0:00:12 > 0:00:14Science is changing Faster than ever, but there's so much
0:00:14 > 0:00:17that we still don't know and we're only beginning to grapple with some
0:00:17 > 0:00:19of the ethical problems that genetic discoveries are forcing
0:00:19 > 0:00:20us to confront.
0:00:20 > 0:00:22Siddhartha Mukherjee, who is a cancer doctor, wrote
0:00:22 > 0:00:28about the disease in The Emperor of All Maladies,
0:00:28 > 0:00:30has written what he calls An Intimate History
0:00:30 > 0:00:31of the Gene.
0:00:31 > 0:00:33And it's a history, starting in a monastery
0:00:33 > 0:00:36garden 150 years ago, into a future where we are going to
0:00:36 > 0:00:39have to deal with the consequences of what we're beginning to learn
0:00:39 > 0:00:49about how we're made up and what makes us function.
0:00:49 > 0:00:53Welcome.
0:00:57 > 0:01:07This is a comprehensive history of how we came to know what we know
0:01:07 > 0:01:09and its implications, but it's also a deeply
0:01:09 > 0:01:10personal story, isn't it?
0:01:10 > 0:01:11Yes, it is.
0:01:11 > 0:01:16You know, this book begins with an exploration of my own family
0:01:16 > 0:01:20and in particular a history of schizophrenia and bipolar
0:01:20 > 0:01:26disorder in my family that crosses multiple generations.
0:01:26 > 0:01:30Really the book begins with the question, why?
0:01:30 > 0:01:33Why me?
0:01:33 > 0:01:34Am I susceptible?
0:01:34 > 0:01:40Are my family susceptible?
0:01:40 > 0:01:43And what happens, what do I do with that knowledge.
0:01:43 > 0:01:44Let's trace the story from this monastery garden.
0:01:45 > 0:01:46Yes.
0:01:46 > 0:01:47Because it is quite remarkable.
0:01:47 > 0:01:49Here's a chap playing around in his garden,
0:01:49 > 0:01:52and he makes a discovery, and it really is one of the landmark
0:01:52 > 0:01:53discoveries in modern science?
0:01:53 > 0:01:56You know, we are taught about Mendle, about Greta Mendle,
0:01:56 > 0:01:58we are taught about him in some kind of abstract way.
0:01:58 > 0:02:02He was a monk, in a garden, etc, yet from that little plot
0:02:02 > 0:02:04alone emanates virtually all of modern biology.
0:02:04 > 0:02:09You know, you can trace a line from that plot.
0:02:09 > 0:02:12All he could see in contradistinction to his priors
0:02:12 > 0:02:17was that information, information was moving
0:02:17 > 0:02:21across the biological world and it was moving like units.
0:02:21 > 0:02:24In a kind of, almost as if particles were moving.
0:02:24 > 0:02:26He didn't know what the physical form was,
0:02:26 > 0:02:27what the chemical form was.
0:02:27 > 0:02:29No-one had even heard at that time, made the connections
0:02:29 > 0:02:34between DNA and genes.
0:02:34 > 0:02:36And even the word, gene, Mendle didn't know.
0:02:36 > 0:02:41It was coined afterwards.
0:02:41 > 0:02:48If we race forward 150 years.
0:02:48 > 0:02:51We are all aware that the pace of this exploration speeded up
0:02:51 > 0:02:53in a way that, you know, whether you were born
0:02:53 > 0:02:55in the early 1970s, would have been inconceivable.
0:02:55 > 0:02:57Well, what can we do now?
0:02:57 > 0:02:59We can read, we can read the sequence of a genome.
0:02:59 > 0:03:02Your genome, my genome, and the cost is plummeting.
0:03:02 > 0:03:05It used to be, the first one, people say, well a sequence
0:03:05 > 0:03:08was about ?billion-odd dollars, now you can sequence,
0:03:08 > 0:03:12not the whole genome but the active part of the genome for about ?000.
0:03:12 > 0:03:15You could then, therefore, potentially sequence
0:03:15 > 0:03:18the genome of an unborn child.
0:03:18 > 0:03:21You see, this is the question that our children will be facing:
0:03:21 > 0:03:25Should have I a genome sequenced?
0:03:25 > 0:03:28Should I have the genome of my unborn child sequenced?
0:03:28 > 0:03:30Should I do it even before I conceive?
0:03:30 > 0:03:31Before implantation?
0:03:31 > 0:03:33What you're talking about is a power that's produced
0:03:33 > 0:03:35by these discoveries...
0:03:35 > 0:03:38Yes.
0:03:38 > 0:03:41Which we have, and which human beings have to manage in some
0:03:41 > 0:03:43way, of a kind we have never known before?
0:03:43 > 0:03:46I mean the power is as John Solsten, the great scientist, once said,
0:03:46 > 0:03:49what happens when a machine begins to decipher the own language
0:03:49 > 0:03:54of its construction?
0:03:54 > 0:03:56What if a machine could write its own manual?
0:03:57 > 0:03:58That's where we are now.
0:03:58 > 0:04:01We are machines that are learning to read and write our own
0:04:01 > 0:04:03manuals of instruction.
0:04:03 > 0:04:06You know, genes are not destiny.
0:04:06 > 0:04:09There's chance, there's environment.
0:04:09 > 0:04:11Genes are a kind of constraint that place a constraint
0:04:11 > 0:04:14on chance and destiny.
0:04:14 > 0:04:17So I don't want to say that genes equal you.
0:04:17 > 0:04:22No.
0:04:22 > 0:04:25But what is important is that it is impossible to think
0:04:25 > 0:04:27about you without at least paying very, very serious
0:04:27 > 0:04:29attention to genes.
