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Stephen Hawking to turn 70, defying disease (heraldonline.com)
164 points by edw519 on Jan 5, 2012 | hide | past | favorite | 88 comments



Hate to raise a cynical tone, but in all likelihood his his longevity is mostly due to him having money. I expect, that in most cases patients with similar motor neurone diseases, their money simply runs out--unable to afford ongoing medications, care and new treatments, they die from the disease they simply can't afford to treat.


>in all likelihood his his longevity is mostly due to him having money.

I think you mean "Socialized Medicine"

"I wouldn't be here today if it were not for the NHS," [Hawking] said. "I have received a large amount of high-quality treatment without which I would not have survived...."

http://www.huffingtonpost.com/2009/08/12/stephen-hawking-ent...


Yea, you don't need money to be healthy in a civilized country. Someday, America might catch on, but I'm not holding my breath.


"Yea, you don't need money to be healthy in a civilized country."

You just need enough other people's money.

"Someday, America might catch on, but I'm not holding my breath."

Why is it that anyone with any kind of money that needs urgent care comes to the US? I will give you a hint: it's not because of nationalized health care.

Our system isn't perfect and is expensive, but in my opinion, it's the best in the world (in terms of quality doctors, surgery, and hospitals).


Why is it that anyone with any kind of money that needs urgent care comes to the US? I will give you a hint: it's not because of nationalized health care.

Many of the inbound medical tourists to the U.S. are coming from countries that don't have nationalized health care or are coming because their nationalized health care system is paying most of the cost of their care and trip. Relatively few are buying their way into better care vs. a nationalized health system.

Also, the number of inbound U.S. medical tourists is around 70,000[1], while the number of outbound U.S. medical tourists is around 650,000[2] (surgery dominates). There are many factors involved here, but as a basic matter, it would be simpler to say that people leave the U.S. for medical care much more than they visit for it.

[1] 2008 number: http://www.forbes.com/2008/05/25/health-hospitals-care-forbe...

[2] 2009 number: http://www.tampabay.com/news/health/article1079824.ece


It's quite regular that local media in Britain will report on a fundraising drive to send someone (often with a rare condition, sometimes not) to America for treatment because the NHS won't pay - here's an example just from today, where a family's trying to raise ~$100,000: http://www.moorlandsradio.co.uk/2012/01/help-katie/

It's not because our health service is poor - in fact, it's excellent for general healthcare and I literally trust it with my life. The country (as in you, me, everyone who pays taxes) sadly just can't afford to treat very expensive edge cases, or send people for highly expensive experimental procedures, without jeopardising the sustainability of the service for others. Conversely in America, if you have the money, you get the treatment.


In America, insurance companies call that an "experimental procedure" and they wouldn't cover it either.

Meanwhile for every case you can find for someone traveling to America, there can be an identical case found for someone traveling to Europe.

http://www.kulr8.com/news/local/Cerebral-Palsy-Fundraiser-10...


> Meanwhile for every case you can find for someone traveling to America, there can be an identical case found for someone traveling to Europe.

You've found 1, which hardly equates to "every".

Do you have any actual data? I'd be curious to see what the real difference is between "them" coming "here" vs. "us" going "there".


Sure, check wikipedia on medical tourism. An order of magnitude more people leave the US than enter to seek medical treatment. http://en.wikipedia.org/wiki/Medical_tourism#United_States

My point in finding one was that sensational stories about fund raising for medical treatment make easy news filler. Linking to any of them is meaningless!

America has a medicore health care system. We excel in some experimental treatments, and have some great medical centers for those with money.

Meanwhile we rank equal to Cuba on life expectancy http://en.wikipedia.org/wiki/List_of_countries_by_life_expec...


Anecdotally the USA has, amongst all the rest of it, some of the world's elite health institutions. The global wealthy can choose from a select few clinics doing leading edge research-oriented treatment to use in selected fields (e.g. some cancers).


North Koreans think their country is the best too.

The US health system sucks. The US spends more public money on health, let alone private money, and still has a crappy system.

The reality is, medicine is something that any idiot can manage. Get a doctor and some nurses, put them in a clean building, and give them a few million to buy machines and stocks. Even the government can do it, and the government does it at a lower price, because they aren't looking to rip off desperate people. There's huge barriers to entry (regulatory issues, deals with insurers, no way to boot strap unless you are a doctor), but it's not all rocket science. No-one competes on value (i.e. quality of life over price) - not many people shop to find the cheapest hospital (it's too hard and confusing), they just go on vague stuff like how nice the lobby looks. You won't lose much if the government replaces pretty private lobbys with Stalinist admissions rooms, and tells doctors to look after the patients rather than con them into expensive, unnecessary, and sometimes risky procedures.

