Faith (a.k.a how to get into a top 10 university)

Most of us find ourselves too often backed up against a corner, contemplating what are we doing with our lives. Whether our actions and choices have truly been our own, or are they just providence. Are things what they seem to be, or is it just our filter bubble showing us things the way we want to see them. I know this feeling of self doubt where you are unsure of everything. I have been there many times, too many times in the past couple of months than I care for. Today I am here to tell you that things have a funny way of working themselves out. If you keep your head down and focus on your work at the same time have compassion for people around you, things do work out. Missing a few parties, working sincerely when slacking off seemed enticing, working on your research project when rest of the college was busy mugging up for the exams, is not too big a price to pay for ending up in a top 10 university (for AI) in the World. 

During one of my internships, one of my mentors who is now at JPL gave me a piece of advice that has really stuck with me: 

Do good work. Thats more important. Enjoy your time, but do good work. Great work.Very few manage to get good opportunities. Use it well.

Look at your mentors and the people you admire and firmly believe that you will get there too one day. It is only a function of your hard work. You will have that lifestyle, you will have that success both personal and professional, it is just a matter of time and faith. Faith in yourself, in your hard work and gratitude for the opportunities that you have been lucky enough to have. 

Gratitude and humility are very important traits to have. They make the journey a whole lot easier. Be humble and apologize when you screw up. Do good upon the world and that good will find its way back to you, karma is real. Trust people, as Randy Pausch put it 'if you wait long enough, people will surprise you'. If you are disappointed in someone, you have just not given them enough time.

You can't get there alone. Having an amazing support system in your family is an amazing asset to have. It is very important to have a space, it can be with family or friends, where you can discuss things without being judged. A space where you do not bring your pride and ego, a place where you listen to feedback instead of coming up with excuses for your shortcomings, a place where you identify your weakness and come up with ways to work on it. It is a difficult process. Whenever I spoke to one particular mentor of mine my self confidence would go for a toss, his feedback was brutal things were only compounded by the fact that he was out there achieving so much. But that is the kind of feedback which helped me the most. You will find hordes of people who will be willing to tell you how great you are, only a limited few will give you real actionable feedback. Treasure them.

Trust me, one day, and that day is not far away, you will look back at your journey, at your struggles, on all those occasions where you could have taken the easier way out, when almost everyone around you took the easier way out. You will look back and you will be proud. 

I am UMass Proud! 

How did I not know about this?

Mary Claire King visited the Indian Institute of Science as part of the 'Cell-TNQ India Distinguished Lectures Series' and her lecture just blew me away.

We start with a brief introduction of this amazing scientist who has literally changed the world in more ways than one. A Berkeley educated geneticist, King proved for the first time that humans and chimpanzees are 99% genetically identical, giving weight to the theory that the two species diverged only about 5 million years ago, a view that was not very popular at that time. She is responsible for discovering the BRCA 1 and the BRCA 2 genes and announcing to the world that cancers like breast and ovarian cancers can be hereditary. She is also known for her human rights initiatives. She joined the protesting grandmothers in Argentina, whose grandkids and kids had been taken from them by the regime and were forced to live with military families.  Her work in genetic forensics provided irrefutable evidence that has since helped thousands across the world.

Dr King at the JN Tata auditorium 

Now this is important: I am not a geneticist, my formal links with classroom biology were severed in high school, so inspite of King's wonderful talk the content that follows is my understanding of the talk, which may be inaccurate at several points.

Okay so here goes,

Breast and Ovarian cancer have been dubbed as the disease of the educated and the disease of the rich. We know for a fact that human females are the most evolved organisms to have roamed the face of this planet, unfortunately they seem to have become victims of their own advancement.

One might wonder why did evolution not take care of curing cancer, by natural selection for healthier indivisuals? The answer lies in the fact that both breast and ovarian cancers are post reproductive, thus escaping the scrutiny of evolution.

The risk of breast and ovarian cancer is directly proportional to the gap between the age women start menstruating and the age at which they have their first pregnancy. Who knew!

Menstruation starts when estrogen (the female hormone) hits a certain level in the body. Interestingly the production of estrogen in the body is related to the body mass index (BMI) (defined as the body mass divided by the square of the body height).

As families start to become more educated and are more well to do, young women are hitting the BMI threshold earlier (as they have access to better diets), therefore we see young women hitting puberty much earlier, the age has progressively lowered from 18 to 16 to now around 11.

At the same time women are making an active choice of putting their carriers first and choosing to start a family at a much later age.  Thus increasing the gap.

This phenomena is highly correlated with the how well to do the society in which they live are. In the past Europe and the US have been the primary victims of these cancers but as the developing world catches up to the developed world it inherits their problems too.

Studies show that the cases of breast cancer in Indian cities are growing at an exponential rate.

The graph looks like this, this is not the original graph just a py plot simulation 

If you are looking for an interesting read check out The race to clone BRCA1 in 'Science', which documents the fascinating story of discovering the gene.

Dr King's work shows that individuals who have a BRCA1 or BRCA2 gene mutation are at a very high risk of developing breast or ovarian cancer. Infact these people have an 80% chance of developing these cancers over their lifetimes. 80%. Let that sink in.

Complex Structure of the BRCA1 RING domain and BARD1 RING domain
credit: By Emw - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=8763313

But my mother and grandmother did not have these issues!
It is not just the women!
BRCA 1 and BRCA 2 can be inherited from the paternal side too. Also men carrying these genes are predisposed to developing prostate cancer in their lifetimes. [The new England Journal reports that 15% of patients suffering from prostate cancer have a BRCA-2 mutation]

THE SOLUTION 

Knowing what we know how can we help ourselves? The answer is early testing for these genes. The BROCA gene panel can be used to conduct a simple sequencing which costs about $225. If the patient is a carrier of the either the BRCA 1 or BRCA 2 gene then Dr King recommends a salpio oophorectomy around the age of 35-40 i.e. the surgical removal of the ovaries and fallopian tubes to lower the estrogen levels in the body. This will significantly reduce the risk of both breast and ovarian cancer. PARP inhibitors have also know to be helpful.

If there is one thing that you take away from this post let it be this: get yourself and your loved ones tested for the BRCA 1 and 2 genes. It is just $225 test which can change your life. 

"Every breast or ovarian cancer patient with a BRCA1 or BRCA2 mutation detected after diagnosis is a missed opportunity to prevent cancer. "

Thank you Dr King!

Update: 

Dr Priya Mathur, a PhD holder in Biochemistry & Molecular Genetics from the University of Chicago weighed in with the following advice:

My concern with advocating for BRCA testing for the general population is that it can lull people into a false sense of security. It is critical that those with a family history of BRCA-mutant cancers be tested because these mutations drive an aggressive form of hereditary cancer and steps can be taken to prevent it. However, the vast majority of breast cancer is sporadic, or non-hereditary, which means that even with a negative BRCA test result, a person carries the risk of developing sporadic breast cancer. Early detection via routine screening is the best way to improve outcomes, BRCA1/2 screening is not a substitute for routine mammography and self-screening.