Swing, Batter, Swing!

The SF Giants’ pathetic lack of offense in a 1-0 loss last night had me grinding my teeth, against the advice of my dentist (probably a Dodgers fan).  Then, in this morning’s NY Times, comes an article (How Do Athletes’ Brains Control Their Movements? by Zach Schonbrun).  Two Columbia University neuroscientists, Sherwin and Muraskin, have been using EEGs to look at a batter’s decision to swing at a pitch (the moment he makes that choice shows up as a burst of neural activity on the EEG), and then correlating their measurements with performance outcomes.  They are applying what is known as rapid perceptual decision-making to the sport of baseball.

Schonbrun points out that a 95-MPH fastball travels 60 feet 6 inches from the mound to home plate in just 400 milliseconds (the blink of an eye), and by then, given the maximum speed of nerve conduction/activation, the time available to react has already been cut in half.  A good batter has to respond to his nerve activations in a very different way than normal people.  Quick:  Is this a fastball or a slider?  At which millisecond does the batter decide to swing at, versus to take, a pitch?

In my second novel, Fourth World Nation, Benn Marr– who possesses certain uncanny abilities due to his unique genetic makeup– has his turn at bat:

Suppressing his excitement, Benn nodded at Hank, picked up a bat and stepped up onto the field.  A thousand hostile baseball fanatics, many wearing black PWE uniforms, glared at him. A metallic voice announced the substitution, to a chorus of catcalls and booing.  Even the programs clutched in the fans’ hands—supposedly there to provide objective analysis of the game—reacted poorly. The crowd rained scorn on Benn as he stood at home plate, their expletives addressing everything from his Asian ethnicity to the “gouging” water rates set by Hydra.

Benn, however, focused his thoughts and heard none of the noise; to his ears, the diamond was still and quiet. Behind him, the mobile QI umpire adjusted his mask. The catcher shifted stealthily to the outer half of the plate, his shoes grinding into the red clay. The pitcher Helmut rolled the ball deep in his glove, his fingers seeking its seams.  To Benn’s eyes, events unfolded as if in slow motion: he anticipated the limited wind-up; the delivery from a low release point; the seams spinning centrifugally; the appearance of a red dot at the center of the ball. It was a slider, unhurried in its journey toward home plate, where Benn waited patiently. He flexed his knees, shifted his front foot forward, then planted his lower body firmly.   As the ball curved low and away, Benn extended his arms and kept his body balanced. On impact, the bat exploded into a hundred shards.

“There it goes, a high fly ball!” yelled the robotic announcer, whose positronic eyes calculated the arc of the ball’s flight, its velocity leaving the bat, and the distance to the warning track, where it bounced off the wall above the leaping right fielder.  All this data was instantaneously transmitted to the fans’ programs, which murmured their grudging admiration. “The Giants have a double!” the announcer added, when the play was over. “So the game is tied up at two runs apiece. Ladies and gentlemen, please… further throwing of trash from the bleachers will result in ejection from the park.”  Discarded programs continued to land on the infield. Many of them were still gushing about the inside-out swing and the broken-bat, opposite-field RBI double.



Choosing a Sharper Blade

Bacteria, it seems, rule our health, living as they do at the interface between our protected internal selves and the wide external world.  We all know that they can act as harmful pathogens, but often they also function as mediators, brokers, an essential part of normal health and homeostasis.  At the time of my retirement from Rheumatology in 2015, an ever-increasing understanding of the role played by the microbiome– the bacterial population of our intestinal tracts– in driving autoimmune diseases such as rheumatoid arthritis and systemic lupus gave me pause:  should I retire, just as such an interesting and important field was opening up?

For example, there is a bacterium called Enterococcus gallinarum that can migrate from the gut to tissues such as lymph nodes and liver, where it triggers autoimmune processes and inflammation; an antibiotic or vaccine against this bacterium reverses its effect on autoimmunity, at least in genetically susceptible mice.

And recently, a team at Yale has looked at a protein called Ro60 in lupus patients.  Ro60 is found in bacteria from the mouth, skin and gut of these patients, where it induces the immune response and antibody production.  In theory, a topical antibiotic might be designed to target Ro60-containing bacteria and thereby suppress the autoimmune process in lupus.

