Sunday, May 11, 2014

It Might Get Messy

Entropy. The cold, unstoppable Master Control of the physical universe. And one of the few high-level concepts of modern physics that is accessible and generally understandable. Basically, unless fed with matter and/or energy, things deteriorate. Sand castles don’t build themselves, and sand castles once built quickly revert to randomly blown grit unless they are coddled, protected, maintained, repaired, and replaced.

In more formal terms, a sand castle is a physical system. If the system is isolated from additional inputs of matter and energy for protection and maintenance, the Second Law of Thermodynamics demands that the nicely-placed grains of sand in a castle revert to the more disordered, higher-entropy condition of randomly tumbling along the beach [1]. 

Entropy is often invoked on Discovery Channel programs as the ultimate hammer of suicidal gods, an overriding property of the physical universe that dooms us to eventual thermodynamic equilibrium in unimaginable cold darkness as the energy of the “Big Bang” that birthed us dissipates over time. 

But this ominous vision of the (very) long haul requires simplifying assumptions that seem highly unlikely. The universe will only wind down to the great cold and dark of thermodynamic equilibrium if it is isolated from inputs of matter and energy that would work to maintain or even increase order. It seems to me that the Big Bang itself was an enormous input of ordering energy. And unique, one-time events don’t happen in nature, so it’s highly likely that whatever pumped us up 14 billion years ago will pump us up again as we toddle along time’s arrow. In addition, we are only able to see, feel, hear, smell and taste 4% of the total universe. The remaining 96% of the universe is “dark matter” and “dark energy” that we only know is there. We have no way to reach it to figure out what the hell it is and what the hell it is doing. Seems to me that our active 4% of things is only a side show in a much, much larger circus blaring behind a curtain we cannot peek through.

Anyway. Why, you ask, am I subjecting you to this harangue about the state of modern-day physics, when the nominal focus of this weblog is the biology and sociology of human cancer? And the answer is that the physical infrastructure of cancer treatment is subject to the universal laws of thermodynamics. If you were to have, say, a polyvinyl tube inserted through your stomach wall so you can pour in matter and energy to keep your body ordered via inputs of United Nations Emergency Liquid Food Rations, said polyvinyl tube would be expected to deteriorate with time absent ongoing cleaning, maintenance, repair and replacement.

Basically, this week my feeding tube exploded. In fact, this wasn’t the first time I’ve had to input some matter and energy to counter the corrosive properties of time and entropy. Some months ago, the “distal”, or outer, half of the tube sprouted a quite colorful garden of what I presume was yeast and/or fungus along its lumen, slowing the influx of liquid and making me suspicious about possible health effects. At the time, I sliced off the fuzzy tainted length of tube, fitted it with a little plastic plumbing coupler from Lowe’s, and added a short length of (better quality, by far) replacement tubing, also from the back shelves of my local home improvement store. So I’m down to about 12 centimeters of original surgical tube poking out of my gut wall, the other end of which is coupled to a sphere the size of a golf ball that Dr. H implanted last time I was in for surgery. (I know this because, if you will recall, in the brief period between my cancer diagnoses, Dr. H had to yank the tummy ball out through the little hole the day before I flew to Germany for the toxicology conference a couple years ago). 

And this residual hardware is itself showing signs of imminent catastrophic failure. I’ve been leaking gut fluids and liquid rations around the insertion point in my tummy. This is ominous. If the feeding tube abandons ship, I have no way to input the nutritious glop that serves as “food”, or the water so necessary for the physiological processes of life. Basically, I’d have to be admitted to hospital so I could be hooked up for intravenous inputs of the necessities of life. 

I surmise that the designers of the feeding tube hardware didn’t contemplate the need for long-term functionality. Certainly the material  itself isn’t sturdy enough to last for years. And I hope to be around for quite a number of years, now that my cancers have been wrangled into submission. 

I presume that repairing/replacing the failing feeding tube hardware will require full-on, lights out surgery. It was painful enough when Dr. H yanked out the original internal components while I was on my way to Germany. I don’t see any obvious means for pushing and pulling replacement parts into place, certainly the yank-out-the-old-gut-globe through the tiny aquarium tubing hole in my stomach muscles doesn’t have any obvious way to reverse the process to insert new infrastructure.

I see Dr. H on Wednesday this week. I’m actually looking forward to the visit. I anticipate a discussion worthy of a Monty Python sketch as he decides how the hell he’s going to construct a long-haul version of the stopgap structure presently in place. Cancer does indeed have substantial humor value along with its more obvious dark properties. Check back here next week after my visit with Dr. H. I’ll be sure to keep you fully informed, particularly with whatever slapstick outcomes might arise.

Live ‘em while you got ‘em, my friends. I love you all. 

Notes

[1] a nicely hyper-linked presentation of the concepts of entropy, in easy-to-follow format, is at http://hyperphysics.phy-astr.gsu.edu/hbase/thermo/seclaw.html#c4

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