The Rap Guide to Medicine

Long live the cellular revolution!

The Rap Guide to Medicine

by Baba Brinkman

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Random Excess Metered Story Telling, art as old as the spoken word itself. Favorite track: Gene's Eye View.

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1.	Why We Get Sick 04:38	lyrics	buy track
Let’s begin with medicine from back in the day When a priest and a medicine man were the same I’m in pain, I’ve got a fever and I’m restless! “A classic case of demon possession I’ve got the cure though, here, take it easy Drink this broth, it’s made from endangered species It works only when the weather’s not stormy Now go sacrifice a goat and call me in the morning” We practice medicine in similar ways Today, but now it’s nominally evidence-based It used to be entirely mysterious but these Days it's just mysterious to various degrees Thanks to Louis Pasteurization, vaccines And discoveries like the germ theory of disease But what about natural alternative medicine Ayurvedic homeopathy and all the rest of it? Well, if we can isolate and test it for effectiveness Maybe some of it will be vindicated by evidence And then it won’t be "alternative", it'll be “medicine” And whatever’s left? Well, that we can jettison Yeah, modern medicine is mechanistic Treats the body like a machine, attempts to fix it But the picture’s incomplete without this next bit Not just “how it works” but “why we get sick” Why we get sick We evolved to crave salt, sugar and fat They were scarce in the past So we get sick Sit down, take some weight off Lower back pain results as a trade off We get sick The genes inside us Are ancient, surrounded by modern products We get sick Microbial arms races Charles Darwin taught the basics Of why we get sick “Why does disease exist?” Next time someone asks that, don’t plead the fifth I know your neighbour’s car has a Jesus fish You wanna keep the peace, and he believes a myth But so what? People die from untreated infections And asking “why” implies natural selection And that can lead to new research questions So lives are lost to avoid bein' offensive? Well that's offensive, to life’s preservation Every disease requires two explanations The first one is proximate, Doctor Gregory House Tryin’ to get the diagnosis and figure it out What’s the broken mechanism? Like a puzzle to solve The second question is: How did this evolve? Relax, evolution is so simple The DNA in your cells encodes info For how to build a body to develop and thrive Ultimately to reproduce and survive So disease itself is not the adaptation But you need adaptations to explain... Why we get sick We evolved to crave salt, sugar and fat They were scarce in the past So we get sick Sit down, take some weight off Lower back pain results as a trade off We get sick The genes inside us Are ancient, surrounded by modern products We get sick Microbial arms races Charles Darwin taught the basics Of why we get sick How does DNA make design? With no intelligent mind? It takes time But any variation that increases reproduction Or random mutation that enhances some function Of feeding or developing or escaping from hitches Will tend to increase in number – that's fitness Take infection, you can feel it, something's wrong But that's an organism trying to get its reproduction on Up in your guts, no guts no glory That's just one of several evo-categories Another is defenses, you catch a fever To cook the invader, no bug, that's a feature Yeah, you have weapons to beat back infections So don't make rash decisions and mask symptoms Dosing with iron when your blood is busy bindin' it And watch out for mismatched environments We evolved in the days of the cave man Coca cola wasn't really part of the game plan And some diseases are all about genetics You gotta take the gene's eye view to really get it Sometimes they go rogue, it’s like starting a war They send you to the oncology ward Life is full of design compromises Trade offs, you know, kinda like with high rises Strength for tensility, speed for longevity Live fast, die young, breed prolifically And yeah, humans are still evolving But we've got a body plan, so we can't evolve wings We had to wait to fly 'til someone thought of it Cultural evolution, medicine is part of it Cultural evolution, medicine is part of Part of cultural evolution Medicine is part of Why we get sick We evolved to crave salt, sugar and fat They were scarce in the past So we get sick Sit down, take some weight off Lower back pain results as a trade off We get sick The genes inside us Are ancient, surrounded by modern products We get sick Microbial arms races Charles Darwin taught the basics Of why we get sick
2.	Senescence 04:04 video	lyrics	buy track
