Indulge me. I'm going to ask what must be a stupid question:
Why haven't we cured every disease?
I use the term "cured" loosely. In some cases, it would more than suffice to simply diagnose diseases early in their courses. So why can't we?
Some day, you'll be able to walk into a General Practitioner's office, stand near a machine, and leave with a very clear picture of what is or is not wrong with your innards.
If only someone would write a book about this.
The keys to this whole process will be in the hardware that takes the pictures and the software that analyzes them. The former can always be clearer, higher-resolution, more multimodal, smaller, and faster. The latter can always be more accurate, more robust, have larger libraries, and of course be faster. Let's leave cheaper to the business majors.
Once we've found the problems, nothing should stand between the patient and a clean bill of health. A simple surgery, a cocktail of drugs, perhaps a few sessions of acupuncture, and you could be on the road to recovery! It'll take untold man-hours to develop these cures, but in many cases it just a matter of time and resources before we figure out what to prescribe and how to make it happen.
I predict that most, if not all, of the trailblazing - and oh, but there is a lot of it to be done - will happen at universities. This, of course, mandates that the lion's share of the burden will be shouldered by graduate students (just as the lion's share of the glory will go to the professors).
Consider this: The technology that may save your life in twenty years is being developed by an unkempt twenty-something in a dark cubicle. The person whose work could make cancer as dreaded as a head cold makes as much money as the stoner high-schooler who pours your coffee - and only one of those two gets tips.This brings us back to our original question. With all of these poor (literally) researchers slaving (literally) away in their labs, why haven't we cured every disease?
Allow me to rephrase that: Why are we wasting money on things that aren't medical research?
Okay, wait. I am not anti-art. On the contrary, I recognize that art, poetry, theater, and the like are vital to any healthy society. We shouldn't be pursuing a new Sparta, but a new Renaissance. That said, for every 100 federal grants in 2004, 15 went to the arts, while 14 went to health (the latter grants were admittedly larger, since incubators probably cost more than easels) [1]. Wouldn't that money be more productive elsewhere? More to the point, is the weekend artist any less beneficial to society than the one living off a government stipend?
At the risk of making an even-more-hugely unpopular political statement, I'm going to limit your political statements (here at TheNinjaDon, free speech is a right only for Ninjas, and a privilege for all others). I reject any point you make about the expense of the Iraq War as moot, as the problem at hand predates 2003. Furthermore, I reject any points you make about Welfare, Global Warming, the War on Drugs, etc., as those cans of worms are deep enough to drown in.
Having just summarily rejected a few dozen legitimate, feasible solutions, I feel comfortable enough with these boundaries to move on.
It doesn't make sense to me that the researcher's holy grail isn't knowledge, but funding. Too many friends have been bounced out of grad school for want of grant money - some for lack of "what it takes", but most for bad results, bad timing, or just plain bad luck.A series of flabbergasted letters to the editor in a recent issue of Science echo my sentiments with heartfelt incredulity and provident timing. John Moore of Cornell put it best when he said,
...the number of papers that are written is diminishing because scientists are able to spend less time writing papers! Instead, we spend ever-more time on the increasingly burdensome administrative requirements of conducting science legally, and on writing, rewriting, and re-rewriting grant applications as the NIH’s pay line drops to catastrophically low levels.The system is putting the passionate scientists in the backseat to the bureaucrats. It is the rare passionate, bureaucracy-savvy scientists who give me hope, and I can only aspire to be one of them.
In the meantime, I'm not asking for handouts, and I'm certainly not delusional enough to expect wealth. I'm just surprised that given the demand for our services, we researchers aren't more highly valued.
- UnderstandingGrants.com, "Federal Government and Grant Foundations Statistics", http://understanding-grants.com/understanding-grants2.html
- Letters, Science, 318 (3 Nov 2007) p913, http://www.sciencemag.org/cgi/reprint/318/5852/913a.pdf
N.B. Today's argument will be rebutted soon, with an equally scathing counterpoint. With that in mind, feel free to flame away.
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8 comments:
I agree. There's too much money being spent on a war and not enough on medical research.
As for the diagnose-all-cure-all magic machine you refer to -- it will never happen. Even if the technology becomes available it won't work. Simply stated, people ignore their own health and do not adhere to treatment.
Agreed, not enough money to medical research. That's not just a thought, it's a fact.
And you hit it perfectly: it's taken a back seat to the beaurocracy. It's all about money, and the red tape that goes with it. (Because Heaven Forbid that you cure cancer with money that was earmarked for that particle accelerator/corn subsidy/big industry "funding" (read, kickbacks for campaign contributions).
Call me a cynic, but the ubermachine you mention won't happen because then pharmaceutical companies would make less money, so they would be pushing against it. (Or just one compnay would make the money on the Patent. And that wouldn't be allowed either.) It's all about money, unfortunately.
Oh boy, here we go... Sorry, but I must chime in regarding why we can't have the perfect picture of our health.
Regarding your machine that will let you know everything that is wrong with you or may soon be wrong with you, please see every point regarding health insurance and genetic screening. The main issue in personalized health care, is that everything becomes a pre-existing condition. By having a genetic profile from birth or this theorized profile that you speak of, insurance companies will be able to assign a risk to each individual, rather than having the risk be spread out over the cross-section of the insured.
