A philosophy of biotechnology II

A final lecture delivered to the students of ENGR 100, December 10, 2018

I passed a frozen pond in a graveyard today, which I think is a fitting metaphor for our energies here at the end of the semester. After time and effort, persistence and follow-through, we have arrived, as we must, at the end. How we face such an end is indicative of our character. It has been said that one prepares their whole life for their final act. Our purpose here is not so grand nor so terminal. It is the closing of a single point in time and space where we all learned similar things. For now, we must scatter. I for one hope the winds of happenstance and circumstance bring us back together. At least in parts. At least so that we might see what we have made of this thing call “life” we spent so much time studying.

Last year, I won an award for how I taught this class. Not to toot my own horn, but I’m proud of that. I earned that. (I hope.) What I was awarded was a prize for “innovative teaching”. My innovation, such as it is, was in humanizing engineering. I contend that when a human face is put to a problem, people tend to see it more clearly. When somebody falls out of a rollercoaster, we feel the need for safety; when we see a child smile at their mother’s voice after being fitted for a hearing aid, we sense the power of engineering. We forget to our pedagogical peril that we are creating human engineers to solve human problems.

In the class this year, as the last, rather than attempting to show scientists and engineers who have come before us as giants upon whose shoulders we must first climb and then peer beyond (an approach typical of those wishing to infuse something of the humanities into the STEMs), we instead saw our subjects accurately as human, all too human, capable of penetrating insight and superficial grudges, brave and foolish, loved and loving human beings. Moreover, we began to see the patients we would come to serve not as mere numbers and symptoms and statistics, but rather as husbands and wives, mothers and fathers, brothers, sisters, neighbors, co-workers. We saw them for who they were: people. Just people.

Knowing who and what these people are is important to solving their problems. But before one knows others, it helps to know oneself. It is why, in most ways that I could, I tried to put you in the center of the class’s story. We’ve tried to get at what you think about a given topic, how you interpret a certain result, how you respond to a colleague with whom you agree or disagree. I’ve tried to get you talking out loud and to each other on a few occasions to greater and lesser successes. All the while, though, you have had the opportunity to engage your peers and see who you are in relation to them and the field towards which you are all heading.

However, you will, at times, find yourself alone. In those quiet moments, the time will be filled, generally at your discretion. Of a typical moment, what do you make? Do you, think of something profound, petty, perplexing? Do you hum a song? Stare out to the distance, check your phone? Talk out loud? Recall that soul-crushing defeat to Ohio this year?

At such times, you are perhaps your truest “self”, if but for the simple and clear demarcation between you and everything else. You are who you are when you are alone because you can’t be anything else.

We haven’t yet the technology to really know what anyone is thinking to any great degree. Though representations in popular media make it sound like we can read minds (right down to whether or not someone is lying), the fact of the matter is that social interactions arising from individual psychological states situated in neurobiological stuff subject to neuroscientific laws that we are only just now beginning to quote, “understand”. Our field is yet young, our technology primitive.

Let us say we gained something like paradigm shifting insight at the Hodgkin-Huxley model, 1955, 63 years ago. Let’s also take the low-end estimates of how long biological human beings have been around and say it’s been 100,000 years as Homo sapiens sapiens. That’s 0.063% of our time as human beings that we have understood. That’s equivalent to getting to about the word “frozen” in this speech and thinking you have some sense of what’s to come. You might. But it can difficult. And your conclusions must necessarily be hedged.

As such, who you are and what you are studying are developing. That’s okay. Today is not about who we be, but rather who we become.

You will at times find yourself alone as the person in a room capable of and responsible for making a decision. For the most part, most of us haven’t yet been in such a situation. We have been among peers or instructed by learned mentors for most of the time on earth we can at this point call to mind and may have never made a fateful decision until now. Who you are and who you choose to grow into during your time here in Michigan is of direct relevance to both you and me. You, for obvious reasons. Me, for my investment in the future of biomedical engineering.