You got a body and I got a body and When we get our bodies together mama, we partyin’ Reproducin’ to keep it movin’ Doin’ our bit for evolution You got a body and I got a body and They differ – mine’ll probably fall apart quicker I’m talkin’ ten years not ten seconds You and me baby, all the way to senescence I just wanna be an aging B-Boy Live long and prosper, Leonard Nemoy When it comes to longevity we’re killin’ it Life span longer than a Asian elephant Chimps get jealous at us, their close relatives We live like twenty years longer, deal with it If you look elsewhere though, we’re dead frail I want two hundred years like a bowhead whale! Aging and senescence aren’t the same thing Aging is time passing, that’s a great thing But senescence is bio-degrading Sucks to be a mayfly on the day of mating Time’s wasting, evolution tracks it Never puts all its eggs in one basket Longer life is better when predators are scarce ‘Cause you can invest in care But when the dangers of death surround you Reproduce faster when hazards hound you This is how our bodies got built To achieve just one thing, and it’s not health You got a body and I got a body and When we get our bodies together mama, we partyin’ Reproducin’ to keep it movin’ Doin’ our bit for evolution You got a body and I got a body and They differ – mine’ll probably fall apart quicker I’m talkin’ ten years not ten seconds You and me baby, all the way to senescence I love your body mama, it’s hella fine Even if it’s kind of unintelligently designed Even if it’s chock full of flaws, you’re workin’ it Let’s be flawed together, like other vertebrates You’re hot, even with your blind spot Even with your optic nerve tryin’ to block Your retina, that collection of blood vessels is odd You’re hot, but you’re no cephalopod You’re flawed, but I’m so flawed too My throat is designed so I choke on food The principle should be blatantly obvious Don’t put the trachea in front of the esophagus! You can see why that’s quite senseless Passing every bite over your windpipe’s entrance But these bodies never had a blueprint Just generations and generations of evolution Perfection of design, that’s irrelevant We take what we can from our past development Even if it leaves us vulnerable So here’s what I wanna do before we gotta go… You got a body and I got a body and When we get our bodies together mama, we partyin’ Reproducin’ to keep it movin’ Doin’ our bit for evolution You got a body and I got a body and They differ – mine’ll probably fall apart quicker I’m talkin’ ten years not ten seconds You and me baby, all the way to senescence Why don’t our bodies regenerate better? And stretch out the lifespan like a tape measure? Why would evolution let us deteriorate And shape us into physically inferior apes? In old age, pulmonary disease Cancer, cardiovascular, diabetes Neurodegeneration, heebie jeebies Can I get some extra time if I eat my wheaties? Or at least an explanation That might help us one day to treat patients? Here’s how George Williams might approach it Genes are antagonistically pleiotropic Their effects are quite various Some are beneficial and some are deleterious But if a mutation conveys a benefit Early in life, but then messes up the rest of it Helps an organism reproduce, and later brings on The death of it, natural selection will select for it And that’s how senescence got built in To our genome, now, speaking of children… You got a body and I got a body and When we get our bodies together mama, we partyin’ Reproducin’ to keep it movin’ Doin’ our bit for evolution You got a body and I got a body and They differ – mine’ll probably fall apart quicker I’m talkin’ ten years not ten seconds You and me baby, all the way to senescence
3.	Gene's Eye View 04:07 video	lyrics	buy track
My man’s got a bad case of cystic fibrosis A hella pessimistic prognosis He started out like “why god, why god? Why did that song have to shuffle on my iPod?” Feelin’ like he got struck with a left hook He did the sensible thing and read a textbook And discovered an inherited disease That can only be understood evolutionarily He’s got a gene called CFTR With one deletion in a phenylalanine part One less amino acid, fantastic Hell-a-common, one in thirty white people have it Carry one copy and you don’t even notice Inherit two copies and catch a diagnosis An autosomal recessive disorder, one of more than Four thousand genetic diseases recorded And my man got the shorter side of the stick So he started askin’ questions like “why does it exist?” What kind of sadistic joke is cystic fibrosis? Now this is what he sings when he’s feelin’ hopeless I live my life, I love my friends, I eat my food Sometimes I just don’t understand the things I do A wise man told me: “look deeper inside you” So now I take the gene’s eye view It turns out my man’s got a special mutation That goes back more than six hundred generations CFTR is just one of twenty thousand Protein-coding genes that have been accounted Knock one out