PASSING FOR NORMAL

Science.. What is it good for?

I still remember reading into biology books and getting very enticed and challenged whenever I would reach the end of a section describing an unknown function of a protein or a gene. I remember the way I used to eat up pathways and go through them in my head like reciting poetry. I remember the scientific discussions with the new comers and the fresh ideas about how to cure a disease or another. I remember the hopeful passages of significance we included in dissertations and proposals about a non-ventured route in drug development and a potential gold mine for therapeutics. I remember knowing all there is to know about the intricate cross talks and upstream and downstream regulators that lead to cancer. All what could go wrong and all what could fix it. I remember walking to the lab everyday going through the hospital, faces, shaved heads and little hopeful kids and I remember the vow we took to keep working and to make a difference. We wanted to make a difference and we believed that this is the ultimate selfless way to do it.

For years we were pupils of greatness, void of any self-interest. To us, this was the noble venue, far from being money-oriented and far from the glamour or the instant gratification of immediate care giving professions. Science was our salt and bread. It was what we lived for; it was our passion and existence. Part of us had the discipline to love science for the knowledge and the intrigue; we called them the NSH group. Others were NIH idealists, including myself, and we believed in funding for human’s sake. We did not care about funding for imaging spectroscopy of compositional maps of Saturn's moon Phoebe and we did not care about crystal trays of some gene in yeast that did not have human homology. We cared about money for human diseases. We cared about every penny and every minute of a researcher’s time and focus to go towards curing diseases. We could not bear looking at those ill faces while we stood useless and we would not stand for indifference. The idea of an AIDS vaccine not made available for people so that it won’t encourage teenagers to go and be wild with it and the funding cuts on the way to war, these were our battles and our issues. We had big dreams and we were rivals on the way to save humanity.

After a decade of science, I wonder what is left of our hopes and dreams. I wonder if P. still wants that private research facility. I wonder if the cuts on funding will persist in the post-Bush era. I wonder if people lost faith in us; that if we haven’t lost faith ourselves. Every now and then you are reminded of what you’re here for. Some people give you a feeling of importance and make you want to believe again, others through passive dismissal and hidden disapproval make you want to prove how great this profession is. Someone argued that one cannot compare the nobility of the medical profession to someone who goes to lab everyday based on the fact that doctors get an immediate satisfaction in making a difference. I am happy for this person to think that his job is the greatest of professions if this helps him perform better. But just for the sake of arguing, isn’t a nobler mission when you are making a huge difference in the life of the masses without even getting the slight recognition or monetary compensation? To each his own.

A recent significance passage from a proposal: In the last two decades an enormous effort has been produced to understand the biological and genetic bases of cancer, a progress fueled by both industry and government based research. Unfortunately, relatively few innovative therapies have been introduced in the clinics that proved to be more successful than or as powerful as available drugs. Drug development is certainly a difficult, time consuming process, and the success rates of new compounds that pass clinical trials is very low. This in turn slows down the appearance of new drugs that use innovative mechanisms of action to treat cancer. The bulk of modern chemotherapy is indeed still based on combination therapies that feature anti-mitotic drugs, like vinca alkaloids and taxanes, very effective molecules which target the function of the microtubule cytoskeleton. A major concern of these therapies is the development of resistance in some individuals and strong side effects which include neuropathies caused by the interference with microtubule function. In fact, I am exceptionally proud of my department chair who got the lifetime achievement award for introducing the use of taxanes into chemotherapy and who is still grounded enough to talk to me about hair dyes.

The use of anti-mitotic approaches is old fashioned now since mitosis, as we all know, is crucial in health as well for immunogenesis. The latest craze in research was apoptosis. The gold card in cancer therapy. Instead of inhibiting the cancer cells from dividing, which could affect the healthy cells, reactivate their controlled death. Brilliant, we all thought. Unfortunately though, and like most other phenomena, the amount of genes and proteins responsible for apoptosis would make your head spin too. BAK and BAD and BCL-1 and BCL-X and bim and dim and little tim and DIABLO (we started getting quirky with the names) and LAT and Syk and src and Fyn and FAK and rho and rac… names much as they are combinations for the alphabet and more. Proteins that cross talk in all possible ways. I remember my professor laughing when I asked how could a tumor suppressor be also an oncogene in response to the same stimulus and in the same cell line?

We went from that to cancer cell motility. If you can’t kill it and you can’t make it stop dividing, break its legs. Brilliant we thought. We want to disable breast adenocarcinoma from metastasizing. Keep on dreaming. Every pathway is different, at every time, at every subcellular location, in every cell line, within the same tumor, in each hand, in different labs and more. And even when a consensus is reached to the best fit of our best ability and best assessment, it will be different in vivo. Mice or rats and how old and what tumor. Is it the same in humans? Of course not and start again. And they still ask you, are we close to curing cancer? You want to say, the more we know the less we know and the less we hope, but it’s better to keep quiet. Asking me to cure cancer is like asking an underground rail road worker in Manhattan to build the infrastructure in Iraq and more. Cancers are like snowflakes in their uniqueness. Scientists find it to be fascinating and I think it’s fascinating that they do. My mom still doesn’t know what I exactly work on. So a drug that will kill tumors? No. a specific kind of tumors? No. A chemotherapeutic potential? No. What then? I work on understanding the localization of a specific protein, that is upregulated in some cancer cell lines some times, in response to a specific stimulus at a specific time under very rare conditions in vitro in a very specific cell line extracted from rats…

Maybe he’s right. Maybe P. quit. Maybe the age of big discoveries is long gone. Maybe we’re just nitpicking to keep the government money rolling to keep our doors open and people working. Maybe. Maybe science is good for nothing. Maybe Cancer won. An exquisite fascinating disease. An accumulation of minute mutations that is completely unique in every case and every human body. Maybe I don’t care anymore and that left me with nothing.

We say we’re godless and we only believe in science. Well guess who proved to be a bigger prick?

For better or worse though, it is who i am and it is what i do.