(in response to “Lost” by Steven Murphy)

I claim that you can’t expect results better than the ideal model by using that model.

I claim that it’s not enough to choose another ideal model that gives you answers that you like irrespective of reality. That method already exists; it’s called religion. Go to church.

I say that genomics is the best opportunity of which I’m aware to design and implement a better model of human medicine, but that the gravity and magnitude of this potential as it can be applied to each human individual to themselves has been so far squandered by people who —by all external appearances— had just wanted to throw parties for themselves.

My frustration is that the leaders of “genomics medicine” were unworthy —which I claim by evidence including:

• their lack of quantitative results as measured in unhealthy people made healthy
• their failure to lead their teams and companies over even a few years
• sometimes even outright abandonment or exile which I can only interpret as shear cowardice or perhaps weakness but nonetheless was at the expense of the domain and those invested in it
• demonstrable commercial gluttony of pricing the market for genomic tests and services far below the sustainable cost to provide them
• demonstrable civil gluttony of abusing permissive public health regulations and academic endorsement until law enforcement is forced to interviene (e.g. FDA)
• demonstrable intellectual gluttony of abusing academic endorsements including those by Stanford, Harvard, Yale, Oxford, and Google which were justified as “experimental” until the community was forced to publish work which has humiliated even the endorsement of the theoretical substance of these “experiments”
• demonstrable publicity gluttony of abusing the trust of media institutions including the New York Times and Time magazine to broadcast bombastic declarations of the future which were then held against them when they were found to be absurd which has substantially damaged both the credibility and the morale of these institutions —particularly regarding their participation in this domain

I claim that the continued entertainment of the residual sophistry propping the myth failed leader’s success and their obnoxious superstitions is an obstruction, a distraction, and an insult, and I think that the people at fault are not the majority of the domain leaders themselves who are probably all too acutely aware of their own failures, but the crowds of teaming enthusiastic groupies who had believed the original mythology on the cheap but now will not be constructively disabused otherwise for a reasonable expense because it is more difficult to unlearn an identity than it is to adopt a new identity and because of a residual interest by this leadership to not publicly flagellate itself at its own expense and pride. These people are largely worthless excluding their unconditional support or cooperation which will no longer be readily available due to the abuses I described. It is my advice that this mess be labeled “DTC Genomics,” publicly mocked, cast away, and then relaunched under some other label which actually is the same people in the same domain doing the same work but without the negative connotation of “whatever was bad about the last time” which will be labeled as “DTC.”

People fail, but fail honestly, accept responsibility, and learn from your mistakes. No yoga happy fun time go team A for Æffort bullshit is going to get code written or diseases cured. This isn’t China; but it’s not the Special Olympics either.

Dr. Steven Murphy expresses another frustration which is that he knows that the best of what is already available in medicine has not been already widely applied before new methods are being explored. I agree, but I don’t think that is relevant to exploratory genomic medical application like as in the Lancet paper because that was not the intent of the paper and that would not have changed its conclusions or relevance. I also think that Steve conflates his general frustration with the politics of the domain with his frustration of its substance, and that this weakness (ie he’s a shitty writer and a sloppy debater) makes his arguments read like incoherent rants when in demonstrable reality he knows more about the successful application of genomic medicine at an individual patient level appropriate to expect in common practice because he actually regularly achieves this in his daily work as opposed to merely publishing theories about such application with experience limited to practice within City Of God like enclaves of a world class medicine institution. Being a shitty writer and a sloppy debater is irrelevant to Steve’s excellence as a medical doctor and is unlikely to necessarily prevent him from improving these skills given practice and relevant corrective exposure.