A Note to Skeptics: It’s Time to Go Radical

By Deepak Chopra, MD

 

Anyone who has had the audacity to question mainstream science soon runs afoul, particularly in the blogosphere, of hard-line skeptics. Whether they are simply insistent or outright aggressive, the skeptical viewpoint has long been founded on a simple principle. Reality is what lies before us, in the three-dimensional world “out there” that’s verified by the five senses. If you can see it, feel it, touch, taste, and smell it, the thing in question is real (making provisions for scientific instruments like telescopes and microscopes that extend the naked eye).

No amount of argument shakes the skeptic’s credo, and so it’s refreshing that they are being upended, not only by metaphysics or deeper investigation into consciousness–all of which gets dismissed as woo-woo, but by science itself. With the discovery of so-called dark matter and dark energy, which either obeys none of the laws of nature that apply to ordinary matter and energy or else conforms to those laws in a hidden way, the primacy of the visible universe has shrunk alarmingly. Every solid object in the cosmos, including interstellar dust, is barely the cherry on the top of an ice cream sundae, because only a fraction of 1% of creation is constituted by ordinary matter and energy.
This common-sense objection to the physicalists, as materialists now prefer to be called, doesn’t shake their faith utterly, because it might be possible to redefine matter and energy in such a way that the old model of “if you can see it, it’s real” won’t collapse. But other challenges to physicalism are more radical, which is why skeptics need to follow their credo to the nth degree and apply it to themselves. There is almost universal agreement among physicists that the universe emerged from a pre-created state that is a void, known as the quantum vacuum state. This void offers no empirical data. The world’s most powerful high-speed particle accelerators can barely budge any data from the quantum vacuum state, whose existence is so abstract that one might as well call it totally mathematical, i.e., mental.

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If your foundation of reality is mental, it’s obvious that the five senses have long ago ceased to be reliable (skeptics tend to overlook that among the greatest quantum pioneers a century ago, everyday matter and energy had already been thoroughly dismantled). The notion has long existed, as first evidenced by Heisenberg, that elementary particles have no set qualities; instead, nature delivers measurements tailored to the expectations, experimental setup, and observational bias of human beings. There are no fixed qualities of space, time, matter, and energy that exist “out there” without being extrapolated from human experience.

 

If you want to be radically skeptical, look with doubt upon a basic fact like the big bang, which we say in human time took place 13.8 billion years ago. With so much agreement on this fact, how could anyone be skeptical? The reason lies deeper than the clock ticking away on the shelf. The big bang has no known origin when you get to the finest level of time and space, known as the Planck scale. At this level, which is measured in trillionths of a second, the emergent universe is about to be born. Its birth wasn’t a bang, for obvious reasons. One, there was no sound, and two, explosions require a place and a time. The Planck scale precedes time and space (granting that “precede” makes no sense without time already existing).

In this pre-reality, if we can call it that, the universe originated everywhere at once, and contemporary theorists speculate over whether the same is true today as well. You can argue, from various viewpoints like eternal inflation, that the existence of matter and energy, whether at the subatomic scale or on the massive scale of galaxies, is a process that never ceases. Besides being timeless, it is also dimensionless. The whole notion of the quantum vacuum state, which is ground zero for reality, can be mathematically tinkered with so that the void has no dimensions, infinite dimensions, or a specific number in between. In a word, reality at its core is inconceivable, and trying to model it with mathematical formulas may serve a certain purpose abstractly, but even diehards like Stephen Hawking concede that current theory may be far removed from reality.

Skeptics should be chewing on the current imperfect and very malleable state of cosmology before they point accusations at anyone else. The defense of common-sense physicalism is not only outmoded by about a hundred years, but it amounts to an article of faith and a superstition, the very things the skeptic movements is dedicated to oppose. In an era of radical skepticism, should it ever arrive, a post-physicalist perspective could be of tremendous benefit to everyone.