Unless you believe that competition lowers price to the marginal cost of supply (which is pure fantasy cooked up by economists, and is completely at odds with how business actually run), or you think that the management of hospitals needs innovative techniques, then there's no reason not to have public health.


> North Koreans think their country is the best too.

I often see many similarities between the USA and North Korea too.


I hope that's sarcastic ... I was just using NK as an extreme example.


Nope, Nothing sarcastic about that at all.


"Get a doctor and some nurses, put them in a clean building, and give them a few million to buy machines and stocks. Even the government can do it, and the government does it at a lower price, because they aren't looking to rip off desperate people."

They may not be looking to "rip off desperate people", but they sure don't know how to efficiently spend money (example: every single government-run system in the history of humanity). If the government ran anything like an efficient business, I might agree to more government-run services. The problem is that over time, almost all end up hemorrhaging money and I can't trust my life to a system like this.

"You won't lose much if the government replaces pretty private lobbys with Stalinist admissions rooms, and tells doctors to look after the patients rather than con them into expensive, unnecessary, and sometimes risky procedures."

Except freedom of choice. Once you have a government system in place, nearly all private care will be put out of business because the government is allowed to play by their own rules. Look at the UK: private care is so expensive, unless you are in the top 1%, you can't afford it.

Nobody likes monopolies, yet those same people are fine with the government running one. The same exact rules apply. A monopoly on health care means the government doesn't have to compete, innovate, or have any incentive to give us better care.

"or you think that the management of hospitals needs innovative techniques, then there's no reason not to have public health."

Nobody that is pro-universal health will ever discuss the problems with it. I mean nobody. I can't believe a system is perfect. No system is. If we can't have intelligent discussions about the pros and cons of a system, I won't ever support it.


The UK NHS is usually regarded as being extremely efficient, but not the most effective health system e.g.:

http://www.guardian.co.uk/society/2011/aug/07/nhs-among-most...

Private health care in the UK really isn't that expensive - I have it for our accident prone family of 3 and I don't think it's more than about £400 a month, with pretty minimal excess levels (about £100 per treatment). Note that I get this as part of my pay from my employer - which is fairly common.

Note that for anything like an emergency or a child birth you will want to be in an NHS hospital - for a variety of reasons...


That's actually pretty affordable. Thanks for the link. I will check it out.


My view of the main con of universal healthcare systems is that it's harder to get care for chronic conditions that are unpleasant/painful but not ultimately dangerous. I think it's hard to dispute that the US offers substantially better care for these issues if you have the money.

The fact is, though, that I believe this is the case largely because of how doctors are allocated. Doctors are, of course, a limited resource - there's simply an insufficient number of people with the requisite intelligence, mindset and dedication necessary to do the job. In universal healthcare systems, doctors are allocated largely by need first, whereas in the US the system is biased substantially by ability to pay. Personally I find that dubiously moral, but I think perhaps it fits well with the US mindset - it's been my experience that the poor are judged quite harshly there, and not necessarily seen as deserving of good care.

(a quite sidenote here - I often see people essentially saying 'if they want healthcare they should be more successful'. I don't really understand this point of view, because since healthcare is largely a limited resource, as people earn more money the cost of healthcare will go up with their ability to pay. No matter how hard everyone tries, there will always be a bottom percentage who get poor care)

> Nobody likes monopolies, yet those same people are fine with the government running one. The same exact rules apply. A monopoly on health care means the government doesn't have to compete, innovate, or have any incentive to give us better care.

The same rules do not apply if you have a functioning government - in principle if a government produces poor results with respect to public services, you kick them out and vote in a replacement, something you can't do (without monopoly regulation) to a private company. This happened when the Tory government got junked in favour of Labour in the 90s. Labour, for all their (many) other faults, saved the NHS and helped turned it into the highly efficient system we have today. Is it perfect? No, but it's much better than most alternatives.

> They may not be looking to "rip off desperate people", but they sure don't know how to efficiently spend money (example: every single government-run system in the history of humanity)

I see this meme spread a lot, yet the UK's publicly-run system indisputably achieves better overall results for the amount of money put in than the US's private one.


