David B. Agus, an oncologist with a practice in Beverly Hills, Calif., has seen the future and it is good.
In that future, patients and doctors will be able to do more because they will know more, so much more that cancer will lose its terror and death its long prequel of decline and suffering.
People who can see into the future have been known to be impatient with those who cannot, and so it is with Dr. Agus. He has "developed a unique way of looking at the relationship of the human body to health and disease," is "exasperated by the backward thinking that science continues to espouse," is at the forefront of "a whole new way to make this world a better, healthier place."
Agus, in short, is at the forefront of a paradigm shift, and when other doctors come around to his way of thinking they will be practising a wholly new type of medicine. Instead of diagnosing the problems you already have, they will (with your help, of course) be constantly on the lookout for the problems you will have.
As a paradigm to triumph, its rivals must either step aside or be pushed aside. Pharmacology and the germ theory of medicine still have a place in Agus's promised land, but on very different terms than they enjoy today.
The first, we read, has produced as much as it ever will: What is left is to learn how to use all the drugs that are already out there. And, through the technologies that are just around the corner, to tailor both the types and quantities prescribed.
As for the germ theory of disease, it is not so much wrong as it is no longer especially helpful. Its drawbacks, Agus tells us, are twofold: Not only does it encourage physicians to practise diagnostic rather than preventive medicine, it is a poor fit with the chronic diseases that have now overtaken infectious diseases as the leading killer worldwide.
The breakthrough, when it comes, will come from an endeavour the author is vitally concerned in: proteomics. The thinking goes like this: Listen to what your body's proteins are saying and you will know what is going on at a cellular level inside you. You will know, for example, whether your body is already undergoing the subtle changes that precede different types of cancer. Take this thinking to the next step and a simple blood test will tell you whether you really need that colonoscopy.
The body's proteins are so numerous, the changes they undergo so dynamic and the causes so multiple that proteomics presents a challenge that only supercomputing can possibly unravel. And Agus just so happens to have the hardware, the team and the will to do just that at his Physical Sciences in Oncology Center at the University of Southern California.
Agus may very well be right. But until he is proved right, he must fall back on certain unobjectionable tips designed to keep you alive for the 10 years or so it will take proteomics to realize its full potential.
These tips are so unobjectionable that I can see no earthly reason for the legal disclaimer absolving the author of any responsibility for their consequences. Lose weight. Get exercise. Wear sensible shoes. Keep a regular schedule and make sure you get enough sleep. Eat your vegetables. Do your homework so that you get the most out of your annual physical. Stop thinking that all those vitamins you're taking will save you because they won't. Get a flu shot. And while you're at it, ask your doctor whether you really need all those drugs you're taking.
What you will find in this book are clear and compelling reasons to be more pro-active about your health. The sections explaining physiology and the latest medical findings are very good, and are far more persuasive than the usual lectures we are given about all our bad habits.
To misquote the Hippocratic Oath, "First do no harm." It will do you no harm to dream of the end of illness, but until that time, it might just do you some good to follow Agus's eminently sensible advice.
Jessica Warner teaches at the University of Toronto's Institute for the History and Philosophy of Science and Technology.