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Podcast Episode: Part Six: Living
Pip: Gratitude Squared has been building a framework for understanding biology, medicine, and what it means to live inside a body that keeps surprising you — and this episode sits right at the center of that project.
Mara: The territory today is what the series calls living with uncertainty — how healing works when it isn't clean, how treatment becomes part of the biology itself, and what it looks like to stay a participant in your own care.
Pip: Let's start with what that actually means when the stakes are real.
Living with Uncertainty: When the Body Becomes the Whole System
Mara: The central question in "Part Six: Living" is not whether healing happens, but how you orient yourself when it can't be guaranteed — when repair is probabilistic, not perfect, and you are living inside that gap.
Pip: The post names that gap directly. Here's the framing: "We don't promise to remove uncertainty, rather we are hoping to give people moments of clarity, perspective, and perhaps even wonder while they're living with it."
Mara: That's the anchor of the whole piece. Not resolution — orientation. The goal is not to eliminate fear but to replace enough of it with knowledge that you can participate in what happens next.
Pip: And participation turns out to be load-bearing here. The post argues that understanding your biology changes your emotional experience — that when you're a member of the intervention team, informed consent becomes something you actually inhabit rather than just sign.
Mara: The model the post builds is four concentric circles: biology at the center, then medicine, then human experience, then meaning at the outer ring. Each layer depends on the one inside it, and meaning only becomes available once you understand what the inner layers are doing.
Pip: Which sounds tidy until lived experience breaks the diagram open entirely.
Mara: That's exactly what the post does next. It introduces a fourth response to the existing three — repair, persistence, response — and that fourth is simply experience. The model has to expand because real lives are more complex than any framework drawn in advance.
Pip: The sepsis story in the post is where that complexity stops being theoretical. A Friday text to a physician's assistant becomes a hospital admission, then a sepsis diagnosis, then a surgical team pushing for immediate intervention, then an oncologist arriving on a Sunday morning to stop it.
Mara: And the detail that lands hardest is this: the chemotherapy keeping the cancer in check was the same reason surgery was dangerous. The treatment had become part of the biology every physician now had to consider.
Pip: Two sets of doctors, different hospitals, a weekend, a port in the chest that ruled out standard home IV care — every proposed solution was contraindicated by something else in the system.
Mara: The post walks through those conditions methodically, asking the reader to identify the repair crews, the conflicting interventions, the conditions of significant medical risk. It's structured as a teaching case, but the stakes in it are entirely personal.
Pip: What comes out the other side isn't a cleaner model — it's a more honest one. The post lists the emotional responses that tend to follow serious illness: fear, grief, frustration, uncertainty, and hope coexisting. And then it offers this: "another perspective may become available — one grounded in curiosity, collaboration, gratitude, and wonder at the extraordinary work still taking place within us."
Mara: The post closes by widening the frame beyond cancer — heart disease, autoimmune disease, neurologic disease, serious infection, unexpected diagnosis. The biology differs, the post says, but the uncertainty does not. This framework is for anyone whose confidence in their own body has been shaken.
Pip: And the final note is that the series isn't finished — a closing piece is coming, framed around the invitation to "Come With Me," with the reader choosing an image that helps them continue living.
Mara: The body, the post keeps insisting, is always working for you. Even when the repair is complicated, even when the crews are arguing — it's still working.
Pip: Living inside uncertainty, staying curious about the biology, keeping yourself in the room where decisions are made — that's the thread running through all of this.
Mara: And the next piece in the series promises to take that somewhere new. Worth staying close to what comes next.
Part Six: Living
What have we discovered about healing?
Living systems keep repairing, adapting, healing, and sometimes surprising us. Healing is a process inside of uncertainty.
Medicine supplements the body’s own response when the need for repair becomes urgent. But biologic and medical repairs typically strive for continued living, without certainty.
Therefore, biologic and medical repairs are probabilistic rather than perfect, at times. So how do people learn to live in biologic partnerships with uncertainty?
Living With Uncertainty
We don’t promise to remove uncertainty, rather we are hoping to give people moments of clarity, perspective, and perhaps even wonder while they’re living with it. We want individuals to identify their fears and settle into something beautiful, encouraging positive choices even while living with uncertainty.
Scientific Understanding of the Various Repair Processes Changes The Human Experience.
What happens when your lived experience becomes more complex than you expected? That is, when your misfires of particular biological cells are long-term, and continuous what happens? When your diseased cells don’t stop misfiring or multiplying what do you do?
When do your repair crews (biologic-internal and medical-external) change their intervention plans? When the complexity of your treatment is introduced and explained further to you, how/who identifies the need for a repair? How do you determine when the medical repair crews are more necessary than your biologic repair crew for your survival?
Now that you understand biology differently, how will you live differently? Understanding does change your emotional experience.
Imagine four concentric circles.
Center:
Biology
Next:
Medicine
Next:
Human Experience
Outer ring:
Meaning
Given the above model, when/where does meaning for an action plan for intervention come from? From where does your understanding of your various treatment options come?
Greater understanding often helps people participate more fully in their treatment decisions and may reduce fear by replacing uncertainty with knowledge. Why? Because when you participate in your treatment decisions, as a member of the team, you enrich your human experience and make informed decisions beginning with consent.
Moving Away from a Simple Explanation of Biology: Expanding the Model
Given real human lives, living under real conditions with disease, changes our view of biological repairs. Our model has to expand again.
Medicine is practiced under uncertainty. Every treatment represents a careful balance between anticipated benefit and known risk. Patients consent to treatment because they and their physicians hope the expected benefit outweighs those risks. When unintended consequences occur, a deeper understanding of the diagnosis, and recognizing the complexity of caring for your living body is necessary.