You could say the US problems are partly due to African Americans in bad areas - the problem is socioeconomic, not an issue with the health system.

You could also say that the UK cooks its data more, trying to look good.

But you can't dispute that the US spends a lot on healthcare, and it's hard to believe that they get much more value for money.

Of course, doctors in the US might work harder, as they have better incentives (working at a higher hourly pay). Or maybe they have less incentives to work hard, as they are already time poor and cash rich, and giving them more flexibility and a higher hourly pay will just make them cut back on hours. (Paradoxical results are often assumed to be impossible, given certain assumptions in economics, but those assumptions just don't work).


> Doctors are, of course, a limited resource - there's simply an insufficient number of people with the requisite intelligence, mindset and dedication necessary to do the job.

That's not exactly quite true; we have far more qualified people than we actual doctors, the AMA strictly limits the supply [1] by controlling the schools and this of course seriously affects the market, the prices, and their salaries. Things would be much cheaper if 57% of qualified applications weren't turned away every year.

[1] http://wallstreetpit.com/5769-the-medical-cartel-why-are-md-...


That's interesting! Do you have any thoughts on why there is not more outcry about this? I'd guess the social status of doctors has something to do with this?


In the UK, private medical insurance comes in a broader range of costs - and generally costs less than insurance in the US.


Its not much good to those people who cant afford it. In fact it might as well not be there at all. I think that is the point.

Steven has said he owes his life to a FREE healthcare system provided by the government and you want to dismiss this claim with a rant about how great the US system is. Just typical.

Why can't you just accept that 'socialised care' has worked for someone and has done some good. He would have got the same treatment if he had been rich or poor. Like millions of other people in the UK.

Its not about who's money pays for it, its about respecting the value of all human life equally regardless of wealth. In this respect the American system does not even come close to competing.


Why is it that anyone with any kind of money that needs urgent care comes to the US?

Do they? Here in Ireland people going for specialized treatment would go to private hospitals in the UK.


Nope! Whenever you see an American ignorantly claiming the US as #1 in something you can safely chalk it up to American Exceptionalism. http://en.wikipedia.org/wiki/American_exceptionalism

It's a neat little ideal that helps people assert we, as Americans, are intrinsically better than everyone else, by fiat.

It avoids all the hassle of constantly working to live up to our own ideals, or expending any effort to improve ourselves as a nation. Also people holding that mindset generally learn much further right/conservative than the average American. And keep in mind America has two parties, Moderate Right and Extreme Right. We have no left wing to speak of, when compared to European politics.


Having spent many of my childhood years in Europe (and being of European origin), I agree that US exceptionalism is a problematic phenomenon, but I also think that lately it has become a thought-collapsing meme amongst intellectuals.

One cannot deny that America is unique in its global position, and that said uniqueness is not just of the special-snowflake variety that every nation has. It has an extremely high concentration of wealth, geopolitical clout, and intellectual/creative output (which, of course, leads to unfortunate and probably largely unintended cultural imperialism).

In this particular instance, it's not an unreasonable claim that the US has a large advantage at the highest end of medicine (research of new procedures, pharmaceuticals, and so on). Obviously, this alone wouldn't justify calling it #1 (whatever that means in a multifaceted problem like healthcare, especially given that other nations feed off US-based research in their socialized systems without bearing the development risks). But I think the "Disregard speaker due to US Exceptionalism" response is thought-dulling, rather than thought-provoking.


I won't comment on your other points but with regard to the flow of medical research information, I'd like to point out that it goes both ways.

Private US healthcare also feeds from research carried out world-wide without baring development risks.

For example, look at the amount of work done in genomic research in say the UK.

I think it would be somewhat naive to say that private US healthcare firms and their patients didn't benefit hugely by work placed into the public domain by organisations like the Wellcome Trust.


Yes, I don't think I ever implied that that the flow is unilateral, but I feel like this is indicative of the broader point.

The sensitivity to US exceptionalism has made it hard to say something seemingly trivial like "the US is a huge, rich, politically powerful economy and contributes a huge fraction of global medical research" without having to caveat against "You know, other people contribute as well."

No reasonable person (certainly not me, reasonable or otherwise ;-) suggests that the flow is unilateral.

