Robert Oppenheimer

Prelude: The geneticist who played hoops with my DNA

There’s a high probability that for Homo sapiens, the process of evolution as we currently think about it, as natural selection, is for all intents and purposes over. It is going to be replaced by our desire and capability to tinker.

                          -- Stuart Schreiber, Harvard geneticist

I’m playing basketball with a Viking geneticist on a half-court at the ends of the earth, and he is toying with me. Also known as Iceland’s most famous geneticist, he’s dribbling a basketball in a Reykjavik gym on a typically damp, cold day in August near the Arctic Circle. Notorious for being rude, as well as brilliant and filled with an infectious passion, Kari Stefansson, a descendent of the murderous Erik the Red – an early Viking explorer and marauder – insisted that I go one-on-one.

            Every day at 2:00 p.m., when he’s not wandering the globe rustling up cash or giving talks, Stefansson drives from his office downtown across this speck of a capital city, home to nearly all of Iceland’s 290,000 people, to a gym that requires a retinal scan to enter (Icelanders love gadgets). Just beyond the gym’s parking lot the city ends and a hardened lava field begins, though this is hardly a landmark in Iceland. Here the black rock everywhere remains raw, hardened in waves and eddies, once lava-hot, covered only by a thin veneer of lime-green moss. Overhead, the sky boils with immense gray-white clouds that turn nearly black above a ridge of distant mountains where active volcanoes still blow off steam. The land looks ripped from a primeval moment in history, when cones spewed ash and fire and Titans roamed the Earth.

            It’s a fitting place for Stefansson to be exploring the raw ingredients of life, the nucleotides and other molecules that he first began to study as a medical student at the university here before moving on to the University of Chicago and then to Harvard. There, as a medium-important neurologist, he delved into the mechanics of multiple sclerosis and other maladies of the brain. At first, before new technologies made deoxyribonucleic acid DNA easier to work with, he cut open brains of persons who had died of neurological disorders. Later, he parsed out their DNA, looking for links. But the academic approach was too slow, so in 1996 he returned home to Iceland to start a company.

            On the court Stefansson destroys my pathetic game, despite being fifty-six years old to my forty-four, a difference he notes everytime he overpowers me to plant a basket. At 6’ 5”, with close-cropped white hair, a pointed beard, and biceps that bulge out of the tight black designer T-shirts he tends to wear, Stefansson looks as formidable as his wild-eyed Norse forebears in the Icelandic sagas he likes to read, those hairy warriors who sailed in flat-keeled longboats one thousand years ago, snatching women from the British Isles and taking them to this bleak edge of the earth.

            I haven’t played basketball in years. When I finally grab the ball he flashes me a glare that Erik might have used before hacking to death an enemy in the tenth century.

            Prior to playing, we had been talking about a test that Stefansson’s company, deCode Genetics, had just run on my DNA, a guinea-pig experiment to check my nucleotides for genes associated with disease. Back in the States, I had a lab extract three vials of my blood to ship on dry ice to Reykjavik. DeCode’s technicians then plucked out my DNA from the white blood cells and tested it against the company’s database of genetic maladies. Do I have a genetic proclivity for heart disease, Alzheimer’s disease, osteoporosis, anxiety? “We will tell you if you are crazy, or if you might die of a stroke. You will become our first American lab rat,” he had told me a few months earlier, when we met during a biotech conference in New York.

            Stefansson had promised to reveal my results when he returned that afternoon to his office, making me one of the first persons ever to reveal publicly so much personal information about a raft of disease markers hidden in everyone’s genes. In a few years, he says, these tests will be routine: a screening like a cholesterol test that will tell us whether we might one day contract a dread disease or die sooner, rather than later. They also might be used to tease out genes that affect behavior, telling us whether we have a predilection for anger, risk taking, happiness, or homicide. Yet I know this sort of predictive genomics is still very much nascent, the information incomplete, the connections between genes and disease or behavior murky, the forecasting power faulty and poorly understood. But I’m willing to listen, and to imagine the possibilities as described by this Armani Viking.

            Of more immediate concern to me is how to react if Stefansson tells me that my nucleotides may be harboring an aberration I never suspected, a dread disease ticking inside me like a secret time bomb ready to strike when I’m fifty years old, or seventy. A fatalist, I don’t think much about how I might get sick or die, but I can’t help but feel a small apprehension.