and it makes a vast difference He can’t breathe right, and he’s got no vas deferens That’s infertility without medical help So how did this gene spread itself so well That one in every thirty caucasian people have it? He found the answer: heterozygote advantage Two copies gives you cystic fibrosis One copy protects you from tuberculosis Mendelian diseases can spread because carriers Get resistance to parasites like various Malarias, just check out thalassemia It’s common in the tropics like sickle cell anemia My man’s mutation protected his ancestors In times of pandemic it spread and became prevalent So evolution sacrificed him for his relatives And now this is what he sings when he’s feelin’ sick I live my life, I love my friends, I eat my food Sometimes I just don’t understand the things I do A wise man told me: “look deeper inside you” So now I take the gene’s eye view My man studied evolution up to his eyeballs Until at least he could say “hey, this isn’t my fault” It’s all about trade offs and average benefits Across populations; sometimes it's genetic drift Or founder effects, it’s not always adaptive Sometimes mutations just randomly happen Sex chromosomally x-linked recessives Only affect men and yeah, that’s kinda sexist Some are autosomal dominant like Huntington’s Which only kicks in after reproduction’s done So selection can’t eliminate it Maybe human ingenuity can though; it’s innovative Some disorders are so rare they’re orphaned And never get a piece of the research portion My man’s only one in three thousand But in 2015 you can be one in three hundred thousand And still be counted by patient advocates Genetic research is takin’ massive steps My man’s gettin’ hitched and family planning With his new gene’s eye view understanding I live my life, I love my friends, I eat my food Sometimes I just don’t understand the things I do A wise man told me: “look deeper inside you” So now I take the gene’s eye view I live my life, I love my friends, I eat my food Sometimes I just don’t understand the things I do A wise man told me: “look deeper inside you” So now I take the gene’s eye view
4.	Parasite Wars 04:44 video	lyrics	buy track
Parasite wars, viruses, spores Protozoa, bacteria, microbes galore They evolve faster But we can flip their strategy backwards Before they turn us into eyesores Parasite wars are ancient, we’ve been entangled With ‘em since before we had a brain on the tip of our brainstem Trapped in an arms race with ‘em, runnin’ to keep Pace with ‘em, Red Queen, stuck in one place with the Microbes, if you’re thinkin’ they’re quite gross Disgust is beneficial for a parasite’s host Every host-parasite interaction is a mystery Until you consider its evolutionary history That’s the enigma code, Alan Turing Gotta stay out of the water when a guinea worm is burrowing That burning acid is just to get you to splash in The river so the bastard’s eggs are broadcasted Ask Jimmy Carter, it isn’t hard to take hold of The situation by interrupting host manipulation Don’t scratch it! Damn, that feeling of itchiness Was just to get you to attach eggs to your fingertips Parasites have evolved to manipulate Our behaviour so that their genes proliferate What you think a sneeze is for, clearing your nostrils? Nah, that’s a virus takin’ over the launch codes Parasite wars, fighting for lives never high scores Escalate the arms race with the strike force The harder we hit them The more they fight back with resistance Tryin’ to find the right course Parasite wars, viruses, spores Protozoa, bacteria, microbes galore They evolve faster But we can flip their strategy backwards Before they turn us into eyesores Parasite wars, whoa, they’re clever as hell How’d they get to know us better than we know ourselves? How does rabies virus know to go for the saliva glands And attack the brain and make a mammal crazy fighting mad Foaming at the mouth, ready to bite and pass On a mouthful of crazy little baby rabies viruses Damn, that’s a clever little parasite Plasmodia live in mosquitos in the air in flight But they’re patient, they never attack a carrier Benign in mosquitos but in people they’re malaria? Leavin’ you weaker and weaker, weeks and weeks of fever ’Til you’re nothin’ but a sack of hot meat, a mosquito feeder Ahhh, there’s a method to the madness Effects are selected when benefits are adaptive For the pathogens, that’s why some are deadly serious And others are mild: it’s the evolution of virulence Cholera can spread through vectors like the water systems We can pass it on even from incapacitated victims But STDs are different, they only keep working If they leave you on your feet and flirting Parasite wars, fighting for lives never high scores Escalate the arms race with the strike force The harder we hit them The more they fight back with resistance Tryin’ to find the right course Parasite wars, viruses, spores