Both of these examples herald a paradigm shift in our understanding and treatment of rheumatologic conditions (and other autoimmune diseases)– diseases where a wayward, dysregulated immune system attacks one’s own tissues, such as kidneys, lungs, brain, skin and joints.  When I was in training in the 1980s, treatments consisted largely of poisoning the immune system with chemotherapy agents and steroids.  As in cancer chemotherapy, we would bludgeon the target, stopping just shy of dangerous toxicity.  Not until the turn of the century did the biologic agents come along:  a new class of medications that finely targeted proteins along the complex inflammatory pathway, cutting with smaller and sharper blades where previously we had operated with dull machetes.

And now, antibiotics and vaccines for autoimmune conditions?  Examining these diseases with ever-greater resolution leads to better identification of culprits and “surgical strikes” with a minimum of collateral damage.  In teaching residents and medical students about lupus and RA, I would often use this analogy:  you’re enjoying a peaceful stroll through the park, when suddenly you encounter a boom box lying on the ground.  It’s playing a type of music you hate (for me, until recently, that was rap), and playing it very loudly.  In the 1980s, I would have taken a sledgehammer and pounded that boom box to bits.  In 2000, I would have found the volume dial and turned it way down.  In 2020, they will be figuring out how to change the radio station– or rather, the live stream.

No matter how far we think we’ve gotten in advancing the field of medicine, there will come a day when we look back at current practices with a mixture of amusement and horror.  In that same vein, here’s an excerpt from my sci-fi novel Fourth World, the first in a trilogy:

“Dr. Vincent?” the intern ventured.  “I understand why you would combine the gene fragments from the biogenome menu to make therapeptides?  And how the therapeptides correct the deficiency state? But you would have to keep administering the peptide indefinitely, right?  Because it wears off?”

Dr. Vincent, unaccustomed to interruptions, stared at him with eyebrows raised.  “Yes, of course, there is a finite half-life for every therapeptide,” she replied warily, sensing the question to follow.  “They have to be administered periodically. But they can be engineered to have extremely long half-lives, as you know.”

“Yes?  But wouldn’t a better solution be to transfer the PerMutation into a stem cell?  Then introduce the stem cell into the host, you know, to grow actual tissue? Once the genetically modified tissue took hold?  The patient could then, you know, make his own permanent supply of the therapeptide?”

Vincent’s face reddened as she consulted the seating register at her lectern.

“No… Mr. Messler.”  Her smooth delivery had been brought to a sudden halt by his naïve- no, appalling- question.  “That would not be a better solution. Not at all! You haven’t studied medical history much, have you, Mr. Messler.  The PerMutations obviously consist of multispecies DNA. Multispecies Proteomics- and subsequently the use of the protein products as pharmaceutical products- is a well-developed field.  But not the incorporation of PerMutations themselves into human beings. It has been over ninety years since the first attempt at introducing multi-species DNA into humans. Can anyone here please tell us what the consequences were?”

Benn and Lora looked at each other blankly.

An intern sitting across from them, a bearded black man a few years older than his peers, spoke up:  “I believe you’re referring to the Boston Gene Project. In one experiment, chimeric DNA, part mouse (from a strain of New Zealand mice with hyper-immune traits) and part human, was inserted via stem cells into patients suffering from a variety of immune deficiencies.  Balancing deficiency with excess: it seemed a straightforward idea. But there were nucleotide sequences in the DNA, previously considered ‘junk’ or nonsense, and even some non-genetic material, such as the associated proteins you mentioned earlier, which turned out to be important.  Ninety percent of DNA doesn’t code for proteins, yet remains biochemically active: for example, directly regulating- or coding for RNA which regulates- gene expression. The ‘junk” interacted in unpredictable ways with the patients’ genes, sometimes destroying them, or worse yet, re-sequencing them and changing the end-products.  In the Boston experiment, subjects developed unexpected consequences: aggressive auto-immune diseases, multiple cancers, and even bizarre body changes involving… non-human tissue.”

“Yes!  And therefore, in vivo application of multi-species DNA became illegal, Mr. Messler- it’s a major violation of the genetic engineering code.  In fact, the law forbidding this application is second only to the universal ban on human cloning! Does that answer your question?”


