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April 2011

Translational Neurology

Author Affiliations

Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Neurol. 2011;68(4):541-542. doi:10.1001/archneurol.2011.43

At the first glance, translational medicine might seem to be a timely concept to deal with complex contemporary realities such as genomics and molecular biochemistry. After reading the article by Helmers et al,1 however, especially with the decades-old topic of temporal lobectomy for epilepsy chosen as an illustrative example, it becomes clear that translational medicine is simply a term that describes an attempt to systematize a practice that has been evolving since the days of Jenner and Pasteur. The authors ably divide the “bench to bedside” process into 3 phases to inject coherence into a potentially chaotic situation, particularly in view of the additional responsibilities (and subsidies) that have come with the enacted health care reforms. There is another basic issue, however, that is only touched on tangentially: how are we to deal with the illnesses and treatments that will be, we hope, clearly defined in the future? Can fewer than 100 fully equipped, staffed epilepsy treatment centers meet the needs of a population of 300 million? How will the potential patients be chosen? How will the care be financed? How will the potential caregivers be trained? A political phase must be added to bring translational medicine into reality. Unfortunately, the health care legislation left largely intact the illusory belief in the value of market forces and the all-too-real power of for-profit insurance companies. The true benefits of translational medicine will come to fruition only after our physicians and medical scientists can complete their training without incurring crushing debts and our patients can be cared for in a government-backed single-payer system in which policy decisions are made not by the faceless bureaucrats invoked by fearmongering naysayers, but by well-trained committees of impartial experts who function in a transparent and responsible context.