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Neal Stephenson's Latest: REAMDE

It takes guts to title your blockbuster novel using an intentional misspelling. But fortunately for readers, Neal Stephenson has guts, a killer story, and -- for the first time since Cryptonomicon -- a thriller I can thoroughly recommend to any reader, not just the King Dorks of the crowd. Expect to see REAMDE enjoyed by regular human beings on airplanes, in coffee shops, and in geek-dens (the hive-like underground warrens where computer programmers go to sleep). I can only begin to tell you how exciting this is. The book comes out today (September 20, 2011) and is, as we speak, in a bookstore near you. Or, if you're not near a bookstore, there are links at the bottom of this article to some internet-based retailers who would love to get you a physical or virtual copy right away.

Note: this review is intended to be spoiler-free. I do discuss the book, but don't give away anything that isn't in the promo materials. If you want to be utterly devoid of context, here's the tl;dr version: buy it and block out a solid three days to work your way through it. If you liked Cryptonomicon, Snow Crash, Anathem or The Diamond Age you will freak out with joy about this book. If you don't know what I'm talking about, frankly you might still enjoy this thing -- do you like rip-roaring tales of adventure, told by a smart guy, involving the technical aspects of guns, planes, boats, computers, and more guns? I thought you did. So let's get into things.

Let's Go Back to 1992

In 1992, Neal Stephenson made waves with Snow Crash, a smart cyberpunk thriller featuring the aptly named "Hiro Protagonist." Although Snow Crash was his third novel, it was Stephenson's first work that put him on the map, immediately elevating him into the pantheon of godlike sci-fi writers who could do no wrong (this status lasted until about halfway through the first volume of The Baroque Cycle, at which point many frustrated readers simply gave up). I read Snow Crash in 1996, and proceeded to devour everything the man ever published (including the pseudonymous "Stephen Bury" novels, which are fun techno/political thrillers). Since the mid-90's, my life has been punctuated by long periods of delay, waiting for Stephenson's latest work. I do things around the edges (you know, jobs and stuff), but mainly I'm just waiting for the next book.

A Series of Obsessions

Stephenson, from 1992 through now, has developed and written about a series of intellectual interests that appear to the reader as obsessions. These obsessions have appeared over and over in his work, and in REAMDE we have a book touching on each. If I may catalogue them:

Currency: the notion of currency (not "money"), the creation and destruction of value, and currency flows appear throughout Cryptonomicon and even more in The Baroque Cycle. In REAMDE, several characters are involved in a MacGuffin-ish plot involving currency flows. This plot serves to set the story in motion, then quickly drops into the background as characters come forth and bring us to some other obsessions, to wit:

Technology: Stephenson seems to be interested in the notion of technology specific to a given culture and time period. This is notable because while he is clearly a geek, he doesn't seem to give a damn whether he's geeking out about computers, guns, swords, winches, boats, air travel, horseshoes, chemistry, rope, you name it. In REAMDE (set roughly in the "present day"), we see technology across cultures and circumstances. Without spoiling anything, I'll also note that gun enthusiasts will have a lot to dig into. Those who know next to nothing about firearms (ahem, like myself) will enjoy the education offered by this novel (for example, "red: you're dead" for the red dot often visible when the safety on a firearm is disengaged). I found myself quite interested in the detailed mechanics of firearms and their management, transport, firing, and reloading -- that's not something that has interested me in the past. It takes a geek to explain why something is interesting to another geek.

Cultural Differences: It's no secret that Stephenson likes to write large, sprawling books involving characters who speak different languages and live in wholly different situations. But in this one, I smelled an interesting undercurrent that extended beyond the now-typical international angle of his work. The new work (again, without giving anything away) has to do with a cultural divide within the US (some might call this the Red State/Blue State divide, though that seems a vast oversimplification to any Cultural Differences Geek). This novel includes Seattle tech geeks wearing utili-kilts as well as people in RVs camping in WalMart parking lots, and attempts to get into the heads of both. Well done, Stephenson.

Family Ties: In past works we've seen cross-generational plot lines, sometimes spanning generations and even hundreds of years. Remember the scene in Cryptonomicon when the family divides up Randy's grandmother's worldly possessions by placing them on vectors of monetary and sentimental value and applies a knapsack algorithm to solve the problem? You're in for much more of that kind of thing in REAMDE. Don't worry, you don't have to care about math to enjoy it -- though it might help to have a passing interest in grizzly bears.