If anything I feel like there's a reverse statistical bias here. If we assume the UK is equally productive in research per capita as the US, you'd expect about a 6x research contribution from the US relative to the UK just based on population (never mind that the GDP per capita in the US is about 50% higher, as is the number of "top universities" per silly metrics like http://www.usnews.com/education/worlds-best-universities-ran...). Assuming no intrinsic difference in ability between the US and the UK citizens, it would be extremely surprising for the UK's contribution to be comparable to that of the US just based on population, university density, and economic output. This is not a judgement of UK researchers; it is merely a statement about the aggregation of people that is the US vs the aggregation that is the UK.

Anyway, I will reiterate that I recognize important contributions from all over the world. That doesn't directly bear on relative contributions and the net flow of research benefits.

(edit: clarified second-to-last paragraph with final sentence)

(edit 2: having looked up the relative GDP per capita on google, my 50% was an overestimate... 25% seems about right).


Nice to see an argument in such a civilized manner.


Yes, I'm aware that there lots of people in USA who think USA is the best at everything. However there are some things the USA is best at. So just because someone from USA thinks USA is the best, doesn't mean they are wrong. They might be right. Look at the evidence.


A couple reasons for this but the main one is for many a year the NHS was underfunded by the Conservative governments of the 80s and 90s in the hope that it would crawl into the corner and die so did not/does not have the resources (doctors, nurses, beds, equipment etc) necessary to cope with a growing and aging population.

This resulted in waiting lists that for some patients are unacceptable and so people pay to go private to skip the wait.


  > Our system
"Our system" is a hodgepodge of different systems. We've got regular system that most people are on (private hospitals, private insurance). We've got MediCare (private hospitals, public insurance). And we've got the veterans system (public hospitals, public insurance).

If a medical care system that even touches public money is so bad, then why do we have systems like that? Why is 'socialism' some sort of political hot-potato when we have so many current social programs that no one wants to give up that qualify as 'socialism?'


Because rhetoric has nothing to do with truth. We soaked generations of Americans in the idea that 'socialism' = 'communism' = 'Russia' and 'China' = 'The Bad Guys'. That creates emotional responses on part of a large segment of the population whenever you assert something is "socialist" and good luck trying to reason with someone in the middle of an emotional response.

So convincing the voting public that something is "socialism" skews public support, and thereby the inevitable compromise, more toward your private benefactors.

The disconnect between rhetoric and objective reality is how we've managed to create a society where people at Tea Party rallies can emphatically demand that the very government that can do no right and needs to be largely dismantled in their eyes, needs to leave their social security, medicare and military alone.


"You just need enough other people's money."

The point of a tax is that it is not your money. It is societies money. "The public's" so to speak.


Our system isn't perfect and is expensive, but in my opinion, it's the best in the world (in terms of quality doctors, surgery, and hospitals).

That's probably true for the best doctors, surgery, and hospitals in the USA.

But it isn't true on average. The average hospital in the US isn't as good (well-equipped, well-staffed) as the average hospital in, say, Japan.

It also isn't true for most people -- even those with health insurance -- because most people simply cannot pay out of pocket for this best-of-breed care. The health care that most people in the USA actually get is well below the quality of many other countries.

So US health care is only the 'best in the world' in the same sense that a $1.7 million dollar Bugatti Veyron might be considered the 'best sports car in the world'.

Great, if you're rich as fuck. Otherwise not too relevant.


>But it isn't true on average.

From the statistics I've seen that's not true. The lowest 20% may have worse care than the lowest 20% in other developed countries, but the average American has access to the best health care in the world. Just look at American cancer survival rates--they are the highest in the world.

>The average hospital in the US isn't as good (well-equipped, well-staffed)

Now that's just plain wrong, the vast majority of hospitals in the US are incredibly well equipped.


Well, I have to ask: what the hell statistics have you seen?

A baby born in the USA is almost three times more likely to die at or immediately following birth than in Japan. [1]

Your cancer stat is true for prostate and breast cancer, but Japan has the best rates for some other types of cancers [2], and importantly Japanese people actually develop much less cancer[2.1], one reason for which is much better preventative medical care (for average people); the average Japanese person sees a doctor three times more often than the average Americans, and have three times more MRI scans[3].

Speaking of MRI machines, Japan has twice as many of them per capita than does the USA[4], and routinely uses them for preventive care. I've lived in both, and my government health insurance in Japan routinely covers MRI scans for preventive and diagnostic purpose, while my employer-suplied HMO in the states refused all MRI scans until actual debilitation had already occured.

