Psychoneuroimmunology

Producing outcomes without being a healthcare company.

Humaginarium is not a healthcare company. We’re unlike startups whose therapies heal or cure; also unlike those who manage medical service delivery. Nothing we do for patients requires access to medical records or histories; nothing we deliver to patients requires prescription, clinical control or reimbursement. In fact we rarely think of users as patients at all, but as regular folks.

Likewise Humaginarium doesn’t cater to providers, payers or suppliers of the healthcare industry. We don’t make things for them to buy or ask them to finance what we make for consumers. True, we are working to earn their versions of the Good Housekeeping Seal of approval, but not because it has monetary value. The effort to gain healthcare industry blessing will simply make us a better company.

All of the foregoing seems rather odd and uneconomical positioning for a health tech startup, but hopefully it’s rational. I’ll try to explain.

Humaginarium is an entertainment company. We develop video games and ancillary apps that amuse and inform. We use our programs to educate and empower people; not about everything, of course, but about their bodies and health; in particular about chronic illness they have or risk getting. Why? So they themselves can actually do something about it!

The foregoing category description rests on four functional pillars known as health promotion, health literacy, health education, and health equity. With a difference. Most programming within those pillars is behaviorist. It’s about conditioning: what, how and when to do things in order to become healthier. It’s rarely about learning: why something is and why it can be different.

Humaginarium is all about that why. As artists and educators we know there is only a dotted line between understanding and making a difference in real life. Our project turns those dots into a solid line with an arrow pointing to personal empowerment.

Yet as a high-tech artist and educator, am I certain that Humaginarium won’t heal or cure? I’m really not sure of that, so I don’t claim that it will; but I think it’s possible. Moreover likely.

I say this because I believe, from study and experience, in causal connections between mind and body; between mental and physical. The clinical term for such connections is psychoneuroimmunology (PNI). Everybody experiences PNI throughout their lives, practically every day and certainly when enjoying great entertainment, but science is only beginning to recognize and explain it. Clinicians by and large don’t have a clue. But it’s real.

A palpable example of PNI is the placebo effect, by which perceptions and beliefs improve health outcomes. Peer-reviewed research has proven (beyond any reasonable doubt) that the way people think and feel about themselves and their environment alters the biochemistry of their bodies. In plain English, our state of mind can actually make us well or sick. Everybody knows that, but why is it?

“Theorists propose that stressful events trigger cognitive and affective responses which, in turn, induce sympathetic nervous system and endocrine changes, and these ultimately impair immune function.” Did you get that? So for example, job insecurity or marital difficulty can, and often does, make people literally frail, vulnerable and symptomatic.

But what are job insecurity and marital difficulty? They are types of stress produced by the same thing: a lack of control. The same kind of stress that occurs with chronic illness. You have it, you don’t understand it, you can’t predict it, you can’t avoid it. It feels like a bewildering constant threat, like an asteroid heading towards your personal planet.

As such chronic illness is a self-perpetuating condition. The more fearful and anxious and angry the patient gets, the worse the disease may become. That’s fact, not fiction.

Humaginarium answers that fact with fiction. Literally, with fantasy in which users can face and understand and oppose and overcome illness in their minds. Fantasy of this kind is not merely an escape from reality, it’s an engine for belief in oneself; belief that “I am the master of my fate.”

When discussing PNI in the context of his long medical career, Sherwin Nuland wrote, “The question that remains is how these three major networks – the nervous system, the endocrine system, and the immunologic system – interact and, how, by understanding these interactions in precise quantitative terms, we can learn to predict and control them.”

That question is for scientists including positive psychologists, but not for artists and educators like me. We already know PNI works, though we can’t yet explain the molecular and cellular dynamics. If it works, we want to use it right now, not after decades of clinical trials, for the benefit of folks who have or risk getting a miserable chronic illness.

That is what Humaginarium is doing, and that is why I expect to produce meaningful outcomes without being a healthcare company.

Checklist

Putting my nose to the grindstone for Humaginarium

During the past week of travel in Scotland, I was reminded every day of The Checklist Manifesto, the book by Dr. Atul Gawande that recommends the use of checklists in complex situations like an OR or airplane cockpit. For years I’ve used the Wunderlist app to make and manage lists of practically everything I set out to do. I don’t know if I could function these days without it! Even when traveling last week, starting each day with a neat list on my phone of goals to accomplish, whether large or small, and ending the day by making a fresh list; well, there is nothing more satisfying than that – except maybe a wee glass of Aberlour A’Bunadh before a hearty dinner of Scotch chicken and leek pie.

