"The journey into the complexity of life is one of the greatest challenges of our century and will succeed only if we shall collaborate internationally and manage to cross disciplines - all on a large scale." - Lee Kuan Yew's Distinguished Visitor, Chemistry Nobel Laurette, Prof Aaron Ciechanover
Today, I attended what I would like to describe as one of the most "inspired" and "thought-provoking" lectures. Just hours ago, the lecture at LT 19A at NTU is not by any lecturers, but someone of great portfolio and background, the Jewish Professor Aron who is also the Nobel Laurette. The whole lecture is about the drug discovery and a cure of all diseases, which include various issues and the subject of aging. The lecture is set in a way of questions and thoughts, and absolutely not just information or content-based.
Prof Aron talked about the 3 revolutions of medicine and drug discovery that changed the world, and doubled the average lifespan of humans. Discovering the concepts of microorganisms like bacteria and the discovery of antibiotics have made many things possible. He stated that based on the course of history, and the development in Science, it is very possible for the human to live more than 100 years as mean for the coming years to come. Even though, all drugs would always have some form of side-effects.
The 1st revolution is about the way civilisations discovered and use medicine especially herbs to treat diseases. Particularly the Egyptian, the Babylonian, the Greeks and the Chinese. Incidental discoveries and documented historical ones are being noted. A more recent context will be Penicillin and Aspirin.
The 2nd revolution is about the brute force way of finding the drugs to cure diseases. That means identifying the millions of chemical compounds and use them on screening on cell samples such as Hela cells. This is a huge process and with many efforts, time and money. Successful stories would be Statins (anti-LDL) and Taxol (anti-cancer).
The 3rd revolution which is a more modern or 21st century method would be a more "smarter" method of finding drugs. First, scientists would have to understand the correct mechanism pathway. From this, with the utmost understanding, specific drugs can be discovered or screened to fit the cure. Personalised medicine can be introduced because same diseases can be caused by different causes via mechanisms.
In the same drug usage, there would be responders and non-responders. The non-responders are the one that is of concern. New drugs would have to be developed for the non-responders. For example, breast cancer causes are molecularly different. Taxmoxifen might not work for every single breast cancer in the world. Genetic variations would have to be taken into consideration. Drugs like herceptin is also used for breast cancer but the mechanisms and etiology is different. Other examples such as CML (Central Myeloid Lymphoid) for the use of Gleevec by inhibiting BCR-ABL are also mentioned. There are obviously many etiology to a disease. (同病异治)
Henceforth, importance of understanding the different mechanisms that lead to the same results are important, as the pathway and treatments might be different, even though the results might be the same. This is the same thought as TCM. Cough and headaches, for instance, are common syndromes and hassles. However, the etiology and pathogenesis is different, and hence different diagnosis and treatment. I believe this will be the same as Western medicine, though western medicine explanation and theories might be more technical and have to be less philosophical. TCM has ways of explanation, which should not be judged whether they are wrong or correct. Such is the problem of the concepts and ideas that is related very closely to the fundamental aspects of the philosophy and inevitably, culture, and in this case, Chinese culture.
The best type of treatment, as supposed to the present limited concepts, would be to identify the ailment with cheaper and faster test (with Human Genome Help on the genetic basis). A good aim would be a short 15 minutes and less than US$1000, albeit not so cheap but yet manageable price for the identification of the mutations and the diseases for the genomes or karyotype of genes or chromosomes. The key would be PCR or genotyping and sequencing technology as diagnostic tools. Hopefully, by this sort of principle, merging the genetics aspect with Chemistry, personalised drugs development from the molecular level of epigenetics could be given to the individuals. This concepts sounds vaguely familiar with the TCM treatment process. However, for the present moment, some ailments such as different types of cancer could still have same treatment ( (异病同治). Malignacy of the tumours can have more than 70 mutation causes, but the result is the same and so a "one size fits all" drugs might befit the purpose and treatment itself. Essentially, concepts could not have an unification sort of theories or principle.
There are other issues, as usual, whenever it comes to the power of Science, especially breakthrough. In this case, the concern about the privacy, secrecy and information. Who should handle? Law, Religion, Science, Military, Government are all linked and can be highly sensitive. Not to mention the concept of Economics and insurances that are not impervious to the issues. Conspiracy such as the "Forceful and secretive" profiling and sequencing or even cloning of the genes of the individuals even when people do not want, is this morally or ethically correct? Is this some sort of theft? Can this be treated even as intellectual property rights?