Deepak Chopra MD, FACP, founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing, is a world-renowned pioneer in integrative medicine and personal transformation, and is Board Certified in Internal Medicine, Endocrinology and Metabolism. He is a Fellow of the American College of Physicians, Clinical Professor UCSD Medical School, researcher, Neurology and Psychiatry at Massachusetts General Hospital (MGH), and a member of the American Association of Clinical Endocrinologists. The World Post and The Huffington Post global internet survey ranked Chopra #17 influential thinker in the world and #1 in Medicine. Chopra is the author of more than 85 books translated into over 43 languages, including numerous New York Times bestsellers. His latest books are You Are the Universe co-authored with Menas Kafatos, PhD, and Quantum Healing (Revised and Updated): Exploring the Frontiers of Mind/Body Medicine. discoveringyourcosmicself.com

How Patient Advocates Can Help with Doctor’s Visits

By Deepak Chopra MD, Lizabeth Weiss, BA, Nancy S. Cetel, MD, Danielle Weiss, MD, Joseph B. Weiss, MD,

 

When the average American goes to the doctor, shows up at the ER, or enters the hospital, the risks and complexities of our healthcare system strike home vividly. Besides the expense of care and the intricate tests and procedures a patient faces, there is a widely under-reported risk of medical mistakes and “adverse events,” as they care called, which can range from minor to disastrous.

 

The new idea whose time has come is the patient advocate, someone who represents the patient’s best interest in any medical situation. An advocate might be a well-meaning relative who helps an older patient understand what’s going on, stepping in to do attendant tasks like picking up prescriptions and organizing medical bills. But more and more we see the need for an advocate who is professionally trained to buffer the mounting risks in a healthcare system where less and less time is spent between doctor and patient, raising the possibility of a wide range of bad outcomes.

The public has limited knowledge of the relevant facts:

  • Medical errors are estimated to cause 440,000 deaths per year in U.S. hospitals alone.
  • The total direct expense of adverse events is estimated at hundreds of billions of dollars annually.
  • Indirect expenses such as lost economic productivity from premature death and unnecessary illness exceeds one trillion dollars per year.

 
untitled-design102What the patient is all too aware of is the doctor visit that goes by in the blink of an eye. A 2007 analysis of optimal primary-care visits found that they last in total 16 minutes on average. From 1 to 5 minutes is spent per topic discussed. Although a visit to a primary-care physician or specialist has increased to 20 minutes, a shift in a doctor’s workload in recent years, some of it mandated by law, finds more time being allocated to computer and desk work, such as entering data in the Electronic Health Record (EHR).

 

The actual face-to-face time with a doctor or other health care provider actually comes down to 7 minutes on average. Therefore, a patient advocate clearly has a huge gap to fill. The advocate can begin by simply observing the visit or procedure to make sure that simple mistakes and errors in communication don’t occur. Many of these are unavoidable byproducts of nurses changing shifts, hospital doctors on rotation, etc.

 

But in an aging population, the advocate’s efforts become even more critical. An advocate can take time to take a detailed patient history, something often lacking in our rushed system. They can translate information into the patient’s first language as needed, calm nerves in the stressful and unfamiliar surroundings of a hospital or clinic, and thereby bring to the fore the questions and answers that need to be transmitted. In the stress of a medical event, it’s very common for patients, particularly the elderly, to be so flustered and anxious that they forget to ask important questions or give important information.

 

Not everything is potentially positive if patient advocates become a standard part of health care. If they have their own agenda because their employer is a hospital or insurance company, the patient’s best interests may not be uppermost. One anticipates antagonism between the advocate and the doctor, who isn’t used to third-party input and values his autonomy. And if the advocate isn’t calm, professional, and common-sensical, adding another anxious person in the examining room would be a detriment.

 

Still, we feel that the benefits far outweigh the potential downside. The key is for advocates to be accepted as a positive extension of the existing system, not an opposition party. A concerted effort to standardize a curriculum and certification for advocates is now being developed. It needs all the support it can get. The creation of an educated, licensed workforce of professional advocates can and should be an integral part of improving the safety and efficacy of our national health care. With your eyes now opened, you’ll see how great the need is the next time you need to see the doctor.

 

 

 

 

Deepak Chopra MD, FACP, Clinical Professor of Medicine, University of California, San Diego, Chairman and Founder, The Chopra Foundation, Co-Founder, The Chopra Center for Wellbeing

 

Lizabeth Weiss BA, Research Associate, The Chopra Center for Wellbeing, Assistant Director, Rancho Santa Fe Senior Center

 

Nancy S. Cetel, MD, President and Founder, Speaking of Health and specialist in women’s health and reproductive endocrinology.

