from that so quickly is something of a mystery to me.
> [1] - How humanity bounced back from that so quickly is something of a mystery to me.
There is always the "it wasn't as bad as in Mad Max/Fallout/..." explanation. Nuclear winter is now understood to be either less severe than predicted back in the 60s, or nonexistent. Nuclear weapons will kill people and destroy cities, but if they aren't aimed at people or cities, but at military installations such as the US nuclear sponge[0], death toll and destruction will be far less severe. Things like the Golden Gate Bridge or the Eiffel Tower might be left standing, as seen in a few Star Trek episodes. Which would also mean that humanity would be in less of a severe turmoil than other nuclear war SciFi might have imagined.
[0] https://www.reddit.com/r/nuclearwar/comments/18e01zh/would_t... https://www.thomasnet.com/insights/nuclear-sponge/
> Nuclear winter is now understood to be either less severe than predicted back in the 60s,
Back in the 80s. In the 60s it was just megadeath, with a chance of mutants.
(The Krakatoa movie was in 1968, but the winter thing took a while to sink in)
https://en.wikipedia.org/wiki/Nuclear_winter <- look at "Early work".
But you are right that the concept was only made popular in the 80s, and a lot of the earlier works were classified or unknown and obscure to the public.
Back to the future 2 called a Chicago cubs World Series win in 2015. It actually happened in 2016.
My favorite fan theory as to why they went to a future of flying cars that’s so different from our own is that it was the events of the first movie (going back there and changing history) that ultimately led us to that different path.
Housing can be affordable or an investment. It can't be both
Hoarding land and land speculation is really the root problem.
It's not bad for society if it was used to make building to provide rentable space to industries and business or to provide homes, or quite often both, but it doesn't provide easy money to investors.
Now sitting on land and seeing it appreciate with no hard work from you? That's easy money.
This should be an easy choice and yet…
The key words here are "a basic" level of housing. A house in the most exclusive area of town will always be an investment (not necessarily a good one), because it primarily offers exclusion of other poorer members of the society from your surroundings, not habitation for yourself. It can't be affordable by definition.
But a basic level of housing is a human right, because it's a prerequisite for maintaining your humanity, ditto for healthcare.
It's also possible for housing to be neither affordable nor an investment. If there's an expensive area of town, and property tax is 100%, that would be expensive and I don't think people would consider it an investment.
At a system level - in Singapore it is. HDB (public) for affordable, private for everything else. 75+% of housing is part of the HDB system.
Has no real democracy and the govt is able to plan decades ahead. It seems much better than the typical Western political system to me. But then again gays were only very recently accepted there, right?
> Has no real democracy and the govt is able to plan decades ahead.
I get the sentiment but accuracy is important here. It's a real democracy vs counties where voting is a sham.
But yes, it is widely managed by a single party that was setup by a benevolent dictatorship and the current administration generally does a good job and is voted in with strong support.
So agreed, they can do really interesting things because of their time horizons of control combined with willingness to work for the better of the people.
The west doesn’t have real democracy either.
For the gay stuff, like the west?
In 2001 Texas court prosecuted Lawrence for having gay sex in his home (supreme court decided against it 2 years later).
Counterhypothesis: housing that's not affordable is a bad investment.
It can be sort of both. What you need is more housing built at affordable prices. But dont oberbuild. In that situation housing should act as store of value to avoid inflation loss, but not something that you get rich buy borrowing and buying up dozens.
You need socialism to do this efficiently. There isn't room for a profiteer. You need the government to invest (in the for people sense) in allocating land and building housing. Ideally dense housing.
> housing should act as store of value
Why? Housing should act as a means to live decently. If my house depreciated to 0 once I'd built it, I wouldn't mind at all.
> You need socialism to do this efficiently
No you don't, you need to heavily tax empty and secondary residences and the issue solves itself in capitalism just fine.
> heavily tax ... in capitalism
Many of us are taught that heavy taxation is socialism, or at least incompatible with capitalism.
Those things have been figured out, you're just choosing not to implement them (you generally, not you specifically).
The US can't, but humanity as a whole can. Finland has both, for example.
The US can’t. This has long been solved in other countries, to varying degrees.
Very few examples of this. None in democratic countries.
Finland is a democracy.
can't? lol. more like doesn't want to. not everyone in the world shares your personal values.
We're slowly starting to realize that societal problems are as hard as (or even harder than) technological problems.
At least we seem to have figured out how to, um, steer large populations quickly, now we need to use that to effect positive change.
oh we can “figure it out” trivially. There’s no technology or actual resources preventing that from happening.
But the status quo benefits many parties… alas, “people” problems are harder than technical ones. Most humans can be remarkably greedy, and also stupid in large groups.
We've figured that out, but certain members of society decided that extracting wealth through protectionist zoning/building code behavior is much, much more lucrative.
that just moves the figuring out one step to the right. knowing how something will work but not knowing how to get it implemented means the problem is not completely figured out yet.
Exactly. We haven't figured out how to solve the problem, because we still have the problem. Maybe it's unsolvable, and it's just a limitation in our ability to live together in large numbers. Or maybe we need to redirect our spending on (among other things) frightfully expensive experimental medicine and spend the money on things that are a lot cheaper and will help a lot more people.
