Science Friday - Eye Implant Ethics, Sled Dogs, Tranquility Sound Scapes. Feb 25, 2022, Part 1

Episode Date: February 25, 2022

Paul Farmer, Global Health Leader, Dies At 62 Paul Farmer, physician and co-founder of the humanitarian medical organization Partners in Health died unexpectedly this week in Rwanda at the age of 62. Farmer was widely known for his compassion, and his conviction that all people around the world, regardless of their means, deserved access to quality medical treatments and interventions. Sarah Zhang, staff writer at The Atlantic, joins John Dankosky to remember Paul Farmer and his work around the world, from Haiti to Peru to Russia. They also discuss concern over a possible re-emergence of wild polio in Malawi, a new U.N. report linking climate change to a potential increase in wildfires around the world, and the case of Hank the Tank—a burly bear troubling Lake Tahoe. We’ll also get an update on the tale of a wayward piece of space junk soon to impact the moon, and dive into the link between Epstein-Barr virus and multiple sclerosis. We recently discussed research establishing the link between the two conditions—and now there is new work looking at the possible mechanism of the connection.   Blind Patients With Eye Implant Left In The Dark As Its Startup Struggles Barbara Campbell was walking through a New York City subway station during rush hour when her world abruptly went dark. For four years, Campbell had been using a high-tech implant in her left eye that gave her a crude kind of bionic vision, partially compensating for the genetic disease that had rendered her completely blind in her 30s. “I remember exactly where I was: I was switching from the 6 train to the F train,” Campbell tells IEEE Spectrum. “I was about to go down the stairs, and all of a sudden I heard a little ‘beep, beep, beep’ sound.’” It wasn’t her phone battery running out. It was her Argus II retinal implant system powering down. The patches of light and dark that she’d been able to see with the implant’s help vanished. Terry Byland is the only person to have received this kind of implant in both eyes. He got the first-generation Argus I implant, made by the company Second Sight Medical Products, in his right eye in 2004, and the subsequent Argus II implant in his left 11 years later. He helped the company test the technology, spoke to the press movingly about his experiences, and even met Stevie Wonder at a conference. “[I] went from being just a person that was doing the testing to being a spokesman,” he remembers. Yet in 2020, Byland had to find out secondhand that the company had abandoned the technology and was on the verge of going bankrupt. While his two-implant system is still working, he doesn’t know how long that will be the case. “As long as nothing goes wrong, I’m fine,” he says. “But if something does go wrong with it, well, I’m screwed. Because there’s no way of getting it fixed.”   Read the rest at sciencefriday.com.   Climate Change Ruins The World Championship Sled Dog Derby Teams of sled dogs and mushers from across the United States and Canada visited Laconia this weekend for the 93rd annual World Championship Sled Dog Derby. Racers were in good spirits, though they faced slushy conditions on Friday and Saturday—a situation that has become more common, many mushers said, as climate change causes winters to warm. Vince Buoniello was the chief judge for the Laconia race, which has a deep and prestigious history in the sled dog world. He likened it to the Super Bowl. “Laconia was always a magic name. Everybody wanted to race Laconia,” he said. Through his 65 years in the sled dog world, Buoniello has seen big changes—fewer people seem to be involved in the sport, and it’s harder to find undeveloped land for sledding trails. And, he said, warming winters have made races difficult to schedule. “We raced every weekend for years and years. It was an exception if a race ever got canceled. Now, forget it. It’s changed drastically,” he said. “To see mud, it just blows your mind. It just never used to happen.” Buoniello, who is 90, said judging the race in the warm conditions had tired him out a bit. But, he said, his love for the sport and the animals has made it worthwhile throughout his career. “The dogs kept me going,” he said. “It was just such love. It was just pure love.” Read the rest at sciencefriday.com.   An Elusive Search For Freedom From Human-Made Noise If you stand in the middle of a busy street in New York City and listen to the sounds around you, you’re hearing what Bernie Krause calls “the anthropophony.” It’s the cacophony of “incoherent and chaotic” noise that’s drawing people away from the natural world. “In fact, the further we draw away from the natural world, the more pathological we become as a culture,” he said. Krause has been charting this change for more than 50 years, as one of the world’s foremost chroniclers of nature sounds. He’s recorded more than 15,000 species and their habitats. In his new book, The Power of Tranquility in a Very Noisy World, he makes the case that human-made noise is causing us stress. Krause offers a simple prescription: “Shut the hell up,” and listen to the soundscapes of nature, what he calls “the biophony.” “If we listen to sounds of the natural world, for example, which are the original soundscapes that we were exposed to, it’s very restorative and therapeutic,” he said. Read the rest at sciencefriday.com.     Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm John Dankoski in for Ira Flato. Like the rest of you, we're watching closely as Russian troops continue their invasion of Ukraine. Scientists in both countries have organized protests and written open letters against the incursion as they are increasingly concerned about threats to their lives, livelihoods, and global stability. We'll continue to watch what's happening and bring you news in the coming weeks. We'll also send out our thoughts to those in harm's way, including the journalists covering this invasion. The world of science suffered another blow earlier this week. The world lost a giant in medicine, Dr. Paul Farmer, a physician and co-founder of the humanitarian

medical group Partners in Health. Dr. Farmer died unexpectedly this week in Rwanda at the age of 62. I wanted to start with a clip from Dr. Farmer on Science Friday back in 1999. Here he is talking with NPR's Joanne Silberner about treating tuberculosis in Haiti. It's a window into the way he thought about public health. in our program in Haiti when we offered patients financial aid during the course of their therapy. And this frankly is done widely, although sometimes people seem a little bit sheepish to discuss it, you know, but we were very proud to offer a financial aid to our patients.

