The Boston Globe from Boston, Massachusetts · 33

IU in Also Inside Medical Help Wanted 35 LivingArts 38 TV and Radio 43 Classified 45 u n THE BOSTON GLOBE MONDAY, JUNE 29, 1992 1 1 No two doctors handle the task just the same way. Health Sense ; BETSY A. LEHMAN A number that often ' means little r Fl HEN LISA WHITESIDE if I was diagnosed with ovarian If II Iff cancer at the aere of 31. she read everything she could find on the disease. She knew the odds were against surviving for five years. But she never asked her doctors for a prognosis. Whiteside thinks other patients would benefit, too, from skipping the big question How long do I have to live? And doctors, she says, can help by refraining from givinj hard answers. It's now 12 years after her diagnosis, and Whiteside is doing well and working for the Watertown-based cancer support group, Wellspring. Thirty years ago, it was common for doctors not even to tell patients they had cancer. Then, doctors started telling the "truth," revealing everything, sometimes more than patients were equipped to hear. Today, doctors and patients alike are concluding that tailoring such discussions to each person's needs, rather than spilling ou all the available "facts," may not only be more fair and kind, but ultimately will be more true and honest The truth is that no one can say for sure how long anyone will live. The only thing doctors have are statistical averages, which may apply to a particular individual, or may not. Those averages are subject to the inaccuracies of research studies and they change over time as ; treatments and diag nostic tests alter the course of diseases such as cancer. And the information is by necessity dated, based as it is on what happened to people in the past They are a "historical snapshot," says one surgeon, nothing more. They are not a death sentence. How doctors tell seriously ill patients about their prognosis, and how much they tell them, is a delicate matter for which they receive little formal training. Yet these discussions, for better or worse, shape the experience of patients with many serious diseases. No two doctors handle the task just the same way, and no two patients have precisely the same needs. But doctors, social workers and patients say a balance must be struck between informing patients while helping keep hope alive, guiding patients who need to put their affairs in order while not causing panic, and most of all, making sure that every patient even to the moment SENSE, Page 35 Propulsion system has no moving parts By Colin Nickerson GLOBE STAFF OBE, Japan - There was little fanfare and no speeches as the Yamato 1 - looking less like a watercraft than something Luke Skywalker might pilot against Darth Vader3 Death Star -was towed from the dock at Japan's most advanced high tech shipyard two weeks ago. Then the tow lines were cast off. The Ya mato 1, equipped with a revolutionary superconducting magnetic propulsion system never before tested at sea, was on its own. "We have 1,000 amperes of electrical current," the skipper's voice crackled over the radio. "Speed, 1.2 knots." And yes, the 100-foot, 185-ton Yamato - propelled by a futuristic propulsion system that essentially turns sea water into part of an electric motor - was moving, slowly, slowly surging against the light chop of Kobe Harbor and into nautical history. "We have 2,000 amperes of electrical current." The skipper's matter-of-fact tone sounded distinctly forced as the vessel's superconducting electromagnetic propulsion system cranked soundlessly up to full power and full speed. "Speed, 6.2 knots." About seven miles per hour, barely faster than Robert Fulton's steamboat Clermont as it chugged 130 miles from New York to Albany in 32 hours in 1807. This was not a test of speed, however, but of a new technology - a potentially highly energy efficient, almost totally si-SHIP,Page36 0 Magnetic water jet propulsion Revolutionary" system fcr marine vessels eliminates all moving parts, including propellers and motors. Magnetohydrodynamic (MHD) propulsion uses a superconducting magnet to exert a powerful force on electrified seawater passing through a duct in the magnet. The seawater is expelled as a water jet, which propels the vessel. I Helium H. I,,, , refrigerator rf jj j- Electro i . magnetic - I Ministers .J "Exhaust '3!:te'f I Man A ifr water flow v,M The Yamato 1 in Kobe