Really? I think I can agree that the zoning isn't helping, but claiming we have figured it out seems like bold claim. Where _is_ it working? My impression is that housing costs are increasing faster than inflation and wages not only in North America, but also in the UK and EU, which don't have the same kinds of zoning laws.
It’s working in Japan
I wouldn't believe most in the US would live in Japanese style housing at all.
Most homes in Japan aren't built in the traditional Japanese style at all IIRC.
I was referring to the little space and tiny storage. Pay isn't exactly great for the rent either.
Why not?
Aren't Japanese homes super tiny? Even smaller than the already small homes and apartments in Europe? That's one reason. In the US, it seems that people live in bigger places, with higher ceilings.
The American Dream has become living in a McMansion in suburbia?
My understanding was that Japanese housing costs are only good in USD because the yen is devalued. I had the impression that housing is expensive relative to local wages. Is that not true?
Sure we can, how do you think our governments have managed to avoid it so artfully all this time?
Classic whataboutism.
[flagged]
Tough problem when laziness and low IQ both correlate to high reproduction.
Provide with what money? Every major country is an ocean of debt
America spends a greater percentage of government money on healthcare than many systems with universal healthcare. Medicare, Medicaid, and Veterans Affairs and Military medical spending are about 7% of GDP. Add another 1-3% and you would be ahead of almost everyone.
And that would still be a savings of 7% of GDP.
Not providing universal healthcare is entirely a political cocktail of wasting the money, letting big corporations loot it with tactics like using many partial vials of medicine instead of a full vial, letting the medical professional groups stuff up the pipeline of medical practitioners, and electing members who did all of the above to Congress.
Debt to who? If every country is in debt who is the creditor? Mars?
But you actually said every major country is in debt, so do all the major countries owe money to um...minor countries?
Perhaps it is not the country that is in debt at all, but the government? In which case it must owe money to entities like people and corporations. The government has powers to take money from entities in its jurisdiction and pay its debts, it is called taxation. In fact since the money is issued by the government in the first place, you could consider a token of government debt is actually a token meant to pay your taxes with. By lending money to the government you receive interest, or in other words a discount off your future tax.
All very neat, and why a government being in debt is no reason for it to not be able to pay for things.
In fact you might argue that government debt takes money out of the economy, so keeping inflation down. This means the government can spend more without causing inflation. If a government borrows a dollar and spends that dollar, there is the same amount of dollars circulating. However if it borrows it off someone who is hoarding it, and spends it then you create gdp growth. Magic.
Perhaps it's time to get past puritanical hatred of debt?
Taxing the land and removing zoning limits on it is the big hurdle.
https://ips-dc.org/wp-content/uploads/2023/05/fy-2023-fed-bu...
Defense is only 13% of federal spending: https://fiscaldata.treasury.gov/americas-finance-guide/feder...
Military spending has actually decreased a lot as a % of GDP in the US over time, so old narratives about this have become less true. So the anti-military-spending orgs have to abuse the numbers if they want to keep that narrative going:
https://econofact.org/u-s-defense-spending-in-historical-and...
Though, a reasonable person can still argue that the many billions we still spend on the military can be better used elsewhere. There’s no need to cook the numbers to make that point.
Healthcare spending is now 4x higher than military in the US (across the whole economy, not just government). So it’s hard to claim the problem is we’re prioritizing the military over healthcare. In my opinion, we have a systemic issue where we get poor value for money across a variety of sectors. Healthcare, education, military, housing, transit…
If you include things directly related to, but not classified as defense spending, like veterans benefits, VA, and the cost of foreign bases; the military is about ~20% of the total US budget.
https://www.govinfo.gov/content/pkg/BUDGET-2025-PER/pdf/BUDG...
>> poor value for money across a variety of sectors
Yup this. I went in for a cardiac stress test a few months ago. Less than 30 minutes in a room with a treadmill, an ekg machine and a low-mid level technician. $10k.
What's the pressure in the system keeping the price down? Many could supply a treadmill and ekg machine for a few hundred.
> Healthcare spending is now 4x higher than military in the US (across the whole economy, not just government). So it’s hard to claim the problem is we’re prioritizing the military over healthcare.
I don't think that's a hard claim to make in other terms than % of gdp—I can't imagine many americans want to devote that much of our gdp to it when other countries manage a high degree of care with much more efficiency. But we seem to have largely talked ourselves out of democratic control of such matters, somehow, for some reason, repeatedly over the last 70 years or so.
Actually tax the rich?
Even if you took all the money from the "rich" the goverment would shut down as usual the next year because the debt they create is way more than the private money available out there.
Insane take. Even if you confiscated ALL the money from all the billionaires (instant 100% wealth tax) and spread it to everyone worldwide, it would be a one time sum of under $2000. And what then?
Spend the money on things of actual value rather than distributing it equally among a group of people who will inevitably just spend it on an iPhone?
You can shear a sheep many times but skin him only once.
It seems like billionaires have a knack for making lots of money every year. Why don’t we just take a bit more of it than we do now and invest it into useful projects?
We're capable of taking the money but not of investing it into useful projects. Inherent system flaw.
