The Future Of Medicine

Everything nowadays is moving at an unprecedented rate. That includes medicine and other fields of science. Among the greatest accomplishments of recent years has been the decryption of the human genome. And in the years before that was the development of computers from large and (relatively) slow machines to the “super” computers we have today. And they're getting better. Gordon Moore was too conservative in his estimate. Human ingenuity is a powerful engine. And Watson will probably find a way to improve on what we can already do.

I suspect that at some time in the not-too-distant future, if it is not the case already, human DNA research and computer science will be linked to carry out more of the research into disease and its treatment than is already the case. Although I admit to ignorance of current exploitation of these tools, there are some avenues I'd like to propose questions for these efforts. Some may already have been answered, but I suspect there is room for additional inquiry.

Specifically, having identified the various genes that make us human, do we know what chemical each one, or each combination, produces, or what process it controls? Do we know the composition of all of our microscopic structures, tissues, and organs in respect to those chemicals and processes? Do we know how the various diseases affect our internal environments? And do we know the effects of common (or uncommon) combinations of diseases?   

And to what degree can we digitize proposed pharmaceuticals and determine how they would act in the environments of our bodies, and how they would interact with the disease processes that afflict us and the bacterial and other invaders attacking us? Can we determine the unanticipated side-effect that are likely to occur when those pharmaceuticals come in contact with our “components.” (I raise this question because I suffer from side-effects of some of the medicines being introduced into my system. Of course, these discomforts are well worth enduring on the assumption that the medications can produce the effects for which they are being given, but I'd wonder if a computer-generated variant of the pharmaceuticals can be suggested that would produce the benefits that are required, but would lessen the side-effects, the physical costs.)

Speaking of costs, it's probable that doing much of the study in a computer rather than a laboratory and, ultimately, a long-term study with a test group, will shorten the process and make it cheaper. And, perhaps, it will lessen the need for test animals, a result that will bring elation on the part of many animal lovers. It doesn't seem likely that the need for animal and human studies will be eliminated – at least not in the near future – but the magnitude of such studies can be reduced, and they can certainly be entered with more knowledge. And if the cost of pharmaceutical development can be reduced, so can the cost of the products developed. And the cost of medical care in general, which will make better health for poorer nations as well as those that are developed.

Another area that might be explored using the same techniques is the effect of drug combinations on the diseases being studied. It seems reasonable to expect that here, too, the required information can be obtained quickly, less expensively, and with a minimum of harm to humans or other animals. Similarly the study of interactions between target drugs and those likely to be in use for the treatment of other associated, or incidental, processes could be explored. It's better to anticipate problems than to react to them. Over-the-counter potions should also be included in such studies, and a “library” of medications would be of value to all investigators. (And some commercial firm will be able to make a good deal or money by creating such a library.)

As I said earlier, I don't know the stage of development of all these ideas – whether they are plausible or if they are already in the works. But a world in which disease can be studied more quickly and with lower cost would be a wonderful result, and techniques to perform the functions I'm discussing, if they don't already exist, and if they are possible, might be worth exploring.

The Big Bang

It was just announced that a century-old hypothesis of Einstein's – something about gravity waves – has been confirmed. (Yes, I know this will be old news by the time this essay is published.) The scientific evidence which has been touted as demonstrating its veracity results from the collision of two black holes, and it happened about a billion years ago – give or take. That's before I was born and I wasn't there anyhow, so I can't confirm it personally.

The physicist from whom I heard it on the radio was very excited. It seems that this knowledge brings us closer to understanding the beginnings of our universe (that's said to have happened with the “big bang” but I wasn't there either – though some of my favorite atoms may have been) and suggests a new approach to the research on the subject. He said something about directing new projects based on this knowledge – that it would open a new “window” to the exploration of that field.

I couldn't care less.

Well, maybe I could. But not much less.

I've written disapprovingly before about the amounts of money that our nation (and other nations as well) put into such research. In fact I dissed a lot of research in a variety of fields in The Golden Fleece which appeared nearly three months ago. My conclusions (they weren't stated explicitly, but I think they were obvious) were that I supported (the late) Senator Proxmire, and I questioned the wisdom of spending tax dollars – our generous if not voluntary donations to the government – on research into the answering of questions that we either don't have (especially those whose answers are so obvious – as well as questions that are so inane – that the research seems silly), or questions which will have no value for us, or any likelihood of being of of significance to our children or grandchildren – or even great-grandchildren.

I don't wish to suggest that the questions, and the benefits that research into them may provide, are totally without value. Indeed, the research provides jobs for those who participate in it, whether directly or in the manufacture of materials needed for it, and for the papers that it yields, and the benefit of it adding bulk and luster to the resumés of the researchers, contributing to their academic prestige. But even if it has neither of these consequences, for the true intellectual it satisfies his (or her) curiosity. That may have killed the cat but, as Einstein himself said,

Curiosity has its own reason for existence. One cannot help but be in awe when he contemplates the mysteries of eternity, of life, of the marvelous structure of reality. It is enough if one tries merely to comprehend a little of this mystery each day.

It should be remembered, however, that Einstein's most famed work was done without the help of academia or government. He tried “to comprehend a little of this mystery” without having others pay for his doing so. His “annus mirabilis” occurred in 1905, when he was working as a patent clerk. (It was a government job, but the government contributed in no way to his research. The credit for his discoveries is entirely his.)

We spend large amounts of money on research. People are homeless, starving, and in need of medical care. (The role of taxpayers in what once were charitable endeavors is a separate subject, which I have addressed in the past and likely will again in the future.) Yet we spend money to determine what happened a billion years ago or will happen a billion years from now (if our universe lasts that long). And we send spacecraft and telescopes to explore inhospitable worlds we will never visit. Or we explore earthly matters which may be interesting to the researcher but are of no value to the rest of us, whose taxes support their interests, thoughts, and endeavors.

There is no minimizing of the value of curiosity. It is more difficult, however, to justify the use of limited resources – resources that could be applied to the solution of current problems – for the purpose of simply satisfying someone's curiosity. In academia it's called “pure” research, and revered for its purity. The curious are answering questions without regard to any practical use for the information they acquire. Perhaps someday someone will find a use for it, but that isn't really relevant to what they're doing. They'll do it anyway.

In the meantime, however, it is valid to question whether taxpayers should be supporting such curiosity of those who could use their intellects to solve existing, rather than theoretical problems. The greatest value of research is in the solution of problems that exist today – not in those we may, or may not, discover tomorrow. If our resources are limited, it makes the most sense to devote them to problems we face now, not to what our descendents may find in the future.

More importantly, in a world that has more problems than it can afford to solve, we have to get the biggest bang we can from the buck.