Siddhartha Mukherjee Meet the Author

Science is changing Faster than ever, but there's so much

that we still don't know and we're only beginning to grapple with some

of the ethical problems that genetic discoveries are forcing

us to confront.

Siddhartha Mukherjee, who is a cancer doctor, wrote

about the disease in The Emperor of All Maladies,

has written what he calls An Intimate History

of the Gene.

And it's a history, starting in a monastery

garden 150 years ago, into a future where we are going to

have to deal with the consequences of what we're beginning to learn

about how we're made up and what makes us function.

Welcome.

This is a comprehensive history of how we came to know what we know

and its implications, but it's also a deeply

personal story, isn't it?

Yes, it is.

You know, this book begins with an exploration of my own family

and in particular a history of schizophrenia and bipolar

disorder in my family that crosses multiple generations.

Really the book begins with the question, why?

Why me?

Am I susceptible?

Are my family susceptible?

And what happens, what do I do with that knowledge.

Let's trace the story from this monastery garden.

Yes.

Because it is quite remarkable.

Here's a chap playing around in his garden,

and he makes a discovery, and it really is one of the landmark

discoveries in modern science?

You know, we are taught about Mendle, about Greta Mendle,

we are taught about him in some kind of abstract way.

He was a monk, in a garden, etc, yet from that little plot

alone emanates virtually all of modern biology.

You know, you can trace a line from that plot.

All he could see in contradistinction to his priors

was that information, information was moving

across the biological world and it was moving like units.

In a kind of, almost as if particles were moving.

He didn't know what the physical form was,

what the chemical form was.

No-one had even heard at that time, made the connections

between DNA and genes.

And even the word, gene, Mendle didn't know.

It was coined afterwards.

If we race forward 150 years.

We are all aware that the pace of this exploration speeded up

in a way that, you know, whether you were born

in the early 1970s, would have been inconceivable.

Well, what can we do now?

We can read, we can read the sequence of a genome.

Your genome, my genome, and the cost is plummeting.

It used to be, the first one, people say, well a sequence

was about ?billion-odd dollars, now you can sequence,

not the whole genome but the active part of the genome for about ?000.

You could then, therefore, potentially sequence

the genome of an unborn child.

You see, this is the question that our children will be facing:

Should have I a genome sequenced?

Should I have the genome of my unborn child sequenced?

Should I do it even before I conceive?

Before implantation?

What you're talking about is a power that's produced

by these discoveries...

Yes.

Which we have, and which human beings have to manage in some

way, of a kind we have never known before?

I mean the power is as John Solsten, the great scientist, once said,

what happens when a machine begins to decipher the own language

of its construction?

What if a machine could write its own manual?

That's where we are now.

We are machines that are learning to read and write our own

manuals of instruction.

You know, genes are not destiny.

There's chance, there's environment.

Genes are a kind of constraint that place a constraint

on chance and destiny.

So I don't want to say that genes equal you.

No.

But what is important is that it is impossible to think

about you without at least paying very, very serious

attention to genes.

Of course, the moment we get on to this subject,

people begin to think, in a nightmarish way, about,

people who talked about eugenics in the earlier and middle years

of the 20th century, and you deal with this

here, and in a way, that's the horror of where

these things can lead.

I do think that the gene is the defining idea of this

new century.

It is the most important and potentially the most dangerous

idea of this new century.

The capacity to control genetics, either through what we choose,

how we choose to read and write genomes is absolutely of importance.

So I don't think we will go back to a state mandated eugenics project.

I just think it is very unlikely.

But eugenics will become personal.

You will make a decision about what kind of,

in a very broad sense, about what to do about

your unborn child's genome.

So either we look away, or we confront, what I think

is the most important and most dangerous idea of the 21st century.

It seems to me we need a much wider conversation about this,

much like the conversation that occurred when we

learned to open up the energy and the atom, and the broader

conversation is, you know, we need to ask people who have been,

who have experienced devastating genetic illnesses.

We need to ask people, you know, genes have the capacity,

the ability to manipulate genes, they can have an incredibly

important effects on the biosphere, you can make new kinds

of animals and crops.

You can make wonderful things like vaccines.

You know, virtually all of the new vaccineses that are made

today are using genetic technology.

You can make new medicines that change the course

of devastating illnesses.

There's an incredible amount of good that you can use genes for,

genetic technologies for.

In your profession...

Yes.

Things must have changed hugely?

I mean, and so much has changed.

I'll give you two examples, you know I see cancer patients,

virtually every patient that I see has some aspect of their genetics,

their cancer genes, sequenced and analysed

and something in that information is used to direct their therapy.

It was unthinkable ten years ago.

Yes, even ten years ago?

Even ten years ago.

We were doing it on small numbers of patients.

Virtually every patient that comes into my clinic has some aspect,

some have their entire genome or the active part of the genome

sequence, that is one example.

A second example, we are beginning to take immune cells from patients,

bring them out, culture them in test tube, genetically engineer them

to kill cancer, in the test tube, and reintroduce those cells

into human beings for leukaemias that were previously absolutely

deadly, you can bring out a person's own...

I mean think about that for a second, bring out

a person's own immune cells, reengineer them, and make them

specifically deadly killers to their own cancer, and now inject

those cells back, all because, in part,

down to genetic technology.

What it boils down to is this: Our expectations of life what life

holds for us are changing extraordinarily fast as a result

of this, as we speak?

Absolutely.

There's no doubt about that.

And it will continue to change and in order to contend with it,

it's at our doorstep, we cannot open the door

without knowing its name, without knowing

what its powers are, what, how it's been used

in the past and why you and me?

Why schizophrenia in my family?

Why diabetes in yours?

Why Huntingdon's disease in another person?

Why breast cancer in yet another family?

How do we have the knowledge and the vocabulary?

And the consequence of that is that we have to think

about it and we have to confront it.

Absolutely.

Siddhartha Mukherjee, thank you very much.

My pleasure, thanks.

My pleasure, thanks.