And initially we did that in telling them that, you know, you've got to buy food with this, because our patients in Haiti were malnourished. It's a very different kind of setting than in New York where you had a lot of patients whose co-morbid problems were, say, substance abuse. it was really malnutrition and subsequently, to some degree, HIV. But when we gave them the money initially, we said buy food with it. Well, they didn't buy food. They'd buy shoes for their children or school books or tin for their roof. But the impact on the family was always beneficial. I mean, the patients would do better no matter what they did with it. If they used them again to help their

children to buy school supplies, it still had a beneficial impact. And at the same time that we got to meet these families through the person with active... tuberculosis disease, we also got to offer, again, the children, preventive therapy. It was a way of getting inside what Peggy just called those concentric circles and really having impact on, we hope, on the incidence of disease in the region. Here to help me remember Dr. Farmer and also talk about some of the other stories from the Week in Science is Sarah Zang. Staff writer at the Atlantic. Welcome back to Science Friday, Sarah. Thank you for having me, John. So how will you remember Paul Farmer?

Oh, gosh. So, you know, I've talked to a lot of public health experts for the past couple of years because of the pandemic. And it was just so striking in this past week to see almost everyone talk about how Paul Farmer was an inspiration or even influenced them to go into the field of public health. As you say, he was just such a giant. I don't think there's anyone in public health who's not been touched or influenced by his work in some way. And in the clip that we heard where he talks about treating tuberculosis in Haiti, you know, we heard him talk about not just giving people, uh, medicine, but also giving them money. I think this is also a really influential idea, you know, the social determinant of its health, which is that health is not just about access to pills or access to having a surgery. It's about how you live your daily life. And if you are poor and you get sick, you're sometimes forced into these terrible tradeoffs where can you still feed or close your children, can you still keep a roof over your head? And what he's promulgated is just in some way so simple, but so revolutionary, that if you just give people some money, not that much money by American standards, they can be not forced into making these terrible

tradeoffs, but actually doing things that will make them healthier in the long run. Health is not just about medicine. Yeah. And of course, at this time during the pandemic, and you're talking to so many health experts, his voice is a very relevant voice at a time like this. Yes, absolutely. You know, I think we can see this both globally and here in the U.S. The people who have died of COVID, it is just so disproportionately among people who are

poor and working class, people who had to work through the pandemic who could not work at home. I think globally as well, Paul Farmer was also just a great advocate for the equality for vaccines around the world. And we're in the moment where in the U.S. and in Europe we're getting third and fourth shots, and there are still lots and lots of people in the world who haven't gotten a single shot. There is some other big public health news this week. You pointed out a story to us about a case of polio in Malawi. Why is this so significant? Yeah, this is a big deal because the world has actually gotten really, really close to eradicating polio from the earth, which would be, you know, a great thing to do if we could accomplish it. So for the past few years, the only two

places in the world where wild polio has been circulating have been Pakistan and Afghanistan. In Africa, you know, there hasn't been a polio case in years, and in Malawi in particular, there hasn't been a polio case in decades. So what's really concerning about this one case is that it's probably just the tip of the iceberg. It kind of came to attention because a young girl was paralyzed by polio. And actually, most polio cases are asymptomatic. You don't get really sick at all. And even if you do, it might just kind of be fever and headaches. It's really only in one percent of cases that patients actually become paralyzed. So if we have this one such case, there are possibly hundreds of cases out there. According to the sort of the genetic sequence of this virus, it seems like it's

quite similar to something that was circulating in Pakistan a few years ago. So it's kind of a big question of how this virus travel thousands of miles to Malawi. So there's going to be a lot of work ahead to try to eradicate polio again in Malawi. We have an update now to one more medical story, something that you've been following. A few weeks ago, we talked about a study of military members that had a pretty convincing association between the Epstein-Barr virus and then later developing multiple sclerosis. You say there's some new research out on this. Tell us about it. Yeah, that's right. So that study you mentioned in military members was just kind of like a really incredible study using tens of millions of records, finding a really clear correlation that getting infected with this really common and someone's fascinating virus called Epstein-Barr increases risk of multiple sclerosis. Now we have a second paper, which actually kind of gives us maybe some causation to what this relationship is.

