Book Review: NEXT

NEXT is a novel by Michael Crichton. Or atleast it claims to be. It has a disorganized plot, too many characters with too little characterization and gratuitous sex. Just about two weeks after reading it, I can hardly remember the characters or their roles in the plot. The main plot describes the efforts of a biological research company engaged in creating genetic drugs to recover some cells that could be used to fight cancer. The cells have been obtained during a routine treatment and the patient is unaware that his cells are special. The doctor who treats him discovers that the cells are special and continues his research without informing the patient. When he decides to commercialize the cells, the patient sues his company but loses the case. He then gets an offer from a competitor for his cells and goes into hiding. Meanwhile the cell samples are stolen and the company attempts to obtain cells from the patient’s daughter and grandson, providing enough material for all the action. There are also some sub-plots. There is a researcher who discovers a “maturity” gene, accidentally gives it to his drug addicted brother who comes out of his addiction, then tries out the gene on some other people, only to discover that the gene actually causes premature ageing and death. There is another researcher who inseminates a female chimpanzee with his own sperm with some genetic process (I don’t recall the details) and lands up with a humanzee kid, resembling a chimpanzee in appearance but capable of human speech. He takes the kid home and sends him to school disguised as a child with some rare medical condition. Overall, the plot is somewhat incoherant and one has to make an effort to remember the characters when they reappear after a few pages. As a novel Airframe was much more engaging and Prey was a lot more exciting even though the plot in Prey was much worse. (Airframe and Prey are the only other novels by Crichton that I have read). If NEXT were just a novel, it would be a waste of time. But NEXT is more than a novel. It raises serious questions about patent laws in the domain of genetics, intellectual property rights, what it means to own ones body, commercialization of genetic research, role of universities and government in research etc. In fact, Crichton has a 7 page note at the end of the novel, explaining his views on these issues. Since one of the purposes of this novel (perhaps the primary purpose) is clearly to raise these issues, let me present a summary of some of the issues from the novel and Crichton’s views.

Crichton presents a world that is almost out of control, a world in which the state of the art in genetics has far surpassed the state of the relevant laws. Here are some examples:

The lawyer representing the doctor and his research company tells the patient’s daughter after winning the case, that it would be futile for the patient to appeal the ruling. “UCLA is a state university. The Board of Regents is prepared, on behalf of the state of California, to take your father’s cells by right of eminent domain.”

The CEO of the research company wants a divorce and custody over his children but his wife doesn’t. His wife’s grandfather died from a fatal genetic disease and there is a chance that she might have it too. The CEO’s lawyer demands that the wife be genetically tested and gets a court order. The wife is unwilling to be tested since a discovery that she carries the disease would ruin her life.

An insurance company cancels a person’s coverage based on some genetic information about his father who died in circumstances that caused a legal enquiry. Someone at the company that performed the genetic tests says “Anyway the son is saying he did not authorize the release of genetic information about himself, which is true. But if we release the father’s information, as we’re required by state law to do, we also release the son’s, which we’re required by state law not to do. Because his children share half the same genes as the father. One way or another, we break the law.”

“The COX-2 inhibitor patent fight was famous. In 2000 the university of Rochester was granted a patent for a gene called COX-2, which produced an anzyme that caused pain. The university propmptly sued the pharmaceutical giant Searle, which marketed a successful arthritis drug, Celebrex, that blocked the COX-2 enzyme. Rochester said Celebrex had infringed on its gene patent, even though their patent only claimed general uses of the gene to fight pain. The university had not claimed a patent on any specific drug.”

Op-Ed commentary: “Columbia University researchers now claim to have found a sociability gene. What’s next?… In truth researchers are taking advantage of the public’s lack of knowledge… Geneticists will not speak out. They all sit on the boards of private companies, and are in a race to identify genes they can patent for their own profit…”

At the end of the novel, Crichton presents his views in the form of a 5 point course of action

1. Stop patenting genes: Crichton writes that genes are a fact of nature and such cannot be owned or patented.

2. Establish clear guidelines for the use of human tissues: Crichton writes that there should be legislation to ensure that patients can control the purpose for which their tissues are used.

3. Pass laws to ensure that data about gene testing is made public: Crichton suggests (not very clearly or convincingly) that there should be some genuinely independent verification of findings and full disclosure of research data.

4. Avoid bans on research: Crichton essentially argues that “To the best of my knowledge there has never been a successful global ban on anything. Genetic research is unlikely to be the first.”

5. Rescind the Bayh-Dole act (an act permitting university researchers to sell their discoveries for their own profit, even when that research had been funded by taxpayer money): Crichton laments that thirty years ago, universities provided a scholarly haven, a place where disinterested scientists were available to discuss any subject affecting the public. Now universities are commercialized, the haven is gone and scientists have personal interests that influence their judgement. Also “Taxpayers finance research, but when it bears fruit, the researchers sell it for their own institutional and personal gain, after which the drug is sold back to the taxpayers.”

I agree with points 1, 2 and 4 and strongly disagree with points 3 and 5. In fact I believe he has got the issue backwards.

In his support for point 3, Crichton writes “Government should take action. In the long run there is no constituency for bad information. In the short run, all sorts of groups want to bend the facts their way. And they do not hesitate to call their senators, Democratic or Republican. This will continue until the public demands a change.” This is true but his conclusion doesn’t follow. An “independent agency” in charge of verifying findings has to be under the control of politicians who will be all too willing to oblige the groups who who want to bend facts in exchange for backing. This phenomenon is not new at all. It is called lobbying. Requirements for disclosure are even more ridiculous than bans. You can force a person from doing something with limited success. How do you force a person to disclose what no one else knows? And most importantly, government has no moral right to <i>require</i> someone to do anything. Men are not slaves.

About the Bayh-Dole act, again Crichton has the facts right and the conclusion wrong. Universities are certainly commercialized today. And researchers who are funded by public money and allowed to make private profits certainly act in unscrupulous ways. The incentives are definitely wrong. But the solution is not to de-commercialize research. That is neither possible nor desirable. It ignores the context of why the act was passed in the first place. It was passed because non-commercial research does not work.

Describing a character who is a director of NIH (National Institutes of Health), another character says: “Rob’s a major player at NIH, He’s got huge research facilities and he dispenses millions in grants. He holds breakfasts with congressmen. He’s a scientist who believes in God. They love him on the Hill. He’d never be charged with misconduct. Even if we caught him buggering a lab assistant, he wouldn’t be charged.” and again “It was classic Rob Bellarmino. Talking like a preacher, subtly invoking God, and somehow getting everyone to push the envelope, no matter who got hurt, no matter what happened. Rob can justify anything. He’s brilliant at it.” The solution to unscrupulous researchers (in as much as the problem can be “solved”) is not to have more such men like Rob. It is to make them impossible, or more precisely to make it impossible for them to enjoy political clout and arbitrary powers to grant millions in grants. It is to divorce research from government.