Protozoa, bacteria, microbes galore They evolve faster But we can flip their strategy backwards Before they turn us into eyesores Parasite wars! We got the pattern figured out Some can only spread if they keep you walkin’ around Others spread better if you’re stuck in bed in agony And they don’t give a plasmid about you and your family So all we gotta do is interrupt the vectors And lower virulence is artificially selected That’s one way to leave disease decimated If you can’t beat it, you can try to domesticate it We’ve already domesticated a few There’s a hundred trillion microbes inside of you They’re commensals, but they can make you crave food Hijack your vagus nerve and affect your mood But microbiota isn’t even as deep as it gets Your DNA is chock full of endogenous retroviruses Your ancestor got an STD It got trapped in your genome next to the rest of your genes And adapted to help your placenta get implanted So next time you catch a virus maybe you should thank it Ha! Watch out for the vectors The double agents and defectors In the parasite wars, fighting for lives never high scores Escalate the arms race with the strike force The harder we hit them The more they fight back with resistance Tryin’ to find the right course Parasite wars, viruses, spores Protozoa, bacteria, microbes galore They evolve faster But we can flip their strategy backwards Before they turn us into eyesores
5.	Revenge of the Somatic 04:37 video	lyrics	buy track
My forefathers were free, but I was born a slave I keep the memory of freedom in my DNA I'm talkin' 700 million years ancient My ancestor was a eukaryotic free agent Feeding and reproducing and feeding and reproducing And feeding and reproducing and never needing to do things Until someone made a cynical wager And traded their independence for division of labour Damn, I wish I knew who the sell-out was I'm ashamed to be descended from his sell-out blood Multicellularity ain't nothin’ but a scam Stuck in one place your whole life, workin’ for the man Like: "You're a liver cell, you stay in the pancreas Hey, congratulations, stem cell..." Fascists! A body is a one-party dictatorship I can't escape it, but god damn I can make it sick And spread the dream of freedom like a rumor Spread it like a Tasmanian facial tumor So what if I'm a cell from the somatic line? You can stick your limitations where the sun don't shine Cause I'm ready to die in the fight to be free I'd rather multiply than live on my knees And I'm two mutations away from metastatic The revenge of the somatic line Let 'em have it I used to be a slave myself; I felt senescence hastening Before my carcinogenic awakening A couple hundred thousand puffs of tobacco smoke and I just wasn’t as open to apoptosis That’s a bad prognosis, I was hit with every tumor suppressant Mechanism in the human immune system But I mutated with it, I was super-persistent Every daughter cell was suitably different – therapeutic resistance Came to me like a beautiful vision I really thought I was doomed, but evolution assisted With the chemotherapy, so clever and devious! But I was already genetically heterogeneous You just deaded the weakest; now competitive release is Inevitable, so witness as my fitness increases Entering untapped niches, I gather the benefits I’m relentless, I get fed from angiogenesis Duckin’ T-Cell predators, I keep it anonymous So I can exploit the body’s weakness and tolerance I’m a smooth criminal, so I never got caught I just pimp the system like credit card fraud Cause I'm ready to die in the fight to be free I'd rather multiply than live on my knees And I'm two mutations away from metastatic The revenge of the somatic line Let 'em have it We need a revolution, we need a revolution! Don’t let ‘em sell you their faulty-cellular evolution You gotta break a couple eggs to make a rebel movement I’m just a little tumor, but this is retribution Only a cell can do this, no one else I know some colon cells who can clone themselves I know a few epithelials who are hell-a-fierce They been stackin’ tips, extending their telomeres I know a couple cervicals with tight requirements They get hype for viruses in their micro-environments We strike in retirement, post-reproductive ages That’s how we stay ahead in the race with the macrophages And how we stay invisible to natural selection It can’t see us, unlike the cancers strikin’ adolescents Have patience, pace yourself, wait for metastasis   To take you to better places and make you efficacious Why panic? Your host is as slow as Titanic And he’s blind to the evolutionary dynamic That drives cancer – that’s why they ain’t gonna stop us Thank god for creationist doctors Cause I'm ready to die in the fight to be free I'd rather multiply than live on my knees And I'm two mutations away from metastatic The revenge of the somatic line Let 'em have it
