No, of course it won’t make you live forever. But people who drink it — up to quite a lot of it — are less likely to kack than people who are too — what, English? — to drink the most fantastic thing available for drinking.

What is it about coffee drinking that cuts down on the kackage? Not caffiene, apparently, because even decaf is associated with a lower kack-risk.

Ultimately, science is about improving life on earth, however, so who cares HOW coffee protects us from death and destruction? It just does.

But if I had to venture a guess as to why coffee makes a person stronger in the face of inevitable kacking, I would say two things:

Antioxidants! These are “rust inhibitors” of the human body, and Americans get most of ours from… coffee!

Happiness! Boatloads of research shows that people without coffee are grumpy, disgruntled, miserable, and unhappy, all of which encourage others to kill them.

The study: Researchers measures pregnant women’s cortisol throughout pregnancy. Cortisol rises with stress, so it’s a fair measure of how difficult a person’s emotional life is.

Researchers then measured two things in the resulting kids: the size of the right amygdala, which is sort of an emergency operations center; and mood problems.

The women who experienced high stress early in pregnancy produced stressy girls — girls with large right amygdalae, and with mood issues.

But the boys were unremarkable.

WTF? Why should male and female brains respond differently to the warning that they’re going to enter a difficult environment?

Because males and females need different behaviors to succeed.

Males, biologically speaking, evolutionarily speaking, need to take substantial risks in order to stand out as an awesome hunter and protector and provider. If anything, a male brain should respond to the “dangerous environment” lesson by taking bigger risks, and being less fearful. And in fact, research does suggest that the male children of stressed moms are more inclined to ADHD — the ultimate risk-taking, impulsive brain type.

Females, however, are more successful when they are “fearful for two.” Every female who ever wished to get pregnant has had her wish come true. Attracting sperm is not a challenge for females. But protecting that fetus, and then a helpless baby, is a challenge — even more so in a difficult environment.

Hence, I propose wildly and without supporting evidence, a developing female brain will err on the side of becoming more sensitive to danger.

Researchers took an uncommonly holistic approach to studying the efficacy of two “drugs.” Instead of isolating the “active ingredients” in the traditional preparations, they used the whole enchilada, the complete stew, the full monte.

These are some full montes, indeed. Amla, a traditional fertility treatment and general invigorator, is made from Indian gooseberries. But the process of grinding the berries, extracting the juice, then repeatedly drying the pulp as you add back doses of the juice, takes THREE MONTHS!

Rasa-Sindoor begins life as mercury — that famous nerve toxin and carcinogen. But it’s mixed with sulphur, which itself is purified in butter and milk. With aloe juice, these ingredients are ground for approximately 240 hours. The paste is dried on a wooden board in the shade for four days. The dry gunk is pulverized and sealed inside two bowls; this sphere is wrapped in clay-coated cloth; which is dried and baked in a furnace. The flakes that remain are scraped off the inside of the bowl and pulverized.

Got it? You can see why simply isolating the “active ingredient” might miss some of the subtle transformations of the chemistry. The meds are typically mixed with more clarified butter and/or honey to make them taste better.

The flies got it with their regular food. And, as predicted by ancient Ayurvedic texts…

• Amla gave flies a lifespan bonus of about ten percent.

• It also made females produce more hatched eggs if they ate it during larval stage. (The equivalent in mammals might be giving the Amla to a pregnant mother, and seeing a healthier reproductive system in her grown child.)

• It also made them more hardy under starvation — a measure of how efficiently an animal handles stress.

• It also had a salubrious effect on a detail of cellular genetics. I won’t endeavor to elucidate.

• Rasa-Sindoor made females produce more hatched eggs but only if they ate it as adults. Say the authors: “…it is interesting to note that in Ayurvedic practice, RS is not recommended for growing children but is indicated, among other things, for genital disorders and rejuvenation in adult subjects.”

