A philosophy of biotechnology

A final lecture delivered to the students of ENGR 100.500, Fall 2017

To have a philosophy of something is to know more of something than you need. Philosophies are the luxury of the unhurried. And they flourish best, I’ve found, on academic grounds. Where there is time to bask in the shade of the ivory tower, overlooking the quote real world. Of my experiences in this quote real world, I have personally found the rarified airs we breathe here on campus to be of the most stimulating sort, and those best approximating it out there are and will continue to be secondbest and below. Put in a bullet, “what you’re doing at this university is important” and in an off-bullet “take the time to do it right.” Jump-question: “How will I know I have taken the time to do it right?” Splash-bullet: A philosophy.”

Segue. Today, I am going to give something of a philosophy of what I believe this class was all about. Pithily: “A philosophy of biotechnology.” It will, however, consist of a fair bit of rambling on the topics of engineering, education, and our biomedical condition.

I should note here that this is the last day of class. That none of what I’m about to say will be on any test (except when I review some of our homework problems, which you should already know to expect on any test in this class), and that what follows is a long-form, semi-edited meditation on what I think you ought to have gotten out of this class, which you should not feel compelled to sit through if you do not want to. It’s just going to be me reading this speech and if this mode of academic exercise doesn’t work for you at any point, your time is your own. Because this is going to be a weird one. This is not merely a recitation of what we’ve learned or even much of a comment on why I felt we’ve learned it, the answer in both the individual and general case being “I think it’s important for you to do so.” It gets at the layer underneath: why is this important? Why should we give one single damn about one single fact went over one single time in this class? To which I offer the rather lengthy and at times circuitous reasons that follow. If you would like to be spared all of that: those are the doors. They are not locked.

Indeed, let us start there. These doors are not locked and you are always welcome. You are part of the community you want to be. And you should want to be this sort of community. In case no one’s ever let you in on the secret to the school you applied to. You didn’t apply to get in, you applied to be a part of it. That’s the great lie never told: you are the University of Michigan, not me. I mean, yeah, a little bit of me too, but when the history of this class is told, you comprise the 98/99% of it. Surely you’ve been told this at some point: you don’t need to be here. You’re an adult, you have all the rights I’ve got. Maybe not to drink or rent a car or apply for a mortgage quite yet, but you’ve got most of them. Foremost among them, whether you realize it by this point or not, is intellectual parity with just about every other adult you will ever meet. You all are about as smart as me, which is to say pretty darn smart. Many of us will carry around a healthy humility of that fact. Many of us will also maintain a gnawing belief that that simply can’t be true: I’m dumb and one day everyone is going to figure that out or maybe they already know or maybe they already know and they’re being polite or maybe they know and they’ve let me know and I’m too stupid to know it, or is all of that dumb too thus confirming my perceived lower sense of self worth. Do not any of you in any of those camps be afraid, this is all perfectly natural. There is nothing at all to be ashamed of in knowing that you – those of you sitting in this class – are very smart people.

Like I said, about as smart as me. In fact, I’d wager just as smart as me, we’ve just got our knowledge spread across different disciplines in different proportions, but they all add up to about the same overall smarts. We’re not all the smartest person we’ll ever meet and we’re certainly not the dumbest either. And woe be onto those for whom such statements are true! Can you imagine being the smartest person you knew? If every idea you ever had was the best you ever heard and never went up against someone who could really think worth a damn? How simple the life and tedious the days! To know how to do everything in your world? Those who see only instructions and never creations! Where’s the meaning in such drudgery? We do not turn to our microwave’s manual to soothe the aching heart or measure the still/beating one. That is to be discovered elsewhere, in spaces beyond instructions where real problems lay not dormant, but quiet, in depths yet plunged.

And I’ve got to get you ready for that.

