From the Double Helix to Genomic Medicine[dhelix]

The monumental contribution of Watson and Crick—proposing the structure of DNA—is being celebrated this spring on the 50th anniversary of their classic publication in Nature(1). Expressed simply, clearly, and logically, their analysis was a signal event in the history of science. In the five decades that have followed, a series of truly remarkable discoveries have occurred throughout all of science based on the implications of their conclusions. While it is very difficult to quantify the effect of this progress on clinical medicine today or what it might be in the future, several observations may provide a perspective for the busy clinician.

First, it is important to emphasize that the living cell or, indeed, the complex human organism, is not constrained by our definitions of disciplines. It is not chemistry, biology, genetics, genomics, proteomics, computer sciences, or, indeed, bioinformatics that the cell has to choose among to conduct its life processes. Rather, it is a wondrous integration of all disciplines, known and perhaps unknown, that is used by the cell, tissue, organ, or even ourselves. The accretive and interdisciplinary nature of scientific progress has brought us to a highly sophisticated understanding of both normal and aberrant processes in the human organism.

Second, the impact of scientific progress, as it may be applied to clinical medicine, may not always be fully appreciated if one is looking only for that “silver bullet” as evidence of progress. Two examples well illustrate …