A philosophy of biotechnology III

Delivered to the students of ENGR 100, December 11, 2019, 2:30 p.m.

This will mark the third such time I have put together thoughts on the matter regarding my own particular philosophy on the subject that brings us together day after day. My philosophy might differ markedly from yours. For one, my thoughts on the class rarely revolve around the grades, a fact ever before the minds of some participants in this class. To the extent I pay them any mind, I hope they serve as honest assessments made by one’s experienced peer. And perhaps this philosophy is best started there. As with all assessments, even with all precautions and guards for one’s objectivity, at the end of the day, what I say – present speech included – is just one man’s opinion. And while I have tried to hone this opinion to be as reasonable and knowledgeable as possible in the subject of the class, the long and short of it is, I am just one man with just a few dozen hours at my disposal to introduce you to as much science, engineering, technology, mathematics, economics, law, societal impacts, ethics, and figures of importance in the biomedical fields as possible and to judge your capabilities of retainment, applications, explanation, and prediction given fundamental knowledge, seen as some ending “grade” to you. And I only have a few dozens of hours to do all that. And while I try to be thorough, precise, understanding, I am but human and can err with the best of them. To accept, understand, and seek to fix our errors is a definition of our best effort. And I employ it here.
It is at this point that those of you baffled by the quasi-performance-art-piece diatribe you are seeing unfolding before you that I like to point out you are an adult with all the same rights and freedoms as me. Be at liberty to stay or leave as you please. If at this point in the semester you have not asked yourself or your maker why, O, why you took this, then I provide such a moment here to do so.
[A pause.]
To the question, why learn biotechnology, I pose the following answer. Most of the stuff you’ve ever cared about is biological to some degree. From your food to your friends, what you consume and what consumes you adheres to the laws of biology. This solipsistic framing hides what is in other respects a contradistinction between our “biomedical” engineering discipline and those others practice by our engineering brethren and sistren: we concern ourselves with the lives of others as a matter of professional integrity, expertise, and plain curiosity. You don’t get to being a biomedical engineer without some deep and abiding passion to understand the biological workings of human beings you conventionally care about.
Some of you, as you sit in those seats, care more about these things than others conventionally. It’s what help make you all the leaders and the best. It is what makes Michigan special.
So what should you do if you want to do more of this? [Again, I note for those who wish not to get even one more minute of this material, those doors are not locked and you are the freest of adults in the room to leave.]
  1. I would suggest seeking out a research experience in one of the many fine engineering laboratories we have here at the University of Michigan. Nothing can match the actual in-lab training an academic lab can provide. The scientists care about training new scientists. The investigators understand the importance of mentorship to continual scientific excellence. They want to nurture your skills, turn you into the best scientist you can be, and learn a little bit more about some focused aspect of the world you all are (at least semi-)interested in.
  2. Barring research, identify a few upcoming seminars this fine institution has to offer and make time to attend every once in awhile. This is one of the greatest research collectives the world has ever known. We have plenty of leading minds leading discussions that lead us into the future. Be part of it.
  3. Whatever you like about the world is likely to be found in the myriad hearts and minds of the occupants of the University of Michigan. Here, there is everything in greatness. Find something you like to do and do it with others. The heart of this suggestion: have, share, have more. This is the simplest delineation I can formulate of the importance of community to anything you want to do well in life.
  4. Read the texts. I find it hard to believe that anyone who is interested in a topic wouldn’t read something about it. Do that as often as you can. Read more about the stuff that sparks your interests. Whatever lights a fire in your belly, motivates your actions, guides your spirits, please do yourself the favor of taking the time to read someone’s considered thoughts on the matter. You will find that learning always requires others, even if they cannot be physically present. You can read the documents they provide. You’ll scarcely be the worse for having read a little each day (especially of that which you love).
  5. Make time to do other things. It might be frustrating to hear that to do something well, considering doing something else. What I mean is not to dismiss your efforts but only to say Mohammad Ali wasn’t throwing punches every minute of the day. Even Zucky B needs a break from Facebook. For all your passion’s burn, do not let it consume you fully. Refuel regularly to keep your motor humming.
It is worth perhaps highlight the importance of that experience thing that I’ve got just a little bit more of than most in the room. I’ve done a lot in my life. Sit me down one day and I’ll tell you all about it. In those stories for every triumph I may find its mirror – tragedy – just as numbered among the bunch. Which is to say, I stand before you having gone through much. On the otherside of your current experiences, I report things are generally sunny, if one doesn’t consider the weather. I’m still growing into who I am in the world I inhabit and I suspect many of you are too. It takes time, and that’s all I have on any one of you: time. We are otherwise equals in most all capacities, plus or minus some typical variation. And as with all things varied, a large sample must be sought to cover the distribution of reality. As such, be not afraid to ask others for help in your learning processes and to help others in return in theirs.
Consider for a moment the thought/fact/sentiment you would write down to rebuild society. Richard Feynman suggested the atomic nature of the universe. A solid suggestion. I pose the following statement printed in black and white: share what you have while you can with who is near. Putting that on a piece of paper would build a society well up from the ashes of other written tomes. For one, it would allow any member of that society to verify for themselves the veracity of the founding document. As a start, you’d have to share with others, to trust others, to build with others. All of this is required of learning and a Great Society requires an educated populace. Having that, we can make more. Of ourselves and for others. If we would but share (and receive) when we are able with who we can! This is but one of the reasons I encourage honest and open dialogue in this class as elsewhere. Many voices are needed for a choir.