harbor, Japan on its maiden sea trial i'I Exhaust .silencer. ENGINE " r, ROOM p Helium:. rciirefngeratofji Afl PHOTO Length: Breadth: Draft: Weight: Crew Speed: 98 feet 34 feet 5 feet 185 tons displacement 10 persons 8 knots Ship direction Ji-4- I Electrode current J ?! roonr ( "SU L , 1 source room j . T flow Electro magnetic thrusters The Lorentz force: When current passes at right angles through a magnetic field, it generates a force - the Lorentz force - in a direction perpendicular to the plane in which they intersect. Hold your left hand like this: your thumb is the direction of the magnetic force, your forefinger the direction of the current; if you point your middle finger away from your palm, that is the direction of the resulting force. Magnetic flux Current Yamato l's design: Two magnetohydrodynamic thrusters are located in twin pods that extend downward on either side of the hull. Cooling machinery for the superconducting magnets fills much of the hull. SOURCE: Ship and Ocean Foundation, Mitsubishi Heavy Industries. Ltd.; Knight-Ridder. GLOBE STAFF GRAPHIC NEIL C PINCHIN I A 1 'f paim, tnat is tne direction of , Sfc. I A the resulting force. SSVfc Q Fleming's VK v. s w left hand 1 '-15 Electricity source I The thrusters: Sea water flows Into to a duct surrounded by a super conducting magnetic coil. Electrodes on either side of the duct set up an electric current in the water. The resulting Lorentz force pushes the water out the rear, driving the vessel forward. I I i t r Snap, crackle, whizz, boom! Modern technology puts artistry back into fireworks By David Arnold GLOBE STAFF t has been said that Kenneth Clark's head is one-part flute, one part violin, one part kettle drum and one part potassium nitrate, the ingredient that gives fireworks the snap, crackle and boom. Clark is the 48-year old artistic director of the Fourth of July fireworks show on the Charles River Esplanade. According to his admirers in the industry, he is also a leader in the pyrotechnic revolution that is putting artistry back into the chemistry of fireworks. Not since the Renaissance have firework displays sought to orchestrate color, pace and sound as they do today, says John Conkling, executive director of the American Pyrotechnics Associaton. Th biggest changes in the industry have not been chemical They've been artistic said Conkling. "The trend toward choreographing large shows such as Boston has been phenomenal." The chemistry of fireworks has changed little since the Chinese discovered 2,000 years ago what a little saltpeter (potassium nitrate) mixed with charcoal and sulfur could do. What is new is the use of computers and synchronized firing to add artistic flare to the spectacle. With the sky as an easel, the pyrotechnician is becoming recognized as an artist in his own right - which gets us back to where things were in Renaissance. The trend has been buoyed by an increasingly sophisticated audience with a growing appetite for flair in its fireworks. Ten years ago, patrons were spending $50 million annually to attend large aerial fireworks displays; the figure is now more than $S0 million, inflation adjusted, says Conkling. Spending has led aerial shell manufacturers (there are about 40 K- BOOM, Page 34 Scientists press for human rights By Judy Foreman GLOBE STAFF Science Watch At the height of last year's Gulf War, Egyptian psychiatrist Mc-hamed Mandour was suddenly detained by his country's security forces, beaten and brutally tortured all over his body with an electric cattle prod. He was never formally charged, but Mandour's "crime," if there was one, was probably this: he had been treating Palestinian patients through the Palestinian Red Crescent Society, at a time when Palestinians were viewed as supporting Iraq. Mandour was lucky - compared to other political prisoners. Within days of his arrest, letters, faxes and telexes from doctors, scientists and lay human rights activists poured into Cairo, an international effort that Mandour later credited with shortening the torture, getting him better food and finally, 16 days after his personal hell began, prompting his release. In Guatemala three years ago, a "disappeared" pediatrician, Dr. Carmen Valenzuela, reappeared a week after her abduction, her life, like Mandour's, probably saved by a flood of letters and faxes from scientists, doctors and other activists abroad. fl SCIENCE, Page 37