Book Review

Physician to the Gene Pool: Genetic Lessons and Other Stories

N Engl J Med 1994; 331:684September 8, 1994

Article

Physician to the Gene Pool: Genetic Lessons and Other Stories
By James V. Neel. 436 pp., illustrated. New York, John Wiley, 1994. $24.95. ISBN: 0-471-30844-7

This is James V. Neel's account of his career in genetics. It deals not with the personalities of the author and his associates but with the results of his research and theirs, which make up a major part of what we know about human population genetics. Neel's work has encompassed hereditary diseases and assortative mating in Michigan, hemoglobin variants in Africa, inbreeding and the genetic effects of surviving the atomic bombs in Japan, and the population structure of the last tribal peoples in Brazil and Venezuela still living in their traditional way.

Taken as a whole, Neel's findings lead to the conclusion that the accelerated increase in human numbers and the modern way of life are inhibiting the way nature has mopped up after itself in the past and that our species has been creating a crisis for its own continuing existence. Mutation rates are high even in tribal populations. In industrialized countries the chief problem is not the burden of new mutations caused by radiation from industrial and military sources. Rather, the problem is a loss of the ways that unfavorable mutations were eliminated in small, divided, and relatively isolated bands of people during most of the long period of prehistoric human evolution.

Neel is formally trained in genetics and medicine and self-trained in anthropology. This background helps explain how he has been able to make several important breakthroughs in transdisciplinary areas: the mode of inheritance and balanced polymorphism of hemoglobin S, the extent of human susceptibility to hereditary damage from ionizing radiation, the determination of the effects of genetic inbreeding, and genetic differentiation within tribes as a result of repeated fissions of village populations.

Neel fears that humankind is squandering the genetic legacy -- its diverse gene pool -- acquired during 5 million years of human evolution. But he is confident that reason can prevail and lead to worldwide planning for a sustainable society. He reminds molecular geneticists that it is the genotype-phenotype interaction that has produced the tremendous variation in the gene pool on which continued human adaptation must depend.

The theme of the latter part of the book is the tragedy building up as populations skyrocket and resources dwindle. Neel proposes an immediate program for the limitation of population growth based on the egalitarian principle of two children per family. This would stabilize the gene pool for the time being. Neel also suggests a greater effort at optimizing the expression of the genotypes of the “common man,” since he believes that human genotypes will need to function at top efficiency in the difficult times ahead.

Neel's life work on atomic-bomb survivors and on untouched tribal peoples was unthinkable earlier and is unrepeatable now. This autobiographical account of a unique research experience is directed to physicians and others who have considerable knowledge of biology. On the basis of a lifetime of studies, Neel sees the size of the human population and the changing structure of its gene pool as even more urgent issues than research about molecular biology, which produces findings to be synthesized with knowledge about population genetics. The message is gripping and urgent, and readers will be inspired to convey these facts and interpretations to other audiences who also need the information in order to encourage rational policies for our future.

Gabriel W. Lasker, Ph.D.
Wayne State University, Detroit, MI 48202