I'm Paul Turke.
I'm going to be telling you a little bit
about Evolutionary Pediatrics.
I started off as an anthropologist,
worked and helped to develop a field
called cooperative breeding in humans.
That required me to understand
some evolutionary life theory
but specially trade-offs
between early and late-life events.
That led me down the hall to an immunologist
at the University of Michigan
named Richard Miller,
and I collaborated with him as a Postdoc
for a while on planning evolutionary theory
to the problem of T cells senescence.
From that my interests
in medical complex peaked,
and so I moved
to the Michigan State University,
where I went to medical school,
and after that I came back
to the University of Michigan
to complete my pediatric residency.
And then finally in 1999,
I bought a small private pediatric practice.
I and our partner Suzanne Thomashow
in the small town of Dexter,
which is next to Ann Arbor,
we take care of over
1,000 different families.
Before I tell you a lot about
I want to talk just for a minute
about science in general
and how science is done.
As most people know science
has two main components,
there's the ideas or theory side
and then there's the data or evidence side.
And in reality they are all wrapped together
but we separate them from time to time
when we're actually doing science.
And in fact, on a given day,
a scientist may work
purely on the data side
or purely on the theory side.
fields of science can be
somewhat out of balance with respect to one
or the other at any given point.
So string theory, for example,
in physics is heavily weighted
on the theory side right now.
The technology tests
a lot of the theories there
just aren't available.
That's not bad, they will be,
and so right now,
theory is pointing the way
to the kind of data to look at,
so there is not a problem.
Medicine on the other hand is over-weighted
in terms of evidence and data.
Medical doctors, medical scientists
are the best in the world
probably at collecting data and analyzing it
and culling it, and putting it
into usable formats and so on,
but they're fairly light on the theory.
So medical science
is sort of summarizes is evidence-based
but light on theory.
And that's okay for now,
there's nothing wrong with evidence,
but those of us who know
something about evolution
and are interested in evolutionary medicine
have been arguing for a while
that what medical science really needs
is to pay more attention to Darwin's theory
and that will help
to put the science back into balance.
And I think it will help us
to advance medical knowledge
and also to prevent
some of the mistakes that go on
when we try to use evidence
that don't have the right theoretical context
from which to understand it.
So let me talk a little bit about
what evolutionary pediatrics is.
Basically, it's evolutionary medicine done
on smaller or younger people.
And in general,
it's using the ideas of evolution,
and the information that we have,
the evidence that we have,
and applying it to understanding problems
that have to deal with human health
and wellbeing or their apposite.
In a very practical sense,
what many of us who are involved
in evolutionary medicine do
is we tend to divide the world
into clinic least into defenses
and I'm going to explain what those are
beginning with the next slide.
So defenses are adaptations.
And how do we recognize an adaptation?
Well, the first clue that we're dealing
within adaptation is complexity,
something that has complex design.
The late Stephen J. Gould said,
"An engineer's criterion of good design,"
in the sense,
engineers build things that work
or design things that work
that brings function into their picture, too,
what an adaptation's function
is, is to do something adaptive
to increase the organism's fitness
in one way or another.
So evolutionary biologists
are pretty good at finding adaptations
and coming to an understanding of them,
whereas medical science,
medical doctors, really, again
because they're not
so much explicitly evolution minded,
they kind of fall down on the job
when it comes to this.
They don't look for adaptations
as carefully as they should
and perhaps they don't know
how to recognize them
as readily as they should.
And therefore, they end up
sometimes attacking adaptations,
the defenses in particular
when what they really should be doing
is letting them go
and letting them to do their job.
So let me in the next slide go through
and give some examples here.
Let's start with fever.
So fever has all the hallmarks
of an adaptation.
And I put this slide up not
that I want anybody to remember
the pathways here,
but just to show that a complex cluster
of signals has to be carried out
in order to produce fever.
At the top, we have LPS
which is a component of the cell walls
of gram-negative bacteria.
It's a strong inducer of fever,
so when the immune system sees it,
the series of pathways is activated
and the body temperature rises.
So it has the complexity component
we require for something to be an adaptation.
About fever it's also been learned
over the years, it has a function.
Fever, sort of, revs up the metabolism,
revs up the immune system,
and helps us to fight germs.
Now when my children were young,
in the late '80s and early '90s,
doctors didn't at all recognize this.
In fact, when I would take them
to their doctor
when they would have a fever,
before they even saw the doctor,
someone in the office
was trying to offer them
a fever reducer like acetaminophen
And I would step in and say,
"No, they don't need that."
And, of course, they would roll their eyes,
and I'm sure they said plenty of things
about me in the backroom,
but although I wasn't a doctor then,
I knew that fever looked
a lot like an adaptation.
And I had a pretty strong feeling
that it was functional.
And I met the Evolutionary
Physiologist Matthew Kluger
at around that time,
and he started to tell me about
the actual evidence showing
that fever is helpful.
And nowadays, we have a lot of evidence
that fever helps to fight illness.
And doctors nowadays
are much more cognizant of that,
and so they're not so quick
to recommend fever reducers
as they once were.
I'd like to say that
they've come to that conclusion
because they've become
good evolution-minded adaptationists
but I don't think
that's what it is for the most part,
I think it's because doctors,
you know, are very tuned in to the evidence.
And the evidence
has now been gathered showing that
that's what fever does
but there was this time
when the evidence wasn't all that clear.
But we did have
a strong theoretical reason
for believing fever was an adaptation,
and I think if we had combined those two,
we would have stopped giving
fever-reducing medicines as often sooner.
So I think theory would have helped to move
our understanding along in a way
that would have been beneficial
to a lot of patients.