The effect to the low risk individuals would be positive, of course, as the few ailments that they may encounter could be addressed up front. However, the high risk individuals would have to pay exorbitantly high health insurance premiums or be flat-out denied coverage. At present, if such an individual is lucky enough to get health insurance as a benefit of employment, that employer would have to pay for his insurance. It is illegal for health issues to be used for hiring, but would it be fair for an employer to have to pay MUCH MUCH more for one employee's time than for an equally qualified employee's time? No, and they don't have a clue until after the employee is hired.
Here is a case study of how pre-existing conditions work. I am 21 and get an accute auto-immune syndrome that costs the insurance companies ~$200,000. This makes it so that my limbs are no longer paralyzed and the ailment doesn't continue to progress, where it would have eventually suffocated me through paralysis of my diaphragm. OK, thank you insurance companies, right? Now, I'm 25, must leave my parent's family policy and have ownership of my policy transfered to me. Um... Nope! I have had some sort of auto-immune deficiency and they refuse to write me a new policy. As an IGERT fellow, I am not a Rutgers employee and must purchase the Rutgers rinky-dink student insurance as a stop-gap before the University recently decided to provide fellows with insurance. Thank you Rutgers!
So, basically, it is unknown if any future insurance company will cover any treatment related to Guillain Barre syndrome. I may be unable to purchase personal health insurance for the rest of my life and will rely completely on employee benefits.
Without health care reform, genetic screening or Don's magic technology that doesn't exist would localize the risk too much for the current insurance scheme to be fair to individuals or to employers. I hate to say it, but Don, this isn't a science issue at the moment, this is a political issue.
As these technologies are becoming closer closer to routine clinical use, the need to address health care from a political front is becoming more urgent.
I personally don't favor Hillary as a presidential candidate, though she seems to have more urgency regarding universal health care than anyone else.
Lastly, um... you can't cure everything and you have to die of something. Let's not make a cure for everything so that each human's last decade is spent going in and out of hospitals 'till they can find something we don't have a cure for or find a malpractice suit.
Have a bright, sun-shiny day!
Charlie
Regarding the pay of graduate students, we are students, not experts in our fields. We are getting paid while we are receiving from the university. We get training and employment opportunities that wouldn't be accessible if not for being a graduate student. Yes, we produce advances in research, but the advisers have constructed their laboratories and established the over-arching themes of their research and bear the vast majority of the risk of the laboratory and your employment.
I am glad that the university pays us to train us. I consider it a gift. Eight to eleven years of life on a loan would be too much. Thank the current system to limiting that to four years. If you disagree, go market yourself today and see what you can get for your services that will grant you the same long-term employment opportunities.
Sorry Don, but I guess I just disagree with your post today. I think of how much MORE training I'm going to get in my first year or two in industry before I can really contribute to their bottom line, and I am certain that our pay is a gift, though maybe not as generous as you'd like.
If you want to denounce my comments as I am paid a bit more than a graduate student (though I have inferior benefits), feel free. However, I marketed myself (applied for training grants) to determine my current pay.
Flame over, Charlie
I'm pretty sure Johnson & Johnson''s 2007 revenue will far exceed that of the Museum of Modern Art.
The private sector of the science and medical industry has substantial amounts of money, obviously. Why should my tax dollars fund more work?
Isn't in the best interests of companies such as J&J, Merck, etc. as well as various medical subsidiaries such as hospitals to have as many sick people as possible?
As nice as it would be to think that these mega-billion dollar companies are putting their focus into curing major ailments, perhaps they are only doing "just enough" to meet the expectations of their stockholders.
Nice post, Don.
I'll say my opinion, mostly because it's always right.
In the middle ages (almost) nobody died of cancer. As the oncologists with whom I work say, people are usually lucky to die of cancer because it means they survived everything else. The goal of modern medicine, in some senses, is to keep you alive until cancer does you in. (yes, it sounds horrible, but it's somewhat true, neglecting the pediatric cancers, of course)
What happens, then, if we "cure" cancer and live until we are 200? Like Chaz said, we still have to die of something. There will be some new disorder, call it agingitis, that kills us. Just as there was no funding for cancer research in 1800, there is no funding for agingitis research now. The pharma companies will still get their money and the labs their grants, even though we did away with the 21st century diseases.
I thus think it's flawed reasoning to suspect that drug companies or academic facilities are somehow witholding cures, evidence, or methodology to treat our ailments. We, in the collective human sense, will be extinct by means of our societal stupidity long before big pharma runs out of things to cure.
I suppose my response was inevitable.
Why spend money on the arts?
Because I sure as hell don't want to live to be 150 years old in Plato's Republic.
Simply put, why extend or save life when the things that give us joy and meaning in that life are absent?
Last time I checked, reading an article in an oncology journal didn't count as a life-affirming experience for most people.
Successful funding of the arts and humanities doesn't come at the expense of the sciences.
though my response, like mark's, was NOT inevitable; i will weigh in. did you see "i am legend"? scary shit. curing cancer that way. everybody became zombies.
scared, very scared.
don, i am ignoring all the other stuff in the post because i am on winter break and thinking is not required until mid-january so i can prep for my interviews at companies like j&j, and plead that they share a teensy bit of revenue with moi.
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