Raising the Physician Voice

Physicians Should Stand Up for Science

In this edition of “The Wired Practice,” Ron Harman King of Vanguard Communications says that although gene therapy, stem cell research, and pharmacogenomics are leading the way into the future of medicine, society continues to exhibit “Frankenstein phobias.” Doctors can ease those fears by joining conversations about science and risk.
Watch the video on MedPage Today

Video transcript

Three big science stories in the news recently have captivated my attention. And there’s an unusual link between them that fascinates me more. First, came a paper published in the journal Nature, wherein a team led by biologist Shoukhrat Mitalipov at the Oregon Health and Science University demonstrated the possibility of altering human embryo DNA to prevent congenital disease.

Gene editing, mountain goats and babies, oh my!

Perhaps not surprisingly, much of the public reaction to the so-called gene editing breakthrough focused on worst-case scenarios: designer babies. In my small-sample observations, callers and guests on talk TV and radio often seemed more worried about abuse of the technology than its potential, despite the possibility that it could lead to eradication of some of the worst of human diseases.

How quickly they must have forgotten little Charlie Gard. Charlie was the one-year-old boy in Great Britain whose parents desperately fought in vain to bring him to the U.S. for experimental therapy for mitochondrial DNA depletion syndrome. Ironically, Charlie died the same week the gene editing news broke.

Which leads me to the third huge science news story the exact same week about grizzly bears, mountain goats and human urine. What? You didn’t see it? It was in the New York Times. Big as day.

A study published in the journal Biological Conservation reported the finding that mountain goats in Glacier National Park are increasingly congregating around human hang-outs – specifically trails and scenic overlooks where tourists pee. Over three years of observations, scientists discovered two reasons. First, the goats consume salt from the dried urine. And second, where there are humans, there are no grizzly bears, which prey on mountain goats. In the most interesting part of the study, a researcher dressed in a grizzly bear suit and noted that goats used to being with humans did not flee as far or as fast as their backcountry counterparts.

Physicians as teachers of science

I see a parallel among humans: Many of those more afraid of designer babies than of future Charlies have not had the advantage of a certain experience, just like the goats. Namely, people without a science education often leap to assumptions and conclusions that scientists are trained to avoid. We shouldn’t blame them. It’s like the saying attributed to Mark Twain: “We’re all ignorant. Only on different topics.” Within this context, I see a vital role for physicians to play in society, that as teachers of science.

Social researchers tell us that humans generally are much more motivated by fear of loss than by the reward of gains. For this reason, when it comes to research on genes and gametes, the natural instinct is to think in Frankenstein terms. We witnessed this in full force forty years ago with the arrival of in-vitro fertilization. The parents of the first IVF baby in the world – Louise Brown, of England – received bags of hate mail after the birth, including letters covered in red liquid, a broken glass test tube and a plastic fetus. Since then more than five million babies have been born through IVF, and the technique is now widely accepted. But new Frankenstein phobias have arisen around gene therapy, stem cell research, and pharmacogenomics. For every research health scientist who envisions a salt lick around the corner, thousands see only grizzly bears.

Thus, I believe health caregivers should join the public dialogue about the risks AND the immensity of potential rewards of scientific research. I know of three ways to do so.

On the smallest of scales, one way is in clinical and social conversations – with patients in exam rooms but also at dinner parties, at the grocery store, at places of worship, wherever a controversial science topic might come up. In these settings the professional clinician has the opportunity to remind others that people don’t become physicians and scientists to make a quick buck creating super babies. Rather, their training and interests are laser-like targeted at alleviating human suffering. Repeating this message may make a small effort individually, but collectively it could have great effect.

Don’t just author research studies, author blogs as well

Second, we have this amazing invention called the internet. And the beauty of it – some might also say its curse – is that anyone can be a publisher and a journalist. The internet lets you repeat your message to thousands, hundreds of thousands and even millions of humans. This is why I’m a huge fan of physician and scientist blogging, as well as use of social media to communicate to the masses.

Three, for those of more daring spirit, there’s the mass media. Newspapers, TV newsrooms and news websites have a voracious hunger for science experts to interview. Make yourself available when big science news breaks. And don’t be bashful about submitting opinion essays and letters to the editor. For example, Robin Lovell-Badge ­– the British scientist co-credited with discovery of the gene on the Y chromosome that determines sex in mammals – reacted to the gene editing news by penning a newspaper column that said, and I quote: “Knowledge is power. But it is not the scientists alone who wield that power, it is society as a whole. In the future, thanks to science, diseases that have blighted families for generations could be wiped out.”

Generations of blight could be wiped out. That, my friends, is heap big medicine. In this spirit, I offer this humble insight: The physician has a voice. Use it. If you don’t speak up for science – for Charlie and for millions like him now and for decades to come – who will?