• It also had that salubrious effect on a detail of cellular genetics which I won’t endeavor to elucidate. It had even more of that effect than Amla did.

To study how humans strategize, researchers treated one group of people like squirrels with something to hide; and another group like squirrels hoping to find what the others buried.

Researchers presented human “squirrels” with a “lawn” of office floor tiles, in a real office. Each tile had a manila folder on it. Hiders hid three index cards in three of the folders; seekers tried to find the cards.

Scientists counted how many times each tile was used as a hiding place; and how many times each tile was searched.

Put yourself in a squirrel’s shoes: You’ve acquired this resource through hard work and risk taking, gathering an acorn without getting nailed by a hawk. You have some investment in this acorn. Where ya gonna put it?

No, more interestingly: You are the seeker. Given the layout below, which tiles would you check for three hidden acorns? Which three tiles are most likely to produce a hidden acorn or index card?

I don’t know what squirrels do. But human hiders tend to avoid hiding things in PRECISELY THE REGIONS THAT SEEKERS SEEK.

Seekers travel farther and check tiles that are more dispersed than hiders do. And in general, hiders stashed their nuts toward the center of the “lawn;” and seekers sought them at the edges and corners. Here’s a glimpse at the “average behavior” of hiders (left column) and seekers (right column). Note how fond seekers are of the corners! Hiders also avoided putting cards in the bright area near a window; and seekers preferred to search that area.

Perhaps squirrels are better at this — the researchers suggested that people may “overthink” a hider’s strategy.

The chimp lives on an island with a couple of females and young. About 20 feet across the moat is a visitor’s viewing area.

Nobody knows what inspired Santino to start firing projectiles at the gawkers. Perhaps a bratty kid fired something at Santino. But chimps are avid throwers by nature, so it may have been a natural evolution in his effort to maintain dominance in his territory.

He always did his ammo collecting after hours, when he wouldn’t be seen. That’s insightful thing number two.

(Insight number one was that his tormentors would return in THE FUTURE.)

And often he hid his ammo behind objects that blocked the visitors’ line of sight. That’s number three.

Now the peevish primate has taken two new measures to deceive and defeat his enemy: When the zoo opened for the (short) season in the spring of 2010, he greeted the first round of visitors by ambling casually toward the moat. He performed no “piloerection” (fur raising), or other aggressive posturing. He ambled. He paused to taste an apple.

I’m just chillin’.

And then without warning he hurled a couple hunks of concrete that had been hidden in his hand.

Here’s the thing — it works. The intruders backed away when Santino “attacked” them. And when the coast was clear, Santino implemented his next innovation. He went indoors and brought out a clump of hay bedding. He put it down nice and close to the moat. And the he stuck a bunch of ammo under it.

Instead of exploiting the “natural” landscape to surprise his foes, he actually created a new landscape that worked even better.

While fascinating, this element of zoos troubles me. If Santino’s behavior is about dominance and aggression, then I guess I’m OK with it. But if it’s about defense, and he’s throwing rocks because he’s fearful of his territory being invaded, I’m not so OK. If Santino’s stress level is higher during the visitor season than the closed season, then the least he deserves is for the gawkers to be kept behind one-way glass, so their eyes can’t drill into his psyche.

Art Note: Also piloerection.

The results of this survey are best shown in graphs. But first, the survey. It was mailed, with no obligation to complete it, so the sample does not represent the German population. But it may represent the portion of the German population who would help to craft, and vote on, a policy for dividing limited medical care among a population.

The survey asked people to prioritize patients for medical care: Should children, or working people, or retired people receive priority, leaving fewer resources for others? Should people who have “social obligations” such as overseeing a bunch of employees get priority? Or should people with mental illness, or severe heart disease? Or people who smoke cigarettes? And so on.

The top-priority hypothetical patient, when all responses were combined, surprised me:

She or he is “a 43 year old patient with a severe disease and a severely restricted quality of life who has an unhealthy life style, comes from a low socio-economic background (occupation) and is a single parent.”

