Science has always issued medical promissory notes. In the 17th century, Francis Bacon promised that an understanding of the true mechanisms of disease would enable us to extend life almost indefinitely; René Descartes thought that 1,000 years sounded reasonable. But no science has been more optimistic, more based on promises, than medical genetics.
Recently, I read an article promising that medical genetics will soon deliver “a world in which doctors come to their patients and tell them what diseases they are about to have.” Treatments can begin “before the patient feels even the first symptoms!” So promises “precision medicine,” which aims to make medicine predictive and personalized through detailed knowledge of the patient’s genome.
The thing is, the article is from 1940. It’s a yellowed scrap of newsprint in the Alan Mason Chesney Archives at Johns Hopkins University in Baltimore. The article profiles Madge Thurlow Macklin, a Hopkins-trained physician working at the University of Western Ontario. Macklin’s mid-century genetics is not today’s genetics. In 1940, genes were made of protein, not DNA. Textbooks stated that we have 48 chromosomes (we have 46). Looking back, we knew almost exactly nothing about the genetic mechanisms of human disease.
These genetic promissories echo down the decades with an eerie resonance. In 1912, Harvey Ernest Jordan—who would become dean of the University of Virginia medical school—wrote: “Medicine is fast becoming a science of the prevention of weakness and morbidity; their permanent not temporary cure, their racial eradication rather than their personal palliation.” (By “racial” here Jordan simply meant any large, loosely related population.) “Fast” is relative; 99 years later, in 2011, Leroy Hood wrote: “Medicine will move from a reactive to a proactive discipline over the next decade.”
HENRY KOTULA 