 

Danielle Weiss, MD, FACP Clinical Assistant Professor of Medicine, University of California, San Diego, Medical Director & Founder, Center for Hormonal Health & Well-Being

 

Joseph B. Weiss, MD, FACP, Clinical Professor of Medicine, University of California San Diego.

 

References: Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med 1991;324:370–6.

 

Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington DC: National Academy Press, 2000.

 

Department of Health and Human Services. Adverse events in hospitals: national incidence among Medicare beneficiaries. 2010. http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf.

 

A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care James, John T. PhD Journal of Patient Safety: September 2013 – Volume 9 – Issue 3 – p 122–128 doi: 10.1097/PTS.0b013e3182948a69

 

Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ 2016;353:i2139. doi:10.1136/bmj.i2139

 

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review. Mirelle Hanskamp-Sebregts, Marieke Zegers, Charles Vincent, Petra J van Gurp, Henrica C W de Vet, Hub WollersheimPublished 22 August, 2016 http://bmjopen.bmj.com/content/6/8/e011078.full

 

Weismann JS, Schneider EC, Weingart SN, et al. Comparing patient-reported hospital adverse events with medical records reviews: Do patients know something that hospitals do not? Ann Intern Med. 2008; 149: 100–108.

 

Overview of medical errors and adverse events. Maité Garrouste-Orgeas François Philippart, Cédric Bruel, Adeline Max, Nicolas Lau and B Misset Annals of Intensive Care 20122:2

DOI: 10.1186/2110-5820-2-2 Published 16 February 2012

 

Valentin A, Capuzzo M, Guidet B, Moreno R, Metnitz B, Bauer P, Metnitz P: Errors in administration of parenteral drugs in intensive care units: multinational prospective study. BMJ 2009, 338: b814. 10.1136/bmj.b814

Ridley SA, Booth SA, Thompson CM: Prescription errors in UK critical care units. Anaesthesia 2004, 59: 1193–1200. 10.1111/j.1365-2044.2004.03969.x

 

Garrouste-Orgeas M, Timsit JF, Vesin A, Schwebel C, Arnodo P, Lefrant JY, Souweine B, Tabah A, Charpentier J, Gontier O, et al.: Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II on behalf of the Outcomerea study group. Am J Respir Crit Care Med 2010, 181: 134–142. 10.1164/rccm.200812-1820OC

 

Garrouste-Orgeas M, Soufir L, Tabah A, Schwebel C, Vesin A, Adrie C, Thuong M, Timsit JF: A multifaceted program for improving quality of care in ICUs (IATROREF STUDY) on behalf of the Outcomerea study group. Critical Care Med, in press.

 

Overview of medical errors and adverse events. Maité Garrouste-Orgeas, François Philippart, Cédric Bruel, Adeline Max, Nicolas Lau and B Misset Annals of Intensive Care20122:2

DOI: 10.1186/2110-5820-2-2 Published 16 February 2012

 

Kennerly DA, Kudyakov R, da Graca B, et al. Characterization of adverse events detected in a large health care delivery system using an enhanced Global Trigger Tool over a five-year interval. Health Serv Res 2014;49:1407–25. doi:10.1111/1475-6773.12163 Google Scholar

 

Rutberg H, Borgstedt Risberg M, Sjodahl R, et al. Characterisations of adverse events detected in a university hospital: a 4-year study using the Global Trigger Tool method. BMJ Open 2014;4:e004879. doi:10.1136/bmjopen-2014-004879

 

Christiaans-Dingelhoff I, Smits M, Zwaan L, et al. To what extent are adverse events found in patient records reported by patients and healthcare professionals via complaints, claims and incident reports? BMC Health Serv Res 2011;11:49. doi:10.1186/1472-6963-11-49 [CrossRef][Medline]Google Scholar

 

Classen DC, Resar R, Griffin F, et al. ‘Global Trigger Tool’ shows that adverse events in hospitals may be ten times greater than previously measured. Health Aff (Millwood) 2011;30:581–9. doi:10.1377/hlthaff.2011.0190

 

Sari AB, Sheldon TA, Cracknell A, et al. Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. Qual Saf

 

J Health Care Finance. 2012 Fall;39(1):39-50.