Because if someone hasn’t told you by now what you’re getting into, I’ve got to make sure I’m the one to prepare you for it. There’s so much of the world to know and understand and you’ve got to figure out a way to synthesize every bit of information you’ve got to make the best damn fixes to these cursed cracks in the world by the time you get out there fixing them. The University of Michigan has afforded me approximately 107 hours of instruction in this class to do so. Those hours are divided between: (1) laboratory sections where you needed to see, engage in, and understand the material and the workload to a degree of competence that those in industry wouldn’t mind working with; (2) discussion sections ably taught by Drs. Christian Casper and Rob Sulewski on important topics as myriad as paragraph design and sustainable engineering which might easily for most of you have previously fallen comfortably down on the list of Things I’ve Spent Time Critically Thinking About; (3) a design project that was thrown at you like it’s going to come at you just a few short years from now; and (4) lectures taught by a man who to this point had never taught a class of this caliber before in his life and you, however fortunately or unfortunately, had thrown into yours by this very fine establishment. All so that you might have the necessary skills, critical thoughts, and personal motivation to get from where you are to where you want to be.

It is a lot to take in.

But that will serve as good as any other definition of an art: that finite expression of something greater than. All art is essentially trying to say more than it’s saying about more than it’s saying. The compaction of meaning into a specific form is the job of the artisans; the result of their labors, their art. And so what I’ve tried to put together for you over the course of the course is an artistic expression of what I believe biotechnology entails. Certainly, it entails far more and, depending on your specialty, far deeper knowledge into the topics we’ve covered and many else besides, but this ought to serve as a generally sound introduction to the field in the form of what has mostly been a mostly-one-man, one-act show about biotechnology and its consequences. Believing that it is my job that you understand this topic, I have tried many ways of carving out some brain space in your head to get your pretty darn smart minds considering pretty darn important and hard to solve problems in our field.

By this definition of art, I feel comfortable saying that I have maintained artistic standards and encouraged aesthetic development of you as engineers in this class. If I have but tried to bring some sensibilities to the genre in a way that gets you a little beyond the average engineer’s average introduction to engineering, I’ll have done my artistic duty as a “performer” of this information, tasked with ensuring that you see more of these topics. I hope to have conveyed to you not merely the content of the material (the rote facts and relations to map), but instantiated something of the field in the moment. I’ve wanted to show how biotechnology comments on its place in the world. What are we to make of a discipline that has monkeys with neural links to robotic arms, at least five completely different ways to sequence your entire genome, an ever-strengthening hand over the mechanisms of bacterial immunity, a forty year-long inhumane investigation of infection and injustice, a nearly non-existent gender deficit, new ways to control our growth and development that calls us to question what is important to our growth and development, and you can only see all of this through a very narrow window in the exact center of your vision.

It’s why I put time into these presentations. To attract those eyes, to tap that brain, to get it thinking on our craft, our science.

Our science, as we’ve noted, is an odd one. Among the aforementioned facts we must square ourselves to, we must at some point grapple with the factual commercialization of biology that we’re all getting ourselves into. It’s surreal terrain. In less than half a decade, you will be aiding in the design of drugs, the creation of regulatory compliance systems, the beginning of your first years of medical school, treating your first patients in the flesh. And that’s all objectively weird when you think about it. The invisible hands of our markets are guiding us over a particular swath of the biomedical landscape.

Perhaps it will be illustrative to review some of sites we have seen along our stroll amongst this landscape. That is, what have we learned during this education?

The first emphasis I wanted to place in this class was on getting to know one another. From the stats that would make up the bulk of our previous homework–

–to the all the thousands of days we spent in preparation for this class (and which will serve as the primary factor of a ranking system to follow).

I wanted to make sure you knew the cost and the value of your education.

Every now and then I wanted to get you to read a quote from someone smart you might not otherwise here from in a biotechnology course.

Even from mad men.

I wanted you to know some of the biggest names in this field.

Some reputable law firms to use in the future.

And dome professional organizations that I’d like to see some of you leading in the not too distant future.

I also wanted to call upon your higher faculties to address uniquely biomedical situations. Ethical thinking played a somewhat outsized role in this class. But I think to no one’s detriment.

I wanted each time we met to be an opportunity to create something new–

–and to stress to you the importance of what you’re getting yourself into.

