Tag Archives: needles

An early use of the term “precision medicine”

“Precision medicine” has become a biomedical buzzword, largely replacing “personalized” or “individualized” medicine.  In his 2015 State of the Union Address, President Obama announced a “Precision Medicine Initiative.” I first heard the term in May 2013 as an updating ofThis seems to be about the time its use began to take off. Researching a talk, though, I was surprised to find a much earlier use, from 1979. The sense is the same, but the context very different.

In the first issue of volume 7 of the American Journal of Chinese Medicine, Ling W. Wei, an electrical engineer at the University of Waterloo, Ontario, published an article titled “Scientific advances in acupuncture.”[1] At that time, “alternative” or “comparative” medicine was new enough that he felt the need to define acupuncture as a branch of Chinese traditional medicine. He notes that Richard Nixon’s visit to China in 1972 put acupuncture in the spotlight for Westerners, noting that the scientific community was “aloof and apathetic, if not down right scornful” of the technique. Wei proceeds to evaluate acupuncture as scientific medicine.

There’s much to say about this fascinating paper, but I note here just one passage, on pp. 70-71.

The trend of technological advance in acupuncture holds great promise of promoting medicine in three directions,” he writes. These are what he calls the “three P’s”: preventive medicine, precision medicine, and people medicine.” This is remarkably close to Leroy Hood and colleagues’ “P4” medicine (“personalized, predictive, preventive, participatory”), first discussed in 2010. Wei’s formulation captures all the sense of Hood’s, but more concisely (preventive follows from predictive). But where Hood’s P4 medicine is predicated on reductive genomics, Wei imagines an equally high-tech but image-based approach.

Preventive medicine, writes Wei, “can be realized only with the availability of a simple, non-invasive and thorough physical check-up method. Like a TV screen, it should be able to expose the whole picture of the body’s condition in various colors and patterns.” He then goes on to imagine much more than a TV screen. “Precision medicine,” he continues, “requires similar methodology and, furthermore, a great analytical power in technology. For example, two common diseases of modern times, headache and hypertension, have many causes and the precise origin of the symptom is sometimes very difficult to diagnose.” Acupuncture can help. “Acu-points can serve as alarming outposts in internal organs when sick.” Merging ancient Chinese medicine with futuristic Western technology, he writes,

“If the electrical signals from 365 or a selected number of acu-points of the whole body are successively stored and then fed to a specially designed TV monitor, the pattern of this “holography” could tell us the whole story of the person’s health condition and thereby reveal not only the precise origin of the current illness but also perhaps some hidden signs of developing symptoms. To make the interpretations more precise, this holographical pattern could be fed to a “diagnostic computer” and let it be compared to thousands of standard patterns (in storage) of established causes. If a match or near-match is found, then the cause is said to be pinpointed. A man could take a “holography” anytime or once a year and the film can be as small as the palm. If in the future every drugstore had a terminal link (perhaps through telephone lines) to a central computer, one could simply insert his holography film into the machine and get an instant print-out telling his health condition. That day is not too far off; because the technology in opto-electronics and computers is almost ready for this “diagnostic automat” to be within reach.

The precision required in acupuncture is obvious and material: you have to put the needles in exactly the right place. It’s rather stunning how close Wei’s vision is to what contemporary precision medicine is aiming at, by very different means.

[1] Wei, L. Y. “Scientific Advance in Acupuncture.” Am J Chin Med 7, no. 1 (Spring 1979): 53-75.


We’ve been pretty serious for a while, which always makes me a little edgy. And “tattoos” or some version thereof continues to be one of the biggest search terms for this blog. So, to raise the font size of “tattoos” in the tag cloud, I’ve put together a gallery of eye candy.