And when you are at last in such a situation, when you are by yourself at that time when you must make a call that’s worth a damn, I hope to have through the course of this class impressed upon you the relevance of certain virtues: open communication, an honest search for the truth, a willingness to be wrong, a quick wit coupled with careful consideration, creativity bonded to competence, confidence in the things we know and caution in the things we don’t. If I can augment these virtues  with some unsolicited advice: Be smart, be humble, be quick. Jump over every candlestick they put in your way. Don’t get burned. Don’t get burned out. Relax every once in awhile. Work harder than you think you should. Understand failure: its causes, its effects, its hold on you. Try not to focus too much on the individual moment, see yourself across time.

Be present, no doubt,
but look beyond the here and now
to the where and when
you’ll be able to say you were there and then
who you wanted to be
and accomplished what you set your mind to.

There are few thrills greater than achieving. As they say, there is no substitute for winning. Though said mainly of war, here in peace we can still take its thesis to heart: success is the doing of something well and here in this class a whole cast of characters have helped us learn this material well. And as we began this class, who was involved was particularly emphasized. These were each of the human beings who helped us learn something about biotechnology during out time in this course.

We, your instructors, are Barry Belmont, R. S., C. C., and T. B.

And we peered out onto at least fifty-three variations of that question.

Even employing some statistics along the way to take another look at the data.

(And actually showing you how much this class costs, so that you might scale it against this class’s value to you.)

There were the nameless hundreds and thousands of people that make up the largest biotechnology companies,–

The tens of thousands of legal experts that aid them,–

The million or so peers and colleagues associated with this field,–

And a group of people that sits around and talks about it all.

We each were participants in an intellectual property sharing arrangement, which I hope convey to you the seriousness with which you ought to take the class.

We saw Henrietta Lacks’ tumor cell line (“HeLa”) a time or two.

When we thought, every so ought we drift into a sonder: “the realization that each random passerby is living a life as vivid and complex as your own”.

We saw over one thousand victims of mass and complex death.

We met the latest victim identified–

–and saw what was really important.

We surveyed what was important to us in the field–

–before surveying these two anonymous human subjects. Though they intended to help the art world, they have influenced our world.

We had a baker’s dozen of clinicians helping us to face the current issues in their current practice, including Dr. B., Dr. T., Dr. H., Dr. G., Dr. C.. Dr. B.. Dr. S., Dr. B., Dr. G., Dr. S., Dr. V., Dr. C., and Dr. L.

A random person donated their kidneys so that we might learn of polycystic kidney disease, a single gene disorder.

Another person agreed to have their picture taken so that we might see how Marfan Syndrome manifests as an autosomal dominant disorder.

At least two people donated their brains for plastination so that we might see what Huntington’s Chorea, a consequence of too many repeating sequences in a particular neural protein.

Though this might stretch some of our definitions of person, here we see the approximate beginning of every human being, even if these specific specimens never came to be “one of us.”

I thank the person who donated their blood so that we might see sickle cells.

I’m sorry that the person who donated their lungs to the Children’s Hospital of Pittsburgh ever had to experience cystic fibrosis. May their donation help us help others.

Moreover, I am sorry for the families burdened with Tay-Sachs. If there is any silver lining to be gleaned from those MRIs is that blood really is thicker than water.

I thank this child for their phenotypic representation.

I mourn this student we lost too soon.

Samuel Beckett proved the worth of resuming the struggle.

Theodore Roosevelt challenged us to dare greatly.

Ayaan Hirsi Ali kept us mindful of intellectual traps to avoid.

We met simple scientists in their labs.

We got a general overview of the organizational structure of our healthcare system and how each role is filled by individual players: insurers giving funds to allocators who dispense them to purchasers buying up healthcare from providers providing it to consumers. Clear as crystal.

We also met Christian’s dog.

