From Genetics to Energetics: An Optimistic New Framework for Biomedicine

By Martin Picard

Ask any biomedical researcher what health really is, what lies at its core, what makes it flourish or fail, and you’ll probably get a long pause. Despite centuries of progress in medicine, we still don’t have a clear, universally agreed-upon definition of health. We can detect disease with precision, but we can’t measure health itself in a meaningful, quantitative way.

Over the past few years, my colleagues and I have tried to approach this differently: by returning to health “from first principles.” That means setting aside the concepts we memorized in school or picked up in lecture halls and textbooks, and instead asking what those ideas are truly built on: the most basic, unshakable foundations.

When you start there, the answers begin to shift. The picture of health that emerges is simpler, more universal, and far more powerful than we’ve been taught.

I’ve written in more detail about how integrating energy with structure and communication can lead to a more holistic model of health; one that includes, but also surpasses, the pharmaco-molecular framework. 

As co-director of the Columbia Science of Health (SOH) program, I’ve also proposed that health is a field-like state that emerges from the flow of energy, moving through biological structures, coordinated and guided by communication. We call this Intrinsic Health.

Below, I explore how our intense focus on diseases and molecules has caused us to lose sight of this essential connection: health and energy.

We live in a time of change. New initiatives integrating the science of energy and the human experience will create the foundation for a new era of science. One where we can transform human health, through energy. 

Energy: The Missing Ingredient in the Definition of Life

So what is health? 

Think about health from first principles, and you very quickly arrive at energy. 

Energy is the distinguishing feature between the thinking, feeling, moving body of a living person and the cadaver. The main difference between a dead and living body is not the genes, cells, organs, or some combination of mysterious molecules. It is the flow of energy, the force that brings the physical hardware of the body to life.

Energy is the potential for change. It takes different forms such as heat, electricity, light, sound, and pressure. Energy is never created nor destroyed, only transformed from one form to another, including within your body. Energy flows, and as it flows, it is transformed. Through its transformation, energy creates life. Your life, my life, and that of others around you all rest on one fundamental thing: the flow of energy.

Yet biomedicine has invested very little in studying it.

Biomedicine’s Obsession with Things Over Processes

If energy is the essence of life, you might expect it to be at the center of medicine. Yet in practice, modern biomedicine has largely ignored it, choosing instead to focus on what can be easily seen, touched, and measured.

Genes, proteins, and organs, these solid, visible structures dominate the conversation. Especially when they’re “dysregulated” in some disease state. For a scientist, they’re grant-worthy. For a clinician, they’re testable. For funders, they’re actionable.

The NIH has poured almost its entire budget into chasing these actionable targets. And in doing so, clinical medicine has built an empire on disease detection and management. Leaving the question of health and its most essential dimension, energy, largely unexplored.

In reality, energy is where all of life’s inputs meet: the food we eat, the way we move, the air we breathe, the water we drink, the stress we carry, and the people we connect with. Every one of these threads converges deep inside our cells, where energy is transformed. 

The choices we know to be good for us all work toward the same end: charging the quiet, tireless transformers that make life possible: our mitochondria.

The Mitochondrial Connection: Where Energy Becomes Life

Mitochondria are tiny organelles that live inside nearly every cell of your body. A typical cell contains anywhere from hundreds to thousands of them. The number of mitochondria per cell depends on the amount of work it needs to perform, and on the level of biological signaling it has to handle.

Their job is extraordinary: to take the food you eat and the oxygen you breathe, and transform them into the spark of life. This is respiration at its most fundamental level—a slow-burning fire inside you. Not the violent flash of an explosion, but a controlled combustion, softened by the wetness of our tissues and the steady rhythm of biology.

That inner flame burning in your mitochondria is why your body is warm. It may even be why your living cells, including those in your brain, emit light. And perhaps, in some profound and literal way, it is where human warmth itself comes from.

Life Is a Waterfall: A New Metaphor for Human Health Knowing all of this, it’s helpful to think of life as a waterfall.

A waterfall only exists as long as the water is flowing. Yes, it’s made of H₂O, but it’s so much more than molecules. It is a process, a dynamic pattern, created by movement. Stop the flow, and the waterfall disappears.

So it is with us. When the flow of energy stops, life ends.

Like the waterfall, your existence is not defined by static parts (simply genes, cells, and organs), but by the constant flow of energy moving through them.

And at the center of that flow are your mitochondria.

Mitochondria don’t create energy out of nothing. They guide and shape it, like the riverbed that gives form to water. They channel the raw potential from food and oxygen into the dynamic “energyfall” that is you.