We were initially blown away by what previous students in this class were able to put together.

But we have assembled something about as impressive if not more so if I do say so myself.

Our training began with humble axiomatic biology. The first principles of biotechnology.

In becoming acquainted with the environment, we saw the scales at which life lives–

–and the boundaries on which it relies.

We met HeLa a time or two.

And learned about some of the things biomedical engineers do.

One day mitochondria went from being “the powerhouse of the cell” to–

–”the quasi-organelle that creates adenosine triphosphate via oxidative phosphorylation”. I am told this can be a shocking day in early adulthood. And I’m glad we were able to go through it together.

We saw the first cells.

We saw the first DNA.

We saw numbers of people affected by biotechnology.

We saw the people.

We put together the teams–

–and met the clinicians.

We pondered the uniqueness of ourselves and others time and again.

We got down pat the basic structure of the basic form of our genetic material.

And we unfortunately now a little too familiar with the geometry of helices.

We learned about the many ways DNA is compressed–

–and the one way that it is synthesized.

We considered the molecular processes involved in DNA replication–

–and these two naked folks for quite some time.

We began to appreciate the size, scope, and, scale of the biology we were talking about.

We could begin to make comparisons and

– and analogously expand upon our reasoning.

Life’s basic cycles were explored–

–and its errors carefully considered.

We discovered many such errors, including two Tay-Sachs down here.

We went through a few examples of disorders, some of which went on to lie at the hearts of your projects.

We understood the difference between genotypes and phenotypes.

We learned a bunch of nonsense about mutations.

We were told to find typos.

And design diagnostic tests.

We learned to be sensitive.

We learned to be specific.

We learned how to start a chain reaction–

–and to predict what it leads to.

We learned the basics of the basics–

–and took a peak at what complexities really lie beneath.

I really hope you learned how Sanger sequencing works. It really is important from a conceptual viewpoint as most technologies are a variation on its theme. We even did that pop-beads hands-on demo because I thought it was so important.

As important are the effects of next generation sequencing.

And what it means to have a home and a moment to think on it.

With one of those moments to ponder, please use it to rethink your use of jupiterscientific.org.

Don’t be afraid to dare too great.

Or to delve too deep in the details.

In the great many details.

I hope you did not mind my solicitation of what you wanted out of the class and I hope my presentation of it was mostly to your liking.

There is something this side of fitting irony that we have learned to express ourselves in lock step with learning how our cells express themselves.

The whole process has a bit of a magic to it.

Even though we know a lot of this from experiments that are this hodge-podged together.

We know we can make mice glow green if we want.

We can detect/make just about any molecule if we exploit the immune systems of organisms.

We can see genes being expressed.

We can see the healthcare systems in action.

Our work here has taken us down some strange winding paths, such as our estimation of a life’s monetary worth–

–the interrelated and jumbled design processes–

–and how a medical device actually gets made.

In weighing the balance of costs and benefits, we consider the gambles we could take–

–and the trades we could make.

Along our stroll on this biomedical landscape, we encountered a paradox or two that ought to make our traveler’s eyes weary, leery, and squinting skeptically at some of our better ideas.

We saw that some of our better ideas have been codified in documents long ago.

We also saw that some of our not better ideas have also been codified. How we deal with this speaks to the material of our character.

Of those good ideas we have had, we found that they must satisfy at least five important conditions for patentable consideration.

I think some of the better ideas we’ve had in class have helped better the class including much of your feedback that I hope to have taken well in stride.

I think we were even able to make it through the handwritten statistics portions, too.

I tried at times to make the data as relevant as possible as in our investigation of a per-row heart rate difference. Seen here as a cross between a handwritten receipt and modern art.

We explored the details of good statistical tools.

We indulged in a few extra along the way.

We learned how to test a test–

–and to describe it well.

From rigorous definition, it’s important to develop healthy intuition. And so we tried.

With real world examples plucked randomly for mutual exploration.

We even got to thinking about how we’d like our own tests to look. That was probably new for all.