My checklist for the next four months is going to be broken down into daily milestones that I must meet before I turn in each evening. I am coming to the start of a nasty nose-to-the-grindstone quarter for Humaginarium, exciting and dreadful at the same time.

Wait, isn’t that what every quarter is like for a startup? Well no, not for this one. I love keeping lists, but I also love “slack time”: leaving plenty of play in every day for work that is not consciously goal-oriented; for example, writing this blog. My most satisfying accomplishments are often randomly inspired and unplanned. Alas, there won’t be much of that for the rest of this year.

My top priorities are to finish writing two grants – one to the NSF, the other to the NIDDK – for Phase 1 SBIR funding of R&D. The grants are more than seed funding; they are blueprints for an enterprise that will ascend in 2020 like a hot air balloon, with me and my colleagues in the basket holding on for dear life. I’ve been working on the grants for a while, but somehow not taking them seriously enough. They have not been properly committed to checklists! Now the time has come to get very serious. These grants are not quick wins or slam dunks. They require meticulous planning and writing, the kind I can do when I’m not enjoying myself very much. Oh well, nose-to-the-grindstone.

In the same period I will also facilitate a new cohort of experiential learners at the Northern Illinois University College of Business. These undergraduate business majors will be directed by Humaginarium and a team of financial consultants in Chicago and San Francisco who like what Humaginarium is doing with health promotion and video games. We’re going to study and make better sense of things like valuation and commercialization, if that’s not biting off too much between now and the end of the year.

A different cohort is likewise forming as I write this, one with enormous potential value if managed well. It’s a Circle of Industry Advisors including corporate stakeholders at provider, supplier and payer organizations who are strategically committed to my four pillars: health promotion, health education, health literacy and health equity. You know, the important stuff that I care so much about, but is hard for most folks to monetize even in their heads. The stakeholders will help ensure that Humaginarium moves the needle of population health in ways that industry endorses. I am not looking for funding from the Circle, just knowledge and brand equities.

That is an overview of my current checklist. Will I do just this and nothing more? Well, there’s one more little thing that may be added. Humaginarium was asked to create an innovative module of continuing medical education for practitioners of a medical specialty. I’ve been slow to take this up because it doesn’t feel particularly altruistic; in other words, it’s work for a fee and it isn’t likely to change the world for the better.

For reasons unknown to me at the present moment, altruism has become almost a filter that I use to evaluate opportunities. This is very strange, to put it mildly. It may be because I am painfully alienated by the economics of American health care. They are pretty disgusting and dispiriting, and I don’t like getting my hands soiled with them.

Yet the prospect of making boatloads of money from consumers with health problems is a key driver of Humaginarium. I’d better put that goal on a checklist so I can chunk it down to bites I can swallow, maybe with the help of Aberlour A’Bunadh.

Miracles

Belief in miracles is central to the mission of Humaginarium.

According to Merriam-Webster, the spiritual meaning of miracle is an extraordinary event manifesting divine intervention in human affairs. A miracle may also be a divinely natural phenomenon experienced humanly as the fulfillment of spiritual law. Can the miraculous, when candidly understood, really have anything to do with modern biomedicine?

Well, from the perspective of Humaginarium, the answer is yes. I am long known for saying (every time I get the chance) that “your body is a miracle.” No matter how young or old, how well or sick, how strong or weak, how happy or sad, how beautiful or ugly; our bodies are miraculous!

Oddly though, my claim has never been challenged. It’s odd because Humaginarium is scientific, technical. It leverages high-fidelity simulation of human physiology and biochemistry. Can miracles occur and be expressed in an environment like this? I say they can; moreover they must.

Belief in miracles is central to the mission of Humaginarium. You don’t have to believe in them when you first come to play; you don’t even have to believe when you tour homeostasis in the Arcade. However by the time you cut a path through the Morbid Frontier and killed or captured disease that haunted and persecuted you, you will gladly believe. And belief may change your life.

With miracles, am I referring to fantasy that overlays biology in our scientific entertainment? Are the miracles I speak of just figments of the imagination? They are not. They are tangible, objective and real. Rather than argue this point logically, I prefer to cite two authorities who come at it from different experiential perspectives: one a physician, the other a patient.

