The Uncertainty of Stochastic Models and Human Mortality

Stochastic models help us predict events that deal with uncertainty. We can use them to do cool things like predicting the levels of noise in gene expression [1]. The randomness of genetic mutation, epigenetic factors, and other biological mechanisms that influence genetic expression isn't something that we look at as some sort of black box that we can never know. Not only is it a truly remarkable demonstration of concepts that are inherent to theoretical physics in the messy world of biology, but I loved how these types of models incorporate the epigenetic factors that we have previously deemed "unpredictable" on the gene expression scale.

There are some thing we can't really know with much certainty, though. Death is one of them. 

My grandparents are the coolest people I know. Growing up in a household with my parents and grandparents is like living in a time capsule. But the message I get from them is not as clear as you might think. Both my grandpa and my grandma are about the same age, but, if you had met both of them, you would have never guessed they shared similar life stories. When you visit my house, you can find my grandpa remains in his room as he watches TV and reads book for most of his time. But, while you're in my house, you might not expect to meet my grandma because she's always spending time with the neighbors, working on the garden, or swimming. (Yes, swimming. My grandma swims. Usually, for four hours a day.) To me, it always seemed like my grandpa accepted his poor health as a harbinger of the end of his life while my grandma wanted to punch death in the face. I always admired both of them.

My understanding of the world is not only shaped by what my parents have to offer, but what my grandparents have to, as well, and I've always had a tremendous amount of respect for the elderly. Aside from the unique experience and wisdom that comes from their long, meaningful lives, the contrast between the way my grandpa and my grandma view their roles in life raised questions about how we should address issues in the elderly care. Particularly, end-of-life issues such as predicting the risks of certain treatments for fatal disease and judging the quality of life for those patients who undergo such treatment methods were reflected in my own home. 

After reading Atul Gawande's new book, "Being Mortal.", it has become more and more apparent to my me the extent to which we need to re-evaluate the way we care for the elderly and address these end-of-life issues. (Dr. Gawande was actually one of the people who inspired me to take an interest in medical ethics.) From my own perspective of living with my grandparents, the idea of sending the elderly off to nursery homes and foster care for senior citizens has always been completely foreign and horrendous to me. Both points of view have their own benefits that we should try to embrace, and these types of living facilities have been becoming more common in most parts of the world. The markedly different cultures between my generation and the generation before have helped me realize that, as human beings, we can all view death not as something that should be avoided without regard to our own lifestyle otherwise. I hope that, in the future, I can tackle these problems in an ever-changing world to make the world safe for the elderly. (But hopefully they won't be the same problems that I will face when I approach the end of my life.)

[1] Raser JM, O'Shea EK (2004) Control of stochasticity in eukaryotic gene expression. Science 304: 1811–1814