Billionaires generally do not have a knaxj for value creation. What they do generally have is an egregious amount of greed and a total lack of empathy which enables an incredible amount of exploitation.
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Then the former billionaires won't have the ability to influence society to pass laws that favours them. We'll finally be able to build a society for everyone.
> We'll finally be able to build a society for everyone.
I assure you this isn't the only blocker and its naive to think that [other_set_of_humans] will not try to consolidate power for themselves after you remove the current set.
Most people are not in it for their fellow man and whoever sold you this idea that billionaires are the only impediment to, or even blocking now, a better society -- lied to you.
By all means get rid of the billionaires, I don't particularly care; just don't be so surprised when it turns out that was just a side quest.
I think there are other avenues here that are probably better spent to make society better.
Everyone in the US misses the 50s, marginal tax rates were crazy high. "Oh, but people had lots of deductions and not many people actually paid the top rates" - yeah, that's exactly the point, it encouraged money to be spread around more. And a whole lot of people prospered, while government revenue was less lopsidedly concentrated too.
Get people away from paycheck-to-paycheck debt loads and you've improved a lot of lives regardless of if those people are egalitarians who will then vote for utopian policies. We know that allowing more and more consolidation ain't the move.
We have 4-5x the normalized GDP per capita compared to the 1950s.
The amount of taxes we collect isn’t the problem. Excessive government spending and inflationary pressures on things like housing is (Which, btw seems to always go up regardless of what political side you want to point fingers at)
While the economic output per person has indeed increased 4-5x, the inflation adjusted median household income has only increased by 50% (1.5x). Government spending is not the issue here.
The things you mentioned are always a problem because even the far left in America is incredibly right-wing.
Maybe but society was more egalitarian when we did so maybe we start there.
That is not how macroeconomics works.
What does that even mean? Care to elaborate?
And who is on the other side of that debt? And how did it get there?
Re: “how do we handle how this changes what it is like to be human today?” part of your post... I think that came to prominence when cheap, effective birth control became available. I think it was about the first time that the common people could decide to make major alterations in how their bodies function. That debate continue in the current fight about trans rights.
As science and medicine progress, what was once considered solely god-given, or exclusively biologically determined, will be for people to decide for themselves, the decision made between them and their doctors.
fwiw, biological heart valves, as opposed to metallic valves, are already quite commonly used today.
biological ones are typically made from either cows, or pigs (bovine, porcine respectively).
but this is on another level altogether.
I had heart surgery 2 months ago to repair my mitral valve. In the lead-up to that, I had to make a decision what to do if it turned out replacement was needed instead of repair. Choices were metallic valves requiring me to be on warfarin the rest of my life or pig-derived valves. I chose the latter, mostly to avoid warfarin for life, but also because my surgeon was a PhD for work on creating biological-derived valves that didn’t trigger the immune system. Just mind-blowing what can be done. But I’m glad repair and not replacement worked out - and I now have GoreTex fibers attached to my valve.
Pig and cow valves will calcify and fail eventually. But it’s a slow process so you have time to plan and make decisions for replacement. Mechanical values are great until one day the clicking sound stops and you need to get to a hospital ASAP.
Back in the 90’s there were a series of values where the flipping plate shattered-sending shrapnel into the heart and beyond. Typical failure mode is stuck open which is survivable. Stuck closed is very bad.
GoreTex being the brand of a material that was put into your heart sure sounds amusing.
At heart, he's a GoreTex™ guy.
I'll just get my coat...
> I'll just get my coat
And what fabric is that coat made of?
Sheepskin (the “I’ll get my coat” reference is from The Register).
https://theregister.com? It's much older than that.
I am not surprised, but that's where I learned it.
I’ll have to remember that one
But why cows and pigs and not chimps?
Size. Pig hearts are the same size as human hearts, cow hearts are larger, so easier to cut up for parts. Chimp hearts are usually smaller.
Also, the risk of transmitting zoonosis is larger in primates than in other mammals, because with humans being primates as well, more viruses/prions/fungi might be infectious to both.
Presumably because we already farm pigs and cows so there’s a supply chain and the ethics are ok in most people’s heads.
most likely because their (heart) valve anatomy is similar to humans ? this is just a guess btw.
We're deep into the part of the sci-fi timeline where the tech works, and now the real challenge is cultural, ethical, and existential
We've invented social media, but democracy wasn't ready for it.
I think Alan Kay deserves the credit for the tablet. We have vague allusions to tablet like things before Kay but it was Kay who really came up with concept.
Does he? It seems to be mostly keyboard operated, and references to any stylus interaction seem to be retconed, let alone direct touch ones.
My search only finds modern claims that he's the true tablet inventor and tablets are touch this and stylus that, but these poison results about any possible original reference of that interaction model having been conceived at the time.
What tablet are you talking about?!
> “Xenotransplantation” is pretty #%^*ing metal
Replacing human heart valves with pig valves has been a thing at least as far back as the 1970s with decade-ish survival rates.
Granted TFA is about a whole organ -- not just a piece of tissue -- but xenotransplantation per se is not new.
Eh, "figuring out how to deal with it" is the easy part. The hard part is first making it work, and then proving its effectiveness, scaling it and improving it.
