The medical world is holding its breath, waiting for the revolution. It will be here any minute. Definitely by the end of the decade. Or perhaps it will take a little longer than that, but seriously, it’s right around the corner. More or less.
That’s the genomics revolution, with its promise of treatment focused on the individual rather than the group. At last, patients will be more than the product of their age, sex, ethnicity, illnesses and bad habits; treatments will be aimed like a laser at their personal genetic particulars, and if those genes are not quite what they should be, then those genes will be fixed.
…A particularly readable and comprehensive vision can be found in Dr. Eric J. Topol’s new book, “The Creative Destruction of Medicine.”
Dr. Topol, a cardiologist and researcher at the Scripps Research Institute with the energy of 10 (if his prose style and his honor-laden biography are any indication), dispenses in short order with our current population-based medical strategies. They are wasteful and inexact, he points out, often marginally beneficial to the group and downright harmful to the individual.
He presents an array of far better ideas, a few now actually being practiced in rudimentary form. These include pharmacogenomics, in which specific genes that govern responses to medications are routinely assayed, and cancer treatments that probe tumors for specific genetic targets rather than relying on standard chemotherapy…
In “Am I My Genes?,” the psychiatrist and ethicist Dr. Robert L. Klitzman plunges readers into the world of genomic medicine as it exists today: a barely mapped terrain of immense overlapping uncertainties. Many thousands of patients are bravely stumbling along in there…
Although written for an academic audience, this book should make compelling reading for anyone considering genetic testing for…many conditions: It provides an instant community of fellow travelers along with a sophisticated moderator. Dr. Klitzman moves through all the basic landmarks, including the big ones: “Do I want to know?,” “Whom should I tell?” and “Why me..?”
And that is exactly the phenomenon that fascinates H. Sebastian Seung, a professor of computational neuroscience at M.I.T. whose “Connectome” lays out the newest research into why we think the way we do. For Dr. Seung, it is self-evident that you are more than your genes. The real you sits firmly within your skull, and while your brain’s 100 billion nerve cells may carry your genes, the “you” they form is shaped by the ways they connect to one another…
As a newborn, Dr. Seung writes, you are pretty much just a product of your genes and some initial random connections, but every second of your first few years adds to the cumulative web of connections that form you. By the time you are a toddler you have more synapses, or connections among your neurons, than you ever will again: In some ways the adult you is just an edited 2-year old, one of many eminently pleasing thoughts he sets forth.
This is complicated stuff, and it is a testament to Dr. Seung’s remarkable clarity of exposition that the reader is swept along with his enthusiasm, as he moves from the basics of neuroscience out to the farthest regions of the hypothetical, sketching out a spectacularly illustrated giant map of the universe of man.
All added to the list. I may have to resume my practice back when I only edited and wrote for one blog. Take a chunk of Friday off to catch up with my reading.
Problem is – this site of mine is especially satisfying because readership and followers are within the margin of error for 50/50 women and men – and depending on the time of day here in the Rockies and time zones around the world, the audience varies from 18% to 68% US-based. The rest of the world is onboard just about all the time.