The Future of Medicine: The Era of Artificial Hearts

05Between artificial knees, total hip replacements, cataract surgery, hearing aids, dentures, and cochlear implants, we are a society that is fast becoming transhuman. Basically, this means we are dedicated to improving human health through substitution and augmentation of our body parts. Lately, bioprinting has begun offering solutions for replacement organs; but so far, a perfectly healthy heart, has remained elusive.

Heart disease is the number one killer in North America, comparable only to strokes, and claiming nearly 600,000 lives every year in the US and 70,000 in Canada. But radical new medical technology may soon change that. There have been over 1,000 artificial heart transplant surgeries carried out in humans over the last 35 years, and over 11,000 more heart surgeries where valve pumps were installed have also been performed.

artificial-heart-abiocor-implantingAnd earlier this month, a major step was taken when the French company Carmat implanted a permanent artificial heart in a patient. This was the second time in history that this company performed a total artificial heart implant, the first time being back in December when they performed the implant surgery on a 76-year-old man in which no additional donor heart was sought. This was a major development for two reasons.

For one, robotic organs are still limited to acting as a temporary bridge to buy patients precious time until a suitable biological heart becomes available. Second, transplanted biological hearts, while often successful, are very difficult to come by due to a shortage of suitable organs. Over 100,000 people around the world at any given time are waiting for a heart and there simply are not enough healthy hearts available for the thousands who need them.

carmat_heartThis shortage has prompted numerous medical companies to begin looking into the development of artificial hearts, where the creation of a successful and permanent robotic heart could generate billions of dollars and help revolutionize medicine and health care. Far from being a stopgap or temporary measure, these new hearts would be designed to last many years, maybe someday extending patients lives indefinitely.

Carmat – led by co-founder and heart transplant specialist Dr. Alain Carpentier – spent 25 years developing the heart. The device weighs three times that of an average human heart, is made of soft “biomaterials,” and operates off a five-year lithium battery. The key difference between Carmat’s heart and past efforts is that Carmat’s is self-regulating, and actively seeks to mimic the real human heart, via an array of sophisticated sensors.

carmat-artificial-heartUnfortunately, the patient who received the first Carmat heart died prematurely only a few months after its installation. Early indications showed that there was a short circuit in the device, but Carmat is still investigating the details of the death. On September 5th, however, another patient in France received the Carmat heart, and according to French Minister Marisol Touraine the “intervention confirms that heart transplant procedures are entering a new era.”

More than just pumping blood, future artificial hearts are expected to bring numerous other advantages with them. Futurists and developers predict they will have computer chips and wi-fi capacity built into them, and people could be able to control their hearts with smart phones, tuning down its pumping capacity when they want to sleep, or tuning it up when they want to run marathons.

carmat_heart1The benefits are certainly apparent in this. With people able to tailor their own heart rates, they could control their stress reaction (thus eliminating the need for Xanax and beta blockers) and increase the rate of blood flow to ensure maximum physical performance. Future artificial hearts may also replace the need for some doctor visits and physicals, since it will be able to monitor health and vitals and relay that information to a database or device.

In fact, much of the wearable medical tech that is in vogue right now will likely become obsolete once the artificial heart arrives in its perfected form. Naturally, health experts would find this problematic, since our hearts respond to our surroundings for a reason, and such stimuli could very well have  unintended consequences. People tampering with their own heart rate could certainly do so irresponsibly, and end up causing damage other parts of their body.

carmat_heart2One major downside of artificial hearts is their exposure to being hacked thanks to their Wi-Fi capability. If organized criminals, an authoritarian government, or malignant hackers were dedicated enough, they could cause targeted heart failure. Viruses could also be sent into the heart’s software, or the password to the app controlling your heart could be stolen and misused.

