Hideously Improbable

"[When the spine is cut, the neurons] cannot be reconnected, so it's scientifically impossible."
"Ethically it's impossible. How can you put one person's head on another's body?"
Dr. Huang Jiefu, (former) deputy minister of health, China

"For most people, it's at best premature and at worst reckless."
Dr. James L. Bernat, professor of neurology and medicine, Dartmouth College, Hanover, New Hampshire

"The Chinese system is not transparent in any way. I do not trust Chinese bioethical deliberation or policy. Add healthy doses of politics, national pride and entrepreneurship, and it is tough to know what is going on." 
Arthur L. Caplan, medical ethicist, New York University

"I don't want to see China's scholars, transplant doctors and scientists deepening the impression that people have of us internationally, that when Chinese people do things they have no bottom line — that anything goes." 
Cong Yali, medical ethicist, Peking University

"We see the reactions among Western commentators as a misunderstanding of the current situation."
"[Critics are unwilling to acknowledge China] as an equal partner in the international debate about proper limits to the development of new biotechnologies."
Zhai Xiaomei, dean, School of Humanities and Social Sciences, Peking Union Medical College

"At this stage, I would call the attempt stupid rather than crazy. Crazy means it may be done. Stupid should not be done."
"And using the gluelike substance, polyethylene glycol to facilitate the growth of nerve endings] Put it this way: It is like if the trans-Atlantic phone cable is cut by half, and someone wants to put it together using Krazy Glue." 
Dr. Abraham Shaked, professor of surgery, director, Penn Transplant Institute, University of Pennsylvania

Stefan Irvine | LightRocket | Getty Images  Instruments for spinal surgery, photographed in an operating theater. Chinese surgeon Ren Xiaoping is experimenting with full-body transplants on mice and human cadavers, with a view to using the technique on spine-injured patients

 If it is given full, rational thought, who in their right mind would ever want to volunteer themselves for such a transformative surgery; agreeing to become a pioneer in the art of the impossible, the transplantation of a head onto the body of another person, preserving the brain, the thought processes, presumably the soul accompanying the mind resident in the head, but transferring it all to sit atop the shoulders of an entirely different person. Might nature herself not shrink in dismayed revulsion?

Of course, if the individual in question who may have doubts, but yet views such a surgery as their last best hope to continue living has no other option but to face death without such a hoped-for solution, it is the emotional attachment to life itself that instructs that person's decision-making. No one wants to face the permanence of the absence of life, becoming nothing, knowing nothing, fading into nothing.

And so it is with Wang Huanming, paralyzed six years earlier down from his neck. Who might have imagined that a bit of fun, wrestling with a friend, might have resulted in such a catastrophic bodily collapse. Mr. Huanming sees his only hope for a future in the possibility that a full-body transplant to permit him to resume life as he would normally have done without his accident, leading him to place his hope in a never-performed whole-body surgery.

And the surgeon who is prepared to undertake that history-making surgical procedure is Dr. Ren Xiaoping in Harbin, China. Dr. Ren is fully aware of the censure that is coming his way from the medical profession who view his plans as noxiously absurd, dangerously reckless, and philosophically dented. His country, on the other hand, likely is more than ready for him to proceed, when a success of this magnitude would burnish the country's reputation.

The rest of the world, sitting on the sidelines, tut-tutting in professional outrage, expects nothing less from China, only too willing to push the ethical and practical boundaries of science to enhance their reputation on the world stage -- for making the attempt, and possibly even the remote potential of succeeding in the attempt. Yet it isn't only Western medical professionals who have their doubts, but Chinese experts as well.

The extreme difficulty inherent in connecting nerves in the spinal cord represents the major stumbling block to success. Failure to succeed would result in the patient's swift death, rather more immediately than if the condition they were suffering was allowed to take its natural course. Mr. Wang is not the only volunteer; there are others in China who have also responded as body transplant volunteers in Harbin.

Dr. Ren of Harbin Medical University, has a surgical history in the United States, having been involved in the first hand transplant undertaken in 1999 there. And he is determined to proceed with his own very special breakthrough in surgery transplantation. So determined that he is busy putting together a surgical team, research is underway, and the operation is scheduled to take place "when we are ready".

His daunting plan of action is to remove two heads from two bodies, then connect the blood vessels of the body of a deceased donor with that of the recipient head during which procedure a metal plate is to be inserted stabilizing the new neck while the spinal cord nerve endings are bathed in a mucilage substance to hasten regrowth and to attach the skin back in place.

Dr. Ren has a rival for those aspirations, another surgeon, Dr. Sergio Canavero in Italy, advocating for the same type of scientific-medical breakthrough in transplant potentials. As well, scientists with the Institute of Theoretical and Experimental Biophysics at the Russian Academy of Sciences are also involved in investigating various aspects of the mechanical/biological process.

For Mr. Wang there is hope, as dim as it might seem to onlookers. His daughter Wang Zhi, 34, and her mother have been hand-pumpimg oxygen into his lungs for three years. Their care for him has been relieved somewhat with a new automatic pump, acquired through donations. But the medical bills associated with his care have left them paupers.

"He cannot live, and he cannot die", said his daughter. Mr. Wang's family echo his hope that if the surgery succeeds he will live, if it fails to triumph over his adversity, he will lose whatever life is left to him. "A medical procedure that sounds impossible may save us", his daughter explains simply.

Ebola, Malaria -- Now Yellow Fever

"[Factories producing the vaccine] are above the capacity of production. They don't produce more than 2.4 million doses per month. That hampers what we are doing."
"We need to vaccinate 24 million people [in Angola]."
Hernando Agudelo, WHO representative, Luanda, Angola

"It is tragic, because we have an intervention that makes the disease entirely preventable."
Ray Arthur, director, Global Disease Detection Operations Center, U.S. Centers for Disease Control and Prevention

Photo for The Washington Post by Nichole Sobecki     Women grieve over the casket of a young boy who had died two days prior in Luanda, Angola. The family said doctors had been uncertain whether the cause of death was yellow fever or malaria.

An old scourge has returned with a vengeance; even though there is a solution with the use of a vaccine against yellow fever, one that eighty years earlier was created in a laboratory in New York. But it is seldom in the countries that most require their citizens to be immunized that the vaccine becomes an instrument of avoidance decreed by the nation's public health agency. An epidemic has raised its ugly head in Angola, where the vaccine was not distributed and used to inoculate the vulnerable.

Angola now has over three thousand suspected cases of yellow fever to cope with while in neighbouring Congo yellow fever is making inroads to create the largest urban epidemic of the disease seen in decades. Over 400 people haven't recovered from its effect, and families are in mourning. In an age where the easy movement of people by air means that communicable diseases can be spread with lighting speed, concerns are growing that Chinese workers will carry the virus from Angola to Asia. There too, in that massively populated country, few have been inoculated.