Medical advancements in particular are notorious for having a hideously long lead time. This here is an experimental procedure that, if all goes well, will only start becoming commonplace by year 2035. It's not guaranteed to all go well.
You'd think there would be a massive push for new medical technologies that have the potential to save hundreds of thousands of lives, and you'd be wrong. Healthcare is where innovation goes to die. Most companies that attempt to develop this kind of bleeding edge treatment crash and burn either before or shortly after seeing the first results. Just the cost of early testing of a new treatment option is enough to bankrupt many.
> “how do we handle how this changes what it is like to be human today?”
Progress, invention, is part of being human, so this is natural and normal thing that these thing happen. You can stop, marvel, and then go improve upon your own niche.
> But also… we got the tablets from Star Trek. And now we have the ship’s computer from Star Trek, and the early makings of the holodeck.
If this is Star Trek then I suppose it's a good example of "be careful what you wish for"...
The “pigmen” as you insensitively refer to them aren’t necessarily seniors. Organ failure affects men of all ages and the patients themselves are not to blame, often they have terrible support structures surrounding them and other factors beyond their control. You can be optimistic and compassionate simultaneously.
Sci-Fi movies aren't that far from reality. It was just a matter of time.
Seems like we'd want to be careful about the one(s) we're picking though.
Sci-Fi movies don't tend to be all happy, happy, fun and joy for everyone in them. o_O
Unfortunately not everyone is careful.
And people skiing down Mt. Everest. I always like to think about progress and our current reality in comparison to Star Trek….
Next is Old Man’s War style bodies
And yet while (legitimate) science can universally agree continuing to burn fossil fuels will cause unimaginable chaos for planet earth, half the planet doesn't seem to care about the impending collapse.
So while in my personal vacuum this is awesome, when I stop to consider the situation for 30 seconds I can only think: huh, we might have been able to find a new cure for humanity that isn't going to matter when having "a profession" (like doctor) is no longer relevant to our inevitable hunter/gatherer lifestyle.
Most experts don't predict the collapse of industrialized society. Higher temperatures, rising sea levels, and more energetic weather events will cause damage and make life difficult for decent chunks of the population especially those in less developed areas that are both hotter and more poorly equipped to cope with climate change. But I'm not aware of a consensus or even a plurality among climate scientists that industrialized society is going to collapse even in the more pessimistic predictions.
I'm not sure how Cambridge, Massachusetts, where the company building these pig kidneys is located, becomes a hunter-gatherer society on account of climate change.
Legitimate science doesn't concluded unimaginable chaos from continuing to burn fossil fuels that's what influencers or movies or tiktok reels present because they are part of the attention economy where scaring you is profitable.
Besides hunter/gatherers need medicine men who understand the old ways.
I was just thinking about heart transplants and how they’re treated as commonplace now, but they are nuts when you think about them.
You can hook up the nerve wires and blood pipes from one body into the heart from another body and it works? Just thinking about the simple physical connections would make me nervous. Why isn’t there blood just leaking out in your body? Why isn’t that other heart sliding out of place while you move around?
Fun fact: the nerves between the brain and heart are never reattached. A heart already has all of the facilities to keep working all by itself.
Even weirder is that an adult kidney transplanted into a child will actually shrink to fit.
But presumably the nerves between the brain and heart exist for a reason. What functionality do you lose by not reattaching them? Do things like "heart beating faster when nervous" depend on this nerve signaling, or is it done via other chemical signaling.
Yes, nerves from the brain to the heart can influence heart beat (and other features like heart conduction and blood flow to the heart itself) in response to stress and exercise. Heart transplant recipients lose these features. They make poor marathon runners :)
Heart rate muscle tissue is largely influenced by hormones. The sympathetic system releases noradrenaline to speed up the heart rate, while the parasympathetic system releases acetylcholine to slow it down. But the release of these hormones is controlled by nerves, which are largely severed. So you typically end up with a less "dynamic" heart rate -- resting rate higher and responsiveness to stimuli reduced. These nerve connections can regenerate to some degree but it's individual and rarely close to what they were before.
Reading up on this there is some chemical signaling from the blood, but the brain is not controlling the rate of the new heart
That is actually wild and I wonder about the practical consequences as well.
So you get into a stressful situation or get a flee or flight response, and your heart is not affected by it, or at least the heart rate, but your cardiovascular system may be needed because in that case the rest of your body is, and presumably you may need much more blood to be pumped out to your organs among other things.
It is a cool food for thought.
He's asking about what the nerves do in a normal person
Another fun fact: you can remove all of the brain of a cat on threadmill except the brainstem and he'll keep walking.
…Do you have a link? I’m not sure if I want to see proof of that, but I’m at the same time curious how you’d manage to do it without disturbing the cat.
Will it grow again as the kid ages?
Yes
The part that always gets me is the lack of nerve reconnection - the heart keeps beating on its own, no nervous system hookup required. It's literally running off internal timing, like a mechanical watch made of cells
A human counting is also a mechanical watch made of cells.
It's not exactly the same as a biological heart transplant (I assume), but you might be interested in reading the surgical instruction manual for a SynCardia artificial heart: https://www.accessdata.fda.gov/cdrh_docs/pdf3/P030011c.pdf
For instance, there's a fun diagram on page 11.