Some examples for the repair crews facing high-stakes during biologic repairs include a patient who experiences acute system stress (high-intensity intervention+ biological fragility+ unsuccessful treatments).
This situation may cause an emotional response to their biology.
The emotions accompanying serious illness are real and deserve respect. Fear, grief, frustration, uncertainty, and hope often coexist. This framework does not ask us to deny those emotions. It simply suggests that, over time, another perspective may become available—one grounded in curiosity, collaboration, gratitude, and wonder at the extraordinary work still taking place within us.
There are other issues linked to uncertainty. Medical intervention is not a purely physical science. It is based on hypotheses and outcomes from clinical trials. The human body does not always respond similarly to each treatment as human beings are not identical. They are not clones. Humans are not carbon copies of each other. Human beings, presenting various physical conditions, health status at the time of treatment, age, diets, exposure to toxicity over their lifetimes, and so forth introduce variables which may not always be controlled during treatment, and may then link to uncertainty.
The very name “clinical trial” implies an understanding of clinical variability. The patient signs a permission form acknowledging such in hopes of success for their particular illness.
A Multi-Condition Model of Lived Biology: Intervention Becomes Complex
The currently proposed model has three responses: repair, persistence, and response. Lived experience is introduced, and so expands the model to include a fourth – experience.
Responses may be layered (body + medicine+interacting under stress).
There are times when treatment and disease together create conditions of significant medical risk. During my decade of survival, there have been unintended consequences from treatment, what I term collateral issues. Specifically, consequences having a history with sepsis, bacteria, a macular hole, dehydration, and potential blindness, to name a few, led me to propose a multi-condition model for intervention.
Let me provide one example of an application for the Multi-Condition Model:
Review the facts within the story, and then answer proposed questions:
On a Friday afternoon I was not feeling well. I texted my PA and asked for an antibiotic. She told me to go to the emergency room. I went, was examined and ended up being admitted to the hospital. I had never been in an emergency room in my life, nor admitted to a hospital. Suddenly, I was alone and called my son in another State. My little dog was left home alone.
I texted my PA and explained that I was admitted to the hospital. The hospital physicians went into swift action, administering three antibiotics through IV. I was told I had sepsis! They sent a physician in who said I needed immediate surgery. I texted my PA again who told my doctor. My doctor phoned me to say “Do not let them do surgery, and he needed to speak with them.” I explained I felt I had no control. He set up a group chat on the phone with the medical team in the hospital. He did not have doctor’s affiliation with that hospital group. I continued to wait, with a medical flurry around me. I must admit that, at that point, I felt fear.
On Saturday they were planning the surgery. My oncologist had spoken with the on-call surgeon explaining that I was under treatment with infusions (chemotherapy) and I would not heal from surgery because of the Avastin. They continued to be in and out of my room. A different physician set up home health care minimally for one month with IV antibiotics ongoing. I waited. My son arrived. I was less fearful now, and learning.
Early Sunday morning I was surprised to see my oncologist walk into my hospital room smiling. He examined me and left to meet my doctors in the hospital. After their meeting, he stopped by and said I was being dismissed from the hospital and on Monday I would go to another one of my physicians for examination and continued care. Immediately, thereafter the doctor from the hospital in which I was admitted stopped in and said, “You sent your gyno doc in after us! We will discharge you today”. I thanked everyone. I was now in awe and wonder, and I felt joyful.
During this two day ordeal, I reflected on my situation. I now had sepsis. My mother had died from sepsis just before her appointment to see her cardiologist. My sepsis was advanced, and my health placed me at significant medical risk. I felt confused as I had always expected I would die from my multiple cancers, yet now I could die from sepsis, a collateral condition, unintended from my treatment. I also had just learned that my chemotherapy, while saving my life on the one hand from the persistent accumulating biological cells, was prohibiting my body if and when I needed a surgical, medical repair crew, because of the way in which the chemo impacted the growth of blood vessels. I learned something new.
I continued with various doctors’ orders, engaged in multiple ongoing conversations, developed a new action plan, continued to receive multiple antibiotics for weeks, and continued to live. I never forgot that for a day I had a choice to be treated for sepsis and/or cancer. How might I die?
Looking back, I realized something that had never occurred to me before. My cancer was no longer the only medical problem being treated. The treatment itself had become part of the biology that every physician now had to consider. My repair crews were no longer working on one problem. They were working on an entire living system.
Sit with the details shared within this story for a moment before answering several important questions from the evidence:
Why did intervention become complex?
- Consider the urgent that had to be made about treatment(s).
- What physical findings warranted the rapid response?
- Who were the medical providers interacting under stress?
- What were the conditions of significant medical risk?
- What might have been the unintended consequences from treatment?
- What do you notice about how the treatment and disease together created conditions of significant medical risk?
Do you recognize the various factors we have been discussing throughout this series?
- multiple repair crews
- conflicting interventions
- uncertainty
- collaboration
- informed consent
- changing treatment plans
- biological complexity
- Consider the urgent decisions that had to be made about the treatment(s).
The treatments included multiple rounds of IV antibiotics and ongoing chemotherapy. One urgent treatment would have been surgery.
- What physical findings warranted the rapid response?
The physical findings included blood tests that indicated sepsis in the blood stream. The physical findings also discovered the development of a fistula that needed immediate surgery to prevent further spread of infection throughout my body.
- Who were the medical providers interacting under stress?
The medical providers were two sets of physicians within two different hospital settings. The medical providers had different backgrounds, training, and practices in their specialities: oncology, infectious disease control, general surgery, emergency care. Their stress was exaggerated by the occurrence over a weekend, when the doctors were on-call or not available.