Your thoughts, your emotions, your drive, your very self, emerge from this patterned flow of energy.

Health, then, is not a fixed “thing” but a process of continuous flow. To sustain it, we need a well-formed riverbed: mitochondria supported by our genes, but also sculpted by our environment, lifestyle, and mindset.

The Failure of the Genetic Blueprint Model

When our bodies are fed the right food, and that food is transformed into energy by healthy mitochondria that easily flow and transform energy, life flourishes. This is the basis of life and health: not just how much energy, but how it is patterned by the riverbed of your energetic self, in your mitochondria.

So why does that idea of you as an energetic process feel so foreign, and so at odds with what you’ve learned in school, in a book, or on the internet?

Because for decades, modern science has been built on another story. A story based on a worldview where molecules reign as absolute drivers of everything else, aka physicalism, or materialism. Building on that largely unsupported premise, science has poured trillions of dollars and thousands of careers into the belief that health is written in our genes, and that disease can be fixed with drugs aimed at molecular pathways.

It was a compelling hypothesis. It inspired the Human Genome Project (HGP), which promised to reveal the code for life itself. But when the results came in in 2001, the picture was disappointing. Except for a few exceptional cases, genes explained only a sliver of human illness.

Gene variants can tilt the odds, but they do not determine who gets sick, when, or why. And the drugs built to correct those pathways? They can suppress symptoms or buy time, but they rarely restore health. Drugs, alas, do not heal.

Genes Don’t Determine Your Destiny. And Drugs Don’t Heal or Prevent Disease

The answers to health simply aren’t written in our genome.

If life is a waterfall of energy, you can’t explain its movement by analyzing a single droplet. Genes may shape the edges, but they don’t determine who gets sick, when, or why. Research shows they account for only about 7% of how long we live, which means more than 90% is guided by something else.[*]

The other promise of the genetic blueprint model was drugs. The idea was simple: if we could trace disease back to molecular pathways, then we could design small molecules (drugs) to block, boost, or fix them. It was a compelling vision. Lucrative, too. It inspired billions of dollars to be invested into decades of work.

But the reality has been sobering. Hundreds of FDA-approved drugs have come to market. Many can reduce pain, quiet inflammation, or hold symptoms at bay. Some even save lives. But they work downstream, far from the source of health.

Think about it: no existing drug actually heals. And no single drug exists to prevent things like Alzheimer’s disease or mental illnesses, two of the most intensively researched diseases.

The lack of a strong genetic signal, combined with the failure of drugs to truly heal, should have been a turning point.

Genes don’t determine your destiny. And drugs don’t heal nor prevent disease.

In science, when a hypothesis fails, the next step is clear: pivot, rethink, and search for a better model. But instead of moving forward, deeply rooted scientific and financial forces have continued to keep alive the compellingly logical, yet expired gene-centric hypothesis. Entire careers, industries, education programs, and billions in funding have been built on the genetic–pharmacological framework. 

And so the model has lingered. Not as a working theory, but as dogma; an idea treated as truth, repeated so often it became invisibly woven into the way we research, fund, and practice medicine. It even shapes our disempowering views of health, and of ourselves as molecular machines that break down. It’s gone so far for so long that it’s made it illogical and quite difficult to think of ourselves as energetic processes.

Sadly, this paradigm has failed to improve population health, metabolic health, and mental health. What then?

A Call for a New Scientific Paradigm

If genes and drugs can’t fully explain or restore health, then where do we turn? 

Back to first principles.

If health indeed begins with energy, the challenge ahead is to understand how life’s great patterns—growth, aging, resilience, and decline—emerge from the flow of energy. And more importantly, how to intervene not downstream at the molecular level, but upstream, at the level of energy itself.

We need new ways to protect and restore that flow before disease takes hold. We need new approaches rooted in bioenergetics and in the mitochondria that power every living cell. Those approaches will take many forms, like energy. Light therapy through biophotomodulation, nutritional ketosis through the ketogenic diet, electromagnetic neuromodulation through transcranial magnetic stimulation (TMS) all involve the use of energy in one form (light, biochemistry, fields) to tweak biology.

But perhaps more importantly, if we are to achieve a lasting, sustainable shift in human health, we need a culture shift in how we see ourselves—not as machines made of parts, but as processes sustained by energy flow. 

Of course, shifts like this are never comfortable. The biomedical system feels unstable, full of uncertainty, and high in entropy. Like a red, hot piece of metal heated up to make it more malleable.

For those of us inside the biomedical system, that looks like confusion, fear, and uncertainty. Energy scattered in all directions. Not fun. And not the best way to get creative minds to come together, empowered to discover and innovate.

