MUSC Commencement Address
Graduates still have mountains to climb
by Philip Needleman, Ph.D.Chief Scientific Officer, Pharmacia Inc.
Commencement infers a point of change—it is a bridge between the past and the future. The Class of 2003 happens to be starting its journey at a rare and exciting pivot point. Your future will be filled with new opportunities and great challenges. Time will tell us if this bridge is like the proverbial glass of water—was it half full or half empty.
To provide a context for change I’d first like to talk to the parents in the audience. Since we are about the same age we probably remember similar things from our past.
In my teen years we had a single, black, rotatory telephone in the house, and in fact, it was a party line.
A long distance call was an expensive luxury and we all had a three- ring signal to let everyone know we arrived at some distance safely.
Dr.
Perry Halushka, right, dean, College of Graduate Studies, walks with Dr.
Philip Needleman during commencement.
In my teens and college years, if I had to write (that’s hand write-than manually type) a report—I would look in an encyclopedia; go to the library and hand search the card file to dig out textbooks that were instantly outdated or journals which were at least 6-12 months after submission.
Communication and information transfer were outdated, slow, and predominantly local.
Now let’s jump to today. I don’t think our home is much different from many of yours. Recently I inventoried our house phones:
- one common phone line with answering machine and dialer ID
- one line for my wife’s modem
- one line for a fax
- one for the security alarm system
- one broadband high speed DSL Wi-Fi line for my computer
- two mobile phones
- one palm top-with instant Microsoft outlook.
Biotechnology revolution
I’d like to now turn to the 2003 graduating class and talk about the
unique medical circumstance you are entering. None of you were born 50
years ago, when two young scientists stepped into an English pub in Cambridge
and announced that they found the secret of life. On April 25, 1953, James
Watson and Francis Crick published a paper in the journal Nature that described
the structure of DNA.
They found that DNA looks like a twisted ladder made of two complementary strands, the double helix, and they famously noted that “It has not escaped our notice that the specific pairing immediately suggests a possible copying mechanism for the genetic material.” In other words, each strand provided a blueprint for the elements of life itself.
They provided the foundation for understanding mutation and variation, species diversity, evolution, replication and inheritance.
This irreversible discovery triggered unimaginable progress.
It enabled the cloning of individual genes, and now as you graduate in 2003, the landmark sequencing of the whole human genome has been achieved.
The Class of 2003 steps into the world with the genetic owner’s manual. This is the great science story of our time. For medicine, DNA science (molecular biology) has provided the technology necessary to generate new sets of targets for small molecule drug design. It has also enabled the creation and production of recombinant proteins such as interferon, erythropoietin, and insulin, as well as therapeutic antibodies.
In our most lofty dreams, we believe that with genomics, genetics, and information technology that we will speed the understanding, diagnosis and treatment of such diseases as: cancer, diabetes, Alzheimers, schizophrenia, multiple sclerosis; cardiovascular and lipid diseases. Treatments of patients will not be just based on symptoms (phenotype) but will be personalized taking genotype (the patient's individual genetic makeup) into active consideration. Clinical trials will be monitored utilizing surrogate genetic and protein biomarkers and ultimately disease prevention strategies will emerge.
But now for a large dose of caution. In order to achieve these wonderful opportunities, it will be necessary to overcome some significant challenges. In fact, the enormous scientific enthusiasm and public attention to genomics science and its potential may have raised expectations to an unrealistic point. There is no question about the “if” of biotechnology—it’s the “when” and “what else” we need to know that is the issue. In some ways, when it comes to the current state of translation and utilization of this new genomic information we are very much in the analogous position of my preteen rotatory telephone compared with the current state of communication. The discovery of the human genome is about structure not function. It is a map. The analogy is the Lewis and Clark expedition, commissioned by Thomas Jefferson, to learn the route through the wilderness which then had to be followed by the trappers, pioneers, and settlers that advanced and built a great nation.
It was surprising to learn that the human genome was composed of only 30 to 40,000 genes—a small number to so exquisitely build, maintain and regulate the complex functions of life.
We each have a unique mixture of genes with major confounding influence of modifier genes. Only about 5 to 10 percent of human disease can be traced to a single gene mutation (monogenic). With polygenic disease, i.e., defects in multiple genes the issues are more complex.
One approach to study the relationship between genes and disease is to study identical twins who are genetically identical. The genetic contribution to disease occurrence in identical twins varies from slight in some cancers and multiple sclerosis; to moderate in diabetes, heart disease, migraine and asthma, to high in psoriasis. The discordance between identical twins—where twins show different diseases despite being genetically identical, illustrates how the substantial influence of environmental factors over a lifetime affect an individual’s chance of developing disease. Genetics describes susceptibility while environment describes exploitation. The admonition then is that we still have very significant scientific challenges to address and resolve before we can achieve our lofty medical ambitions. The discovery of the genome is like your commencement today, only the beginning of the adventure.
I’ll take the commencement speaker’s prerogative and offer advice.
1. Embrace a lifetime of learning. Your university education represents
only 10 to 20 percent of your working careers. At this rate of scientific
and technical advancement everything you learned will be obsolete in a
decade or less.
2. Be willing to change. Totally novel transformational discoveries, diagnostics and drugs are on the horizon. The concept of personalized therapy has major implications about how you will relate to your constituencies.
3. Control your own destiny—or others will. Skills, technologies, hospitals, industries all change—they grow, merge and some disappear. Broaden your own base skills and constantly strive to improve your competitive position.
4. Give something back to society. You are the recipients of remarkable advances and education and wonderful opportunities. While there are young children and toddlers on the information highway, others go to schools where survival is their major concern. Further, despite all the medical and scientific progress in this country, we have too many people (somewhere between 30 to 57 million) who lack health insurance and medical care. As future leaders in your health professions and society, you carry the challenge and the burden to address these unmet needs. We must collectively be vigilant about the less fortunate.
In closing, as you graduate, you step into the health care world armed with the remarkable genetics owners manual. But you face significant technical, educational and societal challenges. I cite these not to alarm or dissuade you but to remind you how far we’ve come and how well you all are prepared to handle the hurdles.
You see that half glass of water actually always was full—half liquid
and half air. Don’t stumble on the pebbles in front of you; there are still
mountains to climb.
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