Jun 20 2016

Reflections on a Beached Whale

by at 10:33 am under Uncategorized

I hope you had a good week. I spent mine at Bethany Beach with my extended family. We had a wonderful time, and I feel refreshed and ready to get back to work. One of the great things about family beach vacations is the wonderful rhythm of paradoxically action-packed yet lazy days that blend together – wonderful nothings that create gauzy memories and unbreakable bonds. However, a few mornings ago our oldest son Ken took a run on the beach and came across a 35 foot long, 35 ton whale that had washed up onto the shore the night before. Apparently this magnificent creature had been killed by a boat’s propeller blade and had probably been dead for about two weeks.

The body was cordoned off and officials (with the help of volunteers) set about doing an autopsy and preparing for disposal of the carcass. Needless to say, one does not move a behemoth easily. In the end the body was buried on the beach. It was a sad, massive undertaking, and it got me thinking about the destructive potential of modernity, which in this case felled one of nature’s noblest creatures. In paradox, as technology changes, there are good and bad consequences, often unintended.

What does this have to do with cancer research and clinical care? At first glance, not much. But, clinical care, now so technology-dependent and algorithmic, too frequently involves physician/patient interactions where the doctor sits at a computer, with only cursory interactions with the patient sitting before him or her. Has clinical care actually improved? The answer is undoubtedly yes, since cancer cure rates and survivals have improved. But technology, like the whale, has the potential to be blind to its destination. There is certain finesse to balancing the metaphorical propeller in front of us with the sonar technology that saves. In the end, a patient is a person, just as the whale is a creature. Even as treatment is not perfect, it is important to see the life of the patient beyond disease.

Just as in medicine, technology has utterly transformed cancer research. In general, this transformation has been for the better, but I suggest you check out the classic Watson and Crick paper describing the structure of DNA (Nature. 1953 Apr 25;171(4356):737-8.). One page; one figure… It would never be sent out for review by any modern journal editor. To get a paper published today we need immense data sets, gargantuan teams, and enough figures and tables (to say nothing of supplementary data) to populate an entire issue of Nature in the early 1950s. Is this progress? Yes, but a paper describing simple, rigorous experiments is as endangered as a whale in the midst of an armada. There is room for both technology and scientific intuition in science (indeed, they are complementary and essential). There is much that technology has done, and despite its potential for error, there is always room for research and exploration to improve the lives of many. Whales die, but whales can also be saved.

Have a great week.

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