Insistence of Vision by David Brin Read Free Book Online Page B

excellent match, there’d be an agony of immunosuppressant therapy and risk of lethal infections. Nor was it easy on us doctors. When a transplant failed, you felt you were letting two patients down, both recipient and donor.
    Sci fi dystopias warned where this might lead. Sure enough, some countries started scheduling criminal executions around the organ want-list. Granting reprieves till someone important needed a heart... your heart. Then, off to disassembly.
    When micro-surgeons got good enough to transplant arms, legs and faces – everything but the squeal – we knew it was only a matter of time till the Niven Scenario played out. Voters would demand capital punishment for more than just heinous crimes. Your fourth speeding ticket? Time to spread you around. Is it really death, when nearly all your parts live on, within a hundred of your neighbors?
    Hell gaped before us. There had to be a better way.
    And we found it! Grow new parts in the lab. Pristine, compatible and ethically clean.
    Caterpillar eat! Chew that big old leaf.
    Ugly little caterpillar, your relief,
    When you’ve chomped your fill, will be to find a stem.
    Weave yourself a dressing room, hang in it, and then
    Change little caterpillar, grow your wings!
    Now go find your destiny, nature sings.
    When we started trying to regrow organs in situ , George Stimson claimed the process would turn out to be simple. He offered me a wager – ten free meals at his favorite salad bar. I refused the bet.
    “Those are your stakes? Lunch at the Souplantation? Acres of veggies?”
    “Hey, what’s wrong with healthy eating? They have the genuine stuff.”
    “My point exactly, George. Every time we go there, I look at a plate full of greens and think: this is what real food eats!”
    He blinked a couple of times, then chuckled at my carnivorous jibe before swinging back to the main topic – building new human organs.
    “Seriously. I bet we can get away with a really simple scaffold. No complicated patterns of growth factors and inhibitors. None of this stuff.”
    He waved at the complex map of a human esophagus that I had worked out over the weekend – a brilliantly detailed plan to embed a stretchy tube of plastic and collagen with growth and suppression factors. Along with pluripotent cells, of course, the miracle ingredient, cultured from a patient’s own tissues. Some of the inserted chemicals would encourage the stems to become epithelial cells here and here. Others would prompt them to produce cartilage there and muscle-attachment sites here and here and...
    ...and George thought my design way too complex.
    “Just lace in a vascular system to feed the stems,” he said. “They’ll do the rest.”
    “But how will they know which adult cell type to turn into?” I demanded. “Without being told?”
    This was way back near the turn of the century, when we had just figured out how to take skin or gut cells and transform them back into raw stems, a pre-differentiated state that was pluripotent or capable of becoming almost any other variety, from nerves to astrocytes to renal... anything at all! Exciting times. But how to assign those roles in something as complex as a body organ? We had found specific antigens, peptides, growth factors, but so many tissues would only form if they were laid out in ornate patterns. As complex as the organs they were meant to rebuild or replace.
    Patterns we were starting to construct! Using the same technology as an ink-jet printer, spray-forming intricate 3-D configurations and hoping to someday replicate the complex vein patterns within a kidney, then a spinal cord, and eventually...
    “We won’t have to specify in perfect detail,” George assured me. “Life will find a way.”
    I ignored the movie cliché. Heck, why not try his approach in a pig or two?
    We started by ripping out a cancer ridden esophagus, implanting a replacement made of structural polygel and nutrients. This scaffolding we’d lace with the test