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April 17, 2012 @ 6:11 pm

Ecology and Medical Innovation

My interview with Metta Spencer is taking a looong time to edit, given the holographic nature of a 50-year career.  Everything is related to every other thing.  I have a little more sympathy for my students, who want to learn things one at a time, in a disconnected and atomized way.  But only a little.

Meanwhile (as they say in the comics). . .

Carl Zimmer was on Fresh Air today after my class let out at 3:15, talking about just how little we know about the roughly 3 pounds of microbes that make up our internal ecosystems.  He suggested thinking of them as a new organ, as important for our health as the heart, or the liver, or the kidney.  Particularly listen to his description of a fecal transplant about 30 minutes in.  I was shocked to hear him say they are 95-99% effective in these cases where antibiotics have screwed up the internal ecosystem.  That sounds much too easy . . .

This is a radically different way of thinking from Industrial Medicine (make drugs as cheaply as possible, and use them as often as possible), but it's not a new way of thinking.  The British Society for Ecological Medicine has been around for almost 30 years.  The Russians were using bacteriophage viruses to kill their natural prey, bacteria, as a way of treating infections before World War 2.  There's a review of that literature available here.  Why that cultural practice never took hold here is kind of an evolutionary, ecological question.  They mention several good reasons related to proof.  They don't mention the idea that  drug companies couldn't patent living things in the USA at that time, and that the FDA had no rules for regulating the production of living medicine (although they must have had rules for the yeasts and things that bakers and brewers use).  Those other reasons are more like ecosystem effects, really, like the gut bacteria Zimmer described in the interview being able to kick the disease bacteria out fairly easily (99% effective!).  Invading bacteria or invading ideas face the same kinds of coordinated resistance from whatever's there already.

The idea of the tail wagging the dog (my son is doing homework on idioms this week) is not limited to drug companies being able to set agendas for the medical community.  I follow Zimmer on Twitter, and today he mentioned this post on evolutionary biologist (and Corbin's academic grandfather) Jerry Coyne's blog, which is about how writing grants has become the primary job of the college professor.  From the university's point of view, we are no longer researchers or teachers, but revenue producers. I know it's true in my case.  The grants section of my CV is longer than the papers section.

When you change the goal of a system, you change the behavior of that system.  When your goal is to produce as many babies as possible (like an oyster), you get lousy parenting.  When your goal is money and not quality, competition will optimize the system for money at the expense of quality.  The unintended result is that the number of papers that have to be retracted (taken back) goes up A LOT.

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