Individually and personally, people would not want to live a life knowing he has some diseases or would fall sick at certain age or act as a carrier. This would affect the quality of life and the mental well-being of the people eventually, even with profound genetic profiling or aspects. It is a tricky issues, and indefinitely, it will affect the good way of life, the tradition and the society as a whole. Would that remove empathy or even compassion at the end of the day and increase the insidious discrimination and hatred?
Things are never simple but yet we should not be paralysed totally by not wanting to do anything. We are given the gift of Hope and we should appreciate and cherish and know how to use the gift of intellect and eventual wisdom which are a gift to us. We could make a national database. This should be an international issue with identification protection and the ever-waging wars with criminals and hackers and so forth. By far, thou shall not speculate for if it can reach that stage, then the solution should be found by the brilliance the generation.
Science is just tools like fire. It can be destructive or it can help or it can stay neutral by itself, a phenomenon. It is the users, Humans, at the end of the day who will decide on the moral, ethics, future, directions, abuses and the actions. Science advances should not be stopped just for the sake of stopping. Not all humans are evil and greedy just as not all humans are compassionate and generous. It is the thoughts and the intentions that count as much as the results that occur.
There is also the issue on the thought-provoking aspect of the longevity and anti-aging. There is this abstract concept of that nature will always have a way of dealing with us, essentially Biology in the case of the ever resistance and emergence of the pathogens like bacteria and viruses. The philosophy: If we are not killed by diseases, then what will kill us. To be frank, there are probably many ways that we will get killed a nd so we should stop worrying that and focus on the problem solving with far-sighted wills. In terms of knowledge, can we ever be omniscience? The more we know, it seems we will never know enough or not really know. Am I thinking too much? Perhaps. But as Socrates famously said, "The only thing I know is that I know nothing". This is especially true about the exploration of diseases or even life per se. We are still at the newbie or ignorant for all we know.
Another imaginative thought of the what-if scenarios would be what will happen if we truly gain the miracle way of the average age of 100 years old, by today's standard and present context? This would have make an interesting Science fiction anyway.
Finally, to the concept of TCM and herbs. Prof Aron has mentioned during a question posed by a Biological Science student doing TCM final year project. He is disturbed while touring in China, with many hawkers, putting many different herbs into his pocket and spreading the inaccurate information about the uses of herbs and so forth. As a practitioner in Medicine, he is bothered by the truth or even the way the herbs are used. In other words, he is entirely concerned about the TCM itself. He knows that TCM is a treasure cove, but it should be well regulated, managed or organised and researched. His question is or the herbs, will it work on everyone?What is the check? Where is the statistics? There should be profiling of every herbs. Drugs like statins give "guaranteed" results not withstanding genetic factors in dealing with cholesterol factors.
As a TCM learner, I would have answered him that the TCM concepts are scientific in nature as it does hit the nature of empirical observation and achieving high effectiveness for treatment especially by very good physicians. It is the rationale that the Western scientists or even doctors will never fully comprehend due to cultural or philosophical lack of understanding. TCM should not be treated as unorthodox. Even if things are done differently, not necessarily, it is always wrong. I do admit TCM industry still have many misgivings, with some bad practices and TCM hawkers or doctors still in the market and around us. It is not a hit and miss thing, let alone luck, as long as the diagnosis is well done. However, like many other things in the world, it cannot cure everything. Of course, there will be advantages and disadvantages to every single sort of treatment, and henceforth, they should be treated as tools to be used for the well-being of patients in mind. Perhaps it is the responsibility of some, perhaps people like me, to make aware of the better communication to the current scientific community and minds about the alternative treatment of TCM. There should not be condescending, there should not be bias or unfairness or even the discrimination of superiority. As the saying goes by Deng Xiao Ping, a former premier of China, "不 管是黑猫还是白猫，只要能捉到老鼠的猫，就是一只好猫！"
Overall, I have gained a lot from the sharings by Prof Aron. I am inspired by him and do want to service the Man kind in terms of diseases or pathology. Great minds do think alike, and hopefully, I could be part of the forces or phenomenon that will usher in the new era of health and well-being for the Mankind. For now, I shall focus on what I can do best. To learn and apply as much as possible. To stay healthy in both physical and mental aspects. To set examples, so that the same advice could be given to the people around other than the patients, and of course to gain the trust so that things could be done.
Faith and hope ... And perhaps, only time can tell ... -_-x
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