20-year saga with brain disease highlights questions about precision medicine plan

Which chapter came first? Was it the genetic predilection for alcohol that created [Barbar’s] lifestyle (pure chaos) and environment (streets, shelters, hotels)? Or did the story start at another point in the cycle, with alcohol selected as a comforting longtime companion, then taking over?

Either way, Barbara’s medical problems are predictable spokes on the wheel: bad heart, terrible liver, crumbling hips, gummed up lungs, AIDS from a brief foray into injectable drugs.

Sober Barbara is smart, analytical, full of plans. (“Gotta stop drinking.”). Drunk Barbara is impossible. We usually catch her somewhere in between, full of incompletely articulated thoughts, dipping erratically into her medications, promising reform. And yet she survives through years and decades without it.

How will the president’s hundreds of millions of dollars, presumably the first installment of billions to come, help patients like her?

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Announcing his initiative, Mr. Obama specifically celebrated a future in which one’s genes would no longer spell one’s medical destiny. But genes are seldom the whole story behind illness and are possibly not even the sternest of the medical fates that control us. Perhaps some of the others, like environment and lifestyle, will someday, somehow be corralled as well.

Read full, original article: Genes Tell Only Part of Story

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