Genetics

Since I am down to only one class this quarter, I have a bit more free time than I am normally used to. Without much in the way of a social agenda these days, I have been watching a lot of Netflix. Last night, I watched a documentary about genetics. The bulk of the documentary focused on the advances that have been made and how the discussion around the possibilities has changed greatly in the past 10-15 years because major advancements to the field. Years ago it was easy to say what a person may or may not agree to when it is theoretical. It encompassed a passionate debate about stopping horrific genetic diseases from afflicting the next generation (Huntington's disease, early onset Alzheimer's disease, BRCA 1 and 2 genes for aggressive breast cancer, etc.) 

The documentary followed a boy who was about 11 or 12 years old. He has sickle cell anemia which is a genetic disorder of the red blood cells. For those without this genetic disease, the red blood cells are round and efficiently carry oxygen throughout the body. His red blood cells are moon-shaped or "sickle" shaped which reduces the oxygen they carry and can get stuck in transport throughout the body. He was hospitalized during his interview with a sickle cell crisis which is extremely painful for him. The filmmakers interviewed his grandmother who was his caregiver. She would give anything to make this disease go away and have him not suffer. Toward the end of the film, the filmmaker asked this boy if he would like to have kids some day. "I don't know, but that might change." The interviewer explained that maybe by the time he was interested in having children, genetic alterations might be available so that his children would not develop sickle cell. "The gene would be turned off." 

The child was almost confused by this concept. On one hand, he said, "well, you turn that one off, how do you know that you aren't going to turn off the one for growing hair or something." Smart kid. He, then, started talking about how he learned a lot about having this disease. "I learned patience. I learned how to be happy for great days. I met many people." A child shall lead us! He was a lovely addition to the discussion. First, there always could be unintended consequences to manipulating DNA. Second, which disorders meet the criteria for the eradication list? Personally, I hate ALS. If they were able to deactivate the gene or genes for ALS, I am all for it. As a person with a genetic predisposition to addiction, would I want this gene deactivated for my children to reduce the risk of developing addiction? There was a mention of addiction genes in a hypothetical scenario with a set of parents reviewing their genetic "disadvantages" and listing the genes that could be deactivated to take these concerns out of the equation. In that, they mentioned addiction. "We took care of the gene for alcoholism and other addictive disorders. The child is still you, just the best version of you."

I immediately thought of the "grateful alcoholic" post I did years ago. In a quick summary, at a meeting this guy says, "Hi! I am Tom and a grateful alcoholic." I thought he was nuts. Who is grateful for this crap? After establishing more recovery time, I got what he was saying. The child with sickle cell anemia reminded me of him. Yeah, we got this thing, but it's not all bad. In my favorite movie about addiction, Pleasure Unwoven, the narrator of the film talks about developing addiction and overcoming it is a good thing. We teach others (the children as well) the concepts of coping and acceptance. There is also an acknowledgement that the recovery process is tough but worth it because life looks so much different now, not to mention I found a new respect for gratitude for all that I have. 

Generally speaking, I don't like to play the "what if" game. What's the point, really? Even if I could fully map a situation out, I still cannot change what has happened. I have wondered, at times, if  addiction hadn't taken over so quickly and at such a young age, what would I have done differently? I often took the path the least resistance. I took classes in college that I knew I would be good at because I didn't want to have to work really hard at something and then fail at it. Initially, when I was applying for college after high school, I wanted to do nursing. I got super scared of taking chemistry, biology, and anatomy. I knew that I would have to work at it because those are not the most intuitive subjects for me.  So, I never pursued it in college. I was scared of failure. Alcohol was my escape from a lot of self-doubt and fear. Would I have gone for it out of the gates instead of getting my RN at 43 years old? Probably not because the issues around my own abilities were still there. My personality was still there. My avoidance was still there. 

Those years of addiction were not easy. I lost a lot. The hardest thing to lose was me. Anything that was important to me got thrown out of the window. If I didn't have addiction issues, what would my life look like? I don't know. Part of me thinks I would have found something else to be unhealthy about. I just can't image my life without those times. I would have found another way to hide. Part of me thinks of those times and would say, take that genetic component out of my kid. I don't want him/her to EVER suffer through something like that. Addiction and, more so, recovery are such a huge part of who and what I am. It's hard to imagine a life without those experiences. Every decision I have made, every step that I took, right or wrong, has led me to where I am today. Since I can't even imagine what I would have done differently, having the gene removed for alcoholism probably would have manifested in a different way. Not much would have really changed from a 10,000 foot level.

I have a certain personality. I don't think you can turn off the genes for that. I will always have an impulsive part of me. I have a thrill seeking side. Heck, even if the gene was turned off, I probably would have developed addiction anyway. The way I understand it is that the genetic component has more to do with how I physically process alcohol. I can tell you, alcohol does not make me sleepy. Alcohol makes me feel like I am on meth (or what I assume that feels like). I have grandiose thoughts. I run 1000 miles per hour. I have little to no forethought about consequences to actions. I want to conquer the world. I want to run and do crazy things. That, my friends, is not how "normal" people process alcohol. So, to suppress that process probably wouldn't be enough for me to love the feeling of being buzzed even it the buzzed were taken down a notch or two. 

If I were to have a child, would I look at silencing the gene for addiction? In grad school, one of my professors gave us the "rule of thirds". One-third of people who are clinical and diagnostically addicted to a substance will stand up and walk away for good with very few changes needed to stay away. One-third of people will need some type of assistance including treatment, counseling, medications, etc. And the final one-third will, no matter what intervention, not get better. Ever. When I think of 23 million people having addictions issues, that last 1/3 is a whole heck of a lot of people who will succumb to the consequences of addiction or of the addiction itself. Having spent those years in the counseling field, these stats felt about right. Would it be worth attempting to save some of those lives in the next generation by muting a component of addiction?

What about recovery though? I would say about 1/4 of the friends I have made as an adult have come from the recovery community. A lot of the appreciation I have for life is because life was so bleak for so long, I have learned to appreciate every color now. No matter what I do for a living, recovery will always be a part of the journey. I learned how strong I can be. I learned how to put boundaries in place. I learned to respect myself more. I have come to know what acceptance is. I took a leap of faith that I could do something different and I did. I have spiritual connections I never dared to dream of while I was actively using. I feel like if I hadn't gone through this recovery process, something would feel very empty in my life. 

Technology and science move quickly these days. A lot is possible now of days. I won't have to make that decision and, for that, I am grateful. I truly can see the argument from both sides about any disease, not just addiction. Are we playing God? Will nature get back at us for trying to manipulate it? Can we ease the suffering of a child? Can we give a child an opportunity to grow up free of disease and pain? What about the diversity of the world? All great philosophical questions with hundreds of different answers. So, I have no answer for you because, honestly, I am not in the situation where I would have to make it. It's easy to make decisions when there is no immediate or long-term consequence to that decision.

That's all I got for tonight! 

​Julie