Naturally, there are also some critics who worry that, beyond the efficacy of the device itself, an artificial heart is too large a step towards becoming a cyborg. This is certainly true when it comes to all artificial replacements, such as limbs and biomedical implants, technology which is already available. Whenever a new device or technique is revealed, the specter of “cyborgs” is raised with uncomfortable implications.

transhuman3However, the benefit of an artificial heart is that it will be hidden inside the body, and it will soon be better than the real thing. And given that it could mean the difference between life and death, there are likely to be millions of people who will want one and are even willing to electively line up for one once they become available. The biggest dilemma with the heart will probably be affordability.

Currently, the Carmat heart costs about $200,000. However, this is to be expected when a new technology is still in its early development phase. In a few years time, when the technology becomes more widely available, it will likely drop in price to the point that they become much more affordable. And in time, it will be joined by other biotechnological replacements that, while artificial, are an undeniably improvement on the real thing.

The era of the Transhumanism looms!

Source: motherboard.vice.com, carmatsa.com, cdc.gov, heartandstroke.com

Biomedical Breakthroughs: Vascular Network Bioprinting

bioprintingThe ability to generate biological tissues using 3-D printing methods – aka. “bioprinting” – may one day help medical researchers and hospitals to create artificial, on-demand custom body parts and organs for patients. And numerous recent advancements – such as the creation of miniature kidneys, livers, and stem cell structures – are bringing that possibility closer to reality.

And now, according to a new study produced by researchers from the University of Sydney, it is now possible to bioprint artificial vascular networks that mimic the body’s circulatory system. Being able to bio-print an artificial vascular network would give us the ability to keep tissue and organs alive where previously it would not have been possible. The body’s vascular network enables it to transport blood and, therefore, oxygen and nutrients, to tissues and organs.

vascularIt also provides a means of transporting waste materials away from tissues and organs. Dr. Luiz Bertassoni. the lead author of the study explained:

Cells die without an adequate blood supply because blood supplies oxygen that’s necessary for cells to grow and perform a range of functions in the body. To illustrate the scale and complexity of the bio-engineering challenge we face, consider that every cell in the body is just a hair’s width from a supply of oxygenated blood. Replicating the complexity of these networks has been a stumbling block preventing tissue engineering from becoming a real world clinical application.

In order to solve this problem, the researchers used a bioprinter to create a framework of tiny interconnected fibers to serve as a mold. The structure was then covered with a “cell-rich protein-based material” and solidified using light. The fibers were removed to leave a network of tiny channels that formed into stable human blood-capillaries within just a week’s time.

stem_cells3According to the University of Sydney study, the technique demonstrated better cell survival, differentiation and proliferation compared to cells that received no nutrient supply. In addition, it provides the ability to create large, life-supporting three-dimensional, micro-vascular channels quickly and with the precision required for application to different individuals.

This is a major step forward for the bioprinting industry, according to Bertassoni:

While recreating little parts of tissues in the lab is something that we have already been able to do, the possibility of printing three-dimensional tissues with functional blood capillaries in the blink of an eye is a game changer.

bioprinter1In addition, Bertassoni claims that the ultimate aim of the research is for patients to be able to walk into a hospital and have a full organ printed with all the cells, proteins and blood vessels in the right place:

We are still far away from that, but our research is addressing exactly that. Our finding is an important new step towards achieving these goals. At the moment, we are pretty much printing ‘prototypes’ that, as we improve, will eventually be used to change the way we treat patients worldwide.

Bioprinting that uses a patient’s own DNA to generate custom-made organs and tissues offers a world of medical possibilities in which organ donors are no longer necessary, and the risk of rejection and incompatibility is negligible. Not only that, it will usher in a world where no injury is permanent and prosthetics are a thins of the past.

Sources: gizmag.com, sydney.edu.au

The Future is Here: Deka Mind-Controlled Arm Gets FDA Approval!

Deka_armFor years, biomedical researchers have been developing robotic prosthetics of greater and greater sophistication. From analog devices that can be quickly and cheaply manufactured by a 3-D printer, to mind-controlled prosthetics that move, to ones that both move and relay sensory information, the technology is growing by leaps and bounds. And just last week, the FDA officially announced it had approved the first prosthetic arm that’s capable of performing multiple simultaneous powered movements.

