My first child was born last week. Shortly after the delivery, I was handed a pair of surgical scissors and asked to cut the umbilical cord. Blood shot out and sprayed everyone within spitting distance, and my baby daughter was rushed aside to be cleaned and stabilized while two nurses went about collecting the remainder of her cord blood and samples of her cord tissue. Later that night, a courier came for the collection kit, and by the next afternoon Aviva’s cord blood was in cold storage somewhere out in Arizona. Probably in a top-secret, state-of-the-art facility deep beneath the desert.

The ritualistic nature of the birth experience lingered with me for days after. By ritualistic I mean to include the physical processes of labor, and the sharing of birth stories with friends and family before and after, rituals that extend back to the roots of humanity. I also mean to include the cutting of the umbilical cord, a distinctly modern ritual with no lineage I can trace, no doubt an attempt to nudge fathers from spectator to participant. But I mean to include as well the banking of cord blood and tissue, an option today that may yet become a ritual in its own right.

Whether to bank your newborn’s cord blood and tissue is almost certainly the first decision with futurist implications that you as a parent will get to make. (There are plenty of pre-natal decisions with such implications, but technically you’re not a parent yet when you make them.) As with most thorny futurist topics, it presents an optimization problem without a simple or universal answer. I’ll try to help by spelling out some of the pros and cons and suggesting a good framework for making your decision.

Cord Blood Banking Explained

Cord blood and tissue are rich in certain types of stem cells, which can be used in some medical treatments today, and likely many more in the future. They can be collected from the severed umbilical cord post-birth, cryopreserved, and stored for later use. You can find an informative overview from the Parent’s Guide to Cord Blood Foundation here.

Some cons of cord blood banking:

• Cord blood and tissue banking costs $1500 – $2500 for the initial collection and $100 – $200 in annual storage fees, money that could arguably be put to better use in protecting the health and safety of your child
• Treatments are only available for certain blood and immune system diseases at present (~70 and counting…), and additional uses are speculative. You may not get much bang for your buck
• Cord blood and tissue stem cells aren’t as versatile as pluripotent (e.g., embryonic) stem cells, meaning that broader therapeutic uses may prove limited as well, subject to more fundamental breakthroughs in research
• Treatments for your child using her own stem cells are further limited as some diseases are genetic and cannot be treated using blood coded with the same defects
• The amount of cord blood collected from your newborn’s umbilical cord is rather small and insufficient to treat adults at present. Unless methods are discovered to stretch this quantity, use may be limited to the first few years of life
• The private cord blood banking sector is new and proto-regulated, and systemic uncertainties persist about storage conditions

Now some pros:

• Cord blood banking is available today and highly actionable. Unlike many futurist interventions you may wish to make for your child, the infrastructure for cord blood banking already exists and is easily engaged
• Cord blood is actively being tested for other uses. Current studies registered with the U.S. federal database are treating people with conditions as varied as diabetes, spinal cord injuries, heart failure, stroke, organ transplants, and neurological disorders such as multiple sclerosis. Other treatments and therapies are likely to emerge
• Your child’s cord blood may also be useful in treating other family members, including you and your spouse and your newborn’s future siblings (or, ala My Sister’s Keeper, her older siblings)
• Much like your newborn, stem cell research is still in its infancy, and present-day unknown unknowns may yield disruptive future applications
• We’re firmly in the space carved out by works like Brave New World and Gattaca Everything I’ve learned form sci-fi suggests that having a stock of healthy stem cells from birth is a good thing (unless of course they’re used to clone and secretly replace your child)

So. Should you bank your newborn’s cord blood and tissue?

The Futurist Calculus

Many of the topics I intend to cover in this series will involve choices for you as a father, choices that entail financial, mental, and temporal investments of varying magnitudes, usually under conditions of uncertainty, with payoffs that may not materialize for decades, if at all. You’ll have to decide for yourself whether any particular investment seems right given all the competing things out there fighting for your money, attention, and time. While no one can answer these questions for you, I can try to outline the futurist calculus:

• Time. Cord blood banking is widely available today, and easily engaged. If the services is offered in your geography, it will require only a small investment of time to take action
• Attention. For the small percentage of families that can already benefit from existing cord blood treatments, the investment of attention required to determine its usefulness for your child is moderate but probably very worthwhile
• Attention. For families hoping to benefit from future uses of cord blood, there’s a lot of information available about the topic. Unfortunately, experts disagree on many aspects, and much of the research is still in its infancy. Unless you’re particularly interested or knowledgeable about this field already, you’ll need to make a serious commitment of time to reduce the inherent uncertainty beyond flipping a coin
• Money. The cost is relatively clear. It may be reasonable for some, but too speculative to justify for the 3 out of every 4 Americans living from paycheck to paycheck, who might be better served by a better stroller or car seat

In many ways, cord blood banking is a perfect litmus test for the futurist parent. It requires an investment today that has limited proven utility but significant potential upside, depending on the course of research over the next few decades and the specific medical needs of your family.

