LIFE SCRIPT: How the Human Genome Discoveries Will Transform Medicine and Enhance Your Health - Review

Washington Monthly, Sept, 2001 by Phillip J. Longman

LIFE SCRIPT: How the Human Genome Discoveries Will Transform Medicine and Enhance Your Health by Nicholas Wade Simon & Schuster, $24.00

TO HEAR NICHOLAS WADE TELL IT, June 26, 2000, marked "the beginning of a new era of medicine." That was the day President Bill Clinton, speaking in the East Room of the White House, announced that biologists had completed a first survey of the 3 billion DNA letters, or sequences, that define the human genome. Clinton compared this accomplishment to "learning the language in which God created life." Wade, with only slightly less rhetorical flourish, assures us that the sequencing of the human genome "provides the basis on which to understand the human body almost as fully and precisely as an engineer understands a machine."

From that understanding, Wade continues, "physicians can hope to develop new ways to fix the human machine and in time to correct most--perhaps almost all--of its defects" Before long, these future fixes might even allow humans to become "effectively immortal," he concludes, speculating that people endowed with such potential might want to separate themselves from lesser beings by establishing a society of Methuselahs on Mars.

If you've just returned from a long visit to Mars, you might be shocked to find a journeyman science writer and editor for The New York Times carrying on with such sci-fi themes. But Wade is hardly alone in his estimation of how profoundly the revolution in genetics will affect the practice of medicine. Controversies rage over who owns the information contained in the human genome, and over the ethics of cloning, gene-therapy trials, and most recently embryonic stem-cell research. But implicit in all these debates is a widespread assumption that genetic research holds the potential not only to produce miracle cures for major diseases, but to prolong the human life span significantly, if not indefinitely. From President Bush, who promises to fund a "medical moon-shot" (even at the expense of federal investment in physics and space exploration) to the man in the street, who hears each day that biologists have discovered a "gene for breast cancer," or a "gene for shyness," the conviction grows throughout the culture that genetics hold the ultimate explanation for most human afflictions, whether physical or mental. Would that it were true.

For those who have failed to keep up with their newspapers, Life Script provides a useful and up-to-date survey of the biomedical headlines you may have missed in recent years. Early chapters rehash the colorful clash between James D. Watson of the National Institutes of Health's Human Genome Project, and J. Craig Venter, the National Institute of Health (NIH) scientist who broke away to undertake his own privately funded quest to map the human genome. Later, Wade introduces us to various figures celebrated for their efforts to create bioengineered drugs, or for their claims to have isolated a genetic basis for diseases such as Alzheimer's or diabetes, or for their success in using stem cells to grow new organ tissue in animals. Wade often writes at a level of detail that presupposes the reader has at least minored in biology, but even those who don't know an SNP from an allele will be able to tough it out. (In a bibliographical essay, Wade helpfully suggests obtaining a copy of the college textbook, The Molecular Biology of the Cell.)

Readers should be aware, however, that Life Script is a deeply misleading book, not in what it reports about recent developments in genetics, but in its neglect of the bigger picture. Despite all the hype surrounding the "completion" of the Human Genome Project, many biologists are disappointed by its results, and there is a deepening suspicion that gene sequences by themselves explain very little about why we get sick and ultimately die. As Harvard biologist Richard Lewontin has recently written, "Now that we have the complete sequence of the human genome, we do not, alas, know anything more than we did before about what it is to be human."

Lewontin isn't making the obvious observation that genetic research can never give us the meaning of life or an understanding of the soul. His thoroughly materialistic point is that the human body isn't programmed by any simple code. Rather, it is a complex adaptive system that both influences, and is influenced by, its surrounding environment on many different scales. If you want to make accurate predictions about how such a body will fare in this world, or intervene meaningfully in extending its life, you're far better off paying attention to what it eats, the cleanliness of the air it breathes, how often it exercises, and even to what indignities it must suffer at the hands of other humans, than you are paying attention to its genes.

As yet, the study of DNA sequences has not led to the cure of a single human disease. Better understanding of genetics has led to the creation of some useful new drugs, such as Herceptin, used to fight some forms of breast cancer, and Glivec, which when used in combination with other drugs, may prove a significant advance in treating one form of leukemia. But gene-based cures for major diseases remain well beyond the horizon, and there are strong theoretical and empirical reasons to believe that they always will. Indeed, genetic determinism is becoming, in the words of the eminent molecular biologist Richard Strohman, "a failing paradigm in biology and medicine."