- What were the conditions of significant medical risk?
The conditions of significant medical risk included possible death from the infection throughout my body (sepsis), and the possibility of my body not healing and therefore blood loss after surgery. Without the surgery one group argued possible death. With the surgery one group argued possible death.
- What might have been the unintended consequences from treatment?
The unintended consequences from any of the treatments might have been continued infection and/or death. The infectious diseases team plan was further complicated by the present of a port in my chest. Home health care teams typically administer IV meds through a vein. That was not possible in my case, I would have had an at-home care team without proper training to meet my particular medical treatment need.
- What do you notice about how the treatment and disease together created conditions of significant medical risk?
All proposed treatments: surgery, IV infusions or treatments, medications to treat infection were contraindicated. Fortunately, my oncologist persuaded the surgeon and other physicians to stop moving towards surgery, to discharge me, and I was sent on Monday (next day) to yet another medical setting where a plan was developed to continue to treat the sepsis and cancer.
Through this example, one should see that the repair crews moved away from a simple explanation of biology. The balance between an anticipated benefit and known risk was lost, but an new alternative plan was developed and “living” continued.
This experience is an example of a moment when biological misfires and their treatment become urgent, so the system was forced into rapid, high-intensity response.
This is one example of a collateral issue during which a complex intervention plan was necessary, and the previous repair crews’ plans were modified. Misfires, persistence, rapid accumulation, and both the biologic repairs and medical repairs were not successful, thus a high-intensity medical intervention was rapidly developed. All medical teams discussed each option with me and each other, and we selected the presumed best option together. Our action plan was effective.
This example is applicable beyond discussions of the disease of cancer.
The framework proposed in this series is offered for anyone who has ever had their confidence in their own body shaken.
Cancer.
Heart disease.
Autoimmune disease.
Major surgery.
Neurologic disease.
Serious infection.
Unexpected diagnosis.
While the biology may differ, the uncertainty does not.
This multi-condition model of lived biology has layers:
Normal repair
Persistent misfires
Long-term adaptation
High-intensity medical intervention
The model has three responses…
repair
persistence
response
lived experience becomes the fourth.
Up to this point, we’ve been asking readers to expand their thinking regarding biology. Here, we are beginning to ask them to rethink their relationship to biology. This discussion makes interventions with “live biology” more complex.
Structurally, the framework is beginning to move through an understanding of four different stages:
- What is a biological misfire?
- How does the body repair itself?
- What happens when repair is overwhelmed?
- How should we live when biology remains uncertain?
I would offer another layer: mindfulness, or mindful interpretive responses.
Earlier in the series, we discussed “being aware”, “looking around”, “taking notice”, “paying attention” and “taking action”. Biologic repairs, and medical repairs are positive actions on the patient.
The emotional and interpretive responses, part of the human condition, from the patient typically will be positive as well, after the initial fear, grief, and frustration noted when a patient first learns of their diagnosis of disease. Responses like wonder, understanding, collaboration, sincerity, and thankfulness are frequently observed responses within the multi-condition model of lived biology as intervention becomes more complex.
Summary
What do we discover along the way from disease to health? We understand that “We must go on Living!”
We live through uncertainty, but we continually expand our model basing the expansion on:
- real-life experiences,
- participation in your own treatment, and
- increased knowledge regarding available treatment options, as a
- member of your intervention team.
Reflections
- If you were to summarize your thoughts after reading this discussion on Living how would you describe your real Living Biology?
- What are the various layers/available treatment options you have experienced, if any?
- Did you review several different treatment options?
- Do you see that treatments are not lost, they keep building on each other?
- Has the process of decision making , even under uncertainty become a bit clearer?
Remember Living is your end goal. Your body is always working for you!
As always, I hope you may view your life with wonder and find peace.
Note: The final part of this series will focus on your future.
The proposed ending is changing, just as our framework has changed, has extended.
The essay will suggest “Come With Me”. Several possible visual images will be presented, with the message:
“Choose the image that helps you continue living. Choose one, or keep all. They have become companions for me.”
Soon… it is coming…..
#gratitudeultra
Podcast Episode: Biological Misfires And Hidden Healing
Pip: Gratitude Squared has been building something quietly unusual — a series that asks you to feel wonder about your own biology before it asks you to feel anything about disease.
Mara: That's the territory across these recent posts: what biological misfires actually are, why the body succeeds so overwhelmingly often, and how wonder might be a more durable response to a diagnosis than fear.
Pip: Let's start with repair — and what happens when the crew can't finish the job.
When the Repair Crew Hits Its Limits
Mara: The question anchoring this segment is what happens when the body's own systems are overrun — and what that actually means for a patient sitting with a diagnosis.
Pip: The post frames it plainly, after walking through DNA repair, immune surveillance, and protein quality control: "Misfires occur. Repair crews usually succeed. Sometimes they fail. Medicine helps."
Mara: So the upshot is that medicine isn't foreign to the body's project — it's a late-arriving member of the same team. That reframe matters practically, because fear often comes from treating a diagnosis as an attack rather than a repair problem that needs outside help.
Pip: Part Five extends this into time itself — asking why some misfires persist while others disappear. The answer isn't failure; it's accumulation. Aging, genetics, inflammation, chance — none acting alone, all interacting continuously.
Mara: Right, and the framing shifts accordingly. The question moves from "why did my body betray me" to "how does a living system carry its history while continuing to repair itself." That's not softening the science — it's placing biology inside time where it actually lives.
Pip: Which, it turns out, is also where resilience lives.