Perhaps I’m surprised because my own culture tends to be more punitive of “weak” members of society. Would my fellow countrymen send a poor person who’s restricted to a wheelchair and smokes and drinks to the front of the line?

Take a shot at one of the questions, yourself. (Heavy disease is stuff like an emergency, cancer, or heart failure; light disease is non-life-threatening stuff, like schizophrenia or chronic lung disease):

Take a look at where the German respondents would place you on their list of whom to let into the hospital. If you fall to the right side, you’re a low priority. If you land high on the graph, there is a high level of agreement. If you’re low on the graph, there’s little agreement.

I’m pleased to see mental illness has achieved parity with other “chronic illnesses,” instead of being relegated to some alternate universe of medical conditions.

I learned two awesome words from this study:

Militate: to influence. Use that one in a sentence to day, and I’ll buy you a lollipop.*

Posteriorization: opposite of prioritization. It delivers a pleasingly anatomical image. “Take your request and posteriorize it!”

“I appreciate your input, but I’m going to posteriorize it.”

*Shipping and handling fees may apply.

Infanticide seems antithetical to everything we know about biology. Our genes are supposed to be intent on replicating themselves in a new generation — of rabbits, yeast, or humans.

But a few genes remain focused on the present generation, as well, guarding a parent’s ability to produce additional replicas in the future.

My rabbit experienced a stressor in her environment that predicted a bad future for her offspring. Perhaps I, age eight, peeked at her babies too often, activating an “lurking predator” circuit in her brain. Whatever she detected, it was sufficient to convince her to cancel this round of reproduction. She recycled the energy and nutrients she had put into the pregnancy.

The young father’s reason for cutting his losses?

Humans are more complicated, but some fundamental circuitry remains the same. In this case, the father’s stress was complex. As a child he had been physically and sexually abused while in foster care. That kind of trauma can seriously derail a brain’s response to stressful situations. He took medication for PTSD.

And then he fathered twins.

The panda bear often bears twins, and allows one to die. Her DNA “tells” her to make one healthy kid, rather than two runts. An eagle species lays an “insurance egg” which hatches after the primary egg. If all goes well with the primary chick, the parents will feed it only; and allow it to peck its rejected twin, which takes a few days to die. Even in some “primitive” human cultures with tight margins between survival and starvation, infanticide — quick and decisive — is a routine act of population control.

This guy was already heavily stressed before he burdened himself with two offspring. He reportedly washed out of the military for violence. He was living with a three year old girl described as the twins’ “half sister,” which I expect means he wasn’t her father. Her daycare had reported her bruises to authorities. The young father was allegedly fighting — and winning — a battle against alcohol addiction. That fight takes a huge amount of concentration and energy.

Then he reproduced. Somewhere in his DNA, he knew he would not be able to raise two offspring. The unlucky twin took ten weeks to die.

The paper quotes a friend who said the father favored one twin from the beginning; and the mother’s observation that the dead twin ate less than his brother, and was smaller. The beaten baby arrived at the hospital comatose, dirty, and with diaper rash. Doctors found a previously broken arm, and a prior brain injury. There were no peck marks, but you get the idea.

The big difference between humans and other animals is that we have many effective methods to limit our reproduction. But as a culture, we believe that reproducing is an inalienable right — regardless of the risks a parent’s illness presents to his own offspring. There is no law, no regulation, not even a public sentiment, to prevent this mentally ill man from reproducing as often as he can manage.

I don’t care for it. Increasingly, I think reproducing is a privilege, not a right.

Researchers presented captive titi monkeys with a special beverage — well, it wasn’t that special, seeing as it was Tang. But titi monkeys apparently are no more discriminating than your average astronaut.

They compared how much Tang each class of monkey would slurp up — a measure of how much biological happiness a monkey would treat itself to, essentially.