So a second paper out of Stanford finds that people with multiple sclerosis, they have antibodies that bind to the virus, but these same antibodies, also bind to a protein in their brains. Multiple sclerosis is an autoimmune disease where the immune system sort of mistakenly attacks the nervous system. So this idea that there's an antibody that binds to both the virus and the brain has kind of just been theorized for a really long time. But this is the first time it's really even found and identified. It might not explain every single case multiple sclerosis

is really a complex illness. The immune system is really, really complicated. But it really might explain a subset and really kind of tell us, like why we are seeing this association. Would this make it more difficult to just vaccinate against Epstein-Barr? I mean, what does this mean as far as treatment? Yeah, that's a great question. So on one hand, maybe there are ways of thinking about targeting this antibody that is somehow maybe getting the new system to mistakenly attack the nervous system. The other big question as you asked is vaccination. Just to talk a little bit about Epstein-Barr for a minute, it's a virus that actually infects almost all of us,

95% of us, so statistically speaking, you and I probably have had this virus. And it doesn't really make you very sick. Usually what happens is you get it as a kid and you probably don't even know that you got it. If you get it as a teenager, though, it can sometimes give you mono, which is sometimes called kissing disease. We don't really know why there's this age gradient, but there is. So there have been efforts to develop a vaccine to Epstein bar before, but they found that while it can prevent mono, it can't really prevent infection in general. So now we kind of have this question well, okay, if we have a vaccine that does not prevent infection, can it still prevent multiple sclerosis?

And there are reasons to think that it might. We don't know the definitive answer. The good news is that just recently two new clinical trials for the vaccine to Epstein Barr just launched, one of them from Moderna, a company that also makes the MRI vaccines for COVID. So this is an mRNA vaccine for Epstein Barr. And another group at the NIH. So these are really early stage clinical trials, but there are some real viable vaccine

candidates in the road. And just to be clear, and we talked about this a few weeks ago when we covered this initial research, if this is correct what we're saying, this wouldn't account for every case of MS that we have, right? MS, like all out of immune diseases, is such a complicated disease. It may have lots of different factors that kind of go into it. It sort of runs in families in some ways, so there may be some generic component. The other part of it is, of course, that, as I said, almost all of us have been infected with this virus. Most people will not get multiple sclerosis. So there's also just a question of, well, this virus could be a triggering factor, but maybe there also need to be other factors. And we don't exactly know what those are yet. We're going to go to another story that's a bit of a downer. It's not quite an update. Last week, we talked about recent research that shows that climate change was increasing the risk of flooding around the world. And also that extreme drought was occurring more frequently around the world. This week, a new report. And it says, there's more fire in the world. Oh, my goodness, Sarah. What's new?

Yeah, well, in some ways, if you've been living for the past few years, this is probably not surprising, right? There's been so many wildfires in the American West and in Canada and Australia, even the Arctic. So a new report from the UN kind of lays out that the risk of highly devastating wildfires might go up by 57% because of climate change. And I think in some ways, like why this has happened is a little bit intuitive, right? If there's less rain, it's going to be drier. If it's really hot, it's also going to be drier because the moisture inside fuel. is going to evaporate. So what you have is just basically a lot more fuel that is ready to go up at any sort of spark. And unfortunately, we've been seeing that already and it'll probably happen some more.

The really scary thing is not just that places that have historically dealt with wildfires might have to continue to deal with them, but that there may be happening in places that historically haven't, like the Arctic, for example, which a couple years ago was also on fire. So I think the risk of wildfire is not just going to get bigger in some places, but it's going to change and we'll have to adapt to that. We'll wait and see what other scary study comes out next week about global climate change. We're going to finish with one last update. And a few weeks ago, we mentioned the case of space junk that will soon impact the moon. And at the time, Sarah, we said that it appeared to be part of a space X booster, but there's actually new news here, a bit of a mystery. Yeah. So we still

don't know exactly what it is. So we have a better idea. So originally, a group of independent astronomers thought that it was a piece of a SpaceX booster. Some more analysis by astronomers at Harvard and NASA says it's actually maybe a piece of a Chinese rocket booster. This is part of a Chinese rocket rocket that launched in 2014. Usually rocket boosters, they kind of just fall into the atmosphere and kind of burn up. Somehow in this case, it did not happen. The Chinese, however, are saying that it is not their booster, that there's actually burned up.

So, you know, someone is clearly mistaken here. But in any case, this booster is on its way. towards the moon and is still going to crash into it by March 4th. It's so interesting that we just don't know who owns this piece of space. Does anyone keeping track of all this stuff that's up there? No, that's the problem, right? So the U.S. Space Force does keep track of everything that's sort of around the Earth. So everything that's kind of close to us and, you know, might be a problem for satellites

close to the Earth. But when you get a little bit further out, when you get out to around the moon, no one is really tracking it. Part of the problem is that the moon is really, really bright. So if you're looking at like a small piece of space junk, it's like this tiny little black spec and then something that's really bright and that's just hard to see or hard to identify. Space Force, I think, did recently give a little bit of money to astronomers to try to come up a better way to track this lunar space junk.

But yeah, this is kind of problem that no one is really responsible for. We'll see if we have any more updates. It's fascinating stuff. Sarah Zang is staff writer at the Atlantic. Thanks so much, Sarah, for being with us this week. Thank you. Good to talk. Coming up after the break, a specialized implant in the retina can help blind people have limited vision.

But what happens when the company that major bionic eyes stops offering tech support? Some ethical considerations ahead. We'll be right back after this short break. This is Science Friday. I'm John Dankosky. Medical devices come in a wide variety. Insulin pumps for diabetes, CPAP machines for sleep apnea, or high-tech implants in your retina.