In fact, we got to trying a few new things along the way.

And we got to see a unique side of humanity thereby.

It has situated us.

It has fragmented us.

And it’s got us asking: what-the-what?

Who even am I?

How is my broken DNA joined back together?

How is it repaired with changes?

Must Romulus kill Remus for Rome to flourish?

Is CRISPR/Cas9 really as simple as all that?

It is kind of cool to see it in action though.

Almost as cool as the use of over-extended metaphors of the founding of an empire–

–to explain contemporary descriptions of molecular editing systems–

–currently awaiting arbitration by as high of a court as the parties can convince to see them.

We learned some of the names behind the names behind the big stories.

We paid them our respects here along our biotechnological journeys. We may not see them again.

But that’s okay. We’re learning to keep things in perspective.

Within the path of that perspective have been a great many topics.

Topics as important and as fleeting as the origins of life–

–and as varied as the cells that follow.

We met the newly saved–

–and the old standards.

We saw how things can get out of control–

–and learned the basics of how they can be kept within it.

We learned history while we learned method.

Example and definition were coupled.

You were invited to see the intellectual edges of some part of the field. I hope some of you took me up on this offer. At the very least, I hope you do yourself the favor of at some point sitting in on a PhD defense. Perhaps even your own.

We ruminated on our society’s branding of some of our work as playing at god.

We were baffled and bamboozled by illusions.

Even as it was brought to the center of our attention that we have a very narrow center of attention.

Your instructor indulged himself with the quotes every now and then.

And never made it quite clear what you were supposed to write down and what you could listen to.

And I have tried continually to make the point that that is not the point. That some things ought to be known or the very least said. How often those things are written into history is ultimately on us.

I tried a little something different by introducing the mathematical modeling of biological scenarios.

And for the most part I think we “get it” even if we don’t “get it”

I think there’s plenty more that we similarly “get” even if we don’t. If we don’t get it now, may we at least get better.

We touched on hot topics–

–and unflinchingly asked hard questions.

We have looked at hard numbers facing us–

–and powerful people redefining us.

We’ve gotten answers from genuine stakeholders.

We’ll hope to get the right answers from the right questions as we go forward.

And we’ve got to be willing to listen to them. Because they all say something important about something important.

With that, I hope you are willing to listen to me for another twenty minutes yet. As each and every one of you were important to what this class was and I think I as your instructor ought to acknowledge that. What follows is an individual thought for each of you. You were my first students and I hope I have taught you well.

I have listed you all in order from the date of your enrollment.

1. Number one. J. G. The first to sign up for this class. This speaks to a certain spark I like to see in a person. May you continue to charge boldly into the unknown with a great deal of forethought.

2. Number two. C. The first to get a 100% on a homework I assigned. As most the rest of us can attest, that’s not the easiest thing in the world. Congrats.

3. Number three. M. I have you quoted as saying “personality and character are the main ways to characterize who a person is.” From the glimpses of each I’ve gotten from you in this class, you have sufficient amounts of both and I hope you are able to put them to good use.

4. Four. S. S. I could always count on you to say something in class. Continue to have smart things to say.

5. Five. S. Given that you came into this class having broken the most bones (somewhere in the double digits), I will count it among my accomplishments to say that, barring last minute accidents to the contrary, we have safely made it through this class with no injuries.

6. Six. B. Or, as your nametag once had it, the Honorable G. You have demonstrated solid judgment in both the engineering-y and humanity spheres of this class. May it only be bettered.

7. Seven. A. Your explanation of cystic fibrosis and its effects on the world ranks among the top I’ve ever personally encountered. You should take pride in and continue to hone your ability to carve out descriptions of biomedical problems.

8. Eight. M. I will remember you for the ease with which you called to mind particulars of Roman history far in excess of what I might expect of the typical engineer. May you always far exceed the typical engineer.

