Medicine and Health
I started my journey with medicine through learning about various system from Gray’s Anatomy and Guyton’s Physiology books. I wanted to explore the medical career more, and am deeply intrigued by all the possibilities the field offers. However, I am also intrigued by the intricacies of the field, as well as the more societal questions; I have done several analyses understanding different aspects of medicine and how they incorporate into society.
Many believe we face daunting global challenges ahead. How can long-term thinking in the field of Medecine foster optimism about the future?
Submitted for consideration for the Oxbright 2023 scholarship
“Optimism isn’t about ignoring negative feelings. It’s about being hopeful about the future, even when the present seems wholly negative” (Wong, 2020).
The future can often seem entirely bleak. Especially after the COVID-19 Pandemic, our society seemed to lose all sense of past and future; 2019 feels like yesterday, and 2025 feels as if it’s an eternity away. With such confusing circumstances, it’s not a surprise that people feel daunted by the upcoming future, with many believing that our generation has been “pushed aside as a problem to deal with later”, and are ‘a sacrificed generation’ (Butler and Bannock 2021). But psychology shows that all this anxiety and unsurety can be quelled quite simply: According to a psychology study by Dan W. Grupe and Jack B. Nitschke on Uncertainty and Anticipation in Anxiety, humans generate embodied predictions of event’s emotional impacts through the simulation of future events; Therefore, effective planning and preparations for the future can alleviate anticipatory anxiety and foster a more optimistic outlook (Grupe and Nitschke, 2013). By carefully considering potential outcomes and developing adaptive strategies, we can reduce uncertainty and enhance confidence in facing future challenges
The COVID-19 pandemic lost many people’s faith in the world’s healthcare industry, through its mishandling and the sheer amount of time it took for the world to move on. In the mind’s of the people, medicine failed its purpose; instead of being able to turn to the medical advancements that we’ve made over the years, we had to turn to the most inconvenient solution of all: self-isolation for preservation. To effectively address these global challenges, we must undergo a profound shift in mindset. It is not enough to focus solely on treating diseases when they emerge; Instead, we must embrace a paradigm that prioritizes prevention, sustainability, and long-term thinking in medicine.
More than anything, long term thinking entails understanding the technological advancements and breakthroughs that will undoubtedly occur, and acknowledging that they will change the field of medicine. It means embracing these changes, and rather than fearing how they will affect the world, using active thinking to anticipate how we can use them to our advantage. At the moment, that would be understanding how Artificial Intelligence and Machine learning will affect the world and all related industries, and having the foresight to be able to plan for their effects. AI and ML have already made significant inroads into medicine; Many current programs such as LYNA and DLAD are able to improve medicine by making faster, more personalized diagnoses. “In the long term, however, government approved algorithms could function independently in the clinic, allowing doctors to focus on cases that computers cannot solve” (Greenfeild, 2019). Long-term thinking requires us to envision a future where these technologies play an even more profound role. In a world where AI-powered algorithms can analyze medical data with unparalleled precision, diseases would be addressed before symptoms even manifest, entirely circumventing the possibility of another pandemic. Imagine a healthcare system where machine learning algorithms optimize treatment plans for each patient based on their unique genetic makeup and medical history. All these technological advancements will advance medical research to the point where personalized healthcare is the norm, raising the faith of the general public in the medicine industry.
Optimism isn’t dependent on the current state of the world, nor the way that people feel at the moment; It will ultimately lie in the hands of the future generation, provided by long term thinking and perception of technological advancements.
The Genetics behind Obesity
Submitted to the ASHG DNA Day Essay Competition
“Just diet”. “Be more active”. Words that people trying to lose weight encounter constantly, be it within the cages of their own mind or the nagging words of others. However, this is a mindset propagated by the untrue assumption that everybody’s metabolism and biological systems can function in the same capacity. Obesity is a significant public health concern worldwide and is widely recognized as a health issue caused by environmental factors, such as an unhealthy diet, or a sedentary lifestyle. However, the genetic influence on metabolism and obesity is largely overlooked. It is important to recognize that both of these factors play a role in propagating obesity.
The FTO gene or the fat mass and obesity-associated gene is located on chromosome 16 and studies show that it plays a crucial role in regulating energy, balance, and metabolism, specifically in functions that regulate appetite, energy expenditure, and fat metabolism (1). It has been shown that the presence of one mutant allele of rs9939609 (gene FTO) and rs4994 (gene ADRB3) leads to a statistically significant association with obesity (2). The FTO gene may influence the function of the hypothalamus (a brain region involved in appetite control), while the ADRB3 gene encodes the beta-3 adrenergic receptor (responsible for the breakdown of fats and regulation of insulin secretion) (3 and 4). Altered pancreatic islet blood flow and insulin secretion can contribute to disturbances in glucose metabolism, insulin resistance, and ultimately, the development of metabolic disorders such as obesity (5). Individuals carrying these specific alleles often show differences in appetite regulation, causing an increased food intake and a tendency to overeat (5). The FTO gene is also involved in the regulation of adipocyte function, and lipid metabolism (6). Variants of this gene have been implicated in altered adipocyte differentiation and lipid storage, potentially contributing to adiposity or a greater amount of body, fat and consequently obesity risk (3 and 4). Additionally, new evidence suggests that the FTO gene may play a role in modulating the sensitivity of peripheral tissues to insulin, influencing glucose metabolism, and insulin resistance, which are closely linked to obesity, and metabolism (3). However, while these genetic occurrences may contribute significantly to metabolic dysregulation, it is important to consider the environmental factors that have added to the obesity epidemic.
Sedentary lifestyles, propagated by factors like recent technological advancement, urbanization, and changes in transportation methods, have led to a decrease in physical activity levels. Many areas often don’t have the safe recreational spaces needed for physical activity due to the dangers of high traffic. This reduction in activity combined with the increased necessity for screen time and desk-bound work causes a general decrease in exercise habits. High-calorie diets also have become increasingly prevalent in modern societies, further promoting weight gain. This is because when someone has a high caloric intake (consumes high amounts of energy, particularly found in high-fat and high-sugar foods) (7), and does not use all of the energy through physical activity, much of the extra energy will be stored in the body as fat (8). These foods have become more easily accessible through fast food outlets, vending machines, and convenience stores (7); The seemingly infinite supply of these places makes it challenging for individuals to make healthy dietary choices, particularly when dealing with busy schedules and limited access to affordable options. In this way, socioeconomic factors like income inequality, food insecurity, and limited access to health care cause differences in the obesity rates within communities.
Finally, anxiety can also disrupt eating behaviors and metabolic processes. When the body is under prolonged stress, it triggers the release of cortisol, often referred to as the "stress hormone (9)." Cortisol plays a crucial role in regulating metabolism and energy balance (9). However, chronically elevated cortisol levels can lead to increased appetite and cravings for high-calorie foods. Additionally, cortisol promotes fat storage, particularly in the abdominal region, through its actions on adipose tissue (10). This hormonal response to chronic stress also increases the risk of obesity and is also associated with a higher risk of metabolic disorders such as type 2 diabetes and cardiovascular disease (10).
While many people believe that their health is affected solely by their environmental conditions, the truth is that genetic factors often interact with these environments to either exacerbate or mitigate the condition. By understanding genetic predispositions, environmental influences, and psychological influences that affect a person’s well-being, it is possible to develop more personalized and effective approaches to the prevention, treatment, and management of various diseases and conditions.