The classes: married males; single males; and teen males attached to their daddies.

Who drank the most? Who guzzled down life’s sweet pleasures? Who swilled Tang until he was fit to burst?

Married men.

Ergo, it’s not parent-child attachment that makes a monkey feel warm and Tangy. The young guys didn’t wrap themselves in Tang’s sensory embrace. And single guys seemed more intent on defending the Tang or being ambushed: They walked around and raised their hackles instead of languishing by the Tang.

But the married men were content to settle in and swill, whether their gals were by their side or not.

Females were not tested, because… [fill in the blank].

Schizophrenia symptoms are divided into positive and negative groups.

Positive elements include delusions, hallucinations, grandiosity, conceptual confusion, hyperactivity, hostility, and a sense of persecution. These may not sound positive, but they reflect a fundamental “approach” orientation.

Negatives include a flat emotional life, inability to relate to people, disinterest in social interaction, apathy, inability to converse, lack of spontaneity, and rigid thinking. These look more like depression, or avoidance, than the “positive” elements.

Anyway, Chinese researchers studied smoking in a whole bunch of hospitalized schizophrenics. And they measured their pos and neg features, and their intellectual function.

The good news: Smoking correlated with lower negative symptoms!

The bad news: It correlated with lower intellectual performance IN BOTH SCHIZOPHRENICS AND CONTROLS!

The researchers speculate that nicotine interacts with faulty dopamine receptors in schizophrenics, perking them up.

And I guess if I were locked in a Chinese schizophrenia ward, and had to choose between being more sociable and less brilliant, I’d rather be dumb and companionable, myself.

The new CDC report continues:

“During the days following, he experienced fever, nausea, vomiting, and on August 18, difficulty swallowing. He visited the ED at hospital A on August 15 and 17 and was discharged with diagnoses of neck tendinitis and gastritis, respectively. He twice visited a chiropractor for his pain during August 15–16.”

This is so typical of how it develops, with doctors so unaccustomed to seeing rabies that it never crosses their mind. The U.S. sees about three cases a year.

“On August 19, the patient experienced ataxia [stumbling] and syncope [fainting], was evaluated at Fort Drum’s medical facility, and was transferred to the ED at hospital A. Upon arrival, he was dehydrated and markedly hydrophobic [wouldn't drink]. He was lucid and described having received a dog bite on the right hand during January 2011 while deployed to Afghanistan. Rabies was suspected on the basis of symptoms and this history.”

The virus had taken at least six months to migrate from his hand to his brain, where it caused symptoms. Once symptoms occur, death is inevitable.

On August 20–21, Wadsworth Center (NYSDOH’s public health laboratory) detected rabies virus antigens in hair follicles of nuchal [neck] skin biopsy specimens… ”

The patient, now known to have the potential to infect others, is transferred to another hospital.

“Upon admission, the patient exhibited severe aerophobia [fear of flying] and hydrophobia [inability to swallow water], became combative and agitated, and was intubated for airway protection. Dysautonomia [nervous system shutdown, basically] and fixed dilated pupils [ditto] were noted. [CAT scan] of the brain revealed no abnormalities.”

But by his fourth day in the hospital the soldier’s lungs were congesting, and his fluid was building up in his brain. On day twelve his brain bled heavily, and his family agreed to take him off life support.

That it took five days to diagnose rabies isn’t atypical. Who would think of it?

In fact, diagnosis often takes longer, because the patients are often too delirious to speak by the time they’re hospitalized. This soldier’s ability to recall and communicate the dog bite greatly simplified things. Some patients go the the hospital over and over as the disease progresses, leaving with a different diagnosis each time.

I’m not sure what makes rabies so frightening. It’s vanishingly rare in this country. But perhaps the fact that it makes a human “crazy,” and does so quickly, is spooky. Usually when a personality changes, it does so slowly, through depression, or schizophrenia, or senility. We have time to get used to the idea.