The Biology You Never Thought to Notice
Mara: The deeper argument running through this series is that fear gets its grip partly because we've spent no time noticing how overwhelmingly well the body works before anything goes wrong.
Pip: Part Two makes that case with a line that carries the whole argument: "Disease is memorable because health is so abundant."
Mara: Seven words, and the logic holds. A diagnosis feels catastrophic partly because we've never built up any counter-weight — no felt sense of the trillions of events that succeeded quietly while we were doing something else entirely.
Pip: The introduction to the series lays the conceptual groundwork for that shift. It draws a distinction that sounds simple but isn't — diseases have two parts, the biological event and the emotional weight the patient carries, and those are not the same thing.
Mara: That distinction is what the companion metaphor "misfires" is designed to carry. It acknowledges that something malfunctioned without implying the whole person is broken. The series is careful to say this isn't a replacement for medical language — physicians keep their terms — but it changes the emotional landscape in which medicine takes place.
Pip: And then there's the podcast episode on biological misfires and hidden healing, which pulls the whole arc together — from the philosophy of what a misfire even means, through the repair systems, and into how we replace fear with something more useful.
Mara: What the series keeps returning to is a three-circle model of awe: the world is extraordinary, the miracle is also inside you, and health might be better understood as an ongoing symphony of successful events rather than simply the absence of disease.
Pip: Wonder, apparently, is more durable than fear as a long-term operating mode. The evidence is a decade long.
Mara: The series is candid about that. Ten years of living with cancer, following the Human Protein Atlas, pushing for additional biopsies, sitting with results marked indeterminate. The framework is tested against a real, ongoing situation — not a thought experiment.
Pip: What stays with me is the insistence that health is the baseline — and that noticing it changes what a misfire actually means.
Mara: The next stretch of the series moves into living without blame, and what it means that human beings are never reducible to their biology. There's more ground ahead.
Part Five: The Persistence of Misfires Over Time
We have seen that the body is remarkably successful at repair, and that medicine often extends that success.
Yet one question remains.
Why do some biological misfires persist while others disappear?
This question shifts our attention from discrete events to a focus on time itself.
The Biology of Time
Biology is often described as a series of events: a change occurs, a repair begins, a system responds. But this view is incomplete. The body is not a snapshot in time. It is a continuous, living process unfolding across years, decades, and a lifetime.
When we begin to ask why some misfires persist, we enter the biology of time.
Several well-known forces influence how biology changes over time. These include: aging, inherited genetics, environmental exposures, inflammation, changes in immune function, and random biological variation.
These influences are not separate explanations competing with one another. None of these influences act independently. They interact continuously throughout life. There is interaction, not isolation.
The supporting actors are aging, inflammation, genetics, and so forth, but the main character is TIME.
Everything happens because of time: cells divide, DNA changes, proteins wear, immune systems mature, repair continues, medicine adapts, and healing continues. Time is the constant, not aging. This is a subtle but important distinction for understanding the persistence of misfires.
Biology is not a snapshot. It is a continuous process.
Aging is often the most visible of these influences, but it is not the only one. Genetic makeup provides a biological starting point, but not a fixed outcome. Environmental exposures accumulate gradually. Inflammation may persist beyond its initial trigger. The immune system changes across the lifespan. And chance events, though unpredictable, are part of every biological system.
Together, these forces shape how effectively the body maintains repair.
It is important not to think of these influences as failures of biology. They are part of biology itself. The body is always responding, always adjusting, always repairing. But it is also always living through time.
And time leaves traces.
This is where the idea of persistence becomes clearer.
Some biological misfires resolve quickly. Others take longer. And some persist, not because the body has stopped working, but because biology is a dynamic system influenced continuously by multiple interacting forces.
Persistence, in this sense, is not separate from repair. It exists within the same process.
We can begin to think of this as accumulation over time. Small biological changes may build gradually, not as a sign of failure, but as the natural outcome of a system that has been active without pause since the beginning of life.
The body does not reset. It adapts.
From this perspective, persistence is not simply something that goes wrong. It is something that unfolds. Biology is not static, and neither is repair. Both continue across time, shaped by history, environment, and internal change.
Even when a misfire remains, the story is rarely finished.
Understanding persistence in this way is important. As we continue to seek deeper knowledge, a quiet realization emerges, i.e., an understanding of persistence moves us to expanding our metaphor. We no longer think just about the repair crew, we think about resilience.
The Biology of Resilience
The repair crew explains how biology responds. Resilience explains why life continues.
What happens after years of repair? Resilience!
Time changes biology, but resilience persists alongside it.
The universal idea is that our biology does not exist apart from our lives. Chronic stress, disrupted sleep, grief, fear, caregiving, aging—these all become part of the biological environment in which repair is taking place. That idea is well supported by science, and it doesn’t require focusing on any particular conflict or tragedy.
Every person’s biology has a history.
Not just a genome.
A history.
Years of infections.
Years of healing.
Years of joy.
Years of loss.
Years of sleep.
Years of stress.
Years of adaptation.
Every cell carries part of that story.
Before I became ill, I was always busy and rarely slowed down enough to notice the small things. Now, through my illness, I have time to reflect, and read, and to encourage people to slow down and notice the extraordinary work our bodies are doing every moment.
Let me help you see your biology with more wonder and less fear.
This promise to you is universal. While we start with biology, we invite gratitude. Through gratitude a patient may integrate ideas and beliefs relevant to their own cultural and spiritual understanding. My blog site gratitudesquared.com includes a discussion relevant to “from where does my gratitude come?” Resilience definitely partners with biology.