We recognized the fundamental right of all people to a stake in their own person/body.

We met Lakhdar Boumediene and saw how the recognition of fundamental bodily rights can have profound ramifications.

We met Justices of our current Supreme Court.

We put ourselves in the place of John Moore who’s cells were taken from him for fun and profit of which he received neither. But he did get a substantial Supreme Court case bearing his name, so that’s something most of us will never get.

We heard from Brittany Maynard as she gave her reasons for approaching her end as she did.

We met widows who touched the reanimated face of her deceased husband.

We met a little boy whose skin was grown in a lab.

We met Theseus and his ship via Plutarch.

And we saw just how wicked the Wicked Witch could be.

We got to know one another a time or two.

We got to know a brother or two at odds.

We got to know a research organization or two at odds.

We got to see their generally underspoken-of students and collaborators.

Because we should recall that it was thought to be the Senate and people of Rome that made the empire great.

Whether the empire will be the greater for having gone through its legal battles, remains to be seen.

However, there will always be a half that doesn’t get told.

Just as this photo was not given enough credit in the discover of DNA–

–nor Rosalind Franklin for her pioneering scientific output–

–we might also fail to give enough credit to the PhD student who took the picture.

Or to all others who have come before us and do something significant.

But it helps to keep things in perspective.

In the scheme of things, we are but the temporary inhabitants of “a mote of dust suspended in a sunbeam.”

We are born.

We grow, as Kaiba Giofriddo is able to do with the aid of advanced medical technology.

Technology you were exposed to here.

I tried to expose you to a lot here, like a fellow like David Foster Wallace. While strictly speaking, casting such a character in a class such as our is not necessary–

–I think he captures something true and uniquely prescient about the world around us, about this “water.”

I think x-rays can quite easily pass through that water and produce images such as the one provided by this volunteer.

And this volunteer.

I think there’s something romantic in Wilhelm Röntgen testing his medical imaging on his wife’s hand. Then again, how did he really know it was going to work…?

We could have tried to look inside his head, as we did with this volunteer–

–but we might be accused of playing god in such a scenario.

Of course, we could have vision that he was pure of heart–

–Or we could take it on faith.

Sometimes it’s best to just wait things out.

But then again, we have not always had the same liberties as one another.

The man on one side of this picture has a power over the man on the other side stemming only from inequalities in health. What are we to make of that?

Nearly 400 men, black men, with syphilis were untreated for 40 years. What are we to make of that?

A story in the New York Times is largely cited as the reason it came to an end. Had Jean Heller not written it when they did, when do you think the study would have stopped? What are we to make of that?

In this class we saw a president apologize–

–and eight man gracefully accept.

We learned how to categorize one another in the event of any number of disease models–

–thanks in part to Kermack and McKendrick.

In this class we asked ourselves questions–

–more difficult questions–

–and really tough questions.

We considered the phenomenon of “mansplaining”–

–and the identity of a “woman engineer”.

We took a look at field’s long-term gender gap–

–and asked what biomedical engineering might be doing different.

We met a man, Ryan Karnoski, who is petitioning what he believes to be the injustice of the military’s recent policies regarding transgender individuals.

Such policies arise from the Defense Department of James Mattis and state that a transgender individual can serve in the military so long as they have no history of gender dysphoria. This portion of history remains to be decided outside the bounds of this class.

We gazed at the traumatized people and bodies of war.

We looked our own fragile mortality in the eye (especially those younger among us).

We met a military officer with no legs.

We met a model with no legs.

We met an actor playing a character missing an arm (seriously, go watch Mad Max: Fury Road).

We met a random man missing a random arm.

We met a monkey that could control a robotic arm with their thoughts.

We met a science fiction author–

–considered his eight very good rules for writing–

–and modified them to be a pretty good approximation of a good engineering process.

I emphasized then as now that “everybody wants something” and that much of the skill of an engineer lies in correctly identifying that want.

