Survival of the Sickest

I want to thank everyone for coming last week to the event hosted by McNally Robinson in nyc. It was wonderful to see so many people interested in science and evolution. For all those who couldn’t make it I’m sorry I didn’t get around to posting event details earlier. And Suzanne here’s the the link to the my frogsicle friend, Rana sylvatica and a link to the NYT article about my work that you requested.

The paperback for Survival of the Sickest is finally out!
I’ll be doing another talk and book signing tonight,
7pm at McNally Robinson one of my favorite
independent Bookstores in nyc. The address is
52 Prince street in between Lafayette and
Mulberry St. Go here for more info.

I’ll be giving a talk today about Survival of the Sickest, at Columbia University Medical Center at 3pm as part of their monthly discussion series. If you’re interested in coming it’s taking place at the Alumni Auditorium 630 W. 168th St. in Manhattan.

Does anyone think this ad works?

It’s been almost a year since I first wrote a post on this topic and I’m happy to see that the story has finally reached a wider audience. BUT, there are a few important qualifiers that need to be reiterated. First off, even though the amount of drugs detected was very small, that’s not to say that they can’t have any physiological effects.

We already know that hormones like those used in oral contraceptives also work at small doses, but for the other drugs and their byproducts we still don’t know what the longterm effects are, if any. So what should we do? Drinking bottled water is not really going to help since most of the sources of water that are used, at least for the big brands such as Dasani and Aquafina, are really just repackaged tap water anyway. Even if these products are filtered, I don’t think that they are actively removing the pharmaceuticals or their byproducts from the water.

What should be done? Since people shouldn’t stop taking their medications anytime soon (probably quite the opposite with an aging population), I think the first thing that should be done is to create a buy back program for unused medications so that they can be properly disposed of, not unlike existing deposits on some glass and plastic bottles. Along with a good public education campaign, we might help prevent people from flushing unused pills down their toilets.

The most positive thing that might come out of all of these reports is the realization that we live in somewhat of a fixed system. The water that’s in your toilet today may be in your latte tomorrow. Not exactly tomorrow, maybe next year, or the year after… I’m sure you get the idea.

In a previous post, I wrote about Rana sylvatica a type of frog that can increase their sugar levels to survive the cold. Being a rather blisteringly cold day today made me think about my blood sugar level. A few years back I proposed in a paper* that some of us may be predisposed to having diabetes - higher sugar levels or insulin resistance like conditions - because it may have helped our ancestors survive the cold.

Well my hypothesis got a big boost recently with a study that published some interesting findings regarding some versions of genes, such as ones that predispose you to Metabolic Syndrome, and cold climates. Being at greater increase for metabolic syndrome also puts you at a greater risk for increased blood sugar levels and diabetes.

Having higher blood sugar levels, is exactly what I proposed would protect populations from inclement cold weather, at least in the short term. The problem is that you end up paying for it dearly in the long run with all the complications that can arise, especially today given the fact that most people have the luxury of central heating.

* For more info on the Diabetes-Cold Weather connection see the following NYT article. on my ideas.

A study published in the January 17, 2008 New England Journal of Medicine has found what I’ve been saying all along, that complications from hemochromatosis mutations, especially the C282Y variant, are much more common than was first suspected. An important caveat about this study when trying to draw conclusions for the American population is that the specific genetic variant (C282Y) that results in the highest iron loading or absorption from the diet is much more common in those of north and western European descent.

What this means in practical terms is that for historical reasons this specific gene is more likely to be common in Australia than in America today. The study also found that men were more likely to have other conditions associated with having this gene that can result in excess iron. Not a big surprise since men don’t menstruate or bear children and typically don’t lose blood unless they are frequent blood donors or have other medical conditions.

So if you can, just another reason to donate* your blood.

*I have no affiliations with any blood donation center except for a love of their cookies and juice.

It’s been really great to keep getting so many emails from people around the world. When I starting working on the Survival of the Sickest I really hoped that some of the excitement that I get from making discoveries would come across. Like learning a new magic trick or testing new ideas for treatments to fight superbug infections, I think the real reward and what fuels discovery for me is that a-ha moment. That brief flash where you move into a new understanding, even though at times fleeting, makes the entire endeavour worthwhile.

Sometimes I run into people who seem to have lost whatever sparked them at some point in their lives. You all know people like this. This may even be you at times. These people (or parts of ourselves that we’re in the process of recognizing) are stuck and in some sense separated from what initially brought them pleasure. So here’s my suggestion, give them a hug (if it’s culturally appropriate of course) or send them some type of encouragement. Remind them that they are not alone and there are others who may be going through similar issues.

For one thing touch has been found to have beneficial health results. When I first started medical school I never understood why physicians measure someone’s blood pressure manually when we have the technology and machines that can do it probably more accurately.

Having practiced the art of measuring someone’s blood pressure for only a few short years now I’m beginning to understand why. I think that this simple procedure goes far in creating a sense of caring towards another, in this case a patient, that no machine can as of yet replicate (this can go the other way as well with some patients getting “white coat syndrome“). So although there is much talk of medicine moving towards the “telemedicine” direction, which of course is very useful in situations where it might be difficult to get medical care because of geography, ultimately for most of us to feel cared for we need a reassuring touch.