Is genomics a medical game changer?
In “Am I My Genes?,” the psychiatrist and ethicist Dr. Robert L. Klitzman plunges readers into the world of genomic medicine as it exists today: a barely mapped terrain of immense overlapping uncertainties. Many thousands of patients are bravely stumbling along in there: The book is based on interviews with 64 whose family history suggested a risk for the mutations associated with breast and ovarian cancers, the neurological killer Huntington’s disease or the destructive lung condition alpha-1 antitrypsin deficiency… Dr. Klitzman moves through all the basic landmarks, including the big ones: “Do I want to know?,” “Whom should I tell?” and “Why me?”
But for uninvolved observers, perhaps most striking is the book’s clear demonstration that science of the future notwithstanding, human beings faced with illness or its likelihood tend to react in the same old human ways. They protest, weep, change their diet, blame stress, consult a psychic, consult another psychic, accept the inevitable and generally muddle through valiantly.
In other words, the genomic revolution may not wind up changing the landscape of illness quite as much as its proponents may envision: patterns of thought and reaction run deep. As one of Dr. Klitzman’s patients remarks calmly, “It might run in families, but I don’t think it’s genetic.” She may have the family cancer, but “now, everyone is showing up with cancer.”
Well, when personalized, ‘omic medicine does more than just predict disease outcomes, when it actually and reliably leads to cures, remissions, etc., then people will have to accept the inevitable less often. I don’t imagine that this will put psychics out of business, but it will relieve a lot of suffering.