9. Nine. T. You have given voice to a deeply held belief of mine: Quote, “I do not believe these complaints” regarding the modification of biology “should limit the advances of biomedical sciences because public opinion is so fickle.” I might more charitably say public opinion is “flexible” but it largely describes the same thing: that our society’s perceptions of the terrain we tread are awash in naivety and that we must be bellwethers of the truths we discover. May you be such.

10. Ten. A. You will be remembered by me and likely by E. as being the fellow who swooped in for those points in helping with our dying with dignity laws. I like your gumption and I hope you keep it with you.

11. Eleven. N. You will forever live on in my heart as The One Named Man, the one and only: N.

12. Twelve. N. You had an excellent eye for the contents of this class, asking questions with acuity and answering them with clarity. Keep it up.

13. Thirteen. J. I hope I have helped you learn how to conceptualize a statistical problem and how to avoid biasing ourselves prior to and following from our analysis of data. As I have said to you previously, be confident in your methods and you can be confident in your results.

14. Fourteen. T. I’m sorry I did not know more about some of the surgical details of the topics we included in this class. I hope it does not dissuade from pursuing your interest in being a neurosurgeon.

15. Fifteen. R. I listen exclusively for the clarinet when I watch Michigan games because of you. Beyond your instrumental status in the marching band, you have served this class well with your insights and questions. May they serve you just as well.

16. Sixteen. A. S. A man after my own heart in his preference for pens over pencils. May you be ever more certain with the answers you write them in.

17. Seventeen. K. I have heard many explanations of the diagnosis and treatment of sepsis in my day and your presentation of the subject in the final oral report ranks among the best. Truly top-notch nut-shelling of difficult subject matter.

18. Eighteen. S. I remember your justification for using a differential benefit of 1 QALY per year as being rather succinctly put as “you’re either around or you basically die.” I have heard no truer description of this life than that.

19. Nineteen. L. I believe you may have been the first student to visit me during office hours. Thank you for that. You are welcome to visit anytime in the future while on your path through the biomedical landscape. You also gave rise my second favorite bulletpoint of this semester which reads quote “Is breeding dogs ‘playing god’?” which is precisely the sort question I want to get to the bottom of in this class.

20. Twenty. N. You’ve got a mind going a mile a minute on a dozen different topics that are all pretty cool. I hope you continue to lend your opinion to our bioethics discussion group and that you win that upcoming video contest. If you need us to spam anything, please do not hesitate to call upon your ENGR 100 section 500 brothers and sisters.

21. Twenty-one. B. P. Thank you for coming to the very first bioethics discussion. You got to see what it was before it was anything at all. Hope you continue to cultivate your curiosity.

22. Twenty-two. E. Thank you for your unwavering participation in this class. You have leant a strong voice to many of our shared opinions and I for one am glad that you shared it.

23. Twenty-three. A. You were quite spirited in just about all aspects of this class. From the project to the test to discussions in class, you had an energy that I urge you to use for the good of us all and our biomedical condition.

24. Twenty-four. Y. Hopefully by this point you have had sushi. If not, might I recommend it in celebration of your excellent final oral presentation or potentially after your sound handling of our up-coming final exam.

25. Twenty-five. A. K. You have demonstrated great abilities in this class from spotting errors in the homework to once describing our work here as an “appl[ication of] a problem-solving, collaborative mindset to help the human race.” May you continue to solve problems with those around you for the benefit of all.

26. Twenty-six. G. You have put well the reason we all should be here: “want[ing] a direct impact on people’s lives and combining the fields of math and science to do so.” Indeed, engineering in one of its purer senses is just such a distillation. May you make ever greater impacts on those around you.

27. Twenty-seven. C. I will remember you for your answer to the ethical use of unethically acquired data and for your notion of its use being accompanied by a message of warning. You correctly noted that we cannot undo our experiments, but we can learn from them.

28. Twenty-eight. J. You had a comment on your latest homework that teachers like me live for. You said, quote, “Thank you for making me question my existence,” which is just about the highest compliment you can give me for a class like this. This is the sort of thing I want to ensure is present in engineering classes that doesn’t quite have an ABET guideline associated with it. This class is but a brief exploration of who we are biomedically speaking. If some of our sites have us questioning our standings in this world, all the better.

