When the Doctor Becomes the Patient
George Church is a professor of genetics at Harvard Medical School and a professor of health sciences and technology at Harvard and MIT. In 1984, Church, along with Walter Gilbert, developed the first direct genomic sequencing method and helped initiate the Human Genome Project. Church is responsible for inventing the concepts of molecular multiplexing and tags, homologous recombination methods, and DNA array synthesizers. Church initiated the Personal Genome Project in 2005 as well as research into synthetic biology. He is director of the U.S. Department of Energy Center on Bioenergy at Harvard and MIT and director of the National Institutes of Health Center of Excellence in Genomic Science at Harvard, MIT and Washington University. He is a senior editor for Nature EMBO Molecular Systems Biology.
Church: We’ve been using sequencing to help us discover some of the blockbuster new drugs, protein drugs, antibiotic drugs and so forth. But it’s transitioning to a time where it becomes an important component of personalization and preventative medicine.
I’m George Church, Professor of Genetics at Harvard Medical School.
Question: How will DNA sequencing change healthcare?
Church: The test, it’s kind of like insurance against floods or fires or something, you don’t say, 'I don’t need any insurance,' you just buy it and you hope you never need it.
Question: Why are electronic medical records important?
Church: Electronic medical records are incredibly important. We have a very mobile population and so they need to be able to easily get all new physicians in their life up to speed, that’s one utility. They might actually help with research in the sense that if people, the small set of the population that wants to participate in that, they can easily share their electronic medical records, that could help inform research of all types, noninvasive as well as drug-related. Electronic medical records could reduce errors in principal, you have to have great software and you have to have good training but if it’s coupled with devices and good practices, it can allow a very strong accountability and strong quality assurance procedures.
Question: How have electronic medical records helped you personally?
Church: Around 1999, very early on, they gave me full access to my medical records and I put all my medical records up on the internet and interestingly a hematologist contacted me and noticed from my medical records that I was overdue for a cholesterol test, having picked up a cholesterol drug, Lovastatin. And sure enough, I tested it out and it was having no effect; it was an inadequate dose and so that resulted in getting the right dose and the right diet and may have added many quality years of life in my case.
Question: How else is technology helping reinvent the healthcare industry?
Church: A huge one is really bringing the knowledge to the individual via the internet. It allows people to do social networking and so if they have a fairly specialized form of a disease, it could be a very common disease but if they have something that’s idiosyncratic, they’re no longer limited to their family, they can find other families that are similar to them. So that’s a potential use of technology, it’s actually quite simple and quite accessible.
Question: How can we improve access to healthcare?
Church: Access is a huge problem, not just to insurance, the 45 million that aren’t covered well, it has to do with long waits, it has to do with the inconvenience of traveling, and you can see the beginnings of revolutions around the edges, you can see more home test kits, more information available on the internet, more reliable information, ways of determining what’s reliable or not and so patients are coming in, when they come in, much more well-informed. Again, there are issues about false positives that you might get or false alarms by becoming, maybe, what people might think that’s too well-informed. But I think as a whole, as a population becomes more well-informed, has greater access to self-testing, we might consider that better access and it will lead to possibly reduced hospital visits, possibly reduced clinic visits.
Question: How can we improve integrative medicine?
Church: So, to make the transition to patient care of highly integrative technologies requires, along with the technologies, requires a lot of computer software and it requires computer interfaces so that to some extent, people can be directly educated and to some extent physicians can be educated because for example, genetics is new to almost all physicians, even in very sophisticated countries and so a huge component is software that does the integration. It used to be that a family doctor could do all these integrations, they could keep everything that they needed to know except for various specialized operations in their head and they could deliver the advice directly there during a house call. But now that the opportunity has been for years and is now becoming more realistic, is that far more information than a single individual or even a team could integrate requires prior development of software and constant vetting and updating of that software in collaboration with patient groups and physicians.
Question: What is the future of genomic medicine?
Church: The generic human genome is complete but we need to have this information for each individual because it’s very clear that we don’t all share the same genome. What’s very important is the differences from person to person, both genomic and their environmental differences and the integration of those. So some of the next big breakthroughs are going to have to do with how we obtain this information for each of the individuals at low cost and high quality and how they share it.
Genomics pioneer George Church found that cutting-edge medical technology added years to his own life.
Why do people with bigger hands have a better vocabulary? That's one question deep learning can't answer.
- Did you know that people with bigger hands have larger vocabularies?
- While that's actually true, it's not a causal relationship. This pattern exists because adults tend know more words than kids. It's a correlation, explains NYU professor Gary Marcus.
- Deep learning struggles with how to perceive causal relationships. If given the data on hand size and vocabulary size, a deep learning system might only be able to see the correlation, but wouldn't be able to answer the 'why?' of it.
