Francis Collins Interview (page: 4 / 9) Presidential Medal of Freedom	Print Interview

What are the greatest satisfactions you derive from what you do?

Francis Collins: Satisfaction comes in a variety of flavors. There is the satisfaction simply of seeing this instruction book take shape. Before this year (1998) is over, we will finish the complete instruction book of a multi-cellular organism, a roundworm; it's part of the Genome Project. This is a very exciting milestone.

All 100 million base pairs in the DNA sequence of this particular organism will be completely determined. That's never happened before. I will feel a great sense of satisfaction when that comes together. I will feel it to a much greater extent when it's the human genome sequence we're talking about. Simply from the pure joy of having achieved that kind of milestone.

But the joys are more extensive for me as a physician seeing those discoveries utilized in a medical setting. When I talk to a family who have been torn apart by concerns about a genetic disease, and because of this new molecular insight that we have, we can explain to them precisely what's going on. Sometimes we can tell people who assume they're going to die of this terrible disease, that they're not even at risk, because they didn't inherit it. That's very gratifying.

This is an early stage in the application of genetics to medicine, but there are already circumstances where you can tell somebody that they're not going to die young of cancer or Huntington's disease. More often than not, it turns out they're in the same boat as everybody else and they have a long life ahead of them. That's an experience, to convey that kind of information to someone and change their life.

That must be satisfying, to know that your work could have this impact on the lives of millions of people.

Francis Collins: Yes, but there's one thing I worry about in these discussions about achievement. Young people might assume that unless your life has a huge and lasting impact on millions of people, that you haven't quite succeeded, you haven't measured up. I fell into that trap a few times and it's very dangerous to take that view.

I went to West Africa to work in a small mission hospital for a month. I went there in the midst of all sorts of other scientific endeavors. It was a bad time to leave, but I really wanted to do this. I went there with this image that I was going to make a profound difference in that situation. After a couple of weeks, I was really depressed. Here was a circumstance where all the patients I was trying to take care of had diseases that didn't have to be. They were the consequence of poor public health, of contaminated water, of inadequate nutrition. I knew I could pull some of these people back from death, but I knew they'd go right back out to that situation. My dreams of myself as the healer for this large population were lying in pieces on the floor.

One morning I walked in to see a young farmer who we had treated the day before for tuberculosis, and he looked at me and he said, "You know, I get the feeling that you're wondering why you're here." He said, "You came here for one reason. You came here for me, and that ought to be enough." And that sticks in my mind -- more than any moment I think I have experienced in my life -- as truth. We should have our grand dreams, we should pursue them, that's what being human is all about, that's part of the nobility of our enterprise. But we should never forget that what really matters is what you do one-on-one with a single human being. Where you reach out and you try to help them make their life a little better. And if that's all you do, your whole life is to do that occasionally, then you have succeeded.
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If you don't do that, you may have wonderful grand dreams and maybe even succeeded at some of them, but I think you will end up being disappointed, frustrated and unfulfilled.

When we finish documenting the human genome, what's it going to do for us?

Francis Collins: I believe that the goal of medicine, one of the noblest undertakings of human beings, is to alleviate suffering. So much suffering comes from disease. We've eliminated some terrible diseases like small pox and polio. We have treated childhood cancer, so that most of those kids, who used to die, now survive and live a normal life. We have made major advances with heart disease, and other kinds of cancer, but far too often we find ourselves trying to treat the symptoms of a disease we don't understand.

The goal of the Human Genome Project is to open a new window and allow us to see the molecular level. What is the cause of diabetes? What is the cause of hypertension, of heart disease, of schizophrenia, of the common cancers? We can use that information to try to prevent the disease before it even starts. That's the dream, that's what gets me up in the morning. It's a wonderful intellectual achievement to imagine we're going to have this instruction booklet out in front of us, but the real point of it is to use that information to alleviate suffering and allow people to live long and healthy lives. I think that's one of the most important things we can do as human beings, and this is a tool to get us there.

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