In their 1994 book, The DNA Mystique, Susan Lindee and Dorothy Nelkin write that “habitual images and familiar metaphors…provide the cultural forms that make ideas communicable.” The double helix is the scientific icon of our age—much like the Bohr atom was during the Cold War. Putting it on your body identifies you with science, with biotechnology, with life. It is also just a stone beautiful image, which works in a line, say down your spine, wrapped around a biceps or ankle, or curving sinuously just about anywhere. The best collection of science-themed tattoos of course is Carl Zimmer’s “Science Tattoo Emporium.” Many of these were borrowed from his archive, so a big hat-tip (tat-hip?) to him. I have the hardcover version Science Ink prominently displayed on my coffee table. Others drawn from elsewhere around the web. Click the picture to open the original url.


A DNA riff on the Darwinian image of the “tree of life.” But it of course also reminds me of the eugenics tree…


Foot tattoos are hard. Here's a cute rendition of unwinding DNA that flows nicely with the anatomy.

Foot tattoos are hard. Here’s a cute rendition of unwinding DNA that flows nicely with the anatomy.

Not the best execution of the image (no major and minor grooves), but a neat black-light effect that reminds me of fluorescent labeling.

Not the best execution of the image (no major and minor grooves), but a neat black-light effect that reminds me of fluorescent labeling.

Just. Wow.

Just. Wow.

All right, I admit I'm wondering whether this represents bacterial DNA (and is therefore circular).

All right, I admit I’m wondering whether this represents bacterial DNA (and is therefore circular).

An interesting “biomechanical” visual effect.

Here artist Jason Stomber has woven the double helix into a full sleeve.

Here artist Jason Stomber has woven the double helix into a full sleeve.

Clever use of the DNA icon by a pair of twin sisters. Of course, when they line them up, they become prokaryotes.

Clever use of the DNA icon by a pair of twin sisters. Of course, when they line them up, they become prokaryotes.



Science of the tattoo-obsessed

Scientists are nerds. They are passionate about something most people can’t care about, dig deeper into it than most people have patience for, and are easily bored by subjects they are not obsessed with. Nerds can be fun, in the way that autoclave spaghetti and midnight races with experimental sea slugs are fun. But what nerds aren’t, therefore, is cool.

Tattoos are cool. It hurts to get one, they evoke sailors and bikers and punks and other naughty people. And damn, man, that thing’s permanent, what are you going to tell your mom, and how the hell do you think you’re going to get a job? The problem with tattoos is that most of them suck. They are done by slacker punk kids with no talent, they are flash designs of butterflies or hearts or anchors or swallows. Employing my favorite technique of rectally deriving my statistics, fully 90% of tattoos are clichés, and 90% of those are badly placed and badly executed. And with them, the wearer usually proclaims, “I’m part of a group!” Historically, most ink signifies membership in some (usually seedy) club.

Brachyhypopomus (originally, Hypopomus) pinnicaudatus, a Venezuelan electric fish

One of the all-time great Reese’s Peanut Butter Cup moments in recent cultural history, therefore, is the advent of science tattoos. Nerdy tattoos. Unique images chosen out of passion for one’s calling, designed lovingly late at night over strong coffee and weak beer, collaboratively modeled to sculpt the body region best suited to it, meticulously needled by artisanal craftsmen charging upward of $200 an hour, and worn proudly as a badge of individuality rather than uniformity. (Tattoo aficionadoes are chagrined, and sometimes furious, when they see “their” image on someone else.) Beautiful, sexy tattoos that you can wake up in the morning, stone sober, and look at in the mirror and be glad you got. And do the same 40 years later.

Me, I have a fish on my back. Brachyhypopomus pinnicaudatus, to be both generic and specific. I discovered it in Venezuela in 1987, during a long and traumatic field season. I wrote the paper describing the new species, I wrote a Master’s thesis on it, and I drew the illustration that accompanied the type specimen. It was a painful experience in many ways. That fish came to symbolize both achievement and failure, as well as my first attempt at synthesizing art and science. I carried that experience for 20 years, until I figured out ways to overcome the guilt, shame, and emotional scarring of those first years in grad school. And so I brought my original drawing to the best tattoo artist I could find, Tom Beasley at Dragon Moon Tattoo, and had him ink it on me. Its electric organ discharge, as visualized on an oscilloscope, plays above it on my neck. This body ornament took about 4 hours and cost $600. While Tom’s needles played over my dorsal tissues, I meditated on that experience. As he worked, I felt the weight lifting. Tom lifted that fish off my back, actually.