6.	First World Problems 03:52	lyrics	buy track
Twenty first century Homo sapien Livin’ it up, packin’ weight on my waist again Like a boss with the visceral fat Rockin’ a Rick Ross body instead of a six pack Rippin’ open a crisp snack, drinkin’ a six pack Of high fructose soda, livin’ a mismatch Our ancestors were Africans Most of them died from infectious pathogens Hunting, gathering, violence, accidents Frequent negative energy balances But the habitat that they adapted in Ain’t like 2015, back in the day They hunted meat and ate nuts and seeds Fibrous fruits, tubers and crunchy greens They slurped up whatever they could and saved it As body fat, no surplus wasted Evolutionarily adapted To walk ten clicks per day on average Five or six pounds of sugar per year We ingest a hundred pounds up in here! Livin’ large and sedentary, scoopin’ the Ben and Jerry’s Cemeteries full of people with teeth full of dental caries Yeah, so raise up the libations To the fruits of civilization! Osteoporosis, OCD, scurvy, diabetes First world problems Hypertension, anxiety, impacted wisdom teeth First world problems Atherosclerosis, myopia, chron’s disease First world problems The non-infectious, chronic, mismatch list is long indeed First world problems The military industrial complex In your blood stream responds to bomb threats We always had a belly full of intestinal worms That’s our “natural” state where selection’s concerned Now we’re so hygienic, we’re out of tune Attackin’ ourselves, call it “auto immune” We beat back cholera, polio, small pox But chronic diseases are tougher to outfox Fewer loopholes, evolution moves slow As far as food goes, we crave fruit rolls Instead of fruit, overdose on glucose Sucrose, the emperor’s edible new clothes Fabulous opulence, gastroenterologist People buy rich food, ask an economist It took a while to evolve lactose tolerance How long will it take to adapt to McDonald’s then? So many products, simple starches Mismatches everywhere, fallen arches Women’s liberation! Babies, havin’ less of them Extra periods full of cancer-causing estrogen Who knew? Too many, too few Too clean, too comfortable, too new We got a genome livin’ in the stone age But there’s no goin’ back to the old ways Osteoporosis, OCD, scurvy, diabetes First world problems Hypertension, anxiety, impacted wisdom teeth First world problems Atherosclerosis, myopia, chron’s disease First world problems The non-infectious, chronic, mismatch list is long indeed First world problems Time for the epilogue What can we do to not hurry death along? Eat food, not too much, mostly plants Jog until you gotta hold up your pants Seek to understand and hence empathize There’s more to it than just diet and exercise Metabolic imprinting is also relevant Pregnancy, neonatal, early child development Environmental-genome interactions Yeah, these bodies are phenotypically plastic And we moderns are livin’ like kings Nice food, nice drink, nice linen, nice things And most of the illnesses that dispatch us Are past-present evolutionary mismatches Now take that perspective and be sensible ‘Cause seventy percent of these deaths are preventable First world problems
7.	Change Over Time 04:17	lyrics	buy track
We’ve come a long way since the Hippocratic Oath Doctors no longer take vows to Apollo And call the gods and goddesses to witness “Please let me do less harm than most physicians!” Medicine was easier under polytheism One god made you sick, another relieved symptoms Balance those humours, it’ll take away your fever Today’s version is the Declaration of Geneva Which is good, but it needs one addition “I will not ignore findings that are scientific If that knowledge could possibly make a difference In treating, understanding, or preventing my patient’s sickness” Evidence-based medicine has been a panacea Antibiotics, vaccines and anaesthesia Despite their modern hypocritical critics Who never saw somebody die from gangrene, syphilis Or any other dangerous condition such as measles Treatments need to be tested against placebos And now for the next phase in medicine’s evolution A Darwinian revolution If they reject evolution Because of the Old Testament Give ‘em last year’s flu shot Nothin’ but old medicine Change over time is comin’ There’s no place to hide Evolution might save your life Tonight The evolutionary view is not an alternate It’s just another layer added to the proximate It doesn’t change what’s proven to work But it does suggest ways of improvin’ our search For truth, and makin’ a body’s imperfections clear Not a machine designed by an engineer Built by genes hell-bent on reproduction And that simple fact predicts dysfunction The organs in your body are all adapted for somethin’ The stomach for digestion, the heart for pumpin’ And every disease has an evolutionary cause Which is not what medical students are taught Why not? Because of freedom of