Rabies is a sore shoulder one day, and a personality meltdown the next. And there’s no turning back.

Art Note: “Mad dog biting a man.” Illustration from a 1224 Arabic medical text. Note dog’s tongue out, indicative of inability to swallow saliva; and lousy condition (ribs), ’cause it can’t swallow food, either. Dog is clearly “combative and agitated.”

The body operates on its own clock, and expects to power down at a certain time every evening.

Fooling with the clock can cause you to feel like you’re sleep-walking through Paris, because you kind of are. Your brain is aching to be asleep.

Now research on bees finds that anesthesia has the same effect. Knocking out bees for six hours put them out of step with daylight and nighttime. They went to work at the wrong hour. It was as though the Earth had turned for six hours, and they had not. hours. It was a Rumplestiltskin kind of thing.

The researchers suggest that timing human surgery to do the least damage to the clock would improve recovery. Nighttime anesthesia did not affect the bees’ clocks. They were supposed to be “off line” then anyway, so they hopped right back on the treadmill in the morning.

I can SO NOT SEE doctors agreeing to do all their surgeries in the middle of the night for my convenience. And I guess I’d rather not have my doctor’s brain sleep-walking through surgery.

The team looked at death rates for four different conditions in elderly people: COPD, diabetes, congestive heart failure, and heart attack. In a whole slew of cities, they compared deaths to temperature variations in the summer.

For each condition, death rose along with temperature variation: the more abnormal the heat, the more dead bodies.

This isn’t surprising. Old bodies with chronic conditions are poised on the brink. Their systems are working hard to maintain even a minimal level of activity. So when a heart that’s already galloping to keep the tissues oxygenated is then asked to push more blood to the skin in order to cool the body, well…

It’s not surprising, but it does remind us that our environment still dictates our fate, to some degree. As well as we’ve managed to insulate ourselves, we are not invulnerable.

One surprise in the data was that cities with more acreage of greenery were less vulnerable to the old-person kill-off.

Bumpersticker: Green Roofs* Save Grampies!

*Rooves is apparently considered obsolete. The next heat wave will probably put it in the ground.

The money game was thus: Money was randomly divided among a group of people. To what extent would each person go to make the unfair distribution fair?

The MRI machine in which players lay showed that the more a person sacrificed, the more active this particular brain region was.

The insular cortex (from Latin insula, island; and corium, bark; for “covering of the island”) is a little fist of a mini-brain buried behind your temple. It integrates physical sensation and emotional response. In humans, it seems to do much more, helping us to empathize with the sensations and emotions of others.

As with any feature of personality, and the behavior flowing forth from personality, we vary. Some of us empathize strongly with our fellow human; others feel little when we see a homeless person or a crying child. This natural variation allows some of us to care for the weak, and others to forge ahead to find new opportunities.

It also causes a fair amount of friction. The high-empathy personality sees the low-empathy personality as heartless; the low-empathizer sees the high-empathizer as brainless.

(And at the extreme end of the spectrum we find the sociopath, who is biologically blind to your distress, and not awfully concerned with fairness.)

Perhaps it’s helpful to remember that even the low-empathizer among humans is “nicer” than your average bear, who has next-to-no empathy.

And even more helpful to remember that if you need a loan, you should hit up someone with an active insular cortex.

*Grammar mavens: The copyeditor for my last book manuscript crossed out every  instance of “each other,” and replaced it with “one another.” Really?

In 2008, the Wenchuan earthquake slaughtered, buried, and burned 80,000 people. EIGHTY THOUSAND PEOPLE. That’s one thousand people, times eighty.

Since then, many scientists have concluded that the quake got started, the earth began to rupture, right under the Zipingpu Dam reservoir. By backing up a river and creating an inland sea, that damn peasant-pleasing government apparently caused such severe strain on the Earth’s crust that it gave way like a zipper. The Zipingpu Dam became the “Unzipping U Dam.”

