September 2010
From the desk of Dr Sam Shohet
BDS MGDS LiAc MBAcC ICAK
Bringing Medicine into the 21st Century and Beyond
DNAWe all accept that without genes there would be no life on our planet. Centuries ago Mendel discovered how heredity works but it was not until 1953 that Watson and Crick showed the structure of DNA as being a double helix. This was a profound discovery and it clearly showed that genes are able to replicate and copy themselves and that they are responsible for far more than simple heredity.
The Quest for the Genome Since then gene science has advanced at an astronomical pace and we began to understand far more about the intricate workings and associations of our genes culminating in the sequencing of the Human Genome in the year 2000.Although that in itself was a historic achievement, it was the realisation of the importance of the epigenes, or what we once called junk DNA since they did not code for a protein, that turned our understanding of genetics on its head.
Gene FunctionWe now know that genes are responsible for every single change in our body, that diet, lifestyle and environment can and do affect that change, that even emotions and stress may alter the outcome of our genes and, above all, that these changes can become hard-wired so they are transmissible to our offspring. Just consider what this means! It means that a mother in a stressful situation and going through hard times is able to transmit these emotions to her unborn child so the child is born already wired to express these negative emotions immediately they are triggered! The consequences of these emotions we recognise on a daily basis on our streets and in our schools to name a couple of instances. It means that a mother who is going through austere times where nutrition is almost non existent, will transmit this to the unborn baby so the child, once born, will convert every morsel of food into fat and store it for a rainy day! The consequences of that in a society where junk food is the norm and where there is no shortage of food are plainly evident.I could go on with examples and possibilities but I am sure that you are beginning to appreciate the wide-ranging implications.
The Present Practice of Medicine Despite the fact that every single cell in our body carries EXACTLY the same DNA making every one of us unique, for well over a hundred years Medicine has been more concerned with changes in an organ or a tissue rather than the cause or the reason the change had taken place. Treatment methods were devised to reflect that: surgery, radiotherapy, chemotherapy, drug therapy and so on. As a result of that thinking, we found it necessary to learn the specific role of each and every organ and tissue without paying too much attention to its relationship with the rest of the body. For example, cancer which appears in the breast tissue we recognise as BREAST cancer and we treat it differently to cancer which appears in the lungs, the stomach, the throat and so on. But surely if every cell has the same DNA, does this not logically mean that that INDIVIDUAL has undergone a change in DNA expression that is manifesting itself in different tissues because of their specialisation and not because they are completely separate and cut off from the rest of the body. Does it not also logically follow that we should be looking at whatever is affecting the individual as a whole rather than to treat only the diseased organ or tissue? Failure to treat the cause will surely, sooner or later, result in some other organ or tissue becoming diseased. This flawed thinking plus the fact that Medicine has not kept up with the advances of science of which it is a part, is really quite odd.
The Bizarre AnomalyWhat is odd is that a great deal of this groundbreaking research is carried out by research departments within the very same teaching establishments usually charged with the teaching and training of our future doctors. This research is mostly either commissioned by a third party such as a drugs company or for postgraduate research, yet the findings are never passed on to the teachers of the medical schools to incorporate within the teaching curriculum. What is more curious is that some of the researchers will sometimes double up as undergraduate teachers.
A Fundamental Change is ImperativeIt is all very well instituting drastic changes in the way the NHS is run to save on spending the ever-escalating billions, but surely we should be looking far more at the fundamental change needed at the very root of the system: the way we educate our medical students. Once our doctors are shown that we are the product of our genes and that the outcome of our genes is dependent on external factors such as diet, lifestyle and environment –genes can either be turned on or off with no intermediate position - then it is far cheaper, longer-lasting and more effective to address any problems that ensue.Only then would we be treating the individual as a whole rather than the bit parts which make up the whole.
A Brave New World There is no need for bravery here in thinking that this is still unchartered territory and the realm of science fiction because it certainly is not. The pharmaceutical companies have been using gene research and the understanding of how genes function for decades to manufacture drugs which target certain diseases by switching genes off – it is impossible to target single or groups of genes since they are all interdependent and hence ALL drugs have side effects for which other drugs need to be given and the very reason the average pensioner is on a cocktail of four + drugs. Also, Harvard Medical School has reorganised its entire teaching curriculum to reflect the importance of system medicine where individual organs form only a part of the whole and where treatment is of the whole body rather than its individual parts. Our quest should no longer be the specific treatment of cancer, diabetes, depression or cardiovascular disease, but rather the identification of the factors that have affected that individual’s genetic outcome and have led to the adverse alteration of their state of health and wellbeing.
Now or Never The biochemistry is there, we just have to decide how we wish to use it. Do we stay with the present system which is basically doomed to failure and, once again, see all our efforts become another total waste of time, money and, above all, hope? Or do we embrace the latest findings that every organ plays a bit part for the whole and that the whole is far greater than the sum of its parts? Much like an orchestra where every individual instrument plays its role in a section to create the final masterpiece; not alone but as part of the whole with the ultimate prize being resounding health. For only then can we finally bring this dinosaur into the 21st Century.
With warm regards
Sam Shohet
For more information:
01483 522133
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