29. Twenty-nine. E. You have demonstrated a keen and unique sense of many of the issues we deal with biomedically. I suspect your personal experience and motivations have lined you up for a great career in biomedical engineering. I hope you enjoy the trajectory.

30. Thirty. J. J. I am sorry to hear that you feel biology is not for you now. I hope I can persuade you here by saying my telling of it is but one of many ways and even if you didn’t like my way of doing it your continued investigations of the subject matter will lead you to yours. I wish you luck on the way.

31. Thirty-one. R. You once expertly described the mathematical reasoning behind vaccination within minutes of learning the material. Such quick and thorough understanding of topics will serve you well in life. I wish you well in your desire to become a “doctor [with] a strong intent in making devices that help people.” You have the skills to do so.

32. Thirty-two. A. You had a keen thought on the matter of “playing god” putting it thusly: “Why should we not cure if we can cure, or create what we can create it?” Such practicality will always serve an engineer. Your additional caveat of “certain ethics apply[ing]” will serve you even better.

33. Thirty-three. E. E. You had many great questions in this class and I hope I was able to provide at least okay answers to them all. May you continue to ask the right ones.

34. Thirty-four. A. R. You thus far have the distinction of having created my favorite title for an essay in one of my classes with “Legal rights to biological information: the beauty of capitalism and the trouble it gets us into.”

35. Thirty-five. R. S. In what has quickly become something of a weekly mantra of mine, you once said that biomedical engineers should quote “do something that betters mankind.” Do something that betters mankind. I can think of no better wisdom that I can impart than just that: do something that betters mankind.

36. Thirty-six. J. You once described yourself as “the exact combination of the exact cells that I am right now” and that by said definition of biological identity it would be impossible to describe someone given the zettabytes of information that changing all the time. So far as I am, I am glad that we had you and your million variations in this class. May you in myriad form enrich others.

37. Thirty-seven. R. I hope your aunt’s wedding goes well. And I hope you are able to go on another one of those Disney half marathons during your college career.

38. Thirty-eight. I. You have been wicked smart in this class in just about every way we’ve asked you to be. I can see why they let you on Who Wants to be Millionaire. May you one day get what you want.

39. Thirty-nine. A. K. I hope that you hung up that poster of the Pale Blue Dot and that it gives you sufficient perspective of the world, wherever you may sit upon it.

40. Forty. N. I am sorry that I presumed all here wanted to pursue biomedical engineering. However, I hope I have made as convincing a case as I can that you should pursue a career in biomedical engineering. Look at all the cool stuff we get to do. You don’t get to get to talk about puberty suppression for the treatment of gender dysphoria in the blimp class. We’re doing some pretty cool things here in biomedical engineering and I think it’d be pretty cool if you considered a career in it. All the same, I wish you well in whatever path you take on this campus to get to a better life. …Hopefully as an engineer.

41. Forty-one. I. You and your team were able to pull together a fantastic presentation in forty-eight hours. I liked that you had the confidence to pursue a last-minute change given by the last-minute constraints of your physician and the pesky anatomy of the whole thing. Given that it was you whom I mostly interacted with in the run up to your presentation, I suspect you a had a leading role in the end product. Its quality speaks to some measure of your leadership.

42. Forty-two. E. S. I found most of your written answers absolutely fascinating. For example, you once said of the boundaries biomedical engineers should respect that “nothing should go so beyond the way of nature that it goes against it” which is just downright poetic.

43. Forty-three. R. M. You had a fascinating expansion of the Ship of Theseus metaphor based on a thought-experiment challenging the definition of continuity that I hope you explore more thoroughly. If not here, then elsewhere. Take a creative writing class or something and get it in print.

44. Forty-four. A. You have described your reason for taking this class as “something that would combine what [you] love – biology – with something that runs the world – technology.” May you have learned a bit more of what you love and how to use it to run the world.