The problem with hearing from so many voices – from learning so much – is realizing there is still much to learn. When you start to know something, when you really start to get a grasp on it, you see how small your hands are in comparison. How miniscule the retained, how vast the knowable. In a million lives, we couldn’t know it all. We can be pretty convinced of this fact by recognizing there are at least as many part of this here scientific enterprise and to a person, they’d likely tell you we don’t know it all yet. But we know a lot. A great deal of a lot, in fact. To the extent that we have synthesized for ourselves some rudimentary understanding of the subject matter before us, we may be content. That said, we ought to recognize how much more there is to it all.
Don’t believe me? Get to know just one person in this room. Get to know what they think about, what they eat for dinner, the sound of their knuckles popping, the variations in their heartbeats, its cause, its prediction, its elicitation, the control they exert over this or that variable you might include in some hyperdimensionally weighted form of “the good life”. And you will see for however much you know, there is yet more to learn.
From multitudes spring multitudes.
From the multitudes of this class sprang the following excellent projects:
  1. Designing A Better Sepsis Diagnostic Test;
  2. Early Stage Esophageal Adenocarcinoma Diagnosis;
  3. Continuous Hemoglobin Detection;
  4. Method to Predict Immunotherapy Response for Breast Cancer Patients;
  5. Immunofluorescence Test for Fusarium Keratitis;
  6. Diagnostic Test for Melanoma;
  7. Improved Diagnostic Test for Idiopathic Pulmonary Fibrosis;
  8. Diagnosing non-small cell lung cancer using salivary analysis;
  9. Diagnostic Test for Myoclonic Epilepsy with Ragged Red Fibers;
  10. HIV and TB Diagnostic Testing Device for Sub-Saharan Africa;
  11. Using Real-Time Metagenomics to Diagnose Cystic Fibrosis Infections; and
  12. Diagnostic Test for Familial Exudative Vitreoretinography.
Though many masses were needed to execute each, I would like to personally thank by name each and every clinical client who participated in this endeavor with us. Without their participation this class would not have been half of what was. To wit, thank Dr. U. B., Dr. C. B., Dr. M. C., Dr. W. G., Dr. S. H., Dr. K. L., Dr. S. M., Dr. M. S., Dr. R. S., Dr. B. S., and Dr. H. T.. For as precious as is our own time, theirs is all the more coveted, all the more valued. Please, every time you happen across one of them on your path, thank them again for me if you get a chance.
Please do happen across the paths of as many smart people as you can. It is one of the chief joys of this institution. Academic grounds allow for a growth of self not afforded elsewhere, and that growth and renewal is ever invigorating. Walk these grounds like they are yours, turning many strangers into friends. I think I have Van Humbolt about right when I quote him as saying, the most dangerous worldview is of those who have not viewed the world. Though a small town, Ann Arbor leaves a large footprint on the world stage. During your time here, be sure to expand your horizons, enhance your perspectives, and be part of the many voices of many choirs.
And not to put too fine a point on it, but there are worse habits one could form than a lifelong commitment to learning more about the world around you. With that, much can be done. If you lack for examples, consider my advice: ask others. Someone, somewhere, has to know something. And if not, there is the prospect that you could be the first to know. A diem we ought always carpe. Start each day wanting to know more than you did yesterday. Be ready to learn a little bit more tomorrow. Or relearn, or refresh, or remember that this was but one class of many you have taken in your life and you may not ever again be required to call to mind every single thing in the knowable universe and trust others to know what you might not and learn more on the subject when you have the inclination. Knowing what there is and having the bootstraps and wherewithal partly developed here to figure out more (if necessary) is ultimately all I would ever hope you got out of this class.
With regards to what I wanted you to get out of this class, it will be instructive to review what we (hopefully) did get out of this class.
  • We began this course with a welcome
  • And asking ourselves who, what, where, when, and why.
  • We are, were, will be, B. B., R. S., T. B., and R. M.
  • You all were numerous.
  • Though I ran the stats, there was still much to know about each of you.
  • In total you spanned the human life
  • And confronted our mortality.
  • We saw that sum totals were not all to be known.
  • We waited patiently.
  • We were given an outline, a chart for our course,
  • Told of a project,
  • Told of previous projects,
  • Eventually formed into teams.
  • I tried to stress even then the triangulation of factors guiding this class: biotechnology, human values, and the engineer. To say it again here at the end.
  • “Biotechnology”. I interpret this broadly to include biomedical techniques, procedures, and work products that concern the modern biological context in which we find ourselves. Our basic cellular functions and an expansion to medical effects as discovered for ourselves through client stakeholder analysis with real honest to goodness medical professionals. And at least a first attempt at a perplexing problem in the penumbra of our biomedical landscape.
  • “Human Values”. To know what one stands for and why one stands for it is the chief ethical imperative I can bestow upon you. That is: please be ethical. Please be considerate. Consider a situation. Consider how others might consider a situation. Consider compassion as a response. Understanding and compassion, those twin threads sewn into any resilient ethical tapestry.
  • “The Engineer”. Just as I encourage you to jeer at the distinction between an “engineer” and a “woman engineer”, I am not sure how much I subscribe to the idea of “the engineer”. As an archetype, the profession is notoriously hard to categorize with modern engineering projects of any scale requiring multiple disciplines, subdisciplines, specializations, approaches. There is no “the” engineer. There are only engineers. Of which I hope you will one day count yourselves among.
