Question: How can we promote better collaboration between doctors and scientists?
Paul Nurse: The training and also the way of actually carrying out the profession is quite different between a scientist and a doctor, understandably so. That's not a criticism of either side; it's just how it is. So then we mix two sorts of people like this together, in the same activity, and we expect them to work together, it's like mixing somebody who only speaks English with French and assuming that it is going to work, it won't.
So what do we do about that? First of all recognize the problem and analyze it. And then secondly, we have to deal with it. We have to get the two types of individuals to understand their differences, to see where they are coming from, to realize why they have differing views, and how they can perhaps work best together.
Do you think any of us in the biomedical profession take the slightest bit of notice of trying to do that? It smacks of Sociology and stuff like that. We don't. But this is something where we really need to think in the future.
Have I applied it successfully in my own work? My own work has tended not to involve directly medicine, so I've not being exposed with my own research in that way. But I have seen it many times in my colleagues, and because I've led research institutions, and I've done my best to, at the very least, get mutual respect on both sides of that divide.
I actually think we need a much more professional approach on that problem. I would say it's key for greater success in this area.
Question: How can we improve preventative medicine?
Paul Nurse: Prevention is really important. It's often not given the airtime it should by the scientists themselves because it's quite a difficult subject to study and often requires very long-term trials, sometimes over decades, with large numbers of individuals before you can get good statistical results. It doesn't fit in well with a normal scientific career. If you got a PhD of four years, say, knowing that you're participating in a study that takes 20 years to carry out, it just don't fit. It's quite difficult to do good work in some cases in this area.
It's also a very complicated issue. We all know of individuals who've smoked 40 cigarettes a day, who live till 90. But of course we know that if you do smoke 40 cigarettes a day on average in the population, your life expectancy can be reduced 15 or 20 years (I forget exactly the number). So, it's a hugely negative impact upon your health, even though certain individuals may actually survive that.
Understanding the interaction between the impact of environment with genetics, is really crucial in getting good preventative advice out there. But, this makes these epidemiological studies, that's population-based studies, as their called, even more difficult, because you're not only then trying to simply control for whether an individual is exposed to a particular environmental impact, such as the sun or tobacco or whatever, which is difficult enough in itself, but you're also saying we need to subdivide the population up according to their genetic make up to get good results. And we may not even quite know how to divide them up and which particular variant of genes are important.
These are difficult problems but we are beginning to get into the territory where we can perhaps address them. Maybe that will help us put to rest a lot of the quackery that can go round advice about prevention. I would really like to see that because there is so much nonsense published out there. The media like it because it's relatively easy to understand, and it's a scare story.
If we ask questions like, "Is butter good or bad for you?" I can never remember because what was the last thing I read about it? Usually the reasons that we, as a public, get confused about such matters are that are reported are actually pretty small, and it all depends on the context of the trial, let alone the genetic make up the individuals involved in it. And we get blown around like a weather vane by just the latest report which is often made to be rather sensational.
I see this being rather slowly developed, because the studies have to be so long-term, and we're not yet in a good place for looking at the interactions between genetics and environment well. But I think it's really important because if we can give good advise to individuals about what their lifestyle is, that's going to have the big impact.
Recorded on: May 20, 2009