The physician is Sherwin B. Nuland (1930-2014), an eminent surgeon at Yale who wrote several books and articles about practicing medicine. In The Wisdom of the Body (1997) he reflected:

Centuries ago, when little was known of science, the mystery of the body’s internal machinery enthralled ordinary people and tantalized the educated. It seemed a miracle, this bustling edifice of thought and action – beyond the capacity of mere mortals to comprehend, and yet providing here and there a hint that the inscrutable might somehow be understood if only properly directed efforts were made. In time, the right direction was indeed found and the efforts were rewarded, yet the tantalizing and the mystery not only did not lessen; they actually grew. The more became known, the more miraculous seemed the intricacies of the whole and the more urgent the drive to expand our knowledge.

The patient is William Ernest Henley (1849-1903). At age 12 Henley was diagnosed with tubercular arthritis that eventually forced the amputation of a leg just below the knee; the other foot was saved only through a radical surgery. As Henley healed in the infirmary, he began to write poems, including Invictus (1875). This famously inspiring poem seems to be about many things, but in fact it is about one thing: a debilitating chronic illness that eventually killed him:

Out of the night that covers me,
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

The soul that Henley celebrated is the miracle that Nuland found in his practice of medicine. It is the courage that users unleash in themselves as they explore Humaginarium. Miraculous because science can’t explain it; unconquerable because medicine doesn’t eclipse it; courageous because it is the unfettered expression of the human spirit in our mortal, phenomenal bodies.

Scientific entertainment. Prometheus Creating Man in Clay (1845), by Constantin Hansen. Pictured with a swarm of microbes and viruses like those that swarm our bodies.

Mechanics Redux

Adventure is agon. Not merely fighting, but fighting for something that matters.

Mind Mapper. Experience in the morbid frontier is enchanting, intriguing, dangerous, bewildering. As a meaning maker, your job there is to filter experience for things that matter – things you can use – and relate them to an obscure metabolic condition that is ominously unfolding in the shadows. Like an archeologist, you interrogate each shard you pull from the biomuck for the story of what it is, how it works, where it came from, what it wants and why. The shards are tangible things with familiar, physical properties; moreover they are metaphors for other tangible things that were beyond your ken before Humaginarium: atoms, molecules, cells, tissues, fluids, organs, mechanisms. You capture their stories with the aid of dynamic mind mapping. This is the visual equivalent of “mapping sentences” that distill coherence from a churning chaos.

Dorian Gray. Users in the morbid frontier are not told what to do or forced to do anything. They do what they want in light of self-interest; which means, whatever it takes to win. Most users will do anything to win, yet their moral and intellectual lights are dim to begin with; and they lack wisdom to make good choices intuitively. So they wind up making and having to cope with bad decisions and failures. How does that affect them? The way crime affects Dorian Gray in Oscar Wilde’s novel: by scourging the alter ego. Users who do bad things for the sake of quick wins – such as skirting or accommodating rather than confronting and controlling morbidity – may appear outwardly heroic, but they are wounded warriors in Diabetes Agonistes. They can eventually heal their wounds by atoning (changing, compensating) before it’s too late; or allow wounds to fester and settle into disability.

Monsterography. Maybe the worst thing about chronic morbidity in real life is transparency. You can’t see, hear or touch this disgusting thing that’s inside you, but is not you. You feel it when it flares, but even when that happens all you can see and hear and touch is not disease, but the tracks that disease leaves on your flesh and psyche after the ravages. The physical evidence indicates that your body itself is the disease: the perpetrator rather than the victim. You blame the victim for your pain and suffering. You’re revolted by your own body that is relentlessly harming you. You fear, you’re angry and you deny the body the way a prisoner despises a jail cell. “What have I done to deserve this? My body hates me.” But unlike life, in Diabetes Agonistes morbidity is not transparent. It appears as it feels: monsters in the body, but not of the body. Horrible monsters that you can more than revile: you can, if you’re clever, destroy them without ever mistaking them for the world they occupy. Monsters here are personified, parasitic, repulsive chronic diseases that users capture and kill while the godlike body lives on.