There's also an operator's manual for the "driver" that powers the heart: https://www.vumc.org/cvicu/sites/default/files/2020-03/Opera... Which includes all kinds of (appropriately!) paranoid warnings such as:
> To avoid accidentally switching off the AC power to a docked Driver, do not plug the Driver into any electrical outlet controlled by a wall switch.
Blood pipes yes, nerves no. Transplanted hearts are de-enervated.
Heart surgeons are straight up deleting the equivalent of dead code produced by evolution.
Heart surgeons are superheroes.
In all viscera sympathetic and para- keep balance of muscle function. But in steady state the para- must fire more powerfully because the sympathetic intrinsically dominates a little. So if you cut off both systems, the organ has a sympathetic boost. In heart's case this will make it beat faster, I believe about 20-30 more beats per minute (after some self-compensation). This is easily treated with a beta blocker.
Richard Slayman was a pioneer. He made an amazing decision, to see if it could be done. This was hard work done through eGenesis, and the steps to get to this point is quite interesting.
>> First, the donors were often created on a commercial pig breed whose heart and kidney sizes are too large for human application. Although elimination of growth hormone receptor gene expression could reduce organ sizes, it comes with other undesired biological consequences. Second, the donors were designed for testing in OWMs. They lacked the α-Gal (galactose-α-1,3-galactose) or the α-Gal and Sd(a) (Sia-α2.3-[GalNAc-β1.4]Gal-β1.4-GlcNAc) glycans but expressed the Neu5Gc (N-glycolylneuraminic acid) glycan to match with Neu5Gc expression in OWMs. However, in vitro analysis suggests that a human-compatible porcine donor should ideally have all three glycans eliminated to match with the absence of the three glycans in humans. Although renal grafts derived from the porcine donors lacking these three glycans and carrying various human transgenes have been tested in OWMs, graft survival was short8 or not all human transgenes were expressed. Third, the donors carried porcine endogenous retrovirus (PERV) sequences in their genome, which present a zoonotic risk, as PERV transmission to human cells in culture and their integration into the human genome have been demonstrated.
https://www.nature.com/articles/s41586-023-06594-4
https://en.wikipedia.org/wiki/Richard_Slayman
OWM is old-world monkey, for those who don't bio.
Pig-human organ transplants make me think of The Onion series, Porkin' Across America.
https://www.youtube.com/watch?v=PwQns6vGfj4&list=PL4NL9i-Fu1...
This was not what I expected but thank you for sharing. The onion does not cease to amaze me in eccentric productions
So I'm not alone who knows about this series.
well, that was horrifying. I’m getting a “Do Not Transplant Pig Organs” tattoo urgently.
"This is the longest a pig organ has survived in a living person." Not quite the way I thought it should be phrased...
A bit of medical and historical context seems to invert its interpretation entirely. For example Louis Washkansky, the recipient of the first human transplant (performed by Dr. Christiaan Barnard in 1967 in Cape Town, South Africa) lived for only 18 days before passing away from pneumonia. But nobody considers that historical fact as a negative when thinking about heart transplants these days. In comparison, this statement about the pig kidney is actually very exciting. It means that the xenotransplantation technology is progressing rapidly and will soon become widely available. They seem to have overcome most of the serious difficulties in the process.
I think the person you replied to was objecting to the fact that the wording makes it sound like we're using humans as vessels for extending the life of pig organs outside of pigs.
Not necessarily that 6 months is a short period of time.
That's an interesting way to interpret it! I see what you mean, but I still can't see myself interpreting that headline in that way. Does it really give that vibe?
Yeah I re-read it now and don't feel so strongly about it. But I think its the sentence structure:
"This is the longest a pig organ has survived in a living person"
The pig organ is the first thing mentioned, with the living person last.
Whereas:
"This is the longest time a patient has survived after a pig organ transplant."
This puts the patient first, and doesn't give as much of that kind of vibe.
Edit: Actually, that updated sentence may need some adjustment. I assume when organ transplants fail we don't just let people die with them. So maybe that's why the original sentence had such emphasis on the survival of the pig organ...
Seeing as the subject of the sentence is the pig organ, it's saying the organ is the one doing the surviving and only tangentionally mentions the person surviving by calling then living. I (and presumably we) only come to a different interperetation because I have the context that the latter is the important bit. If I give some other similarly structured sentences but without context, how would you interperet these?
- This is the fastest Alice had driven since Bob broke the speed limit.
- This is the oldest tree still standing in the burnt forest.
- This is the most stable chemical additive to our long-lasting concrete.
Without context, to me these examples sound primarily about Alice going fast, the tree being old, and the chemical being stable. But if those appeared in articles about traffic law, natural disasters, and sidewalk design, then these phrasings might be less ambiguous if flipped (as another commentor pointed out).
Well, the pig organ could fail immediately, causing the person to go back on dialysis for 6 months. That person would've also lived for 6 months after a transplant.
> It means that the xenotransplantation technology is progressing rapidly and will soon become widely available
It also validates the platform. If it can last for 6 months, chances are there isn’t some catastrophic failure mode that would keep it from lasting for 6 or 60 years.