0:04:29 > 0:04:31Of course, the moment we get on to this subject,
0:04:31 > 0:04:34people begin to think, in a nightmarish way, about,
0:04:34 > 0:04:36people who talked about eugenics in the earlier and middle years
0:04:36 > 0:04:38of the 20th century, and you deal with this
0:04:38 > 0:04:43here, and in a way, that's the horror of where
0:04:43 > 0:04:46these things can lead.
0:04:46 > 0:04:49I do think that the gene is the defining idea of this
0:04:49 > 0:04:50new century.
0:04:50 > 0:04:52It is the most important and potentially the most dangerous
0:04:52 > 0:04:54idea of this new century.
0:04:54 > 0:04:56The capacity to control genetics, either through what we choose,
0:04:56 > 0:05:02how we choose to read and write genomes is absolutely of importance.
0:05:02 > 0:05:06So I don't think we will go back to a state mandated eugenics project.
0:05:06 > 0:05:09I just think it is very unlikely.
0:05:09 > 0:05:11But eugenics will become personal.
0:05:11 > 0:05:14You will make a decision about what kind of,
0:05:14 > 0:05:16in a very broad sense, about what to do about
0:05:16 > 0:05:19your unborn child's genome.
0:05:19 > 0:05:25So either we look away, or we confront, what I think
0:05:25 > 0:05:28is the most important and most dangerous idea of the 21st century.
0:05:28 > 0:05:31It seems to me we need a much wider conversation about this,
0:05:31 > 0:05:33much like the conversation that occurred when we
0:05:33 > 0:05:36learned to open up the energy and the atom, and the broader
0:05:36 > 0:05:39conversation is, you know, we need to ask people who have been,
0:05:39 > 0:05:48who have experienced devastating genetic illnesses.
0:05:48 > 0:05:52We need to ask people, you know, genes have the capacity,
0:05:52 > 0:05:55the ability to manipulate genes, they can have an incredibly
0:05:55 > 0:05:57important effects on the biosphere, you can make new kinds
0:05:57 > 0:05:58of animals and crops.
0:05:58 > 0:06:00You can make wonderful things like vaccines.
0:06:00 > 0:06:03You know, virtually all of the new vaccineses that are made
0:06:03 > 0:06:08today are using genetic technology.
0:06:08 > 0:06:10You can make new medicines that change the course
0:06:10 > 0:06:11of devastating illnesses.
0:06:11 > 0:06:14There's an incredible amount of good that you can use genes for,
0:06:14 > 0:06:15genetic technologies for.
0:06:15 > 0:06:16In your profession...
0:06:16 > 0:06:17Yes.
0:06:17 > 0:06:20Things must have changed hugely?
0:06:20 > 0:06:26I mean, and so much has changed.
0:06:26 > 0:06:29I'll give you two examples, you know I see cancer patients,
0:06:29 > 0:06:32virtually every patient that I see has some aspect of their genetics,
0:06:32 > 0:06:34their cancer genes, sequenced and analysed
0:06:34 > 0:06:39and something in that information is used to direct their therapy.
0:06:39 > 0:06:40It was unthinkable ten years ago.
0:06:40 > 0:06:42Yes, even ten years ago?
0:06:42 > 0:06:45Even ten years ago.
0:06:45 > 0:06:48We were doing it on small numbers of patients.
0:06:48 > 0:06:50Virtually every patient that comes into my clinic has some aspect,
0:06:50 > 0:06:53some have their entire genome or the active part of the genome
0:06:53 > 0:06:55sequence, that is one example.
0:06:55 > 0:06:58A second example, we are beginning to take immune cells from patients,
0:06:58 > 0:07:01bring them out, culture them in test tube, genetically engineer them
0:07:01 > 0:07:05to kill cancer, in the test tube, and reintroduce those cells
0:07:05 > 0:07:11into human beings for leukaemias that were previously absolutely
0:07:11 > 0:07:17deadly, you can bring out a person's own...
0:07:17 > 0:07:21I mean think about that for a second, bring out
0:07:21 > 0:07:24a person's own immune cells, reengineer them, and make them
0:07:24 > 0:07:27specifically deadly killers to their own cancer, and now inject
0:07:27 > 0:07:28those cells back, all because, in part,
0:07:28 > 0:07:31down to genetic technology.
0:07:31 > 0:07:36What it boils down to is this: Our expectations of life what life
0:07:36 > 0:07:40holds for us are changing extraordinarily fast as a result
0:07:40 > 0:07:43of this, as we speak?
0:07:43 > 0:07:44Absolutely.
0:07:44 > 0:07:50There's no doubt about that.
0:07:50 > 0:07:53And it will continue to change and in order to contend with it,
0:07:53 > 0:07:55it's at our doorstep, we cannot open the door
0:07:55 > 0:07:56without knowing its name, without knowing
0:07:56 > 0:07:59what its powers are, what, how it's been used
0:07:59 > 0:08:01in the past and why you and me?
0:08:01 > 0:08:05Why schizophrenia in my family?
0:08:05 > 0:08:08Why diabetes in yours?
0:08:08 > 0:08:09Why Huntingdon's disease in another person?
0:08:09 > 0:08:11Why breast cancer in yet another family?
0:08:11 > 0:08:14How do we have the knowledge and the vocabulary?
0:08:14 > 0:08:16And the consequence of that is that we have to think
0:08:16 > 0:08:18about it and we have to confront it.
0:08:18 > 0:08:19Absolutely.
0:08:19 > 0:08:21Siddhartha Mukherjee, thank you very much.
0:08:21 > 0:08:25My pleasure, thanks.
0:08:25 > 0:08:31My pleasure, thanks.