Stockpiles of the vaccine are in steep decline resulting from the strain realized in response to the explosion of yellow fever. The major manufacturers producing the vaccine are unable to produce sufficient to enable the kind of vaccination campaign capable of swiftly halting the disease spreading to other places in the region. This new international health threat is adequate proof that global health institutions like WHO are unprepared to face the reality of Africa's transition toward an increasingly more urbanized and interconnected continent.

Angola now has networks of highways and the presence of airlines permitting greater numbers of people to travel far and fast. That far and fast capacity to move people from one area to another in the world has been of inestimable assistance to the diseases awaiting the opportunity to rage and range far and wide. From their sinister beginnings in remote locations that are sparsely populated, diseases like yellow fever have made immense inroads into crowded urban areas.



The World Health Organization took precautions to warehouse six million doses of the vaccine 'just in case' a public health emergency might someday emerge. Now that it has, that six million doses has proven sadly insufficient to counter the fast-moving epidemic characterizing yellow fever's capacity to cross borders. A campaign to vaccinate six million people in Luanda has left millions of others unvaccinated. The fears are that if areas in rural China needed immunization the skyrocketing demand for vaccines could never be met.

Each dose of the yellow fever vaccine takes roughly a year to produce, making it impossible to react with the speed required to meet the needs of an expanding epidemic. Urban epidemics are especially threatening, considering the swiftness with which disease can spread in areas of dense populations which have never been vaccinated.

Universally Coping With Pain

"While clearly there are issues with some prescribing practices, there's also clearly a risk to vilifying these medicines [opioid painkillers]."
"[In some countries] a clerical error in a morphine prescription [can lead to criminal inquiries]."
Diederik Lohman, Human Rights Watch

"Many low-income and middle-income countries continue to fail to provide adequate opioid analgesic medicine for pain."
Report: International Narcotics Control Board, United Nations

"It's not that we shouldn't be concerned about addiction."
"We basically have zero access in most countries around the world. You don't go from zero to the situation in the United States [addictive risks with the use of pain-relief drugs too freely available]."
Felicia M. Knaul, international health economist

Chris Hondros  /  Getty Images file  

In the United States, the abuse of prescription medications has gone beyond almost all illicit drugs with the exception of marijuana, according to the International Narcotics Control Board 

 

In North America, a runaway problem of prescription drugs readily available on the street has led to widespread drug addiction and the use of opioids and more powerful drugs like fentanyl causing an epidemic of drug overdoses and death. The abuse of prescription-type drugs which have a societal value in helping seriously ill people cope with pain, has arisen as a public health-addiction issue in Canada and the United States, but elsewhere in the world there is a clear shortage both of painkillers and the institutional-political willingness to make them available to health sufferers.

Extremely sick people whose legitimate requirement for drugs to ease their intolerable pain find oxycodone and other narcotics out of their reach and the result is inevitably that they suffer and they die in pain. This, according to health officials, doctors' and patients' rights advocates. Many doctors in Russia, India and Mexico, fearful of possible prosecution or other problems with legal authorities feel reluctant to prescribe painkillers.

Only recently have health officials in Kenya authorized production of morphine, as one of the most effective of pain-relief drugs, to make it available to those in dire need of pain relief. It had been available only in a handful of the country's 250 public hospitals, leading to a public outcry and criticism that authorities had little option but to heed. The Human Rights Watch advocacy group reported that only a small fraction of doctors in Morocco are allowed to prescribe opioid analgesics since they're considered poisons in that country.

Even for patients suffering from the dreadful effects of terminal cancer, AIDS or wounds suffered from conflicts are unable to access painkillers since in most poor- and middle-income countries such drugs are restricted and largely unavailable. An absence of medical training, onerous regulations, prohibitive costs and an official drive to eliminate the scourge of illicit drug use, along with a cultural acceptance of pain have all led to this situation.

A report issued from the International Narcotics Control Board indicated that the use of opioid analgesics had grown exponentially in North America, Central and Western Europe and Oceania, but remained in low usage in Africa, Asia, Central America, the Caribbean, South America and Eastern and Southern Europe. According to Stefano Berterame, heading the narcotic control and estimates section of the board, officials in many of those countries cite expense and a lack of suppliers.

The World Health Organization estimates that 5.5-billion people in countries with "low or nonexistent access to controlled medicines for the treatment of moderate to severe pain", are out of luck when it comes to access to painkillers. In other words, it is being recognized as a human right for people to be able to have their pain humanely alleviated with the prescribed use of opioids, but due to a multitude of reasons, economic and cultural, legal and accessible, they are denied that relief.

In Mexico for example, an amendment in its health law requiring hospitals to offer palliative care to terminally ill people, which was passed in 2009, was ignored for years. Leading to a situation where, as Human Rights Watch pointed out, "tens of thousands" of Mexican patients were unable to access the pain relief they were entitled to. "The irony for a pediatric oncologist is that it's much easier to buy [drugs] on the street than go to a hospital [to obtain painkillers]" observed Ms. Knaul.

Clinging Delusionally

"And that's true [smoking will exacerbate any cancer situation and prognosis] whether or not it's a smoking-related cancer in the first place, or even if it's not a cancer with a strong relationship to smoking."
"We're not laying blame on anybody. I think most of us who are non-smokers, we have our own view of the world. We think, 'oh sure, if I was given a diagnosis of cancer, I'd quit on the spot."
"This is an addiction, and it's very, very difficult to quit."
"If we say 'culpable if you smoke and you're personally responsible for all of the consequences', where does it end? What about eating too much? What about not exercising enough?"
"We're in the business of trying to help people -- not blame them."
Dr. David Mowat, senior scientific lead, population health, Canadian Partnership Against Cancer

"Where do you draw the line? An addiction is a treatable illness. If you've got an illness,  you're going to make judgments about them? It doesn't make a lot of sense -- you need to offer  help with the addiction."
Dr. Kerry Bowman, bioethicist, University of Toronto

Jeff T. Green / Getty Images

Lifestyle has consequences. Sometimes those consequences are a long time surfacing, but eventually they may. And if one's lifestyle is inclusive of an ingrained habit that becomes a fierce need to repeatedly ingest a chemical that is a known carcinogen no one can be surprised, least of all the individual addicted to tobacco, that lung cancer ultimately has the final say. No one in today's world can be ignorant of the simple fact that nicotine is a tried-and-true path to an early death.