But entropy isn’t just disorder. Entropy shakes loose rigid structures and makes space for new patterns to emerge.

That’s why disruption matters. It shakes us loose from models that no longer work, even when we’ve built our careers on them. It loosens our grip on old certainties and opens the door to something truer.

We are at a juncture in biomedicine. The rise in public awareness around metabolic health, the unprecedented political shifts that challenge the pharmacological hypothesis, and a global awakening among my fellow scientists are setting the stage for something significant. Something we’ve needed for at least a couple of decades now. 

The shift is happening. It’s a cultural shift that permeates both science and the general population. We’re finally beginning to let go of the molecular dogma of biomedicine, albeit not without pain and discomfort.

Think of it. Imagine you’re a scientist standing on uncertain grounds, trying to make sense of the world and arguably the most complex and unpredictable problem known to humankind: health. If you’re reasonable, you know you’re clueless. Unlike the certainty you get from a genetic test returning a clear pathogenic “causal” variant for a given disease (extremely satisfying, scientifically speaking), the answer around the basis of health is highly uncertain.

For a human being, uncertainty is one of the hallmarks of stress. We evolved to avoid it. So when we face complex problems, we naturally cling to the models and hypotheses that help us make sense of the world. When we see potential solutions passing by, we grab onto them and take them in as belief to “try them out.” Finding answers, even partial answers, temporarily cures us of the fear of the unknown, or the mystery.

When what you’ve cherished for years or decades is found to be wrong, it’s understandably hard to let go. Perhaps impossible, for it’s as if your intellectual self depends on a reasonable explanatory model of the world. In practice, letting go of our old models might be nearly impossible, until you find another compelling model to ground yourself.

Energy as the New Scientific Foundation

That model is what the science of energy is pointing to.

Focusing on mitochondria, the emerging field of Mitochondrial Psychobiology is beginning to resolve the false, albeit seductive, mind-body split. As we explore the energetic consilience between body and mind processes, we explore how the structure of your body’s organs, cells, and mitochondria arises from energy flow. The mind, too, is born from this same movement and transformation.

Body and mind emerge from energy flow. And when that flow is disrupted, disease, whether physical or mental, takes hold at its energetic origin.

Our new understanding of health as a field-like state brings a fresh, new perspective on health and well-being. And a framework to quantify it. In the next decade, we’ll likely see the first real, quantitative measures of health and healing. New tools, technologies, and practices so that you can start to do something about your health before disease shows up on a scan or in your blood work. 

A Science That Honors Human Diversity

A sustainable and healthy future begins with understanding the energetic foundation of health. If energy is life’s essential currency, then mitochondrial health must be safeguarded as a public good. 

Change is needed across every level of our scientific, social, and political systems. That change begins with recognizing that health is not merely the absence of disease, but the active maintenance of energy flow.

We could talk at length about how we will accelerate the ongoing cultural and political transformation. They are so important, and a valuable part of what the Coalition for Metabolic Health is focused on. But here I’ll focus on critical pieces we need to consider as we move forward with science.

From my perspective, the next compelling biomedical model must integrate the science of energy and the full spectrum of human experience. The science of energy includes mitochondrial science, bioenergetics, nutrition, behavior—all important parts of the puzzle. We need to bring in the energetic dimension of life, develop, and scale approaches that tap into not only the molecular structure of our brains and bodies, but their energetic underpinnings.  

The human experience, on the other hand, is the most fundamental part of what we are. And it might be the most critical. For if we continue to push the human experience out of biomedicine, we will remain blind to the true drivers of disease and healing.

Considering human experiences brings us to a related key point: individuality. Most of our research is based on a science of averages. The goal in clinical trials is to move the average by x points, and to get statistical significance at the group level. As we move forward, we need to develop a way of doing science that doesn’t assume everyone functions like a clinical trial’s “average.” You are not the average. I’m not the average. No one is.

With a first-principle framework for health, I believe that over the next decade we can make progress that today seems truly unimaginable.

In 50 years, future generations may look back at the quarter of century between 2000-2025 with disbelief. I suspect they’ll feel sorry for us. Or angry, perhaps, at how blind we were. Like fish unable to perceive the water around them, we clung to the genetic–pharmacological model long after it had failed, unwilling to recognize our true energetic nature.

I likely won’t be here to see that day. My son might, with his own family. For those who will be alive 50 or 100 years from now, our search for the truth about health and healing will have been worth every second.

To get there, we need humility. The humility to admit that we’ve been wrong. We need the openness to see health through the lens of energy. And the wisdom to build a new era of science grounded in real human needs, with the potential to touch and improve human lives.