Below are a few snapshots from Dr. Harald H.H.W. Schmidt‘s seminal talk, found at the bottom of this article, on why he believes the future of medicine will be in the emerging field of network-based spatial biology.
“Medicine itself is sick.” He writes on the landing page for his book The End Of Medicine As We Know It. “We hardly understand any disease and therefore need to chronically treat symptoms but not the causes. Consequently, drugs and other therapies help only very few patients; yet we are pumping more and more money into our healthcare system without any added value.”
The talk is a brilliant breakdown of the many faults of modern medicine and why the vast majority of drugs that do make it through have little-to-no real world benefit. Today billions are spent by drug hunters working in Big Pharma looking for single targets for single diseases in single organs. Unfortunately for patients like me, this has created a system of medicine in which innovation is stifled.
As Dr. Schmidt points out, “The most profound problem (of this system) is that we do not understand diseases.” He goes on to say that, “the biggest conceptual error that we have all made in medicine is that we have divided the human body organ by organ, for every organ we have a clinic, a specialist, and a research discipline ….we really think that by looking at one organ that whatever we see there is THE disease.”
What Dr. Schmidt and his colleagues are working towards is a future where medicine will be driven by mechanism based small molecules designed to precisely target dysfunctional networks. By doing so they have seen that diseases often cluster across organs, and that by myopically studying one organ after the next in our crude way to try and stamp out diseases we have missed the networks from which these diseases actually arise.
In order for this paradigm shift to really take root, Dr. Schmidt argues, doctors and scientists must be made to work for the benefit of patients. Currently the model that medicine works on is analogous to a hamster wheel where discovery is made or observed by basic scientists who distill years of work into a single static publication, that publication then gets made into a drug and pushed through preclinical models that do not recapitulate well enough the organ or the disease they purport, then a tiny fraction of those make their way to the clinic where real people finally take them.
“We think this model is totally broken. If we really want to cure patients we need to focus on patients and patient data…there is a plethora of existing data out there, with that data we need to come to new, mechanism based disease definitions, basically a molecular pathology.”
Amen.
Below is the talk in its entirety. Can’t recommend this one enough for all current and future drug hunters out there.
Hamster wheel is one analogy. Chasing our tail is another one I like. Our top neurologists/neuroscientists have little basic understanding of Parkinson’s movement issues. Startlingly, they don’t even want our insight. I believe the system is worse than you have previously warned us about. The hurdle of conceding error and shifting direction is our biggest medical challenge. Can you imagine that? It’s not the lack of knowledge holding us back as much as the lack of interest in knowledge. And there’s no accountability, so how does the hamster wheel ever stop? Patient like us can only use precious energy to fight that battle for so long.