An Interesting Man

 Jim Watson passed away. As the Guardian notes:

 James Dewey Watson, whose co-discovery of the twisted-ladder structure of DNA in 1953 helped light the long fuse on a revolution in medicine, crimefighting, genealogy and ethics, has died, according to his former research lab. He was 97. The breakthrough – made when the brash, Chicago-born Watson was just 24 – turned him into a hallowed figure in the world of science for decades. But near the end of his life, he faced condemnation and professional censure for offensive remarks, including saying Black people were less intelligent than white people. Watson shared a 1962 Nobel prize with Francis Crick and Maurice Wilkins for discovering that deoxyribonucleic acid, or DNA, is a double helix, consisting of two strands that coil around each other to create what resembles a long, gently twisting ladder. ... He has shown “a regrettable tendency toward inflammatory and offensive remarks, especially late in his career”, Dr Francis Collins, director of the National Institutes of Health, said in 2019. “His outbursts, particularly when they reflected on race, were both profoundly misguided and deeply hurtful. I only wish that Jim’s views on society and humanity could have matched his brilliant scientific insights.”

I first learned genetics from Watson at Harvard. I snuck up Mass Ave in the 60s. I knew about DNA from my secondary school bio teachers who in 1957 as a doctoral student at NYU studied Watson's work on the subject.  

I believe that Watson's major contribution was the revitalization of Cold Stream Harbor Labs, a place for brilliant geneticists. I often wish it was somewhere else other than Long Island but that is a personal bias. 

When I cam back to MIT in the early 2000s, he gave a talk at the neuro institute and a bunch of my  doctoral and post docs went to hear him. They cam back startled as to how he really discounted engineers and physicians. My comment was that is one reads the Double Helix, Watson was just being a good engineer, not a scientists. The scientists gave him the data and he and Crick just assembled it. That made my students happier.

Watson was acerbic at times but at CSHL he was a true leader. 

PSA: How not to do an experiment

 Back in 2009 in NEJM a European group reported the results of a study that alleges that PSA testing has no value after certain ages. Now the group adds additional data but claims only marginal improvement. It still delimits testing to less than 75.

However as I noted then and now again the test protocol was:

The screening interval at six of the seven centers was 4 years (accounting for 87% of the subjects); Sweden used a 2-year interval. In Belgium, the interval between the first and second rounds of screening was 7 years because of an interruption in funding.

As I had noted, I have seen patients got from 4 to 40, and 40 to dead in 4 years. Testing annually, along with %Free is essential just for monitoring. Measuring rates of increase are sine qua non. Change is the critical factor in any diagnosis.

PSA value can vary from one test method to another. From time of day. From state of exercise such as cycling. And other factors. The more frequent the measures the more these exogenous factors can be averaged out. Yet if we have 4 year intervals in my opinion and my experience the results are useless.

These studies were used to justify reducing PSA monitoring and eliminating it in the over 75 group. PCa is a horrible disease if not caught early. More frequent PSAs under common conditions using the same method of valuation is essential.