Wrapping up 2009′s Scientific Philanthropy

It is time to reflect on 2009 — a challenge for all of us who try to take scientific philanthropy seriously.   The space where science, philanthropy, and society converge has become increasingly complex, crowded, and muddied.    It is too early to tell how the huge infusions of stimulus funding into academic science research will impact priorities and planning into the future.  Private funders disbursing relatively small sums will have to pick their way carefully through the morass of federal dollars if they want to truly have any measurable impact.    It is difficult to get researchers to think along heterodox directions when orthodox thinking keeps the wheels well-oiled.

The recent spate of news articles questioning the utility of cancer screening (needed airing) and the veracity of climate change data (not helpful) is shining a spotlight on the types of the problems that happen when an enterprise becomes to large and when the usual self- correcting processes break down because “there is too much at stake.” Similarly, a number of high-profile retractions in the most prestigious of journals is causing some to question whether the sheer volume of publications and the pressure to secure high imapct papers (and the subsequent publicity) is causing errors to go unnoticed.

It is difficult to maintain standards much beyond 2 or 3 generations – norms shift, implicit knowledge becomes lost, standards decline.     When I first started working in the lab where I did my Ph.D. research – my mentor used to train all new people on the procedures.    He thought that each time someone he had trained trained someone else (who might then train a third person) something was lost.    We all develop short cuts.  We forget to make implicit knowledge explicit.   We all learn over time what really matters and what you can let slide.    But he didn’t want such habits passed on — knowing what would eventually happen.   The lab would become increasingly shipshod and sloppy.    If he started each individual off to his own extremely high and exacting standards – that individual might slide a little bit – but not too far.

It is time for all of us who care about scientific research – be we in the lab or working for funders – to tighten up our thinking.    It is time to revisit our assumptions.   We can benefit from thinking about why we do what we do they way that we do it.    We should think about how we are training and mentoring others – and renew our commitments to high standards.    Systems can coast on momentum for only so long.   Order requires energy.

Time to roll up our sleeves and recommit to the hard work.   progress in 2010 depends on it!

Happy Holidays!   Happy New Year!

The lure of beauty

Almost all private funders who support biomedical research with the aim of yielding new treatments and therapies are increasingly obsessed with the challenge of the “translational” pipeline.    Apparently – all we need to advance cures is to unstick the knowledge that is stuck.

The reality may actually be something quite different – to quote a friend, “most likely the pipeline is a pipe dream.”

Much of what is done in biomedical labs, published in biomedical journals, and presented at hundreds of conferences each year in un-translatable.    And in truth, it is not translated because it is not meant to be translated – it is produced as an end in and of itself.

There will not be a Rosetta Stone.

Recently, while sitting at a small meeting focused on a particular brain disease I heard a young MD-scientist provide a compelling and UNINTENDED explanation of why much of biomedical research becomes stuck somewhere in the pipeline.      Essentially it comes down the difference between the needs of research – and the demands of the clinic.

To carry out research – and generate papers, grant proposals, and train students and postdocs – research needs to be done with animal models because they are:

1)convenient to study, 2) consistently available, 3) genetically homogenous, 4) efficient in the use of resources, and 5) familiar and well- characterized by other researchers.

Research needs to be elegant.  We are lured to the beauty of designing experiments that work, that yield to our tools, that provide clear results.

Unfortunately, persons with disease are and do none of these things.

We have to change the incentive and reward structure.   Pushing more and more knowledge about the model model is not going to clear the pipe.

I’ll take a double dose of the “or”

Over the thanksgiving holiday I found myself picking up and reading lots of ‘wellness’ articles in various newspapers and magazines.   Tis the season.   The recipe for not feeling our best during November and December: a dollop of overindulgence at holiday gatherings, a bowlful of reasons to miss exercise and sleep, and a heaping serving of list-generated stress.    Blend it all with short days and colder temps and voila — lots of column inches filled!    The remedies?   Oh – need we say pharmaceuticals ( for example antidepressants) and devices (think light therapy)?   The answer for whatever ails us has to be external to us.

I can not resist reading these articles.   The game for me is quessing how far buried in the text will be what I am looking for — the or.

After the discussion of some aptly-named syndrome and the various interventions offered (usually making someone $) there usually is the gratuitous “or.”    You can spend a fortune on prescription medications, treatments, special equipment… or – you can eat sensibly and get some outdoor exercise.    When are we going to get it?

The more natural we live — eating the freshest, least mucked-with food we can find and using our bodies for purposeful movement in whatever way is possible for us – the better we feel.

The mystery to me is why all the health charities and foundations have thrown in their lot with the medical-ag-industrial complex (MAIC).   In my view -the real purpose for much of what goes on in the MAIC is to generate ever-more syndromes that need to be diagnosed and treated.     Why are we not supporting research that really looks at what it is that makes us well — and for the most part keeps us well?

Our physiologies are complex systems and sure, things can go wrong — but in general, they work most of the time.   Particularly if kept in balance.   Clean water, good food, fresh air, purposeful activity.   Medical care appropriately provided is part and parcel of the overall package – but think about it — how many times do we find our interactions with the medical establishment unsatisfactory?   Too often – when they have little to offer for what ails us they deflect to something they can provide.    The recent epidemic of Vitamin D deficiency being a perfect example – they can test for it and they can give you something to take.   And the likelihood of doing harm is small while the chances that you may eventually feel better on your own are high.

Foundations with a professed interest in health should be more willing to challenge researchers to question the basic ideas we currently use to think about what it means to be well.