Cervical Cancer, Deep History, Diagnostic Chips

Professors Goldie, Smail, and Whitesides all work on topics featured in one day’s New York Times

The front pages of the New York Times’s news, arts, and science sections on September 27 featured articles bearing on pioneering research conducted by senior Harvard faculty members.

The news article, “Fighting Cancer with Vinegar and Ingenuity,” highlighted the use in Thailand of an inexpensive technique—employing vinegar and topical freezing—to combat cervical cancer. The application in the field was developed at Johns Hopkins, the Times reported. But Sue Goldie—Lee professor of public health; director of the center for health decision science and of the Harvard Global Health Institute; and professor of global health and social medicine—proved the cost-effectiveness of just this approach in her research, featured in “Medicine by Model,” a 2002 article from this magazine’s archives. As Nell Lake reported then:

In sub-Saharan Africa, cervical cancer deaths take an especially high social toll: many victims are women who have reached their late thirties—the age at which most cervical cancers develop—without becoming carriers of HIV. These women are caring for their own children and the children of women who have died of AIDS. Their value in their communities is great.

Many of them could quite easily be saved, despite their countries’ meager resources. That’s the conclusion of Sue Goldie, M.D., M.P.H ’97, assistant professor of health policy and health decision science at the School of Public Health (SPH). Through research in South Africa, Goldie has found that inexpensive screening and treatment strategies—alternatives to Pap smears—could prevent up to one-third of cervical cancer cases there. Her findings, she says, could likely be applied in other impoverished settings. Now she wants developing nations and international aid organizations to know that such options are available.

In the arts section, “History That’s Written in Beads as Well as in Words” reported on the forthcoming book Deep History, to which Daniel Lord Smail, professor of history, is a lead contributor. “Our Psychotropic Lives,” in the March-April 2009 Harvard Magazine, reports on Smail’s  biologically based history:

We like to think that as humans, we are somehow above biology—capable of self-restraint and subverting base urges. But professor of history Daniel Lord Smail argues that for humans and animals, life is by and large a quest to feel good. We may be responding to biological urges that are complex and sophisticated, but they are biological urges all the same.

In his most recent book, On Deep History and the Brain (University of California Press), Smail posits a new view of human history in which physiology and culture evolve symbiotically in a process driven by brain chemistry and psychotropic effects. Seen from his perspective, we are all hooked on the hormones and neurotransmitters that signal pleasure and relieve stress.

In the new story, Times reporter Patricia Cohen wrote,

Distressed by most historians’ overwhelming preoccupation with the modern world, an unusual coalition of scholars is trying to stage an intellectual coup, urging their colleagues to look up from the relatively recent swirl of bloody conflicts, global financial exchanges and technological wonders and gaze further back, toward humanity’s origins.

The up-close and personal accounts that have won professional praise and rewards in recent years are worthy, said Daniel Lord Smail, a medieval historian at Harvard, but he says the “microhistory” trend has stunted the ambition to think big.

“In the last two or three decades, historians have found it hard to think across large time spans,” he contends; gone are the sweeping narratives of humanity’s advance. The antidote to this “shallow history,” he said, is “deep history,” stretching back 50,000, 500,000, even 2.6 million years to the earliest humans. Recent advances in archaeological analysis, gene mapping and evolutionary ecology have led to an astonishing expansion in our knowledge of the distant past, despite the lack of written records, the historian’s traditional sidearm.…

After reviewing the roster of professorships, course offerings, dissertation topics and publications in recent decades, Mr. Smail and Andrew Shryock, a cultural anthropologist at the University of Michigan, concluded that both of their disciplines rarely venture beyond the last 250 years. Most of the long march of human existence is being ignored, they complain.

To point the way toward what Mr. Smail calls the “new intellectual frontier,” a small cadre of diverse collaborators in anthropology, archaeology, primatology, genetics and linguistics have spent the last two and half years working on a forthcoming book, Deep History: The Architecture of Past and Present (University of California Press) that serves as a kind of manifesto for their cause.

Finally, Science Times—in a special section devoted to “small fixes” for health challenges in the developing world—focused on Flowers University Professor George Whitesides and his paper “lab on a chip” diagnostic tools, now being tested for development and deployment by Diagnostics for All. The technique was described earlier in a University news story. As Times reporter Donald G. McNeil Jr. began his account, in “Far from Any Lab, Paper Bits Find Illness”:

While other scientists successfully shrank beakers, tubes and centrifuges into diagnostic laboratories that fit into aluminum boxes that cost $50,000, George Whitesides had smaller dreams.

The diagnostic tests designed in Dr. Whitesides’s Harvard University chemistry laboratory fit on a postage stamp and cost less than a penny.

His secret? Paper.

His colleagues miniaturized diagnostic tests so they could move into the field with tiny pumps and thread-thin tubes. Dr. Whitesides opted for a more novel approach, reasoning that a drop of blood or urine could wick its way through a square of filter paper without any help.

And if the paper could be etched with tiny channels so that the drop followed a path, and if that path were mined with dried proteins and chemically triggered dyes, the thumbnail-size square could be a mini-laboratory — one that could be run off by the thousands on a Xerox machine.

Whitesides’s other research is covered in, among other recent Harvard Magazine articles, “Snuffing Flames with Electricity” and “Thinking Small,” an overview feature on nanoscience.

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