What seems like a small step now often ends up being the foundation for something revolutionary a decade later
The organ can die without the human dying too, so it makes sense to phrase it that way
The person can go back on dialysis and have the kidney removed if it starts failing. Which is what happened to an earlier recipient of a pig kidney. So it makes sense to phrase it that way.
Transplanted kidneys get rejected by the recipient's immune system eventually, you'd really need to clone the kidney from the individual's DNA to solve the rejection problem. There's also been some success with integrating the DNA from the kidney donor (a human) into the recipient's bone marrow to stop the rejection process, but I hear it can be a brutal procedure in which the original bone marrow must be destroyed using chemotherapy or radiation.
https://newsnetwork.mayoclinic.org/discussion/video-eliminat...
https://www.immunofree.com/how-it-works/
If I were a patient, I'd probably want a pig kidney now and really hope it lasts until something like kidney cloning is a thing.
> and really hope it lasts until something like kidney cloning is a thing.
There was another technology under development, colloquially called the 'ghost heart' [1]. It uses a dead heart that's similar to a human's, most likely a pig's heart (I speculate that an unused human heart can also be used). They remove all the cells from the heart using a soap-like substance to obtain a ghostly white colored scaffolding of a heart (probably made of collagen). Then they use the recipient's own stem cells to grow heart muscles, blood vessels, etc on the scaffold. The process to get it to work like a human heart seems complicated, but doable. As you can guess, this heart is fully immunocompatible with the patient and doesn't require immunosuppressants like after a regular transplant. I imagine that this can eventually be replicated for any organ and that the improvement in the patient's quality of life it will bring is unthinkable in the current state of affairs. I'm not sure about the progress and current state of this technology, but several articles do turn up on searching.
[1] https://edition.cnn.com/2022/06/01/health/ghost-heart-life-i...
Any time I haven’t heard about a tech for ten years I assume it didn’t work. I think I first heard of this stuff around ten years ago. At the time I think they were focused on kidneys. But those have a lot of complex plumbing.
As an outsider, who is either missing a mountain of context, or not so close to the problem they can’t see it, I would assume a better tack would be growing ghost arteries for bypasses and aneurism repair operations. Ghost intestines for reconstruction surgery for people with cancer or massive internal trauma. You’d have a simpler organ to reproduce, but in the artery case you’d likely have to also work turnaround time. Heart failure can be slow, but bypass surgery is often scheduled as either urgent or emergency (I just had a convo with a man who wasn’t allowed to leave the hospital after an angiogram showed he was one stairwell away from a fatal heart attack). But not having to harvest material from the thigh before surgery begins should shorten the surgery and reduce complications. You can have as much artery as you want for the surgery. You could have spares.
The article I cited is from 2022. At that time, the principal scientist had left the academia and was working to commercialize it. So I'm guessing it's still within your decade threshold? Besides, perhaps that threshold should be longer under the current circumstances. One of the greatest medical advancement of the recent times is the mRNA vaccine technology. But it's true origin is in the 1970s. They were solving numerous related problems in the meantime, though it could have been finished sooner had someone invested in it as intensely as they did during the pandemic.
Looking at bibliographies, it seems like a lot of the research for decellularization was 2011, 2013, and a handful after. So they were still working on getting a clean substrate while working on how to fill it back in.
It’s a big problem, but still seems like they’re swinging for the fences when they could save people in the short term while working on organs.
Interesting! I just remembered that there is another team that's working on plant based scaffolds (cellulose scaffolds from leaves like spinach) [1]. This one is from 2017. So I'm guessing that the interest in the technology hasn't waned yet. I also wonder if any biocompatible scaffolds can be 3D printed, rather than having to decellularize the available ones.
[1] https://arstechnica.com/science/2017/03/spinach-leaf-transfo...
It's not entirely impossible that a broadly compatible tissue could be engineered - in a more through version of the same process that yielded those "somewhat human-compatible" pig organs.
That's a part of the reason why this tech is so promising. If we can already target immune incompatibilities to make "elongated pigs" with organs that fit human bodies somewhat, then what are the limits?
Keep in mind the amazing thing is the survival of having the transplant in addition to kidney failure. People have been living up to five years without kidneys by relying on dialysis.
Dialysis is hell.
I had a friend that chose to die, after several months on a home dialysis machine.
That's rough, I'm sorry for your loss. I've been on dialysis for 5 years now (in-center, I couldn't do home for.. reasons). In the beginning I was considering giving up, but it did finally get somewhat better, and I'm fairly well adjusted now. I mean, it still sucks (especially losing about 5 hours 3 days a week), but I'm able to not think about it when I'm not there, at least.
Damn. Sorry to aggravate. I sincerely wish you well.
>> Dialysis is hell.
I've seen this sentiment before but I've been unable to find an explanation why. Searching around it's noted as relatively painless.
Can anyone explain why it's so difficult?
I've a kidney transplant patient and also have been on dialysis previously.
The pain can come from fluid removal and electrolyte imbalances during the dialysis. The fluid removal is important because if you kidney fails, at some point you stop urinating. The in-clinic dialysis process is also compressing the 24 hour a day function of your kidney into a 3-4 hour process typically every other day. So if you remove fluid and shift electrolyte during a short period of time it can cause cramping and pain.