Time, Geology, & Geography: While Anathem was most obviously influenced by Stephenson's involvement with The Long Now Foundation (and thus spans, or at least considers, immense stretches of time), REAMDE takes place over just three weeks -- but we see Stephenson's innate interest in deep time when he describes geological landforms. Every time we see a new bit of land (a mountain, a bay, and so on), Stephenson introduces it with an eye towards its geological origins. It's like the man can't see a hill without thinking about the process that formed the hill somewhere in deep prehistory. Without spoiling anything, let's just say that there's an in-story reason for characters to have this level of geological awareness, though this is one clear moment where Stephenson peeks through to reveal his own interests.

So What?

With REAMDE we have a very smart page-turner -- a global chess game expertly played, switching perspectives among something like eight main points of view with the deftness we expect from this old master of new sci-fi. And to be clear, there's nothing "sci-fi" in this book (no aliens, no speculative technology, and nothing non-contemporary); but it's fiction in which characters confront tons of interesting problems with scientific and technological solutions, and a sort of geeky enthusiasm about the details of those solutions that belies the author's interest in sci-fi. What I mean to say is: you will like this book, but so will Tom Clancy-reading sales execs flying Business Class. Somehow Stephenson has written a book that's true to his intellectual level, but he's kept it accessible. Expect it to be a major bestseller, and expect to feel sad when it ends and you must wait three years for the next one (which might be, who knows, about clocks or something). Perhaps during the wait you can go read Stephenson's essay on cable-laying, or his other fine work from the 90's and before. (Though to be frank, The Big U was kind of a letdown; you should probably skip that one.)

On Length and Weight

Stephenson's recent work has routinely spanned well into multiple kilopages, much to the frustration of the aforementioned Baroque Cycle quitters. I'm happy to report that REAMDE just barely exceeds 1 kilopage, however the hardcover is exceedingly hefty, weighing in just shy of 3 pounds -- making it heavier than some laptops in my office. Plan accordingly if you're going to take this thing on vacation or even out of the house. Note that you can also use it for home defense (at close range) or as a structural member in minor construction projects. For this reason, you might consider an ebook for this one. If you can handle the weight (and the lovely rough-hewn paper edges), pick up a paper copy starting today (September 20, 2011) from Amazon, Barnes & Noble, or Powell's (signed!).

Blogger Disclosure

I received an Advance Reader Edition of the book at my request, but no compensation for reading or reviewing the book. It was quite a thrill to get an early look at Stephenson's next work, and I hope to keep checking out more ragged-right paperback previews in the future. (Ahem, take note, PR folks.) In the bookstore links above, the Amazon ones are affiliate links that kick back a small percentage if you buy the book through them. If you'd rather not kick some pennies my way, here are non-affiliate Amazon links for the hardcover and the Kindle edition. I hope you enjoy REAMDE as much as I did.

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science
6 Radiant Facts About Irène Joliot-Curie
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Hulton Archive/Getty Images

Though her accomplishments are often overshadowed by those of her parents, the elder daughter of Marie and Pierre Curie was a brilliant researcher in her own right.

1. SHE WAS BORN TO, AND FOR, GREATNESS.

A black and white photo of Irene and Marie Curie in the laboratory in 1925.
Irène and Marie in the laboratory, 1925.
Wellcome Images, Wikimedia Commons // CC BY 4.0

Irène’s birth in Paris in 1897 launched what would become a world-changing scientific dynasty. A restless Marie rejoined her loving husband in the laboratory shortly after the baby’s arrival. Over the next 10 years, the Curies discovered radium and polonium, founded the science of radioactivity, welcomed a second daughter, Eve, and won a Nobel Prize in Physics. The Curies expected their daughters to excel in their education and their work. And excel they did; by 1925, Irène had a doctorate in chemistry and was working in her mother’s laboratory.

2. HER PARENTS' MARRIAGE WAS A MODEL FOR HER OWN.

Like her mother, Irène fell in love in the lab—both with her work and with another scientist. Frédéric Joliot joined the Curie team as an assistant. He and Irène quickly bonded over shared interests in sports, the arts, and human rights. The two began collaborating on research and soon married, equitably combining their names and signing their work Irène and Frédéric Joliot-Curie.

3. SHE AND HER HUSBAND WERE AN UNSTOPPABLE PAIR.

Black and white photo of Irène and Fréderic Joliot-Curie working side by side in their laboratory.
Bibliothèque Nationale de France, Wikimedia Commons // Public Domain

Their passion for exploration drove them ever onward into exciting new territory. A decade of experimentation yielded advances in several disciplines. They learned how the thyroid gland absorbs radioiodine and how the body metabolizes radioactive phosphates. They found ways to coax radioactive isotopes from ordinarily non-radioactive materials—a discovery that would eventually enable both nuclear power and atomic weaponry, and one that earned them the Nobel Prize in Chemistry in 1935.