45. Forty-five. T. I will remember you for your handle of orders of magnitude. May your grasp be yet refined.

46. Forty-six. A. I take it as something of a compliment that on the very first day of class you were about as far back as could be and here you are right in the front. Means you couldn’t have been too put off by the material or my presentation of it.

47. Forty-seven. S. I feel that engineers are afforded a matter-of-factness missing from all other realms of life. For doctors, every patient is different; for scientists, every experiment unique. Engineers, operating with approximations and fudge factors seem the most comfortable saying “yeah, that’s the way it is” with no hint of abdication. S, you once said “performing […] unethical things should never happen, but to ignore any information from them that could potentially save lives would be stupid and counterproductive.” Most in the humanities will not tell it to you quite that straight. May you continue on your engineering career with an ever-honing bluntness.

48. Forty-eight. A. S. Your work in this class has been exemplary. May you continue to “feel that doing this will allow [you] to help people each and every day.” In other words, may new days make your sunshine anew.

49. Forty-nine. J. One thing I attempted to emphasize in this class was the role of the patient in our whole engineering process. You said this more concisely and yet perhaps more broadly of the matter: “Yes, there are boundaries we should respect; we should respect the patient’s medical wishes.” Such a crystalline formulation will always help you to find clarity in biomedical engineering.

50. Fifty. D. As I did with A, I will take it as a compliment here that you have sat front and approximately-center for much of this course’s duration. Hopefully it has earned your attention to it. May it aid you onward.

51. Fifty-one. M. Your questions during office hours have been some the most illuminating for me pedagogically. That is, you have helped me (I hope) teach better in the future. On behalf of future students who understand the material just that bit better and who owe you debt of gratitude they do not yet know, thank you for participation in this class.

52. Fifty-two. B. I didn’t know there was going to be a category in my brain for Favorite Bulletpoints, but you have provided this year’s best with: “assisted suicide, designer babies.” There is something uniquely magical to our biomedical enterprise when such a bulletpoint can be written. May you continue to find that magic in your further study of the field.

53. Fifty-three. A. Perhaps I best got to know you on our walk from the room we both thought we were supposed to be in to the room we were actually supposed to be in, where you came across as a smart cookie. People don’t just come across as a smart cookie. Keep coming across as a smart cookie.

54. Fifty-four. S. Believe it or not I always mean to ask about your pet tortoise “S” but there’s never the right segue offered in class. “Here’s the mathematics describing a dubious medical trial tense with racial injustice and honest-to-goodness crime against humanity. How is your tortoise, S?” And as there has never been a better time than now, how is your tortoise, S?

55. Fifty-five. S. You have at times demonstrated excellent moral character. If even half of us had that, we’d have better.

56. Fifty-six. S. You have said of your interest in biomedical engineering that you wish to “improv[e] the well being of humans.” I think is just about as laudable a goal as any person can have. And I hope you continue to do so from here on.

57. Fifty-seven. A. The first student to contact me as an instructor of this institution, doing so before the class even began. May you forge ahead with such fortitude in all life’s endeavors.

58. Fifty-eight. M. Upon this class’s consideration of using a controversial medical treatment, you said that “intrinsic distress has to be compared to the extrinsic distress” of said treatment. Knowing that you must balance factors is the critical first step in optimizing those factors as an engineer.

59. Fifty-nine. M. You came to review sessions with questions to ask and answers to pursue. May you keep at that doggedness and answer a great many questions with it.

60. Sixty. D. Thank you for your participation in both this class and in our bioethics discussions. You’ve made substantial contributions here and elsewhere. May you continue to contribute substantially.

61. Sixty-one. K. You are the first (and as of yet, only) student of mine to get over 100% on an assignment. Just as we commended C early for being the first to 100 for its difficulty, here we commend you for skills in being the first to surpass it. Keep doing what you’re doing.

62. Sixty-two. M. Among my favorite phrases describing our biomedical condition in this class comes from your most recently graded homework in which you state that it is “the combination of all of our maybe-not-perfectly-unique characteristics [that] makes us who we are.” I suspect this seed of truth has to be growing in a few more minds if we are to have any hope of world peace.