We met Susannah Engdahl–

–and considered some of her work.

We heard the wise, paranoid words of a wise, paranoid man in Thomas Pynchon.

We met a man who felt $5 was to great an insult to his personal liberty and took the matter up with the highest court in the nation.

We met a woman who history shall vindicate–

–and heard of her judgment by nine men that she and her lot were not welcome in these United States. A blot still on the register.

We met a chicken thief who overturned state law.

We found a bearing for our privacy–

–even if it came by the roundabout dissatisfaction of Justice Harlon, I feel his delineation that “a freedom from all substantial arbitrary impositions and purposeless restraints” is as true a formulation of the kind of liberty I wish to see grown by our profession as I’ve ever heard.

Indeed, privacy is that veil we may choose to draw at will, “for as noble a purpose as any”.

We, in a rather indirect way met the people of pre-2000s Georgia in which the outlawing of sodomy was a constitutionally protected imposition.

Though we also thankfully indirectly learned of a certain “Lawrence” who made gay a-okay in the U. S. of A, today, tomorrow, and probably the next day too.

We learned of Nancy Cruzan.

We learned of her parents.

We learned of her healthcare providers.

We learned of an accident in January 11, 1983 that changed the course of medicine in America.

We learned of John Arthur, a man who suffered and died of amyotrophic lateral sclerosis.

We learned of his husband James Obergefell, who wished to be listed as the surviving spouse on John Arthur’s death certificate and as a result helped make gay marriage legal in America–

–a country, I contend, in which the non-denial of liberty is our highest aspiration.

While we might debate amongst ourselves whether more individual or communal means are preferred–

–in the spending of our tax dollars–

–here in this room we must face the current and future problems of healthcare.

Because, by and large, we Americans aren’t doing it so well right now–

–and we really should.

Hence, this philosophy–

–which, if we are to boil it down is essentially that you and other people really matter in the operations of this world. It is my hope that the instructors of this class have prepared you to take the reins of such operations if and when the time comes for you to do so.

Crucial to our pedagogical design on these matters have been the contributions of each and every one of you. As such, if you’ll allow me a few moments, I’d like to take the opportunity to share a thought about each and every one of you and your effects on this class. I have listed you in order of your registration initially into one of my classes. We begin where I last left off.

211. S. P. There’s something every instructor appreciates about the first person who signs up for a course. It’s the first time it’s really “real” and it’s the first time there’s a “class” of which to speak. And from your performance in this course, I feel comfortable ranking as a kind of “first”. April 11, 2018, two-forty-three days ago, you started this class. I hope you learned something in the interim.

212. A. R. Much of the way I teach – a way I think can be pretty gosh darn effective – relies on at least one person popping up a hand and adding something to what I’ve just said. You have on more than one occasion served such a role. You have done more in this class, but you have also done that. And for that, I thank you.

213. J. F. K.. There’s an unspoken appreciation of “front row students” and their instructors. You have, for most of the semester at least, always chosen to sit somewhere near the front. In most thing in life, front row seats are what you want. I contend the same is true of a good class. I hope you have gotten something worthwhile out of this class’s front row.

214. P. B. S. You’ve provided great answers in concise ways and seem like a pretty upstanding fellow. Keep doing what’s working for you in life.

215. A. J. W. Your recent delineation modern healthcare systems was likely among the best “unscripted” explanations of such a topic as I’ve ever heard. Keep learning to teach the rest of us something.

216. E. L. C. When posed with a problem consider, “what does a just and equitable distribution of health look like?” you responded with concisely by twisting the twin threads of the Fourteenth Amendment (due process, equal protection) into one tidy statement: “No matter your socioeconomic class, you get the healthcare that you need.” If we find something within ourselves resonating with such a statement, it is because you have likely tapped into something real.

