Myth 5: It's All About Genes and Germs

Or: Understanding a medical condition involves locating a gene or isolating a foreign agent.

The fundamental premise of this myth is that the human body is characterized by simple, linear cause-and-effect relationships. Granted, some leeway may be given for multiple causes and "complicating facors," but these are mere qualifications of the basic linear model which is employed.

Example 1: Genes. Medical researchers have become obsessed with finding the gene or set of genes responsible for everything from autism to homosexuality to political preference.

However, any responsible researcher will also admit that the relationships between genes, "internal" bodily processes, and "external" environment are not clearly understood. Furthermore, as discussed in Myth #4, many of these conditions may not be of a homogenous or easily definable nature (i.e. they are not "things" that can take part in a linear causal chain), and some (such as sexuality and political preference) are social constructions. This is akin to looking for the gene that causes one to speak French rather than English! True, genetic correlations are often found. But correlations are pretty easy to construct, and they do not by any necessity have any real significance.

Example 2: Germs. "Sickness" is most often conceived in terms of infections and germs. We take all sorts of measures to avoid "catching" other people's germs, which some people carry to the point of clinically-defined neurosis. We also view germs within a military framework - invasions and attacks - and seek all-out assaults on the perpetrators of illness via copious use of pharmaceuticals.

The whole idea that ill-health is caused by the intrusion of foreign agents derives from a Medieval religious perspective in which physical malady was conceived as a moral condition caused by the invasion of the body by tiny demons. This idea has persisted and, stripped (partially) of its religious component, frames our current understanding of illness. In fact, medical researchers throughout history have often ASSUMED the presence of foreign agents with absolutely no proof of their existence, and worked laboriously to find material evidence to back up what they already believed to be true.

There are several shortcomings of the "invasion" perspective. First, the body does not have a clear "inside" and "outside." In fact, the skin is the largest organ of the human body. Second, there is not always a clear distinction between what is part of the body and what is "foreign." Parasitic relationships are extremely common, and the human body also makes use of this arrangement. Bacteria, in fact, perform many vital functions in the human body. If you have ever taken an antibiotic that has killed too many of your intestinal bacteria and experienced the uncomfortable results, then you might not think of them as intruders! Third, most disease-causing agents are already present in the body under normal circumstances.

Some in the medical field have sought alternatives to the "invasion" metaphor. Ludwik Fleck suggested that the human body might more effectively be likened to a garden, in which the key to health involves a particular balance among its various components. Certain stressors or events may upset the balance from time to time. Since there is no distinct barrier between the "outside" and "inside," altered balances in the overall environment (for example, the people who surround you) may ripple and affect you as well. This is still a notion of contagion, to be sure, but a more holistic one, which does not rely as heavily on a linear causal chain, and views the body together with its environment as a unified, complex system.