63. Sixty-three. G. You had many great responses in this class and perhaps my favorite response of all: to having been explained the tin man’s origin you responded thusly. Which I think is something of a contemporary eureka moment. You got something in that moment that I hope stays with you. And I hope you get many more things from many more moments just like that.

64. Sixty-four. A. M. You had one of my favorite expressions of the intrinsic human goodness of our topics here. When asked about the conditions that ought to govern the behavior of biomedical engineers you responded “As long as biomedical engineers are working towards improving quality of life for all […] then there should be no boundaries” and held that we “should aim to help all regardless of who they are.” The world will be objectively better with more engineers of your persuasion.

65. Sixty-five. R. C. You provided me with one of my favorite justifications for the mandated use of vaccinations: “Yep. Herd immunity for the win.”

66. Sixty-six. L. Thank you for your supplemental material for this class on the topics of the angle of our vision and the design of our prostheses. I am glad to see that you pursue the material beyond the confines of this class. May you do so in others.

67. Sixty-seven. K. I am glad your two previous heart surgeries have enabled you to sit through this class. I hope the one you have next year goes well and I don’t think I’m speaking out of turn if I say I am speaking for all us here in wishing you the best and urging you to keep your ticker ticking.

68. Sixty-eight. A. Your motivation for pursuing biomedical engineering was put more succinctly and thus better than my own: “I love the human aspect of engineering. While I love the innovation of engineering in general, biomedical engineering gives me insight on a person’s life and allows me to have a direct impact on their stories.” May you go on to impact many stories hence, telling a few of your own.

69. Sixty-nine. M. You have described the field of biomedical engineering as having “the potential to make a great positive impact in people’s lives and” – more to the point – you “want to do that.” I hope this class has helped expand your realms of potentiality and that you continue to wish to make great positive impacts on the lives of others.

70. Seventy. E. You have, to this point in my life, the best notes I have ever seen taken for a class. May your concise and artistic interpretation of the information before you yield ever more creative fruit.

71. Seventy-one. H. Perhaps the youngest in our class, but no less the wizen. May you continue in stride your education here.

72. Seventy-two. J. A late, great addition to this class. Though I know you likely will be going on to pursue an aerospace or nuclear engineering based program, I hope your brief foray into the biomedical scene has given you an appreciation of what it is we’re up against on this side of the fence. May you ever keep the interests of human beings first in your mind in whatever you engineer.

Okay, so to you, that one or two or three of you sitting in the audience thinking, well, maybe I want to do some of this stuff for real, how do I get there, may I, a fellow traveler across this landscape, tend a piece of advice: the roads ahead are treacherous, it’ll be hard to get where you’re going. And if the map I’ve offered is complicated, it’s because the quote real world it represents is even more so.

I can only mark off so much territory for us to look at and appreciate. I hope I’ve chosen some good images to show you of the world you’ve got to appreciate as a biomedical engineer, specifically and perhaps more so to those who might go into professions which call upon such knowledge: designing a functioning healthcare systems, creating cancer therapeutics that will save the lives of husbands and wives, children and parents, and only now, only just now, do I as your intellectual peer think that you are in any way qualified to do that. You have convinced me and I am sure you will convince others.

For those who do not want to pursue work in this field, I wish you the best in whichever you may find yourself.

Regardless of your inclination towards the material, you may have, throughout some portion of this entire course, already known everything I tried to teach you. So much so that you may have been bored to tears you wept in your dreams. Present speech included. This touches upon my earlier point: the world you already know is boring. And the world ahead of you isn’t that. Take your time here at the University to develop a philosophy of your own. Learn what you like, study what you need, become what you want.

I have tried in my own way to convince you there’s so much to how this big wide world works that you in a hundred million tries couldn’t figure out all of it. But for this first pass at it, you ought to have learned a few things. Chief among them, though rarely said aloud, is that deep down, in a very real place in your instructor’s heart, he wants you all to succeed in a meaningful way in a meaningful world.

That’ll be enough.

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.