            On the court I’ve got the ball and I’m dribbling toward the basket, making a few clunky moves I remember from years back. I whip around Stefansson; he pushes in close and I feel his hot Viking breath on my face. I zig left; he cuts me off. I zag right, and we crash shoulders as I push to turn a corner around him. He’s behind me, pushing, and I start my leap, holding the ball up, eying the basket when he blurts out, “I have your DNA results.”

            “Yeah?” I say, suspended for a moment in the air, feeling that electric rush that says this ball is going to connect; it’s going into the damn basket.

            “You are genetically defective.”

I hesitate for all of a split second. He jumps high and grabs the ball, twirls, and races down the court, dribbling and flashing me Erik’s demonic smile.

I’m visiting Kari Stefansson as part of an experiment to unlock the secrets of my own DNA. In due course, I will find out my results. But as I watch him play, his dark green eyes alluring and murderous, I’m struck by a simple revelation. Stefansson in many ways is the early twenty-first century equivalent of Erik the Red. He is a marauder and warrior, a larger than life figure who slices through frigid waters in a longboat with an outsized passion to conquer, to achieve glory, and perhaps to get rich, but mostly for the sheer joy of it.

            Lest we build him up too much, Kari Stefansson is also just a man. I have seen him tired, and downcast. On one of my visits to Iceland, the stock in his company had dipped down to about $2.00 a share, prompting him to fret about an unwanted suitor who might attempt a frontal assault to buy the company out from under him. The Viking was watching his backside – though this Norseman is also a physician who wants to alleviate suffering, if he can. Moody and stormy, he looked depleted after a round of calls to investors and advisors, as if he had been fighting the Furies all day and was still standing, but was exhausted by the effort.

It seems evident that Stefansson’s prickly, infectious personality is crucial to his success in being a scientist and entrepreneur: that peculiar blend of DNA and experience that makes this Viking gene master a genius, bully, and force of nature. As he humbles me by swishing yet another basket, I tease out this idea – that the Stefanssons of this rarified world of scientists and entrepreneurs are driving this era of biological discovery as much as the science itself. This is obvious, though maybe, I think, this is a way to delve into the heart of the matter with genetics: to tease out first what is the crux of the science, and the implications of the discoveries for us humans, by trying to understand its creators – the Prometheuses bringing us fire, the Faustuses taking us to either heaven or hell, the Eves about to bite into another apple on the Tree of Knowledge, and the Erik the Reds blustering about and trying to score big with basketballs and nucleotides.

Here is a man who has glimpsed my most intimate secrets, my DNA, those unique combinations of chemical compounds that make me me: my blue eyes, a crooked left second toe, a tendency to be far more curious than is healthy. I also have this flip in my left eyebrow that my grandmother once called “the lick of God.” All the men in my family for at least five generations have had this upward spike in our left eyebrow that points straight up in the air: my great-grandfather Harry had it, my grandfather, my dad, me, and my two sons. Genes are not the only factor; the environment I live in also plays an enormous role: the food I swallow, the gasoline fumes I breathe in when I fill up my gas tank, the ultra violet rays that permeate the ozone and burn the skin on my nose. But it’s my genes that are the basic ingredients that make me both human and unique – and I’ve just handed them over to Erik the Red.

Stefansson’s aim in Iceland is to unravel genetic secrets from the island’s entire population, looking for patterns in genes that might account for diseases such as stroke and osteoporosis. Thanks to meticulous genealogical records kept for one-thousand years in Iceland and collected by deCode into a computerized data base they call the Islendingabok, the “Book of Icelanders”, Stefansson can tap into what medical and mortality details exist about the 680,000 people who have lived on the island since the first Vikings arrived here in the ninth century. deCode uses powerful computers to pick out how families inherited disease. The company also has assembled another data base containing certain medical details about modern-day patients, with consent, that pertains to diseases deCode is studying. Iceland’s parliament, the Althing, has created an oversight process to protect patient privacy, and to allow patients access to their genetic test results, where it is appropriate. About 110,000 Icelanders so far have willingly handed over their DNA for the program, which asks, for instance, patients with asthma to hand over their medical records and their DNA to be tested for nucleotides that are anomalous when compared to the nucleotides of the non-asthmatic population. This provides clues to where the disease-influencing genes might be located. The company has roughly mapped the location of several dozen suspect genes, and have found the exact location of a few major diseases, such as stroke and osteoporosis – news that was important enough that the discoveries landed on the front page of the New York Times when each was announced in 2003.

