BioPharma in Fiction
I think we could all name a story, if asked, that starred some miracle drug that conveyed, say, near-eternal youth, beauty, or other startling effects to all who took it. I do believe there are plots that center around pills that when taken, give the patient huge intelligence. The quest for all these things is hardly new – Ponce de Leon’s trip to Florida was only the first of millions of aging retirees who would seek that warm place looking for the Fountain of Youth. Alchemists for hundreds of years believed they could cure all, or at least transmute dross into gold, and won’t having money cure everything? Elzbet Batory sought youth not in drugs, but in the blood of tender young things, and we’re doing exactly the same thing in the modern era, and no, I’m not pulling your leg. I rather recoiled from the screen when I came across that paper and the article that led me to it.
The problem, of course, is that it doesn’t work that way.
Drug development is an arduous process and one that isn’t exactly fully understood yet. We’re trying hard, spending billions of dollars every year on research, testing, trials, and marketing of the ones that (seem to) work. But it’s complicated. Boy, is it complicated. The human body is a miracle of complexity. If you’ve ever taken a biochemistry class, you might recall that the very first thing you studied was probably the concept that what makes cells (the basis of every other system in the body)work is counter-intuitive. Basically, cells shouldn’t be as elegant as they are, because entropy. Only they are, because entropy. Um. I’d have to spend a lot of time on this, and I’m going to gloss over it and get to the really complicated bits, which cell walls aren’t, even though they are pretty amazing. No, the complexity of nearly every cell in the human body is in the nucleus, the mitochondria, and the proteins. And when those processes – of DNA making RNA making proteins – are disrupted, we get disease. Cancer? Is the proliferation of our own cells. That’s why it’s so daggone hard to kill, “We have met the Enemy, and He is Us.”
Now that I’ve skimmed lightly over that, let me throw another rock in the pool and get the ripples all crossways and interlocking. Not every human will react to the same drug in the same way. I’m pretty sure most of you are aware of that, but in fiction we have a tendency to create a monomythic human race that’s all the same and we can just create this youth serum and boom – immortal society. Except that there will inevitably be individuals who will be allergic to it, who will die from it, who it won’t affect at all for some peculiar reason. It’s the reason that proper drug trials and studies include the broadest possible pool of people to study. People aren’t all the same. And people aren’t animals, which brings me to the final complexity of drug discovery that I don’t think most authors touch on – unless it’s to decry the use of poor innocent furbeings in the development of medicines for humans. Sigh.
In most cases, we use animal models in order to study human diseases and their possible treatments. This is, of course, limited. A mouse is a mammal and a human is a mammal, but they are not identical. That much is true. However, the ability to study the course of a disease in an animal is much more powerful than trying to study it in a human because animals (like mice) live shorter lives, and we can look at the progress in that much faster time. Also, it gives researchers the chance to strive for the gold standard in science that is all too often elusive: reproducibility. According to a recent article in Nature, something like 11% of studies done on ‘novel’ methods were able to reproduce the same results when done by a different team. I don’t know about you, but that’s a shockingly low number.
And this isn’t even wading into the field of psuedoscience and quack doctors that have been around since time immemorial. The field that makes us think that a drug that could cure aging is possible in our time. Er… probably not. The fact of the matter is, we just don’t understand the human organism well enough yet. Or, to take a step back from the grandiose, the conspiracy theories that rant about how Big Pharma is keeping the cure for cancer secret. Cancer, to begin with, isn’t a simple problem. There are as many cancer types as there are systems in the body, and there are all kinds of ways that cancer spreads, grows, and when we can figure those out, we can sometimes stop the cancer and we can sometimes kill it. But there will never be just one thing that will kill all the cancers. Also, to address the other side of that theory, you would condemn hundreds of thousands of good men and women (who work hard at a job they feel to be worthy because it allows them to be a part of teams helping their fellow humans) as liars and cowards. They too have family and friends who suffer from cancer. Even if they wouldn’t speak up for the general populace, you also would say they will not speak for their loved ones?
Drugs, fiction, biology. So many possiblities! But also, so many pitfalls.
(Header image: ‘Viral Load’ digital art by Cedar Sanderson)