217. W. P. Not too long ago you went on something of a tear in regards to our discussion on parental chosen puberty suppression for pre-adolescent gender dysphoria, demonstrating the misused stats of our colleagues, making us recall all the times we disagreed with our parents, and looking sensibly at some of the necessary realities of the procedure. It demonstrated competent synthesis and analysis, pretty much the highest form of the stuff we aspire to (well, along with design). And if you’re already near such heights this early, I look forward to how much more you can do.

218. H. H. K. I am glad that you were able to get your purple folder back after having left it behind. I hope that we can say that it is still with us. May you and your purple folder be with for many days, years, eons to come.

219. L. A. L.. Often a better measure of “learning” is not comparison against some objective standard, but how well one improves upon one’s self. As I consider your section from your group’s as one of the most noticeably improved (in subtle, but substantive ways), I am led to believe that this class has honed some subset of your skills. May you continue honing on your own(ing).

220. M. D. A many of many words here and elsewhere, you contribute substantial to every conversation of which you are a part. May your discussions be ever more interesting.

221. R. K. You’re a bellwether of sorts for me in this class. You sit up front, you pay attention, you keep up with the class, and I know that I’ve truly made a rather confusing blunder when I get you to furrow your brow. Thankfully, I can report that such furrowings were few and far between. Still, I thank you for your consistent (and nonverbal( participation in this class.

222. S. G. C. D.. Though you did not say much aloud in class, in your homework assignments your thoughts really came across. I share one here with the class, slightly shortened for brevity: “People are characterized by their thoughts, actions, and impact on people. […] These may not be the factors that can pick an individual out of a crowd, but they are the factors that can unambiguously distinguish one random person from someone you know.” Having heard your thoughts, seen your actions, and felt your impact, I feel I have gotten some sense of distinguishing you from one random person. And that’s a pretty good view of character.

223. M. E. L. Though this may seem small, your group was among a shockingly small subset of those in this class to correctly perform a cost-benefit analysis. Though this may seem small, knowing how to properly count up your costs and your benefits can be very useful. Though this may seem small, you know it. And for that, I am glad.

224. S. C. I think yours was among the first names I learned in this class. Though I am sad to say I cannot recall when/how I first learned it – the true pinpointing of details are lost to history – I am glad to count it among those I have learned. You, the man, make the name worth knowing.

225. E. D. If one is best gotten known sitting on the floors in the halls of HH DOW on Monday and Wednesday afternoons, then I can say I’ve gotten to know you pretty well. As I suspect there are better ways of doing that, I unfortunately haven’t gotten to know you well enough. My loss whose only rectification can be found in your continued education in this fine institution. Hope to see you in the future.

226. E. S. One of the things we as instructors look for when assessing how well you all are learning (i.e., how well we are doing our jobs) is to look for references to in-class learning. Thus, you can understand, why in your third homework my heart might be warmed in reading “In class, one comment in particular stuck out.” I imagine such a phrase is true of many here and I am glad you have given voice to it. May you give voice to many more truths.

227. S. A. B. Perhaps it’s just my bias, but your explanations of adenocarcinoma for your first and second oral presentations are essentially my go to reference on the matter now. You clearly and concisely can compact complicated physiology into a neat and tidy summary of well narrated images. As this is essentially my profession up here, I appreciate those capable in the craft. May you learn and explain much more.

228. M. M. B. On the subject of EpiPens you noted that the current price is quote “just ridiculous.” Indeed, that might be all that it is. It is not fair or just or based in market forces or any other sensible reason. Sometimes the problems that face us are just ridiculous. I am glad to see you are able to identify them as such. Now, please get good at solving them. We could really use your help.

229. A. L. H. You have contributed substantially to our in-class discussions, often playing the backfield with Anish. This class would be nothing without people talking about what they know. I thank you for sharing all you have.

230. C. N. K. I’ve got you initially as saying “I believe that modifying an organisms immune system is []morally wrong and could lead to major issues in the future.” Presumably this is before you learned of CRISPR/Cas9 in the detail to which we looked at the topic here. Whether your opinion has changed or stayed the same, I hope at the very least it has been improved by your time as part of this class.