A Body of Evidence

My son Christopher, a first-year medical student, has just begun his Anatomy course, marking with a pen the body landmarks and dissection lines on the skin of the female cadaver assigned to his dissection group.  Lines in place, the scalpel comes next.  He said it was his first experience in medical school that imparted such a visceral sensation, with no pun at all intended.  Unlike him, I remember needing to lean lightly on humor on my first day in the very same Anatomy class, when the four of us students first met our cadaver in the fall of 1976, that of a skinny man in his nineties:  it was surely a solemn, awe-inspiring moment, but also made us (I had just turned 21) a bit nervous and anxious– and in such circumstances, we often resort to humor to ease our discomfort.  With all respect, we voted to name our cadaver Slim.

In the year 2196, organs are grown in situ by injecting specialized stem cells intravenously, but there have been notable mishaps.  Here’s an excerpt form my first novel, Fourth World, in which Dr. Nestor Neelin demonstrates on a cadaver, whose name is Bob.  The course he teaches is Recombinant Anatomy:

Neelin dived in quickly:  “Now if you’ll observe:  here in Bob’s brain, there sit not one, not two, but look– three temporal lobes!  Bob, you see, suffered a devastating stroke in his sixties, and in those early days of therapeutic stem cell infusions, an effort was made to replace the lost brain tissue.  This effort marked a step forward in stem cell technology, prior to which most tissue types, such as brain, liver, eyes and so on, required engineering in vitro, then transplantation of the developed tissue to the patient.  The new targeted stem cells, in contrast, could be infused intravenously, and would find their way to their appropriate location, guided by seeker molecules implanted in their membranes.  There they would differentiate to the desired organ, thus obviating the need for a transplant procedure.  In Bob’s case, the infused stem cells did develop into a temporal lobe as planned, but unfortunately, growth stimulators infused at the same time caused the partially necrotic lobe to regenerate within his already-crowded skull– leaving him, quite literally, with not enough room to change his mind!”

Many in the audience, confused by this last phrase- was it meant to be funny?– consulted their data-discs only to find their screens blank.  Only one laugh could be heard, a loud “HA!” coming from the opposite side of the hall, some twenty rows below Lora.  “Ha-HAH!” the same voice persisted.  And that was how Lora finally located Benn.


Neelin held his right hand up.  “I have one more example of quackery to show you.  Bob, you see, was a victim not only of technical incompetence, but of outright fraud.  Late in his life, he fell out of a Banyan tree while bird-watching in the district then known as Australia.  He sustained a pelvic fracture and had to enlist the help of a migrant clinic in the back country, in order to regenerate the broken bone.  They infused him with an unidentified stem cell, his diary shows, but the end result was only discovered at Bob’s post-mortem.”  Neelin appeared to be rummaging around in Bob’s intestines.  He finally pushed them toward the back with outstretched fingers, exposing two thin bony structures pointing upward from the pelvis.  Puzzled interns frantically interrogated their data-discs, again without success.

“Their treatment provided Bob, bless his original heart, with these two extraneous bones, which you see protruding here.  These bones did nothing to help Bob with his pelvic fracture, but he would have found them useful– very useful indeed– had he… been… born… a…”  Neelin paused expectantly.

“A kangaroo!” shouted Benn triumphantly.

Neelin released Bob’s intestines with a loud flop and whirled around to face Benn.  “A kangaroo or any marsupial– excellent!  Young man, you are the first intern in over two decades to recognize these as epipubic bones:  their function is to support a marsupial’s pouch.  Excellent!  Your name, please?”


Shameless Commercial II

At a large trade tasting of the wines of Bordeaux held in San Francisco yesterday, a friend– the owner of a great chateau in St. Julien– told me he had downloaded and started to read Fourth World Nation, the second book in the trilogy.

“Oh no,” I replied (despite an initial flush of success and gratitude– maybe it was time for a translation into French!).  “The series is meant to be read in order– so it’s better to start with Fourth World, and then move on to Fourth World Nation.”  Otherwise it would be hard to understand Benn’s abilities, his relationship to Lora, and why they are running away from the Pan-World Electorate.

In going back to Fourth World, my friend would probably be amused by Chapter Eight, in which Dr. Nes Neelin holds a tasting of the Greatest Wines of the Century in the Mellon College dining hall.

