Human Knowledge in the Age of Information, page 2

If I am writing a research paper, I access the biomedical literature from my home or office computer via the free, PubMed database of the National Library of Medicine in Bethesda, Maryland, USA. When I made a somewhat late start as a research immunologist more than 30 years ago, I was familiar with everything worthwhile that was going on in the broad field of cellular immunity. This covered lymphocyte differentiation, the role of the thymus, transplantation, auto-immunity, and my own specific area of infectious disease.

The expansion of possibilities resulting from the very recent revolution in molecular medicine has now made the spectrum of scientific reporting in these areas so vast, and so complex, that I am hard pressed to keep up with what is happening in my sub-field of viral immunity. I no longer command a detailed understanding of all the technologies relevant to my research, and must rely on the insights and contributions of highly specialized collaborators.

Biology has always been complex, but it is only now that we can access much of that complexity. The question of how we select, analyse and integrate information to provide solid generalisations and useful knowledge may be the major challenge of our time. There are some very exciting developments. Let me give you an example that draws on three different types of databases, or libraries.

Much of the past 16 years of my life has been spent at St Jude Children’s Research Hospital in Memphis, Tennessee. I still have a small research effort there, though I now spend most of my time at the University of Melbourne. St Jude already networks with the cancer programs at Melbourne’s Children’s Hospital via the international Children’s Oncology Group, and we are building other connections.

The mandate given to St Jude just over 40 years ago by its founder, the actor Danny Thomas, was to find solutions for catastrophic diseases of kids. The motto is: 'that no child should die before its time', a goal that is still far from being realised. Two initiatives taken right at the beginning have had enormous, recent impact.

The first was to put equal emphasis on the development of investigative clinical programs and basic science. The result is a cadre of top scientists who win major awards, while St Jude physicians can have 70 to 80 percent protected time to spend in the laboratory. We would love to reproduce the latter in Melbourne for our brightest medical minds, but the resources just aren’t there.

The other inspired decision was to start a physical library of every cancer from every child who was ever treated at St Jude. The hospital basement houses row upon row of deep freezes containing these tumour tissues. Back in 1962, nobody quite knew how this library might be read, but it was kept for the future at considerable expense.

Now it has paid off. Being a hospital that does not charge, treats every child on research protocols and brings former patients back for up to 20 years of follow-up, St Jude also has another massive library, or database, that records the history all the treatments and all the long-term clinical outcomes. Cancer is, of course, a genetic disease, reflecting both inherited characteristics and mutational change.