A Humanistic Biology: Understanding Accumulation Over Time
Accumulation over time is what is happening to our cells every minute. These biological changes should not make us fearful. We should not feel as though we’re being blamed, or taking blame for what has happened to us. Our history influences our biology, but it does not define our worth, nor does it mean we caused our illness. Meditate on resilience itself.
In earlier postings, we noted that understanding biology must be paired with a philosophy of health. Focusing on biological processes is a discrete action; focusing on the human experience is an expansive action, a continuous reflection.
As we focus on persistence in Part Five, we expand our framework to a humanistic biology. That is:
Not biology stripped of emotion.
Not emotion replacing biology.
But biology presented in a way that honors human experience.
My professional background has included decades advocating for persons with disabilities. These individuals, whose voices were often overlooked, merited assistance that kept each person at the center of any discussion, not just a focus on their physical diagnosis or communication needs, but a genuine person-centered plan.
Expanding our framework from a companion metaphor to beyond. Is a natural extension because it causes one to examine how human beings experience vulnerability.
How do we preserve the dignity of this person while understanding their reality?
Viewing biology and health from a humanistic perspective is not an imbalance. Rather:
Some see it as an opportunity for spiritual growth.
Some trust physicians completely.
Some trust elders.
Some trust traditional healers.
Some trust no one.
Our challenge, then, is not merely to explain biology. It is to offer a framework that can be meaningful across many of different worldviews. I have participated in focus groups to examine how each of our lived experiences impact our perceptions of health care. Although beyond the scope of these brief postings, I wanted to simply inject that the proposed framework, and newly defined vocabulary introduced does not compete with people’s deepest beliefs. Using the metaphor of a “repair crew” does not tell someone what to believe about God, destiny, or purpose. Contrarily, this framework simply says:
Your body is working for you.
It’s an invitation to pay attention.
That’s a statement almost anyone can appreciate, regardless of culture or religion.
It is written with the intents to be biologically grounded and philosophically generous.
When I was first confronted with cancer, having advocated for Persons With Disabilities through the United Nations, I searched for answers from around the globe:
I searched for humanity’s answers about illness.
That was my instinct as a scholar for decades. I had spent a lifetime listening before concluding. That was my training through qualitative research methods.
A Humanistic Biology Framework lets me see my biological misfires and the persistence thereof with more wonder and less fear. Advocating for others gifted me with various insights regarding the many ways people make meaning of illness. The vision of biology I describe – the repair systems, the accumulation of changes, the partnership with medicine-provides common ground.
My career, unknown to me at the time, provided a lifetime of learning about humanity. As I unfold these propositions about biology and health, I continue to live within my own model. Most importantly, my lived experiences continue to become more complex than some parts of my model. As I continue to be a survivor, you will note the model keeps expanding to include new experiences.
Throughout this series I have tried to develop a way of speaking about illness that reduces threat without sacrificing scientific truth. I have tried to balance scientific precision with accessibility. I hope these essays invite curiosity without sacrificing accuracy, and offer compassion without abandoning evidence. Because I have a dually of life experiences, as a cancer survivor as well as a teacher-scholar, researcher, I wish to balance the essays:
I want to be both emotionally rich, but scientifically loose for the lay person who might find scientific writings boring and uninteresting or not applicable to them; as well as scientifically precise, and meeting the highest standard as I know it, but emotionally cold. I strive to hold the attention of anyone who may find themselves a new patient who is afraid of a recent diagnosis.
Overall, some misfires persist while others disappear because biology unfolds through time, and various influences accumulate. This is our anchor concept.
In Part Five we have shifted from a static to a dynamic biology.
Persistence is part of how biology unfolds, not simply a failure of repair. Biology is remarkably successful, and medicine often extends that success.
An understanding of how the accumulation of misfires persists is more easily understood when we place biology inside time. The forces of aging, genetics, and so forth are continuously living and adapting. Understanding persistence in this way shifts the questions from blame to observation, and from fear to curiosity.
Here we have built a conceptual model with three pillars:
- Repair
- Time
- Accumulation
This is the basic expanded framework, our architecture. Everything else (emotions, fear, gratitude, medicine) sits on top of this structure.
Parting Thoughts
- Persistence becomes understandable when we place biology inside time.
- What persists is not simply a failure—it is the result of ongoing interaction over time.
- Small influences may accumulate, not because the body is failing, but because it is continuously living and adapting.
- Instead of asking, “Why did my body betray me?”
we can begin to ask, “How does a living system carry its history through time while continuing to repair itself?” - This is not a question of blame. It is a question of observation.
- Observing opens the door to a different kind of understanding—one that holds both realism and respect for the extraordinary work the body continues to do, even under changing conditions.
- Persistence does not mean failure. It means biology is still in motion.
Conceptual Model for the series thus far:
Part 1
Language changes perception.
Part 2
Repair is normal.
Part 3
Medicine joins biology.
Part 4
Repair is probabilistic rather than perfect.
Part 5
Time explains persistence.
Part 6
Human beings are never reducible to their biology.
As we end our discussion for Part 5, I look forward to the next section, Living Without Blame (Part Six). Human Beings are never reduced to their biology. Part Six will include descriptions from personal journeys. Until then, I hope you may view your life with wonder and find peace.
Practical suggestion:
If you’re joining this series for the first time, you may enjoy beginning with Part One, where we introduce the idea of “intermittent biological misfires,” and/or listens to the Podcast listed below.
#gratitudeultra
Podcast Episode: Biological Misfires And Hidden Healing
Pip: Gratitude Squared has been quietly building something unusual — a series that asks you to feel wonder about your own biology before it asks you to feel anything about disease.