Ever since Fourth World Nation came out on Amazon, I’ve been working assiduously on the third novel in the trilogy, in which the setting shifts from Mars back to Earth– in particular, my old stomping grounds of Malaysia and Singapore.  With a minimum of spoiler alerts (I won’t even mention its title), here’s an excerpt:

As a young linguistics student at Cambridge University, Wesley Stuart had appeared in numerous collegiate theatrical productions, including some by his favorite playwrights, Oscar Wilde and Noel Coward.  Which one was he channeling now?  Someone in between, perhaps.  Chou Xia-Yu had found his classmate’s talents amusing, and was therefore willing to tolerate his sporadic spoofing of British Peers, or “p-p-pompous p-persons of p-p-privilege,” as Stuart sometimes put it.

How had a charming but harmless thespian, a Bohemian polyglot such as Wes Stuart, ended up as the PWE Superintendent of Singapore?  Chou knew very well the final step, having promoted Wes to that position during his time as Leader.  Before that, Wes had served for eighteen years as a minister in the British Parliament, a local governing council of the Pan-World Electorate.  There was, of course, no longer a distinction drawn between the House of Lords and the House of Commons (nor had there been for almost a hundred years), but the Stuarts had occupied a seat in Lords since the seventeenth century, and on the day Wesley Stuart had staked his claim by strolling ever-so-naturally through the grand entrance to Parliament, no one had thought to object.  Even the vehement stand taken by The London Stage, a cultural review published and edited by Wes, against the long-lost traditions of aristocracy— which still glowed in the hearts of many Britons like a warm coal among the morning ashes— had drawn nary a negative comment from his fellow ministers.  He may have written and acted as a traitor to his class, but that class now existed only in a dense fog of London nostalgia.

As he closed the front door, Stuart affected a different accent.  “Roit this wye, lidees and gents,” he pronounced like a circus barker, with a bow and a broad sweep of his arm.  Lora walked slowly past him into the living room, pausing to gawk at two huge bronze Buddhas flanking the entryway.

“Wes, you haven’t lost your touch,” said Chou.  He flashed a momentary smile, then cleared his throat pointedly.

“Ah.  By that you mean my touch of craziness,” replied Stuart, feigning embarrassment.  “Well, you were ever the serious one, Chou.  Always getting straight down to business, eh?”  He gestured at the furniture crowding his living room, which consisted of a club-style sofa and three leather wingback chairs (“Water buffalo,” he announced proudly) surrounding an ornately-carved Indonesian hardwood kopi table with a tall Chinese vase at its center.  Bookshelves overflowing with publications in several different languages lined the walls.  Everyone settled into a comfortable seat, but Ari plopped herself down on the edge of the low table, shifting it sideways on the marble floor by a millimeter or two.

Stuart lunged forward and steadied the vase, even though they both knew there was no danger of it tipping over— and besides, it was made of an indestructible polymeric material, the product of multispecies recombinant DNA.  “Oi sye, steady on, young pip!  That’s from the Ming Dynasty, innit?”

Not bloody likely, not unless the Ming Emperors had access to genetic engineering, thought Stuart with an inward laugh.  Ari felt a wave of irony and smiled innocently at her host:  she had liked him immediately, sensing his openness, his affection for Chou, and above all, his excellent humor (what Wes himself might have termed his “infinite jest”).


Let’s Take A Closer Look

One evening in 1978, when I was in medical school, I described to a few dinner companions a fantasy/sci-fi machine for diagnosing illnesses.  CT scanners (which provide multiple computer-generated cross-sectional views, or tomographs, of the body using x-rays) had only recently been invented, and MRI (using NMR technology taught to us in physical chemistry classes at the time) was still a few years away.

My dream machine, I explained to my dinner mates– whose eyes I could see were beginning to glaze over– would compile all the tissue cross-sections to generate a 3-D picture, a hologram.  At that time, CT’s limited resolution showed us the organs and tissues, but what if we could greatly increase the resolution with a different type of energy beam, something other than x-rays?  Radar?  Microwaves?  Cosmic rays?  Who knew?  We would see not only tissues but cells, then drill down to the level of cell nuclei, mitochondria, chromosomes, even individual genes.  The resolution of the imaging technique was the rate-limiting step.

With my dream machine, abnormal cells would stand out right away; combine that information with indicators of tissue metabolism (PET scanners would come along later) and even images of gene sequences, and before you knew it, surgical biopsies of live tissue– for example, to diagnose cancer– would no longer be needed.  “You could examine the hologram from all different angles, then perform a virtual biopsy!” I exclaimed (stimulated by the excellent wine we had with dinner).  The computer, having obtained all necessary data from the high-resolution scan, could “biopsy” pieces of the 3-D image, then project them on a screen for the pathologist:  this could be repeated over and over, without any pain to the patient.