Whichever way you choose, welcome to the future, daddy-o.

I’m a fortysomething science fiction writer who’s spent many many hours alone in rooms pondering stuff, and I KNOW THE FUTURE. Yep, I’ve worked it out, more or less.

But I’m also mere days away from first-time fatherhood, and this new filter has shifted my futurist musings in subtle but momentous fashion. Instead of trying to decode the destiny of the human race, I now gaze into the ether searching for actionable information about the fate of one very specific human.

Journey with me as I seek to prepare myself for fatherhood and my daughter for the possible futures she will inherit.

Statisticity artist Klaus Pillon has finished 3 more illustrations. Check them out below:

Subway Search

Pylons on People’s Square

LingLing at the Control Set

At long last, the search is over (again). I had just about resigned myself to paying several thousand dollars to the original coders of the beautiful Noble Beast release – Steampunk Holmes – to have them update their native app. But then two months went by without so much as an estimate, and I began to fear for the whole project (again).

So I went back to the intertubes to check if any scrappy upstart had emerged in the year since I’d last searched for buried treasure in that weird, nameless, nebulous sandbox where Statisticity plays.

It didn’t take long to find Beneath the Ink, a publishing startup in the enhanced e-book space. Like Noble Beast, they were one of the 2014 Digital Book Award winners (they won for best Adult Fiction – Enhanced Ebook, where Noble Beast won for best Adult Fiction – App). I have no idea how prestigious this award might be, but at the very least it hints at a finished product and some sort of independent review.

I contacted Beneath the Ink through their website, and they responded quickly and enthusiastically. Since then, I’ve had the chance to test-drive one of their finished books as well as their just-released author portal. I’m happy to report that – besides a great name – Beneath the Ink has powerful software. I’ll be able to keep pretty much every feature I wanted in the native app. That means character profiles, illustrations, additional scenes, images, wikis, and more. Beyond that, the author portal is so intuitive and user-friendly that I’ll be able to do most of the technical production work myself, despite being a code-tard. And where the Noble Beast version would only have been accessible on the iPad, Beneath the Ink will also run on any device that can host the epub2 or epub3 formats – including current versions of Kindle, iBook, Kobo, and Nook.

Finally, this upstart is still around and growing fast, which may suggest a better business model as well. At any rate, I’m cautiously optimistic that they’ll be around long enough for Statisticity to see the light…

From the very talented Klaus Pillon:

The View from Her Gilded Cage

Beneath the Nailhouse Lot

Since the unfortunate demise of Noble Beast, I’ve gone back to the drawing board in search of a technology platform for Statisticity. There appear to be four broad categories to choose from, each with its own set of pluses and minuses. A quick summary:

Ebooks

The “traditional” ebook is the original digitized book. The main advantages include ease of creation, inexpensive production, and readability across platforms. The main disadvantage is that, apart from very basic features like hyperlinked table of contents, ebooks offer very little of the functionality I hope to incorporate into Statisticity.

Enhanced Ebooks

Also called Fixed Layout Ebooks, these are basically new versions of Epub and Kindle that incorporate additional features like audio and video. There are a few startups that provide authors with tools and services around these formats. The main advantages include ease of creation (no coding skills required), inexpensive production, and readability across platforms (although more limited than traditional ebooks), along with the aforementioned features. The main limitations are the slow adoption of these new formats and the limitations on look and functionality when contrasted with applications.

Standalone Apps

These custom-made applications (also called Native Applications) allow the author to incorporate just about any feature imaginable. However, they come with a host of disadvantages. First, they are expensive to make, and require advanced coding skills. Next, they generally work on only one platform, and must be updated every time that platform undergoes significant change. Finally, distribution is difficult and can generally be done only through specific app stores.

Web apps

This form of application is generally coded in HTML5, thus avoiding some of the disadvantages of native apps (including the single-platform restriction, difficulty of distribution, and need for regular updates). However, web apps are still expensive to make and require advanced coding skills, and they’re more limited than native apps in the features they incorporate.

Noble Beast’s platform was a standalone app framework that could be customized for each new project’s content, along with a dedicated team that promised to remove many (but not all) of the disadvantages of this approach. With NB out of the picture, I’ve been flirting with the idea of using their platform anyway. But the difficulty of doing so has already become clear, and I am now leaning towards one of the enhanced ebook formats that are gaining currency. Ultimately, this shift may prove to be a blessing in disguise…

Illustrations are a key element of the Statisticity enhanced e-book, and working with artists has been one of the most interesting and rewarding aspects of the project. I plan to write a post about the process of finding and engaging with artists soon. For now, I wanted to share the first five scene illustrations by artist Klaus Pillon:

LingLing Visits the Cluster

Shanghai in Flames

Meeting at the Teahouse

Script Kiddies at the Door

Bicycle Repair