I’ve probably posted this one before, but I’m feeling nostalgic today. Braden and Conor in front of the Globe Theater in London, 2007.
Flying across my Medium feed today came this article by one of my favorite weight-loss doctors, a nephrologist named Jason Fung. Dr. Fung is a proponent of Intermittent Fasting and low-carb diets as modalities for treating all sorts of illnesses, but specifically, of course, metabolic syndrome. In this piece, Dr. Fung talks about what has failed in understanding cancer in Western medicine, which as he describes it is a failure of appreciation of cancer cell dynamics, which are larger and systemic, as opposed to the genetic hypotheses of narrowing down on smaller and smaller genetic scales to find the “one bad gene” that messes everything up. He makes the point that a statistical number of cells have an ability to go bad, and that they mostly don’t, as long as larger metabolic dynamics are healthy. Here’s a great pull quote:
“The same problem exists in the SMT. We’ve zoomed into cancer too closely — right down to the genetic makeup of the cancer and it is gibberish. We can make no head or tail of cancer’s origin and therefore make no progress towards treatment. Over 100 oncogenes and over 15 tumor suppressor genes have been identified, but we don’t know what it all means as a whole. Instead of three blind men and an elephant, we have thousands of blind researchers and cancer. Each sees a tiny, tiny piece of the puzzle and can’t see the whole. The rate of mutation necessary to develop a cancer is far, far more than the known rate of mutation in human cells (Loeb et al 2001). Normal cells just don’t mutate anywhere close to what is needed to produce cancer. Further, while every cancer has mutations, it was not known what the ‘denominator’ was. That is, how many cells had mutations but no cancer. This turned out to be pretty high. You could alter 4% of the genome and still have a cell that looked and acted completely normally. This is a remarkable high degree of tolerance (Humpherys 2002)”
Students of this blog will recognize that what this is really is a classic social structure <=> knowledge structure development of Conway’s Law. We’ve created these fragmented, low empathy/low information exchange Authoritarian/Legalistic hierarchies in the medical research profession where instead of cross-associating among many disciplines and understanding the hormonal flows that create cancer, we have researchers competing for status at smaller and smaller scales by working to identifying “THE CAUSE” of cancer. This kind of research is quite literally killing us.
What this turns into is a clarion call for a new way of approaching medical research. It’s not just enough to have interdisciplinary teams if you keep the same disciplinary boundary fragmentation. You have to have enough people, interested in sharing information, with this important property:
Those people have to not just share information. They have to learn about each other’s disciplines enough to hypothesize and connect across them. No one gets shut down at lunch because they don’t have a degree in sub-discipline A.
In short, they have to evolve their empathy. It’s the only way we’re going to get to solutions in any reasonable amount of time.
Dr. Fung’s piece is well worth the read. Highly recommended.