LawyerScientist Returns!

Welcome to my blog.  This is a site for sharing and discussing information of a legal, scientific, or legal-scientific nature.

As a country, we have seen the excitement of having men walk on the moon and 40 years later, we have no reliable public program to put men in orbit.  We have seen the completion of the sequencing of the human genome, and the rising costs to discover drugs.

Life is a journey, and we are on a miraculous one.  We have moved both ahead and fallen behind in science, and some may say the same is true about human rights.

We have watched Y2K come and go with a fizzle, while many await 12.21.2012 with even more concern than Y2K.

We have seen the Internet revolution creating midnight billionaires, and we have seen excesses in the financial sector driving us into a national depression.

Let me tell you a bit about me.  I earned a PhD in Genetics in 1992 and spent decades in academic medicine, private companies, public institutions, and biotech start-ups.  As the new millennium approached, I saw a future where as a society we would be called on to tackle many issues where human rights and genetics meet.  So, as a modern-day Dr. Jekyll and Mr. Hyde, I continued my cancer research program and earned a law degree in the evening at the only law school (at the time) between Washington DC and Atlanta which had such a program.  With much effort, I graduated and passed both the North Carolina State Bar Exam and the exam to become a licensed U.S. Patent Attorney.  I hold a research leadership position at a law school and spend most of my time as a practicing attorney.  You can learn more about me at my site:

I hope that over the next weeks and months we can have active and thoughtful discussions around the topics discussed.  There is a lot of information on the Internet, and I appreciate any time you spend on this site.

A. Jamie Cuticchia, PhD JD

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LawyerScientist Truly Back Online!

It has taken some time, but the blog is active again.  Look for posts on scientific topics, legal topics, and most importantly their intersection.

A. Jamie Cuticchia, PhD JD

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The Letter: A Satirical Look At Becoming a Lawyer

As an author or editor of 7 books, I am extremely pleased to announce my first work of fiction.

The Letter:  A Satirical Look at Becoming a Lawyer, is loosely based on my own experiences of obtaining a law degree part-time and continuing to manage a large research portfolio.

As a displaced medical professor, I return to the role of student and experience that twist.  I quickly learn the difference between getting a PhD versus a JD, and use coping strategies over the next four years.

This book should be an enjoyable read for lawyers, law students, or readers just interested in becoming a lawyer.

Presently, the book is available only on Kindle, but will be released shortly in paperback form.  The price is $3.99 for the Kindle and $7.99 for the paperback.  A portion of the proceeds will go to charity.

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Is Personal Medicine the New Genomics?

At the same time that the dot com’s were skyrocketing in market valuation, so were the genomics companies.  It seemed that all you needed was a PhD/MD and an idea (over simplification).

So, what happened?  A great number of companies sprang up to look for gene targets.  I remember going to a conference and a well-known member of the Pharmaceutical community stated that the number of peer-review papers on a gene target use to be in the 20’s.  Now the number of papers is approximately 3!  The cost of drug discover, rather than decreasing, doubled.

What did this mean in practical terms.  A higher cost for drug discovery.  Each reasonable target had to be sent down the line of pharmaceutical research.  This process also impeded the mantra of drug development – “fail quickly, fail often.”  That mantra was based on the fact that the further a drug goes down the development pathway, the increasingly greater the cost to the company for drug development (e.g., clinical trials).

Additionally, at the time of the Genomics Gold Rush, a LOT of hardware was purchased.  By hardware, I don’t only mean computers, but sequencers, plate handlers, PCR machines, etc.

And every time an improvement was made, companies rushed off to get the new one, for a perceived business advantage.

So what does this have to do with person medicine?  Personal Medicine is following the same trajectory as Genomics.  Companies are popping up and money to fund them is flowing at a good rate.  Much like Genomics was based on the assumption the knowing human genes would better our understanding and quicken the development of drugs; personal medicine believes a similar fantasy.  But fantasies can come true.

The belief is that if you put enough money into clinical trials and attach to them genomic predictors, the patient will do better than if given a drug randomly. But what is “better” – is it a 25% percent increase or a 2% increase?  Not to make light of an improvement that helps 2% of the population, is this what people expect from personal medicine?

I would argue the answer is NO.  The patient will take whatever advice the physician gives him.  If the physician wants to prescribe based on genomics, that is her prerogative.  But who pays the cost?  Personal Medicine test right now will run in the thousands of dollars.  Will insurance pay for that?  Will patients be willing to pay for  that?

I would take the position that they will, if there is a significant improvement in patient response.  The question, again, is what will that “significant improvement” be?  As the Personal Medicine companies become mature and there founders move to “cash out,” I hope that the results are better than what happened in genomics.

[This a summary of an article which will be coming out.]


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