231. V. O. When invoking that most cherished of American phrases “life, liberty, and the pursuit of happiness” to explain your support for a “right to healthcare” you pithily put the situation thus: “Your health is kind of necessary to all of those things.” Truer words never spoken.

232. G. R. D. A. Alphabetically first among your peers, intellectually capable of laying claim to much the same. You were the among the first to correct the record on follicle stimulating hormones in men and had the last say in your team’s presentation. Know that if you find yourself at the front of any line, whether it’s through chance or effort, you probably got there for a reason. May you continue to cultivate yours.

233. B. M. C. Upon consideration of one of my “four problems to consider” “Are people owed a right to healthcare?” you said something of accidentally poetic: “We said yes to some degree. We said yes to life and death.” Indeed, those two things will be affirmed by every member of this class at some point in time. Somewhere in the between let us, as you say, “say yes to some degree.”

234. J. C. H. It can be a tricky business balancing the amount of detail you need to explain something to any given audience. It can be especially tricky when trying to explain a technique you may have just learned to people who may be semi-experiments. In your description of ELISA and your intended biomarkers for idiopathic pulmonary fibrosis, you struck this balance well. May you continue to explain even the trickiest of businesses.

235. R. L. Though by hobby and semi-by-profession I love to tease out each of the threads involved in complex bioethical situations. However, I appreciate when someone like you comes along and approaches dilemmas in a more “Alexander the Great” style. When shown a Gordion knot of genetic editing, you draw your sword of swift reason and say this passes muster, this doesn’t, where’s the argument. Clear demarcations make for great discussions. Thank you for making ours ever greater.

236. T. P. I have appreciated your contributions to this class, the bioethics discussions, and my own IT needs. My fan is still making noise and will unfortunately will have to be repaired over the winter break. If only I had heeded your counsel earlier. May we all learn from that.

237. Z. M. By my observation and by your intimation you seem to have gotten something out of the human side of this whole class, coming alive more to human machinations than to cellular mechanics. May you keep your humanity about you as you continue on in your academic career.

238. M. A. R. In your first oral presentation you gave an overview of your team’s proposed diagnostic method and placed special emphasis on the economic considerations as you were targeting use in the third world. Your presentation was clear and your thought logical. May you keep keepings things clear and logical.

239. R. L. S. You have at times shown us the lassez-faire, let’s-try-and-see-if-it-works approach so crucial to much of the most important work that ever gets done. May you temper that with reason and judgment.

240. S. C. Your recent presentation on measuring arterial blood oxygen concentration via a Clark electrode was among the best presentations of emergency medicine clinical instrumentation I’ve ever sat through. And I’ve sat through more than my fair share. May you continue to impress every audience you’re before.

241. C. E. K. Not to make a big deal of it, but you sat approximately front and approximately center for most of this class and people don’t generally do that if they’re not interested in what’s in front and center of them. It’s an unspoken compliment to those in my profession. But allow me here a spoken bit of gratitude for it: thanks for showing up and paying attention to what I was trying to do up here.

242. C. A. M. I have you on record as saying, “It is clear that with the absence of many laws now restricting the use of [biological] information, doctors would misuse and mistreat patients”. Indeed, it is clear. What is not is what the future brings. I hope you are able to main such clearheadedness whatever comes your way.

243. J. S. I can’t say as though I know enough about you to speak of you to any great degree. And that’s a shame. I know that everyone who walks through these doors after walking around those halls is someone worth getting to know. Happenstance brought us together, circumstance kept us apart. May we know more of each other.

244. W. W. C. As J., R., and/or R. can likely attest, living up to the “family name” can be tough and having earned mad respect for your brother in the early morning research clinics, you had, in a sense, a lot to live up to. But of just about every assessment of you I have, you have done well. Good on you.

