What's in a Name? (11/26/24)

 Joyce and I both knew that Juliet was full of crap by our third date. We were both starting to sense the long-term potential of the relationship, and it was time to address the elephant in the room. Although we eventually got around to the first name/surname issue, the “potential irreconcilable differences” conversation actually started with a discussion on NFL loyalties. Having grown up in Minnesota, it was unavoidable that I would become a fan of the Dallas Cowboys (see the Wikipedia page on “Herschel Walker trade” if this comment confuses you). Having spent much of her childhood in the D.C. area, Joyce had a preference for the archrival to America's Team, which coincidentally elected to change their name a couple of years ago. Looking back on it now, I realize that these differences pale in comparison to the many flaws that my patient and loving wife would endure on my behalf for our marriage to be successful.

MIT Professor Patrick Henry Winston begins his entry level lecture on Artificial Intelligence with the idea that “naming something gives you control over it.” In the Genesis story, God gives Adam the responsibility of naming the animals. I used to think this would have been an easy job, but after struggling to come up with the names for two children and registering a couple of C corporations in the state of Delaware, I have a new appreciation for the difficulty and importance of this creative act. This theme runs throughout the Bible, with God’s power being manifested through the act of speaking and naming. Abraham, Paul, and Peter are only a few examples of individuals who were literally given a new purpose and identity in the context of a name change.

I guess it shouldn’t be surprising, then, that it came as a great discouragement when we learned yesterday that we still don’t have a name for this cancer. Some new data came back from a tumor genomic test, revealing the presence of KIF5B-RET fusion. This unexpected new finding cast us back into the realm of uncertainty about the origin of the primary tumor, with lung cancer re-emerging as a possible contender. It’s not just that this new finding could impact the therapeutic regimen that is chosen, it could actually mean that we’re seeing the wrong type of oncologist. Beyond the practical disadvantages of not having a name to put on the cancer, there is also an ominous psychological impact. The Dark Lord Sauron understood this when he forbade the speaking of his name as a tactic to cultivate fear and awe, shrouding his identity in mystery and making him seem more powerful than he really was. Hermione Granger also recognized this phenomenon when she astutely noted that “fear of a name only increases fear of the thing itself.”

So where do we go from here? In many ways it seems like we have reached the limits of scientific achievement. Without a name to put on this disease, we can’t rely on the statistical power of clinical trial data to guide our strategy. Instead of following the reproducible score of one of Mozart’s concertos, we’re now in the realm of improvisational jazz. Even with the benefits of “precision medicine,” it feels as though we have crossed over from science to art. Thankfully, there is a source of truth that has proven to be reliable long before such a thing as the scientific method existed. It is here that we discover a name that brings access to a power that can defeat this nameless cancer. John 14:13-14 tells us that “whatever you ask in My name, that I will do, that the Father may be glorified in the Son. If you ask anything in My name, I will do it.” We will continue to put our faith in Him, praying that He will bring wisdom to the medical team as they collaborate to unmask and destroy this malignancy.