The Song of the Cell: An Exploration of Medicine and the New Human

The cell is a key part of most life. Complex organisms are made up of many different cells all responsible for specialized functionality. The science behind our knowledge of the cell took many different turns and even involved some significant competition (and deaths). This takes us on the discovery of the cells and how they work. Then explores the application of this and some of the modern advancements of cellular research. Some of the popular advancements (such as so called "test tube babies") have been achieved by people that do not have cellular biology as their primary focus. While others have been part of mainstream cell biology work. Understanding cells can help us to treat many different diseases and help understand more about life in general.

Laws of Medicine

Laws of Medicine is a short work that distills some of the important "laws" of medicine. Medical care as we know it is a very recent phenomenon, only existing in the last century or so. Medicine had to be "cleansed" of the old "bad" ways (like bloodletting) The intermediate "do nothing" period helped pave the way to medicine as we know it. However, properly practicing medicine requires much more than simply understanding the book learning. That is where the "laws" come in. Every person is a little bit different. A study that showed great results with one population may not have any impact on a different group. Understanding the entire person can help provide insights into possible issues. (He gave an example of learning that a man was a drug user providing a risk factor to test for HIV.) Tests are rarely 100% accurate. If we test everybody for a rare condition, we are likely to get more false positives than true positives. However, narrowing down the population to a more susceptible group can get better results. On the other end, a study that only seems to help a single person may actually show a promising cure for people that match that person's characteristics. However, even the most carefully designed studies are subject to human bias. Even the naming of a procedure can influence its popularity even if the data is hidden. A great doctor has the knowledge and the intuition needed to look at the hidden clues. Alas, as medicine becomes more mechanized, we are becoming more reliant on "tests" at the expense of truly resolving issues.

The Emperor of All Maladies

Cancer is the modern killer that seems to fit our society perfectly. It is not a single disease, but a related group of many different conditions, all of which involve cells growing out of control. Reports of cancer have occurred back in ancient times. However, it has become much more prevalent today. Most cancers require multiple mutations to occur before cells start growing "out of control". People born with a mutation will often have a head start, however, getting cancer is not a given. It occurs more often in older people because they have had a greater chance to have a mutation occur. Carcinogens help aid the mutation process, but are no guarantee of contracting cancer. Some cancers (such as prostate cancer) occur frequently in old age, yet are often not the cause of death. Others may be extremely genetically related and occur at younger ages.
The medical profession has gone through many phases in the attempt to cure cancer. The many different types of cancer have differing biologies and treatments. The understanding of cancer has changed over time. Researchers had thought they had found strong indicators and causes, but the "easy" ones were often isolated to a few small types of cancers. Initial treatment used the "all out war" approach. A cancer and any nearby tissue were removed. Toxins and radiation were used to eradicate any cells. (Alas, this would often cause harm to the person and other parts of their body.) Modern research has helped uncover gene pathways and enable more targeted approaches that only impact unique aspects of the cancer cells. Cancer, however, grows and mutates rapidly, requiring targeted approaches to adapt to the changes. Some cancers have high rates of cure success, while others are still a death sentence.
Politics often becomes involved in treatments. If a potential cure is available, why limit it to a few people in chemical trials? Why not let everyone benefit? The quest to find a great cure has lead to some not-so-great experiences. For breast cancer, a South African doctor was showing extremely high remission rates for his procedure. People demanded it and forced insurance companies to cover it. Alas, it turns out the results were fraudulent, and not independently confirmed. It did not lead to long-term success and the insurance companies were actually right to be hesitant. Even good cures more only prolong life a few months or years. Is it worth it? For some people individually, the extra time may be a great benefit. For society, however, we are still looking for the long term cure.

The Gene: An Intimate History

The history of the understanding of DNA and genetics is a fantastic tale of science marching forward and backwards in a quest for knowledge. There were plenty of detours and missed opportunities in the development of understanding of genetics. The Greeks had many ideas, most of which led scientists down the wrong paths. Mendel had a clear understanding of genetic crosses through his pea experiments. However, his work was ignored for decades due to his lack of "credentials". Darwin had some keen insights, but also had some guesses that turned out to be totally wrong. Eugenics appeared to be to the wave of the future and a way to help "improve" the human race. Then the Nazis adopted it, and it become verboten. (Today, however, it is carried out in a more "unofficial" format with genetic testing and elective abortions of "defective" fetuses.)

In "The Gene", the author uses his family's history of mental illness to weave together a history of knowledge of genetics and the human applications of this knowledge.

Today we have learned a great deal more about how DNA encodes "us". We also have the power to make changes to the genetic code. We have used this power to make extensive changes to plants. We can also make changes to animals and even humans. This gives us great power, but also poses a great risk. Many genes work together to produce a certain outcome. Research is primarily through a "guess and check" approach. We try to change certain genes in an animal model to see the impact. We may look at various people with a similar condition and try to find similarities. It may be tempting to "turn off" a certain gene that leads to a disease. But what will be the ramification? Will this also turn off immunity to a future unknown disease? Will that cause some unknown negative problem in the future?

The power to make genetic changes is perhaps one of the most scary abilities we have today. People are having fewer children and using more medical assistance and genetic screening. Will we accidentally screen out an unknown important mutation that is needed for our species' survival? Will we create a homogeneous society that differs only superficially? Or will we accidentally hit the self-destruct button? The state of the art in genetics lends itself towards a justification of an intelligent design. We have the ability to manipulate genes. Why not create entire species? Are we the first to do it?

I could envision a past world where dinosaurs wanted to be the best dino-league athletes. They engineered themselves to be larger and larger until they reached the gargantuan sizes of the day. This was wildly successful for a time. However, problems arose when the environment changed in unexpected ways. The cultural bias to bigness was so prevalent that they ended up having a dino-war rather than adapting to smaller sizes. Eventually they became mostly extinct. That is, all except a renegade group that decided they wanted to get smaller and smaller. They figured out how to change their DNA to shrink them to be smaller and smaller. They then used the genetic knowledge to create other organisms to house them. Other animals were merely biological "houses" were these beings could live and reproduce. They created their harems and started reproducing like crazy. They were able to get the last laugh in as they "dominate" the big species of today.

What will we humans do with our genetic knowledge? Will we try to do too much before we know enough? Will we cause irreparable before we know what we are doing? Or are we doing things at the proper pace now. We have power, but we are only beginning to understand. I hope we can make good decisions.