The Argus 2 is an eye implant designed to help blind people or those with other visual impairments see in a limited but useful way. Since it was approved by the FDA for a genetic condition called retinitis pigmentosa, it's been implanted in more than 350 legally blind patients around the world. But what happens when the company that makes your specialized, computer-programmed medical implant goes bankrupt, or merges with another company whose focus is not eye implants. They said equipment that's designed for the disabled. You learn that lifetime support means the life of the company making the promise, not the life of the product or the life of the person

who's using it. That's Ross Doer. He received his Argus II from a company called Second Site. An investigation by the publication I-Triple-E Spectrum explores the tricky ethical issues of corporate responsibility for patients. And it introduced us to Ross and others who are left wondering what will happen if they need help with a device that they use to see. The reporters who broke the story are with me today. Eliza Strickland is a senior editor at IEEE Spectrum. She's based in Western Massachusetts. And Mark Harris is a freelance investigative technology journalist. He joins us from Seattle. Eliza and Mark, thanks so much for this reporting. And welcome to Science Friday. Thanks, John. Great to be here.

Eliza, let me start with you and help us unpack this story just a bit more. What exactly was this company offering people? So Second Sites bionic vision system started with a souped up pair of sunglasses, basically, that had a little video camera just over the bridge of the nose. That video camera streamed video to a video processing unit, which converted this rich signal from the world into a very simple pattern of just 60 pixels. That pattern then went back to the glasses where there's a transmitter, and from the transmitter, it was beamed into the implant in the eye.

So the patterns that were generated by the video processing unit use those electrodes to stimulate the eye many times each second and created a very simplified version of the world in black and white and gray, which the person could perceive. The signal went up the optic nerve to the brain. Mark, do we know how many people have one of these implanted right now? Yeah, we know that about, well, over 350 people, people were implanted with them since the device was first approved.

Now, we don't know how many people have them today. Some of those people certainly have had their device just taken out of the eye after it either failed or they failed to develop the vision that they wanted or expected. We have one of the people who received this Argus II implant with us. His name is Terry Byland. Terry, welcome to Science Friday. Thanks so much for joining us. Thank you for having me.

You actually have the Argus 1 model implanted in one eye, and the Argus 2 model in the other. Eliza has said that it's actually a fairly simple black and white image. You can explain it certainly better than we can. What does it look like in your vision? But the Argus 2, I was able to see people's arm movements, head movements. The further away I was from the person I was looking at, the more I could see of them. The closer you get, like anything else, you know, you get close to somebody.

you see less and less of them, you know, even with normal vision. And so that was a big thing for me. It's also based on contrast. And in other words, if you're looking at something that's got two different colors, say if you're looking at a building and it basically will help you determine where the windows are or the doors are, that sort of thing. But here again, it depends, it really depends on how much. contrast you're looking at.

Yeah, we spoke with another one of the patients of Second Sight, Linda Kirk. She explained how just a little bit of vision could go a long way for her daily life, especially her confidence in navigating the world safely. I don't care if it shows me where the window is in my house because I know where my windows are. I don't care if it shows me where the plate is on the table because I know my table on my plate. What I would really like to have done was to see the white lines on the side of the road and the white lines for crossing the street at a crosswalk. I said that would be a great benefit if I get that.

Terry, how exactly did the Argus II change things that you were able to do? Did it make the quality of your life better? Oh, yeah, it allowed me to be more independent in some ways. You mentioned the painted white stripes at the crosswalk. So that's a big help. Otherwise, without that, you wouldn't really know if you're staying inside the crosswalk or not. So with that in mind, you know, you could get across the street pretty quick. And so that there is a big thing as far as mobility goes. We did talk with a patient Barbara Campbell,

whose implant did stop working suddenly back in 2013 and it never worked again. You mentioned, Mark, that this didn't work so well for some people. I don't know if you can talk us through the difficulties that some patients had with the device. So this device did have a number of different failures for different people. Sometimes it really just irritated the eye, people had retinal detachment and other sort of injuries to the eye. Other people had infections or other sort of medical issues with the eye that the device exacerbated. And there were some people, you know, the device actually failed. So perhaps it fails to do the communication where it was receiving the information from the wireless unit or the external units could obviously fail as well. The sunglasses with

the camera, the video processing unit could fail. And some of those easier to fix than others, right? It's relatively easy to fix the external units, a new pair of glasses or a new video processing unit. Much, much more difficult. In fact, it's impossible to repair the device on the eye. Really, the option is to have it explanted taken out. One thing to note is that patients were all told they were going to get upgrades, that the vision was quite crude, but it was just a beginning. The company had talked about a lot of different improvements, cameras, better processing, ways to use a software that would give people radically more precise vision, and none of those upgrades ever came.

This sounds like an awful lot of technology that we all rely on on a regular basis, but when it comes to your actual vision, it's incredibly important. Now, Eliza, what happened to this company? They've promised all these things to folks like Terry. What has happened to second sight? Well, in 2018, they began a trial of a new technology, a brain implant called the Orion. So if they do a brain implant, they can offer it to people who have damaged optic nerves, who have physically damaged eyes, and they saw that as the way forward.