Well, the dream machine is one step closer.  This week– only 36 years later– a newsletter from the dean of Yale Medical School announced the arrival of a high-resolution cryoelectron microscope with tomographic capabilities, enabling researchers to view specimens in 3-D from multiple angles (unfortunately you still have to obtain a specimen, as nobody has figured out how to put a whole patient into the machine).  It can tell us the atomic structures of membrane proteins– now that is small!  By the way, the three scientists most responsible for developing cryo-EM received the Nobel Prize in Chemistry this month.

(Not making any claims to the Nobel Prize– just saying).  Here’s an excerpt from my science fiction novel, Fourth World:

Lora stepped out of the Pan-Bio Analyzer, commonly known as the Probot, and reached for her paper robe.  Her skin was flushed and tingling- it felt like a Sonicspray, she thought, only without the blowing sensation.  The Probot scan, which produced a detailed analysis of anatomy and organ function- it would have detected a gastric ulcer, sinus infection or brain tumor, for example- was the final part of the physical evaluation required of all students, and she had passed without a hitch.  So had Benn and Sool, who were already on their way to the first formal lecture for the incoming class of interns, scheduled to begin in Cushing Hall in just a few minutes.  After a week of organizational meetings and introductory talks, it was a much-anticipated moment.

Lora nodded to the technician seated at a control panel, hurriedly crossed the cold Probot Chamber to the adjacent dressing room, and exchanged the robe for her standard-issue orange bodysuit.  Almost everyone attending YaleConn Med- not only the lowly interns- wore those bodysuits to class, so Lora shrugged off their resemblance to the prison uniforms worn by PsySoc reformees back at Tharsis One.  In a way, Lora was disappointed that the computer hadn’t found anything wrong with her:  no explanation for the distracting noise, that persistent insect buzz that had kept her up for part of the night.  It was faint, but intermittently took on a pronounced throbbing pattern- quite annoying.  Neither Benn nor Sool seemed to hear that noise, whatever it was:  A blood clot?  Eustachian tube dysfunction?  Seizure activity?  The Probot said no, no and no.  Meaning that there wouldn’t be an easy remedy.



Mars or Bust II

It’s really happening.  Among Earthbound, upward-gazing humans, there has always been a deep-seated fascination with outer space; witness the huge popular reaction to the recent solar eclipse.  But efforts by SpaceX, Boeing, Blue Origin and other commercial companies to fly folks into low Earth orbit in conjunction with NASA signal an acceleration of that interest, or what has been called a “new space race.”  When rocket factories, cargo missions, passenger flights and space exploration open up “a whole new world of business,” you know that momentum will build.  According to a NASA director, a manned mission to Mars is “the pinnacle of Mt. Everest” at this point– but once Everest has been scaled, what will keep the momentum going?

In my science fiction novel Fourth World, NASA’s Tharsis Colony on Mars is left stranded when a great war results in the formation of one world government (the PWE) and the elimination of NASA.  Here’s an excerpt:

“At other times, Mr. Walker suggested that the colony’s downfall actually preceded the PWE, that the slow death- he termed it the “apoptosis”- of Tharsis Colony was encoded in its DNA at the very moment it was conceived.  To explain this apoptosis, Mr. Walker would use his guiding principle:  follow the water.  The second manned mission to Mars, launched in 2049 (thus nicknamed “The New Forty-Niners”) discovered significant quantities of liquid underground water, which had only to be mined in order to allow large-scale colonization. Of course, water was necessary for supporting life, but beyond that, water was found in perchlorates, hydrated salts which could be converted to solid rocket fuel (this was before the harnessing of nuclear fusion, Mr. Walker reminded them).  The seminal discovery of water, he said, sweeping both arms dramatically to his left, then to his right, essentially divided the history of humanity on Mars into the pre- and post-Forty-Niner eras.”

Regarding the former, Mr. Walker reviews for his second-grade class the decades-long history of Mars exploration:

“… Many other missions contributing to the ultimate colonization of Mars, such as Mariner, Pathfinder, the Mars Reconnaissance Orbiter, Opportunity and Spirit, were never forgotten by history.