245. P. F. You introduced precise, yet highly nuanced opinions to the roundtable ethics discussion we had earlier in the year. It was the first time I got to hear your excellent opinions. May it not be the last.

246. L. P. You might be surprised how far a solid understanding of sepsis can get you in this world. As it is among the leading things causing emergent medicine and as emergency medicine accounts for about 300 billion dollars in the United States these days, knowing something about its fundamental operation opens a few important doors (especially in the healthcare industry). From your final oral report, you’ve got such an understanding down to about a two-minute pitch. That’s something valuable as is. May you contain to grow its worth.

247. D. N. W. The only one to come to our day-before-Thanksgiving class session. If but for that you will have left an indelible impression on me and the other co-instructors. But may you treat that session as a further lesson: sometimes it pays to show up.

248. J. A. N. Sometimes someone clearly delineates something so sensible you wonder why you never heard it that way before. I quote: “there should be limits on how [biological] material can be obtained and [] who can obtain it. After all, you want to be sure that this biological information isn’t only obtained ethically, but is being used for ethical research and not abused [or] lead[] to [] regression or harm to society.” Preach, brother, preach.

249. A. B. You may not recall, but you were the first person, aside from we instructors, to introduce yourself to the class, describing yourself as “from Pittsburgh” and having recently gone skydiving. You’ve come far and fell just that bit faster to get to our class. Front row. And that speaks to a certain kind of character I like to see in a person. May the world see more of it.

250. S. S. 702 represent. I’m glad to have a fellow Nevadan in the room and your sheer domination of most assignments I’ve given you shows that the leaders and best are to be found just about anywhere, even the Clark County School District.

251. M. N. P. Your team’s approach to sequencing the epigenome of sepsis is both inspired and in line with current thinking in the field. As you were the one who presented how your team’s test would work in both presentations, I assume you probably had something to do with it. May you continue to be inspired by and in line with your preferred field of interest.

252. M. A. B. I’ve seen you with a tiny skateboard, heard you explain how to separate chromosome seven from the others, asked your opinion on more than one topic in this class. You’ve proven multifaceted and that’s one of those attributes that makes diamonds shine. Keep shining, opining, explaining, and shredding on your tiny skateboard.

253. M. E. D. B. While you had a last minute question on the subject, your explanation of CAPP seq was as competent as I’ve ever seen. I hope you take some solace in knowing that you know it now better than most people than have ever lived. A minor expert, but still an achievement.

254. B. M. K. You have often demonstrated clear and exact thinking in this class, something I feel is valuable to our profession. To reference but one, I think your team’s flowchart on the administration of your hybrid procalcitonin and brain natriuretic peptide test to determine heart and respiratory failure in dyspneic patients, was just the bee’s knees. Real cat’s pajama’s stuff. It was how these things ought to be done. And since you presented it I figured you had something to do with it. If you did, congrats on the great work. If you didn’t, congrats on getting associated with great work.

255. B. B. A. S. You are one of those unfortunate first-year engineers caught in a class whose primary focus is not your intended concentration. Sorry about that. Them’s, we’re told, the breaks. Still, I hope you have gotten something out of this class, I know we have gotten something from you having been part of it. And that’s something.

256. Z. S. True North’s introductions to its novel combined-method liquid biopsy diagnostic test for prostate cancer were clear and generally to the point. As the presenter of said introductions, I suspect you had something to do with it. May you not stop at introductions in the future.

257. D. H. I’ve never heard you say a statement that didn’t sound as if you had reasoned through it in your head prior to its saying. That is, you seem like a man of chosen words, a distinction between those of many and of few. What I have heard from you, I suspect you wanted me to. That’s a discipline I respect. May you continue to choose your words wisely.

