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The Personal Genome Project

Harvard researcher, Dr. George Church, is spearheading a project that would make complete personal genome mapping available for a mere $1000. I read his research subject recruitment disclaimer. Here is a choice excerpt:

Volunteers should be aware of the ways in which knowledge of their genome and phenotype might be used against them. For example, in principle, anyone with sufficient knowledge could take a volunteer’s genome and/or open medical records and use them to (1) infer paternity or other features of the volunteer’s genealogy, (2) claim statistical evidence that could affect employment or insurance for the volunteer, (3) claim relatedness of the volunteer to infamous villains, (4) make synthetic DNA corresponding to the volunteer and plant it at a crime scene, (5) revelation of disease lacking a current cure.

I wonder what personal genome mapping means from an ethical and legal perspective? Are we equipped to handle the possible privacy violations and prejudice inspired by DNA coded predispositions? On the one hand, customizing medical treatment to a person’s genes offers some of the best hope for optimal care and cures. On the other hand, having your genes on public display could put you at risk for the five problems described by Dr. Church.

These are exciting and frightening times.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Fly The Ball

I had lunch with an extraordinary physician today. She came to the US from Pakistan 30 years ago with a medical degree, a little girl and a baby on the way. Since she was a foreign medical grad, she had to accept a position at a less competitive residency program in New York’s inner city (even more violent and dangerous then than now). She made it through, with several near muggings and death threats but longed to work at a hospital where she and her girls could be safe.

One day she came upon a large, clean naval hospital and on a whim decided to join the military so she could work there. She served for two decades as a navy physician, and learned many life lessons along the way.

As I hung on her every word, my friend told me about her experience with navy pilots. She said that one of the scariest maneuvers is landing a plane on a dark aircraft carrier on a rolling sea. The pilots dreaded these drills, and truth be told, the officers were more worried about losing a 3.2 million dollar jet to the ocean waves than the life of one of the pilots. “There will always be another pilot. They’re not in short supply. But the planes are expensive.” This was the attitude drilled into the young aviators.

In order to land the plane in the dark, the pilot had to learn to trust completely in his optical landing system. It more or less consists of a pin icon with a ball on top, and a series of red, yellow, and green lights. The goal is to keep the ball well centered so that it remains green for landing. Achieving this is called “flying the ball.” In total darkness with crashing waves and a rolling deck, a successful arrested landing is difficult and perilous.

As I looked at my friend, a petite and beautiful woman, I tried to imagine what life was like for her as a young Pakistani resident – pregnant and alone in a concrete jungle filled with graffiti, trash, and drug addicts. Her life has been an incredible journey with ups and downs, and amazing success against all odds.

“How did you do it?” I asked her, shaking my head. “How did you get where you are today through all that adversity?”

She paused for a moment, then grinned slowly as she replied: “I learned how to fly the ball.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Dr. Val & Dr. Anonymous Podcast

For those of you who missed the Blog Talk Radio interview last night, you may enjoy the audiocast at your convenience by going to Dr. Anonymous’ podcast archives and clicking on the Dr. Val show.

We talked about:

  • How I got started with blogging
  • How I came to Revolution Health
  • What Revolution Health is and does
  • Abnormal brain MRIs
  • Kevin Everett’s spinal cord injury
  • MRSA
  • Cough medicine and kids
  • Concierge medicine
  • The Internet and the future of healthcare
  • My Halloween SNAFU

Click here to enjoy the conversation (you should start the podcast at minute 8 since we had technical difficulties with the audio prior to that minute). Thanks for listening!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Normal People Have Abnormal Brain MRIs

A recent research study suggests that as many as 7% of adults over 45 have had a stroke without even realizing it. Researchers performed brain MRI scans of 2000 “normal” (asymptomatic) Dutch men and women between the ages of 45 and 96, and found that 7.2% of them (145 people) had evidence of an infarct (stroke), 1.8% (36 people) had small aneurysms, and 1.6% (32 people) had benign tumors (usually a small malformation of the blood supply to the brain).

Interestingly, they also found one person with a primary brain cancer, one person with a previously undiagnosed lung cancer that had metastasized to the brain, one person with a life-threatening subdural hematoma (brain bleed), and one person with an aneurysm large enough to require surgery. So altogether, they found 4 people out of 2000 who needed urgent medical intervention.

Although the authors of the article emphasized the point that many “normal” people have harmless brain abnormalities – I was a bit surprised by the fact that they found 4 asymptomatic people unaware of a ticking time bomb in their brains.

Keep in mind that the study was conducted on middle class Caucasian adults in the Netherlands – so we cannot generalize these findings to more diverse populations. But I do think it’s a bit of an eye-opener.

MRI scans are quite expensive (well over $1000 in most cases) and are therefore not offered to the general population as a screening test. But it does make you think about saving up for one. Your radiologist may find something unimportant, or she may find something that you hadn’t bargained for. Or maybe one day the technology will be inexpensive enough to offer as a screening test in a primary care setting. But that’s not going to happen any time soon.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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