Medical student resources

Top biomedical issues of 2001

I had the good luck recently to pick up a book called "Medicine’s 10 Greatest Discoveries" by Drs. Friedman and Friedland. To tell the truth, I expect a boring 10 minutes of reading before I put down the paperback, but instead I got sucked into a series of well written stories about the great medical scientists of the western tradition, their scientific problems, and their love lives. It inspired me to write down what I thought were the most important medical issues for our generation of students and young physicians. I've listed my "Top Three" here - but this is a personal list and you might disagree.

  1. AIDS. Without a doubt, this is the most socially charged and frightening epidemic that our generation of Americans and Europeans has seen. For Africa, "socially charged" and "frightening" would be huge understatements of the problem. AIDS has turned modern medicine on its ear - forcing us to a learn a whole new type of medicine. Along with the immuno-suppression of AIDS weave seen many of the "old" (like TB) or "rare" (like Kaposi’s Sarcoma) diseases strike with a vengeance. It forced modern-day politicians and policy makers to realize that they are in large part responsible for public health - few will forget how President Reagan basically ignored AIDS because it struck a subpopulation of Americans that he did not want to acknowledge. In addition to changing how we think about personal responsibility in the context of a global epidemic, HIV has forced us to develop, really for the first time, a series of pharmacological treatments for viral infections. In the long run, that is, when AIDS as a disease is controlled world-wide, we will be left with the legacy of a new understanding of viral illness and how to treat it.

     

    For an excellent piece on the 20 years of AIDS, see the San Francisco Chronicle's and SFgate.com's "AIDS at 20".

    "And the Band Played On" by Randy Shilts (1987) is a classic account of the "early" history of AIDS.

  2. The human genome project. The completion of the human genome project has been compared to landing men on the moon - but practically speaking, I think this is going to have a much larger impact than that truly amazing, yet mostly symbolic, achievement. In fact, it's not just the "human" genome that will transform our understanding of normal physiology and disease, it's that we will soon be sequencing the entire genome of at least one species a year. This will give us tremendous insight into what is common to life on earth, and what is unique to humans, to family groups, and to the individual. As students of medicine, it will change how we learn about the body. Comparative anatomy will yield ground to comparative genetics, family history will yield ground to 10 minute single-chip genetic screens, and family planning will take on a whole new dimension.

     

    The DOE's "Human Genome Project" home page and the company "Celera" home page are "official" sources of information on the genome projects.

  3. Cloning and germ-line modifications. While some technical hurdles still exist, there is little doubt that a human being can be cloned sometime in the next 10 years. Combined with the ever-increasing ability to change genes in germ lines, this means that the days of genetic engineering of humans are right around the corner. This presents one of the biggest challenges to our generation of physicians and medical scientists - to develop a set of moral and ethical codes to regulate genetic engineering. There is no doubt that this technology will be used by someone, somewhere - so we won't have the luxury of just burying our heads and saying "it's wrong, let's ignore it."

     

    For a general site on human cloning try "HumanCloning.org" and an introductory discussion on cloning ethics try: Genetic Encores: The Ethics of Human Cloning by Robert Wachbroit at the Maryland School of Public Affairs.

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