People are very adept at blinkering themselves to realities, reasoning that what may happen to others will not necessarily happen to them. After all, it's also a well-known fact that some congenital smokers often don't contract cancer. And that people who have never smoked in their lives are also diagnosed with lung cancer. So for some it's a gamble, and for others it's a situation where they believe they are exempt from the biological breakdowns that afflict others.

It's even highly likely that just about everyone has had the experience of losing someone in their family to the ultimate effects of nicotine, through lung cancer or serious heart problems leading to death. For most people the seriously worrisome knowledge that smoking all too often causes lung cancer is persuasive enough for them to discipline themselves through whatever means are successful, to move toward smoking cessation.

New research, however underscores that of cancer sufferers a significant percentage continue to smoke even after diagnosis. In my own family that includes a father whose surgery and suffering from throat cancer didn't suffice to compel him to stop smoking. And a sister-in-law who, despite open-heart surgery, continued smoking. But not for too long.

In a national health survey which asked "Do you have cancer", one in five Canadians reported smoking daily, roughly analogous to numbers in the non-cancer population. The conclusion by experts was that people consumed by nicotine addiction fail to appreciate the hazards of ongoing smoking, despite those hazards being common knowledge.

Additionally, some people simply shrug off criticism in their belief that since the damage has already occurred, why cease smoking? The reasons for stopping are obvious to the medical science community: smoking blunts chemotherapy and radiation effects resulting in lower survival rates. Smoking increases treatment side effects as well as furnishing the basis of a second cancer appearing.

In some parts of the world people who smoke and develop lung cancer lose their eligibility for state-funded cancer drugs (Turkey). In some areas of England and Wales smokers are not offered access to routine surgery like hip and knee replacements until such time as they cease smoking. Dr. Mowat and others in the field in Canada don't subscribe to that line of reasoning.

Their study was published in the journal Current Oncology, based on four years of data -- 2011 to 2014 -- extracted from the Canadian Community Health Survey. Twenty-two and a half million people without cancer were compared to 338,450 cancer patients and of the two percent "current  cancer patients", 20.1 percent reported smoking, as compared to 19.3 percent in the non-cancer population.

"A considerable proportion of smokers did not quit when faced with a cancer diagnosis in Canada", the researchers concluded. The research findings did not, on the other hand, determine from the data available how many people attempted to stop smoking, or how many had stopped but then returned to smoking. Other studies clarified that up to half to two-thirds of those diagnosed with certain cancers, stopped smoking as a result.

Issues such as depression, unavailability of smoking cessation programs and the psychological/emotional stress involved in coping with a diagnosis of cancer represent reasons to explain why it is that some people continue to smoke, according to the study authors. In addition, though lung cancer patients are likelier to directly link tumours with tobacco, and as a result stop smoking, those with breast, bladder, anal or other cancers might not recognize any connection, thus lacking motivation to stop.

"If  you go far back many decades ago, certainly when I was in medical school, the approach was, they have cancer, you don't want to bother them right now, it's too late, there's nothing that can be done and [smoking] is a little comfort they have. Some doctors might say, 'Well, I don't do prevention. This is not about prevention -- stopping smoking is part of the treatment and it will improve the outcomes", explained Dr. Mowat.

In The Capable Hands Of Loving Parents

"Ultimately it comes down to whether we  have the right to vaccinate or not vaccinate without being held liable ... or whether or not we have to rush our children to the doctor every time they even get just the sniffles in fear that something may just randomly happen and then we're held liable."
David Stephan, Lethbridge, Alberta

"The trial was not about vaccination. This is far beyond a child that has the sniffles."
"Mr. Stephan's post conviction actions demonstrate a complete lack of remorse. To this day he refuses to admit his actions had any impact [on the death of his toddler son]."
Justice Rodney Jerke, Lethbridge courthouse

Ezekiel Stephan. (Facebook Photo)

This was a child with bacterial meningitis who had the gross misfortune to be born to a couple whose belief in naturopathic medicine was unshakeable. The father and the child's grandfather, in fact, were involved in the manufacture of 'natural' medicaments. The little boy Ezekiel became gravely ill, and his parents treated the child with natural concoctions that they deemed were appropriate.

The little boy had been extremely ill for two weeks, but the parents had no intention of seeking conventional medical help to diagnose and to treat the child. The home remedies they used included hot peppers and horseradish root, along with supplements and smoothies. To augment their home treatment they conferred for advice with naturopaths.

When the receptionist of one of the naturopathic clinics understood how ill the child was she urged them to immediately seek medical help. That advice was ignored, even though it was the naturopath herself who had instructed the receptionist to render that advice. Instead the couple continued their shopping, to acquire a tincture of echinacea to be administered to the gravely ill little boy.

Soon afterward the little boy stopped breathing and an ambulance was called. The mother had consulted a nurse who was a neighbour, who had diagnosed the probability of meningitis and who had also urged the parents to take the child to a hospital. The parents were charged in the death, a trial was held and they were convicted of failing to provide the necessities of life to their little boy.

In the interim, between that event and the scheduled appearance in court for sentencing, these parents of three other other children have spoken publicly, given interviews and made no secret that they refuse to bear any responsibility in the death of the child. It appears that there was no argument that these were not loving parents, whose grief at the death of the child was genuinely evident.

But they remain firm in their belief that their response was appropriate. The father, David Stephan, felt they had been tried in the media, and the court of justice acted as an "incredible lying machine". Moreover, blame was placed for the child's death on the first responders whose ambulance hadn't been equipped breathing equipment for the paramedics to resuscitate the blue-tinctured infant.

The mendacious trope of vaccinations causing autism, long since scientifically and medically debunked, came in handy for David Stephan to divert attention from his and his wife Colett's neglect of their child's medical needs, and it was evident that their message hit the mark for the true believers who have given their full support to the couple throughout this sad affair.

Supporters, no fewer than 70 who appeared at the courthouse, shouting to the pair "we love you", prayed for them. When the sentence was read out the crowd cried out in anguish at the unfairness of sending this man to prison for four months, his wife to house arrest for three months. A website supporting the pair suggests that "Alberta Justice framed Zeke's parents".

Handout / THE CANADIAN PRESS      David and Collet Stephan pose with their children (left to right) Enoch, 1, Ezra, 8, and Ephraim, 3, while holding a photo of Ezekiel.