A colleague just had a baby here, and not only is the care better than the USA (more visits, less waiting, better outcomes for typical people), health care for the baby is free until the baby is 15. Another reason that baby will see a health care professional more often.

I used to believe that American health care was the best, too. We hear it all the time growing up. And we spend so much. But then I moved abroad, and it turned out everything I thought I knew was wrong.

It's just like saying "American education is the best in the world!"

Sure it is... at M.I.T. and Stanford, maybe. Across the vast majority of the population in public schools? Not so much.

[1]: http://en.wikipedia.org/wiki/Infant_mortality#Infant_mortali...

[2]: http://news.bbc.co.uk/2/hi/health/7510121.stm

[2.1]: http://www.wcrf-uk.org/research/cancer_statistics/world_canc...

[3]: http://marginalrevolution.com/marginalrevolution/2009/09/fac...

[4]: http://www.npr.org/templates/story/story.php?storyId=8962630...

EDITS: fixed my typo that gave USA a worse infant mortality rate than Somalia, and rephrased a couple things more clearly. Added education analogy.


Infant mortality is a horrible statistic. Birth registration varies by country, so what counts as "infant mortality" is so varied that it's useless to compare.

> Japanese people actually develop much less cancer[2.1], one reason for which is much better preventative medical care (for average people); the average Japanese person sees a doctor three times more often than the average Americans, and have three times more MRI scans

Cancer doesn't work that way. Seeing the doctor 3 times per year is not going to keep you from developing cancer. They may catch it earlier

Also how many times they see doctors could be completely cultural.

I have a crappy high deductible health plan I bought because I'm self-employed (that costs about $100 per month), but I can see a GP 6 times per year for $10 a visit.

For the average American the number of times they go to the doctor has nothing to do with cost.


I hate to flog a dead horse, or a dead thread, but:

> Cancer doesn't work that way. Seeing the doctor 3 times per year is not going to keep you from developing cancer.

Utterly, completely incorrect. Seeing a doctor more frequently and doing more preventative care demonstrably prevents cancer:

> They may catch it earlier.

Exactly. Early enough, in fact, to prevent cancer from happening at all. A pre-cancerous growth in the breast is found, treated, and/or removed. A polyp in the colon is discovered and resected. Cancer avoided in both cases.

These kinds of things happen a huge number of times every year here in the comprehensive annual health checks which, under the Japanese health care system, typical companies are required to both pay for (the portion the insurance doesn't pay), and give their employees paid time off to undergo.

> For the average American the number of times they go to the doctor has nothing to do with cost.

Extremely hard to believe when 47 million Americans have no insurance of any kind, and 100+ million more have low-quality health insurance, and more than half of Americans are now living in poverty or low-income situations.[1]

Furthermore, cost means more than the price the hospital charges. Virtually none of my American coworkers or friends regularly undergo a comprehensive medical checkup -- those that do are those who already have something wrong, like high cholesterol.

100% of my Japanese friends and colleagues do it every single year. Why? Here, if you skip your health check, then you're just working at the office instead, because you do it on work time. So the incentives are sane; why not go?

That's baked into the system, and just another reason that the Japanese system provides better health care to most of the people (the bottom 80%-90% of income brackets, I think).

> "infant mortality" is so varied that it's useless to compare.

Not when you are comparing the USA and Japan. That might be true when comparing other sets of countries.

Methodological difficulties aside, infant mortality is one of the most important metrics by which one could compare health cares systems -- what matters more than whether your baby lives or dies? Not much.

[1]: http://www.nytimes.com/2011/11/04/us/experts-say-bleak-accou...


In my opinion the best health system in the world is the one who safe more lives, no the one who safe the lives who can pay for.


America has one of the best health care facilities and best doctors in the world, NOT the system.

This is not a correct analogy but for sake of popular opinion, American health care is like Apple products providing good return for the money you spent but the money spent is too damn high compared to others.

Fortunately, there are lot of better models elsewhere to follow and America is not a shining beacon of health care system in the world.


"America has one of the best health care facilities and best doctors in the world, NOT the system."

and why is that? because the doctors go where the money is. Doctors in all NHS systems have limited salaries.

"Fortunately, there are lot of better models elsewhere to follow and America is not a shining beacon of health care system in the world."

Compared to who? There is so much FUD (especially in the HN community) about NHS, I can't really believe anything until I see some cold, hard, stats.


"Doctors in all NHS systems have limited salaries."