  • I tried to show how the basics of biotechnology would be learned,
  • The tools of biotechnology utilized,
  • The effects on the world considered,
  • A few contemporary examples, and
  • A wider look at a wider world.
  • I did this so you might appreciate what value this class has to you.
  • In this class, we had the no small task of learn engineering and everything else.
  • That is, we ought to have learned a little economics along the way,
  • We ought to have learned a little law along the way,
  • We ought to have learned a little sociability and social sensibility,
  • We ought to have learned a little ethical conduct.
  • We ought to have learned a little everywhere we could,
  • But especially in this here class of ours.
  • I put grandly the notion before you that you are living through a historical moment to which you ought to rise. You will do with this as you will.
  • I put more humbly before you the simple tenets of cellular and molecular biology.
  • The parts of the cell and functions were figured.
  • The parts of cell theory were transfigured.
  • The parts of life we know best, reconfigured.
  • Our gaze was wide, the spectrum of life considered scaling the atom to the animal.
  • We identified the bounds of life.
  • We identified the composition of those bounds,
  • Including specific fats
  • Of many sorts.
  • Proteins of variety
  • Were also surveyed.
  • Briefly, other stuff.
  • The structure of the cell was considered, including the three primary components of the cytoskeleton:
  • Actin filaments;
  • Intermediate filaments; and
  • Microtubules.
  • The tagging Golgi apparatus was met.
  • And vesicles shed.
  • Either to exocytose or endocytose.
  • A couple important vesicles types were noted.
  • The endoplasmic reticulum
  • Where cellular components are made
  • Was understood to be both rough and smooth.
  • We asked what a biomedical engineer could do with that,
  • Found a real example, and 
  • Felt a real example.
  • The mitochondria
  • Are always and ever will be the powerhouse of the cell
  • They are also the place where oxidative phosphorylation creates adenosine triphosphate, the cell’s energy currency.
  • We got to the nucleus
  • Where we found DNA,
  • Though some had found it long before.
  • I asked early on what a few things worth knowing were, to which various answers included:
  • Is cereal a soup? Is a hot dog a sandwich? 
  • Is water wet?
  • Is it soda or pop?
  • Is it cats or dogs?
  • Is it recycling or the inevitable anthropocentric death of the world?
  • Social justice,
  • Healthcare, and
  • Politics all factor in to our conversations these days.
  • Likely because we think about the state of our globe.
  • On a day not to be forgotten, I showed how biotechnology has aided in bringing closure to a national tragedy.
  • On that day we considered but one young man, one of the most recently identified victims of that national tragedy, whose story we leave now to the quiet of history.
  • All history, believe it or not, has been influenced by molecular biology,
  • That’s the stuff that happens down at the dimensions of molecules.
  • In this class there is one molecule we care about a lot here, DNA.
  • A DNA strand may comprise four nucleotides – guanine, cytosine, adenine, thymine – in any combination, in any total number, bound to a sugar phosphate backbone.
  • Guanine and cytosine pairing together across strands via three hydrogen bonds,
  • Adenine and thymine pairing via two.
  • DNA strands pair antiparallel, with pyrimidines pairing with purines.
  • DNA is double stranded,
  • Unforgettably double-helixed,
  • Having phosphodiester bonds along its sugar backbone, hydrogen bonds spanning the strands.
  • There is a hierarchical structure to DNA.
  • There is also a spatial complexity in reality that we general ignore at this level.
  • We learned of DNA replication.
  • We learned of DNA synthesis.
  • We learned of DNA polymerization.
  • We saw a rule applied and apparently violated
  • Until fresh evidence proved fascinating
  • And leading to the discovery of more complicated cellular machinery.
  • We considered these two fine human beings
  • And considered the relative speed of the problems/situations/worlds we’re studying.
  • We translated.
  • We transcribed.
  • We saw differences.
  • We saw similarities.
  • We saw many types of many things
  • Such as how four letters become twenty
  • Via the codon alphabet of RNA.
  • Transfer RNA literally bridged the gap between code and amino acid.
  • The complicated RNA machine that builds up proteins – ribosomes – were scrutinized,
  • Their cycle, hazily sketched.
  • The book of life was periodically read
  • Even if our signatures couldn’t be.
  • Our words were weighed on biomedical engineering, showing our interest in techniques and technologies,
  • Medicine and healthcare, and
  • Benefits and humanity.
  • But engineering is meant to solve errors in our worlds
  • And those may be of quantity or content
  • But they are an undeniable fact of life.
  • As are thousands of genetic disorders.
  • Of which single-gene disorders are a subset that includes
  • Autosomal dominant and
  • Autosomal recessive gene.
  • Genotypic and
  • Phenotypic variations were distinguished.
  • In this class, given the sheer volume of communication, it is certain that we at times, deleted our words
  • Missensing ourselves.
  • At times, we inserted ourselves.
  • At others, we fell silent.
  • When substitutions were sought
  • Nonsense was made. 
  • It serves to remind ourselves from time to time that we can now do some really powerful things.
  • We could, for example, design a (successful) diagnostic test.
  • We could be distinct.
  • We could have our thoughts amplified.
  • We could be sensitive to the needs of others and
  • Specific about the deliverables expected.