 

 

Baby-Rapture-Capture

"Almost before you're consciously aware that  you're looking at anything at all,  you cannot help but feel compelled by that baby."
"There's something privileged about the way babies get into the brain. It's like they have privileged access."
"Crying isn't seen as cute, but it uses these same mechanisms [the cries insinuate themselves into the listener's head]."
"There's something about bringing them [babies] close and smelling the fontanelle, you know, before it closes -- there's just something about that smell. If you could bottle that you'd make a lot of money."
"We've shown for instance that if you listen to a baby cry, the higher pitched it is the more you think the baby's distressed. If you're depressed, you don't seem to catch that cue. You have to be in the right frame of mind to catch these signals."
"If we can focus on how cute works and when it doesn't work, perhaps we could find ways to help mothers and fathers [who don't respond naturally] do that."
Morten Kringelbach, Oxford University, Britain

"We argued here that cuteness goes beyond an attention-grabbing evolutionary strategy that infants use to attract care and protection."
"Instead, like a Trojan horse, cuteness opens doors that might otherwise remain shut [responses of intense need to nurture and protect]."
Research study: Kindchenschema

These chemicals also play a key part in social interaction and intimacy, in particular how we bond with other humans. The bond that a mother shares with her baby needs to be strong so the mother will protect her offspring no matter what. This kind of empathy also enables us to form attachments to our pets (pictured)

New research just published out of Oxford University where researchers looked into the visceral reaction of most people when they see babies, to become enraptured by the sight of large eyes, large heads, and tiny noses, fingers and toes, as an survival endowment by nature to ensure that these helpless creatures are well looked after by their parents, kept safe from existential threats such as not being seen as dinners for ravenous beasts, being fed  appropriately so they thrive and grow and mature, identifies the "cute" reaction as part of cause-and-effect.

"Cute", as defined by the appearance of immature human beings in the drooling, crawling, screaming stages of life represents, according to the researchers, a complex, multi-sensory attack that evolution has designed to ensure that adults respond appropriately to the survival needs of helpless babies. In his research, Dr. Kringelbach found that test subjects shown images of babies experienced identifiable activity spikes in brain regions associated with emotion and pleasure; just as soon as the eyes spied the babies.



When the experiment was repeated using images of children suffering from minor facial deformities like a cleft lip, reactions were not as swiftly noted as exuberantly positive. Leading him to ponder whether a clearer understanding of the cognitive processes behind the phenomenon of "cute" might assist parents who fail the default test of instinctive love-at-first-sight.  The newly published review using all the latest literature on the cute phenomenon argues for the trait's universality and psychic depth.

Preliminary research suggests that the olfactory sense plays a role in the cuteness response. While touch, difficult to adequately assess particularly with the use of a brain scanner, seems a no-brainer for inclusion since there is nothing quite that matches the warm, cuddly packages babies represent, in silky-soft skin to soften the heart of a stone. So that sight, smell and touch appear to work together, entering the brain speedily to trigger the brain process facilitating parental bonding.

Early research points to the cuteness phenomenon bypassing parents suffering from what is known as postnatal depression. But the cuteness factor can, according to Dr. Kringelbach, help build empathy even at times of inattentive despair.

Humans, additionally, react far more positively to the needs of a child who is a stranger to them than they do to an adult. So the cuteness factor goes beyond capturing the affection and dedication of parents only; it extends as an evolutionary strategy for species survival to all of human society.

Conflicting Spousal Emotions Create Environment for Future Health Outcomes

"Our findings reveal a new level of precision in how emotions are linked to health, and how our behaviours over time can predict the development of negative health outcomes."
"Our findings suggest particular emotions expressed in a relationship predict vulnerability to particular health problems, and those emotions are anger and stonewalling."
"For years, we've known that negative emotions are associated with negative health outcomes, but this study dug deeper to find that specific emotions are linked to specific health problems."
"This is one of the many ways that our emotions provide a window for glimpsing important qualities of our future lives."
Robert Levenson, psychologist, University of California-Berkeley

"We looked at marital-conflict conversations that lasted just fifteen minutes and could predict the development of health problems over twenty years for husbands based on the emotional behaviour that they showed during these fifteen minutes."
"Conflict happens in every marriage, but people deal with it in different ways. Some of us explode with anger; some of us shut down. Our study shows that these different emotional behaviours can predict the development of different health problems in the long run."
Claudia Haase, assistant professor of human development and social policy, Northwestern University 

Getty images/Stock photo

A new study published in the journal Emotion was based on twenty years of data                    gleaned from tracking a cohort of 156 middle-aged and older heterosexual couples living in the San Francisco Bay Area, followed since 1989. At the present time, the surviving spouses of those who participated in the study have advanced in age, to their 60s, 70s, 80s, and 90s. Every five years the couples were routinely videotaped in a laboratory setting while they spoke of events transpiring in their lives.

They spoke of disagreements as well as enjoyment in their lives together. With this recorded data, experts in the field of behaviour, accustomed to coding what they interpreted, rated the interactions they saw, placing them into a range of emotions and behaviours, taking cues from facial expressions, body language and tone of voice. The spouses' end of the research included their responses to questionnaires that included an assessment in detail of specific health problems they encountered along the way.

The latest study of the participants and the acquired and accumulated data had researchers focusing on the consequences to health of anger as well as "stonewalling"; an emotion-suppressing behaviour commonly used by some participants. Sadness and fear were also studied as possible predictors of health outcomes, but no significant associations were recognized. Researchers monitored videotaped conversations for indicators to behaviour such as tightly pressed lips, knitted brows, raised or lowered voices and tightened jaws.

Anger is linked to heart problems and stoicism to muscle stress in study of couples. (iStockphoto)

"Away" behaviour, represented by facial stiffness, rigid neck muscles and little-to-no eye contact exemplified the stonewalling technique. The data collected was examined for their link to health symptoms which had been measured on a five-year interval over the twenty-year span of the study. Spouses observed to lose their calm more readily were seen to be at greater risk of developing chest pain, high blood pressure and other manner of cardiovascular symptoms over time.

Those test subjects who stonewalled by keeping their speech to a minimum, exhibiting a stiffness in their demeanor and  avoiding eye contact were likelier to develop backaches, stiff necks or joints, and generalized muscle tension. The study is among a number that Dr. Levenson has focused on throughout his career; the relationships that develop during a marriage of long term.

The hope is that the findings of the study authors, Drs. Levenson and Haase, might lead to those with a tendency to too readily succumb to anger to consider anger management interventions. Those likelier to withdraw their emotions substantively during such marital encounters could conceivably benefit from heightened awareness, to resist the impulse to restrain their emotions.

The authors' conclusion was that overall, the link between emotions and health outcomes was more evident for the males in a marriage, yet some key correlations were also discovered in the wives. The study succeeded in steering the researchers in the direction of sucessfully anticipating which spouses would development ailments in the future based on the manner in which they reacted to disagreements.