So I am hardly alone in being tested by Stefansson’s labs and computers, though what sets me apart is that I’m the first healthy person with no family predisposition for disease to be tested by deCode and to have my results announced publicly. I’m also not the first person to take tests for specific genetic diseases. More and more, tests are offered that identify genes linked to Alzheimer’s, Huntington’s, breast cancer and other maladies. Except for Huntington’s, which has a 100 percent “penetrance” – the rate at which people with the gene will get the disease – most of these tests offer only the possibility that a person will get the disease. For instance, testing positive for the apo-e4 gene, which is associated with Alzheimer’s, a person has a two-and-a-half times to ten times greater chance of getting the disease than a normal person. So this is not necessarily deterministic information, but, rather, offers up probabilities that you or I will get a disease.

These genetic tests fall under the rubric of “personalized medicine” – which offers not only tests for genetic predispositions to disease, but also the possibility of customized treatments; for instance, drugs targeted to your specific genetic make-up rather than the one-size-fits-all medications of today. Yet this is only the bare beginning of what scientists are offering up as future possibilities in this nascent age of genetics. You and I and our children may soon be living in a world where damaged hearts and shattered spines are routinely regenerated, or spare ones are regrown using stem cells; where a human egg containing a person’s DNA can be engineered by adding and subtracting genes; where genetic fixes or perhaps a pill can be popped that extends lifespan, and keeps one young, fit and lean up to age 150, or 300, or longer. The possibilities are thrilling in some cases and frightening in others, particularly since the collective knowledge of genetics and the impact of mucking with the basic recipes of life remain fantastically complex and largely unknown.

This creative fire in biotechnology comes after a half-century of biological discoveries and more recent technological breakthroughs, combined with an unprecedented surge of funding from government and the private sector, and supported by a society that loves the gadgets, the medical miracles, and the standard of living afforded by modern science, even if the pace of change sometimes makes us feel uneasy. The outcome of this explosive moment in genetics is anybody’s guess: a brilliant future or, if something goes terribly wrong, a nightmare. Or both. We will cure cancer, vanquish AIDS, malaria and tuberculosis, increase lifespan to 300 years, eliminate pollution, and feed everyone on the planet. Or we will create a monster, either inadvertently or deliberately. Maybe we’ll do it all. I believe this is the greatest story of our time, perhaps of all time. A species is developing the tools to redesign itself, to self-evolve in a way Charles Darwin never imagined.

Experiments are under way to create new forms of life. The geneticist J. Craig Venter, co-sequencer of the human genome is creating at his nonprofit Institute for Biological Alternatives the first synthetic life form. Working in Rockville, Maryland with the Nobel Laureate Hamilton O. Smith, and funded in part by $12 million in grants from the U.S. Department of Energy, Venter wants to create a simple microbe designed to munch up carbon dioxide pollutants in power plants and to release harmless hydrogen. This sounds wonderful, though this technology could also be used to create organisms for more nefarious purposes such as bioterrorism. Or one of these critters might be released into the ecosystem for a useful purpose, only to mutate or evolve into something deadly. As a nonscientist enthusiastic about science, I am properly awed by the possibilities. I also wonder, at times, whether I should be afraid. I lean more towards amazement than not, but I am skeptical, too, strongly believing that nonscientists need to do their homework to understand the new science, to be informed enough to be impressed, cautious, or afraid. Most of all we need to stop being mystified, to learn enough to question intelligently and to push our high priests of science to explain what they’re up to.

         Lest we forget, periods of explosive scientific achievement and technological breakthroughs have always created the potential for both miracles and horrors. DDT rid the West of malaria-bearing mosquitoes and other pests, but poisoned birds and other animals, including humans; electricity lights our cities and powers our factories, but touch a live wire, and zap!; fossil fuels have provided us with fuel to zip about in the air, and on the land and sea, but befouls skies and causes global warming. The list goes on in the pluses and minuses of television that educates and enervates, drugs that cure and cause side effects, cars and airplanes that convey us places but also turn lethal if they crash and burn. The most classic example of all occurred when the physicists of the early 20^th century found their dazzling theories turn into not only the transistor and spaceflight, but also the bomb. The Manhattan Project chief Robert Oppenheimer, for one, spent the rest of his life after Hiroshima and Nagasaki trying to reconcile his conscious for his role as a scientist in creating this awesomely deadly weapon. “It is not possible to be a scientist unless you believe that the knowledge of the world, and the power that this gives, is a thing which is of intrinsic value to humanity, and that you are using it to help in the spread of knowledge,” he said in the autumn of 1945, three months after the bombs erupted over Japan, in what could be considered a classic statement of a modern scientist justifying his work. Yet he added an important caveat: “and are willing to take the consequences.”