 

The economics of health care quality and medical errors. Andel C1, Davidow SL, Hollander M, Moreno DA. https://www.ncbi.nlm.nih.gov/pubmed/23155743

Where Do You Call Home? A Cosmic Answer

By Deepak Chopra, MD, Menas Kafatos, PhD

 

Home is a charged word for everyone, a source of emotion that’s intimately associated with feeling safe and loved, of belonging. When asked “Where is home?” people reply with a country or city, perhaps a specific street address. Almost no one says “My home is the universe.” But for scientists trying to explain cosmic issues, the fact that the universe is the ultimate home where human life arose poses some huge mysteries. In our book You Are the Universe , we explore these mysteries, but that’s really secondary to something more important. We aim to show that the universe exists to be the home of human beings.

 

In other words, we take the universe personally. Such a position sounds at first blush like a totally wrong-headed stance. The universe, whether viewed by the naked eye or through the Hubble telescope, presents itself as a vast space where some three trillion galaxies, by the latest estimates, are rushing away from one another at high speed, where spacetime is being stretched out, carrying along every object embedded in it. This picture is so well established that many people, including trained physicists, assume that new discoveries will basically just fill in the blanks. It’s not as if we need a totally new definition of the cosmos.

 

But in fact we do, and there’s a growing sense among scientists that this is true. Even those who accept the inflationary model of the universe (a model based upon the reality of the big bang 13.7 billion years ago) realize that the fundamental components of reality–space, time, matter, and energy–remain mysterious. In fact, it’s the breakdown at the most fundamental levels that causes the universe to be very different from what the eye or telescope sees.untitled-design100

 

 

The word “breakdown” must be taken seriously here. The New York Times ran an article over a year ago on the crisis in physics, and quite publicly Stephen Hawking has been exploring the a cracks in a unified Theory of Everything (the holy grail of physics at least since the lifetime of Einstein). Hawking is prone to quotes like the following: “I don’t demand that a theory correspond to reality because I don’t know what it is. Reality is not a quality you can test with litmus paper.” The fact that the most advanced theories about space, time, matter, and energy don’t necessarily match reality opens the way for looking at reality very differently.

 

Our different view is that the universe is trapped in a paradox. On the one hand, everyone holds that the universe developed after the big bang in keeping with random events, whether those events are the collision of two helium atoms or two galaxies. There is no plan or design, no predetermined purpose in creation, and ultimately no meaning to why things happen as they do. On the other hand, and this is where paradox reigns, the universe is the perfect home for human life to have evolved on Earth. In fact, the universe is so incredibly precise in allowing life and intelligence that randomness just does not fit the bill.

 

The evidence for this side of the paradox begins with what is known in cosmology as the fine-tuning problem. After the big bang, there was a precarious balance of natural forces. Given a change one wayor another by less than one part in a billion, the infant universe could have collapsed in on itself or, at the opposite extreme, flown apart so fast that atoms and molecules would never had developed. If the laws of nuclear physics were slightly different, a collapsing supernova could not occur and the heavy elements which are essential to our bodies could not have formed in the cauldron of stellar collapse. Other more arcane disasters and distortions were also possible, but the upshot is that the constants that keep the universe intact are meshed together so finely as to defy any random explanation.

 

 

Human life needed a home to evolve in, meaning a planet, which in turn needed a solar system, which in turn needed stars, interstellar dust, viable stable atoms, and so forth, all the way down the line to the big bang. It’s very suspicious that there were no hitches along the way. Very small hitches would have made it impossible for the most complex molecule in the known cosmos–human DNA, with its 3 billion base pairs–to evolve.

To compound the paradox, there are other enormous gaps in the models we apply every day to explain reality, among them:

  1.  No one knows what came before the big bang because “before” implies time, and time didn’t necessarily exist before the moment of creation. In fact, the very question only makes sense when time exists, not “before” time existed.
  2.  In a similar way, no one knows what lies outside the universe, because “outside” applies to space in the sense of a box that has an inside and outside, whereas such space can’t apply before the big bang occurred. How can there be space outside space?
  3.  No one knows where cause-and-effect came from. Cause and effect both depend on something happening “before” to cause something else “after.” This ties us to a linear scheme that can’t step outside time, even though we can compute mathematically that the quantum world doesn’t seem to work by linear cause and effect–perhaps not any kind of cause and effect.
  4. No one knows where meaning came from. If the universe evolved by random events that are meaningless, how did we humans arrive at meaning, purpose, design, and the concept of evolution? These concepts are fundamental everyday realities. This problem of locating the origin of meaning is tied to an even bigger one: no one can explain how an unconscious universe came up with consciousness. It’s not as if the ordinary molecules of salt, water, sugar, and other basic components of the brain suddenly learned to think.