4. THEY FOUGHT FOR JUSTICE AND PEACE.

The humanist principles that initially drew Irène and Frédéric together only deepened as they grew older. Both were proud members of the Socialist Party and the Comité de Vigilance des Intellectuels Antifascistes (Vigilance Committee of Anti-Fascist Intellectuals). They took great pains to keep atomic research out of Nazi hands, sealing and hiding their research as Germany occupied their country, Irène also served as undersecretary of state for scientific research of the Popular Front government.

5. SHE WAS NOT CONTENT WITH THE STATUS QUO.

Irène eventually scaled back her time in the lab to raise her children Hélène and Pierre. But she never slowed down, nor did she stop fighting for equality and freedom for all. Especially active in women’s rights groups, she became a member of the Comité National de l'Union des Femmes Françaises and the World Peace Council.

6. SHE WORKED HERSELF TO DEATH.

Irène’s extraordinary life was a mirror of her mother’s. Tragically, her death was, too. Years of watching radiation poisoning and cancer taking their toll on Marie never dissuaded Irène from her work. In 1956, dying of leukemia, she entered the Curie Hospital, where she followed her mother’s luminous footsteps into the great beyond.

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ETH Zurich
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Medicine
This Soft Artificial Heart May One Day Shorten the Heart Transplant List
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ETH Zurich

If the heart in the Functional Materials Laboratory at ETH Zurich University were in a patient in an operating room, its vital signs would not be good. In fact, it would be in heart failure. Thankfully, it's not in a patient—and it's not even real. This heart is made of silicone.

Suspended in a metal frame and connected by tubes to trays of water standing in for blood, the silicone heart pumps water at a beat per second—a serious athlete's resting heart rate—in an approximation of the circulatory system. One valve is leaking, dripping onto the grate below, and the water bins are jerry-rigged with duct tape. If left to finish out its life to the final heartbeat, it would last for about 3000 beats before it ruptured. That's about 30 minutes—not long enough to finish an episode of Grey's Anatomy

Nicolas Cohrs, a bioengineering Ph.D. student from the university, admits that the artificial heart is usually in better shape. The one he holds in his hands—identical to the first—feels like taut but pliable muscle, and is intact and dry. He'd hoped to demonstrate a new and improved version of the heart, but that one is temporarily lost, likely hiding in a box somewhere at the airport in Tallinn, Estonia, where the researchers recently attended a symposium.

Taking place over the past three years, the experimental research is a part of Zurich Heart, a project involving 17 researchers from multiple institutions, including ETH, the University of Zurich, University Hospital of Zurich, and the German Heart Institute in Berlin, which has the largest artificial heart program in Europe.

A BRIDGE TO TRANSPLANT—OR TO DEATH

Heart failure occurs when the heart cannot pump enough blood and oxygen to support the organs; common causes are coronary heart disease, high blood pressure, and diabetes. It's a global pandemic, threatening 26 million people worldwide every year. More than a quarter of them are in the U.S. alone, and the numbers are rising.

It's a life-threatening disease, but depending on the severity of the condition at the time of diagnosis, it's not necessarily an immediate death sentence. About half of the people in the U.S. diagnosed with the disease die within five years. Right now in the U.S., there are nearly 4000 people on the national heart transplant list, but they're a select few; it's estimated that upwards of 100,000 people need a new heart. Worldwide, demand for a new heart greatly outpaces supply, and many people die waiting for one.

That's why Cohrs, co-researcher Anastasios Petrou, and their colleagues are attempting to create an artificial heart modeled after each patient's own heart that would, ideally, last for the rest of a person's life.

Mechanical assistance devices for failing hearts exist, but they have serious limitations. Doctors treating heart failure have two options: a pump placed next to the heart, generally on the left side, that pumps the blood for the heart (what's known as a left ventricular assist device, or LVAD), or a total artificial heart (TAH). There have been a few total artificial hearts over the years, and at least four others are in development right now in Europe and the U.S. But only one currently has FDA approval and CE marking (allowing its use in European Union countries): the SynCardia total artificial heart. It debuted in the early '90s, and since has been implanted in nearly 1600 people worldwide.

While all implants come with side effects, especially when the immune system grows hostile toward a foreign object in the body, a common problem with existing total artificial hearts is that they're composed of hard materials, which can cause blood to clot. Such clots can lead to thrombosis and strokes, so anyone with an artificial heart has to take anticoagulants. In fact, Cohrs tells Mental Floss, patients with some sort of artificial heart implant—either a LVAD or a TAH—die more frequently from a stroke or an infection than they do from the heart condition that led to the implant. Neurological damage and equipment breakdown are risky side effects as well.

