(Our love of technology as the answer to all of our problems underlies our lost connection to food. Technology has solved or promises to solve every problem faced by mankind and we believe in our hearts that this is true. The two greatest technological success are the creation of medicines to protect our health and the advancements in agriculture to ensure an abundant food supply. We know these advances have come at a great cost to our external environment, but the cost to the internal environment of the human body is just now being realized. We are just beginning to understand that the technological solutions helped create new problems and these are biological problems that technology can’t fix.)
How we got into this mess
The human race has always lived under the specter of impending disease and death from infections. Life today is immeasurably better than it was 120 years ago when very specific viral and bacterial vaccines were introduced. The quality of life jumped again 75 years ago when availability of broad-spectrum antibiotics became commonplace. Despite living in the Industrial Age, despite automation, despite slowly gaining control of our food supply, and despite our great intellect, until recently we could not conquer the greatest of our foes. The greatest is also the tiniest: bacteria.
This single accomplishment, the development of antibiotics, has transformed the world at every level of organization, from the family to the village to the entire society. And yet, all is not well. We know a hundred times more about bacteria today than we did 30 years ago and one of the things we have learned is that we did not, in any way, shape, or form, conquer bacteria. In fact, bacteria are teaching us about how the world really works and we are now learning that it is not a one-sided relationship. To be fair, our perceptions of bacteria are based on a very long history of negative experiences, but our understanding of the situation was far from complete and probably hindered by our long-standing bacterial bias.
Prior to 1900, about 25% of all babies died before the age of two from a wide variety of infectious agents that included influenza, pneumonia, measles, typhoid, scarlet fever, diphtheria, whooping cough, and syphilis. Another 25% of the population died of other infectious diseases (such as tuberculosis) before the age of 20, which is a period of life that is now almost immune to the lethal ravages of viral and bacterial infection. For women, there was about a one in six chance of dying as a complication of childbirth. Indeed, prior to the mid-1800s, making it to age 50 was an achievement that only about 10% of the population could claim. It should not be surprising that elderly people were uncommon and they were special; they had survived a lifetime facing the gauntlet of hazards of the human environment. The elderly were revered and, not surprisingly, were sought out by younger people to learn their secrets to a long life.
A newspaper from my area in South Carolina, the Horsecreek Valley News from May 1905, reveals an interesting and probably typical view of our culture of the time. Scattered throughout the paper, surrounding the clothing ads and articles, are advertisements for a variety of rather specific products. About every other advertisement is for a life-saving or life-transforming concoction and often accompanied by a testimonial as to its efficacy. Here are a couple of examples:
Strikes Hidden Rocks
When your ship of health strikes the hidden rocks of Consumption, Pneumonia, etc., you are lost, if you don’t get help from Dr. King’s New Discovery for Consumption. J. W. McKinnon, of Talladega Springs, Ala., writes: ‘I had been very ill with Pneumonia, under the care of two doctors, but was getting no better when I began to take Dr. King’s New Discovery. The first dose gave relief, and one bottle cured me.’ Sure cure for sore throat, bronchitis, coughs and colds. Guaranteed by (local) drug stores, price 50c and $1.00. Trial bottle free.
Cheated Death
Kidney trouble often ends fatally, but by choosing the right medicine, E. H. Wolfe, of Bear Grove, Iowa, cheated death. He says: “Two years ago I had Kidney Trouble, which caused me great pain, suffering and anxiety ‘but I took Electric Bitters’ which effected a complete cure. I have also found them a great benefit in general debility and nerve trouble, and keep them constantly on hand, since, I find they have no equal.” [local druggist], guarantees them at 50c.
The Old Time Way
Our grandmothers gave us powders and teas because they knew nothing of modern medicine and methods. In this age of progress and discovery, nicely coated, compressed tablets are fast superseding the old time powders and teas. Rydale’s Liver tablets are compressed chocolate coated tablets, easy to swallow, pleasant in effect, always reliable. They contain ingredients that cannot be used in powders or teas. Ingredients that have an effect upon the liver that is never attained from the so called liver powders etc. A trial will prove their merits.
It’s clear from the abundance of the ads that infections and malaise were a constant concern in the lives of the local population and literally any potential cure would be given consideration although it is highly likely that most of the concoctions were no more than the equivalent of snake oil. However, this was the tone of the times. Death was just around the corner, people of all ages in the community died every day, and any infection or cough or rash could spell the end.
