Monday, January 27, 2014


Prevalence of HIV-AIDS

For the purposes of this post, I am framing the reflection as an interaction between code and pattern.  CODE is defined as a sequence of characteristics like numbers, letters, or molecules.  Like math, writing/reading, and the genetic sequencing of pairs of four basic molecules along a double helix.  PATTERN is how that code plays out in the world, all the various influences of the situation and how the CODE can change it.  Code happens over time, even brief time, but pattern is like a chess game, like still photography, like a ball game scoreboard. Snap/score.  Snap/score.  There might be several codes that interact as "plays."  Codes don’t win or lose.  They just are.  Patterns win or lose.

Most diseases we know (measles, mumps, malaria, pneumonia) are tiny organisms, which are self-contained patterns that invade the big pattern that is our bodies.  When I was in grade school we were shown a movie about vaccines, because people were afraid to get shots.  They had to be forced onto the population by making them a requirement for attending school and then requiring every child to go to school.  That strategy has worn thin, so whooping cough and even polio are back.  But the little cartoon movie used the code of war: red blood cells were little American soldiers and disease entities were black spiders in Nazi helmets.  The vaccines were little green turtles who urged the warrior white cells into battle.  Something like that. 

HIV is not quite an organism.  It is a code in a space capsule, a predator drone that delivers code.  It gets into the blood, injects its code into one kind of defensive white blood cell (the real life electron microscopes videos show it sprouting a little phallic pseudopod and basically raping the CD4 cell) and shoving its code into the genetic code of the cell.  Then it makes the CD4 cell seem to be the enemy so that the CD8 cell bombs it -- essentially killing cells by friendly fire.  In the meantime, the code is manufacturing lots more code-delivering bomblets out of the CD4 cell.  Antibiotics are of no use against HIV because it is code, not quite “alive.”

The code does not just ruin the defensive system of the body, which constantly works to restrain (not destroy) all the little co-organisms we acquire in our life, beginning before we are born and soon outnumbering the original citizen-cells of our body with immigrants sometimes very helpful and sometimes inclined to get out of hand.  HIV code, esp. when it progresses to AIDS, takes down all the defensive walls and infrastructures of the body so opportunistic invaders can get in to raid.

HIV-AIDS is not a population of organisms that attack the body, but a code-breaking key that throws open the gates to everything else.  What “else” depends on the pattern in which the body is living.  If it is a community of people who prey on each other, an environment of not-enough whether food, shelter or water, an atmosphere of despair and the withholding of hope, then people who are vulnerable will suffer and die -- one way or another.  Shunning, stigmatizing, isolating, labeling are strategies that carpet-bomb the vulnerable.

Anti-biotics are machine guns.  (Why do I keep using war imagery?  Why don’t we have more images for peace patterns?)  They are simple, developed by tiny earth organisms (mold) for their own protection which we borrow.  For HIV-AIDS vulnerability, what we need is code-breaking strategies.  It is a game of chess requiring intelligence and the ability to see patterns.  

I’ve just watched two video series.  One was the twelve-part University of North Carolina AIDS course.  It’s on YouTube, easy to find. Each class is about an hour long, just a straightforward lecture with graphics.  The other streams on Netflix, a Brit series called “Kidnap and Ransom” starring Trevor Eve as a hostage negotiator for an insurance company that pays for corporate executives kidnapped in a mix of crime and politics.  They are both about pattern, with Trevor Eve explicitly playing the game metaphor in chess competition against wise old locals.  If there is pattern, then there is strategy.  HIV-AIDS is kidnapping within the human body.  Defeating it is not a matter of a magic pill, but rather a strategy based on the kind of knowledge about how it works, which is what you can learn from following the UNC course.  But it might be helpful to ask what patterns Trevor Eve might see.

An HIV “capsule” holds two single strands of RNA, which is the template for DNA, and little else except for the delivery and defense system of the capsule.  Those are pretty intricate and they morph all the time.  The main protective coat is composed of the molecules classified as “fats” which is why dissolving them with soap or alcohol takes down THEIR cyclone fence.  Simple when the virus is outside the body.  Inside, the capsule attaches to cells with two little “grippers” or keys that look for two locks on normal cells.  Like a missile silo launch, they need both keys to be inserted and turned at once.  

One out of a hundred caucasians has only one of these locks, a loss that is a plus.  (This mutation is a get-out-of-jail free card.  Compare that one out of 99 people in the US is incarcerated and that is a reservoir source of transmission of HIV.  The percentage of new prison inmates who have HIV is single-figure -- the figure rises to 14% by release.)  

The lucky people with the single-lock mutation cannot develop HIV-AIDS.  The Berlin patient, who was cured by a bone marrow transplant that replaced his immune system with that of a man with this lucky mutation, now has that immunity.  He was NOT given a med that eliminated HIV from his own immune system.  His own immune system was removed and replaced.  It did cure his cancer as well, so the cancer must have had a key for a lock somewhere on the cells, a key that keep the immune cells from doing their usual work of search and destroy for overzealously replicating cells.

Much of our thinking about disease (and war, crime, kidnappers, terrorists) means isolating invading entities and destroying them.  We need to shift from that idea to thinking about changing the patterns that produce vulnerability and thinking, even harder, to answer the demand for constant vigilance to search for anomalies in order to understand and deal with them.  Some mutations, like cancer, will be destructive.  Some, like the mutation that eliminated one of the HIV portals, will be improvements.

Nature, when it finds a good thing, replicates it.  Big patterns often develop as echoes of  little patterns, so that the little predator drone that is an HIV capsule capable of pushing its injector into an immunity cell is an eerie/funny version of sex between human beings -- both being an intimate exchange of code in order to create a new pattern.  Our bodies actively want exchanges because bodies operate on process, going forward through time, and that’s what makes them vulnerable to kidnapping.  But systems that try to freeze process just don’t work.   They’re not evil so much as just irrelevant and sometimes destructive.  One cannot solve the problems of sex by not having sex.  Pretty soon there won’t be any problems because there will be no people.  Rather one approaches sex carefully: observing, asking.

The weak and the vulnerable, those who have HIV-AIDS literally thrust upon them, still have strategy.  Learning the code of society, the patterns that develop and how to find the portals, how to develop the keys that will unlock them (art, for instance) can still work with a little help and guidance. 

If you want to watch the class that is the basis of this post, the link is:

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