Mara: That's exactly the territory. The posts move from the philosophy of what a "misfire" even means, through the body's repair systems, and into how we might replace fear with something more useful when a diagnosis arrives.
Pip: Let's start with the biology itself — and what happens when it quietly succeeds, and occasionally doesn't.
Biological Repair And Failure
Mara: The central question running through these posts is whether we can reframe illness — not by denying it, but by first understanding how overwhelmingly well the body works before anything goes wrong.
Pip: And the anchor for that reframe is a single word. The setup is that most people only notice their biology when something misfires — but the post asks us to sit with the opposite. The quote lands here: "Disease is memorable because health is so abundant."
Mara: That's the whole argument in seven words. The upshot is that a diagnosis feels catastrophic partly because we've spent no time noticing the trillions of events that succeeded. The fear response has nothing to push back against.
Pip: Which is where the introduction to the Misfires series does its foundational work. It draws a distinction that sounds simple but isn't: diseases have two parts — the biological event, and the emotional weight the patient carries. Those are not the same thing, and treating them as identical is where a lot of suffering gets added unnecessarily.
Mara: The introduction puts it plainly: "Calling cells misfires acknowledges that something in biology has malfunctioned but does not imply that the whole person is broken." That's the emotional reframe the whole series is built on — a companion metaphor, not a replacement for medical language.
Pip: Right, and the biology behind why misfires usually stay minor gets its own treatment in Parts Three and Four. The body runs what the post calls repair crews — DNA repair, immune surveillance, protein quality control — working constantly without any input from us.
Mara: Most of the time those crews succeed. The post is direct about what happens when they don't: "Misfires occur. Repair crews usually succeed. Sometimes they fail. Medicine helps." When the body's own systems are overrun, medicine becomes an extension of the repair crew rather than something foreign to it.
Pip: There's something almost relieving about that framing — medicine not as the body's adversary but as a late-arriving member of the same team. The fear response, the series argues, partly comes from treating a diagnosis as an attack rather than a repair problem that needs outside help.
Mara: And the posts are candid that this isn't abstract. The author writes from ten years of living with cancer, actively following research like the Human Protein Atlas, pushing for additional biopsies, and sitting with results marked "indeterminate." The framework is tested against a real, ongoing situation — not a thought experiment.
Pip: Wonder, apparently, is more durable than fear as a long-term operating mode. The evidence is a decade long.
Mara: The series doesn't stop at diagnosis — it keeps moving toward what we do with aging, chance, and accumulation over time, which is exactly where the next stretch of these posts is headed.
Pip: What stays with me is the insistence that health is the baseline, not the exception — and that noticing it changes what a misfire actually means.
Mara: The next posts in the series take on why some misfires persist while others disappear. There's more ground to cover.
When the Repair Crew Cannot Finish the Job: More About Biological Misfires (Parts Three And Four)
Every second of every day, countless repair crews work quietly throughout your body.
DNA is copied.
Proteins are built.
Damaged cells are repaired.
The immune system searches for abnormal cells.
Most of this happens without our ever noticing.
Occasionally, however, a biological misfire escapes detection. That is when medicine is asked to join the repair crew.
The Complexity of Life
The complexity of life continues to be one of the great wonders of medical research. Thankfully, life’s secrets do not need to be fully understood for life to emerge, flourish, and often endure without our fully understanding how it all works.
The wonder of life inspires curiosity and has fostered extraordinary scientific research.
The numerous medical strategies for assisting in healing are too vast to summarize within this brief report. However, a few examples of normal cellular processes that repair and protect our bodies are identified within to explain our knowledge of the function of cell mechanisms; this is only a small part of human biology, in reality.
The reader should appreciate, there are an abundant number of biological mechanisms, i.e., the circulatory system, neurological system, endocrine, hormonal, skeletal and so forth. Think of all of the specialists you must select from when you go to a doctor. Our bodies are really still built beyond our comprehension!
Various Cell Mechanisms
Overall, our cells divide, DNA copies, proteins build, and systems work in harmony within our bodies. At each and every level noted, our bodies are built to repair and protect all cells through quality control systems and immune surveillance.
Thousands and thousands of papers are available explaining the cell. Scientific literatures, journals, conferences, funded research projects, and professional societies focus regularly on cell research, and hold meetings to communicate their increasingly new knowledge of such each year.
One remarkable example is the the Human Protein Atlas, an international research project that maps proteins within human cells (https://www.proteinatlas.org/humanproteome/subcellular ) . Given the 200 or so types of cancer this project assists in identifying, with great specificity, the probable antigens which may be utilized to treat a particular cancer through modification of T cells, (CAR-T therapies) (Chimeric Antigen Receptor T-cell) which seek out, attack, and destroy the cancer cells that carry the target protein.
Think of CAR-T therapy as retraining the body’s own immune soldiers. Doctors remove a patient’s T cells, teach them to recognize cancer cells by giving them a new “GPS system,” grow millions of these enhanced cells, and return them to the bloodstream, where they hunt down and attack cancer. It is one of the most promising examples of precision medicine because the treatment is custom-made for each individual patient (TC).
When I was first diagnosed, I discovered this Project and could follow their research on basically a Table on one page. Now their tracking of all of the proteins within cells covers multiple Tables and many pages of reporting from scientists and practitioners around the world.
Personally I am still searching for those proteins within my cell that they may identify so that I may utilize such in my own understanding. Over the years I have had genetic testing, genomic testing, and molecular testing. I am frustrated each and every time my reports mark my biological tissues as “indeterminate” or “unknown”. I often ask for additional biopsies so that current research practices may describe my particular biological misfires more precisely. If researchers someday identify the key biological target within my own cells, perhaps another repair crew will be able to join those already working to keep me healthy.