The last century contains many other examples of science’s running amok: the sick experiments of Josef Mengele at Auschwitz, the program at Tuskegee, Alabama when black sharecroppers who had syphilis were denied treatment for 40 years by researchers who were studying the effects of the disease, and the bioengineering of super virulent smallpox variants by Soviet virologists working for the secret Soviet bioweapons program of the sixties, seventies and eighties. Laid alongside the wonders of the last century, the dangers of modern science and technology are accepted by people in an ongoing Faustian bargain that has become a cliché of B movies and science fiction novels. Mary Shelley helped launch the notion of the modern mad scientist in 1810, inventing the character of the young idealist who sets out on a quest to understand the intricacies of nature and life, and ends up with Boris Karloff in green make up with bolts in his neck.

This bargain is tempered by a demand that governments remain vigilant against future Frankensteins and Mengeles, while ensuring safety whenever possible as science moves forward. Watchdog agencies such as the US Food and Drug Administration and ethics committees in universities, hospitals, and businesses oversee experiments and the release of new products that might prove dangerous. The tension between how safe is safe, and the pressure from scientists to test new discoveries is one of the defining aspects of modern science and culture. Most scientists insist on a code of ethical conduct in keeping with current norms of human rights and dignity, keenly aware that despite science’s power and clout, the public has little patience for errors that endanger people or overtly imperil the environment. They have no tolerance at all with scientists who would delve into the territory of a Mengele or a Frankenstein, even inadvertently.

            This is reassuring, up to a point. Yet as we plunge into tinkering with the basics of life, can we know for sure what they – and we – are doing, and what its impact will be?

Most scientists tell me not to worry: that we humans have not yet destroyed ourselves or the planet, and that on balance science has been an overwhelming force for the good. Yet others worry that we are entering unchartered territory without really understanding the implications. “We have to decide soon what kind of society we want,” says the Oxford neurogeneticist Susan Greenfield, a baroness and a member of the House of Lords, and an author who writes about the brain and the social impact of genetics. “For instance, do we want a world where everyone takes Prozac, uses Botox and plays with Gameboys? We could be heading into a designer-baby world where we sit passively in front of our screens and live in a virtual world. Do we want that?”

         The other day I reread the self-description of Victor Frankenstein in Mary Shelley’s classic, who early in the story describes his intentions. “It was the secrets of heaven and earth I desired to learn; and whether it was the outward substance of things, or the inner spirit and the mysterious soul of man that occupied me, still my enquiries were directed to the metaphysical, or, in its highest sense, the physical secrets of the world.” Shorn of the stigma of being spoken by Dr. Frankenstein, these words could easily describe many of the subjects of this book,

Yet we hardly know the scientists and others sweeping us into this new world, the Stefanssons, Greenfields, and Venters. Their names are mostly obscure outside of molecular biology. In part this is because journalists tend to write articles trying to explain the intricacies of proteomics, genetically modified organisms, RNA, transgenic animals, and therapeutic cloning – and the ins and outs of start-ups, Initial Public Offerings (IPOs), and roiling markets. We mention characters like Kari Stefansson, scratching out quick, throwaway descriptions, treating them as secondary to the science and the spread sheet. Science writers scribble endless books on the solving of the human genome, stem cells, and cloning, often failing to seriously delve into the phenomenon of an age that is producing, all at once, a remarkable profusion of brilliant, quirky, charismatic, possibly dangerous scientists whose work will profoundly impact life itself.

Who are they? Are they megalomaniacs with supersized egos, or individuals of high ethics and morals who will do what one of them, Stanford’s Paul Berg, did when he was in the middle of an experiment in 1971? Berg was creating a hybrid molecule by combining a common bacterium with a monkey virus. He planned to insert his hybrid into E. coli, a benign bacterium found in the stomach of nearly human on Earth. But the monkey virus, SV40, had been shown to cause cancer in mice, and might cause cancer in humans – or not. No one at that time knew for sure, though they now know the virus is most likely harmless in humans. Back in 1971, another scientist alerted Berg to the possible danger of this hybrid molecule’s escaping his lab and infecting E. coli in the stomachs of his lab workers, and possibly beyond, potentially unleashing a cancer plague. This scenario was remote, but Berg could not eliminate the risk 100 percent. So he shut down the experiment, wanting to be cautious about the implications of what became known as recombinant DNA – now used as a basic component of genetics and biotechnology. Would this method of using one organism to produce the proteins of another lead to freakish disasters?