Actually, researchers disagree on whether the quake was initiated by the weight of the water, or by water itself being forced down through fractures in the bedrock to lubricate the weak “rift zone” below.

Either way, eighty thousand people died. 80,000. Eighty thousand times one.

Dead.

The survivors got refrigeration.

Now as the Three Gorges Dam fills, what shall occur? A lot has already occurred — lots of peasants have been dislocated, the endangered Yangtze River dolphin is more endangered, as is the Siberian crane, and other things that I should like to gaze upon with a refrigerated beer in my hand.

The study which inspired my hypothesis (which is mine):

“Hypoxic preconditioning” prevents the depression which sets in after a stressful event. Rats subjected to stress often respond with a period of depression. People, too. But if you take about half the oxygen out of the air, those rats are breathing for a period before the stress, they don’t get depressed.

WTF, rats???

Researchers found that it short-circuits the expression of a certain gene in the brain. Without that gene over-expressing itself, the brain doesn’t get depressed.

Well, reading that, I checked out other uses for intentional suffocation. Wow! Many! Forget about sleeping in an oxygen chamber, people! Avoid the oxygen bar! What you really want is a hypoxygen chamber, a room with 8% or 9% oxygen, versus the 21% found in the air around you right now. Huffing that for three hours will protect you, if you should suffer a stroke in the following 24 hours! (If you’re a rat. )

This has applications, beyond preventing stroke damage in rats: If a baby is born with high risk for brain bleeding, perhaps you could pop him in a low-O2 chamber. If you’re facing surgery and might throw a clot and stroke yourself, you might prepare with a period of hypoxia.

Crazy, huh? But back to my hypothesis (which is mine): We hold our breath during stressful times because it preconditions our brain against any insult that might result from the stressful event.

So all that yoga stuff, about breathing deeply to remain relaxed under stress? Forget it.

Art note: I don’t even know what that is. Wikimedia gave it to me for the inquiry “air in art.”

Ecologists have succeeded in selling regulators on the “corridor” concept: Even if we chop most of an animal’s habitat into square house lots, if we leave corridors of natural vegetation, the animals will use these to commute to their various jobs. (Breeding, eating, sleeping, finding themselves a new house lot.)

It works. It’s a good thing.

But the law of unintended consequences must be obeyed: The corridors, at least in South Carolina, alter the behavior of wild fires. Oops!

Or maybe not oops… it all depends on what you wish to promote in your human-aided landscape.

The researchers note that corridors produce a wealth of “edge.” Now, edge is prime real estate for many species: Where a forest meets a field, or a stream meets a prairie, animals are presented with multiple “ecosystem services” to take advantage of. It’s fabulous! The same thing happens in a square house lot: Your rhododendron acts as  tiny “forest,” which creates an edge with the tiny prairie of your lawn. Animals — many species of them — love it.

So corridors produce edges like crazy: Yay!

But they also alter the amount of fire fuel that accumulates in a given spot: More at the edge.

And they alter the way wind moves over the planet’s surface: Faster in the corridors, like in the streets of Chicago.

And so fire behaves quite differently in a corridor’ed landscape than in a completely forested, or completely fielded, one.

Good? Bad? Just the way it is, so suck it up?

Windier fires produce higher temperatures, which kill different plants than low temperature fires. Some plants need hot fires, to open their seeds and allow them to reproduce. Others are driven from the landscape by hot fires.

Which do you prefer?

Which do your preferred animals prefer?

In a landscape that humans have so successfully conquered, it becomes our responsibility to make those decisions — worldwide, and in each square house lot.

It’s a weighty responsibility! It makes me anxious! It makes me wish we had never invented bulldozers and the grizzlies were still making the big decisions!

Art Note: Already too late. The Homos have horses and steel, which are the technological precursors of the house lot. The Ursids are still relying on tooth and claw, the technological precursors to extinction.

This small study on male soccer players found that the three numbers are related.