The new Deka arm – codenamed Luke, after Luke Skywalker’s artificial hand – was developed by Dean Kamen, inventor of the Segway. The project began in 2006 when DARPA funded multiple research initiatives in an attempt to create a better class of prosthetic device for veterans returning home from the Iraq War. Now, the FDA’s approval is a huge step for the Deka, as it means the devices are now clear for sale — provided the company can find a commercial partner willing to bring them to market.

Deka_arm1Compared to other prosthetics, the Deka Arm System is a battery-powered device that combines multiple approaches. Some of the Deka’s functions are controlled by myoelectricity, which means the device senses movement in various muscle groups via attached electrodes, then converts those muscle movements into motor control. This allows the user a more natural and intuitive method of controlling the arm rather than relying on a cross-body pulley system.

Deka_Arm2The more advanced myoelectric systems can even transmit sensation back to the user, using the same system of electrodes to simulate pressure sensation for the user. This type of control flexibility is essential to creating a device that can address the wide range of needs from various amputees, and the Deka’s degree of fine-grained control is remarkable. Not only are user’s able to perform a wide range of movements and articulations with the hand, they are able to sense what they are doing thanks to the small pads on the fingertips and palm.

Naturally, the issue of price remains, which is consequently the greatest challenge facing the wide-scale adoption of these types of devices. A simple prosthestic arm is likely to cost $3000, while a sophisticated prosthesis can run as much as $50,000. In many cases, limbs have a relatively short lifespan, with wear and tear requiring a replacement device 3 to 4 years. Hence why 3-D printed variations, which do not boast much sophistication, are considered a popular option.

bionic-handVisual presentation is also a major issue, as amputees often own multiple prostheses (including cosmetic ones) simply to avoid the embarrassment of wearing an obviously artificial limb. That’s one reason why the Deka Arm System’s design has evolved towards a much more normal-looking hand. Many amputees don’t want to wear a crude-looking mechanical device.

At present, the prosthetic market is still too broad, and the needs of amputees too specific to declare any single device as a one-size-fits-all success. But the Deka looks as though it could move the science of amputation forward and offer a significant number of veterans and amputees a device that more closely mimics natural human function than anything we’ve seen before. What’s more, combined with mind-controlled legs, bionic eyes and replacement organs, it is a major step forward in the ongoing goal of making disability a thing of the past.

And in the meantime, check out this DARPA video of the Deka Arm being tested:

 


Source: extremetech.com

The Future is Weird: Human Urine used to grow Teeth?!

3dstemcellsStem cell research has been expanding impressively in recent years, and the range of applications has been growing accordingly. And while all are impressive and useful, some are – admittedly – odd and even a tad gross. One such application is the one that was recently unveiled in China, where a team of biologists are using stem cells harvested from human urine to grow structures in mice that resemble teeth.

The team, led by Duanqing Pei and Jinglei Cai from the Guangzhou Institute of Biomedicine and Health, had announced back in 2011 that it had successfully reprogrammed skin-like cells from the kidneys, found in urine, to turn into pluripotent stem (iPS) cells. As researchers have known for some time, these iPS cells can be tweaked to become pretty much any human cell in the body.

tooth-from-urine-cell-regenerationIn a paper produced by the Guangzhou biomedical team – which appeared in the peer-reviewed, open access journal Cell Regeneration last week – they claim the ability to “regenerate teeth with patients’ own cells” is an “ideal solution” to the loss of teeth through accidents or disease. As just one of many applications of stem cell research, the aim is to create synthetic biological tissues that can replace artificial implants.

Once the cell sheets formed into epithelial tissue – the kind of cells found in human skin and teeth – they implanted them with tissue from the jaw of a mouse embryo (to encourage it to grow into a tooth) in the kidney of a mouse. Three weeks later, they noted that the human tissue had turned into cells called ameloblasts that secrete enamel, the hard, bone-like substance on the outside of the tooth.

urine_stemcells_teethThe result was a series of tooth-like structures which possessed the hardness “found in the regular human tooth”, which were then harvested. Assuming that this approach could be scaled to involve dozens of mice across thousands of labs, artificial teeth could be mass produced and then be made available to dental clinics all over the world.