But in 2019, the company then sent a letter to users of the Argus II retinal implants saying that they were no longer going to be making this technology. and Mark could say a bit more, I believe, about what they promised at the time. And also Terry, of course, can say what they promised and what they did or did not deliver. That was a really interesting letter because it said that it promised that the level of support would not change, that it would be ongoing for years to come, and that there would be a full team of these customer care and rehabilitation specialists to help people continuing to have issues or still in the learning path to getting to grips with their new, implant. And they also said that they've taken all measures to ensure that the future supply needs

for the device would be met as well. So they really promised that, okay, perhaps your device is becoming obsolete, but don't worry, we're here for you for the foreseeable future. That was in July of 2019. And then in March of 2020, basically the company ran out of money. They laid off the vast majority of their staff, most of their engineers and rehabilitation specialists. And they sold pretty much everything, all their technical equipment, their lab equipment, they sold their laptops. They sold their shelves. This company was really in dire straits. And they didn't tell the customers. They didn't tell their users. They didn't tell people with the Argus implant that this was happening. The first that some people found out about it was when they had a medical issue and needed to

contact the company and the company simply wasn't picking up the phone. Terry, what was your experience around this time? Were you promised upgrades or something? that you weren't getting, and then you find out, oh, my goodness, this company that's promised me so much isn't here anymore. Yeah, in 2018, I was at Second Site there in Silmar, California, and went through a five-day deal with he had me go back and forth every day trying out this new software. So after that happened, I really didn't get too many phone calls to come down to second site for further testing. And I was just kind of wondering, you know, like, what's going on here. Like anybody else, I mean, you get a taste of something. You want to be able to see more.

It was really baffling to me because I didn't get any calls. I didn't get any phone calls or anything or letters or anything like that about anything. And then finally, I just waited, wait in one day I just said, well, back to this, so I called them. One thing I wanted to say is that I've dealt with these people since 2005. And I know how hard they work at what they're at their craft, the engineers, the scientists, the technicians, and so on and so forth. So, I mean, they tried their best to do what they could do with it. And when the funding dried up, well, everything else went south.

It's heartbreaking to hear that because, as you say, how much work they put into it, but also how much work you put into it. I mean, you think from a journalist standpoint, from just a human standpoint, it seems obvious that a company like this would owe it to the patients with this implant. But legally, what do they have to do? What are you expected to do in terms of support for a device that's so specialized and so technically sophisticated? So you'd have to remember that all of these users also had a really professional medical

team, their eye doctor that was actually doing the implanting. The company itself had responsibility to produce a functioning, safe and effective device. Now the FDA had licensed that device and approved it and said they had a good device. Now when it comes in terms of support, yeah, there did seem to be a mismatch between what the patients expected and what was delivered. And, you know, one of the reports, the anonymous reports from a person whose device had malfunctioned said that they had got this device, assuming they were going to have it forever. But what it actually turned out was, you know, that they felt the device failed within a number of years. And legally, that is unclear whose responsibility

it was, but it was definitely a mismatch between what the patients expected and what the company delivered. Eliza, what has the company told you about their plans to provide resources and in care for former patients? They declined to be interviewed. They did respond to our fact check questions, but they did, second site did not say anything specifically about what it could do for its patients. The most that they said was that they had a limited supply of external equipment, sunglasses and video processing units that they could make available to people who needed them if their units broke. After we started our reporting, they then sent out a letter to all their users explaining that they did have some spare equipment before our reporting started as far as I know most of the

users had no idea. Until that stockpile runs out, people do have some possibility of replacing the externals, but there's really no possibility of repairing or replacing the actual implants in the retinas. I'm John Dankoski, and this is Science Friday from WNYC Studios. Aside from the problems that so many patients will have with upgrading their equipment, their implants, and what will happen if their equipment stops working, there's also some other problems that have been presented to patients. Here's Ross Dorr again. He's talking about the support that he didn't get recently when he needed to know if it was safe to get medical tests with a piece of metal that's been implanted in his eye.

I mounted a campaign of telephone calls and emails. Will you please call my dentist? They are frightened of giving me an x-ray because they're not sure how it'll be. And I should note that Ross was also unable to find out if he could safely get an MRI when his doctor wanted to investigate the possibility of a brain tumor. And Mark, from all the patients that you've talked to, This is another very serious concern. It's not just about whether or not this equipment works or can be supported,

but people in doctor's offices and dentist offices don't exactly know how to deal with a retinal implant, and there's no one to call. That's right. Right now, the only solution these users have is for their medical staff to talk to their eye doctor. But those eye doctors, of course, are not expert on the implant itself. So while they are a great backup, they're not the absolute encyclopedia Britannica on what is going wrong. with that implant. And so there is always the possibility, especially if people need care urgently, or especially if they need an involved medical procedure involving their vision or their head,

that there is going to be a gap there of treatment, which obviously no one, no one would like. You've reported that second site, maybe merging with another company called Nanoprecision Medical. Has that company said anything to you about what they're going to be doing for patients with these Argus implants? We did get to speak with the CEO of Nanoprecision Medical. He said the right things. He said he's, you know, listening. He's keen not to repeat mistakes that have been made in the past. And he's open to maintaining as much support for these Argus users as his new company is capable of.

