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Inheritance: How Our Genes Change Our Lives - and Our Lives Change Our Genes is a popular science book about the relation between genes and health. This is his third book: he has previously written How Sex Works and Survival of the Sickest. Moalem tells many stories of individual patients whose genetic make-up has led to health problems. But one of his main points is that we can change our lives to change the ways that our genes express themselves, and thus we can improve our health. He has a catchy informal style that conveys real interest in his work and sincere commitment to helping his patients. He talks to the reader as if it were a one-on-one meeting -- he says that he is going to do a genetic examination of you. His performance of his book in the unabridged audiobook is strong: he has a good reading voice and he brings consistent energy to the recording.
Moalem hypes his own book, giving the impression that he has a brand new approach to genetics and a revolutionary message. But when it comes down to it, all he is doing is clearing up a simplistic misunderstanding of genetics that supposes that one's genes determine one's future absolutely. He highlights the fact that genes get expressed differently in different environments, and one can control one's gene expression by changing one's diet and levels of activity. A Queen Bee has the same genetic make-up as worker bees; what makes her different is how she eats when she is growing. He points out that trauma and other difficult experiences can changes one's gene expression, which can affect one's physical and psychological health. Some people become much more likely to get cancer if they eat or smoke the wrong substances. Even bullying can alter our gene expression. Furthermore, epigenetic changes can be inheritable. So pregnant women who are traumatized can have their gene expression altered, and this can affect their babies in measurable ways.
The take home message of Inheritance is the more we know about our individual genetic nature and our gene expression, the more we will be able to take control of our health. He emphasizes that the cost of genetic tests are reducing and he focuses on cases where genetic knowledge has made a great difference. However, his message is primarily important to the medicine of the future; right now, our knowledge of most genetics, and our ability to change gene expression, is limited. Furthermore, as Moalem points out, the more information we have about our genetic make-up, the more possible it is for health insurance companies in the USA to discriminate against their customers, judging them to be bad risks. He recommends that genetic testing be done anonymously if there a chance that the results could be used against the patient. We also need to be aware that even if genetic tests are now cheaper, they are still not very cheap, and in most cases they may not be worth the expense given the statistical unlikeliness of the conditions that they are testing for, especially when we take into account the risks of false positives and the further problems that they can cause.
While Inheritance is interesting and informative, it won't be very useful to most readers, in the direct sense of giving them information that they can immediately use to improve their health. But it might increase awareness of the ways in which we can use genetic information when making health care decisions, and we can gradually become used to the idea of consulting a genetic expert as well as other experts when we have medical problems. The way in which most genetic discoveries help people is for rare conditions to shed light on much more common conditions, for which medications can be developed, which in turn can be prescribed by all doctors. So it may be that most of us will benefit from genetic research without ever having to personally consult genetic experts.
The hardcover version of Inheritance has several pages of footnotes which are not available for purchasers of the unabridged audiobook, which is an unfortunate omission.
Link: Sharon Moalem website
© 2014 Christian Perring
Christian Perring, Professor of Philosophy, Dowling College, New York