I hate our current medical system and I hate that industry runs it. I hate it because the medical field and medical industry all abide by a central dogma that “the answer to failures of a biological system (the human body) is a pill.” No. The answer to biological system failures is a biological system solution. It is learning how to manipulate your entire biological system and not just the one part you are concerned about. It is about learning to use the body’s systems to fix itself.
This is our fundamental problem with understanding disease. We subscribe to the belief that a diseased liver is an isolated problem and all you need to focus on is the liver. We forget the body is connected and we do not even explore solutions that might involve unorthodox approaches that manipulate entire systems rather than organs. We need a new dogma in medicine and the idea of personalized medicine might be just what we need.
There is a lot of talk right now about personalized (or precision) medicine after the President revealed his Precision Medicine Initiative. I think this initiative fails to recognize what personalized medicine really is and what is needed to make it real.
To me, personalized medicine is understanding how all the cells of the body communicate and respond to changes in the environment. The question though is how do you figure this out?
The first step is to identify the key metrics you need to understand the connectivity of the body’s systems. Once you figure this out, the next step is to monitor these in groups of people. Why groups of people? We cannot perform all of the controlled human experiments that would help us understand the body as a system because they would be morally and ethically wrong. So instead, it is about acknowledging that everyone makes choices that cause changes in their body. Your life is one giant experiment. Many people are probably similar to you and make similar choices. Many are similar at the biological level and make different choices. People are running around experimenting on themselves all of the time and nobody is asking them to come in so we can take some measurements and figure out what they are doing to themselves. This is the key. Let people be themselves and use Big Data analytics on the massive amount of data that is created from monitoring them. Monitor what the best available science tells us is important, group people into categories based on their metrics and life choices, and then figure out how different choices within a group result in health endpoints.
This is how collective monitoring results in personalized medicine. With such an approach, you will begin to really understand the system level of the body and how it responds to different life choices and the mechanisms for how those life choices alter human health. Then it is just a matter of looking at you and what you have done to make highly informed predictions about the future of your health. You cannot just study one person in detail for the same reason that you cannot study one bacterial cell and say now you know everything that that strain does.
The President’s Precision Medicine Initiative plays into the existing dogma that I loathe. It fails to see the forest for the trees. It is primed to use Big Data analytics on personal data, like genetics, to identify which pill works best for you. There is reason they chose the word precision rather than personal. “Personal” would imply a new dogma, one that really focused on you and not one that focused on the precise pill for you.