  • In genetic engineering, we target a sequence via either a probe or a primer.
  • A probe being used to bind and hold.
  • A primer being used to start a chain reaction.
  • That chain reaction is meant to amplify our genetic product. That reaction consists of
  • Heating,
  • Cooling, and
  • Synthesizing
  • Over a cycle,
  • Over many cycles,
  • To produce copies,
  • Fragments, and 
  • Products of genetic material.
  • That reaction also really means to amplify.
  • With all that genetic material we could run gel electrophoresis,
  • Whose humble mathematical modeling we undertook.
  • We pondered what knowing genetics could tell us,
  • And wondered aloud about a paternity.
  • Gel electrophoresis was up to the task with distinction,
  • But only if there was sufficient resolution.
  • We touched on the basics of Sanger sequencing,
  • Schematically viewed its operation,
  • Graphically viewed its results, and
  • Practically viewed its reality.
  • A kink in an important graph was illuminated.
  • The whole genome was seen thanks to open data,
  • Though some scientists have known this for longer,
  • Though some jupiterscientists say we don’t know, even now.
  • Once on the other side of that kink 
  • We surveyed five next generation sequencing techniques
  • Pyrosequencing,
  • SMRT sequencing,
  • Ion torrent sequencing,
  • Sequencing by synthesis, and
  • Sequencing by ligation.
  • With sequencing techniques sufficiently understood, we then turned to genetic expression. Consisting of
  • Transcription,
  • RNA processing,
  • RNA export,
  • Translation, and 
  • Folding.
  • Techniques to assess expression were introduced, including
  • Reporter genes,
  • Northern blots,
  • Western blots,
  • Immunocytochemistry, and
  • DNA microarrays.
  • Craning our necks up from our small DNA arrays, we sought to understand a few economic pillars of American healthcare.
  • Those pillars ultimately being Medicare,
  • Medicaid,
  • Private health insurance, and
  • Out-of-pocket expenses.
  • Though radical changes might be a’coming, a few things remain constant:
  • There will be benefits and there will be costs
  • And just about everything you propose to do ought to have a differential benefit which outweighs the differential cost.
  • Actuarial actuality was acted upon in the quality-adjustment of a life year.
  • The design process was outlined including identification’s twin needs finding
  • And needs screening features,
  • Inventions interrelated concept generation and concept slection. And
  • Implementations paired strategies
  • And integrations.
  • I outlined the general timeline of a medical device.
  • I asked you stake something of value.
  • I traded ideas with you.
  • I, perhaps at times, perplexed you.
  • For as perplexing as I am, the legal considerations of this country are certainly their equal.
  • We read for ourselves where these intellectual property rights reside in our constitution.
  • Three sources of patent law were identified.
  • Five requirements of patentability were specified including
  • Subject matter,
  • Enablement,
  • Definiteness
  • Novelty, and
  • Non-obviousness.
  • The limits of patents were stressed.
  • It’s strengths on offense 
  • And defense stated.
  • Reasons to get one (or two or three or more) were discussed
  • And who was eligible was made clear.
  • Even if the process
  • Is anything but.
  • I tried to give you a brief legal history of “bio” technology relevant our country.
  • 1672.
  • Habeus corpus means we can ask our imprisoners why we are imprisoned,
  • Written into our Constitution, Article 1, Section 9,
  • Saving a man, Lakdar Boumediene, from unjust imprisonment.
  • 1868.
  • The Fourteenth Amendment provides for due process and equal protection under the law.
  • 1905.
  • Henning Jacobson is told to pay a fine or get vaccinated.
  • 1922.
  • The Zucht family is told their child must be vaccinated to participate in public school.
  • 1927. 
  • Carrie Buck condemned to sterilization, as are we all.
  • With a stain on our system of justice, deep and dark,
  • 1942.
  • Jack Skinner, a prisoner questioning his forced vasectomy,
  • Is told that to be so biomedical altered against his will would be a violation of his rights.
  • 1965.
  • A constellation of rights comes to describe privacu.
  • A constellation of rights older than the Bill of Rights.
  • 1973.
  • Roe v. Wade establishes precedent for abortion law in America.
  • Precedent ever malleable in the hands of nine individuals.
  • 1979.
  • The Belmont Report advocated for respect for persons, beneficence in research, and justice for all.
  • 1986.
  • Bowers v. Hardwick asked if a state could make “sodomy” illegal.
  • To which the Supreme Court said “yes”…initially.
  • We may breathe an asterisked sigh of relief knowing this was overturned in Lawrence v. Texas, nearly two decades later.
  • 1990.
  • Cruzan v. Director of Missouri Department of Health, the first right to die case
  • In 1997.
  • Oregon passed the first “death with dignity” legislation.
  • Legislation that has since expanded to seven states and territories. 
  • Thanks in part to the story of Brittany Maynard.
  • 2013.
  • Molecular Pathology v. Myriad Genetics. A case balancing the interest of innovation and investment with secrecy and research options.
  • 2015.
  • Obergefell v. Hodges.
  • Two men, in love, wishing to have that documented in life and after.
  • Standing for a liberty for us all.
  • 2019.
  • Harris Funeral Homes v. EEOC,
  • Debating whether the Civil Rights Act was meant to include transgender protections.
  • With all that law under us, we moved on to editing the very texts of life via engineered nucleases
  • Enzymes which
  • Create site-specific
  • Double-strand breaks,
  • Causing either blunt or sticky ends.