That, and my other tattoos, are why I pre-ordered Carl Zimmer’s lavish new book, Science ink: tattoos of the science-obsessed. Though bereft of tattoos himself, Zimmer has remarkable empathy for the inked. He gets why we do this. On his blog he collected stories and photographs of science-related tattoos. Zimmer, who writes for Discover magazine, presents the images along with explanations of the science and symbolism behind them. It’s a trove of science knowledge broken appealingly into Reese’s Pieces-sized chunks, and a big bag of eye candy for ink fetishists. These are tattoos that don’t suck.

Zimmer groups the images by discipline: physics, chemistry, natural history, neuroscience, and so on. The tattoos range from dainty anklets to dramatic full backpieces and sleeves. Zimmer is at his best when he walks us through a large, complicated tattoo with many elements. He describes an “ecological allegory” adorning the hip, side, and back of Maureen Drinkard, who wrote her PhD thesis on the bogs of Ohio. He tells us about the bog ecosystem, then describes the cardinal flower on her ribcage, the skunk cabbage that blooms beneath on her hip, the dragonfly she chose as a reminder to be strong and ferocious, and rat-tailed maggot she considers her future. The “ick” reaction some might have to the unromantic rat-tailed maggot is tempered by the “rainbow sheen” it gives off when plucked from the slimy bog and held in the sunlight. Science tattoos are almost always ultimately about beauty.

They are also about facts, which makes these images a playground for a science writer. “Six hundred million years ago,” Zimmer writes about Anthony Pirulli’s full “evo-devo” sleeve,

“a worm-like creature swimming the Precambrian seas used networks of genes to build its body—networks for determining its head-to-tail anatomy, its front-to-back coordinates, its appendages, its organs. That early worm gave rise to many lineages of new kinds of animals, which are still thriving today. And despite their diversity—from insects to squid to starfish to humans—they still use the same basic gene networks to build their bodies. These networks took on new functions through the evolution of the genetic switches that turned the genes on and off. So in a very deep sense, the heart of a fly is much like our own heart. Ever since, Firulli has been studying the functions of some of those genes.”

That’s nice writing. It captures the current understanding of systems biology and embeds it in its evolutionary context, without relying on technical jargon or the dry scientific passive voice. Zimmer gets the science right and expresses it in language a bar-brawling biker can understand.

The book is richly, even extravagantly produced. Though the pages are matte, the photos are mostly high-quality. The cover is in two colors of cloth and has molecular cut-outs, through which neurons, DNA, and microbes peek out. I’m not crazy about the gothic type on the headers, which, I suppose, is meant to evoke 19thcentury German scientific papers. It seems a bit over the top. The text is carefully edited, although in one case a bird is re-classified as a mammal when the South American motmot is listed as a “marmot.” The index is brief but effective; it thoughtfully includes the illustrated organisms and mathematical variables, as well as the names of the doctoral canvases that bear the imagery. Nerds can look up their friends, whether they be researchers or the researched.

Phi, the golden ratio (1.618…)

I was simultaneously proud and a little dismayed that my other science-related tattoo (so far) merits an entry. Phi, the so-called “golden ratio,” is the first irrational number; a constant that, like the more familiar pi (3.1416…), can be carried out to an infinite number of decimal places and thus must always be approximated, its precision foiled by that tantalizing ellipsis. The golden ratio occurs frequently in nature, from the spiral of the chambered nautilus to the whorls of pine cones, sunflowers, and spiral galaxies. Fortunately, none of the four phi tattoos Zimmer presents are just like mine—or as beautiful, in my view. My tattoo has several layers of meaning for me, because I am a nerd, but one of them is as a reminder that mathematics, often called the language of nature, has limitations.

Sometimes natural truth lies not in the number but in the image. Now that’s cool.