"My sense is that The Selfish Gene had a huge impact among evolutionary biologists, ecologists, and behaviourists, recruiting people to these fields and helping to get right the thinking of the less mathematically inclined. But in biomedicine, the largest and most well-funded area of biology, selfish genery has had negligible impact. This is in part because evolution is largely absent from biomedical training, and also because evolutionary biologists have been slow to leave the comfortable natural histories of birds and insects for the jargon-laden natural history of medicine. But it is also a consequence of the overwhelming dominance of a reductionism in (ironically a criticism once levelled at Dawkins). Explanation of disease virulence and infectiousness is usually sought in terms of molecular interactions, cell signalling, and so on. Mechanistic description is of course fantastically important and has yielded substantial insight and some clinical advances. However, such explanations are necessarily incomplete. To explain why something is like it is, we also need to ask about the evolutionary pressures. And this involves the thought processes laid out in The Selfish Gene."