258. V. R. V. I am sorry to hear of the misfortunes which have befell you. It was Nietzsche who first gave rise to the (now cliched) notion that what doesn’t kill you, makes you stronger. Of course, he died an invalid under his sister’s care after breaking down at the sight of a horse beating, still he’s had a wise word or two on the subject. I hope that whatever it is you faced this semester – this class included – that having gone through it, you are the stronger, the better, for it.

259. P. S. R. Not that I have much to compare it to, but your explanation of colormetric measuring of HBA1C concentration via fructosyl peptide oxidase and antibody binding was among the clearest that I have heard. Being able to distill complexity is a skill worth having, regardless of the field. If biomedical engineering is to retain your services, we’d be the luckier for it.

260. F. L. M. C. Coming all the way from the other side of the country, I hope I speak for the class when I say we have genuinely enjoyed your input on a great deal of topics. I hope I have added to your Supreme Court case repertoire and helped humanize some parts of some subjects for you.

261. Y. L. We started this semester with you hardly able to say the word “adrenoleukodystrophy” and we ended with you giving a competent introduction on the subject and your team’s proposed design in relation there to. I mark that as progress of a sort. I hope you do too.

262. M. O. A. A late great addition to our class, adding generally well asked questions on a cornucopia of topics. The only thing better than a fount of knowledge is a fount of curiosity. May that curiosity continue to flow from you.

263. N. D. A. I have to say, I don’t know if I could pick you out of this crowd. And that’s sad way to go out on the class, but sometimes students and professors don’t get to know one another (especially if one’s on-boarding is during that semi-chaotic time at the beginning of the semester). All the same, I hope you feel that in this class there was at least one, I count them, two, three, four instructors that truly and genuinely want to see you succeed in every way in which you are capable and that is true even if we can’t “pick you out of a crowd.” In this crowd, it’s okay not to stand out. This is the University of Michigan, we do things well as a team here. And you were part of that team. And that is something.

And that was us. That was it. That was the class. We have made of it what we could.

I get that for some of you right now, even perhaps in this very moment, the stress welling up, the pressures all about, the strain felt in every limb, due in part to this class or this institutional learning facility can be exhausting. Furthermore, I recognize that in what it is I’m doing up here – getting fifty-three or so folks to learn a set of materials and a set of mind associated with contemporary biomedical engineering (especially of the biotechnological variety) – I may not always be able to see or sense or appreciate those sorts of stresses, pressures, and strains. While, in an ever more intellectual capacity, I can understand what it is you’re going through – I went to college, I worked hard, did a bunch of stuff, burned the candle and a few ends – the fact of the matter is I’m starting to approach the more comfortable side of life. I’ve got a steady job, at which I think I’m pretty good at my best and pretty okay at my worst, I’ve got good family, interesting friends, loves, passions, drives, and a general sense that what I’m doing with my life matters in a way that I myself am satisfied with. You, from where you sit right now, might not even be able to see such a promised land, let alone hope to play in its fields. Some of us might be right where we want/expect/hope to be in sitting in this very classroom. Some of us might have wished to be anywhere else than here in this room with us. Even now, some of us are tempted to scratch that itch.

Ask any doctor, if you’re just looking to start off small talk with someone in the healthcare field, about whether or not one should scratch itches. As with much in life, there is nuance. A little, sure, not too much, everything comes with an optimum. At least for an engineer.

And but so some of you may not have been fully here, with us, trying to get this, because you may have had x, y, z more important things going on in your life right now than understand what some teensy molecules are doing while they twirl about at electron microscope resolution. And though in my ideal world, you would all have the time, space, and resources necessary to understand every single thing there is to know about biotechnology. But this is far from anyone’s ideal world, we can but make it home.

You will, at times, find yourself alone. But never in Ann Arbor, Michigan. An intellectual home I hope you grow into, up in, with over time.

With that, I thank you for the opportunity to dismiss this class one final time. I hope you all do well on your fast approaching exams and on your ever-to-the-horizon journeys. I’ve done what I’ve can for you here and I trust that you can do more. Good luck.