For the third time in my life I had to stand at the deathbed of a man I loved and say goodbye. First was my father, at age 90, after a long full life. My best friend and college roommate, taken from us before his 30th birthday. And now the dearest friend I made in adulthood, so brimming with vitality and poised at the cusp of retirement that I cannot accept the fact that we won’t be spending our golden years together.
The cause in all three cases was cancer. Cancer, with which we’ve been at war for over four decades. Cancer, a disease we fight in the trenches, with progress measured in inches, not miles, amassing casualties into the millions. Cancer, fighting for the same ground, over and over. Cancer, a war still waged with medicine’s most barbarous weapons: Poison. Radiation. Amputations.
Yes, progress has been made. Survival times inch ever upward. Hope is served to patients desperate to believe. But our battle plans are trapped in a failed paradigm. The science is stalled. Massive investment continues to flow, but much into the wrong places. Try as we might to poison the metastatic agents of death faster than we poison the people we love, the chameleon character of living cells are imbued with a power so great it once turned pond scum into us humans. But by its nature, such awesome power includes a tremendous capacity for evasion.
So how do we defeat biology at its own game?
To win, we must look beyond the metabolic battlefield and decipher biology’s enigma machine. We must learn to read the coded messages that tell the chemistry what to do, so we can countermand selected orders and replace them with messages of our own. We must seek out, train, and empower the Alan Turings who understand that information theory must be used to more precisely aim the weapons chemistry and biology provide. We must open a second front where science can commandeer the control plane that directs the living force in all creatures.
This will not come without risks. It will not come without setbacks. And it will not come without controversy, unintended consequences, and unforeseen avenues leading to both good and evil. But there will be no greater triumph in medicine than truly cracking the code of life when it misfires and causes death.
We’ve seen glimpses of that future, yet still too dim and uncertain to fully comprehend. But I know we will one day win this war. Alas, too long from now to save my dear, dear friend.