 

Our book delves into the details of these baffling mysteries, but where a physicist might consider them abstract puzzles to which advanced mathematics must be applied, the mismatch between theory and reality concerns everyone. We don’t know why the universe is our home or even what “home” means in the larger sense. No one would put money down on a house built of materials the builder can’t describe or tell where they came from. Yet we have bought into a conception of the cosmos with exactly those flaws. In fact, far from looking out at a physical universe filled with stars the way a box of chocolates is filled with truffles, we are actually looking out at a conception, a human artifact that we alone are responsible for. That’s a mystery worth pondering if we ever hope to find out who we really are.

 

 

Deepak Chopra MD, FACP, founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing, is a world-renowned pioneer in integrative medicine and personal transformation, and is Board Certified in Internal Medicine, Endocrinology and Metabolism. He is a Fellow of the American College of Physicians, Clinical Professor UCSD Medical School, researcher, Neurology and Psychiatry at Massachusetts General Hospital (MGH), and a member of the American Association of Clinical Endocrinologists. The World Post and The Huffington Post global internet survey ranked Chopra #17 influential thinker in the world and #1 in Medicine. Chopra is the author of more than 85 books translated into over 43 languages, including numerous New York Times bestsellers. His latest books are You Are the Universe co-authored with Menas Kafatos, PhD, and Quantum Healing (Revised and Updated): Exploring the Frontiers of Mind/Body Medicine. discoveringyourcosmicself.com

 

 

Menas C. Kafatos is the Fletcher Jones Endowed Professor of Computational Physics, at Chapman University. He is a quantum physicist, cosmologist, and climate impacts researcher and works extensively on consciousness. He holds seminars and workshops for individuals, health and mental professionals, practitioners of contemplative traditions, and corporations on the natural laws that apply everywhere and are the foundations of the universe, for well-being and success. His doctoral thesis advisor was the renowned M.I.T. professor Philip Morrison who studied under J. Robert Oppenheimer. He has authored 315+ articles, is author or editor of 16 books, including The Conscious Universe (Springer), Looking In, Seeing Out (Theosophical Publishing House), and is co-author with Deepak Chopra of the forthcoming book, You Are the Universe (Harmony). He maintains a Huffington Post blog. You can learn more at http://www.menaskafatos.com

How to Meet Your Cosmic Self

By Deepak Chopra, MD

Science has been falsely portrayed as the enemy of spirituality, largely because of a noisy band of militant atheists who also happen to be scientists. Their outcry that to believe in God is irrational and therefore anti-scientific misses the point. Not all scientists are irreligious, but the whole premise of this militant group is faulty. They don’t just disbelieve in God; they disbelieve in the entire domain of subjectivity. What happens “in here” is unscientific, they say, a preposterous claim given that the works of Shakespeare and Mozart emerged from the inner world, along with all sensations, feelings, and thoughts.
We don’t need to re-litigate the issue, and we don’t need to enter the area of post-truth, to use a favorite term being bandied about. The truth is that the universe, and our participation in it, is a single activity. It takes all the laws of nature to produce a galaxy or to bring the image of a rose to mind. Nature has only one source and origin, whether we are discussing mind or matter.

This point lies at the heart of my new book, You Are the Universe, with co-author and widely published physicist Menas Kafatos. Our title is a free translation of an ancient India aphorism from the Vedic tradition, Aham Brahmasmi. Our intention was to show that the cosmos is intimately tied to human awareness. In fact, human awareness is pivotal and irreplaceable when trying to unwrap every cosmic mystery. That’s because the only reality we know, or can ever know, is based on experience. Even the most abstruse mathematical model of the universe can’t exist outside experience.

