Kerstin Schkrioba

Dr. Wesson
Freshman Seminar
September 6th, 2014

A Comical Look at Medicine

One of my favorite comedians, Joe Machi, has a stand-up routine that is not only sportive,
but also has an insight as to how we look at the past and how we view medicine.

My married couple of friends said, Joe, we dont want to bring a child into the
world the way the world is now. And Im like, What do you mean the way the world is
now? The best its ever been in history? 200 years ago, people were having 15 kids, most
of them would die. Most of your life was having kids then watching them die. Then you
would dieof something they prevent now by washing your hands. Im not even sure why
being a doctor was an actual job. At best they could do was tell you the name of what you
had. Joe, youve got tuberculosis.. Lie downin a room full of people with
tuberculosis. Joe, your arms infected. Well cut it off Although the stump will also
get infected. Well keep cutting that stump shorter until youre dead. Like your kids. (Hulu)

I think this joke really epitomizes major differences between medicine 200 years ago, and
now. Without even getting into the idea of modern medicine, the way we view human life is
drastically different. In the joke, 15 children are born and there is no hope for the survival for every
offspring. I would argue that society now could not handle the idea of infant mortality rates being


that high. In France at the beginning of the nineteenth century, almost half of all children born did
not reach their 10th birthday (mortality); in 2012, only about 3 children die out of every 1000 live
births (understanding). This drastic difference is based on our changes in lifestyle, our heavy reliance
on doctors, the idea that breastfeeding is usually always beneficial to the child, and modern
medicine.
Because of our longer life spans, our biggest worries medically have far surpassed
tuberculosis and infections, we have diseases that are hereditary and modern medicine cannot cure.
Because man cannot simply accept death, they must train, learn, and sacrifice in the name of the
greater good to find ways to cheat genetics and even glimpse into the future of an individual too
see which genetic switches are turned on to predict the onset of devastating diseases.
Huntingtons Disease is caused by a genetic mutation on chromosome 4. There is a specific
portion of DNA that reads CAG, and in a healthy person only repeats between 10 and 30 times. If a
person born with more repeats of CAG, they will get Huntingtons. This disease gets worse over
time, and is extremely hereditary. If only one parent has it, you have a 50% chance of inheriting it. If
both parents have it, you will certainly have it and pass it along to any potential children. If you have
Huntingtons you will slowly lose fine motor control and cognitive decline leading to dementia. It is
irreversible and it has been used in television shows and movies as the diagnosis that will inevitably
lead to the characters demise.
It seems like a movie script was published in papers in 1993 when it was announced that by
the use of a blood sample, a doctor could count the repetitions of CAG on chromosome 4. While it
may seem that this is the answer to prayers all over the country, the promise of prematurely
diagnosing this disease raises more ethical questions than answers.
There are many situations that can arise with this knowledge to determine if an individual
has this disease. If one parent has the disease, there is a 50% chance of inheritance, and from birth it


can be diagnosed now. That means that a doctor could be solemnly informing the parents of a
happy, healthy, newborn that their beloved child will only live around 30 years without the
intervention of this debilitating disease. The child would grow up forever knowing their good days
are limited. This will cause inconceivable emotional stress on the child.
A solution to the dilemma of a child growing up already knowing their fate would be waiting
until the individual reached legal age, 18. This would free the government of the rights and
responsibilities of a minor. Now, a consulting, legal, adult would be making the decision to know
their own destiny, assuming there is no ulterior motive. Health insurance companies, jobs, and
schools could theoretically request for you to be DNA tested, much like they demand drug
testing.
In 2014, the United Kingdom passed a law stating that genetic information cannot be used
in most cases while writing and approving health insurance plans. Surreptitiously, Huntingtons is
specifically excluded (Experts). This can cause discrimination, and if more businesses are targeting
Huntingtons disease, selective abortions can start rising. If a parent knows how difficult is it for
them to function in a society that is so timid around those born with this disease, they will have
second thoughts about bringing in a child who could have the disease as well.
If history repeats itself, it is never good when personal medical information is forced from
any individual. If this data is collected, even if it is for harmless reasons, these people could vary
easily become a target for a eugenics movement. Since it is so hereditary, eradicating the disease is as
easy as sterilizing those with the disease, or creating such a difficult life financially for those infected,
that they do no wish to start a family.
Machi pokes fun at a time in history when doctors did not have the technology to see into
the future and pre-diagnose, but they did try to uphold their hippocratic oath. They tried within their
ability to alleviate pain, prevent disease, care for the sick, and to remember that they are always


treating a sick human. The oath was simple enough to understand during Hippocrates, and even 200
years ago, but now with ethical dilemmas, doctors need to take a stand they believe in. Patients will
always doctor-shop until they find a professional with the answers they want, but it is important that
the doctor lays out the pros and cons of learning their fate, as well as making sure the individual is
ready to accept the responsibilities that come with learning such potentially tragic news.
I think that it is hard for me to say if I would want to know for certain, as I know that I can
never go back in time and un-learn the information. Looking at the past, billions of people went
through their lives without knowing in full detail when specific diseases would take their lives, and
they were able to live very fulfilling lives up until that point. If I learned today that I was diagnosed
with Huntingtons I am not certain if I would stay at this university. I would defiantly continue my
education, and I would still plan on going to med school, if they would still accept a person who
may not be healthy enough to make it through, but I would want to be closer to home.
I think is so interesting to look at gene therapy and how we are treated Huntingtons. If we
look to the past, we see blissful ignorance, and the question arises; are we better off knowing
everything we possibly can? This is a turning point as we move towards the future, decisions will be
made and that will shape the future of the medical industry. If there are loopholes in laws, and
discrimination can take place against people born with any type of disease we can see the beginnings
of a society where we can artificially choose babies who are not born with chromosomal deformities,
and businesses can choose to not hire based off of DNA tests. This is a world that I hope I do not
live to see.










References

Expert backs gene test disclosure. (2007, July 6). BBC News. Retrieved September 6, 2014, from
http://news.bbc.co.uk/2/hi/health/6731623.stm
Mortality rate, infant (per 1,000 live births). Retrieved September 6, 2014, from
http://data.worldbank.org/indicator/SP.DYN.IMRT.IN
Understanding Your Ancestors: Western European Ancestors: Demographics: Death and Illness.
Understanding Your Ancestors: Western European Ancestors: Demographics: Death and Illness.
Retrieved September 6, 2014, from
http://www.understandingyourancestors.com/wea/death.aspx

http://www.hulu.com/watch/648669