However, the real innovation came with the new method that the research team devised to get around some flaws in the traditional method. This method, which involves inserting the stem cells into blanket cells via a genetically engineered retrovirus, can lead to a destabilization of the cell genome, rendering the tissue unpredictable, susceptible to mutations and thus a liability.

stem_cells1Hence why Pei and his team opted for another route, one which they claim presents a safer, faster alternative. Having extracted kidney epithelial cells from the urine of three donors, the team used vectors — a type of DNA molecule useful in transporting genetic information from cell to cell. This allowed them to transport the genetic information without having to integrate the new genes into the chromosome of the kidney cell.

According to their paper, this process may be partly responsible for the aforementioned mutations in the first place. And once they tested out their new process, it took only 12 days for the pluripotent stem cells to form in a petri dish – roughly half the time it takes using the traditional approach.

URINE-STEM-CELLS-TEETH-570William Stanford – a University of Ottawa researcher who holds a Canada Research Chair in integrative stem cell biology – indicated that their approach is not entirely now. Growing various kinds of human tissues inside a mouse kidney is a common technique used by stem cell biologists, Stanford said. In the course of doing so, researchers will occasionally grow what looks like teeth by accident.

However, the Guangzhou team have modified the technique to grow teeth intentionally. And their approach is an improvement in that it does not require skin samples to be harvested by the human subject (a common practice at the moment). Using urine-harvested stem cells only requires that they pee into a cup, and the turnaround time is a matter of weeks instead of months.

Good news for anyone who is missing some chomper, or feels self-conscious about crooked or chipped teeth and can’t afford those expensive, porcelain implants. What’s more, teeth are really just the tip of the iceberg. In time, other organic tissues could be grown as well, allowing for further developments in the already exciting field artificial organ generation.

Sources: cbc.ca, wired.com

The Future is Here: Liver-Cells Made With 3D Printer

bioprinterOngoing developments in 3D printing have allowed for some amazing breakthroughs in recent years. From its humble beginnings, manufacturing everything from 3D models and drugs to jewelry, the technology is rapidly expanding into the realm of the biological. This began with efforts to create printed cartilage and skin, but quickly expanded into using stem cells to create specific types of living tissues. And as it happens, some of those efforts are bearing some serious fruit!

One such example comes to us from California, where the San Diego-based firm Organova announced that they were able to create samples of liver cells using 3D printing technology. The firm presented their findings at the Experimental Biology conference in Boston this past April. In a press release, the company said the following:

We have demonstrated the power of bioprinting to create functional human tissue that replicates human biology better than what has come before.

3dstemcellsThe company’s researchers used a gel and “bioink” to build three types of liver cells and arranged them into the same kind of three-dimensional cell architecture found in a human liver. Although not fully functional, the 3D cells were able to produce some of the same proteins as an actual liver does and interacted with each other and with compounds introduced into the tissue as they would in the body.

This latest breakthrough places Organovo, indeed all biomedical research firms, that much closer to the dream of being able to synthesize human organs and other complex organic tissues. And they are hardly alone in narrowing the gap, as doctor’s at the University of Michigan made a similar advancement last year when they used a 3D printer to build a synthetic trachea for a child with a birth defect that had collapsed her airway.

bioprinted heartAs scientists get more familiar with the technology and the process of building shaped, organic cells that are capable of doing the same job as their natural counterparts, we are likely to be seeing more and more examples of synthetic organic tissue. In addition, its likely to be just a few more years before fully-functional synthetic organs are available for purchase. This will be a boon for both those looking for a transplant, as well as a medical system that is currently plagued by shortages and waiting lists.

And be sure to check out this CBC video of Keith Murphy, CEO of Organovo, explaining the process of bioprinting:


Sources:
cbc.ca, wired.com

Top Stories of 2012

biotech_alienAs Dec. 31st fast approaches, I find myself thinking about New Years resolutions. And part of that is taking stock on what’s been accomplished in the past year. For me, one of those resolutions was to stay current and share all the new and exciting news from the field of science and tech all my followers people; to the best of my abilities, that is.