But if this sounds abstract or like a foray into metaphysics, far from it. The whole point of Aham Brahmasmi is to reveal the existence of a cosmic self. The world’s wisdom traditions sometimes refer to God, but not always. What they absolutely agree upon, however, is a hidden level of reality accessible only through higher awareness. Since everyday reality is only accessible through awareness, such a claim isn’t a stretch. “Higher awareness” doesn’t even have to be a mystical term–it can apply to the greatest artists, writers, philosophers, and scientists. untitled-design96
Modern science is best seen as a jumping-off point for inner exploration. Already there is turmoil inside cosmology because the accepted methods of doing science–conducting experiments, making measurements, and gathering data—have reached their limits. At the far edge of spacetime, as well as at the source of matter and energy, physical reality disappears into the vacuum state, which is a void. It is settled science that the entire universe emerged from nothingness, and yet we can’t go home again–there’s no way to return to the pre-created state of the cosmos given that it probably contains nothing like what we term space, time, matter, and energy.

But if that’s the end point of physical exploration, it’s the jumping-off point for inner exploration. Awareness looks out and creates a world; it looks inward and knows itself. A bacteriologist can’t do his job without understanding how a microscope works, yet for a long time science has tried to explain the universe without understanding how consciousness works, and consciousness is the primary tool at hand. The investigations we lump together as spiritual, religious, or metaphysical are actually one thing–a journey to meet the cosmic self. Higher consciousness is nothing more than being aware of awareness, consciousness knowing itself.

You Are the Universe argues that scientific knowledge will take a quantum leap once consciousness is no longer ignored, and a growing cadre of far-seeing physicists, joined by biologists, physicians, and neuroscientists, agree. But the real value of meeting the cosmic self is personal and applies to every person, in or out of science. The path to enlightenment is a project that is as old as recorded history. We are incredibly fortunate to live at a time when the most sophisticated theories in cosmology and the deepest scientific understanding of the universe offer proof that meeting the cosmic self is actually possible–indeed, it’s the only way to settle once and for all who we are, why we are here, and what the nature of reality truly is.

Deepak Chopra MD, FACP, founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing, is a world-renowned pioneer in integrative medicine and personal transformation, and is Board Certified in Internal Medicine, Endocrinology and Metabolism. He is a Fellow of the American College of Physicians, Clinical Professor UCSD Medical School, researcher, Neurology and Psychiatry at Massachusetts General Hospital (MGH), and a member of the American Association of Clinical Endocrinologists. The World Post and The Huffington Post global internet survey ranked Chopra #17 influential thinker in the world and #1 in Medicine. Chopra is the author of more than 85 books translated into over 43 languages, including numerous New York Times bestsellers. His latest books are You Are the Universe co-authored with Menas Kafatos, PhD, and Quantum Healing (Revised and Updated): Exploring the Frontiers of Mind/Body Medicine. discoveringyourcosmicself.com

The Genetics of a Silent Killer and the Quest for a Cure

By Deepak Chopra, MD FACP and Mark L. Zeidel, M.D

Some diseases make headlines, pull at our heart strings, and inspire high-visibility fundraising events. Others, like kidney disease, wreak havoc more quietly. Chronic kidney disease afflicts more than 26 million people in the U.S., putting them at high risk for other serious illnesses, like heart disease. Nearly half a million people suffer from end-stage kidney disease, a devastating condition often requiring dialysis or transplantation. Medicare spends more than 30 billion dollars a year taking care of kidney failure patients—about 6 percent of the Medicare budget.

While kidney disease is widespread, it disproportionately affects certain populations: African Americans and others of recent African ancestry are more than three times as likely to suffer from kidney failure as those of European descent. African Americans constitute 35 percent of all patients receiving dialysis for kidney disease, despite being only 13 percent of the U.S. population. Some of this disparity is attributable to the most common causes of kidney disease: diabetes and high blood pressure, both of which are more prevalent among African Americans. But there’s increasing evidence that genetics may also play a significant role in the disease. Researchers at Boston’s Beth Israel Deaconess Medical Center (BIDMC) and elsewhere have discovered that two common variations in a gene called apolipoprotein L1 (APOL1) are responsible for an increased susceptibility to several forms of non-diabetes-related kidney disease among African Americans.