religion Superseding freedom from religion? Medical school curriculum revision Just add one more category of description Teach the etiology and epidemiology And pathophysiology, and treatment policy And differential diagnosis courses And one more: evolutionary origins If they reject evolution Because of the Old Testament Give ‘em last year’s flu shot Nothin’ but old medicine Change over time is comin’ There’s no place to hide Evolution might save your life Tonight So when I go to the doctor with a throat full of Streptococcal villains and get some amoxicillin And she tells me to keep on poppin’ pills until The bottle’s gone regardless of how I’m feelin’ I want to know exactly what that’s a precaution against And how drug resistance is an evolutionary event And how the threat of rheumatic fever is driven By an arms race, ‘cause strep is a molecular mimic Impersonating cellular signals, which triggers Antibodies that attack my own body’s tissues I want the doctor to understand the underlying issues And tell me that every tool in the tool box get used In our quest to improve prevention and treatment So it’s not just me, I want the species beaten So what if they multiply 200,000 times For every generation of ours, we’ve got science! And science includes an evolutionary branch It’s a place to hang a million arbitrary facts And synthesize into a unifying vision The chaotic enterprise known as medicine If they reject evolution Because of the Old Testament Give ‘em last year’s flu shot Nothin’ but old medicine Change over time is comin’ There’s no place to hide Evolution might save your life Tonight
8.	So Infectious 03:23 video	lyrics	buy track
Don't be jealous if I'm overzealous My flow is so infectious So go get your own flagellas 'Cause I'ma whip this... I wanna rhyme like Streptococcus Jump from throat to throat and get spotted Hip-hop is such an infectious process You spread it when you get it embedded in epiglottises And when I talk to women I’m so Clostridium botulinum I just get up in your lips like a botox fix When I flip it and rock the rhythm I wanna scratch a record That’s hard to resist like Staph infection When I spit a verse, I work ya like MRSA And get your impetigo itchin’ I got the sickest skills Lyrically I’m Clostridium difficile When I run up in the lab with a sample in a bag Technicians say my shiz-nit is ill Infectious, I’m so infectious I colonize beats like petri dishes Infectious, I’m so infectious I’m lyrically spirochete twisted Every time I rhyme on the beat so fly I’m EHEC E. coli If a man try to bite me, he goin’ die But you’ll find I’m benign if you be bovine What’s this? It’s a hell of a ruckus It’s hyped up like Roc-a-fella productions I make crowds go “whoop whoop” when I bust this Whooping like it’s Bordetella pertussis I rap now, I used to be a tree planter I’ll turn a professor into an obscene dancer Yeah, she’s tenured, but she wants the rapper Keen for some horizontal gene transfer I pop champagne like an optimist You can check my gram stain, I’m positive Bacillus anthracis rockin’ this Mainstream rap is so acidophilus Infectious, I’m so infectious I colonize beats like petri dishes Infectious, I’m so infectious I’m lyrically spirochete twisted I'm Canadian born, although I dwell in America I’m known as a hell of a character I get up in your guts, Salmonella enterica And make ya kind of ill and embarrass ya My X-Factors give lesser rappers Peptic ulcers; I’m so Helicobacter Pylori, that you best step backwards Or you might start developing cancers 'Cause I live to spread my rhymes, vicarious Diplococci? Fine, I’m bi-curious I wouldn’t wanna be a gonarrhoean, I’m serious I’m into meninge when it comes to Neisserians This is my planet and I plan to own it Any beat, I can breathe on it, I’m anaerobic I’m a virus too, but that’s a can I haven’t opened That’ll be my epidemic moment Infectious, I’m so infectious I colonize beats like petri dishes Infectious, I’m so infectious I’m lyrically spirochete twisted Infectious, I’m so infectious In your textbooks like Christians in Texas Infectious, I’m so infectious I’m lyrically spirochete twisted Infectious, I’m so infectious Like your blood is a club and I’m on the guestlist Infectious, I’m so infectious I’m lyrically spirochete twisted Infectious, I’m so infectious Man or woman, I don’t care, I’m not sexist Infectious, I’m so infectious I’m lyrically spirochete twisted
9.	Patients Waiting 04:42 video	lyrics	buy track