Combat. My game mechanics stress cognitive and emotional affordances. I want users to perceive and think their ways through challenges, not randomly shoot them down like snipers in a carnival booth. “Nice shot, lad! Here, have this worthless trinket as your reward.” I daresay I’m bored by meaningless kinesis in play of any kind including video games; and I believe that many adult players feel the same way. We want adventure much more than effects; and adventure by definition is purposeful risk-taking. In most play and in Diabetes Agonistes in particular, adventure is experienced as agon. Not merely fighting, but fighting for something that matters. That something – here and now – is wellness. The fighting that wins wellness is tense, noisy, horrifying, vicious, calamitous, brutal, raw, hopeless, heroic. Fun for its own sake, yes, but these many fights accrete into an epic struggle, a true adventure. Humaginarium rewards wins not with trinkets but with tokens that reinforce users for later, harder, nobler existential challenges.

I have a few other core mechanics for this post, but instead I will end with a reminder about context. Diabetes Agonistes is a simulation. It’s a system simulation of physiology and biochemistry; it’s also an experiential simulation of health literacy tempering medical self-efficacy. As a game simulation, interactivity is maximal; passive displays are minimal. Several times a minute during hours of play, users must ask themselves and the game tech: “What is this? What does it mean? How can I use this? What should I do?” Simulation then is our ultimate game mechanic. The faithful, behavioral representation of how chronic illness manifests inside the human body. Damn hard to get your head around, and incredibly fun to try.

Mechanics

Health may be a human right for others, but you’re going to fight for it.

Users cross the morbid frontier with a plan, a map, a wallet, provisions and a cache of clues. They have a tough job ahead in Diabetes Agonistes. Seize the minions of chronic illness! Reclaim the birthrights of strength and safety! End the pain; end the suffering; end the fear of your own body!

Whoa, whoa, not so fast. Everything you try in this godforsaken fantasy will be challenged or opposed. What you see and feel is a fraction of what’s actually there; and much of that is out to get you. So be careful.

The minions you’re chasing are feral, ugly, numerous, devious, nuanced, complicated and uncannily intelligent. They’re thriving like a nest of vipers while you gingerly probe their squirming skins. When you grasp one it may throttle or bite, or emit begging sighs that lure you inward or downward, but probably not onward. After all, you want to live strong but the minions of chronic illness frankly want you to die. They might go so far as to kill you! It’s not hopeless though. Their crushing powers to confuse and depress may yield eventually, but not to chemical or nuclear weapons. Only to insight tempered with rare, gemlike passion you store in your heart for this quest. Health may be a human right for others, but you’re going to fight for it.

There are structural mechanics in the morbid frontier. By that I mean programmatic activities. Remember you’re in a video game now where NOTHING happens unless you trigger it. The good news is that your path is packed full of affordances. They are the logical, functional, evocative, riveting means to your ends. They’re also symbolic and deeply disturbing. Purpose-built to ignite learning and motivation. In the morbid frontier, everything you’ll do to overcome The Problem inflames your own personal desire to learn and go farther, and accomplish more.

Let’s begin to envision the game mechanics of Diabetes Agonistes.

Trusted Advisor. You may traipse solo through the morbid frontier, if that’s your style; or bond with a droid who has special powers. To interpret clues, weigh choices, fabricate tools, detour into branches, avoid pitfalls, barter, negotiate, interrogate, assassinate. All handy services, but beware of friends. Droid talents and loyalties are time and place dependent, devilishly restricted. You won’t know their limits until you test them; and you won’t be able to test a droid until you badly need it. You must learn when to fire and replace trusted advisors before they steer you into deep shit.

Meaning Maker. You may journey through the morbid frontier for the fun of it, as though it were some grotesque carnival. That would be thrilling and satisfying, but not winning. To win you must continuously make meaning from your experience. The meaning you make guides you onward, makes you more resilient. Emerging knowledge gradually transforms you into a master of fate. Take note of this. Diabetes Agonistes doesn’t teach you; it teaches you nothing. You force the quest to reveal truths that you can use. Making meaning is like fetching the key that turns the lock, from a ring of glittering duds.

Highways and Byways. You enter the morbid frontier with a map. Unfortunately, the map is a character with a quirky personality, a hidden agenda, and is somewhat unreliable. It doesn’t show you which way to go; doesn’t show all the ways to go; it merely indicates topography and suggests possibilities. You interpret the map, filling in gaps with your intuition and discoveries. You treat the map as a data store rather than a bundle of insight. You filter it for wisdom while suspecting it may be lying to you or mistaken. By improving the map in time you will gradually become a skilled cartographer for higher, more difficult levels of the morbid frontier.