In keeping with this, I wanted to create a list of the most important developments of the last year. Many sites have produced a top 10, top 12, even a top 7, list of what they thought the most significant accomplishments were. Well, I wanted to do one of my own! Opinion varies as to what the biggest leaps and bounds were over the course of the last year, and I’ll be damned if I don’t get my say in. Lord knows I’ve spent enough time reading about them, so here’s my comprehensive list of the greatest inventions, developments and advances made during 2012.

I think you’ll all agree, the list packed with stories that are intriguing, awe-inspiring, and even a little scary! Here are the top 12, as selected by me, in alphabetical order:

3D Printing:
cartilage1As far as tech trends go, this one has been in the works for some time. However, 2012 will be remembered as the year that 3D printing truly became a reality. From tree-dimensional models to consumer products to even guns, 3D printers have been featured in the news many times over for their potential and frightening abilities.

However, one of the greatest potential uses will be in the field of artificial cartilage, organs, and even food. As the technology is refined and expands to the field of organic molecules, just about anything can and will be synthesized, leading to an era where scarcity is… well, scarce!

Bionic Implants:
mindcontrolledprostheticPerhaps the years biggest achievement came in the form of bionic prosthetics, artificial limbs which are calibrated to respond to the nerve impulses of the user. As a result, amputees, veterans and accident victims are able to receive artificial limbs that act like the real thing.

The most notable case was Zak Vawter who scaled the 103 flights of Chicago’s Willis Tower using an artificial leg. In addition, two men in Britain had their sight restored after undergoing the first ever case of retinal surgery where bionic implants were placed in their eyes.

Brain Implants:
digital-mind1In September of 2012, scientists grafted an implant onto the brain of Chimpanzee, enhancing its brain power by ten percent. This consisted of an electrode array that was attached to the cerebral cortex of several monkey subjects, researchers were able to restore and even improve their decision-making abilities.

The implications for possible therapies is far-reaching, such as with brain injuries and cognitive disorders. But additionally, it also heralds the beginning of an era where human beings will be able to enhance their intelligence, recall, and memory retention.

Commercial Space Flight:
skylonThough not yet fully realized, 2012 was a big year in terms of commercial space flight. For example, Richard Branson and Virgin Galactic announced the first successful fully-loaded “glide test” of SpaceShipTwo, the rocket craft that will be taking passengers into low orbit as soon as all the kinks are worked out of the design.

In addition, Reaction Engines announced a breakthrough with the design of their hypersonic engine, which they claim will be fitted to their proposed spaceship – the Skylon. Capable of achieving speeds of up to Mach 5, this new craft is expected to be able to take off from conventional airfields, propel itself into low orbit, and deliver supplies to the ISS and make commercial trips around the world. No telling when either company will be conducting its first real suborbital flights, but the clock is ticking down!

Curiosity Rover:
Curiosity_selfportrait
One of the years biggest announcement was the deployment of the Curiosity Rover on the Martian surface. Since it landed, the rover has provided a constant stream of scientific updates and news on the Red Planet. Though the Mars Science Team did not find the “earthshaking” proof organic molecules, it did make a number of important discoveries.

Amongst them was solid evidence that Mars was once home to large rivers and bodies of water. Furthermore, the x-ray lab on board the rover conducted studies on several rock and soil samples, determining what the chemical and mineral composition of Mars surface is.

Faster-Than-Light Travel:
alcubierre-warp-drive-overviewIn the course of speaking at the 100 Year Starship, scientists at NASA began working on the first FTL travel system ever. Long considered to be the stuff of science fiction, physicist Harold White announced that not only is the math sound, but that his team at NASA had actually started working on it.

Relying on the concept of the Alcubierre Drive, the system involves expanding and contracting space time around the ship, allowing it to move faster than the speed of light without violating the Law of Relativity.