But his new company doesn't specialize in vision implants. It's an exciting company with a drug implant technology that could help thousands of people. But it's nothing to do with vision. And so the question really remained is however much goodwill is there, however much he intends to work to this and to keep these patients supported, how much support is actually going to be there in the real world? And that's just really an open question. And we don't even know if the proposed merger will actually complete. So it's still very much up in the air what's going to happen with the Argus units, with the technology itself, and with the support for the patients. Eliza, you mentioned in your reporting that there's a big effort now toward brain implants. I'm wondering about the kind of accountability structure for companies that implant these complex devices in people's bodies. When we're talking about brain implants, it's a step beyond a retinal implant like we've

been talking about. Right. So second site did try to pivot to this brain implant technology, the Orion technology, which is an implant that goes over the visual cortex. There are currently five people walking around with these implants in their brains. They have good support from their neurosurgeons, of course. Their neurosurgeon teams are there for them, but it's very unclear if Second Side is going to be continuing to develop this technology in light of their financial problems and in light

of the merger. Yeah, I do agree that everything becomes more dire when you're starting to talk about actually putting technology into the brain. This field is so new that there's not a great deal of regulation there yet. the brain implants that have been commercialized are mostly from big device companies like Medtronic companies that are well established and not going to go out of business anytime soon. But these smaller companies that are working on some of these really cutting edge technologies, it's not really clear what responsibilities they're going to be held to.

Mark Harris is a freelance investigative technology journalist. He joined us from Seattle today. Eliza Strickland is a senior editor at I-Triple-E Spectrum. She's based in Western Massachusetts. They broke this story about second site and the Argus 2 implant. I also want to thank our guest, Terry Byland, who has had these implants for a number of years. Terry, thank you so much for your time. Mark and Eliza, thank you so much for your reporting.

Oh, you're welcome. Thanks, John. Thanks, John. I also want to thank Second Site patients Linda Kirk, Ross Dorr, and Barbara Campbell for speaking to our producer for this story. We're grateful for your time. More on Mark and Eliza's reporting can be found on our website, ScienceFriiday.com, slash eye implant. We have to take a break now, and when we come back, we'll check in on the sport of Sled Dog Racing and how warming weather is affecting this famously chilly sport.

This is Science Friday. I'm John Dankosky. And now it's time to check in on the state of science. This is KERNO, St. Louis Public Radio News. Iowa Public Radio News. Local science stories of national significance. Leconia, New Hampshire is home to the World Championship sled dog derby. It's a sport where teams of sled dogs and mushers race across the snow to see who's the fastest. But like many things, a warming planet is changing this sport. Many long-time enthusiasts say that change is for the worse. Joining me today is a reporter who's been covering this story. Mara Hoplamazian is Climate Change and Environment Reporter for New Hampshire Public Radio, based in Concord, New Hampshire. Welcome to Science Friday, Mara. Thanks so much, John. Thanks for having me.

So how long have sled dog teams gathered in Laconia for this race? Yeah, so this was the 93rd year of this event. The first races were held in 1929, so it's been around longer than the Iditarod, which I think is what many people think of when they think of dog sledding. The race was started a few years after the famous sled dog run to gnome, Alaska, where sled dog teams brought that community diphtheria medication. And one of the mushers who did that run to gnome actually won the first race in Laconia. So it has that history. World Championships was added to the name in 1936. And Mushers at this year's event said it's lived up to that title.

It's one of the biggest races outside of Alaska. And one Musher told me it's really the event to race in to see how you compare to some of the best musher's in the world who come from all over the U.S. and Canada to compete. The Chief Judge compared it to the Super Bowl of Sled Dog Racing. Wow. So this is a really big event and it's got quite the history. So maybe you can paint a picture for us of what this year's event was like. Yeah, sure.

it was warm. On Saturday, the sun was out. The snow started melting early in the day. Spectators were navigating a lot of mud. My boots got stuck. Right next to the starting line, Mushir's from across the U.S. and Canada park their trailers with a bunch of dogs and get them ready to race. Getting eight or nine or ten super excited dogs into harnesses seemed like a really difficult task. Teams went out one by one, and so as the announcer was sort of counting down towards the starting call, a team of handlers actually had to hold back the dogs because as soon as they get on the snow, they're really ready to run. But there were three events on Saturday, the six dog classic, a three dog junior race and an open class race where mushers have different numbers of dogs.

They're all sprint events. So the times for the six dog classic were sort of in the 15 minute range, which was fun to see the racers go out and come back pretty quickly. And then the times for the open event were in the 45 minute range. So it's really a different scale than a race like the Iditarod, where teams are taking multibes. multiple days to complete the race. It's a sprint for the dogs and for the musher's. So this race has been going on for a very long time. I can imagine that an awful lot has changed over the course of 93 years. What did some of the people that you talked to say about how this event has been changing over the last few decades? Yeah, it does seem like a lot has changed.