The situation can be improved by doing treatment over more days or for a longer period. That is where home dialysis comes in. Some people run it at a gentler pace at night. Some may run it for 5 hours 5 days while watching TV or doing something else. They get some flexibility around their schedule.
You can see one of the new home hemodialysis systems here. They are streamlined and less complicated to use than in the past. But for some older people and those with mobility issues they might not be operate it on their own.
https://freseniusmedicalcare.com/en-us/products/treating-wit...
I'll note however that I used a different type of dialysis called peritoneal dialysis which uses osmosis action of passing fluids through your peritoneal membrane in your abdomen. No needles involved but it doesn't work for every patient and over time it can stop working. But you end up holding a lot of dialysis fluid at night which can be uncomfortable. But it has less of the complications of fluid removal and electrolyte imbalance issues.
There is actually a project for a implantable artificial kidney but it has slow progress due to funding. This devices operates 24x7 do it could operate at a much gentle pace. Maybe its too ambitious but the lead scientist thinks about $50M would be enough to get it through trials.
https://pharm.ucsf.edu/kidney/newsletter/2023/winter
Thanks for sharing your experience!
I have never experienced it, myself, but have seen several close friends deal with it.
They always come back wiped out, and sick.
Usually, it’s a temporary thing; meant to keep you going, until a full cure (like a transplant) can be effected.
My friend made his decision, because a transplant was not an option. He would need to live like that, for the rest of his life. I have a couple of other acquaintances, that got transplants, and were able to go past dialysis.
Thanks for the explanation. I can see how something that intense can look very different if you know it's temporary vs knowing it's forever.
I have always wondered what decision I would make facing such a health concern.
> Reaching 12 months would be another milestone and a “fantastic long-term outcome”, he adds.
I am surprised by this being considered a long-term outcome though. Going through the high risk of a kidney transplant, immunosuppression required, risk of using a pig kidney in general, etc seems like a lot if the hope is for 12 months as a long-term unlikelihood.
The alternative is dialysis, which isn't a good patient experience at all. And this is an experimental procedure, testing an early version of the xenotransplant technology. A bad long term outcome would be "the organ ends up rejected within two weeks, and does some damage to the patient while at it".
In a perfect world, this tech would work first try, and the xenotransplant would last for decades. We don't live in a perfect world.
If this proves a workable stopgap, bridging the wait time for the people waiting for donor organs, extending lives of those who don't qualify for organ donations? It might be worth using on those grounds alone. And it's likely that organ longevity could be improved iteratively.
I.e. use an organ to failure, figure out what went wrong and what the host immune system has reacted to, find a way to gene edit around that, get another 6 months of transplant longevity in the next version. Rinse and repeat.
Yes, we don't know what the true limits are - "universal and permanent organ replacement" is very much on the table with this tech. But it's pretty clear: getting all the way there wouldn't be quick or easy. A year of organ lifetime is a damn good start.
I've been on dialysis for 5 years now... which means when I eventually get listed for transplant, I'll be at the top of the list, because nobody survives 5 years...
This may offer some hope: Thomas Yuen lived for 42 years on dialysis. <https://en.wikipedia.org/wiki/Thomas_Yuen>
My thoughts with you wish you the best. Curious why you aren't already on a waiting list for a transplant?
The rules are very strict, primarily with respect to weight. That is, was (and still am) fat, and that's a no-no. I've lost 120 pounds so far, with at least 10 more to go before I will finally be (possibly) approved!
And this is why this is so exciting. The rules are so strict because kidney supply is extremely limited and they want to maximize the life of the kidney as much as possible.
Having a ready supply of pig kidneys would be fantastic. All the sudden it wouldn't matter as much that you are a bad candidate, you might end up simply cycling through pig kidneys more frequently.
It was unlikely outcome since nobody had lived there long on a pig organ. It is a good milestone since people who live that long, tend to have a good long-term prognosis.
This surpasses the previous record of 4 months
https://www.science.org/content/article/longest-human-transp...
Pretty amazing tech tbh
I ran into this guy nere Interlaken 2 days ago! Had a nice long talk at the post office over how he was going to present this in Geneva. I heard that this is result is with little or no rejection drugs as well!
That's genuinely impressive. Six months without dialysis after a xenotransplant is no small milestone, especially considering how many hurdles this field has faced over the years. The level of genetic modification involved shows how far biotech has come. Still, it's hard not to wonder about the long game. Immunosuppression, organ longevity, possible unforeseen complications - all big unknowns
I wonder what the prognosis was right after the operation. The article makes it sound a bit like this outcome was totally unexpected.
Insulin from pigs can be used by humans, right? But maybe there's more to diabetes than just a new pancreas. Interesting development, in any case. Thanks for sharing.
I think the major worry is that the body rejects the transplant. If that happens, things can turn really bad really fast. The body will attack the kidney and completely wreck it. They'd probably need surgery to remove it.
He'd probably need to go on dialysis if that were to happen. How long he'd survive IDK. I think I've read that people survive around 2 years on dialysis.
> Insulin from pigs can be used by humans, right? But maybe there's more to diabetes than just a new pancreas.
It can be. That was the first developed insulin. I believe it's completely synthetic at this point.