  • Steps of genomic modification were enumerated.
  • We looked at it forwards.
  • We looked at it in reverse.
  • We looked at it in isolation.
  • We took a targeted look.
  • We took a look at a selection.
  • We transformed.
  • We were regenerated.
  • We were confirmed.
  • In a moment of creativity, I told a few vignettes.
  • The first about a man name Andy and who a woman and her son see upon meeting him.
  • A real-life story, exemplar of our biomedical condition.
  • The second about a flesh suit
  • Grown in a lab for a boy with a genetic disorder.
  • Science fiction, reported on the front page of the New York Times.
  • The third vignette came with variations on a theme
  • One from a Greek biographer,
  • One from a child’s story,
  • One from our very cells.
  • Our foundations sufficient shaken, we can fix them.
  • Non-homologous end joining providing a good mechanism for insertions and deletions.
  • Homology directed repair making possible wholesale changes.
  • Double strands breaks can be made by restriction enzymes,
  • Meganucleases.
  • Zinc finger nucleases,
  • Transcription activator-like effector nucleases,
  • And CRISPR, which allowed me to drape recent events over historical counterpart.
  • Romulus and Remus and
  • The Scientists Who Patented CRISPR.
  • Divides can be painful
  • Especially when the difference is slight.
  • Who gets blame
  • Who get credit
  • Will continue to be litigated.
  • Who and what gets remembered is another thing.
  • Rosalind Franklin is left out of many stories of DNA’s history, never joining Nobel ranks.
  • But so too is her graduate student, Raymond Gosling, who took this picture.
  • So too will be Yoshizumi Ishino who published the first paper on CRISPR.
  • So too will the graduate students
  • Of The Scientists
  • Who Patented CRISPR.
  • We shall all live out our days in great similarity when taking a cosmic perspective.
  • When taking a semi-guided perspective, 
  • We began
  • By discussing amongst ourselves how we ought to consider the unborn, given the availability of our biotechnologies.
  • By repeating our thoughts aloud after small group discussion
  • On the consequences of human cloning, and
  • Ended 
  • By knowing when we ought to loose our biomedical control.
  • Having taken a wider perspective, it felt appropriate to take a wider survey of the subject. 
  • Our life begins
  • As a zygote
  • Full of great potential.
  • Eventually there is a demarcation in which we cannot go back,
  • And our cells start to differentiate.
  • Our youth,
  • Such as that of Kaiba,
  • May be extended by innovative 3d printed medical technologies, such as
  • Selective laser sintering,
  • Fused deposition modeling,
  • Stereolithography, and
  • Laminated object manufacturing.
  • Making it to middle age, we have breathed a breath or two.
  • First air entering,
  • Air being breathed,
  • Oxygen diffusing,
  • Entering the circulatory system
  • Via a moving blood stream
  • And venous reservoir.
  • From the blood, oxygen diffuses into cells
  • To power mitochondria, the powerhouse of the cell,
  • Ultimately for us to expel as carbon dioxide and water.
  • In old age
  • Cancer may dominate
  • From a simple cell,
  • Stage 1
  • Stage 2
  • Stage 3
  • Stage 4.
  • Death.
  • Kept in abeyance by mechanical ventilation, a crucial feedback-controller.
  • David Foster Wallace asked us
  • What the hell is water?
  • In our souls, we knew.
  • In X-rays, electromagnetic radiation
  • Is absorbed as a function of atomic numbers, making bones visible under flesh.
  • Take enough pictures, stack them up, you have something whole.
  • Do it digitally and you have voxels
  • From a CT machine
  • And a few related techniques.
  • The basics of MRI were briefly outlined
  • Emphasized,
  • Visualized,
  • And qualitatively understood,
  • If we think hard about it.
  • We took a brief moment to derive for ultrasound imaging,
  • From basic considerations, the fundamental wave equation.
  • Our gods
  • As represented in popular media
  • Were questioned
  • Our religion, our faith, our vision
  • Was shown to be in part comprised of cones and rods,
  • Colors of many types,
  • Color types of many types,
  • Mysteries a’plenty afoot!
  • Subtle eye motions, everything.
  • On morality, well, need I remind you:
  • This is water.
  • On race, what have I to say but 
  • Look here at the  first page of the Constitution.
  • The Tuskegee Syphilis Experiment,
  • A blot on the human register first started in 1932,
  • Involving hundreds of literally mistreated black men,
  • Stopped only when it was publicly reported.
  • Only eight men were ever offered an apology. 
  • Disease modeling has improved.
  • Simple assumptions,
  • Simple parameters,
  • Simple results,
  • Simplifications.
  • Solutions.
  • Hard problems.
  • Actionable solutions.
  • Should action be taken? That’s one question.
  • Should something be acted upon? That’s another.
  • On women
  • You don’t need me mansplaining anything to you
  • As with much in life, there is much a gender imbalance to engineering.
  • To the extent that there are “women engineers”
  • The University of Michigan produces an exceptional amount, many of which are biomedical engineers. Why is that?
  • On sex
  • On gender
  • On gender dysphoria
  • On puberty
  • On puberty suppression
  • On puberty suppression to treat gender dysphoria, we were left with really hard questions and only time to think of answers.
  • On war
  • We saw bodily harm
  • In trauma we see the same
  • We see limbs replaced
  • And advancements made.
  • Even if we only see part of the magic.