Senior doctors in the UK NHS often work "on the side" in private hospitals to boost their income to extremely comfortable levels - their basic salaries aren't too bad when you consider that the cost of medical training in the UK is nothing like as expensive as the US.


Indeed. I'm sure the multiple dedicated full time assistants and general adoration of everyone around him helps keep him positive too though. It's probably easy to have a pretty terrible quality of life with ALS even if you do have money for medical treatment.


Is that why the NHS is collapsing and has been forced to begin privatizing itself?


My view is perhaps even more cynical than yours: I think his longevity is primarily due to luck. He also, if I understand correctly, has a different variant of ALS that doesn't progress as quickly. While money might have been a necessary precursor to his achieving such longevity (I doubt he would have made it this far had he not been wealthy), ALS has taken the lives of many, many people poor and rich alike.

My stepfather died a few years ago from ALS, and he was fairly wealthy and motivated to fight the disease. Unfortunately, at this stage in our understanding, you can throw all the money and effort at the disease you can muster, but you're not going to beat it.


I suspect you're right. Money isn't the issue here; it's luck of the draw.

My best friend's father died of ALS two years ago, and like your stepfather, he was very successful, wealthy, and motivated. He was also professionally and personally productive up until the last second. As I recall, his disease progressed like a step function whose "steps" were of indeterminate length. He'd lose some functionality, then remain relatively stable at that level for months on end, then suddenly wake up one morning substantially worse. The process repeated, and there was seemingly no rhyme or reason to the length of the intervals. At any given stage, his doctors said he could last for years, or maybe months, or maybe days, in that condition.

[Don't get me wrong; I am extremely glad that Dr. Hawking has survived as long as he has, and I hope that he continues to fight and win.]


Another vote for this. My mom died of ALS, diagnosed in November at age 75, died the following August. In retrospect she was showing symptoms maybe 12–18 months earlier but the early symptoms in her case were just a gradual decline in strength that we attributed to aging. Not that anything can really be done; there are one or two drugs that have a very minimal (but statistically measurable) benefit, but they are very expensive and while they may slightly extend your life (we are talking perhaps a month or two on average) they don't improve your function.

After her diagnosis she attended a few support group meetings, and it was striking at how the disease progressed differently in different people. One man had been diagnosed years earlier and was still able to do work around his farm and house, he seemed almost normal. Others were in wheelchairs and could barely talk, and had been normal only a year earlier.

I wouldn't call Hawking lucky as the disease is absolutely a terrible thing, but given that he has it, his remarkable longevity does seem to be on the lucky end of the statistical distribution.


> Money isn't the issue here

You are correct. Health care is free in the UK so money is irrelevant.


His longevity might also stem from psychological factors, after all he still has the (afforded) means of remaining a productive person, whereas a patient that can't talk or move, much less do productive work, might fall into an increasing depressive mood and that has biological repercussions.


If you hate to do it than whats the point? The dude may have the care and the luck to keep him alive but he's also continued to produce jaw dropping work without being able to move much more than his eye balls. He can't eat or defecate or walk or wave or even make facial expressions but has contributed relentlessly to cosmology, theoretical physics, and the education thereof.

Regardless of the reasons why he is surviving, he deserves to survive like everyone else. And in the face of the most possible adversity has made the universe a different place to humans and turned countless individuals into skyward dreamers.


I was in no way indicating he doesn't deserve to survive or that he hasn't made invaluable contributions to science.

>If you hate to do it than whats the point?

Mainly my post is counter weighting others that mostly attribute Hawking's longevity as a testimony to will power. It's also subtly defamatory to the relationship of money and health--in that (perhaps unavoidably so) having money greatly enhances one's life expectancy in the face of mortal diseases. That's not to say wealth is a golden ticket that affords you a reprieve from any illness but it certainly helps to prevent you from being lumped in with all the "average" cases, to be one of the uncommon cases that "defies" the usual outcomes.


For the record (since some USA newspapers were reporting the opposite), Stephen Hawking is from the UK with the NHS (what can be called 'socialized healthcare' in the USA, and 'public health system' in EU).


I suspect you are greatly overestimating the power of money in managing motor neurone disease.


There's evidence that "brain activity" can slow the progression of neurological disorders, particularly those that selectively affect motor neurones. I'd argue that Hawking's incredible utilization of his brain, staying active as a theoretical physicist, has helped to keep his disease from overwhelming him.


his longevity is mostly due to him having money

You are mostly wrong. It is due to his will to live. Even if I could afford it, I know I do not have the mental strength to go through a life in such situation.


