Musings on up-close-and-personal medicine

Having attended Harvard Medical School's Personalized Medicine Conference one month ago, I am high on both the concept of personalized medicine and the progress being made toward that goal by various segments of the healthcare industry. The notion of tailoring therapies to patient groups based not just on the symptoms they present -- or even a multiplicity of factors such as symptoms plus age plus family history -- but also more specific variables such as the presence of a particular genetic marker, holds tremendous promise for both patients and pharmaceutical manufacturers. Targeted therapies should provide greater efficacy and fewer side effects, would require less marketing, and, it is hoped, less post-market scrutiny. What Dr. Raju Kucherlapati and his staff did so marvelously in developing that conference -- that is, bringing together people from academia, industry and regulatory agencies, and from every segment of the healthcare system to exchange information and viewpoints -- is what needs to happen on first a national level and eventually on a global scale. Many brilliant and dedicated people are working to bring these lofty goals to fruition, although it may be hard to visualize such a future from the front lines of a community hospital. Medicine is still both an art and a science; the trial-and-error method remains part of the process. For example, as I sat in recovery after abdominal surgery recently, I was given Vicodin. I cannot recall for certain if I had ever had it before then, but I know I won't ever take it again -- after just a few minutes, my face began itching intensely, especially within my nose, eyes and ears.  After two IV doses of Benadryl gave me some relief, my doctor prescribed Percocet. I have found that that also provokes an allergic reaction, but less extreme than what I experienced with Vicodin. Individualized medicine may as yet be out of our reach; however, treating patients as individuals will never become obsolete. -HP