Tim Robinson, the man behind the Meccano construction you link to, is a trustee of the Plan 28 charity mentioned above.
You are quite correct that we have not built a single demo part. In the two years since I started talking about this project the following has happened:
1. Persuaded the Science Museum to digitize all of Babbage's plans and notebooks (this in itself was a non-trivial task involving a great deal of effort at all levels and they should be thanked for taking on the task).
2. Got the leading Babbage experts to join and work with me (Doron Swade who built the Difference Engine No. 2 and Tim Robinson)
3. Started a UK-based charity (again these things take time as there are legal requirements and the recruitment of a board of trustees)
4. Started research on the Babbage archive itself
5. Begun fund-raising.
No. 4 is non-trivial because there are literally thousands of pages of notes and > 230 large scale plans to decipher. Plus there's a hardware description language to work with. And the archive is not well documented. There are a number of different cross references that conflict with each other. I realize that all this stuff is boring and people would like to see an immediate result, but that's not going to happen. It's years of work to properly study this stuff and build a historically accurate machine.
Note that we have not proposed building the 1,000 memory location machine. That's far too much to demonstrate that it would work and would add to the cost and size. As for the number of parts, until we've deciphered all the plans and come up with a definitive plan that it's hard to answer but we believe there will be roughly 40,000 to 50,000 components to be made.
You are correct that I care about the PR side of things. I need to because I need to raise a substantial amount of money.
But it's far from all PR. There's now a registered British charity with a board of trustees and the pre-eminent Babbage expert, Doron Swade, who built the Difference Engine No. 2 at the Science Museum is running the technical side of the project.
Study of the digitized plans has been underway since February and some first results will be announced this summer. We actively want to build a 3D working model in a tool like Autodesk.
For example, they could better disambiguate between Santorum the tool and santorum the frothy mixture of blood, semen and feces.
I realize this isn't the main point of your post, but if you're doing it right there shouldn't be any blood...
If we compile statistics, we can look for the points where nobody has ever meaningfully recovered.
We do. This is where the guidance to stop resuscitation after 15 minutes without a rhythm comes in. Unless you're a child who drowned in cold fresh water, of course, or an adult who apparently died of hypothermia. The problem is that there are so very many different sets of facts, and people are far more resilient than you can imagine. And in the heat of the moment, we tend to opt to fight rather than to let go. Which is actually OK, I think.
For your example, ECMO can only be useful for acute lung failures including injury. It's useless in chronic cases where the lungs simply aren't going to improve.
Well, yes, ECMO is probably a bad example, because it's by definition an acute therapy that can't be continued more than a few days, at least at the current state of the art. Even there it's a bit questionable in the case of chronic disease exacerbated by acute cardiopulmonary collapse from a (presumably) reversible cause. But other therapies, like the simple $10K/day ICU bed, are much harder to argue against, unless you've given specific instructions. It reminds me a little of the old instructions for tuning a carburetor - turn the screw until the engine dies, then back up half a turn. Most of the really futile ICU cases I've seen didn't START as futile cases, but they sure ended that way.
Most other western countries have a bit less tendency to heroic medicine than the U.S.
I'm not actually all that impressed with medicine in "most other Western countries" as a touchstone for our own. Every country has its own social norms and conventions, all of which fold over into health care. We tend to value privacy, autonomy, personal space, personal choice, and hope for recovery more than most, and it costs us a lot of money.
I think the problem is that we don't know in advance when the "last days of life" are for anyone. Or at least we don't know if prospectively, and knowing it after the fact is kind of pointless in terms of limiting costs.
If there are treatments that are virtually never helpful, we need to stop using them. There aren't many interventions that actually fit that description, though, and even the most invasive of them - ECMO, for example (basically continuous heart-lung bypass) - have their place in restoring people to health in the right circumstances. Eventually the circumstances are such that death is inevitable, but recognizing that point is not something we know how to do with certainty. Even when we're pretty sure, communicating our own conviction is very hard. And where there is no certainty, there is the great likelihood of erring on the side of treatment.
Hospice care, which tends to be very inexpensive compared to attempts at cure, is helping because it gives people a viable alternative path. Most physicians with whom I deal (a very large number, as it turns out) are big fans of hospice care. Not because it's cheap, but because it helps make the case for avoiding further torture. It's not a bad way to reduce costs, though, and that's not irrelevant.
I'm a board-certified physician (among other things). There is no way that I would allow my colleagues to inflict the kind of death on me that they are forced to inflict on so many. Part of this is certainly that I know full well that we all exit this mortal coil toes-up, and there's no getting around it. Part of this is the personal reluctance to experience the diminished autonomy, indignity, pain,and hopelessness that comes with fanatically-treated terminal illness.
But a big part of it, I think, is just that I know that there are so, so many things that are worse than simply dying. Dying in agony, for one. Dying after having bankrupted my wife or my children. Dying after being reduced to a stinking thing in a bed long enough that only those who loved me most even want to be near me, and that only because they feel they must. Physicians see these things all the time, and we see the road that leads to them. We're not (that) stupid, and we would rather exit early on that road, not at its terminus.
As long as I have the capacity for joy I will strive to remain alive to experience that joy. When the capacity - or the joy - is gone for good, I have given quite strict instructions not only to my family but to some other clear-headed and insistent people who will do their best to ensure that I too will be gone without further "heroic" intervention.
The only problem that I have with the article is that it pretends that everyone should make the same decisions. Everyone has their own decisions to make, and without my knowledge and experience I might not make the same ones. I think as physicians we owe it to the people for whom we care to educate as well as we can and help them to understand why we might personally decide one way or another. But I will never tell them how they "ought" to decide - it's really their choice. Taking that choice away from a person leads too easily to very real outcomes that are much nastier than simply a life that ends later than it ought.
BLISS is ignorance.