Researchers assembled a flock of soccer players, and set them to the task of penalty kicks — trying to get a ball past a goalie.

Well, first they administered personality tests, to find where each player landed on the spectrum of “trait anxiety,” a person’s background level of jumpiness, scanning for trouble, assuming the worst, etc.

Then on day one, they just let the guys fire away at the goal.

Then on day two they turned up the pressure:

See if you can improve on yesterday’s middling performance. The other guys did better than you.

Researchers documented two correlations between players’ performance and their trait anxiety:

• The higher their trait anxiety, the higher their “state anxiety” rose under pressure.

• And the higher the pressure, the more they missed.

Nutshell: If you’re fundamentally anxious, you’ll perform better in this sad old life if you’re organized enough to control the pace of your production.

A new study imaged the airflow from coughers’ mouths, to estimate the size of a cough cloud — the germy air that rushes forth from a cough. Size matters: Men coughed bigger clouds than women, presumably because their bigger bodies hold bigger lungs.

Smoking also matters — perhaps: Only two smokers participated, but their coughs were extra potent, perhaps because of narrowed airways or more spastic lungs, which accelerate expelled air.

And direction obviously matters: Coughing into your own sleeve robs your spitty little aerosols, and their burden of virus, of their velocity.

A weakness of the study is that it studied “fake” coughs. You know the difference between a dry cough you work up on demand, and the real thing. A serious cough is far more forceful, I guess because the throat is narrowed by inflammation, and/or the lungs are dead-freakin’-serious about expelling that gunk. I wouldn’t be surprised if a sick cough is twice as forceful as a fake. That’s what it feels like, when you’ve coughed yourself into a headache and a bruised sternum.

Another weakness: Sneezing is probably nine times more forceful.

Bottom line: The Japanese have it right. They wear surgical masks when their bodies are trying to blast out the germs.

A New Zealand study sent some depressed teens to traditional counseling; and others to their rooms. The ones in their rooms played SPARX, an emotional skill-building game. Instead of shooting zombies or blowing up soldiers in order to win points and buy bigger weapons, kids progress by defeating GNATs — Gloomy Negative Automatic Thoughts.

While bringing peace to a world dominated by GNATs, kids practice swapping negative thoughts for positive ones, and discover how to handle anger and hurt feelings.

It worked as well as traditional counseling, and most of the kids said they’d recommend the computerized version of emotional fly swatting to others.

This study makes a big stride toward accepting the inevitability of death from heart disease. By taking the time to count all challenges faced by a given patient’s body, the researchers demonstrate that we can predict, to some degree, when that person will die. Armed with that knowledge, patient and doctor alike can make more caring decisions about prolonging, or abbreviating, the dying process.

It may seem like a subtle shift — shifting the focus from maximizing days of life to a focus making the remaining days less stressful and painful. Oddly, they may work out the same, since patients treated with “palliative care” — care that concentrates on comfort, versus longevity — has been shown to make patients live both happier and longer.

Anyway, this study considered patients hospitalized for serious heart disease.

“We know that cardiac patients generally receive limited information about their condition and have poor access to [end of life] care services,” the authors write. They cite lousy coordination among specialists, and a lack of sound predictors of how long a heart patient will live. “Prognostic paralysis,” they call it: The doctor doesn’t feel confident saying, “Time’s limited, buddy. Do you prefer more surgery, or more time at home with your grandkids?”

They went on to identify some sound predictors for those doctors. One of them, surprisingly, is the “surprise question.” A doctor familiar with the patient should ask herself:

“Would you be surprised if this patient died in the next six to twelve months?”

The answer significantly improves the accuracy of the prognosis. Doctors do actually have a sense of where a patient stands.

If the patient has had a stroke, that’s another sound predictor. Likewise if the patient has kidney disease or chronic lung disease. Recent hospitalizations also help to improve the forecast.

So… how’s it look for you?