Wednesday, January 5, 2011

Radium, dopamine and innovation: Name your poison

Reading Deborah Blum's "The Poisoner's Handbook" is an intellectual treat. Although non-fiction, it paints in understated sepia tones the crevices of New York City at the dawn of the Industrial Revolution, where bootlegged booze and poisons were fare of the day, homicides went unpunished and the corrupt coroner system basked in the glow of its own willful ignorance and political approval. That is until Charles Norris and Alexander Gettler, two single-minded and tireless men, brought science into the lagging American medical jurisprudence and created the now burgeoning field of forensic medicine.

The chapter on radium in particular sparked my interest. Blum describes in vivid detail the well-known misadventure of the "radium girls", a label given to young women in a watch factory in Orange, NJ, in the early 1920s. She sets up the story with the fascinating background of radium discovery by the Curies and Marie Curie's penchant for carrying a "pet" bottle of radium in her skirt pocket, exhibiting its breathtaking beauty in a circus-like fashion (she died a horrible death from aplastic anemia induced by radiation exposure). Once its tumor shrinking properties became known, it did not take long for entrepreneurs, backed by the medical establishment, to create and sell all kinds of tonics and pills containing radium to the clueless public searching for the fountain of youth. The tragic tale of the radium girls, who, because of occupational ingestion of radium used for painting numbers on the faces of watches (according to Blum's account, the girls were encouraged to lick the paint brushes to make them pointy), and playful applications of this glow-in-the-dark paint on their lips and faces, developed debilitating jaw necrosis and other bony complications and early deaths, delivered a dose of sobriety to the public and policy makers about this new health panacea. Even the gifts of radium to Marie Curie were now delivered in a thick lead shield to contain its homicidal particles.

The story of radium raised all sorts of questions for me. When the element was first discovered, even the scientists could not conceive of its deadly health effects on human tissues. And for this reason there was no caution exercised in its use. What I puzzle over, as you may have guessed from many previous posts, is how we can balance our adoption of new glittering technologies, about which we do not have complete information, and keeping a modicum of caution about their currently unknown potentially adverse effects. I particularly wonder about this in the context of how our brains are wired and of our prevailing concerns for the economy even at the expense of our health.

Humans are seekers. I recently read Jonah Lehrer's "How We Decide", and it made me appreciate just how susceptible we are to the pleasurable effects of dopamine, and how craving its effects drives us to perform irrational acts that will soothe our neurons in a bath of dopamine bubbles. Addiction, the ultimate seeking-and-never-finding behavior, is, at least in part, mediated by dopamine. Does this addiction fuel our drive for innovation as well? And does it also make us throw caution to the wind when a desirable new object, like, say, glow-in-the-dark radium or a smart phone, is within grasp?

On the same side of this equation is the corporate voice, thundering in the background about the importance of innovation, injecting doubt about the potential for untoward effects and invoking the reigning rhetoric of Queen Economy as the ultimate justification. You don't believe me? Just look at the tobacco history, rife with denials, manipulation and lies. And this is exactly what our consumer brain wants to hear. So we paint caution as unscientific alarm and walk away from it, shaking our heads, filled with self-righteousness.

This balance that I am describing is once again the baby and bath water problem. We encounter it in every aspect of our modern lifestyle: the environment and the threat of climate change; the healthcare system with its record technology spending without commensurate results in health; our food system and obesity and superbug epidemics; the galloping pace of technological development, far outpacing our cognitive abilities to incorporate these technologies sensibly into our lives. Simply put, the question becomes, how do we harness innovation without demanding corpses (literally and figuratively) as proof of its potential untoward effects?

The first step is clearly understanding our history, and for this read Blum's book -- you won't be sorry! Next we need awareness of how our brains operate and how these biological principles set well known traps in our reasoning. Using metacognition to understand these pitfalls in thinking may at least put us on a smarter course walking this fine line. Finally, as I have advocated before, we need to stop shouting at each other and start listening. Perhaps we are not so drastically different in our views as the press and politicians will have us believe. After all, we are all susceptible to the same poisons. And dopamine.                

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