Saturday, October 11, 2008

I'd Rather Not Know

As soon as humankind attained consciousness, we wanted to know the future. From a layman’s standpoint it seems fun. You could make a fortune betting on sports (or anything for that matter) and you might be able to see if the Chicago Cubs actually win the title again (unlikely). But, there is a much darker side of knowing the future. We would see our ultimate decline and death. Can we handle that? I am of the belief that humans would best not want to know their biological future.

A company in Mountain View, California called Complete Genomics will soon be providing a person’s complete genetic blueprint—sequencing and all—for $5,000. Will there be any takers? Do we really want to know what is hidden in our genes (not jeans)? What if you were 30 years old and your genome showed you were going to develop Huntington’s chorea, Alzheimer’s disease, multiple sclerosis, or amyotrophic lateral sclerosis (ALS)? Would you live life differently? Would you want to live? Would you reproduce?

I have seen more death than most people can imagine. Death is not to be feared. Sometimes in medicine we get so involved in worrying about electrolytes and fluid balance that we forget the patient will die regardless--often without dignity. There is a fine line between extending life and prolonging death. Death is not always the enemy. I don’t fear death for it will come to all of us in time. I do fear the years before death. I watched my father and paternal grandmother die from the ravages of Alzheimer’s disease. There is nothing dignified about Alzheimer’s disease for it steals the very soul. While I don’t fear death I fear that I have the Alzheimer’s gene. I don’t want to spend my final years in Last Chance Nursing Home thinking that the potted ficus plant in the corner is one of my children.

For me, I would rather be surprised as to what my genome holds. I am an optimist and a survivor. Until we can safely change our genome, knowing what it contains is worthless. I would rather spend the $5,000 enjoying my friends and family while I still have the consciousness to do so.

“I am not afraid of tomorrow, for I have seen yesterday and I love today.”
William Allen White

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