You are wrong. There is very little that medicine can do for ALS sufferers. With more research, perhaps this will change, but for now money has very little bearing on the outcome of this disease.


I've often wondered if his sense of purpose, and ability to continue working are what have contributed to his longevity. Certainly inspiring to see what he has accomplished in his lifetime so far.


His mind is travelling at relativistic speeds, so he's actually only forty years old.


My dad died of MND in 2003 after a fairly short length of time, somewhere in the region of 3.5 years after diagnosis. I put Dr Hawking’s longevity at least partially to being happy to work completely in his brain. Conversely, my dad was a very phsyical person and always had some project to build on the go. When that was taken away from him he seemed diminished.

Incidentally, he did try to carry on coding using Dragon Dictate, but it was painful to watch. I wonder if speech recognition has come on any since then? Apple’s Siri seems fairly remarkable although I haven’t had a chance to use it yet. Is anyone on HN coding by speech?


I completed a large fraction of my thesis by speech, including coding and LaTeX. While there are tools to help with coding (there used to be many knowledgeable people at http://tech.groups.yahoo.com/group/VoiceCoder/, but I'm not up to date since my condition has improved) I wouldn't want to wish it on my worst enemy. I'm amazed that Hawking has te patience to function like that, he must be an extremely driven individual.


Conversely, I wonder if his extraordinary luck of being the only known long-term survivor of ALS has pushed him to accomplish more.


If you haven't seen it yet, his most recent show on the Discovery channel is incredible. It includes a lot from his previous writings but some new stuff too and it's all set to pretty stunning effects and a great soundtrack reminiscent of scifi movies from the 70s and 80s. You can check it out here:

http://dsc.discovery.com/tv/stephen-hawking/

and the whole series is on netflix. It's truly amazing. Don't miss it.


His discussions and examples for why we wont be able to travel back in time are perfect for explaining the concept for people. He manages to communicate such high level stuff in such a great way on that show (well, always, but the show is much more approachable to the masses).


I think it's a combination of top notch care and an engaged mind. Even the medical establishment is acknowledging the connection between state of the mind and health (placebo effect research).

On a lighter note, here is something the great physicist cannot fathom: http://news.yahoo.com/women-mystery-british-physicist-hawkin...


I did ALS research in grad school and his case seems to be an outlier. Generally ALS is late onset (55+) and rapidly lethal (<3 years expected survival). That being said, early onset cases are often slower to progress and if I remember correctly his onset was in his late 20s, which is very early. There are really no medications or treatments that are effective for ALS, no matter how much money you have.


As a native South Carolinian, I encourage everyone to read the comments on the original article, and compare them in tone, content, and relevance to those posted on HN.


OK. Top-voted comments from the site:

1. "...making a killing on hypothetical theories... pie in the sky science. I'm sick and tired of these theories... Lying to keep the global warming cash cow rolling..."

2. "When Hawking stands at The Great White Throne Judgement and asks why he (Hawking) is being cast into the Lake of Fire, Jesus will tell him... blah blah blah"

4. "I think that Mr Hawking is going to be in for a big surprise when he is standing before the throne of God..."

Etc. etc. etc.

Comparing tone, content, and relevance, I'd say three to nil HN. Was that your point?


Expound upon that.


What this points out to me is how little we know about ALS/MND. The majority of those diagnosed die within three years, but a handful can survive for decades.

Do bulbar onset ALS patients live longer than limb onset? What about those with familial ALS? Were patients who die sooner exposed to an environmental trigger? ALS is significantly more common among military veterans than the general public - why, and is their survival rate better or worse than civilians?

I love that Dr. Hawking has survived so long. He contributes to awareness of ALS and gives patients hope. But I sometimes wonder if it's a sadistic, unrealistic hope and if his longevity decreases the urgency of the need for research into causes and treatment of a disease that is a death sentence for the majority of those diagnosed with it.


I can answer some of your questions. The longevity and age of onset of patients with familial ALS is partially dependent on the mutation they harbor. That being said, genetic background is an important contributor. Fortunately or unfortunately, familial ALS isn't common enough to have significant statistics on the matter. To my knowledge there is no solid proof that environmental factors play a role in ALS. I'm fairly certain some will be discovered, but to date specific factors that enhance or prevent ALS are not known. On the issue of veterans, it is thought that the enhanced physical activity may be the cause for the increased risk of ALS, though the increase is merely 2 fold and once again the statistics are poor. If I remember correctly, this increased risk was present for both combat veterans and those that didn't see any combat. Once again outcomes are identical with the civilian population.