  • Recall that you are living in a science fiction novel.
  • The rules for writing a science fiction novel, as it turns out,
  • Are pretty serviceable as rules for engineering.
  • Chief among an engineer’s considerations: what do they want?
  • Smart people
  • Know how to ask nuanced questions for many alternatives.
  • In politics
  • It will help to know how to ask the right questions.
  • In capitalism and communism
  • The distribution of shared contributions factor in health
  • To what extent should they?
  • I asked you then, way back on Monday, how do we improve healthcare?
  • Because, I contend to you, it really matters.
And no matter how you look at it, that’s a lot of material to learn, especially if it is our first exposure to it. Still, I am proud of each of your efforts and encouraged to see so many of you make it to the end. If you will allow me, I would like to share with you a brief thought for each of you given our work in the class. I have numbered you with respect to the total number of students I have taught and in order of earliest registration. 
  1. 374. Z. E. There is always something to be said of the first of anything. One hundred eighty-nine days ago you became the first student to step through the (virtual) door and thereby set the tone. May you always get there early and be a part of what follows.
  2. 375. L. F. A frequent participant in the class discussion, your insights and guidance for leading our learning. May you continue to be a leading voice in every room you find yourself.
  3. 376. S. M. A generally quiet man, Sho, you spoke clearly of the results expected of your team’s photoacoustic imaging to find melanoma in its earlier stages. May you continue to find the voice to express the expected and unexpected alike.
  4. 377. S. O. I swear, some people know the operations of this class better than I ever will. You rank among such folks for attention to detail and accountability. For that you ought to be commended. May you bring such detailed accountability to all your future endeavors.
  5. 378. S. D. A bold speaker in a crowded field of peers must always have something in the fearless in them. As you command a room with a thought or two, may you always have at the ready a good thought or two. 
  6. 379. S. W. I have you down as saying “I believe that the mind of a person characterizes their identity. The mind contains all of a person’s experiences, values, thoughts, traits, etc., which is what makes every person unique.” As just such a unique individual, I hope your mind – characterizing your identity – has been enhanced by your time here. May all of your experiences, values, thoughts, traits, etc. be for the better.
  7. 380. A. B. Active in just about every class-wide discussion I can remember us having, yours have been opinions shaping my own. Putting the force of thought behind a clear sentence or two is just about all the power we scientists and engineers will ever have (with the exception of the extraordinarily powerful machines the build and run cities, etc.). That you have used yours well, demonstrates a budding talent. May it continue to bloom.
  8. 381. J. C. Every class has at least one individual who comes in, sits off in a corner, and quietly dominates the class. On just about every assessment I have of your performance in this class you have exceeded expectations, all from your oblique silent seat. May you continue to dominate at whatever volume you choose.
  9. 382. S. C. I have you on record as remarking “It is extremely difficult to determine what seems right”: the sum total thesis of our ethical reasoning in this class. Saying concisely what others say profusely is a skill that will serve you for many of your days. May your concision wed with precision such that you do well what you do specifically.
  10. 383. J. P. You concluded your group’s presentation well, no easy feat given the balance of competing details (support vector machine classification, cost benefit analysis given an ROC curve with one standard deviation of variance, a quick patentability analysis, etc.). May you always stick the landing.
  11. 384. K. R. In considering what a parent should do for a child wishing to undergo puberty suppression, you say that “a parent should respect the child’s wishes because the child should be allowed to be who they want to be.” So should we all. May you, in your time here and elsewhere, be allowed to become who you want to be.
  12. 385. C. P. In comparing the costs of your team’s proposed solution to HIV and TB diagnosing in sub-Saharan Africa, costs which were reported down to the penny for each reaction in the machine, to the benefits which arise, you made the case starkly that in some parts of the world, a little improvement may go a long way. May you find yourself ever improving along the way.
  13. 386. K. K. Your handwritten homework are some of the most well-laid out I have ever had the pleasure of grading. While it may be an odd compliment to receive, I believe such an orderly presentation must be the result of an orderly mind. May you continue to bring order all about you.
  14. 387. C. T. “Ultimately,” you said, “a person can have many identities that they choose to relate with.” I hope your many identities have found many kindred spirits among our ranks. May you always keep the motto of the Great Seal at the front of your mind as you develop into who you are: e pluribus unum – out of many, one.
  15. 388. C. G. On the subject of vaccination, you advocated for “the interest of ALL people”. On the subject of poorly acquired data, you insisted that it not be used to “cause further harm”. On the big issues, you have your eyes on the prizes. May you continue to assess the topics before you effectively.
  16. 389. J. P. I have you one record as saying “The memories of a person truly define who they are due to the fact that their lives are stored as memories as the days and years go by.” As the days and years go by, may you have fond memories of this class and truly define yourself as a person.
  17. 390. C. S. Though maybe I coaxed you into a contribution or two, the questions and comments you shared with the group consistently moved us forward. And though our tastes in rap may diverge slightly, may you consistently move forward as, as Kanye reminds use, “every hour / every minute”.
  18. 391. M. B. Your explanation of your team’s test design using immobile antibodies testing for three biomarkers correlating to non-small cell lung cancer using a saliva sample was top notch. The details were clearly articulated and the visual aids engaged effectively. May you always explain yourself, and the work of your teams, well.
  19. 392. K. B. “I have developed,” you said in a recent homework, “overtime into my own person through what I have learned and experienced.” May you have learned and experienced much in this class and learn and experience more outside of it.
