23 and Me? I’m Not So Sure.
(My thread from Twitter):
1/
Listening to Ann Wojcicki, the creator of @23andMe, on @Freakonomics the other day, a few thoughts came to mind.
I find the #idea of genetic kit testing appealing, as a general consumer. Who wouldn’t want 2 have possible #future illness exposed? #SoMeDocs #medtwitter
(a thread)
2/
As an MD, in fact, I salivate at the idea of being able to solve the world’s #future ills. Or to identify genetically-linked #illness that could otherwise be thwarted off. Can u imagine if we could obliterate all that ails us, or even do this in advance of the debut?
3/ But idealism aside, I practice #medicine in real time, & see first hand both the intended – & often unintended -consequences that testing can have on body and #mind.
I’m thinking, specifically, about the ‘anxiety factor’ of it all.
4/ Here’s the thing: anxiety factor isn’t always our friend. The sophisticated machine that is our human body, w/its V8 engine -🧠- sitting on top, can’t always synthesize bad news w/grace.
Just b/c we know diagnosis is imminent, doesn’t necessarily mean we know how to prepare.
5/What’s worse is that it FEELS imminent in 1st place, regardless if it really is.
It may, in reality, not affect us for a long time. & sometimes NOT EVEN AT ALL.
So who is responsible 4 sleepless nights? Or time spent searching 4 a cure? Who pays for consequences of #stigma?
6/
These observations don’t make me a pessimist, they simply make me pragmatic. I’ve delivered my fair share of bad diagnoses & seen them linger w/their owner, haunting them each & every day.
(note I’m an optimist IRL & am fascinated by the combination of optimism & pragmatism)
7/
I‘ll quickly add here that despite anxiety factor’s negative connotation, it can also serve us in beneficial ways.
In a nutshell, it can ‘worry a patient into’ initiating #prevention tactics.
This is essentially the basis of what @23andMe intends its product to do.
8/
Indeed there r # of ex’s in which early diagnosed predisposition 2 illness helps alter course (breast/colon #cancer) vs those w/which not much can currently be done (Alzheimer’s/Parkinson’s).
I’m happy, furthermore, 2 hear thoughts from Twitter-sphere on this type of screen.
9/
That’s my knee-jerk commentary on the kit’s genetic disease testing. Note,
I’m all 4 advancing scientific discovery & patient empowerment.
I’m simply questioning implication of essentially cutting out middleman -#healthcare- when disease is foretold.
ie r we fortune telling?
10/
I do have a different reaction to @23andMe’s ancestral arm, which I find fascinating & useful, 2 say the least. Who doesn’t want to discover potential long-lost cousins?
Worth adding: disease-part has recent #FDA approval.
Now I’ll pause to👂🏼what y’all have 2 say. #SoMeDocs
