In this age of hyperbole and disingenuous narrative, it’s important to have keen and skeptical appraisal. This is true even (or especially) when it comes to life-saving cures and the promises of the end to various terrible afflictions. Part of the reason for skepticism is simply to manage expectations. The people developing or marketing their cures (whether in research stage or as products) have a secondary interest in being realistic; you, on the other hand have a primary interest in not expecting things that are not likely to happen. Like curing cancer next week, or reversing grandfather’s Alzheimer disease. In this regard, here are a blog posting and an article that speak to why we are being promised so many medical miracles that don’t seem to happen. They help set a framework around medical ‘breakthroughs’ and science in general, that you may find useful:

The first is from Derek Lowe, blogger of In the Pipeline, one of those rare writers who is a technical specialist (in his case bio-medicine) and yet finds the right words, mostly without jargon, to express a complex field in a way most people can understand. It’s a short blog entry, so I’ll quote the whole thing:

Emily Yoffe at Slate has a very accurate piece up on just how hard it is to make progress against things like Alzheimer’s, Parkinson’s, and other neurodegenerative diseases. The contrast with the hopes of patients – and the hype often surrounding the initial discoveries – is painful.

And we’re back to that optimism/realism tightrope. On the one hand, I don’t see any reason why we shouldn’t be able – eventually – to stop such conditions in their tracks, or to keep them from starting in the first place. (Reversing the damage once it’s done, though, is much more of a stretch, to me). But on the other hand – sheesh, we really, really have a lot to learn about these things. The likelihood of any one discovery being the key breakthrough is small – nonzero, but small. So in the long term, I’m an optimist, but in the short term, well. . .every little bit helps, and most of the bits are going to be little.

That’s not the sort of news you want to give to someone suffering from these conditions, of course. That desire for encouraging news, along with plenty of other good intentions (and a few not-so-good-ones) leads to the cycles of hype that we’ve seen over and over. Stem cell research is a perfect example. There really are huge possibilities there, extraordinary ones. But our level of ignorance is also extraordinary. And to go out and make claims that we’re going to be able to cure X and reverse Y soon, based on our present knowledge, is just plain irresponsible.

But plenty of people do just that – politicians, headline writers, and others. And then people who only know what they see in the news wonder where things went wrong, and how come these wonderful cures haven’t arrived yet. It all makes explaining the real situation that much harder.

It’s not like the real situation is even all that terrible. As I said above, I really do think that these diseases – and many others – are eventually going to be treatable. No one likes that word “eventually”, though.

[Source: In the Pipeline]

Derek refers to the article by Emily Yoffe at Slate. If Derek gives the colloquial expression to the real nature of advancement in difficult areas of medical research (slow, careful, incremental progress), Yoffe’s article provides many of the details to current dilemmas. Well worth reading in its entirety, here’s a lead quote:

The disappointments are so acute in part because the promises have been so big. Over the past two decades, we’ve been told that a new age of molecular medicine—using gene therapy, stem cells, and the knowledge gleaned from unlocking the human genome—would bring us medical miracles. Just as antibiotics conquered infectious diseases and vaccines eliminated the scourges of polio and smallpox, the ability to manipulate our cells and genes is supposed to vanquish everything from terrible inherited disorders, such as Huntington’s and cystic fibrosis, to widespread conditions like cancer, diabetes, and heart disease.

Adding to the frustration is an endless stream of laboratory animals that are always getting healed. Mice with Parkinson’s have been successfully treated with stem cells, as have mice with sickle cell anemia. Dogs with hemophilia and muscular dystrophy have been made disease-free. But humans keep experiencing suffering and death. Why? What explains the tremendous mismatch between expectation and reality? Are the cures really coming, just more slowly than expected? Or have scientists fundamentally misled us, and themselves, about the potential of new medical technologies?

[Source: Slate]

Both of these writers are trying to express their frustration, tempered (mostly) by an understanding of the difficulties and realities that drive so many researchers to make so many near-empty promises. They are also aware that while the new worlds that are opened by molecular biology are probably the most fundamentally important we have encountered – we’re really still babes in the woods, stumbling from one tree to another. Their concern is that we quit pretending – or marketing – the work as if we had a mature understanding of the forest.