FOLKS grab a seat, buckle in because WOW. Are you ready for a bold statement? There has been more progress in medicine in the past 6 months than in the past 6000 years!
We have moved into a new age, from the agricultural to the industrial, information and now to the bio-intelligence age where no longer is an advancing technology just an advancing technology but rather an explosion of intersections of different technologies.
A cell phone, for example, isn’t just an advanced phone but rather it is a camera, a stereo, an alarm clock, an entertainment system and an app store where, depending on your mood, you can change the weather to extra sunny or launch ICBMs. A car is also a satellite-guided map, a movie theater, and an intelligence system of its own unless it is in the hands of my sons in which case it is just a weapon. So too in medicine, the merging of technologies has combined with amazing medical discoveries, primarily the unfolding of the human genome, to create fascinating advances in the worlds of bioengineering, epigenetics, pharmacogenomics, artificial intelligence, ImmunoTherapeutics, nanotechnology, robotics, vaccinology etc.,
Medicine is truly a dynamic, promising and exciting place to be as we balance precariously on the heady cusp of the third great revolution in medicine, namely the biomolecular revolution. The FIRST era of medicine involved painfully scouring the plant kingdom in search of herbs or fruits that might scare away dreaded diseases. Hmmm perhaps leaf of yellow Sabu flowerpecker fix Saber tooth abscess. But as one country doctor who founded the Mayo clinic stated “The only two things in my black bag that I know works is morphine and my saw.” The second great era began around WW2, What was that? The era of antibiotics and vaccines and Frank Leonard. The fact that these actually worked to make people better, made doctors look like they could actually do something and were responsible for elevating us from barber surgeons to our current lofty status… that of golfers. But now we are on the cusp of the third great revolution of medicine and medicine today is now changing so rapidly that we barely recognize it.
Genetics is the very cornerstone to the future of medicine. Genetics is about to become the central science of all of clinical medicine. Speaking medicalese means speaking DNA. The Human Genome Project is an example of just how quickly the intersection of various technologies can advance medicine at breakneck speed. It began in 1990. It took a full year to complete mapping of a single gene. Given that humans have 25,000 different genes and given the rate of one gene per year, this project looked like it might take as long as it takes the Toronto Maple Leafs to win a Stanley Cup again. Optimistically it was felt that as technology improved the project could be accomplished by 2008. But Dr. Craig Venter, the CEO of Celera Genomics got a hold of some really skookum tools and mapped a couple of billion nucleotides in only 9 months. The timeline was changed to 2005, then 2003, and then on June 26 2000 the mapping of man’s complete genome was announced by President Clinton, or at least her husband.
At the unveiling of the Human Genome Project Bill Clinton stated “today we are learning the language in which God created life. (Bill Clinton of course being an expert on God’s language.) With this profound new language, humankind is on the verge of gaining immense power to heal. It is conceivable that our children’s children will know the term “cancer” only as a constellation of stars.” Ten years later I will go so far as to state that to many of us in this room today, cancer will become an inconvenience. This new language that Clinton spoke of is DNAese. Do you speak DNA? If not then you will be left behind and relegated to the backbench when you ask Billy Bloggins how his day in Grade 3 was and he replies “Well Doc, my arm is a little sore form the Alzheimer’s shot. Our history teacher is teaching us about a disease called diabetes and my bioinformatics teacher wants me to finish my proteome project. Can I borrow Dad’s MRI and use some of your RNA transferase.” Truly and clearly, the map of the human genome is the map of the future of medicine. Opportunism and optimism. When I think of opportunism and optimism, I think of this. Guess who’s which.
How many have seen the movie Gattaca starring Uma Thurman and Ethan Hawke, Jude Law? Anyone know where the letters in the word Gattaca come from. It was a silly futuristic movie (and I emphasize was in 1997) that begins with Junior being born into this world at a young age and within a few minutes as mom lies on the birthing table a drop of the baby’s blood is processed on a biogrid. The nurse states and I quote to the best of my recall “Nice baby but he has a 87% chance of congestive heart failure, a 26% chance of diabetes and worst of all a 48% chance that in a moment of weakness he may vote for Frank Leonard”. Of course with that kind of a readout we don’t get to be astronauts or even pass an insurance medical, but in the end as happens to all men in our dreams Uma Thurman will love us for who we are, despite our future risk of developing supernumerary nipples or halitosis of navel lint.