These complications mean that total artificial hearts are "bridges"—either to a new heart, or to death. They're designed to extend the life of a critically ill patient long enough to get on (or to the top of) the heart transplant list, or, if they're not a candidate for transplant, to make the last few years of a person's life more functional. A Turkish patient currently holds the record for the longest time living with a SynCardia artificial heart: The implant has been in his chest for five years. Most TAH patients live at least one year, but survival rates drop off after that.

The ETH team set out to make an artificial heart that would be not a bridge, but a true replacement. "When we heard about these problems, we thought about how we can make an artificial heart that doesn't have side effects," he recalls.

USING AN ANCIENT TECHNIQUE TO MAKE A MODERN MARVEL

Using common computer assisted design (CAD) software, they designed an ersatz organ composed of soft material that hews closely to the composition, form, and function of the human heart. "Our working hypothesis is that when you have such a device which mimics the human heart in function and form, you will have less side effects," Cohrs says.

To create a heart, "we take a CT scan of a patient, then put it into a computer file and design the artificial heart around it in close resemblance to the patient's heart, so it always fits inside [the body]," Cohrs says.

But though it's modeled on a patient's heart and looks eerily like one, it's not identical to the real organ. For one thing, it can't move on its own, so the team had to make some modifications. They omitted the upper chambers, called atria, which collect and store blood, but included the lower chambers, called ventricles, which pump blood. In a real heart, the left and right sides are separated by the septum. Here, the team replaced the septum with an expansion chamber that is inflated and deflated with pressurized air. This action mimics heart muscle contractions that push blood from the heart.

The next step was to 3D-print a negative mold of the heart in ABS, a thermoplastic commonly used in 3D printing. It takes about 40 hours on the older-model 3D printers they have in the lab. They then filled this mold with the "heart" material—initially silicone—and let it cure for 36 hours, first at room temperature and then in an oven kept at a low temperature (about 150°F). The next day, they bathed it in a solvent of acetone, which dissolved the mold but left the printed heart alone. This process is essentially lost-wax casting, a technique used virtually unchanged for the past 4000 years to make metal objects, especially bronze. It takes about four days.

The resulting soft heart weighs about 13 ounces—about one-third more than an average adult heart (about 10 ounces). If implanted in a body, it would be sutured to the valves, arteries, and veins that bring blood through the body. Like existing ventricular assist devices and total artificial hearts on the market, it would be powered by a portable pneumatic driver worn externally by the patient.

FROM 3000 TO 1 MILLION HEARTBEATS

In April 2016, they did a feasibility test to see if their silicone organ could pump blood like a real heart. First they incorporated state-of-the-art artificial valves used every day in heart surgeries around the world. These would direct the flow of blood. Then, collaborating with a team of mechanical engineers from ETH, they placed the heart in a hybrid mock circulation machine, which measures and simulates the human cardiovascular system. "You can really measure the relevant data without having to put your heart into an animal," says Cohrs.

Here's what the test looked like.

"Our results were very nice," Cohrs says. "When you look at the pressure waveform in the aorta, it really looked like the pressure waveform from the human heart, so that blood flow is very comparable to the blood flow from a real human heart."

Their results were published earlier this year in the journal Artificial Organs.

But less promising was the number of heartbeats the heart lasted before rupturing under stress. (On repeated tests, the heart always ruptured in the same place: a weak point between the expansion chamber and the left ventricle where the membrane was apparently too thin.) With the average human heart beating 2.5 billion times in a lifetime, 3000 heartbeats wouldn't get a patient far.

But they're making progress. Since then, they've switched the heart material from silicone to a high-tech polymer. The latest version of the heart—one of which was stuck in that box in the Tallinn airport—lasts for 1 million heartbeats. That's an exponential increase from 3000—but it's still only about 10 days' worth of life.

Right now, the heart costs around $400 USD to produce, "but when you want to do it under conditions where you can manufacture a device where it can be implanted into a body, it will be much more expensive," Cohrs says.

The researchers know they're far from having produced an implantable TAH; this soft heart represents a new concept for future artificial heart development that could one day lead to transplant centers using widely available, easy-to-use design software and commercially available 3D-printers to create a personalized heart for each patient. This kind of artificial heart would be not a bridge to transplantation or, in a few short years, death, but one that would take a person through many years of life.

"My personal goal is to have an artificial heart where you don't have side effects and you don't have any heart problems anymore, so it would last pretty much forever," Cohrs says. Well, perhaps not forever: "An artificial heart valve last 15 years at the moment. Maybe something like that."

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