Profit and Loss. You carry a digital wallet, starting in the Arcade and throughout Diabetes Agonistes. The wallet is initially stocked with enough capital to float your quest; but not enough to complete it. The wallet holds identity cards, credit cards, biocurrency and tokens that have specialized uses and surprising half-lives. In the morbid frontier you draw down this capital to pay for provisions and clues, bail, gadgets, services like protection, ferries and contract kills, healing balms and magic incantations. You may replenish your capital by earning rewards, trading objects, robbing minions and their bosses, ransacking their troves, trading on the Metabolic Exchange. The wallet is your permanent and personal property. It goes with you when the game is over and you’re on to a new quest in Humaginarium.

Are there more mechanics than these I’ve just shared? Indubitably. I want to keep writing about them. I’ll resume in my next post.

Morbid Frontier

This frontier is a newfangled transubstantiation of the body.

The exposition of Diabetes Agonistes turns on goal-setting, surveillance, and discovery of The Problem – by users who are going to experience and try solving it. In the real world The Problem is called metabolic syndrome – a nexus of chronic illness including diabetes mellitus type 2. In the fantasy of Diabetes Agonistes The Problem has no name. It’s an ominous presence, an irresistible force that manifests metaphorically, visually, dramatically as a vague, existential threat. More suicide bomber than complex medical condition.

Up to this point, users have glimpsed and probed the borders of a frontier full of hazards and portentous implications. They’ve observed and gathered biological phenomena that eerily materialized before their eyes – each unpacking different clues and warnings about what lies ahead in a quest. The clues suggest where and how The Problem may be found, observed, engaged. Warnings promise enrichment and fun to “all ye who enter here,” while darkly insinuating ambush and horror for hapless adventurers.

The frontier I’m talking about is a new transubstantiation of the human body. Rather than body into wafer, this is body into earth and sea. The frontier is underpinned by computational models of physiology and biochemistry that we’ve exploded and reorganized, reshaped and robed as a chronological, three-dimensional space like Eä and Arda and Middle-earth. Those dreamscapes are symbols of nature at every level and civilization in every moment. They are make-believe geography and history that were created to be explored, claimed and defended by questers pursuing salvation and truth along with victory and peace. Somewhat like the mythos of yesteryear, our new biological fantasy evokes metabolic structures, forms, content, mechanics and processes of a diseased human body; not as a body per se, but as a world that users bravely traverse and strive to master.

A typical user enters this frontier by choosing among three trails that present different perspectives on The Problem. Each trail attracts a different kind of user, but all lead precariously to the same endgame.

The first trail is elemental. It winds through the biochemistry of a metabolically disordered body at its least visible and experiential; its most enigmatic and elusive. From the elemental perspective, the constituents of metabolism have existed for billions of years – since life on earth began in the primal slime – and will continue long after their human hosts have departed. They are like the Valar. They make human life possible; they can sustain or end it in a snap; but all the same they are woefully indifferent to it. Their concern is all life, not human life in particular; and their fate is not bound to ours. This is a molecular agon.

The second trail is combinative. It makes its way among microbial tribes of the afflicted body, populated by wholly formed and determined agents who have unique personalities and life stories. Some tiny organisms are virtuous, others malevolent; some are brilliant, others mechanical; some are empathetic, resilient, capable of serving the greater good; others selfish and moronic, having little on their minds beyond the next meal and procreation. Neither immortal nor transcendent, they persist as long and as well as their tribe does; causing or enduring metabolic disorders and maybe overcoming them alone or with help; but rarely able to survive far from home. The whole of their population is equal to the sum of its parts. This is a cellular agon.

The third trail is civic. It cuts across the anatomy of an unwell body in which relations between tribes are modulated by rules, authorities, competing interests and economic pressures. The actors encountered here are systems rather than molecules or cells. When they are not disoriented by morbidity, they rest in balance and harmony: the endgame of homeostasis. However they are extremely vulnerable to attack, and in defending themselves these organs, tissues and fluids may spiral into conflict and chaos that end badly. This is a physiological agon.