Geo-engineering:
converted PNM file
In October, the world’s first – and illegal – act of geo-engineering took place off Canada’s West Coast. The product of a “rogue geohacker” named Russ George, who was backed by a private company, the project involved the dumping of around 100 tonnes of oron sulphate into the Pacific Ocean. This technique, known as ocean fertilization, was meant to stimulate the growth of algae which metabolize carbon and produce oxygen.

The experiment, which is in violation of two United Nations moratoria, outraged many environmental, legal, and civic groups, many of whom hail from Haida Gwaii, the traditional territory of the Haida nation, who had enlisted by George as part of a proposed “salmon enhancement project”. Though illegal and abortive, the act was the first in what may very well become a series of geoengineering efforts which will be performed the world over in order to stay the progress of Climate Change.

Google’s Project Glass:
google_glasses2012 was also the year that augmented reality became… well, a reality (oh dear, another bad pun). Back in April, Google unveiled its latest concept device for wireless and portable computing, known as Project Glass. Combining an active display matrix, a wireless internet connection and a pair of shades, Google managed to create a device that looks like something straight out of cyberpunk novel.

HIV and Flu Vaccines:
HIV-budding-ColorWhen it comes to diseases, HIV and the Flu have two things in common. Until 2012, both were considered incurable, but sometime in the near future, both could be entirely preventable. In what could be the greatest medical breakthroughs in history, 2012 saw scientists and researchers experiment with antibodies that have been known to fight off HIV and the flu, and to good effect.

In the former case, this involved using a new process known as Vectored ImmunoProphylaxis (VIP), an inversion of the traditional vaccination method, where antibodies were introduced to mice. After allowing the antibodies to reproduce, researchers at Caltec found that the mice were able to fight off large quantities of the virus. In the latter, researchers at the Friedrich-Loeffler Institute in Riems Island, Germany used a new RNA-based vaccine that appeared to be able to fight off multiple strains of flu, not just the latest mutation.

Taken together, these vaccines could bring an end to a common, but potentially deadly ailment, and signal the end of the plague of the 20th century. In addition, this could be the first in a long series of developments which effectively brings all known diseases under our control.

Medical Implants:
enhancement2012 also saw the culmination of several breakthroughs in terms of biomedical research. In addition to the world’s first medimachine, there were also breakthroughs in terms of dissolving electronics, subdermal implants that dispense drugs, and health monitoring patches.

Little wonder then that Cambridge University announced the creation of the Center for the Study of Existential Risk to evaluate future technologies, or that Human Rights Watch and Harvard University teamed up to release a report calling for the ban of “killer robots”. With all the potential for enhancement, it could be just a matter of time before non-medical enhancements are a reality.

Mind-controlled prostheses:
woman-robotic-arm_650x366Researchers at BrainGate created a brain-machine interface that allows users to control an external device with their minds. The first person to use this revolutionary new system was Cathy Hutchinson, a stroke victim who has been paralyzed from the neck down for 15 years, who used the robotic arm to drink a cup of coffee.

This news, combined with other advances in terms of bionic prostheses, could signal the end of disability as we know it. Henceforth, people with severe injuries, amputations and strokes could find themselves able to make full recoveries, albeit through the use of robotic limbs.

Self-driving cars:
googlecar2012 marked an important year as three states (California, Nevada, and Florida) made autonomous vehicles legal. Self-driving cars, once perfected and produced en masse, will help with traffic congestion and significantly reduce the chance of auto accidents through the use of GPS, radar, and other technologies.

*               *               *

All in all, it’s been an exciting year. And with all that’s been accomplished, the future is certainly looking a lot more interesting and even frightening. What is clear is that predictions made for some time now are becoming realizable, including replication, a cure for all known diseases, advanced robotics, implants, cybernetics, and even post-humanism. Regardless of where one sits on these developments, be you pro, con, or neutral, I think we can all agree that it is an exciting time to be alive!

