Putting Two-and-Two Together

INVENT.

A poster in the room where I spend some of my days studying is one of few words, including the one above and "motorola.com" (from the respective sponsor of the poster), but to me it means a lot. It has various gears on the poster in a red/blue/green color scheme, and sometimes I'll just look up to Learning medicine isn't just about the memorizing of rote details and quirky facts, it requires an ability to put information together. Kary Mullis in the short TED talk I had an opportunity to watch a few days ago was a man who was able to do the latter.

Kary Mullis, who is credited for invention of the Polymerase Chain Reaction (PCR), in this talk took two very well known pieces together and was willing to take a risk with them:

1) Knowing that there are specific molecules in transplants that are attacked by the human body.
2) Knowing that there are species of bacteria that are achieving resistance to antibiotics.

Putting two-and-two together, as seen in this talk:

Why don't we come up with a way to tag these antigenic molecules to the resistant bacteria, so the body utilizes the molecule to increase effectiveness of the immune system on these organisms?

I'll have to say that is good thinking there. I betcha the idea to some scientists might have seemed quite silly at first, but Mullis went ahead and tried it. He seems to have progress with his research. And I admire him for his ideas, for that's medicine (like I've probably seen seventeen-thousand times in my blog): not just treating people, but working towards preventing any health obstacles foreseen (and unforeseen) ahead of us.

Thinking about how "simple" it was just to put those two ideas together, in reality it seems to take a lot of guts, risk, and work.

Oh... So that's where that came from?

Above: My old workspace in the Aquatic Ecology Lab, during my old research days at the University of Illinois, Summer 2007.

“To me it was obvious, we can’t improve survival unless we test new treatments against established ones.”
- Dr. Scott Ramsey, M.D. in the New York Times.

Looking through a First Aid book the first few times may be daunting: in almost 400 or so pages, the book tries to compile the whole nine yards about the human body. And in order to compress all that information, the information comes in quick-n'-dirty tabular form, where usually the information can only be understood if school had taught that concept properly (at least with the way I studied... so I thought).

But amidst this compression, I think sometimes us med students neglect to acknowledge how much effort and time actually goes into the conclusions that is now common knowledge for medical students. At a point, what we sometimes think now is a typical fact, was previously a conclusion that was came upon due to a series of clinical trials or scientific experiments. Who knows how many studies led toward a single line of "common symptoms" that us clinicians (with the MDs, DOs, and others) need to know.

In the series called the "Forty Years War" in the New York Times, I read a few weeks ago about how getting cancer patients to participate in studies has been quite a fight. From a patient's point of view, initially, the costs mount up quite well: the treatments aren't guaranteed to work, there might be risky side effects, and there's quite a deal of "red tape" and extra meetings that the patient needs to participate in order for the researchers to gather data.

For instance, in one of the latest New England Journal of Medicine articles that I've read, 3200 patients were selected for a study. Even before the actual treatments and data collection were underway, 3059 of them were already excluded (everything from not meeting minimum patient criterium to not even wanting to be a part of the study). That left 141 people to represent the thousands of people with similar conditions in the study. That's quite a small sample, but the researchers did the best with what they had.

In the world of research, the smaller the sample size, most probably the less powerful the findings. I don't know we could exactly fix this problem though... the benefits are there, but I can definitely empathize with the patient, and their concerns. However, they are the ones that hold the power towards the progression of treatment in the world of medicine.

Using lab animals just isn't the same as using good old 100% human beings.

Source: The New York Times & The New England Journal of Medicine