A Bioethical Conundrum

"They'll have all the embryos transferred, so they can die in the uterus."
"[The decision to discard unused embryos can be] gut-wrenching. They [couples attempting conception through in vitro fertilization] think of those embryos as related in some way to the children that they have."
"If we have this idea that embryos are something that need respect, we should have clarity about what to do with them in a long-term way."
"It might not be in the best interest of society to keep human embryos frozen in storage forever -- and ever and ever."
Alana Cattapan, post-doctoral fellow, faculty of medicine, Dalhousie University, Nova Scotia 

"None of us like dealing with the abandoned embryo issue — it’s difficult for us, it’s not an easy decision."
"The important thing is to define, right up front, what to do if the couple no longer wants to take care of the embryos. There has to be absolute clarity with the couple from the beginning — 'if you walk away from this and nobody can reach you, here is what we are forced into doing down the road'."Dr. Matt Gysler, past president, Canadian Fertility and Andrology Society

Mauricio Lima/AFP/Getty Images   When fertility clinics end up with a build-up of unclaimed embryos, a dilemma has been ensuing: How do doctors ensure there's space for existing patients while balancing the ethics of 'disposing' of the building blocks of human life? One doctors' group's solution? Just let them thaw out.

Unused and stored embryos are not just any waste human tissue to be casually disposed of; they have risen well beyond the building blocks of human life, representing nascent human beings simply awaiting transplantation into a woman's uterus to be given the opportunity to grow into a foetus, to become a baby cherished by parents eager to welcome an infant into their hearts and their home. But in the process of producing these embryos meant for multiple transfer but for one reason or another considered to be redundant, they have been left in storage.

But is it for posterity, when the prospective parents decide for any number of reasons not to proceed with their  use? This is an issue troubling ethicists and the businesses of offering IVF (in vitro fertilization) services to a public which values the opportunity to conceive a child through methods that owe more to the laboratory and medical science than to nature's plan for conception, foetal maturation and birth.

Up to a third of patients undergoing cycles of IVF will end up in possession of excess embryos, which is to say more than can be safely transferred, leading to the recognition that more embryos are produced than are necessary for the process at hand. Two scholars out of Dalhousie University in Halifax have published their research findings with the recommendation that Canada take heed of how the United Kingdom, Denmark and New Zealand consider the legality of fertility clinics discarding embryos which no one claims after five or ten  years.

Reasonable effort should have been made in outreach in the absence of no clear written direction how to settle the existence and disposal of embryos whose use is no longer required for reproduction. They might be the possession of those who have completed fertility treatment, or abandoned their treatment, or simply stopped paying storage fees and cannot bring themselves to deciding what to do with the embryos. The opportunity to offer the embryos for transplant to another couple might be offered.

Without a clear legal mandate, clinics are placed in a position where the way forward is lacking; whether to legally be entitled to dispose of the frozen embryos which remain unclaimed, or whether to have to continue storing them on an indefinite basis. Clinics hesitate to act without precise instructions from the people who own the embryos. Sometimes they are loathe to act even when they are in possession of prior instructions on how to proceed.

Dalhousie University bioethicist Francoise Baylis and Alana Cattapan recently published their findings and recommendations in Reproduction Biomedicine & Society Online. "There is no governance of abandoned embryos at the federal, provincial and territorial levels [in Canada]" they wrote. According to Dr. Heather Shapiro, president of the Canadian Fertility and Andrology Society, precise figures are unknown. "I don't think we should assume it's an epidemic, nor should we assume it's a non-issue."

Estimates exist in the United States that 400,000 to 1.4-million embryos are in an abandoned state, but there are no reliable figures, let alone reasonable estimates for Canada, to indicate the number of abandoned embryos in existence. One 2003 study revealed 15,615 frozen embryos in Canada. Since that time, however, another ten fertility clinics have been in operation and logically a plenitude of additional embryos were created and frozen.

Clinics have been incorporating genetic testing of embryos to determine which are the healthiest to be selected for transfer; a process that eliminates large numbers of embryos frozen as 'spares' in case they're needed. And, in an effort to bring solace and closure to the issue of expendable embryo decision-making, some clinics in the United States offer to implant unused embryos into the IVF patient's uterus when there is little likelihood of it resulting in a successful pregnancy, as a method of disposal.

Normalized Canine Butchery

"Grandpa strokes my poodle on his lap and says, 'This is just the right size for a bowl of bosintang. He's joking, but whenever he says that, I snatch my dog from him."
Kim Yoo-na, 14, Wonju, South Korea

"It's the difference between heaven and hell [the life of a pet dog and one raised to be eaten in South Korea]."
"I was not ashamed of my way of making a living [raising dogs to be slaughtered for the table], but I was not proud of it either."
Gong In-young, dog-meat farmer, Wonju, South Korea

Trucks containing 130 dogs are seized on the highway between Thailand and Vietnam. Photograph: Luke Duggleby

Ten to twenty million dogs are slaughtered for their meat in China on an annual basis. A tradition that dates back to the time of Confucius. Dogs are bred, raised, kept in cages then sold to slaughterhouses in China, South Korea and other Asian nations where people consider dog meat an indispensable part of their cuisine. Mr. Gong, for example, keeps dogs locked up in steel cages, and there they are kept their entire lives; fed until they are mature enough to be taken to the slaughterhouse, their meat going to the marketplace.

That this is the tradition that keeps Mr. Gong in business supplying a market for ardent dog-meat aficionados has not kept this 55-year-old from loving and doting on an elderly Spitz on his farm, whom he has named Snow-White and who is viewed as one of his family. The dissonance in how he views the two, his beloved pet, well cared for and treasured, and the dogs that have no present and no future; his mind is shut, as a farmer and dog breeder-for-meat, to their plight.

Animal-rights groups have been attempting to reach people like Mr. Gong, to instill in them a humane reaction to the tradition of viewing dogs as table meat. Those groups estimate that 30 million dogs, most of which have been stolen or are feral, are slaughtered annually for meat throughout Asia. In South Korea the trade in dog meat is of an industrialized nature.

Over 17,000 dog farms, some raising over a thousand animals each, supply two million dogs to the marketplace for dog meat. This is a tradition held to be centuries-old, according to government data. Huskies, Rottweilers, Golden Retrievers and other breeds are held in Mr. Gong's cages complex, barking and struggling at the wires of the cages they're held in. As the dog-eating season in summer draws near, dog traders come to visit.

The value of a 36-kilogram dog is about $250. In transporting the dogs, they are crowded into cages unable to move; some suffocate before arrival at slaughterhouses where they are meant to be electrocuted. From there, wholesale meat dealers deliver the carcasses to dog-meat restaurants. Koreans name their special dog dish "bosintang", or "soup good for your body", popularized at a time when meat was in short supply.

It is a culinary history of which Koreans take great pride, including those who shun the dish, taking umbrage when foreigners criticize the practise. Yet South Korean tastes are changing as are their attitudes toward the practise of eating dog meat, particularly among the young for whom keeping pets has replaced eating dogs. The very idea of eating dog meat is grotesque and disgusting to young Koreans.

