When George Williams and Randolph Nesse made their first pitches for Darwinian medicine in the early 1990s, they turned some heads, but not the right ones. Reviving and building on European traditions that melded medicine and evolutionary biology, the duo argued that diseases could be best understood from an evolutionary perspective. Their first meeting on the subject in 1996 attracted 60 enthusiasts but few practicing clinicians, probably because physicians couldn't envision practical applications. "The folks who were excited about it weren't in a position to do anything about it," recalls anthropologist Peter Ellison of Harvard University. Although a better understanding of the evolution of drug resistance has helped shape the use of antibiotics, when it comes to evolution, "medical schools are mostly oblivious," says Nesse, a psychiatrist at the University of Michigan, Ann Arbor.
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