Book review: The End of Medicine

I finished reading The End of Medicine: How Silicon Valley (and Naked Mice) Will Reboot Your Doctor last week-end. Andy Kessler is a Silicon Valley geek that struck it rich, and wants to find the next big thing in medicine. I give the book 3 out of 5 stars.

Looking for areas where silicon meets biology, he documents one year of dialogs with various researchers including Nobel prize winners. No doubt being wealthy opens many doors. Silicon gets better, faster and cheaper - surely if we can bring these qualities to medicine in a way that can scale we can cure many diseases?

I’m not convinced Kessler is quite on the right track. While the technologies he describe are very promising, modern medicine has had plenty of spectacular failures and the future rarely unfolds as expected. We have bottled water and oxygen bars, but we still don’t have flying cars or X-Ray machines in every living room.

More to the point, his emphasis on early detection misses the most obvious point: prevention. Several times when dining with eminent researchers Kessler judges whether they are true believers by the fat content of their meals. Apparently someone convinced that their research will bear fruit wouldn’t subject themselves to bland and healthy food.

We are already doing much better at curing some cancers like childhood leukemia. Even while more children fall ill, fewer die. In other words, more and more children go through the ordeal of cancer treatment and we still aren’t sure what’s causing the disease.

Perhaps Kessler thinks his bacon and eggs are worth the risk of needing treatment. And in his mind, treatment will be quick zaps at the very earliest onset of the disease. I hope so, but doubt it.

My hope for the future is radically different. As more sensors let us capture more and better data, and as early diagnostics help us better associate environmental conditions and diseases, we will be able to more clearly identify causes. We may finally answer whether and which pesticides cause childhood leukemia.

Prevention won’t make anyone billions the way cheap silicon wafers cancer diagnostic kits and advanced imaging will. Because Kessler is chasing money, he misses the obvious - that prevention always saves many more lives than treatment.