One of the scientists with the Viking missions says yes.
- A former NASA consultant believe his experiments on the Viking 1 and 2 landers proved the existence of living microorganisms on Mars
- Because of other conflicting data, his experiments' results have been largely discarded.
- Though other subsequent evidence supports their findings, he says NASA has been frustratingly disinterested in following up.
Gilbert V. Levin is clearly aggravated with NASA, frustrated by the agency's apparent unwillingness to acknowledge what he considers a fact: That NASA has had dispositive proof of living microorganisms on Mars since 1976, and a great deal of additional evidence since then. Levin is no conspiracy theorist, either. He's an engineer, a respected inventor, founder of scientific-research company Spherix, and a participant in that 1976 NASA mission. He's written an opinion piece in Scientific American that asks why NASA won't follow up on what he believes they should already know.
Image source: NASA/JPL
Sunset at the Viking 1 site
As the developer of methods for rapidly detecting and identifying microorganisms, Levin took part in the Labeled Release (LR) experiment landed on Mars by NASA's Viking 1 and 2.
At both landing sites, the Vikings picked up samples of Mars soil, treating each with a drop of a dilute nutrient solution. This solution was tagged with radioactive carbon-14, and so if there were any microorganisms in the samples, they would metabolize it. This would lead to the production of radioactive carbon or radioactive methane. Sensors were positioned above the soil samples to detect the presence of either as signifiers of life.
At both landing sites, four positive indications of life were recorded, backed up by five controls. As a guarantee, the samples were then heated to 160°, hot enough to kill any living organisms in the soil, and then tested again. No further indicators of life were detected.
According to many, including Levin, had this test been performed on Earth, there would have been no doubt that life had been found. In fact, parallel control tests were performed on Earth on two samples known to be lifeless, one from the Moon and one from Iceland's volcanic Surtsey island, and no life was indicated.
However, on Mars, another experiment, a search for organic molecules, had been performed prior to the LR test and found nothing, leaving NASA in doubt regarding the results of the LR experiment, and concluding, according to Levin, that they'd found something imitating life, but not life itself. From there, notes Levin, "Inexplicably, over the 43 years since Viking, none of NASA's subsequent Mars landers has carried a life detection instrument to follow up on these exciting results."
Image source: NASA
A thin coating of water ice on the rocks and soil photographed by Viking 2
Levin presents in his opinion piece 17 discoveries by subsequent Mars landers that support the results of the LR experiment. Among these:
- Surface water sufficient to sustain microorganisms has been found on the red planet by Viking, Pathfinder, Phoenix and Curiosity.
- The excess of carbon-13 over carbon-12 in the Martian atmosphere indicates biological activity since organisms prefer ingesting carbon-12.
- Mars' CO2should long ago have been converted to CO by the sun's UV light, but CO2 is being regenerated, possibly by microorganisms as happens on Earth.
- Ghost-like moving lights, resembling Earth's will-O'-the-wisps produced by spontaneous ignition of methane, have been seen and recorded on the Martian surface.
- "No factor inimical to life has been found on Mars." This is a direct rebuttal of NASA's claim cited above.
Image source: NASA
A technician checks the soil sampler of a Viking lander.
By 1997, Levin was convinced that NASA was wrong and set out to publish followup research supporting his conclusion. It took nearly 20 years to find a venue, he believes due to his controversial certainty that the LR experiment did indeed find life on Mars.
Levin tells phys.org, "Since I first concluded that the LR had detected life (in 1997), major juried journals had refused our publications. I and my co-Experimenter, Dr. Patricia Ann Straat, then published mainly in the astrobiology section of the SPIE Proceedings, after presenting the papers at the annual SPIE conventions. Though these were invited papers, they were largely ignored by the bulk of astrobiologists in their publications." (Staat is the author of To Mars with Love, about her experience as co-experimenter with Levin for the LR experiments.)
Finally, he and Straat decided to craft a paper that answers every objection anyone ever had to their earlier versions, finally publishing it in Astrobiology's October 2016 issue. "You may not agree with the conclusion," he says, "but you cannot disparage the steps leading there. You can say only that the steps are insufficient. But, to us, that seems a tenuous defense, since no one would refute these results had they been obtained on Earth."
Nonetheless, NASA's seeming reluctance to address the LR experiment's finding remains an issue for Levin. He and Straat have petitioned NASA to send a new LR test to the red planets, but, alas, Levin reports that "NASA has already announced that its 2020 Mars lander will not contain a life-detection test."
Scientists discover the inner workings of an effect that will lead to a new generation of devices.
- Researchers discover a method of extracting previously unavailable information from superconductors.
- The study builds on a 19th-century discovery by physicist Edward Hall.
- The research promises to lead to a new generation of semiconductor materials and devices.