In 1905, the reality of death was not age-dependent. Anyone could die and at any time. Families were large, most couples expected to have many children, and this was partly a response to the fact that several of the babies, toddlers, and children would very likely not survive. For rural families, children were the workforce for food production and many were needed as insurance for the family wellbeing. In a sense, death was an understood possibility and families fought that reality by producing more children.
Today, when someone dies at a young age, whether from flu or a car accident, the story could make the front page of the local newspaper. Such an event is noteworthy because it is rare; death at a young age is not an accepted occurrence in modern society. We have the technological tools to prevent death, even among the elderly, and we are shocked when we fail. As a consequence, life expectancy has risen and risen as fewer and fewer young people are taken by disease. We now consider living into the 80s and 90s to be a normal expectation.
From about 1900, the rapid development of water purification and plumbing systems, electrification, refrigeration, vaccines, and other technological breakthroughs caused mortality among children (and others) to plummet. With the rapid drop in mortality rates and concomitant rise in industrialization, the United States and other developed countries rapidly progressed through the Demographic Transition – death rates dropped, birth rates stayed high, and the populations grew and grew.
Movement away from the poor and sick rural areas and toward the cities and jobs was a move toward technology and health. Of course, many other factors were involved, not the least of which were two World Wars, but the transition was inevitable. And although cities are the most likely places for epidemic outbreaks, they are also the hubs of research and medicine and accessibility to technological advances that create sanitary living conditions.
The end of World War II marked a period of further technological transition: from early medicine to modern medicine, from old-style agriculture to modern agriculture, from chemical extraction of drugs from plants to chemical synthesis in the laboratory. The effect on our quality of life was rapid and widespread. We declared some diseases conquered, we declared restrictions on growth and production to be over, we declared the reach of technology to be without limit. Technology invaded our homes and we embraced it.
Science and technology had conquered the environment and life was better as a result. After 1945, we gained antibiotics that promised the elimination of death from bacteria. After 1947, pesticides and fertilizers promised to defeat food shortages. In the 1950s, the Green Revolution promised the end of worldwide hunger and starvation. Technology was saving us, and much more technology was on the way.
As we moved beyond the 50s and 60s, the presence of new technology became a part of our culture and affected every conceivable aspect of our lives. Pharmaceuticals and synthetic drug breakthroughs were being introduced weekly and were revolutionizing medicine and pain management. Personal care products by the hundreds flooded the marketplace and we applied them to every part of our bodies. Plastics arrived in the mid-50s, replacing glass and metal in every possible way, and became ubiquitous within a very short time. Food became “fast” and some was genetically modified. High fructose corn syrup replaced beet sugar (which had replaced cane sugar) and became ubiquitous in the processed food supply.
Indeed, our food supply was rapidly becoming more and more processed. Grains were stripped of their nutritional value and then “enriched” after processing. Our meat supply became a corn supply transformed into animal flesh. Our veggie production is now shifting from the open farm to closed greenhouse with the plants grown in factory-style hydroponic conditions rather than soil.
In sum, technology has increasingly insulated us from the world to the point that we now consume antibiotics as a matter of course, 32% of babies are born by Caesarean section, and medical interventions manage our obesity. We are being promised that pharmaceutical specificity based on individual genetics soon will address each and every ailment we have. Technology has met and surpassed the challenges posed by the restrictions of the environment and technology promises to never let us down.
Technology has conquered the majority of historical threats to our health and wellbeing and, even though we are currently faced with the rise of “modern plagues”, we can be sure those days are numbered. Since the 1950s, we have witnessed an incredible rise in autism, obesity, diabetes, asthma, allergies, ADHD, lupus, rheumatoid arthritis, colitis, irritable bowels, gluten sensitivity, multiple sclerosis, Alzheimer’s, and Parkinson’s. Yes, these too will fall before the strength of our technology. Or will they? This is the critical question that we should be asking. What if our adoption of technology as it applies to our living environment is actually the cause of these new epidemics? What of the ever-increasing reliance on technology is responsible for the ever-decreasing quality of our environment, both external and internal? What if the disease is caused by the cure?
Is there a hidden cost to our health?
Our desire to sterilize our personal and social environments is rooted in our long and ugly history of plagues and death. The urge to isolate ourselves from nature, especially bacteria, is understandable. This is what technology has offered us in the past century and we have readily embraced each and every breakthrough that reduces our exposure to a germy world, but this isolation from bacteria may come at a cost. This era of technological cleanliness removed us from the world of infections and physical distress, but may have ushered in an era of physiological distress.