  20. 393. S. N. There is, and ever will be, a special place in the heart of anyone who has to stand up in front of a bunch of people and do something (perform, profess) for the people that sit in the first row. Those brave souls willing to confront the perplexing head on. From just about the first day, you’ve had such a privileged seat. May you continue on expeditiously, ever leading from the front.
  21. 394. T. V. To the other end of the room, keeping an eye on us all is Tyler. Following along well and showing an understanding of our biotechnological pursuits, he has followed through on all he has set his mind to here. May you continue to follow through to the end.
  22. 395. J. Z. Considering the potential sensitivity and specificity of your proposed test, you presented an analysis that took into consideration the split-decision results that could stem from your multiple biomarkers. Such a conditional framing fleshes out options. When analyze your condition, may you always find it bettering.
  23. 396. L. T. When posited with the difficult question of puberty suppression for children, you said that “it is the parent’s responsibility to help their child be the best version of themselves they can be”. If the world shared your sentiments, it’d be a better place for it. I hope your parent’s have helped make you into your best self, ever capable of answering the hard questions.
  24. 397. B. T. For your group’s oral presentation you were given the uneasy task of explaining how changes in DNA methylation could be used to indicate the presence of idiopathic pulmonary fibrosis via bisulfite conversion and polymerase chain reaction. That you did all of this in less than a couple minutes shows you know how to use your time wisely. May you always spend well the time you have.
  25. 398. C. M. You would not believe the hours of discussion we in the Biomedical Engineering Department have had with regards to using Python to code up statistical tests. I see rather than talk about it, you did so on your homework without fanfare. May you continue to walk that walk others only talk about.
  26. 399. S. G. Cutting the Gordian knot of unethically acquired data, you tease out the threads by noting that the “unethical data is already collected, so using it doesn’t undo the unethical part, yet using it could still benefit people.” Such clever compromises ensure the stable progress of the world. May you cleverly tease out every confounding detail before you.
  27. 400. E. S. You were ever on the ball, asking questions with acuity and keeping track of this class’s operation with greater dexterity than me. If my first four hundred students were as good as you, I look forward to my next four hundred. May you continue to represent the eons.
  28. 401. S. C. I couldn’t think of a better face to put on the next four hundred, than Sebastian here. Keen, clever, passionate, he represents a man on a mission to learn what he wants to learn. We as professional residers of the ivory tower are warmed by such fires. May you keep on burning as long as you’re learning.
  29. 402. M. E. The first of the triplets to register for the course and therefore my obvious favorite, Mo, has been a consistent participant in our class’s conversations and I speak for most in the room in saying that I have benefitted from it. May you continue to contribute.
  30. 403. A. M. The administration of your team’s diagnostic test follows a clear flowchart indicating risk stratification and treatment options. As the presenter of the information, I assume you had something to do with it. May all your decisions in life be so clearly logical.
  31. 404. K. C. You once remarked, “Women feel more comfortable being in a field that incorporates ideas of women […] like healthcare.” May you always comfortable knowing your ideas are incorporated, hopefully to the betterment of our healthcare.
  32. 405. H. A. I have you on record as saying that the best that could be done with unethical data is to make sure “something good can come from the situation”. Optimism of this sort keeps leaning us forward into the future. May you keep up yours and put your shoulder into all that makes you hopeful.
  33. 406. D. M. In the time that I have known you, you have demonstrated a competent understanding of the subject matter and an open-mindedness to even the more profoundly/absurdly/important bioethical stuff that comes up during in this course. May you continue to be profoundly/absurdly/competent.
  34. 407. L. P. Your delineation of the extent and prevalence of sepsis (and its associated SIRS and shock) was done with the best of them. May you find yourself ever numbering among the best.
  35. 408. L. A. You all should know what a special sort of person Leanne is. As but one example. When in the period I posed that tought transgender biomedical issue, Leanne answered in the following *haiku*: “Ask the child what / they want to do – ultimate / ly  he child’s choice.” That’s one heck of a mind at work. May you continue to creatively reason through the consequences of our actions.
  36. 409. P. Z. It is rare to see MATLAB employed to solve basic statistic tests at the first-year level. That you did so with aplomb on your homework speaks to your rarity as a person. May you continue to employ the unique to solve the fundamental, commonly.
  37. 410. L. T. It is rare to hear an explanation for why a mutation in a mitochondria’s transfer RNA would impede protein production. Rarer still to hear one deliver as expertly as you in this past presentation. May you continue to explain the complex, concisely.
  38. 411. M. A. Always early to class, always in the front row. You will find that though fortune smiles on the well-prepared, it also smiles on the prompt. May you always be so upright.
  39. 412. K. K. Invariably someone describes a biomedical disorder so well, it’s a shame it’s a disorder. Your description of sepsis and by what criteria your team would measure a new diagostic therefor was top notch. To follow it with an engaging explanation of flow cytometry and the specific antibodies your team would like to try for your propose test, also superb. May you continue to communicate the difficult with ease.
  40. 413. J. L. Your keen eyes and quick wit has us ensuring your genetic expression, rather than simply insuring it. May you keenly correct with wit and guile.
  41. 414. M. M. Of yourself you have said, “I am, in a very basic way of looking at things, a mess of nucleotides and biomaterial trying to make my living on a giant rock floating in space.” So are we all. May you keep floating on and making of this giant rock we call home what you can.
