Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

Synthetic Life Created: The First “Micro-Avatar”

For the first time in history, a living organism has been manufactured with the help of a computer-generated genome. Dr. Jon LaPook reports on the groundbreaking discovery’s widespread implications.

Watch CBS News Videos Online

The First Micro-Avatar

Craig Venter and his team of scientists recently announced that they had created the first “synthetic cell” — a bacterium controlled by genetic material that they had designed on a computer and concocted from four bottles of chemicals. This is the closest thing to creating life that has happened outside of a science-fiction movie. If it doesn’t fire your imagination, then you should fire your imagination.

Basically, what Venter et al did was remove the “brain” (the genetic material that runs the cell) from one species of bacteria (Mycoplasma capricolum) and inserted a new brain — one synthetically created based very closely on the known genetic makeup of a second species of bacteria (Mycoplasma mycoides). The new organism then divided just as a normal cell would and followed the instructions of the new brain. Think micro-Avatar, except that the Avatar’s body morphs into one designed by its new brain.

Experts and non-experts are debating the implications. Did Venter and his teamcreate new life? Yes and no. On the one hand, as Venter said, “This is the first self-replicating cell on the planet to have a computer for a parent.” On the other hand, his team didn’t create the organism from scratch. They used the body (minus the brain) of an existing species.

One can imagine all sorts of wonderful possible uses for this technology. Organisms could be programmed to make stuff – for example, to create eco-friendly bio-fuels that reduce or even eliminate our dependence on eco-destructive fuels. Exxon expects to invest more than $600 million dollars to work with Synthetic Genomics Inc. — the company co-founded by Venter — to develop algae that can turn sunlight and carbon dioxide into energy. Bacteria could be designed and programmed to produce antiviral vaccines more rapidly than with our current method, which took almost six months to make last year’s H1N1 vaccine. And medical researchers might be able to develop new treatments by using this technology to study disease. Imagine tinkering with the genes of a nerve cell from a patient with Alzheimer’s to try to make the cell normal.

Ah, tinkering with genes. That gives a lot of people the heebie jeebies. Are we smart enough to fiddle around with genomes? What will be the unintended consequences?  Will we accidentally — or intentionally — create some new kind of bug that will wreak havoc? Will bioterrorists get hold of this technology?  Once scientists become nimble at synthesizing the human genome — about 6,000 times larger than that of Mycoplasma mycoides — will they use that technology wisely? Who decides how and when the technology should be employed? And how can those decisions be enforced?

Venter is keenly aware of the potential for harm and told me last week that he has been working with experts, ethicists, and the government to help develop ethical and regulatory standards. The last paragraph of the May 20th Science article reporting the breakthrough states, “We have been driving the ethical discussion concerning synthetic life from the earliest stages of this work. As synthetic genomic applications expand, we anticipate that this work will continue to raise philosophical issues that have broad societal and ethical implications. We encourage the continued discourse.”

I hope that the continued discourse includes the patent issues surrounding genetic blueprints — either dreamed up or based on a pre-existing organism. Strategist David Bollier has written extensively on the issue of the loss of “the commons” — entities that humanity has shared over the centuries such as the spice tumeric, neem seeds and DNA that have been claimed as private property by corporations.” Twenty percent of all human genes have already been patented. Though a federal court in New York recently ruled that genes may not be patented, Myriad Corporation had already patented DNA related to human genes that cause breast and ovarian cancer, thus in effect cornering the market for BRCA-1 and BRCA-2 testing for those diseases.

Here’s my take. This is an absolutely stunning milestone in a decades-old incremental path towards trying to understand what makes us — and other living creatures — tick. Nobody knows where it will all lead. You can bet your bottom dollar that not all of it will be good but that’s been true of just about every human advance. My vote is for an open discussion of the issues by people from all walks of life — especially  people with no financial interest in the outcome of the discussion. If we’re going to make the right choices, we need common sense and sound ethics as much as we need scientific brilliance.

For more on this groundbreaking discovery, watch the Science Channel’s “Creating Synthetic Life” show on Thursday, June 3rd starting at 8 p.m. ET/PT. The hour-long episode will be followed with a “question and answer” segment hosted by Paula Zahn at 9 p.m. ET/PT. And, if you miss the 8 p.m. show you can catch it again at 10 p.m. ET/PT.

You may also like these posts

Read comments »

One Response to “Synthetic Life Created: The First “Micro-Avatar””

  1. Edwin Leap says:

    Sounds like a great example of intelligent design, doesn’t it?

Return to article »

Latest Interviews

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

Read more »

See all interviews »

Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.


Click here for a musical take on over-testing.

See all cartoons »

Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

Read more »

See all book reviews »