Our Repair Crews
Simply stated our repair crews, within our bodies consist of: DNA repair, protein building, immune surveillance, disease detection, and quality control systems.These repair systems fix the errors found, or remove the affected cells, disrupt the affected pathways, re-wire or create new or alternative pathways, and so forth through the remarkable accuracy and resilience of the human body.
These processes for repair and protection correct most of those intermittent biological misfires. However, sometimes the misfires escape detection. Sometimes defective cells are not found and continue to live and divide and cause various diseases within the body. Consider:
- Misfires occur.
- Repair crews usually succeed.
- Sometimes they fail.
- Medicine helps.
As for my own status, one might say that my necessary repair crew has yet to be discovered. I am maintaining the status quo without a change in status. While I wish I may learn more about my own system, I do believe that through a variety of personal choices I do have a repair crew operating within my own biological system. I must have, or I would be deceased by now.
Finding Persistent Misfires
These intermittent biological misfires are a normal part of living. Our bodies are built with tremendous redundancy. Most misfires are evidentially detected and silently corrected. A few persist. Very rarely. A few defective cells may exist within our bodies and accumulate. These are not a failure-this is the complexity of life. My own life is one example.
Medical science has developed numerous noninvasive strategies to search for misfires through blood tests, x-rays, ultrasounds, MRI, CT scans, PET scans, robotic surgeries, and interventional radiologies. Such are utilized regularly to find misfires, diagnose such, and begin medical treatments.
Biology Versus Emotion
Our biological systems are amazing, silently working throughout our busy lives. They are mostly ignored until a routine annual exam, an accident, or illness emerges. We go to our doctors as we are instructed to do and then, often as a surprise, we discover A MISFIRE!
Your emotional response to the discovery of the misfire is my focus within these papers. As they say, LIFE HAPPENS. It is what you do in life that matters.
It is how one responds to the unexpected, or surprise event in life that is my interest and motivation in speaking with you.
As I noted in Part Two, what I am observing during my life is that many of our responses to health problems, in particular to a diagnosis of cancer, for example, is the response of FEAR.
Fear is a natural response, but it does not have to become your guide.
Fear can narrow our thinking and make it more difficult to weigh our options carefully. You might use the analogy “frozen in fear”.
If your doctor discovers that your “misfires” are persisting, then that means that your natural repair mechanisms, or your “repair crew” can not handle the job at that moment.
NOTE: this does not mean that the misfire does not have a solution. It simply means that your body’s natural systems are overrun. Your body needs external assistance.
Finding Joy Through Medicine
Medical scientific research has uncovered numerous clinical practices to help you at this point. These discoveries are amazing. Medical science is beyond your greatest expectation I would imagine.
The available clinical practices are simply too numerous to describe, and increasing every day for your benefit. If we use our child analogy I referred to earlier, medicine today is like going to a candy store for the child. There are many choices.
This status of the medical professions today should not make you feel fearful, on the contrary, you should feel joyful!
Modern medicine now offers treatments, and often multiple treatment options, for an extraordinary number of diseases that once had few or no effective therapies. I see and hear about all of the wonders of our current medical practices. Please feel free to share your own experiences with me, as well as others.
As I conclude this particular paper, I wish for you nothing but the best outcomes! I do hope that my suggestions are helpful for you.
This world of ours is a world of wonders. Look up. Look around. Be grateful for your life.
Be happy and calm your emotions. Use music. Use art. Read. Share your medical journey with the patients you meet in the waiting rooms. Journal your joy. Explore the world around you. Do not let fear make your decisions for you, as you begin an amazing medical trip from illness back to health.
In gratitude, and hoping for your peace of mind.
# gratitude ultra
Note: In the next section (five) we will focus on various factors such as aging and chance that may also influence your biological findings in addition to cell misfires. As you begin to think ahead with me ask yourself: Why do some misfires persist while others disappear?
Building Our Vocabulary: Can you define or explain each of the terms?
Intermittent biological misfires
Repair crews
Persistent misfires
Silent repairs
What I Hope You Remember
- Most biological misfires are repaired silently.
- Our bodies employ remarkable repair crews every day.
- Sometimes a misfire persists despite those repairs.
- Medicine often becomes an extension of the body’s own repair crew.
- Fear is natural, but it does not have to guide our decisions.
The Miracles We Never Notice Within Our Bodies: Misfires Part Two
When I introduced the Misfires series I emphasized our biology and our emotional health. Biological pathology and human experience are not identical.
Healing requires attention to both.
Perhaps our journey now takes an unexpected turn: understanding emotion through biology.
Today I want to talk with you about health. Specifically, I will focus on your emotions as you focus on your health.
While we focus on emotion, will you trust me enough to take a momentary journey towards “awe”? You may ask, “Mary, where are you taking me?” “What does awe and wonder have to do with biological misfires?” What does wonder and amazement have to do with my emotions and my health?
Please think along with me for a brief second. In my opinion, before we can understand a biological misfire, we must first understand the miracle of your biology. Disease is memorable because health is so abundant.
A misfire matters only because your biological success is so overwhelmingly common. We spend enormous energy thinking about disease, yet we rarely notice the trillions of successful biological events occurring every second that make life possible.
Biology works.
Quietly ….
Shhhhhhh.
Listen
It is working for you even now.
Health Surrounds You All The Time
Health is the quiet success of life occurring within us every moment.
A miracle…..
When you are diagnosed with a disease (a term I don’t particularly like), your emotions typically race towards shock and fear. I’m unsure how fear emerges with the diagnosis, but it typically does. I have a sense that our fear is linked to our probably impending concern that we might die.