  42. 415. C. B. You have said that you “believe that [you are] a collection [of] cells that are built up in such a way that it makes me distinct from other collections of cells.” Truer words of individuality rarely uttered. May you always help build up distinction for every group you are a part.
  43. 416. J. L. I thank you along with Sebastian and Jan of attending a bioethics discussion held within our Department of Biomedical Engineering. Your thoughtful contributions there (as elsewhere) will lead to better dialogue for all. May you always contribute your thoughts.
  44. 417. A. M. Thank you for your deep and abiding interest in arrythmogenic right ventricular cardiomyopathy. It will take such determined focus to eventually solve the current problems of our biomedical world just in time for our future problems to arise. May your interests be enduring and exploring.
  45. 418. A. G. Your introduction to the consequences of lung cancer and what could be done to improve diagnosis (if by the world would listen to you) was as proficient as any I’ve ever seen. Carefully weighing details of a problem and a proposed solution is chief among an engineer’s skillset. May you continue developing yours.
  46. 419. A. G. I found the questions you would ask after class to be the highest variety. Whether it be for clarification or expasion, your demonstrated the sort of curiosity that flourishes well on these grounds. May you continue to seek answers to every question you ask.
  47. 420. N. C. Highlighting the role of systemic subjugation you said that “Women (who have a history of being oppressed at some level) tend to have greater obligation to pursue occupation that benefit wellbeing of society.” An astute observation of contextualizing details. May you observe less oppression and greater well-being.
  48. 421. M. S. A humble first-rower, your observations from that vantage point have often helped progress our learning narratives, telling our scientific stories just a little more logically with a clarified framing. May you always leverage your vantage.
  49. 422. J. C. Noting the diversity of life, you said, “while all of these cells are different, they still combine to form a unique biological creature, which is you.” So too has the diversity of thought you and others have brought to the class combined to give us this unique experience. May you always coalesce with others for the betterment all.
  50. 423. J. R. We had a frank discussion in the first week of class where you looked me square in the eye and said you could and would make it through this class. Here you are, here you have. May you continue to be a person of your word.
  51. 424. I. D. Your answers to many of my questions demonstrate nuance and a commanding balance of interests. For example, on the subject of vaccinations you put eloquently what exhaust so many words over: “individuals rely on everyone else in the community”. May you rely on your community and your community on you.
  52. 425. O. E. As the more level-headed and not-so-quick-to-rush-to-join-this-class of the bunch, Omar is my obvious favorite of the triplets because of this sensibility. Moreover, such sense applies to every assessment of you I have (homework, exam, etc.). May you continue sensibly on, following in the footsteps of giants.
  53. 426. M. M. You once said, “Every person is unique in some way – no one is exactly the same as another person in the world, even in the case of identical twins” and, as we have seen, triplets. As one such unique person, you have you stand distinct among others. May you always so distinguish yourself.
  54. 427. A. M. As hard a working budding scientist/engineer as ever I’ve seen. You ask questions when curious, contribute to the dialogue with points of consideration, and seek out to go every extra mile you know about. May you know joy in every mile more.
  55. 428. M. P. During your final oral presentation you explained the source of your biomarkers, provided a listing of all known mutations (9 missense, 25 nonsense, 10 splicing), and a brief aside on their consequences to familiar exudative vitreoretinography. Such comprehensive detailing will always reside well in the heart of an engineer. May it continue to reside within yours.
  56. 429. C. V. A man after my heart with a phrase beginning “The government has no right”, Christopher continues, “to outright force seomeone to inject something into his [or her] body. However, the government can restrict someone’s usage of public property if they are not vaccindated.” Such a weighing of interests is critical to anyone hoping to do anything work a darn in manner that is worth a darn to begin with. May you continue to to hold your government to account so that you might count on your government.
  57. 430. F. V. A. You put starkly when you said, “you are your brain and your central nervous system. Your body is just the shell you occupy.” Well I thank you and your shell for occupying a seat in this class. May you, your brain, and the whole of central nervous system go far in this world.
That was it. That was us. That was the class.
It was a privilege to get to know each of you to the degree that I did. Maybe in the future, more. We are each of us travelers going somewhere, and we ought to respect anyone pausing for a moment on their journey to tell us something we might not know. I hope looking back, later on in your journey, this will be but an obvious truism as one of the noble citizens living the good life within the great society.
Given the title of this speech, it seems reasonable to ask what my guiding philosophical notions have been in this class. I conclude here with a tidy tentative list of ten such notions formative to this class’s content:
  1. I believe in a material reality whose principles of action we can know and understand.
  2. With this knowledge and understanding comes prediction and control, with that a command “of nature”.
  3. I think human beings are things of value and things which value each other as well typically.
  4. I think we can hold the actions (and thus the decisions that led to them) of human beings to a reasonable set of standards.
  5. I think we can discuss/discover/design those standards to maximize human flourishing, a thing most human beings ought to want for most other human beings.
  6. I think we can reason through situations and leverage past precedent to ensure the arc of progress bends ever upward.
  7. I think we ought to consider the consequences of our scientific, our technological, and our biomedical progress.
  8. I think I ought to provide such an environment where many perspective may be taken on issues of consequence and shared with others.
  9. I think the world is made better by those who work together.
  10. I think you are valued.
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 have done what I can for you here and I trust you can do more.
Good luck.