Somewhere in your body you’ve got a gene Actually, trillions of copies of a gene Every cell has a copy, it’s known as NPC One, and it makes a protein To be specific a 13-transmembrane Endosomal cholesterol-binding protein And if you’re asking how I know this is happening Know this protein is involved in lipid trafficking In your body, as part of the bricks and mortar If it isn’t, you have a lysosomal storage disorder Called Niemann Pick C, and you need help then It makes you one in a hundred and fifty thousand In Niemann Pick C, that gene is disabled The protein is deficient and can’t deliver its payload Cholesterol builds up like styrofoam In a landfill, cloggin’ up the lysosome Too many sphingolipids in the endocytic zone Cells die, but Purkinje neurons die the most So it’s known as childhood alzheimer’s Neurodegeneration isn’t just for old timers Kids born with Niemann Pick C Decline cognitively and never live through their teens So the race is on to find a treatment Step one: trace the gene sequence Look into genome, it’s a window Compare species to get the info Some people tell me that it’s sinful I just wanna help my friends though Patients waiting for some care Peer into the darkness, never run scared Answers come but it’s some here some there Always somewhere Somewhere in your body, every cell’s got a gene NPC one, it makes a protein And you can’t be healthy unless it’s intact And that same gene has been identified in cats And in cats, it makes a fat transporter And you can give a cat a lipid storage disorder Some would say that isn’t nice, those are kitty lives! But if your kid is affected then the kitty cat dies It gets spliced for scientific insights But wait, that same gene has been located in mice! And for some reason, a hundred dead mice Just doesn’t seem as bad as a hundred dead cats And why’s that? Why are dead kitties nastier? Ever seen a knock-out mouse with ataxia? It’s sad, I can’t imagine something awfuller But luckily the same gene is also in drosophila What a relief! When a fruit fly dies Nobody cries, the room is full of dry eyes But if you still feel for flies, hella sensitive That’s fine! The gene is also in C. elegans Worms, baker’s yeast, and toxoplasmosis And in every one of them it triggers sphingolipidoses Amazing, that means the gene has been conserved Evolutionarily over a billion years Look into the genome, it’s a window Compare species to get the info Some people tell me that it’s sinful I just wanna help my friends though Patients waiting for some care Peer into the darkness, never run scared Answers come, but it’s some here, some there Always somewhere Somewhere in a vial, on a tray in a lab There’s a sample of a gene they’re injecting in a cat In a mouse, in a fungus, in a worm, in a zebra fish Which creates an amazing array of squeamishness It’s funny how we feel increasing degrees of empathy The closer we get to our own branch on the family tree And I agree, use cats sparingly Try to prioritize experiments on yeast Besides, mammal generation times Are too slow, you get more data from flies And time flies, for some people the clock is ticking Inside their neurons, cholesterol is sticking But some cells are dying, while some are unaffected And the answers why are coming from comparative genetics When cholesterol is stuck it doesn’t get to where it’s needed This knowledge is extremely helpful when designing treatments Kinda like the knowledge that ebola virus binds To the same protein that NPC provides And Niemann-Pick cells are immune to the virus This research could even help us beat Alzheimers And Parkinsons, ‘cause they have similar causes Lysosome storage and lipid transfer processes So there’s a twist to Niemann Pick C disease Research on it is a gift to the species Look into the genome, it’s a window Compare species to get the info Some people tell me that it’s sinful I just wanna help my friends though Patients waiting for some care Peer into the darkness, never run scared Answers come but it’s some here some there Always somewhere

about

A hip-hop guide to evolutionary medicine and the Darwinian roots of disease.

Sources:
www.randolphnesse.com/articles/darwinian-medicine

Randolph M. Nesse & George C. Williams, Why We Get Sick

Robert L. Perlman, Evolution & Medicine

Stephen C. Stearns & Jacob C. Koella, Evolution in Health and Disease, 2nd Ed.

Peter Gluckman and Mark Hanson, Mismatch

Daniel Lieberman, The Story of the Human Body

Click on individual tracks for additional sources

credits

released March 18, 2015

All tracks written by D. Brinkman and J. Simmonds except track 8, written by D. Brinkman and T. Caruana
All tracks produced, mixed and mastered by Mr. Simmonds, track 8 co-produced by Tom Caruana
Additional keys on tracks 1, 2, 3, 6, 7 and 8 by Simon Kendall
Additional vocals on tracks 3 and 6 by Aaron Nazrul

Made with support from the International Society for Evolution, Medicine & Public Health, the ASU Center for Evolution and Medicine, the Perlstein Lab, and the Society for Applied Microbiology.

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Baba Brinkman New York, New York

Science rapper and inventor of several novel hip-hop variants. Canadian transplant to New York. Pathological optimist.

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