A cloudy view of the future

Dr. McDonnell

By Peter J. McDonnell, MD

Some days I just can’t help feeling great about the future, especially the future of medicine. Some scientist-in my department or someplace else-will show me how stem cells made from adult skin fibroblasts can be coached to become a retina, a sheet of retinal pigment epithelial cells, a layer of ganglion cells with axons that look like they’re trying to regrow an optic nerve, or some other feat of magic that makes me believe we will soon be restoring vision to those who’ve become “permanently” blind.

Ophthalmology residents today know so much more about medical science and the diagnosis and treatment of eye disease, and can do so much more than residents did in my day that the difference is almost ridiculous. And people whose vision was routinely wiped out by choroidal neovascularization when I was a young ophthalmologist are now routinely having their vision saved.

It makes me think that there has never been a better time to be alive or to be a physician, and that hard work and scientific discovery are dramatically improving the human condition.

Moving forward?

And then on other days, like today, I watch videos and read stories on the Internet of people being gunned down in the streets of giant “world-class” cities like Kiev, Caracas, Bangkok, and Aleppo by their fellow citizens. Whatever the facts about who is protesting over what and the political details-of which my knowledge in some of these instances is minimal-I find it so discouraging to see barbaric responses to apparently unarmed protestors.

That this type of thing happens in this day and age makes me question whether, in fact, our human species is really advancing.

I know or have met ophthalmologists from all of these cities, and wonder what it must be like to have to run a practice and take great care of patients amid such turmoil.

From what I read, the economy of Venezuela is in chaos, with rampant inflation, widespread shortages, and escalating crime rates.

In Kiev and Bangkok, there certainly is considerable turmoil and uncertainty about the government.

In Aleppo, an ophthalmologist would literally be operating his or her practice in a war zone.

It must border on heroic, it seems to me, for an ophthalmologist to be able to obtain everything he or she needs and provide the best care for patients in such environments.

Suffering patients

Sadly, in such situations, it is probably the poor patients who suffer the most, as their well-educated physicians and other professionals leave their strife-torn lands for more stable and safe environments in which to raise their families. Far be it for me to blame an ophthalmologist who decides to leave a practice in one of these cities and relocate, but clearly this type of “brain drain” can quickly reverse many years of progress in a country’s medical system and society.

So I find myself questioning whether there is an inevitable “march of progress,” in which societies progressively improve, people get more access to education, economies strengthen, and the lives we humans lead gradually, but irreversibly, become better.

Is it only a matter of time when we live in a future world in which the work of stem cell biologists will give sight to the blind? Or can any of our societies and great cities fall back into the kind of chaos we’ve been seeing lately?

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