Three trails through one frontier, with discrete beginnings but myriad links, dependencies and interferences. No matter where users begin, their quest ranges through all, interweaving their bewildering and frightful perspectives. What will it be like to play on and in them? That’s for my next post.

Quick Wins

She tries to do the right thing and she counts on quick wins to hold it all together.

I’m observing a typical user of Diabetes Agonistes: a woman in her mid-30s, perched on the lower rungs of the middle class; a little large she is with high blood pressure and sugar. She’s attractive, gregarious, restless when she isn’t busy, dreamy when she has time for herself. Years ago she finished high school and landed a sales job in the local mall; now she’s a merchant. A single mother whose days are stretched to the breaking point; but to her it feels heroic. She works hard, plays nice, is conscientious about her family and customers. She reads little for pleasure, but has her favorite shows and podcasts. She tries to do the right thing even when that isn’t easy or obvious or cheap, and she counts on quick wins to hold it all together. Quick wins are also why she plays video games, most days for an hour or less; in the train on the phone, at home on the computer. Her favorite kinds of games stymie her as much as life sometimes does, but they also throw off hot sparkling bursts of light, the crackling noise of walls collapsing, the thrill of snatching well-earned victories from the jaws of near defeat.

She heard about Humaginarium from a boyfriend. He said it’s pretty cool, “but you might not go for it because it’s gory.” Pretty cool as in really nice looking, gory as in bloody; yet no gratuitous violence, and that detail got her attention. She’s bored by dumbass shooters and bosomy warriors. It’s free, he added; it streams so it starts right up, no downloads, hardly any latency. “It’s different from anything I’ve ever played,” he allowed, so maybe she’ll have a look? He got into it two weeks ago and he’s still working through the first level. “Damn thing reminds me of Jules Verne” – 3D science fiction fantasy, clue-finding and brainy calculation, mysteries locked in enigmas that are supposedly true – TRUE – “as the human body itself.”

Her eyebrows went up when she heard that. “The human body? Is it a sex game?” He pondered, “actually more sensuous than sensual.” She wasn’t sure what that meant and neither was he. “Rated M, not A.” Okay, good enough!

One night after brushing her teeth she entered Humaginarium in a browser on her laptop and soon found herself wandering a fabulous Arcade. It was confusing and disorienting, yet funny. “Like I’m Alice in Wonderland,” she mused, “or Spirited Away” as she watched and touched things that seemed to have minds of their own. Lots of colors and movement, fractal images and eerie sound effects, curious linkages that eventually made her suspect something was going on: it wasn’t just random game mechanics. She was witnessing the “miracles” of birth, growth, decay and death of the body as though they were magic shows. They helped her form mental models of wellness that are religion in Humaginarium: things to adore and believe in. A firm grasp of wellness finally unlocked a portal into a different and strangely hidden world, one fraught with danger and mystery yet irresistibly beautiful; the hidden world of morbidity.

She wanted to stop right there, not because she wasn’t curious; she was actually intrigued. But over an hour had passed as she explored the Arcade and turned that lock in the portal. It was past midnight now and her alarm clock was set for 6:00 AM. She wondered, “what will happen if I just stop?” Would she lose everything and have to start over? “This is ridiculous, it’s just a game,” and she decided to exit. Before closing the app asked, Do you want to keep your Humaginarium Key? “Sure, why not? What for?”

The next day on the commute to work she had a few minutes to spare, so she started Humaginarium on an iPad. “This won’t work,” she murmured. Wrong! It worked just fine. The app retrieved her Key from Dropbox, authenticated her identity, and transported her right back through the gates of … what … Heaven? Hell? It’s fun is not knowing which. On the other side of the portal she learned she has to quest. She can start right away and collect greater honors and rewards for speed. Or she can slow down a bit and learn before she leaps. She didn’t have time to decide. As the train approached her stop she had to exit.

Sadly she didn’t return to the game until the end of the week, for reasons that have nothing to do with this history. When she regained her previous position in Humaginarium she watched a quick replay of everything that previously happened to her. Now she was ready to forge ahead. She spent an hour collecting raw intelligence about her adversaries and allies in this weird biological fantasy. When she had enough of that, she entered a path that led to…. We’ll find out where in my next post.

Scientific entertainment. La Baigneuse Valpinçon (1808), by Jean-Auguste-Dominique Ingres; pictured with microbiota in the human alimentary canal.