Berg took this question to a famous conference in 1975 at Asilomar, near Monterey, California, where he and others persuaded their fellow geneticists to cease certain recombinant DNA experiments while safety issues were tested and guidelines for containment of dangerous experiments could be formulated. This process led to thirty years of recombinant DNA experiments without a single accident. Berg’s experiments him a Nobel Prize, with Walter Gilbert and Fred Sanger in 1980.

Berg was careful, where another scientist might have forged ahead despite the dangers. For instance, his fellow geneticist James Watson argued forcefully against a self-imposed moratorium on recombinant DNA work at the 1975 Asilimar conference, insisting that the process could remain contained and safe in the lab, and that a moratorium would frighten the public and might lead to a ban by the government. (This nearly happened.) Personality played a critical role in this debate between Berg and Watson. The science emanates from their minds, from their personal stories, but also from who they are: their hopes and fears; their humility, their arrogance, and their ambition that drives them forward into discoveries and dictates how they react to the possibility of miracles, and of disasters.

“Science seldom proceeds in the straightforward logical manner imagined by outsiders. Instead, its steps forward (and sometimes backward) are often very human events in which personalities and cultural traditions play major roles.” This comes from James Watson, co-discoverer of the double helix structure of DNA in 1953 and an obnoxious, dazzling personality himself. The science historian and journalist Horace Freeland Judson, author of The Eighth Day of Creation, remarks that the personality of scientists “has always been an inseparable part of their styles of inquiry, a potent if unacknowledged factor in their results. Indeed, no art or popular entertainment is so carefully built as is science upon the individual talents, preferences, and habits of its leaders.”

“The whole idea that science is conducted by people working alone in rooms and struggling with the forces of nature is absolutely ridiculous,” says Sydney Brenner, a pioneer of molecular biology famous for talking incessantly with colleagues to tease out ideas. “It is a social activity of the highest sort.”

Why is this important? Because, as Harvard biochemist Stuart Schreiber once told me over coffee, his eyes magnified through thick, wire-rim glasses wrapped around a bald head that looks both thuggish and hip: “There’s a high probability that for Homo sapiens, the process of evolution as we currently think about it, as natural selection, is for all intents and purposes over. It is going to be replaced by our desire and capability to tinker.”

There is the fiery-tempered and temperamental Watson, who in his midseventies still keeps pinups of busty young women in his office close to his Nobel medal. An atheist who believes the double helix proves that God does not exist, Watson has strong views about everything from stem cells to his belief that genetic flaws in behavior as well as disease should be fixed.

There is Craig Venter, a stormy renegade with the gravitas, ego, and devilish brilliance of Faustus, though he also has a cornball sense of humor. In the late nineties, he took on the scientific establishment during the Human Genome Project and succeeded in getting the job done faster and, at least according to Venter himself, better. He ranges about like a junkyard dog snarling and laughing as he brilliantly upsets applecarts. Venter restlessly sails the seas in his yacht, Sorcerer II, collecting microbes from the oceans to sequence genetically, while back in his lab in Maryland he leads a team creating synthetic life forms.

And then there is Francis Collins, the can-do Boy Scout of molecular biology with a steely resolve and intense competitiveness. Chief of the National Institutes of Health genomics programs, he is a born-again Christian and codiscoverer of the gene for cystic fibrosis who went head to head with Venter during the race to sequence the human genome. Collins headed up the band of stalwart genehunters who pursued this nearly $3 billion quest with a religious zeal, proselytizing its benefits and fighting to keep the DNA they sequenced free and publicly available.

Others you will meet in these pages are working to create new life or to extend it, to grow new organs using stem cells, to bioengineer genes – and, in the case of the former Soviet bioweapons expert Ken Alibek, to snuff out the life of his former nation’s enemies when he was working for the secret USSR bioweapons program in the seventies and eighties.

