Lines of Defence – The Future of Medicine and Man

Until now natural selection and personal health were key factors in determining the survival of a human being faced with a threat. Diseases would appear, decimate a society or community and move on leaving the survivors to recoup and reproduce with newly evolved methods of fighting a recurrence. While societal living had a role to play in terms of affording protection, this was still secondary to the fitness of the individual. However the increasing complexity of the medicines and societal mechanisms man has been developing for his protection are changing this. We have come to the point where there is a noticeable externalisation of our lines of defence to health threats. Our defences are no longer so much within our bodies as outside. A recent article in the BBC (‘Will we all be tweaking our own genetic code?’, Karen Weintraub, 19 Sep. 11) exemplifies this shift in a discussion of the possibility of genetically targeted medicines that will help prevent diseases at their inception. Such a shift seems a natural and probably inevitable outcome of our technological advance. Indeed parts of western society are already grappling with one direct consequence of this advance –increased, and ageing, population. However there is another, increasingly relevant, aspect that arises from this conundrum of externalisation – the question of access. In all likelihood, this question will in the long-term vanish, as the now-new externalised 'natural' defence system settles down after going through its initial upheavals. However it will be worth considering the question if we wish to mitigate the pains of transition.

The question itself is not new. Though ethics in medicine and testing have undergone radical changes in recent decades, poor and under-privileged parts of the world have long been, and remain, testing grounds for new pharmaceutical drugs. It is a not-irrelevant point that several life-giving drugs have probably emerged much faster than they would have otherwise as a result of this inhumane process. How these costs and benefits may be added up, and whether at all they can/should be added up are questions that remain unanswered. However the development of genetic medicine arguably intensifies, by a great measure, the pertinence of the issue and its societal implications. An assumption I make here is that genetic medicine will need, by its very nature, to be tailored to a specific individual. In practical terms, assuming the availability of manufacturing facilities at reasonable prices, this will mean the access of every individual to a facility (and doctor) that will use his DNA sequence to determine the type of medicine he needs and manufacture it. At one level, this is a very welcome scenario – cheap, automated facilities that will not discriminate and be accessible to all. However, in nation-states where medication is privatised and socialised healthcare not available, where will the poor go for their individually-tailored medicines? For – and this is the root of the questions being asked here, the more we externalise our defence systems, the more we will depend on them for our survival. The poor of the future will be far less internally resilient to the viruses living with us today. It is likely that with individually tailored medication, we will also have individual-specific side-effects. Even in today’s relatively simplistic times, pharmaceutical corporations have been known to suppress unpleasant facts about the drugs they develop when they are put on the market. Will it be possible to come up with a free, fair and transparent way of dealing with the possible side-effects of genetic medicine? Also, there is the other, well-known thorn – the testing of such medicine. Surely genetic medicine will need far more rigorous and extensive testing than present-day drugs. Will we find suitable platforms for such testing? And finally, systems that become tighter, more complex and more dependent on centralised protection become more vulnerable to unforeseen external threats. Will this be what homosapiens, as a society, face in future?

Ephemeral

I should get out of this rut...but until then, I shall rely on the past! Here's another short piece, written ages ago!

Mirror on the wall, still water in the sink
Show what you are, a snapshot in time;
Hand jerks uncontrolled,
A tinkle, a rush,
The moment passes, so do you;
Shards of glass scatter on the floor,
Still water swirls, ever so untrue;
Like pages torn from a book that tells its story no more
Remind you that just as they are ephemeral, so are you.

Metaphorically Speaking

End Program...

He stood alone in the penthouse. High above, away from the noise, the traffic, the people - away from everything. Everything that is except that nameless, sinking feeling that followed him everywhere, every waking moment of his life. He was done and he knew it. He looked around the hexagonal apartment - at its glass walls and fancy trimmings and as he kept looking the wall in front of him started cracking. Slowly like a cancer the crack spread throughout the fabric of the glass and then with a single tinkling crash the wall came tumbling down in pieces, the glass wall that had been painstakingly decorated with portraits of the people that had come to mean something to him in his fifty-odd years of existence. He looked at the walls to his right, the ones with the pictures of the places he had been to and the paintings of the artists he had grown to admire. The cracks spread outward slowly with a compelling inevitability and he watched in mute fascination as the places and the paintings came crashing down as well. He didn’t turn as he heard the walls behind him go down along with the shelves holding the things he had created that he valued most. Rooted, he turned to his left in time to watch the biggest of the walls go down, the one he had painted himself with his ambitions, his dreams, the places he had wanted to see, the things he had wanted to create. All around him in pieces lay his life while the sun played gently on his features caressing him, mocking him. The sinking feeling lifted. He smiled bemused at the forceful clarity with which the one thought in his head kept bouncing around. He walked to the edge lifted his arms like a diver and jumped.


Restart...

Coincidence?... I think.

You're Siddhartha!

by Hermann Hesse

You simply don't know what to believe, but you're willing to try
anything once. Western values, Eastern values, hedonism and minimalism, you've spent
some time in every camp. But you still don't have any idea what camp you belong in.
This makes you an individualist of the highest order, but also really lonely. It's
time to chill out under a tree. And realize that at least you believe in
ferries.


Take the Book Quiz
at the Blue Pyramid.

Wonder

World-mirror hanging daintily, fragile dewdrop, on the bottom of my window-sill
Spotlight from above, sun ray finds its way through cotton fluff
Wind instrument sighing, singing and rustling, green leaf on brown stem
Ballet artist pirouettes, caught up in the breeze, piece of paper on the wind

And I simply pass by.

Where is the wonder, I wonder?

The Outsider

Like bright sunshine on
A cold bleak autumn morning
stands the outsider.

The fading winter

Glorious sunshine

Runnels of melting snow

Spring is here