Happy New Year to all, and here’s hoping 2013 proves just as interesting, and hopefully a lot more peaceful and sound. And may we ALL find ourselves able to keep our New Years resolutions and build upon all we’ve accomplished so far. And of course, with all the potential for medical and technological enhancements that are coming, I sincerely hope we can find ways to improve ourselves on a personal level too!

A Review of Repo Men, the movie

The following are the core concepts of the novel The Repossession Mambo, by Eric Garcia (the same guy who brought us Matchstick Men and the Anonymous Rex series). It’s 2025. Thanks to a company known as “The Union”, society has been flooded with artificial organs and just about everyone has one. They have saved and prolonged many a life, and cost a mint! And if you fall behind on your payments, a Repossession agent will come to your house, slit you from your navel to your neck, and retrieve it.

In short, its a dystopian future where a single company an unrealistic amount of power – the power to save live, the power to take it away. Most people are struggling just to make ends meet and as a result, the debt-ridden masses struggle to make their payments and stay alive. Right out of the annals of classic sci-fi. And with all the other cyberpunk concepts that have been done, I’m surprised someone didn’t tackle the issue of artificial organs sooner.

And, let’s face it, the premise is very much in tune with our day in age, released at a time when homeowners and families are struggling to avoid foreclosure on their houses thanks to a series of bad mortgages (and re-mortgages) that they were sweet talked and pressured in taking them in first place. Yes, for people coming through the worst economic crisis since the Great Depression, and who are used to dealing with punitive cost of privatized health care, this movie was sure to resonate. A wonder then why it did so poorly at the box office!

Plot Synopsis:
As already noted, the story opens on the US in the near future. Artificial organs, joints, and even a neurological matrix, have revolutionized life by ensuring that the terminally ill, crippled and people near brain death can live on happily, assuming they can pay of course!

Small hints are given as to what is going on in the world at large, all of it quite familiar and relateable to today. On the one hand, there is loose talk of an ongoing debt crisis and a crippled economy. There’s also the passing mention of US soldiers gearing up to go into Nigeria in what has been deemed “Operation: Hope Springs Eternal” (a parody on “Operation: Restore Hope” or “Operation: Iraqi Freedom” perhaps?)

Into all this, we get Remy (Jude Law) who appears to be writing a manifesto of sorts. He opens it with a reference to Schrodinger’s Cat, which any fan of Big Bang Theory will instantly recognize. He wonders how anything could be considered both alive and dead in the same instant, clearly alleging that his story illustrates just that. The movie then opens in a flashback sequence, all things building towards his session in a slum with an antiquated typewriter.

Basically, Remy was a Repo Man who, alongside his age-old friend and army buddy Jake Freivald (Forest Whitaker), is considered the best in the business. However, Remy’s wife would prefer it if he transferred to sales and stopped doing the grisly work of harvesting people’s organs for money. He agrees, but also tells Jake he will do one last job. He is nearly killed when his equipment (a defibrillator) shorts out and nearly kills him. He wakes up in the hospital and is told that he will need an artificial heart now. His angry, panicked reaction tells us all we need to know about his feelings on that 😉 After years of watching others get screwed over by The Union, he now is facing that very thing himself.

Naturally, he tries to go back to Repo’ing since his wife has already left him and he needs the money. But somehow, he just can’t bring himself to do it anymore. What’s more, time is running out on him making his payments. During a final attempt, he goes into a “Nest” – a slum area where people go to flee The Union’s repo men – where he is attacked and knocked unconscious.

He awakens to find a woman named Beth (Alice Braga) – a lounge singer that he’s seen playing clubs before – living in one of the abandoned buildings and decides to help her. After standing watch as she goes through withdrawal, he agrees to help her since they are in the same boat. Seems she has mucho enhancements, including artificial joints, organs, eyes, and ears.

He breaks into the company storeroom and begins filing the bar codes off of all the spare parts they currently have. No bar codes, no scans will be able to detect that they have organs with are past due. However, Remy is caught by his friend and told to get out while he can. Back at their slum lair, Beth has set him up with an old typewriter she found. He sets to work banging out a “cautionary tale” about what he did and what he’s learned, until at last a repo man finds them and they are forced to kill him. Naturally, Remy outsmarts the man and he dies, but Beth is injured in the course of things. They are then forced to find a black market dealer who will fix her up, which takes them to another “Nest”.