I don't believe that his longevity decreases the urgency for research into the matter. However, compared with disorders such as Alzheimer's disease, cancer, and heart disease, which combined will affect some large percentage of the population, the 1:1000 lifetime risk for ALS makes it somewhat insignificant.


Thanks for answering my questions. While the lifetime risk of ALS is (relatively) low, I feel that its high mortality rate should increase the importance of funding research.


I wonder what his life would have been like had he not have ALS?


Such a remarkable human being - I hope someone can help speed up his ability to communicate. If this does not happen, we may miss out on a lot of great wisdom Hawking has to share (during the [what is sure to seem like a] short remaining he has left).


As a society we are lucky to have both his intelligence and patience for all these years.


Has anyone proven that he has ALS? That is, are there proven genetic or other markers that can correctly diagnose the disease? For example does he have a defective super oxide dismutate or heme oxygenase one?


It raises the age old question again. I sometimes think how people achieve so much.

May be being immobile saves his energy from distraction and helps leaves time to think about black holes.


> May be being immobile saves his energy from distraction and helps leaves time to think about black holes.

So that's what the couch guy in college was doing with his time.


I know it's going to be a very unpopular opinion here, but I find it hard to see the worth in thinking about black holes and other physics/astronomy questions.

Is the large hadron collider really worth the money?

Can someone highlight some real world advances that this sort of thing provides? eg will it make holographic TVs possible or hoverboards?


When the Queen asked Michael Faraday of what use his funny experiments with magnets would amount to, he is reported to have said - "Of what use is a new born baby?"

From another angle, during some collider hearings in congress, the physicist RObert Wilson was asked: "Did the collider have anything to do with promoting “the security of the country”"? He replied "nothing to do directly with defending our country except to make it worth defending".

In other words, fundamental research has definite technological implications, but also just satisfying our curiosity about nature is reason enough.


The solid state laser was initially described by it's inventor as "oh, it's probably useless, but it's a cool toy". Now it underlies the foundation of our modern communications infrastructure.

Research into the structure of the nucleus of atoms was initially done "just to see how it works". The unexpected results that came from 'pointless experiments' led to the theory of relativity, and from there, nuclear power, GPS, and dozens of other advances.

Point to almost any bit of modern technology, and you'll see advances that came because of earlier fundamental research that was conducted "just to see" without a specific goal.

So, yes, being able to understand the world around us is indisputably a requirement to be able to mould it around us.


Scientific research has a very high turnaround time. If you want to find out what you're profiting from now, look back nearly a century, when Einstein theorized about simulated emission of photons (laser). Or (more parallel to the LHC), the early particle accelerators, which taught us about the insides of heavy elements and let us construct nuclear power plants etc.

Generally speaking, by the time you can easily see the practical benefit of some piece of research, it's no longer science; it's engineering. Science necessarily does not bring practical benefits for long periods of time.

Edit to clarify wording and add: a pity up-vote for you - that was a good and fair question.


It's impossible to tell in advance what good will come out of such research.

Noone could have foreseen that the general theory of relativity would be fundamental in developing GPS for example


The discovery of the electron led to the electron gun that helped build the cathode ray tube which gave us television.

It's quite amazing to see how one thing leads to another.

http://en.wikipedia.org/wiki/Electron#Discovery

http://en.wikipedia.org/wiki/Electron_gun

http://en.wikipedia.org/wiki/Cathode_ray_tube

http://en.wikipedia.org/wiki/History_of_television#Electroni...


He's the intellectual version of Chuck Norris.


He'll outlive us all lol


Is there a good reason why he isn't the intense focus of technology dedicated to reading brain signals to action results through a computer + display?

There are already functional systems that paralyzed people have used to communicate through on-screen selections in that manner. Surely Stephen Hawking can acquire the technology and afford the upkeep. Hell, surely MIT or someone out there would build a custom rig for him and focus on constantly improving it to get more productivity out of his marvelous brain while he's still here.


True, I think the Hawkman is awesome, but his longevity in the face of disease probably has a lot to do with him being a groundbreaking physicist whom society deems valuable enough to keep alive at great cost.




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