Mr. Gong's own son would never touch dog meat. Recently, he watched as the process of taking 17 of his dogs in flight to the United States under an agreement with the Humane Society International group whose campaign against dog farms in South Korea has made some inroads. Mr. Gong expressed his reaction, viewing photographs of the dogs now living abroad as pets, saying he "felt better".

Yulin, in southern China, has an annual dog-meat eating festival, where protests from animal rights activists have had no effect whatever. At dozens of restaurants across the city, vendors slaughtered dogs, cooking their meat for their avidly awaiting clients. In reaction, activists bought dogs from dealers planning to slaughter them, doing whatever little they could to ease the plight of individual dogs under the circumstances.

The New Prognosis

"We were excited to meet him, even if it was only for an [anticipated] hour. We were just relieved he made it that far [to birth] and we would get to meet him, living and breathing [before his death]."
"But he was crying and he was breathing and he was moving [after birth]. We were all just staring at him. For the first four or five hours of his life, we were all just waiting for something to happen. We looked at the nurse and we said, 'What do we do now?'"
"Because of how different his brain really is, they [medical science] have no one to compare him to. [Doctors think] he will have a rewarding life. We just have to take it step by step." 
Sierra Yoder, Sugarcreek, Ohio, U.S.A.

  Bentley Yoder before surgery. (Katherine C. Cohen/Boston Children's Hospital)

Dustin and Sierra Yoder, living in a small Ohio town, were awaiting the birth of their second child. When she was 22 weeks into her pregnancy Sierra and her husband visited their doctor for an ultrasound. What they discovered would have disconcerted and frightened anyone. They were informed by medical professionals that an abortion might be their best option. After sober thought, they determined to proceed with the pregnancy.

It had been explained to them that their baby would be born with a rare congenital disorder called encephalocele where the brain of a baby, while in the womb, migrates outside the skull. A portion of the brain sits outside the skull, covered with a membrane. The herniated sac that results may contain brain, brain membranes and brain fluid. If the sac is filled with brain tissue absent function it is surgically removed.

If, however, the sac is found to contain vital brain structures, a whole other option presents itself; the operating surgeon must then decide how best to go about fitting the brain back into the skull. In the instance of the Yoders who had named their baby Bentley, doctors warned the Yoders that their son would most likely live only a brief period once he was born. If, on the other hand, he did not die, he would have no cognitive function.

Bentley, however is now seven months old. Surgeons at Boston Children's Hospital planned a strategy that would result in his brain being placed back into his cranium. "It was a life-saving procedure. But it will not restore a normal life", cautioned Mark Proctor, neurosurgeon-in-chief at Boston Children's Hospital.

When the baby was born, what doctors had warned his parents would occur, did not. He lived despite expectations, and several days after his birth the family was informed they could take the baby home with them and from there arrange hospice care for  him. When he was fuor weeks old they took Bentley to a specialist at Nationwide Children's Hospital in Columbus, Ohio. Reviewing his MRI, a neurosurgeon there held out no hope; that Bentley's brain was too damaged to allow him to survive.

Three months later his parents took him to the Cleveland Clinic and there a surgeon informed Sierra and Dustin that while their baby gave the appearance of using his brain, the surgeon was doubtful whether it could safely be placed back into his cranium. And it was at this point shortly afterward that the family visited Boston Children's Hospital where Dr. Proctor, the neurosurgeon, and the hospital's plastic surgeon in chief, John Meara, conceived their surgical protocol.

Sierra, Dustin, Beau and Bentley Yoder. (Courtesy of Sierra Yoder)

Bentley underwent surgery at five months, to have the pouch protruding from his skull holding part of his brain that controls motor functions, problem solving and vision, incorporated back into his skull. Bentley's blonde curls that grew atop the pouch holding his brain material was shaved away. Doctors drained cerebrospinal fluid from the brain, cut into his cranium to ease the brain back into his head, using leftover bone to criss-cross the top of his head, closing the gap.

It is now almost a month since that five-hour surgery. Bentley holds up his head, he is eating, he is smiling and he is making the usual baby sounds.

Mission : Grim Necessity

"It's never an easy place to fly.But there are additional challenges for a winter flight."
"Obviously, we wouldn't undertake this mission if, on the basis of medical experts, it wasn't felt that it was necessary to bring this person out of the South Pole, to a place where they can get treatment that's not available at the pole."
"They're flying across a continent the size of the U.S. and Mexico combined." 
"Weather is a very difficult thing to keep track of. [It's] much more difficult than it would be, say, in Canada, for example, or the United States."
Peter West, spokesman, National Science Foundation

Postmedia News    An image from Kenn Borek's successful 2001 rescue flight to Antarctica's Amundsen-Scott research station, located at the South Pole.

Famously, the world learned in 1999 just how remote and inaccessible Antarctica is during its winter season, when-mid February to late October are the times when it is accessible. When in a place that is exceedingly frigid at any time, it becomes even more so in its winter months, compounded by round-the-clock darkness as well as the distance it takes from civilization to the world's most isolated place on the planet.

This was when Dr. Jerri Nielson who had signed on for a year on contract to become the Amundsen-Scott Research Station's doctor-in-residence. Only to discover that she herself became her most-in-need of emergency treatment patient when she discovered herself with advanced breast cancer. Because she couldn't, at that time be evacuated, even for an emergency like hers, she consulted over email with cancer surgeons and proceeded to take her own breast biopsy.

An emergency follow-up drop of needed medical supplies for Dr. Nielson to embark upon a treatment protocol for her cancer resulted, with South Pole colleagues aiding Dr. Nielson as required to ensure that the treatment was carried forward. The chemotherapy that she trained her colleagues to administer resulted after a second biopsy using updated materials included in the drop confirmed her cancer diagnosis.

Photo: credit Nori Jemil

Fast forward to 2016, and two Twin Otter planes flying out of Calgary's Kenn Borek Air, prepared to navigate the expected and the unexpected in hopes of rescuing a severely ill researcher in a medical evacuation. One of the planes is to remain on arrival at the Rothera British station for search and rescue, and the second is set to travel forward to the Admunsen-Scott Research Station at the South Pole.

A seasonal employee with Lockheed Martin stationed there is in dire need of hospitalization, according to the National Science Foundation. The Amundsen-Scott Station represents a research hub operated by the United States located as far inland in Antarctica as it is possible to be, and as such it is one of the most isolated places on Earth.

The journey is 16,700 kilometre in length. But this is not just any journey. June represents the midpoint of the southern hemisphere's winter season where temperatures can and do hover around -60C. This, at a time and season where the ski remains dark for months on end, and weather always a questionmark, making flights rare. But the small passenger and cargo airline that is Kenn Borek has flown rescue missions there in the past.