Unfortunately, Jake finds them there and reveals to Remy that he is responsible for shorting out his defibrillator. By forcing him to meet the payments of an artificial organ, he figured his friend would never leave the business. The two fight, and in the course of it, Remy is knocked unconscious. What follows is a total mind-f*** which is comparable only to Inception! I shall break it down succinctly.

Basically, Remy wakes up to find that Beth incapacitated Jake. They then flee together and decide the only way they can resolve this is to break into corporate HQ, find the “Pink Door” where repo personnel make their returns, and physically scan their organs. After an over-the-top scene where Remy fights everyone between him and the “Pink Door” (which is ridiculously labeled as such), they break in and begin performing field surgery on themselves so they can scan the bar-codes.

Jake and their boss walk in a moment later, and Jake decides to switch sides and kills their boss. They blow up the repossession machine together and escape to the tropics, where Remy has apparently published his manuscript under the name The Repossession Mambo. However, this idyllic scene is interrupted when things begin to get fuzzy and some hiccups appear, as if it were all a recording…

Oh wait, it is! You see, in real life, Remy was rendered near brain-dead from the blow Jake gave him. The medics who arrived shortly thereafter hooked him up to one of the new neurological matrix’s in order to keep up his brain function. Hence, all this stuff about beating the company and escaping to the tropics was all a lie. Jake also tells them to leave Beth (unconscious but not dead) alone for him to deal with later. He then picks up Remy’s manuscript and notices the title, the same one featured in his little reverie.

I seriously wasn’t expecting that, but respected the movie more for the little dystopian twist at the end. It was in keeping with the whole tradition of cyberpunk tales, making sure that things like happy endings only happen in the movies… or not!

Final Thoughts:
I’ll be honest, this movie didn’t suck. It was very hard to take Jude Law seriously as a cynical, bad-guy, but for the most part, it was ably acted. It was also hard to believe that a former jarhead turned repo man, a man who for all intents and purposes seemed to like killing and didn’t care about the pain he caused, could maintain a marriage and a family. Somehow, these two sides of his personality didn’t fit. And lastly, the gore level, especially in that scene behind the “Pink Door” seemed gratuitous. It’s like, if they can invent scanners that can read a bar code through flesh and clothing, why do they need to slice opens their own bodies to scan the bar-codes for the big machine? I might have mentioned that the fight scene which brought them there was also pretty stupid, but of course, that was all in a dream! Technically, it doesn’t count 😉

But other than that, I actually liked this movie. It had plenty of thematic elements which landed for me. For one, there was the issue of a company pressuring people to sign-up for a product no one seemed to be able to afford. The scenes where we see the salespeople do their thing, or the boss’s BS about “you owe it to your family to do this” and “we can come up with a plan that fits your financial standing” were just too perfect. Tell me that wasn’t a parody of the banking industry, pressuring people into taking sub-prime mortgages when they could barely afford their current payments!

What’s more, the high costs of the new organs, which people had to turn to payment plans, credit, and whatever else to afford were clearly a reference to the health care crisis in America. People need life-saving procedures, have no choice but to sign up for them unless they want to die and leave their families behind. But in the end, its more than they can afford, and all the smarmy reassurances of the salespeople can’t change that very fact.

Yeah, it kind of bombed at the box office, but I’m thinking that rentals, DVD sales and Netflix might help it recoup its losses. And I strongly recommend people, at least those who aren’t turned off by blood and gore, take the time to watch it. If you’re a fan of dystopian sci-fi, you might just like it. And if you’re a writer of dystopian sci-fi (for example, me!) then you might just find it inspiring.

Repo Men:
Entertainment Value: 7/10 (not really a nail-biter, but definitely not boring)
Plot: 8/10
Direction: 7/10 (nothing special, but ably shot)
Overall: 7.5/10