HeadWise HeadWise: Volume 7, Issue 1 | Page 21

Challenging the “one size fits all” approach in modern medicine Anne MacGregor, MD Specialist in Headache and Women’s Health, Barts Health NHS Trust London, UK Alec Mian, PhD CEO Curelator Inc. Cambridge, MA We can easily recogn ize the face of someone we know from thousands, if not millions, of other humans. However, it turns out that individual differences in physical appearance are dwarfed by the biochemical differences within us. In the middle of the last century, Roger J. Williams, PhD, a distinguished American scientist specializing in nutrition at University of Texas, argued eloquently that clinically speaking, the “average man” simply does not exist. 1,2 Indeed, he said the very hallmark of being human is the high degree of individual variation our species exhibits. The variability that Dr. Williams referred to went beyond the obvious differences or even the presence or absence of a single genetic change that can alter drug response. Dr. Williams wrote: “If normal facial features varied as much as gastric juices do, some of our noses would be about the size of navy beans while others would be the size of twenty-pound watermelons.” Beneath this witty statement lies something less obvious and very intriguing. What Dr. Williams may be alluding to is the fact that in human evolution, millions of years of sexual selection and the desire to have mates that don’t look odd, may have acted to greatly normalize our physical appearance. Beneath our physical appearance however, our internal anatomy and biochemical machinery were never subject to such a normalizing selection pressure. Therefore, we may be greatly underestimating the anatomical and biochemical diversity that lies beneath our skin. Today only one of his books remains in print, but at the time Dr. Williams’ studies were widely published and the importance of his work was embraced by some of www.headaches.org | National Headache Foundation 21