Chris Martin / National Science Foundation via Postmedia News     Two Calgary pilots, Sean Loutitt and Mark Cary, landed this Kenn Borek plane at the South Pole in 2001 as part of a successful evacuation mission.

It flew into Amundsen-Scott to evacuate workers requiring hospitalization in 2001 and 2003. Yet the dangers are real and when a disaster occurs help is not just around the corner. In January 2013, a flight delivering fuel to an Italian research team saw one of Kenn Borek's planes crash into an Antarctic mountain south of New Zealand; all three people aboard died.

The distance from Calgary to Amundsen-Scott requires stops in the U .S., Costa Rica, Ecuador and Chile -- accounting for those 16,700 kilometres. Upon leaving South America the planes fly south to Rothera to set up camp and from there decide when it would be most feasible to fly on for an aerial pass at Amundsen-Scott.

Good Intentions Gone Awry

"There are thousands upon thousands of dogs that come into Canada every year, and it's a completely unregulated process."
"Animals aren't supposed to make it into the country if they're sick, but we see it all the time."
"Why is a sick dog that has not been vaccinated against rabies and which can barely hold itself up ... allowed into the country?"
Scott Weese, Canada research chair, zoonotic [animal-to-human] diseases, Ontario Veterinary College

"The new reality is that translocation of animals, whether wild or domesticated, can drastically change an area's local rabies risk picture from one day to the next. Fresh approaches are needed."
Catherine Filejski, public health veterinarian, Ontario Health Ministry

"We're pushing the limits now, without any regulation, without anything, in effect, to slow this down."
"I don't know how bad it can get but I don't want to wait to find out."
Linda Rohdin, founder, Air Angels rescue group

Andrej Isakcovic/AFP/Getty Images   A photo taken on Jan. 28, 2014, shows stray dogs, among 450 that had found shelter and food in an improvised facility run by volunteers in Nis, 200 km south of Belgrade.

One of her volunteers, said Linda Rohdin, doing research on long-distance adoption, sifted through Facebook postings and by that expedient counted no fewer than 600 dogs that had been brought into the country in the space of one week. Duane Landais of Edmonton, former president of the Canadian Veterinary Medical Association adds: "There's probably tens of thousands of dogs coming into Canada every year, from areas where we don't know the disease status."

And it isn't just rabies. A whole spectrum of diseases have come into Alberta with the popular advent of foreign rescue dogs. Parasites rarely encountered in Canada, for one thing, and instances of Brucella canis, a virulent bacterium capable of infecting humans. Rescue dogs, according to Dr. Weese, have brought distemper, fatally infecting local dogs. Migrant dogs have also brought in leishmaniasis, a tropical disease capable of affecting both people and animals.

Matt Cardy/Getty Images   A stray dog is seen in January 2015 in Athens, where homeless canines are a common sight.

It's not as though there are no rules and regulations in place. The Canada Food Inspection Agency does have strict rules for the importaton of young dogs for commercial purposes. These regulations, however, are geared toward puppy mills, and rescue dogs present a whole other story, arriving with travellers who on entry to Canada claim them as their own, and presenting rabies certification which can be falsified.

The Public Health Agency of Canada's Communicable Disease Report points out another practise, that of adopting dogs from Canada's far north, from isolated First Nations communities. Dogs brought in from those venues bring with them allied problems. Puppies flown in from northern Quebec to Montreal and from Nunavut to Alberta and Saskatchewan between 2012 and 2014 appeared healthy.

They later developed rabies and the upshot was that some among them were euthanized while dozens of people were then treated for rabies.

Matt Cardy/Getty Images    Stray dogs use a pedestrian crossing on a busy street in the centre of Athens on Jan. 27, 2015.

This is a humanitarian trend, to rescue dogs from areas or geographic places where their lives are threatened, or where they have no lives to speak of. Well-meaning people become involved with the intention of doing good, hardly realizing the complications that can, and do result. A federal government journal recently documented three instances of stray puppies taken from Nunavut or northern Quebec where rabies is endemic among Arctic foxes ... leading to the situation where their new owners discovered the pups were rabid.

Dogs have been arriving in Canada from the Caribbean, Latin America, east Asia and the Middle East. Bogus rabies-vaccination certificates are used to expedite the dogs into Canada. Dr. Weese pointed out a crowd-sourcing campaign for a puppy that a Canadian tourist had happened to come across wandering about in Ecuador, "very sick". The dog was brought to Ottawa, and a veterinarian diagnosed parvovirus.

Alexander Zemlianichenko/AP   A stray dog and its puppy sit behind the railings in the middle of a highway outside Sochi, Russia, on Nov. 28, 2013. A cull was ordered on stray dogs prior to the 2014 Sochi Olympics, resulting in some dogs being rescued by Westerners.

Now, the council of all provincial chief veterinary officers is involved in preparing a statement that calls for greater regulation. Concomitantly, the Canadian Veterinary Medical Association has also determined that action should be taken and they are in the process of drafting their own position. "Trans-boundary" shipments of dogs should include mandatory registration and a quarantine period, according to both veterinarians and dog advocates.

The plight of homeless and stray dogs around the world is heart-breaking; you bet it is. It is nothing short of devastating to many people to see these creatures in need, and not to respond to help them. If people who do respond in a manner they feel will be of estimable aid to a homeless animal because of their concern wonder why it is that the animal is in that situation to begin with, it is obviously because their feelings of empathy are not universally shared.

Those living in the area where the dogs roam, learning to look after their own needs to survive if they can as feral animals, obviously feel no overall societal responsibility to involve themselves to ensure that they are cared for. What the solution is within a society that shuns such responsibility is anyone's guess. But then, as human beings we're not so great at looking after the welfare and basic human rights of other human beings either.

Rising to the Occasion of Survival

"I knew it wasn't Joey [companion dog]. He [wolf] was baring his teeth and snarling, and ready to pounce. I was just kicking myself. I never go into the bush without my gun."
"Joey has had quite a bit of experience with charging bears. Usually, they take right off. The wolf didn't back down."
"He [the wolf] started pacing and crossing my path. He started directing me, basically. He kept forcing me to go further away from the road."
"Nobody in their right mind would walk through what I walked through. [It] was starting to get closer again, getting braver again. It was a long, long night."
"It was hard to concentrate and make decisions. At one point I stopped and did some prayers around those mosquitoes and asked my ancestors to help me forget about them."
"Out of desperation I decided to walk towards a cub that had been separated from her mom. They were a fair distance apart from each other… I was hoping that the mama bear would find the wolf that was also behind me before I reached the cub."
"Usually bears are pretty quiet, but she must have been panicked or worried about her baby [bear cub]. I just hoped like hell I wouldn't come between them. But I figured I'd rather die with a bear than die with a wolf. I knew they were fighting and I had no idea who was winning and I didn't care."
Joanne Barnaby, Hay River, North West Territory, Canada

Photo provided by Joanne Barnaby     Joanne Barnaby, left, reunited with her friend Tammy Caudron after fending off a wolf.