Not sure this is any more surprising than a human surviving with a Chimpanzee kidney transplant. https://www.macroevolution.net/human-origins.html
Medical history has seen many "miracles." Hopefully, this time, it will become something more people can replicate and learn from, rather than just a flashy headline.
It is fucking wild that we need to resort to putting pig kidneys into humans to squeeze out a few more months of life, while tens of millions of perfectly good human organs are burned or left to rot in the ground each year.
pig of Theseus
I can't read the full article -- what happened with the other two recipients? Science is amazing!
Is he healthy? How much immunotherapy, if any, is he on? Alive is a low bar.
Alive is a very high bar considering the alternative.
It would be interesting what the genetically modified pig looks like.
They have nothing special visually.
https://www.kgri.keio.ac.jp/en/research-frontiers/papers/202...
There are talks to breed them smaller for better handling, as they need to live inside the regulated facility. Having a human size animal roaming around is physically complicated to deal with.
Exactly like a pig.
some say it looks like a small human boy
Porco Rosso
Ghibli! I didn't expect someone would make this comment!
We're rooting for you pal! Stay strong.
Does this mean you can catch pig kidney diseases (they specifically mention turning of a few retroviruses)? I'm assuming pig kidneys are immune to certain human diseases and vice versa. Kind of wild that you have a single organ running an entirely different mammalian OS distro but it is similar enough that it Just Works.
What we really need to work out is how we can incubate humans outside of the womb so we can create brain-dead humans for organ harvesting. Would be both more reliable and more humane than this. Plus you could harvest the heart, liver, etc at the same time. While this is great news, my understanding is that kidneys donors are in larger supply because often family members can give one of theres. This obviously isn't the case for organs like hearts and livers.
I assume that you are being sarcastic and referencing The Island movie?
...still alive but has developed an overwhelming urge to forage for truffles.
New side hustle unlocked
Catgirls when?
If this works, does the reverse also work?
Yes, pig scientists are working on this very problem right now. It gets almost zero attention from human scientists, though.
I thought AI will solve all our problems.
How is the pig doing?
It just needed some oinkment.
Porkly
Is he full of tubes?
We all are...
You know what I mean. A person hooked up to a machine might not even need a kidney.
I remember interviewing for a bioinformatics role at a certain San Diego company 8 years ago and being told by the staff they were working on humanizing pig kidneys.
I thought it was a fucking insane idea and wanted to leave immediately.
Turns out I am a fool.
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Does anyone know why it's so easy to get kidney transplants in China?
That's a (bad) joke, right?
News headline in the not so distant future:
“Man Suffers Unfortunate Loss From Ex Wife, Shows Up at ER with Horse”
How about the donor piggy though?
If this becomes commonplace and animals are bred/raised just for their organs, we get into murky ethical territory. (Yes, people already eat the organs for food, that's murky too. But industrial scale organ farming sounds even worse somehow.)
I'm living with heart failure. I have 20-30 years before I'll need a transplant, if I live a perfect lifestyle and keep my other health issues under control. Due to my other health issues, I am not a good candidate for a human heart transplant. It's not that a human heart transplant would fail, but that when I'd be placed against others on the list for a new heart, my other health issues would reduce my priority such that there is always someone with higher priority to receive a heart, up until the point in which I'm no longer healthy enough to receive a transplant. There are far too few human hearts, and far too many people who need one. All that the transplant boards can do is give hearts to those with the greatest momentary need, with the best chance of surviving.
Xenotransplantation is one of the life lines I'm counting on. I'm hoping that, by the time I need it, the issues that we currently have will be worked out. I have zero ethical issues with breeding and eventually culling pigs in order to save human lives. I hope that there will be other, better, breakthroughs by then, but if not, the best I can hope for is that the pigs are raised in a sterile and enriching environment, and that the only bad day they have is their last day.
The ethical reasoning is we don't care about the pigs, millions of lives will be saved by exno kidney transplants. The argument is already very strong that we should pay to donate their kidneys given the scale of death (especially among the poor) kidney disease already causes, so a pig is nothing in comparison
The donor pig is turned into bacon. Normally the liver goes in the trash.
Unfortunately no, after the surgery the pigs are full of ketamine, blood thinners, anticoagulants, vasoconstrictors, and other medications required for surgery and euthanasia and are not fit for human consumption.
Asking out of ignorance. Why is the liver thrown out? Isn't it edible too?
I like cow liver, it's nasty to handle while raw, but I like it cooked in thin beefs with fried onion.
I also like chicken liver. It's small enough to be cooked whole.
I'd like to try pig liver.
Who would eat it these days? The same with e.g. sheepskins. The labor to process them in western countries is so high so they generally just get thrown away.
I was under the impression it went in to livestock/pet food. Perhaps there just isn’t enough demand.
Does the same apply to offal of other animals? I thought that liver didn't need much processing. What am I missing here?
I'm pretty sure a pig raised for donor organs will be better cared for than one raised for cheap pork chops...
While I agree that it’s is pretty hard to ethically justify killing a pig for food, but I think I am ok with all that pig killing being used for helping sick humans.
While I don’t think we should be torturing animals or anything, obviously, I think I am humanist enough to where I think the ethical thing is to prioritize human lives or avoiding severe long-term discomfort (as is the case with dialysis).
some animals are more equal than others