Emory Report

April 24, 2000

 Volume 52, No. 30

Lawley looks to the future in Teachers lecture

By Michael Terrazas

Calling himself an "unreconstructed optimist," medical Dean Tom Lawley focused on the breakthroughs coming over the horizon in the world of medicine in his April 13 Great Teachers Lecture, "Medicine in the New Millennium: Pressures and Promises."

"There's no question that there will always be pressures," Lawley said. "There are always pressures, but the wonderful part about humankind is our ability to overcome pressures."

Speaking to an audience of about 75 gathered in White Hall, Lawley delivered a lecture of interest both to the many medical professionals in attendance and to the layperson. His talk of "facts, predictions and educated guesses" covered three major areas of medicine: organ transplantation, cancer diagnosis and treatment, and neuroscience.

Lawley said many human organs can be successfully transplanted--kidneys, livers and hearts being the most common--but the two major problems with the procedure are a growing shortage of donors and the extensive regimen of drugs a recipient's body needs to tolerate the new organ.

"The Holy Grail of transplantation biology is tolerance," Lawley said. "If you could do that, you'd have hit a bases-loaded home run."

He predicted that a procedure called a "chimerism protocol" that involves treating an organ recipient with the bone marrow of the donor will improve organ tolerance in the future, and he also said the donor shortage could be alleviated by using animal organs (probably pigs) for human transplantation, although this would certainly raise certain ethical issues, not to mention the possibility of transmitting animal viruses to humans.

Lawley said some cancer research is turning toward a vaccine as a way to prevent cancer or hold tumors in check once they develop. "Cancer diagnosis and treatment has never been better, but most people in oncology still think it's woefully inadequate," he said. The answer could lie not so much in preventing tumors from forming but rather keeping them from developing the blood supply that allows them to grow.

Neuroscience, Lawley said, is the "great frontier" of biomedical science that will enable scientists to put together "essentially the instruction manual for assembling a human being" through the genome-mapping project. He said in the near future doctors could be able to screen patients early in life and give them a list of diseases for which they are at risk, accompanied by lifestyle and diet recommendations to minimize those risks.

He said diseases such as Parkinson's, Alzheimer's, cancer, AIDS, some respiratory diseases and many others could be amenable to gene therapy.

Lawley also said information technology is playing an increasing role in patient care, as people become more sophisticated about health care and demand more information to manage their health themselves. And though the days of doctors carrying their black bags around to patients' homes may be over, online diagnoses could result in "virtual house calls" becoming commonplace in the future.

However, Lawley said such remote health care will never take the place of old-fashioned visits to the doctor's office. "No matter how sophisticated technology becomes, I'm a big believer in the healing touch."

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