In fact, the evidence for a causal connection between modern diseases and the absence of bacteria in our daily lives is growing rapidly, daily, and will soon be, if it is not already, the single most funded and most intense area of medical research in history. The bacteria that live in and on our bodies, our microbiome, are now being recognized as important contributors to our physiological health. And yet, those same bacteria have also been implicated, if not clearly convicted, of our previous health problems, and so we are faced with an incredible conundrum. Is the very thing that we have feared for centuries, the thing on which we have focused our growing technological might to destroy, might also be the thing that keeps us healthy?
We thought we had revealed the Rosetta Stone when the Human Genome Project deciphered all of human genetics. We then we moved toward understanding proteomics (the world of proteins coded by the DNA), and recently to epigenetics (the turning on and off of genes) and other biochemical interactions between genetics and the environment, but now we’ve discovered the microbiome. And what a world it is!
We are finding that the bacteria in our gut may hold the keys to our health, our immune system, our normal development after birth, our susceptibility to cancer and age-related diseases, and we are just touching the tip of the iceberg. We are finding that what we know of genetics, proteomics, and epigenetics may be linked in very complex ways to the microbiome. We are finding that interactions between our bodies and our microbiome might be involved in both the causes and the cures of some of our more puzzling diseases, including cancers.
Very importantly, damage to the microbiome seems to be linked in complex ways to the emergence of the “modern plagues”. Even more importantly, and this will be a theme throughout the rest of this blog, while technology may help us understand portions of the microbiome, technology may well be of little use in correcting the damage we have wrought on the microbiome. To heal the microbiome, and therefore to heal humans, will very likely require a reversal of our almost total dependence on technology for solving our health problems.
In my opinion, we are about to discover how little we know about human health and how the human body really works. We are now discovering that much of what we have done as a society in the name of public health has been to the long-term detriment of.... public health. We have waged war against pathogenic viruses and bacteria, and have saved millions of lives from premature death and disability, but in our ignorance about pathogens, we categorized all viruses and bacteria as undesirable and created technological systems for eradicating them regardless of their ecological and evolutionary role in the world of humans and other organisms.
That is, with the introduction penicillin and deployment of numerous antibiotics, we declared war on the ecosystem rather than on specific components of the ecosystem and without stopping to consider and understand the consequences of such an all-out assault. Understandably, in the heat of the race, for example, to defeat a childhood killer rampaging through our society, we wanted to produce a cure as soon as possible. On the other hand, once the cure had been successfully deployed, we never went back to study the consequences of that deployment on the rest of the ecosystem unless very negative complications arose rather soon after.
While it is true that we understood that broad-spectrum antibiotics kill bacteria indiscriminately and not just at the site of the infection, we were satisfied if the pathogenic cause was eliminated. In the case of bacteria in the digestive system, we did not have an appreciation of the beneficial aspects of bacteria, but we knew that the gut bacteria could and would recolonize without too much help. Nonetheless, we knew (and suspected) nothing about the consequences of bacterial depletion in other parts of the body. Yes, we had no real reason to suspect a problem. After all, genes run our bodies, not bacteria.
This genetic determinism is the ruling paradigm of our current biomedical world in terms of both development and disease. It fit in well with our other ruling medical paradigm of cause and effect in the case of infectious diseases. As with all systems, indirect effects cannot be easily linked, they are often very slow to emerge, and causality is ridiculously difficult to prove. But never mind because even if direct links between cause and effect were impossible to manage, we had technology on our side.
Even today, we remain steadfast in our resistance to the concept that the human body is part of an ecosystem. An ecosystem is an assemblage of many different species that interact with each other in ways ranging from predation and competition to mutualisms and pathogens to facilitators and decomposers. Unfortunately, our understanding of ecosystems is hampered in many ways, not the least of which is related to the quote at the top of this chapter.
An ecosystem is not just a few but potentially millions of organisms made up by thousands of species interacting in direct and indirect ways. Each species may be interacting with dozens of other species simultaneously and interactions in one place may depend on whether or not other interactions are occurring in another place. For example, a wolf does not eat plants, but it does eat deer and deer eat plants. Therefore, the health of the plants is dependent on the presence of wolves and hampered when wolves are eliminated. Many of these indirect interactions may take years to unfold and will be very hard to observe. In the meanwhile, other more direct and easier to observe interactions may be given credit for causing the eventual expression of the indirect effect. This interpretation of a direct causal relationship is a consistent artifact of the way the human brain works.
