Title: “A Crack in Creation”
Authors: Jennifer A. Doudna & Samuel H. Sternberg
My rating: ☆☆☆☆☆
Publisher: Houghton Mifflin Harcourt
Release date: June 13, 2017 on Amazon

More often than not, it’s difficult to determine which new titles will have staying power 10, 20 or 50 years from now. But “A Crack in Creation” deserves to be on any short list of decidedly important nonfiction books of 2017.

The reason is not simply because of the authors’ pedigree — co-author Jennifer Doudna is credited as the chief pioneer behind CRISPR, the potentially world-changing gene-editing technique. The book’s impact is also buttressed by the authors’ scientific rigor, deeply felt passion, and understanding of the world-changing consequences of their research.

Doudna and Sternberg’s “A Crack in Creation” is two books in one. The first third is a short primer on genetic engineering and the scientists who’ve advanced the science over the years. While the attention to detail and footnote-rich documentation is commendable, the lay reader will be forgiven if she skips through some of the dry backstory to get to the good stuff in the remaining two-thirds of the book. Because few of us have yet to reckon with the significant issues raised by the recent breakthroughs in CRISPR research, which only came to light in 2012.

As the authors write:

Many experts predicted that CRISPR would be a research biologist’s dream come true, enabling experiments that one could have only fantasized about doing before. I imagined that it would democratize a technology that had once been the privilege of the few. … Now, CRISPR seemed to be on everyone’s lips and the topic of every conversation. And yet it was still only the tip of the iceberg. …

As I sat on the plane flying back to San Francisco after that first trip to Cambridge, I could already see a new era of genetic command and control on the horizon—an era in which CRISPR would transform biologists’ shared toolkit by endowing them with the power to rewrite the genome virtually any way they desired. Instead of remaining an unwieldy, uninterpretable document, the genome would become as malleable as a piece of literary prose at the mercy of an editor’s red pen.

Doudna’s initial worries centered on whether scientists would prematurely use CRISPR without proper oversight or consideration of the risks and whether bad actors might use the technology for nefarious purposes. So she took the first halting steps to begin a public dialogue about the implications of CRISPR research, first by organizing a roundtable of 17 scientists in January 2015 and then a larger gathering later that year to discuss gene therapy and germline enhancement. Those discussions continue to this day.

Meantime, other researchers and entrepreneurs got busy. Entire companies have sprung up with the mission of conquering such genetic disorders as cystic fibrosis, sickle cell disease and Duchene muscular dystrophy. The reader roots along with the authors in cheering on what amounts to the beginning of what might be called “the precision genetic medicine revolution.”

Scientific jargon kept to a minimum

It’s helpful that the authors translate scientific arcana into everyday language, as when they mention that a snippet of DNA being modified by CRISPR is “roughly one one-thousandth the width of a human hair” or that a molecule “acted like a set of GPS coordinates” to guide the replacement DNA to the right spot or when referring to an enzyme as a “motorized hedge clipper.”

Many readers will be interested in not today’s practical applications in the lab but in what tomorrow may herald. Count me in the latter category, as I just finished writing a suspense novel with CRISPR at the centerpiece. What’s so fascinating about the technology’s future prospects? The authors write:

In the future, parents may be offered the option of selecting for traits that go beyond disease susceptibility and gender and cross into areas like behavior, physical appearance, or even intelligence. The list of known associations between certain gene variants and a diverse list of traits continues to grow, and as the PGD technology improves further, what’s to stop fertility clinics from consulting this genetic information so they can offer their consumers even more choices when it comes to selecting the most desirable or “best” embryos?

Entire conferences and mountains of newsprint will be devoted to dissecting the implications of CRISPR usage on early stage human embryos in the decades ahead. The door has just been cracked ajar.

Where does Doudna, the progenitor of CRISPR, come down on the ethical scales?

I don’t believe there’s an ethical defense for banning germline modification outright, nor do I think we can justifiably prevent parents from using CRISPR to improve their chances of having a healthy, genetically related child, so long as the methods are safe and are offered in an equitable manner. … [But we also need to] redouble our commitment to building a society in which all humans are respected and treated equally, regardless of their genetic makeup. …

Advances in gene editing are enabling us to rewrite the very language of life—and putting us closer to gaining near-complete control of our genetic destiny. Together, we can choose how best to harness this technology There’s simply no way to unlearn this new knowledge, so we must embrace it. But we must do so cautiously, and with the utmost respect for the unimaginable power it grants us.

Well said. The authors smartly observe that society as a whole needs to be in on the decision on whether to move forward with certain aspects of the gene-editing revolution, and that scientists need to demystify the technology so the public can “understand their implications and decide how to use them.” Let the robust debate begin.