A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution

In the opening chapter of A Crack in Creation, Doudna and Sternberg introduce the foundational concepts of genetic disease and the scientific quest to develop gene-editing technologies. The authors begin with a case study about a patient known as “Kim,” who experienced a spontaneous cure from a rare genetic condition called WHIM syndrome. Kim’s story exemplifies how genetic diseases can result from tiny mutations—in her case, a single incorrect letter among billions in her DNA caused debilitating symptoms until a natural accident in her blood stem cells effectively cured her condition. The authors use this case to explain how such spontaneous genetic corrections occasionally occur in nature but are extremely rare. This leads to their central question: What if scientists could intentionally repair genetic mutations rather than relying on such improbable natural events?

The authors then provide essential background knowledge about genetics, explaining how DNA functions as life’s instruction manual. They detail how DNA’s four-letter alphabet (A, T, G, C) creates a code that cells use to produce proteins through an intermediary molecule called RNA. This process, known as the central dogma of molecular biology, forms the foundation for understanding genetic diseases and potential treatments.

Doudna and Sternberg trace the evolution of gene therapy approaches, beginning with early attempts in the 1960s.