Too close for comfort...

It was just another Saturday morning and since I walked in later than usual, instead of seeing empty corridors and desks, I found the usual culprits in the lab, trying to do the little things they could after a long week of work. But today the lab was a slightly different place from all the other Saturdays. Today we had a tumor sample in the lab.

A colleague of mine was trying to isolate some cells from this tumor sample to do a microarray analysis and compare its gene expression signature with other known cancers. This would be routine for a lab like ours but for the source of the tumor. This was a unique tumor sample. It was not from a mouse or an anonymous patient but from his mother. And he was working on it to try and get some answers.  The whole situation was so full of poignance and resilience at the same time that it was hard to just let it pass. 

I am a scientist and I have worked on cancer. I have seen patients and I understand in some corner of my mind that patients are real people. Real people, who are just like us except for this one unfortunate burden that they are forced to carry. And trust me it is easy to lose sight of this one simple fact as you deal with cell lines, genes, stables, drugs, IC50s, xenografts, so on and so forth. Ever so often we all need to be reminded that the samples we are working with are from real people. People who have heard probably the worst news of their life and people who might be counting their last few days. People who have poison leaching through their veins and people, whose families are living on the edge dreading every phone call and every doctor's visit. Families who are feeling betrayed and helpless. Families who are struggling with putting up a brave front even as they feel all hope drained out of them like as they stand mute spectators to life draining out of their loved ones. Amidst the hustle and bustle of a laboratory, amidst all the graphs, bars and p-values, It needs some reminding for all us researchers and academicians to know that all our work is ultimately aimed at benefiting those real people. Real people with real problems and concerns. 

But this incident was cutting it rather close to that dim realization of mine for me to carry on as usual. Someone I knew was working with a tumor. A tumor from his mother in a last ditch attempt to find out what went wrong and what should be done. It's only been a fortnight or so, since my colleague's mother was diagnosed with a large (25cm) tumor in her retroperitoneum. A biopsy didn't tell much and the hope was that a surgical resection would tell the doctors more. But as things played out, removing the tumor and a kidney with it didn't really give any more answers. And so he got into action and got some of the tumor sample to check for the gene expression signature of the tumor with other known cancers to try and get closer to an answer. He looked calm and quiet as he dissected the tumor and isolated the cells to get their RNA but I could sense something more. He was unusually quiet or unusually talkative in phases. Or maybe I was just imagining. But it was difficult to place myself in his shoes and still be so rational and composed about the whole thing. It was difficult for me to even imagine sitting thousands of miles away from my family in such situations and do what he was doing. To do what should be logically the right thing. Do what could make a difference. Do the practical thing. While his mother was battling the disease, I am sure he was fighting his own battles. He was working with the problem in the way he knew best. It was rational, practical and pragmatic but I could never be that way. To me, it seemed more important to be closer to my loved ones in the time of crisis than to actually work at finding a solution to the problem. Its irrational to the core but the "heart" is hardly known for its logic. It certainly is a difficult choice to make, to be rational and clinical about something so deeply personal and I thought his choice was truly courageous.

But it also raised some questions... If there is a gene expression signature that researchers can use, should we keep waiting for a company to develop it, test it, package it and come up with ways to maximizing profitability before releasing it to patients ? How much research can we bring into the clinic and how ? If there were a drug in trial, can we give it to patients with no other hope or should we wait for a clinical trial to be conducted with clear results. Should we let patients make their choices as they gamble with their lives and take a calculated risk ?

These questions are really the wanderings of a mind at the periphery of the unusual. I have never seen such a close intersection between our research and the life of a patient. We all talk of the great future potential of our work and the great possibilities that shall hitherto be opened by our pioneering work but deep down we also know the reality. The reality that our work is fairly far from the clinic or from actually making a difference in the lives of patients. But then when something like this happens, you are forced to acknowledge that which was conveniently buried in the sub conscious - that there is not much your work can do when it comes to saving a life in the immediate future. And even as I marvel at his courage and question my own lack of rationality i hope against all hope that the tumor would not be malignant.

But of course, hope is just a mirage in the vast deserts that span our realities....
But sometimes... hope is all you can do...