Archive for December 13th, 2012

Or, “No, we aren’t there yet!”

Let me natter for a moment about the state of an art — trying to solve a public health problem from the basic science side.

You gather your scientists, and have them do the equivalent of laying out all of the cool things in their magical backpacks: “I’ve got a +10 tissue culture”, or “He’s just rigged up this sweet new potion of protection that we’re pretty sure will work because the 6 unicorns we tried it on haven’t turned to stone yet”, with a side order of “I’ve captured 6 nearly-identical Scrolls of Power, but I think they do different things….who wants to chant them out with me?”  After all the presentations and side discussions, you consider how far you have come in having new techniques to thwart or slay the Dragon.

Except even if saving rolls worked in these cases, there would be public protests over the ethics of using dice.

Ahem.  There’s a big gap between what we can easily study and what we really need to know about. Yes, we can grow some cells on nice agar plates, or in nutrient broths, and learn quite a lot.  About those cells that are willing to endure living on agar plates….

But, as modern genomics is telling us, the average human being is actually a conglomerate of multiple species of organisms — there are more cells in your body that are NOT you than there are cells with your genetic signature in them.  All those other bits of life — bacteria, yeasts, commensal and pathogenic organisms — are doing things — eating, multiplying, seeking to make their environments ‘just so’ — and some of those things really make a difference to human health.  But we don’t know for certain which things do what, nor what happens if you tweak the environment in x way, because we don’t know how many things change with each tweak. We’ve run through the biologic systems that only have a few variables; all the problems left to us are the big messy ones!

The basic scientists ‘solve’ the problem by owning it.  They stick to trying to isolate a very few variables and then tinker with those under controlled conditions.  And that tells us lots about a small number of things.  We can, to a certain extent, build with those small understandings, and we can certainly learn a lot about what we shouldn’t bother trying in more complex scenarios.

But public health issues are notable for NOT being controlled conditions: people are walking around with their individual genomes, and microbiomes, and perhaps not eating diets that promote healthy internal flora, or maybe washing so frequently that the external flora that human skin evolved in concert with cannot survive…Humans drink alcohol, they have sex [in lots of creative ways], they find inappropriate ways to express their anger or frustration —  all of these activities change the functions of the other systems involved, and yet we can’t yet model all those things in a laboratory.  Humans do things that make the best in vitro model look like a 2nd grade cigar box diorama made by aliens.

…People are still waiting for a cure, or a preventative, or a way to intervene, SOMETHING….

So the scientists soldier on.  Some wag will pipe up to insist that more research gelt should go to his flame-proof cape project, and the rest of the assembly will point out that this violates the Conflict of Interest forms everyone had to sign at the beginning of the seminar.

Sometimes the social scientists get to point out that “Hey, I’ve noticed that those extreeemely territorial Night Demons seem to only be active after dark: could we perhaps just travel during the day, then?  That would reduce mortality by much more than any of the other methods described so far…..”

For some reason, that’s generally rejected as a option.  Humans want to go wherever, whenever, and a subset of them seem to always be itching for a fight.

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