Also never forgotten:  the fact that the United States agency NASA had been responsible for all of these missions.  Sure, Mr. Walker allowed, successful probes were launched by Russia, Europe, China, India, Brazil, New Zealand, and even private enterprises.  But only the United States had the means to access the water- to monopolize this most vital of natural resources- and establish a full-fledged colony.  Tharsis was a triumph for the United States, but to the rest of the world, it was only the latest example of American empire-building and colonialism.”

But merely finding the means to colonize Mars doesn’t explain the need to colonize, does it?  There have to be assets to exploit once you get there (and in Fourth World, it turns out, there are valuable resources to discover).  Absent such assets, would escaping Earth justify the trouble and cost of such a long journey?  Despite Hurricane Harvey’s devastating effect on Texas and the startling rise in the number of 500-year floods in just the past decade, climate-change deniers in Congress and the White House still determine US policy.  It seems we will continue to prop up the coal industry until all the coal mines are under floodwaters.  In the original Mars or Bust (which appeared on this blog January 7th, while I was still in post-election shock), I coined a name for the manned SpaceX mission to Mars:  Elon’s Ark.  Let’s hope commercial space flight literally takes off:  when climate change can no longer be reversed, we’re going to need a lot more than one Ark!


To Join This Couple

If only it were possible to love without injury- fidelity isn’t enough:  I had been faithful… and yet I had injured her.  The hurt is in the act of possession:  we are too small in mind and body to possess another person without pride or to be possessed without humiliation.”

The Quiet American, by Graham Greene


Proximity to several weddings and anniversaries has got me thinking not only about hope and wonderful relationships, but also- this may seem a bit neurotic- about the impossibility of attaining the ideal:  complete mutual understanding.  Ideal goals, almost by definition, are impossible to reach- and yet (one hopes) we strive on, grinding the rough corners, losing the old baggage, constantly adjusting our attitudes toward one another and admonishing ourselves to be better people.  In other words, if we are “too small in mind and body,” we need to keep growing!  If only there were an easier way; if only we had chimeric genes or the drug-induced ability to escape our limited dimensions and merge together, like Benn and Lora in Fourth World, both projecting their auras in an out-of-body experience:

“HUH!” was all Benn could manage as their two auras met.  It was not so much a physical joining of bodies- not the sensation he had hoped for, alas- but more like a merging of two liquids.  Lora feels like oil, the odd thought came to him: he pictured a large drop of oil falling into a pool of water.  As it splashed, the strong natural repulsion between auras took immediate effect:  the drop embodying Lora displaced a smaller drop- a portion of Benn’s aura- which rose straight upward.  Then the Benn-drop fell back in and splashed up an even smaller droplet- Lora again- which in turn fell, and so on, until inevitably the last micro-sphere of Lora was captured by Benn’s surface tension and could no longer escape.  As separate liquids, the two of them had different viscosities:  Benn flowed easily, whereas Lora’s character was thicker, more unctuous.  Their collision caused long, finger-like projections of Lora to penetrate into Benn’s aura, causing it to blush red before snapping back to attention.

He recognized her myriad layers, those melodic strains, the steady internal rhythm he had so admired.  With their thoughts intermingled, mutual understanding arrived instantaneously, and no longer required the cumbersome verbal exchange of ideas expressed ploddingly one at a time, over periods measurable on a stopwatch.”

If only we could do that!  But in the sequel, Fourth World Nation, Benn wrestles with the ups and downs of sharing auras:

“Benn thought long and hard before giving his answer.  Even though she had quickly apologized and even made a joke about it, Lora had meant what she said about the survival of their relationship.  Admittedly, he often worried about misconstruing her intentions, being insensitive, and appearing apathetic when he really did care; why would she not have her own set of worries about appearing moody, contentious, or needy when she was anything but?  Only when their auras fused together was there instantaneous and true knowledge of one another.  Who wouldn’t want a relationship completely free of misunderstandings, mistrust, manipulation, projection, guilt, dishonesty or domination?  No more mumbling, lapses of attention, slips of the tongue or difficulty hearing, either!  What could be better?”

Unlike Benn and Lora, the rest of us remain in separate, finite minds and bodies.  It’s as though we are talking through a wall, in different languages, our voices muffled and disguised.  Of course we’ll never achieve complete understanding that way, so we need to keep growing, grinding, adjusting.  But come to think of it, this continual striving on our parts reflects an untiring commitment to our relationships, doesn’t it?  We may not hear each other perfectly well, but that untiring commitment, I think, is at least one ideal we can attain.