blog entry

The Evolution of Medical Treatment as a Personal Odyssey
Saturday 02/10/07

The year my folks were married, they both came down with Rheumatic fever. At that time, there was no treatment other than bed rest and crossed fingers. There were also no diagnostic methods to assess potential heart damage. My mom was told to not have children.

Fourteen years later, I was nine and came down with it too. But by then there was a treatment - penicillin. But there were still no diagnostics to assess damage. And the treatment had risks so it wasn't widely used at first. I was hospitalized for a several weeks. Missed most of a semester of school staying home or at the hospital.

That summer we four (mom, dad, me, little brother) and grandma took a road trip to checkout the desert clime of Phoenix Arizona.

That fall my brother began to have strep infections, which can lead to Rheumatic Fever. So the first week of the new year saw us in Tucson. We were taking the "southern" route to Phoenix. But we stayed in Tucson when my dad found a good job there.

We didn't think about genetic pre-disposition then. But I do now.

In Junior High School, I rode the bus and another kid in my class would get on later and sit next to me. One day, as we got ready to get off, he turned to me and said he had Leukemia and was going away for treatment. I didn't know what to say, other than wish him the best. Never saw him again.

Now there are four known types of leukemia with different treatments, different causal factors.
"Researchers have strong suspicions about four possible causes:
We didn't think about genetic pre-disposition then or how chemicals or viruses can lead to less resistance to other predispositions. But I do now.

I rarely missed school because of illness after that move to Arizona. But, as a young married man, I got the Hong Kong flu. I thought I was going to die and didn't care. Meanwhile my wife slept in the same bed, headed off to work in the morning, checked on me over her lunch hour and generally thought it couldn't be that bad. It was.

We didn't think about genetic pre-disposition then or how various anti-bodies can form from one "bug" and can lead to resistance to another. But I do now.

Now we have researchers teasing out gene factors where one expression of a particular gene is the "genetic predisposition" to a disorder. And the various expressions of another particular gene can predispose the person's reaction to various treatments: expression A means the common protocol X leads to cure, expression B means the common protocol X leads to slower deterioration while expression C means the common protocol X just might kill the patient.

Now we think about genetic pre-disposition and how various chemicals or anti-bodies can lead to more or less resistance to other predispositions. And, over time, this will alter the range of tools available to treat the particular predispositions of a person, as well as the disorders afflicting them.

That can change our personal future. It definitely changes the healthcare system we interact with. The role of the doctor will need to adapt to new diagnostic tests leading to new treatment protocols. It probably leads to blood work leading to tests of the particular gene involved with the "genetic predisposition" to a anamoly noted in the blood workup. Early "diagnois" leading to testing the related genes that predispose the person's reaction to various treatments for the "disorder."

Note I've begun to not use the term disease.
"A disease or medical condition is an abnormality of the body or mind that causes discomfort, dysfunction, distress, or death to the person afflicted or those in contact with the person. Sometimes the term is used broadly to include injuries, disabilities, disorders, syndromes, infections, symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts these may be considered distinguishable categories. In the narrow sense, a disease is the invasion of the body by pathogens."
I'm used to thinking of disease as something caused by something out there, as in "a disease is the invasion of the body by pathogens." Now half the diagnosis is about the body and what it does spontaneously or in reaction to pathogens "out there."

btw, my parents have been married nearly 67 years and are doing well.


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