When I set out to write this book, I experimented with several methods to describe the role of personality in science. In the end, I chose and expanded on a strategy used with delightful effectiveness by Lytton Strachey in his 1918 Lives of Eminent Victorians. Insisting that too much material existed on the recently finished Victorian age to make sense of it in a single book, he picked out four representative figures to profile, among them Florence Nightingale and General Charles Gordon. He described his method as dipping a bucket into the vast ocean of material on his subject, “which will bring up to the light of day some characteristic specimen, from those far depths, to be examined with a careful curiosity.”

I, too, have chosen a few representative people, though in this book I’ve added to Strachey’s idea an element that he would have understood. He chose characters specifically to point up both the grandeur and the flaws of figures whom his parents’ generation had revered and worshiped as heroes and geniuses. He elevates them to godlike status by treating them as standard-bearers of the Victorian era, only to reveal them as all too human. Yet they remain exalted throughout as forceful stories and symbols of the glories and disasters of their time. I have chosen nine scientists with the same emphasis in mind, but with an added element that defines a major difference between our era and Strachey’s. Today, we don’t need to reduce heroes of a former generation to mere humans. In this age of reductionism, that happens as a matter of course. I have taken these very human, and therefore flawed individuals and assigned them each a mythic status by assigning them a character from myth, fiction, or history – Prometheus, Eve, Zeus. Not because I consider these scientists gods or demigods, but because I believe that to appreciate these figures whose work is so critical to the future of life accurately it is useful to see them through the lens of stories, myths, and characters that have endured for centuries as devices to understand and absorb the import of major moments in human history.

I agree with Paul Berg that as we move forward with science we must be cautious. Scientists need to be keenly aware of not only potential dangers, but the ethical and social impact of their discoveries. Yet I also believe that many of the discoveries and possibilities will happen regardless of what society thinks. As in splitting the atom, once the knowledge exists, the science will find a way to happen, possibly in secret in countries where neither ethics nor the public’s fears much matter. This makes it even more crucial that this science be allowed to go forward while being closely watched, with appropriate safeguards. 

Back in Kari Stefansson’s office, I’m reminded of why I have a personal stake in understanding this Icelandic gene master. We’re sitting in deCode’s new building, a blond wood, brick, and glass palace rising on the edge of Reykjavik like a gigantic piece of Skandia furniture. This in a city of mostly squat, functional, wood-slate buildings that seem hunched over, as if holding their heads down in a storm. Rain does fall here frequently, though the nearby Gulf Stream usually keeps the temperature above freezing, even in the winter.

Inside deCode, three towers containing labs, computers, and offices are connected by a glass-enclosed atrium four stories high, an aery and expansive space crisscrossed by open bridges between the towers. Hanging down from the ceiling, over the lunchroom, a gigantic model of a double helix turns slowly, picking up the dull, gray light from outside like an elongated disco ball. In one tower a supercomputer that can process a person’s entire genetic code in twenty minutes.

Stefansson’s office suite is across a bridge from the spinning DNA model. His large windows overlook the old Reykjavik airport, and the vast sweep of lava fields and mountains. He’s wearing his trademark tight black T-shirt and is preparing to drink two glasses of a Pepto-Bismol-colored drink he says is a protein supplement. I see Yeats’s Ghosts and the NASDAQ Rule Book, among other volumes, in his bookcase. He’s about to tell me the results of one of the tests run on my DNA.

KS: The DNA from you is, of course, a scary substance.

DD: I have friends who would agree.

KS: I’m sure. One of the things we did was that we looked at the genes that confirm a stroke. We have established that you have a series of genetic markers that give you something like a two to seven times greater risk for developing a stroke than if you don’t. You have this entire haplotype [inherited sequences of DNA that cause specific traits] so you probably have three times the risk. If this turns out to be the case in the American population, you are genetically predisposed to stroke.

DD: Oh, hmm. Stroke? But I’ve had no stroke in my family, other than my grandmother when she was eighty-three years old. Doesn’t my own family history weigh in here?

KS: The only thing you have done is to inherit a predisposition. What does that mean eventually? It means that if you stay in a certain environment, or if you are born in a certain environment, you will develop stroke.

DD: This is because most diseases are a combination of mutated genes and the environment—that is, the environment can trigger diseases, or not?

KS: Yes.

DD: But this isn’t good news for me. One day I’ll be watching a movie or walking down the street, and, suddenly, I’ll go limp with a stroke.

