21. The End of Illness

21. The End of Illness - by David Agus

“Our bodies are complex and dynamic systems” says Agus, a pioneer of proteomics and oncology. His approach to the field of cancer research, and medicine in general, is preventive rather than prescriptive. By balancing the forces and biochemicals in predisposed patients, as found by the burgeoning analysis of protein levels (proteomics), chronic disease and health issues can be avoided before their onset.

As with any book of this type, it is expected for scary statistics to be thrown around and Agus shies away for as long as possible. When he can resist no longer, he elucidates readers on the rampant obesity and stress-related problems afflicting the US population. Upward of 65% of the country is obese, even though far fewer would think so, and this is trending upward. This is mostly due to the increased sedentariness of our jobs and spare time. For instance, a famous study on bus drivers and their conductors (the former spends much of their time sitting while the latter walks around on the job) found that drivers are at least twice as susceptible to heart disease and other chronic illness. Off work activities now consist of watching TV and browsing the internet which again avoid physical activity.

Agus also pays special attention to the finely balanced intestinal environment inhabited by 100 trillion bacteria. Studies show that the dominant bacteria cannot be predicted by ethnicity, region or lineage and could be a random colonization that distinguishes our individual vulnerabilities and custom treatments. I found this and studies on sedentariness, irregular sleep and vitamin use particularly fascinating.

Agus wants us, each and every one of us, to take responsibility and revolutionize the way we are diagnosed. He chastises the traditional approach of yearly trips to the doctor accompanied by a few run-of-the-mill tests and questions. Instead, he implores us to record our own observations on our health and answer a litany of questions regarding how we feel, sleep, eat and fill our time. These could be instrumental in building a dynamic monitor of our health that would aid in predicting possible future illnesses based on our lifestyle and genetics. He sees this advancement as inevitable given the sweeping changes that information technology has ushered in.

His view of the body and health, as he tells the reader early on, is a take on the physics of complex systems whereby one need not understand each part to understand the whole. He gives the example of Galileo being able to predict the movements of the stars without knowing exactly what a star is. In the same way, through compilation of disease and treatment data, it is possible to tailor prescriptions without perfect knowledge of the underlying infliction. He admits the data analysis would be an enormous undertaking.