The Best American Science Writing 2008

by Nasar, Sylvia

• ISBN13: 9780061340413
• ISBN10: 0061340413
• Format: Paperback
• Publisher: HarperCollins Publications

Summary

Edited by Sylvia Nasar, bestselling author of A Beautiful Mind and former economics correspondent for the New York Times, The Best American Science Writing 2008 brings together the premiere science writing of the year. Distinguished by the foremost voices and publications-among them Pulitzer Prize-winner Amy Harmon, Nobel Prize-winner Al Gore, and award-winning and bestselling author Oliver Sacks-this anthology is a comprehensive overview of our most advanced and most relevant scientific inquiries.

Table of Contents

Introduction	p. vii
Facing Life with a Lethal Gene	p. 1
An Error in the Code	p. 17
23andMe Will Decode Your DNA for $1,000. Welcome to the Age of Genomics	p. 35
Evolved for Cancer?	p. 54
How NIH Misread Hormone Study in 2002	p. 65
Psychiatrists, Children, and Drug Industry's Role	p. 71
After Sanctions, Doctors Get Drug Company Pay	p. 81
Dr. Drug Rep	p. 89
When Is a Pain Doctor a Drug Pusher?	p. 105
What's Normal?	p. 130
Supply, Demand, and Kidney Transplants	p. 145
The Abyss	p. 160
Muscle Memory	p. 182
Duped	p. 196
The Older-and-Wiser Hypothesis	p. 222
Moving Beyond Kyoto	p. 244
Beneath Booming Cities, China's Future Is Drying Up	p. 249
In China, a Lake's Champion Imperils Himself	p. 258
Sowing for Apocalypse	p. 271
About the Contributors	p. 301
Table of Contents provided by Ingram. All Rights Reserved.

Excerpts

The Best American Science Writing 2008

Chapter One

Amy Harmon

Facing Life with a Lethal Gene

From the New York Yimes

Now that genetic testing is becoming more common people at risk for hereditary disease are struggling with whether to find out their genetic fates. Amy Harmon follows one young woman whose test results have changed her life.

The test, the counselor said, had come back positive.

Katharine Moser inhaled sharply. She thought she was as ready as anyone could be to face her genetic destiny. She had attended a genetic counseling session and visited a psychiatrist, as required by the clinic. She had undergone the recommended neurological exam. And yet, she realized in that moment, she had never expected to hear those words.

"What do I do now?" Ms. Moser asked.

"What do you want to do?" the counselor replied.

"Cry," she said quietly.

Her best friend, Colleen Elio, seated next to her, had already begun.

Ms. Moser was twenty-three. It had taken her months to convince the clinic at New York-Presbyterian Hospital/Columbia University Medical Center in Manhattan that she wanted, at such a young age, to find out whether she carried the gene for Huntington's disease.

Huntington's, the incurable brain disorder that possessed her grandfather's body and ravaged his mind for three decades, typically strikes in middle age. But most young adults who know the disease runs in their family have avoided the DNA test that can tell whether they will get it, preferring the torture—and hope—of not knowing.

Ms. Moser is part of a vanguard of people at risk for Huntington's who are choosing to learn early what their future holds. Facing their genetic heritage, they say, will help them decide how to live their lives.

Yet even as a raft of new DNA tests are revealing predispositions to all kinds of conditions, including breast cancer, depression, and dementia, little is known about what it is like to live with such knowledge.

"What runs in your own family, and would you want to know?" said Nancy Wexler, a neuropsychologist at Columbia and the president of the Hereditary Disease Foundation, which has pioneered Huntington's research. "Soon everyone is going to have an option like this. You make the decision to test, you have to live with the consequences."

On that drizzly spring morning two years ago, Ms. Moser was feeling her way, with perhaps the most definitive and disturbing verdict genetic testing has to offer. Anyone who carries the gene will inevitably develop Huntington's.

She fought her tears. She tried for humor.

Don't let yourself get too thin, said the clinic's social worker. Not a problem, Ms. Moser responded, gesturing to her curvy frame. No more than two drinks at a time. Perhaps, Ms. Moser suggested to Ms. Elio, she meant one in each hand.Then came anger.

"Why me?" she remembers thinking, in a refrain she found hard to shake in the coming months. "I'm the good one. It's not like I'm sick because I have emphysema from smoking or I did something dangerous."

The gene that will kill Ms. Moser sits on the short arm of everyone's fourth chromosome, where the letters of the genetic alphabet normally repeat C-A-G as many as thirty-five times in a row. In people who develop Huntington's, however, there are more than thirty-five repeats.

No one quite knows why this DNA hiccup causes cell death in the brain, leading Huntington's patients to jerk and twitch uncontrollably and rendering them progressively unable to walk, talk, think, and swallow. But the greater the number of repeats, the earlier symptoms tend to appear and the faster they progress.

Ms. Moser's "CAG number" was forty-five, the counselor said. She had more repeats than her grandfather, whose first symptoms—loss of short-term memory, mood swings, and a constant ticking noise he made with his mouth—surfaced when he turned fifty. But it was another year before Ms. Moser would realize that she could have less than twelve years until she showed symptoms.

Immediately after getting her results, Ms. Moser was too busy making plans.

"I'm going to become super-strong and super-balanced," she vowed over lunch with Ms. Elio, her straight brown hair pulled into a determined bun. "So when I start to lose it I'll be a little closer to normal."

In the tumultuous months that followed, Ms. Moser often found herself unable to remember what normal had once been. She forced herself to renounce the crush she had long nursed on a certain firefighter, sure that marriage was no longer an option for her. She threw herself into fund-raising in the hopes that someone would find a cure. Sometimes, she raged.

She never, she said, regretted being tested. But at night, crying herself to sleep in the dark of her lavender bedroom, she would go over and over it. She was the same, but she was also different. And there was nothing she could do.

Lesson in Stigma

Ms. Moser grew up in Connecticut, part of a large Irish Catholic family. Like many families affected by Huntington's, Ms. Moser's regarded the disease as a curse, not to be mentioned even as it dominated their lives in the form of her grandfather's writhing body and unpredictable rages.

Once, staying in Ms. Moser's room on a visit, he broke her trundle bed with his violent, involuntary jerking. Another time, he came into the kitchen naked, his underpants on his head. When the children giggled, Ms. Moser's mother defended her father: "If you don't like it, get out of my house and go."

But no one explained what had happened to their grandfather, Thomas Dowd, a former New York City police officer who once had dreams of retiring to Florida.

In 1990, Mr. Dowd's older brother, living in a veteran's hospital in an advanced stage of the disease, was strangled in his own restraints. But a year or so later, when Ms. Moser wanted to do her sixth-grade science project on Huntington's, her mother recoiled.

"Why," she demanded, "would you want to do it on this disease that is killing your grandfather?"

The Best American Science Writing 2008. Copyright © by Sylvia Nasar. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.

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Excerpted from The Best American Science Writing 2008 by Sylvia Nasar, Jesse Cohen
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