So I talked to Vince Bonello, who was the chief judge for the event. He's 90. He's been part of this for 65 years as a musher and also as a judge. And he said he said he's seen a lot of changes to the sport. There's less teams involved. There's less undeveloped land to create trails on, he said. And climate change has really changed how the races look. We've raced every weekend for years and years. It was the exception of the race ever got canceled. Now, forget it. It's changed drastically. To see mud. It just blows your mind. Other mushers said the same. There used to be dozens of races per season. One of them told me, but with warming winters, snow conditions are harder to predict, and they just don't hold up like they used to.

The local paper in Laconia reported that in its first 50 years, the race was only canceled once due to a lack of snow in 1974. But since the 1980s, it's been canceled 13 times, and that's about once every three years. So the racing conditions really are changing. When you talk about mud, people in New England think about mud season, which is supposed to start when spring comes. But you're talking about mud here actually in the winter. just so the people have a sense of this Mara, Laconia, New Hampshire isn't way up by the Canadian border. It's not as far north as the Iditarod in Alaska. It's pretty much smack dab in the middle of New Hampshire. So, you know, the winters are kind of Boston-like in a lot of ways.

Yeah, yeah, definitely. It's in the lakes region, so not way up far north. So how is training changed for people who are involved in the sport, given all the changes to the weather? Yeah, so Mushreys told me that the changing climate has shortened the amount of time per year that they can train. Mushers from across the world told me that. So a musher from Utah, Fernando Ramirez, told me he can see climate change actually appearing in his training log. You know, we used to have really good weather.

Winters were really consistent. We'd have off years here and there, but nothing to what we're seeing now. You know, the past five years, and I have it in all my training logs, to see the snow melt and become unrunnable, quote, quote, in February. It's really strange. Normally we were able to do that in March, you know, early April. But it's interesting hearing from Fernando that the training is a problem in Utah, too. It's not just New Hampshire that's having problems with less and less snowfall over the years.

It's also Utah. So how does this impact the dogs? That's what a lot of us care about. Is it bad for them? Right. So one of my big takeaways from this race was what a deep connection these mushers have with their dogs. And when I asked about how climate change was affecting their training season or the races, Mushers would talk about how their dogs are experiencing climate change.

Sally Minikian is a musher from Northern New Hampshire, and she told me that the heat can be really hard for her dogs. The dogs get hot like anyone. It's sort of like running a marathon when it's 100 degrees in human, so you have to go slower. I try to go slower. The snow is softer, so they work twice as hard, so it's hotter and softer, so it's kind of like a double bind.

And the dogs really seem to love racing. And so this loss of race days to warmer winters is creating a loss for these dogs, too, who are, you know, really trained athletes in this sport. How has this warming weather impacted the other winter sports in New Hampshire? Because, as you said, it really is a big part of the tourism economy. It's a really big part of life in New Hampshire, having a real winter. Well, skiing is what a lot of people talk about.

You know, downhill areas can make snow, but it can be really hard for Nordic skiers who can't get that help. But there's a lot of other things that are affected too. Recently, the town of Hanover and New Hampshire canceled their annual winter festival. that had been going on for 25 years for good. It's this big community event that's usually held on a frozen pond. And they just said with winter conditions, so unpredictable and warming, they can't hold an event that relies on frozen ice. So many changes to winter weather with climate change.

That's all the time we have for now. I'd like to thank my guest, Mara Hoplamazian, is climate change and environment reporter for New Hampshire Public Radio, based in Concord, New Hampshire. Mara, thanks so much. Thank you so much, John. And if you want to see pictures of some of the dogs and the human racers at this year's derby, you can go to our website, Science Friday.com.

Now I'd like to ask you to listen to the sound of what our next guest calls the Anthrophoany. Yeah, that's New York City. This, on the other hand, is the sound of the biophony, the sounds of the natural world that Bernie Krauss says are being increasingly crowded out by man-made noise. Krauss has been listening very closely to these changes over a 50-year career as a soundscape ecologist. He's recorded more than 15,000 species in their habitats, from meadows to deserts to sub-arctic mountains. And in his new book, The Power of Tranquility in a very noisy world, he raises concerns about what he's hearing in these changing soundscapes. He's heard birdsong slowly leave the areas near his northern California home, the result of that state.

long drought, and he's personally experienced the effects of climate change, losing his own home and many of his original recordings in a 2017 fire. But his book is hopeful, too, giving readers tools to listen for natural sounds as a way to heal ourselves, as a people and a planet. Bernie Krauss, welcome back to Science Friday. It's wonderful to have you here. Thank you, John. Could you tell me what the difference in your mind is between sound and noise? Well, noise is sound, and the difference is that some of the noise that we create is controlled sound, like music and theater and language. And then there is a second subclass of sound, which is incoherent and chaotic, that we refer to as noise.

And it has a real impact on us. Noise is partly a consequence of the times that we live in. It's chaotic. What happens is it draws us further and further from natural world encounters. We need to remain calm and to quiet us and sustain us. In fact, the further we draw away from the natural world, the more pathological we become as a culture. You tell a story very early on in your book that illustrates this very well. And you talk about a couple that rents an Airbnb from you that comes from the city, and maybe you can just describe what their experience was being exposed to a place that had more natural sounds than man-made sounds. Well, my wife, Catherine, and I lived in Glenell in California on a 10-acre area that was a

wildlife corridor. And it was very quiet, and it was really extraordinary. It was beautiful. there was hardly any noise there. And a young couple from New York checked in one night. And I went out to run the next morning. And they were downstairs at the bottom of the, in the driveway, putting their luggage in the back of their car.

