Sharon Moalem MD PhD - Inheritance: How Our Genes Change Our Lives--and Our Lives Change Our Genes

Everything Is About to Change

R emember the seventh grade?

Can you recall the faces of your fellow students? Can you summon the names of the teachers, the secretary, and the principal? Can you hear the way the bell sounded? How about the smell of the cafeteria on sloppy joe day? The ache of your first crush? The panic of finding yourself in the bathroom at the same time as the school bully?

Maybe its all strikingly clear. Or maybe, over time, your middle school years have been lost in the fog of so many other childhood memories.

Either way, youre carrying it all with you.

For a long time now, weve understood that we shoulder our experiences in the knapsack of our psyche. Even things you cannot consciously recall are somewhere in there, swimming around in your subliminal mind, ready to emerge unexpectedly for good or ill.

But its all much deeper than that, because your body is in a constant state of transformation and regeneration and your experiences, no matter how seemingly inconsequential, from bullies to crushes to sloppy joes, have all left an indelible mark within you.

And more importantly, within your genome.

Of course, this isnt how most of us have been taught to think about the three-billion-letter equation that makes up our genetic inheritance. Ever since Gregor Mendels mid-nineteenth-century investigations into the inherited traits of pea plants were used to set the foundations for our understanding of genetics, weve been taught that who we are is a resolutely predictable matter of the genes weve inherited from previous generations. A little from Mom. A little from Dad. Whip it up, and theres you.

That calcified view of genetic inheritance is what students in middle school classrooms are still studying to this day when they map out pedigree charts in an effort to make sense of their fellow students eye color, curly hair, tongue rolling, or hairy fingers. And the lesson, delivered as though on stone tablets from Mendel himself, is that we dont have much of a choice in the matter of what we get or what we give, because our genetic legacy was completely fixed when our parents conceived us.

But thats all wrong.

Because right now, whether you are seated at your desk sipping a coffee, slumped into a recliner at home, riding a stationary bike at the gym, or orbiting the planet on the International Space Station, your DNA is being constantly modified. Like thousands upon thousands of little light switches, some are turning on while others are turning off, all in response to what youre doing, what youre seeing, and what youre feeling.

This process is mediated and orchestrated by how you live, where you live, the stresses you face, and the things you consume.

And all of those things can be changed. Which, in very certain terms, means you can change. Genetically.

This is not to say that our lives are not also shaped by our genes. They most certainly are. In fact, what were learning is that our genetic inheritanceevery last nucleotide letter that makes up our genomeis instrumental and influential in ways that even the most fanciful science-fiction writer could not have imagined just a few short years ago.

Day by day, were gaining the tools and knowledge we need to embark on a new genetic journeyto take hold of a timeworn chart, lay it out across the table of our lives, and mark upon it a new course for ourselves, our children, and everyone down the line. Discovery by discovery, were coming to better understand the relationship between what our genes do to us and what we do to our genes. And this ideathis flexible inheritanceis changing everything.

Food and exercise. Psychology and relationships. Medication. Litigation. Education. Our laws. Our rights. Long-held dogmas and deeply felt beliefs.

Everything.

Even death itself. Until now, most of us have been under the assumption that our life experiences end when our lives end. Thats wrong, too. We are the culmination of our life experience as well as the life experiences of our parents and ancestors. Because our genes dont easily forget.

War, peace, feast, famine, diaspora, diseaseif our ancestors went through it and survived, weve inherited it. And once weve got it, were that much more likely to pass it on to the next generation in one way or another.

That might mean cancer. It might mean Alzheimers disease. It might mean obesity. But it might also mean longevity. It might mean grace under fire. And it might just mean happiness itself.

For better or for worse, we are now learning that it is possible to accept and reject our inheritance.

This is a guidebook for that journey.

In this book, Im going to talk about the tools I use as a physician and scientist to apply the latest advances in the field of human genetics to my daily practice. Ill introduce you to some of my patients. Ill dig through the clinical landscape for examples of research that is important to our lives, and Ill tell you about some of the research Im involved in. Ill talk about history. Ill talk about art. Ill talk about superheroes, sports stars, and sex workers. And Ill make connections that will change the way you look at the world and even the way you look at yourself.

Ill encourage you to walk along the tightrope that demarcates the border between the known and unknown. Sure, its wobbly up there, but its worth it. For one thing, the view is unforgettable.

Yes, the way I see the world is unconventional. By using genetic diseases as a template to understand our basic biology, Ive made groundbreaking discoveries in seemingly unrelated fields. This approach has served me well and has led to my discovery of a new and novel antibiotic named Siderocillin that specifically targets superbug infections as well as to the granting of twenty patents worldwide for new biotechnological innovations aimed at improving our health.

I have also had the good fortune to collaborate with some of the best doctors and researchers on the planet, and Ive been privy to some of the rarest and most complex genetic cases anyone has ever seen. Over the years, my career has brought me into the lives of hundreds of people who have entrusted me with the most important thing in their worldtheir children.

In short: I take this stuff seriously.

That doesnt mean this is going to be a grim experience. Yes, some of the things were going to talk about will be heartbreaking. Some of these concepts may challenge many of our core beliefs. Still other ideas may be downright frightening.

But if you open yourself up to this amazing new world, it can reorient you. It might make you think about the way you live. It might just make you reconsider how, genetically speaking, you got to this very moment in your life.

I assure you: By the end of this book, your entire genome and the life it has helped shape for you will never look or feel the same again.

So, if youre ready to see genetics in a very different way, Id like to be your guide on this journey through diverse places in our shared past, across a confounding collection of moments in our present, and into a future rife with promise and pitfalls.