Almost every day we hear so much about the progress of science and technology that we routinely forget how little we know. This week’s Last Word, from Smithsonian magazine, is a reminder. It’s about a family in Italy with one remarkable mutation in a gene known as ZFHX2 that makes them almost impervious to pain. The discovery of the mutation and the associated “Marsili syndrome” involved a chain of coincidences—not least, that Letizia Marsili, herself a scientist, worked with a colleague who studies the biology of pain. The mutation, which appears to let just enough pain signals through to indicate that something is wrong, could be the key to solving the problem of chronic pain without opioids. The discovery of the ZFHX2 mutation was a triumph of scientific sleuthing, yet even having isolated it, researchers still know little about its mechanism of action. In fact, a great deal about the pathways that pain takes in the nervous system is still unknown.
I thought about the pain story this week when the news broke that the pharmaceutical company AbbVie was buying the drug company Allergan for $63 billion (see Business). You may not know the name Allergan, but you probably know its main product, Botox, the drug derived from toxic bacteria that has uses from smoothing wrinkles to (less well known) heading off migraines. In the biological sciences, a big discovery can yield an empire and significant advances can pay off for generations. Yet real science is hard. It took a decade for researchers—backed by a university, not industry—to nail down and publish the findings on ZFHX2. Only more years will determine if those findings can turn into treatments. That’s not an attractive time frame for business, or for the press; it is, however, what science demands. Ultimately, our era will be measured largely not by the latest breathless tech news, but by our ability to take the long view, and build the institutions that support it.