It's 7 o'clock in the morning. And I said, when I asked them what was wrong, the gal says to me, you know, we were scared to death. Those crickets made us crazy. And I said, well, what are you going to do? She says, well, we're going to go to San Francisco and we've got a place on Union Square at a hotel

where we're going to be able to hear traffic. We've got to hear traffic. And that was the, and they signed out, that was it. That was the end of their vacation and wild sanctuary. And the way that you described it in the book, you say that the damage caused by these man-made sounds has already occurred to them. And I'm wondering if you can talk about that,

about how that noise, that din of urban life or of industrial sounds, how it actually damages our ability to enjoy and appreciate the natural sounds around us? Well, it distracts us. And the noise that intrudes on our life, and there's all kinds of noise. There's noise from the television set. There's noise from news programs. There's noise from the entertainment that we choose. So all of these things are affecting us in ways that are causing a stress factor in our lives.

Like for instance, glucocorticoid enzyme levels are rising as a result of all this noise around us. As we begin to understand what listening is all about and what we're hearing, it'll have an impact on how we engage with sound. Sound is very physical. And so it affects us physically because it makes the eardrums move in and out and oscillate. So it's really important to understand how to listen and what we're listening for. If we listen to sounds of the natural world, for example, which are the original soundscapes that we were exposed to, it's very restorative and therapeutic.

I'm John Dengkowski. I'm talking with soundscape ecologist Bernie Krauss. And this is Science Friday from WNYC Studios. Bernie Krause's new book is called The Power of Tranquility in a very noisy world. He also has a traveling installation called The Great Animal Orchestra that's on display right now at the Peabody Essex Museum in Salem, Massachusetts. It's an immersion into the soundscapes that he's created from thousands of field recordings. Let's listen. What they're going to hear is they're going to hear these natural compositions from different habitats, marine habitats and marine habitats and trees.

terrestrial habitats and from the terrestrial habitats, there's everything from sub-arctic up in Alaska down to the rainforests of Brazil. When I went into this field by acoustics and began to record animals, I thought I knew everything there was to know about music. But really what I discovered when I began to record the natural world was I discovered a whole new area of music that had never been a great. explored before. Rhythms and melodies and structure of sound and so on, all of these things in the natural world are far more complex and far more interesting than anything that I've ever

heard humans write or compose. Did you have a first sound as you were doing this work early in your career that really highlighted to you that idea that the now. natural world is so complex and so varied. Do you remember anything like that from early on? Yeah, did you ever hear an ant sing? I probably heard recordings of ants, but maybe an ants singing, no. Ants sing. We've got recordings of viruses. I mean, think about that. Every living organism, by the way, creates its own sound signature, sometimes by its metabolism, and sometimes by an actual stridulation or vocalization.

And so we have a whole world that we haven't explored. And the natural soundscapes are the origins of that. Since you mentioned viruses, you talk in your book about the phenomenon that many of us experienced during the, especially the early days

of the COVID pandemic, that the world did sound different. And what was your experience of that? of just the world sounding different than it had in such a long time. The first thing that I noticed is there weren't planes flying overhead, interrupting our recordings. There wasn't a lot of traffic, and it was pretty remarkable. Maybe we need a day of human silence to celebrate.

And you write, and people have studied this, that it actually, this time period did change some of how the natural world communicated, A change in the vocalizations of urban songbirds, for instance. Yeah, because they didn't have to sing as loud. And they didn't have to change their pitch to fit within the niches that were available to them, the acoustic niches that were available. And it made a big difference. Now they're changing back again. So things are changing, and we're filling those spaces with our own voices and noise.

And it's having an effect on us. It's something that we've been doing for a long time, Bernie, not just in the last couple decades. This has been a human phenomenon that's been going on since the start. I'm wondering how we've reversed that. Well, there are two sides to that one. First of all, we've got to learn to shut the hell up. And the second thing, we've got to keep David Bowie's aphorism clearly in mind. The future belongs to those who can hear it coming.

The book is called The Power of Tranquility in a very noisy, world. And the author is Bernie Krause. Thank you so much for joining us once again on Science Friday. I really appreciate it. And I wish you a tranquil rest of your day. Thank you, John. You too. You can hear some more from Bernie Krause's great animal orchestra and watch a short video he made that shows the impact of the California drought on birdsong over more than a decade. You can find it at ScienceFriiday.com slash tranquility. Here's Ariel Zich with some of the folks who make our show possible. Nahima Ahmed is our manager of impact strategy. Diana Montana Montana is our experiences manager. Christy Taylor, Kathleen Davis, and Shoshana Buxbaum are our radio producers.

And I'm Science Friday's director of audience, Ariel Zich. Thanks, Ariel. B.J. Leaderman composed our theme music. IRIS back next week. I'm John Dankoski.