Within this essay, one of my goals is to encourage you to move away from your “fear reaction” to a response that is more hopeful, maybe even joyful, towards a reaction that is one of wonder.
Wonder
Gratitude
Perspective
Hope
Less fear
Consider if you move very slowly, and mindfully toward a feeling of gratitude, hope, and eventually less fear, when possible. May your emotions immediately trigger a mindset that encompasses a focus on health and positivity regarding all of the various developments in science that have emerged in recent years.
I want to argue that if you receive a diagnosis of a disease or an illness from your doctor, your response will be less emotional if you move your mind away from the immediate trigger of the fear response.
How Do I Change My Fear Response?
How may I change my initial emotional reaction to the diagnosis you ask? Well, that is the basic thesis within this blog.
I want to help you change your emotions when you receive your diagnosis. My recommendations are derived from my own 10 or so years of living with cancer, and from numerous ongoing conversations with patients whom I have met over the years.
As a researcher at heart, I ask many questions to everyone around me, and I analyze their replies. What follows are my conclusions regarding the miracles which are all around us.
I am not writing a cancer series.
This is not a biology series.
It is not even a philosophy series.
I want to take you along with me on a guided emotional journey.
Focus on Systems, Processes, Natural, Nature-Made, Man Built/Designed
When I began to reflect upon the words and those semantics and metaphors, I focused on the word “AWE”. What is awe to me?
I had no idea my body was accomplishing all of this without my awareness. I purposefully began to focus on what was around me and within me. I thought about the single word AWE.
I first thought of awe as moving in three circles (TC). The first circle is Everyday Awe: The world is extraordinary.
A newborn baby moving their tiny fingers around my own.
An ocean wave arriving where physics predicts.
A hummingbird sampling my flowers.
The second circle is Biological Awe: The miracle is not only out there. It is also within me.
Millions of your immune cells quietly protected you while you admired the sunset.
While you were sleeping, damaged DNA was repaired, proteins were assembled, old cells were recycled, and new ones quietly took their place.
Sometimes I sit quietly and think about the extraordinary systems that surround us.
I think about an orchestra. Dozens of musicians reading different notes, entering at different moments, yet creating one piece of music.
I think about a forest. Thousands of living organisms—trees, birds, insects, fungi, streams—existing together in delicate balance.
I think about the space shuttle. Millions of individual parts designed to work together with astonishing precision.
Each fills me with awe.
Then I remember something even more extraordinary.
Every one of those systems exists outside of me.
The most remarkable system I know is the one quietly working within me.
My body.
Without asking for applause.
Without asking to be noticed.
It simply continues.
This realization takes me to the third circle.
The third circle is Philosophical awe. This captures our beautiful destination.
Rather than to think of health as the absence of disease, perhaps to begin to think about health is something much richer. Maybe health is the ongoing symphony of countless successful events within our bodies that occur so faithfully that they rarely ask for our attention.
My own body is one of the most astonishing living systems I have ever encountered. My body is among nature’s most extraordinary creations. My body is a miracle. The biology within my body is a miracle.
I should take the time to celebrate this fact more often, and not be dismayed when rarely I find an intermittent biological misfire. So I did. I changed my thinking.
How Do I Move From Fear to Joy?
My own reality is that I have learned to find joy, comfort, and gratitude in the science and medicine that might find those occasional misfires and immediately begin to correct such. When my own biology does not have necessary repair systems available at my time of need, my doctors, pathologists, nurses, and other scientists and researchers are ready and able to help me. This will be our focus in Part Three.
My 10 year journey leaves me in awe of my biology. I have become mesmerized by the medical sciences that rebuild me, when necessary. Just as nature creates the beauty of snowflakes, ocean waves, trees and forests; and people create symphonies, space shuttles, and freeways; science has evolved to assist in my healing, to locate, understand, and repair my misfires.
Medicine is not fighting the body.
Medicine is helping the body.
Modern medicine is not an enemy of nature. It is one of humanity’s greatest expressions of nature’s own desire to heal.
Why should my emotions rush towards fear? How did I modify my immediate reaction from sadness to awe? How might you reduce your own feelings of fear, blame, and despair when paired with a negative medical diagnosis? Read and re-read the examples on the remarkable human body.
I invite you to challenge my assumption that this is possible. My friends and I discuss the “fear” that accompanies the diagnosis. How does it emerge? What causes this emotion to appear and nearly dominate a patient’s ability to listen and think immediately. Where does all this fear come from? One bit of information from my own background that my be relevant here is that I have studied various cultural differences in how people view health, and make decisions. Perhaps each of our own lived experiences contribute to our reactions as tragedies emerge in life? Remember yourself as a little child. What happened when you felt sick? How did the adults around you react?
Part Two is really about your attention. I am asking you to pay attention to something you probably ignored all your life. I am asking you to:
Learn to Notice!
Every moment you have spent reading these pages, your body has quietly continued its work.
Cells have communicated.
Proteins have folded.
DNA has been repaired.
Your immune system has stood watch.
Your heart has continued its faithful rhythm.
Life has gone on inside you without asking for recognition.
Perhaps that is the greatest miracle of all.
So… Before Our Next Conversation
Keep Looking!
There is more health…
More wonder…
More hope…
Than you first imagined.
In gratitude, and hoping for your peace of mind.
#gratitudeultra
Note: In our next conversation, we’ll meet one of biology’s quiet heroes—the body’s remarkable repair systems. Every day they search for problems, repair damage, and protect us in ways we rarely notice. Understanding this “repair crew” helps explain why most biological misfires never become disease.
Gratitude Squared 