KS: Maybe, but here’s the beauty of the genetic profiling. It’s not going to lead to a genetic determinism like that. You are not going to develop stroke, all right? You now know that you have three times the possibility of the average individual to develop stroke. So you have a strong incentive to take measures to prevent stroke. One of them is to make sure that you don’t have high blood pressure; one of them is that you will not smoke. One of them is you will drink alcohol only moderately, because intake of large amounts of alcohol, binges, increases dramatically the probability that you will develop a stroke.

DD: But this genetic profile for stroke has not been tested for Americans. You’ve just tested Icelanders. Right?

KS: Before you can get too excited as an individual, you have to do a clinical trial in the population where you can use it, like in the American population. But this is a fairly interesting example of how genetic profiling is going to impact the delivery of health care.

DD: How common is this stroke gene for Icelanders?

KS: In Iceland, this is a haplotype that you find in about thirty percent of patients with stroke. You find it in about fifteen percent of controls [those without stroke]. And then you say, “Wow, fifteen percent of controls with no stroke.” But this is an inheritable predisposition. We know this from our genealogical data. Of these fifteen percent, a large percentage will eventually develop stroke. But most of these people carrying this haplotype will not develop stroke.

DD: Those odds still makes we want to go and have a drink.

KS: You cannot drink anymore.

DD: Did you find out anything else about my DNA? Or do I want to know?

KS: We tested your ancestry to see if the population data from Iceland is relevant to you. You told us your ancestors came from Scotland. In the Icelandic Sagas, they said that Iceland was settled by Norwegian Vikings who stopped in the British Isles and picked up slaves and women, in Ireland and maybe Scotland. And we decided to test you by looking at your mitochondrial polymorphisms [mitochondrial DNA that exists in each cell, separate from the double helix of human DNA – polymorphisms are DNA in an individual that are different from the norm]. Remember, mitochondria is passed from mother to offspring. Then we looked at your Y chromosome—these both are fairly good measures of paternal and maternal lineage. When we looked at this, it turns out that when we compare it to all of Europe, about seventy percent of Icelandic mitochondria are Celtic.

DD: The Celts being Irish and British, among others.

KS: Yeah, and about seventy percent of Icelandic Y chromosomes are Norwegian. So it looks like Iceland was settled by Norwegian boys who grabbed British girls. This is important when it comes to your mitochondrial DNA, because if we look at the mitochondrial sequence number one, that people look at mostly for ancestry, we find out that you have a haplotype that is characteristic for Europeans. However, when we look at region two, there is this very rare haplotype found only in Iceland and the north coast of the British Isles. We found this haplotype in you.

DD: Uh-oh, then this stroke gene is relevant to me.

[Stefansson calls someone on the phone]

KS: [Into the phone.] I’m out of coffee and I’m in a desperate need because I’m talking to a very boring fellow. [To me] My eighteen-year-old daughter would have said, “boring dude.”

That night, I meet Stefansson for drinks at an Italian restaurant that served, among the usual pasta and veal, horse meat, apparently an Icelandic specialty. After drinking enough red wine to give me a stroke for sure, we walk up the main drag of Reykjavík—there is only one, though the bars, clubs, and restaurants are as sophisticated as any in the world. Icelanders travel incessantly and take

back music, art, dancing—and genetics—from elsewhere, integrating with their own sensibility.

In one bar heads turn when Stefansson walks in. He’s a rock star here, the second most famous Icelander after the pop singer Björk. He towers over most people and is known by everyone. I step over to the bar to order beers, and two Icelandic women say hello. One of them says she is in love with Stefansson, the other is annoyed with him, because, as many Icelanders did, she bought deCode stock and watched it tumble when biotech stocks took a nose dive. Stefansson comes over and is sullen—he’s had a long day, but we drink until three a.m. As he says good night—and it’s still light out—Stefansson tells me that drinking tonight will kill me, that I’ll have a stroke by morning. I walk home through the eerie lightness, with the streets slick with dampness in the air, and the distant volcanoes black and steaming. I wonder whether I should believe him and ponder the bio luminaries I am talking to about bioengineering humans, extending life, and regenerating hearts and brains, wondering, Can they be trusted?

Emerson wrote that every age has its geniuses, its masterminds who propel humanity in a new direction, for good or evil – though of course, he said, you need circumstances to bring them out. I believe that the time is now. The circumstances are here. The masterminds are in place. The Prometheuses are bringing in the fire, the Florentines are carving Davids, Faustus is talking to the devil, and the Los Alamos boys are building the bomb.