Less = more

This week we covered psychosis and focused in on schizophrenia. One of the lectures we had was by a medical geneticist who, at the end of her presentation, told us about a phenomenon that we’ll need to know about as patients start to use – personal genome service. Basically this company provides you with a copy of your DNA with some basic interpretation for things you may want to “be aware of”. It’s website talks about helpfully pointing out where you may want to “focus your attention” but indicates that it doesn’t replace the advice/consultation with a medical practitioner.

I have to say that I do find this kind of service a bit alarming. Given that many genetic defects are only expressed part of the time and others require environmental triggers to cause them to be expressed (e.g. the few genetic defects that are related to schizophrenia), I don’t understand how this wouldn’t just freak people out.

Case in Point: When I was in the hospital a year ago they did a CT scan to check out whether I had appendicitis or not (not sure why this was required but at the time I didn’t realize that physicians were so “CT happy”). The resident was very kind when she came back with the results and invited me to take a look at my abdominal CT scan. As she walked me through, she casually pointed out “Oh and you have a liver cyst there but it’s likely nothing. About 20% of the population have benign liver cysts.” Maybe as a med student I’m more of a hypochondriac than most, but I have to say that occasionally (well, rarely) I’ll think of the cyst and wonder about it. And really, I’m sure it’s nothing. But frankly, I’d rather not know about it. I wonder if that’s how some people might feel if they pay to get their genome decoded and then see that they have genetic defects associated with a condition they don’t yet have and may never develop and think “S*^%, I wish I never knew that.” Sometimes less is more.