DEATH

Cooke in Oxford Companion to Medical Studies writes “most of medicine is about relief of, and comfort in suffering and the main very little to do with saving life”.

Death is a necessary complement of life and the time is dictated by our cellular DNA.  In any organ failure as long as the critical mass of parenchymal cells is preserved.  Regeneration and restoration of function occurs. However if the genetically predecided end is near, then there is no recovery and multiple organ failure may supervene due to systemic effects of failure of the affected organ. 

Each cell of the body dies a programmed cellular death which is physiological through activation of an internal suicide mechanism - Apoptosis.  Similarly it is probable DNA could programme the death of the human being of organism by increasing the vulnerability and susceptibility to overall apoptosis under attack by disease. 

  In nematodes, the genes have been identified as responsible for apoptysis and are termed CED [cell death defective] i.e. CED-3,4 & 9.The first two need to be active for apoptysis and the last is protective.

In mammals homologues of CED-3 have been identified called Bcl-2 ,the oncogene.The overexpression of this is known to cause oncogenesise.g polycythemia vera. Bcl-2 is protective against apoptysis and Bax and Bcl-x and Mcl genes are enhancers.These act and cause cellular death via proteases called interleukin-1 beta converting enzyme ICE[ also called caspace-1].

So as is rightly said “If your time hasn’t come, not even the doctor can kill you!”