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Lost in the raucous debate over the ethics of human embryonic stem cell research is this: A worldwide medical revolution is underway, and at its center is what science journalist Cynthia Fox describes in her new book as the Cell of Cells.
The book is as ambitious and wide-ranging as its subtitle, The Global Race to Capture and Control the Stem Cell. Whether derived from embryos or rejuvenated adult tissue, the benefits of these remarkable cell precursors go beyond health care. They may prove to be the engines of economic development and the foundation of international technological leadership.
The pace of scientific and political developments surrounding stem cell research must have made this book a challenge to write. Scientific and technological progress is neither unidirectional nor predictable, and political storms brew with little warning. Anything Ms. Fox might write could be superseded within months.
Her solution: to invite the readers along on her investigation, presenting in-the-moment accounts from 2003 to May 2006. With her, they visit laboratories and hospital operating rooms on four continents, attend conferences where breakthroughs leap from dry scientific presentations to journalistic sensations, and watch an unfolding scandal, the full impact of which is not yet clear.
To maintain a narrative thread, Ms. Fox must often interrupt her narration to foreshadow events to come in later chapters or to refer back to earlier ones. That sometimes makes for difficult reading, but it is essential to the story and worth the effort.
Ms. Fox delves deeply into the science, enabling readers to understand the research and its implications in detail. She goes beyond spinal cord injury and degenerative diseases to stem cell therapies in the treatment of cancer and heart disease, organ transplantation, and fertility problems.
Arguing for continued research in both embryonic and adult stem cells, she deplores the intrusion of religion into political decisions about which scientific approaches should be pursued in the United States. She calls it a threat to this nation's scientific and technological leadership, citing the potential brain drain to China and Singapore as primary examples.
Surprisingly, she opens the book in a place where religious fundamentalism is far more influential than here. Embryonic stem cell research is blossoming in the Middle East, because Orthodox Judaism and Islam share the belief that "ensoulment" occurs later in development.
Ms. Fox balances this heavy subject matter with human connections. Parts of the book read like a novel with multi-sensory renderings of its settings. Researchers, patients, financiers, entrepreneurs, and politicians become fully fleshed-out characters.
But unlike a novel, in which the central themes and questions are resolved, this book is as messy as science and politics it describes. It is full of loose ends, as exemplified by its final chapter, "The Fall of Seoul and the Rise of San Francisco."
In 2005, Korean researcher Woo Suk Hwang announced that he had produced a human embryo from the cell of an adult, a breakthrough that could make possible both therapeutic and reproductive cloning, though the latter is almost universally decried on moral grounds. For months, Hwang was the toast of the stem cell world, until the work was exposed as a fraud.
Observers of the stem cell race realized such a fiasco would never have in occurred U.S. science, with its culture of independent thinking and healthy skepticism. As the book closes, embryonic stem cell researchers around the world are hoping that political winds in the United States are shifting. California is leading the way with a massive stem cell initiative, and the 2006 election is several months in the future.
The global stem cell race is rounding a new turn. The scientific and political excitement has only begun. If readers want to hazard a guess about how will it turn out, "Cell of Cells" is an essential handicapper's guide.