The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race

Chapters 32-34 examine how CRISPR technology is being used today. CRISPR has been used to treat diseases like sickle-cell anemia, by making edits in somatic or nonreproductive cells. However, the key roadblock to making this beneficial application widespread is cost. The prohibitive cost of gene editing—and the inequality it can generate—is a recurring motif in the text. Isaacson believes biotechnology will become ubiquitous; however, fair distribution is only possible when cost issues are resolved. Otherwise, gene editing will create yet another oligarchy. Making sickle-cell gene editing more affordable requires skipping the expensive bone-marrow extraction part and editing the cells inside the patient. If the initiative is successful, it can help sickle-cell anemia patients worldwide, 80% of whom live in sub-Saharan Africa.

Isaacson shows the wide potential of CRISPR applications by considering the case of China. In October 2016, doctors in Chengdu, China, removed T-cells, or immunity-building white blood cells, from a lung-cancer patient’s blood. They then used CRISPR-Cas9 to disable a gene that produces a protein called PD-1, which inhibits the cell’s immune response. Cancer cells sometimes trigger PD-1 to save themselves from the body’s immunity. After CRISPR editing, the patient’s T-cells could fight the cancer cells, improving his prognosis. Work on applying CRISPR to treat cancer is also underway in the United States.

Chapter 33 continues the theme of democratizing biotechnology, but with a twist in the form of rebellious biohacker Josiah Zayner. Refusing to affiliate with a university or a research lab, Zayner believes biotech can be “hacked” independently. Further, he believes everyone should be able to do so. Zayner often crops up in the text, questioning the boundary of what is ethically acceptable in gene editing. In later chapters, he will celebrate the controversial birth of the world’s first “designer babies.” Controversial as Zayner’s views may be, it is significant that Isaacson presents him in a positive light. To Isaacson, Zayner symbolizes both a disruptive force and the spirit of adventure. Notably, he compares Zayner to Steve Jobs, an innovator Isaacson greatly admires.

Many scientists are not as charitable in their estimation of Zayner and other biohackers. Many argue that packaging CRISPR editing into a DIY kit prevents people from pushing themselves to learn how complex technology works. Zayner dismisses this criticism and wants to crowdsource CRISPR the same way Linus Torvald created the open-source operating system Linux. Zayner believes technology becomes great only when everyone has access to it, as in the case of personal computers and smartphones that enable everyone to code or create digital content. Zayner’s viewpoint aligns with Isaacson’s. Though Isaacson acknowledges that making a technology like gene editing too accessible can lead to its potential misuse, he also believes the pros of making biotech universally accessible may outweigh cons in the age of pandemics. For instance, people could test themselves for viral illnesses at home, and contact tracing could be crowdsourced.

Chapter 34 explores Doudna’s response to the potential misuse of CRISPR gene editing. Her involvement in the fight against the misuse of CRISPR shows that she is a conscientious scientist. For Doudna, it is not enough to rest after creating a technology; she also concerns herself with its application. Thus, she has a humanist outlook toward science, which Isaacson implies is essential for a geneticist. Doudna’s involvement in DARPA also shows her growth into the persona of a public scientist, which is a natural continuation of her desire to see her work in practical application.