"[When you're collecting mushrooms] you're usually squatted down. Most animals respond when you're taller than they are."
"It's not unusual for wolves to follow somebody. Most often this happens in the springtime when wolves have their pups."
"They're escalating the person away from the den site. From the wolf's view, it's not intended to be overly aggressive."
Paul Paquet, biologist, adjunct professor, University of Victoria

Two friends out for a leisure day of mushroom picking, drove about an hour from where they live in Hay River to find the perfect place to pick mushrooms. What could be more natural than to take advantage of the abundance of natural food within relatively easy access to home? Set out with a friend with like intentions, and don't forget to invite your Rottweiler-terrier mix, since he'd have a ball roaming and snuffling about in the woods.

So that's just what Joanne Barnaby and Tammy Caudron did last week, looking forward to having a good mushroom hunt, fresh air, sun and exercise. They did have all of that, and more. The women decided in late afternoon to part so they could find areas they hadn't already depleted of their mushroom treasure. Alone with her dog, Joanne eventually decided to round up what she already had and return to where the truck was parked.

And that's when she heard the unmistakable warning sound of a growl that hadn't emanated from Joey. And saw a thin wolf standing before her, looking threatening and obviously not prepared to let her pass in peace. Her mind went into overdrive, thinking 'Where the hell's my gun?" Joey responded as a faithful dog protective of his human would, attempting to fight off the wolf. When Joanne tried to walk away quietly, the wolf would have none of it. She thought the wolf was intent on separating her from her dog, then realized it was its den the wolf was intent on separating her from.

Dr. Paquet who has studied wolf ecology for 45 years said that many human-animal confrontations occur at a time when people are busy picking or harvesting natural food in a forest. It was his opinion that wolves are more prone to putting space between themselves and humans under most circumstances. It is his contention that on this occasion the woman had inadvertently wandered too close to the wolf's den, and its reaction was to protect newborn pups from the presence of humans.

The pathway toward where the truck was parked was closed off to her, and Joanne Barnaby found herself stuck between fear of attack and avoidance of directly challenging the wolf, so she and Joey kept moving away from the wolf, toward increasingly rough terrain. By this time she was too far removed from the vicinity where she had left her friend to call out and too distant into the bush for a cellphone signal. She was tired, hot and thirsty, and mosquito-maddened.

She fell on her back across a log where most of the mushrooms she had collected tumbled, dispersing. But she did locate her knife along with an empty beer can. It was a cold night, she said later, and "the mosquitoes were driving me bananas". The wolf remained nearby and she felt it could sense her exhaustion. In the small morning hours she heard something; the sound of a bear followed by a higher-pitched sound; a bear and its cub, the mother searching for the baby after a separation.

This led her to move toward the cub-sound, and she could hear the two separate bear calls becoming louder. Then she heard a crashing noise which she took to be the bear and the wolf colliding with one another, and fighting. This was the cue she was hoping for, and she and Joey ran as fast as their fear and fatigue permitted. Eventually they found themselves at a lake where the empty beer can came in handy.

After an ordeal of 12 hours' duration they reached the highway where a Parks Canada worker helped her get back home.

Green Light for Coffee

"Last year the IARC said that bacon is carcinogenic, but it became clear that when eaten in moderation it is not very risky. In the case of very hot drinks, the IARC concludes they are probably hazardous, but can't say how big the risk might be."
"This may be interesting science, but makes it difficult to construct a sensible response."
David Spiegelhalter, professor, Public Understanding of Risk, University of Cambridge, UK 

A cup of coffee served at a coffee shop in Caracas, Venezuela, February 26, 2015.

Reuters/Jorge Silva/File Photo

The International Agency for Research on Cancer (IARC) is comprised of 23 experts meant to bring their scientific expertise to officially proclaim on behalf of the World Health Organization their collective finding on whether carcinogens exist as a threat to human beings in products we take for granted. Take the morning/afternoon/evening beverage favoured the world over, hot or cold, strong or weak, dark-roasted or light, organic and/or fair-trade (or not) -- the latest finding has been to downgrade the risk of cancer derived from coffee.

Following what the WHO understands to have been an exhaustive review of the data on the part of their agency, the word is now a reversal of their earlier finding; no conclusive evidence of harm. Previously the IARC had issued the finding that drinking "very hot beverages", whose temperatures exceed 65C is a likely cause of cancer of the esophagus, one of the very most deadliest and feared of cancers. That caution remains.

Yet while this latest review saw "no conclusive evidence for a carcinogenic effect" of drinking coffee, the review did point to studies that show coffee may in fact reduce the risk of developing certain types of cancer. "(This) does not show that coffee is certainly safe ... but there is less reason for concern today than there was before", said Dana Loomis, deputy head of IARC's Monograph classification department.

But there is a caution where epidemiological studies out of China, Iran, Turkey and South America indicate that beverages such as tea, mate or coffee traditionally served so hot it can burn the tongue, may lead to esophageal cancer. Studies out of this hot-drink culture indicate that an increased risk of esophageal cancer does indeed exist; the higher temperature does pose a real risk.

But for coffee alone, no clear indication was found of risk associated with coffee drinking -- kind of. "This means simply that the data did not permit a conclusion either that it is safe or that it is dangerous", explained Dr. Loomis. Over one thousand studies in humans and animals were reviewed by the working group. The evidence was found to be "inconclusive" for 20 different cancers.

Studies showed that coffee probably does not increase the risk of breast and prostate cancer and it may on the other hand lower the risk of endometrial and liver cancers significantly. This represents a sea-change from the accepted wisdom in 1991 that coffee was a possible cause of bladder cancer. Coffee now moves from Category 2b ("possibly" carcinogenic to humans) to Group 3 ("not classifiable as to carcinogenicity").

The conclusion is that while "very hot" drinks are likely carcinogenic based on studies from countries where beverages are taken at extremely hot temperatures (around 70C; roughly ten degrees hotter than in North America and Europe), the fear of carcinogenicity in merely drinking coffee itself is groundless. Maybe.

"We say: be prudent, let hot drinks cool down", said Gregory Hartl the WHO's official spokesman in Geneva. The WHO's advice was to "not consume foods or drinks when they are at a very hot - scalding hot - temperature".

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