Thirty percent of African Americans carry these particular mutations, and for much of human history this served them well: This genotype is actually protective against a disease called African Sleeping Sickness, caused by certain forms of African trypanosomes. Transmitted by the tsetse fly, African Sleeping Sickness is common in eastern Africa and can cause fever, anemia, and death from neurologic disease. While these variants may still be of some benefit to populations living in Africa and exposed to the tsetse fly, here in the U.S. the genetic variation has little benefit and carries significant risk, particularly since there is no cure for kidney disease. As Martin Pollak, MD, Chief of Nephrology at BIDMC, explains, “We have treatments like dialysis and kidney transplants to keep those who have advanced kidney disease alive longer, but we don’t have any cures.” He adds, “Fewer than 40 percent of patients on dialysis live more than five years.” (And in developing countries, even these treatments are often too expensive to be available.) Pollak’s hope is that the APOL1 discovery—part of a body of research that earned him election into the prestigious National Academy of Sciences—will help pave the way toward prevention and treatment of the disease.untitled-design85

To that end, the BIDMC investigators—among the top researchers on kidney disease in the world—are using every scientific tool at their disposal. They’re developing human, mouse and fish models to better understand the genetics, cell biology and biochemistry of APOL1’s action in the kidney. Pollak and his team are also trying to understand why certain carriers of the APOL1 mutations are more susceptible to kidney disease than others. “That might give us some clues on how to better treat the condition,” he says.

In terms of patient care, their research has begun to inform clinical practice. Increasingly, doctors are debating the merits of genetic screening and counseling for those at highest risk of carrying the APOL1 gene mutation. However, until more is known about how to prevent and treat this form of disease, the benefit of testing is unclear. Based on this work, the hope is that specific methods for preventing and treating APOL1-associated kidney disease will be developed and implemented in the coming years.

“We want to put our own division out of business by preventing this disease to begin with,” Pollak says. “Short of that, we’d like to develop treatments that allow people with kidney disease to live with it as a chronic disease.” Until recently, he explains, kidney disease was much like HIV/AIDS was in the 1980s—a terrible disease that devastated lives and perplexed biomedical researchers. Once the causative organism, the HIV virus, was identified, combinations of drugs were developed, which now suppress the virus effectively. “With the discovery of APOL1, this major form of kidney failure now has a cause, and we can develop treatments directed to fixing the causal problem,” Pollak explains. “With a clearer understanding of the underlying genetics, we’re hopeful that kidney disease will soon be like AIDS—a treatable condition with which people can live long and active lives.”

Deepak Chopra MD, FACP, founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing, is a world-renowned pioneer in integrative medicine and personal transformation, and is Board Certified in Internal Medicine, Endocrinology and Metabolism. He is a Fellow of the American College of Physicians, Clinical Professor UCSD Medical School, researcher, Neurology and Psychiatry at Massachusetts General Hospital (MGH), and a member of the American Association of Clinical Endocrinologists. The World Post and The Huffington Post global internet survey ranked Chopra #17 influential thinker in the world and #1 in Medicine. Chopra is the author of more than 85 books translated into over 43 languages, including numerous New York Times bestsellers. His latest books are You Are the Universe co-authored with Menas Kafatos, PhD, and Quantum Healing (Revised and Updated): Exploring the Frontiers of Mind/Body Medicine. www.discoveringyourcosmicself.com

Mark Zeidel, M.D., is Herrman L. Blumgart Professor of Medicine at Harvard Medical School and Physician and Chief and Chair of the Department of Medicine at Beth Israel Deaconess Medical Center in Boston. He has made important contributions to our understanding of how the kidney helps control body chemistry, and has led several successful national initiatives in medical education.A national thought leader in quality improvement, he has pioneered the provision of highly reliable, cost-effective care at Beth Israel Deaconess Medical Center (BIDMC), where he helped BIDMC’s achieve of outstanding clinical outcomes, recognized by the American Hospital Association, Society for Critical Care Medicine, the Leapfrog Group, and the Department of Health and Human Services. He has received numerous awards, including election to the American Society of Clinical Investigation and the Association of American Physicians, the Robert H. Williams Distinguished Chair of Medicine Award from the Association of Professors of Medicine and the Robert Narins Award for Medical Education from the American Society of Nephrology.