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Science: Not as Pure as You May Think

Ica, Peru 2017 me and some friends

The unbridled pursuit of knowledge to obtain a

better understanding of the world around us.

Seems like a decent definition of science right? This isn’t taking into account the variety of applications for it aka solving diseases, growing more food, it’s just the discipline itself. Now let’s turn to scientists – a group of truly self-sacrificing individuals that will never get the credit they deserve. What are some characteristics you’d think they would have? Here are some classics:

Quiet, awkward, motivated purely by the pursuit of knowledge, recognized as competent/ intelligent by others, volatile or “mad”

Now here’s me to tell you that, that’s not the whole picture.

First here’s a bit about scientists lives: from the ages of 16-19 I engaged in basic science research, at first experimenting on drosophila flies and then at Harvard working at a stem cell laboratory focused on heart disease. The people in my lab worked 14- 16 hour days. None of them were well paid enough. One of my close friends worked in a chemical biology lab and literally slept in his lab for 2 weeks on an air mattress while they were remodeling his apartment. He said it was pretty much the same quality of life and slightly better due to a shortened commute. He left to work at the Pasteur Institute (one of the most prestigious in the world) in Paris. A few months ago he said he had finally gotten tired of working the 16 hour days for limited funds, limited recognition and little chance of seeing the practicality of his research being put into play. Note: As many people who are working for the benefit of humanity, scientists are often pigeon holed into taking less pay, working more, etc because their work has no direct financial pay off and they must depend on third parties for funding.

Why did they live like this though? I thought everyone would be all for using science to better our world, thus leading to good lives for some of our world’s brightest minds. Nope. Science like everything else in this world is a complex and multifaceted realm. After reading both of Columbia’s Dr. Siddhartha Mukherjee’s works detailing the history of cancer and genetics, and existing in a science filled medium for the past 7 years here are some things I learned.

Science can be…

  • Highly politicized

  • Both under and overfunded

  • Motivated by profit

  • A guessing game

  • A matter of perspective rather than pure objectivity

Some of the most well-known scientists were...

  • Medical school drop outs/failures/ considered weak

  • Ridiculed by their peers for over 100 years

  • Skilled networkers and businessmen

  • Outspoken and confident

  • Fakers

In these next 5 stories I’ll showcase the bullets above and emphasize the necessity of using business, history and policy when rolling out/ creating new discoveries.

Quick Facts

Skip over these if you have an understanding of how science works but if not:

  • The first step is basic science – researching foundational principles in biology, chemistry and/or physics to understand a phenomenon, you need money to do this and are generally a part of a company or university if you’re doing this.

  • Second step is application, if it involves humans then you need to run clinical trials that require lots of money.

  • This comes from pharmaceutical companies, universities, foundations and/or the government.

  • Third: if it works government agencies have to approve it, then you or the people who funded you can patent it so other people don’t make the same thing.

  • Fourth: now it can be distributed at a certain price with certain restrictions.

Note: I’m over simplifying it for ease of comprehension –aka, why the government/ companies/ non-scientists have power & control.

From Egypt’s Queen to Life Giving Poison:

Are you guessing or do you know?

If a doctor just walks in, looks at you and diagnosis you – without checking your ears, temperature, breathing, etc. – be concerned. Be very, very concerned and probably don’t listen to him. The reason medicine has gotten so much better is not because our doctors have finally taken up their true forms of gods who know every detail of your bodily functions at one glance; rather, it is because the tests and devices we have to diagnose have gotten better along with our understanding of science and consequently disease. This is a fairly recent occurrence and until the past 200-300 years, science (aside from anatomy), in my opinion was a farce. A guessing game. Let’s take a look at cancer until the mid 1900s.

Egypt’s Queen

The earliest reported case of cancer was found by Edwin Smith, a self-made Egyptologist who questionably procured a 15-foot long papyrus that detailed a story from 2500 BC. In it, famed Egyptian physician Imhotep, details “a bulging mass in the breast” aka breast cancer, his solution? “There is none.” Great, thanks for not guessing.

2 millennium pass and we see Atossa, the daughter of Achamenid emperors who ruled in the Mediterranean region, develop a bleeding lump on her breast. She refuses to call any physicians and gets her Greek slave to cut off the tumor. Pretty brutal right? Except that’s kind of still how we treat cancer today... so it wasn’t that far off. Nice job for someone who doesn’t even know what a cell is, it can only go up from here, or not.

Black Biles

Although he died in 199AD Claudius Galen would leave his mark on medicine, through his prolific influence he brought Hippocrates humoral theory to its apex with his theory that black bile caused cancer. Galen stated that he had never seen anyone be cured of the removal of a tumor, so that method couldn’t be helpful. Given the lack of anesthesia and sanitation in these times, Galen might have actually given his patients more life by not subjecting them to surgery, but he was still wrong. However, thanks to his networks and fame his ideas kept on going for over a 1000 years, when a 19 year old student from Brussels Andreas Vesalius set out to prove Galen’s black bile at the University of Paris. He couldn’t find it, but he didn’t tell anybody because he was scared.

In 1793 Matthew Baille, published a textbook detailing the body in its diseased abnormal state. According to Galen, tumors should have been filled with black bile – but they weren’t. Finally, Galen was done. Thanks to Baille’s bold moves, and fearlessness medicine could finally progress.

Brutal Amputations

Great, now we could see that removing tumors would be helpful. By the mid 1880s surgery, armed with the inventions of antisepsis and anesthesia, could be used to treat cancer. Surgeons went at it and saw positive results, and so they thought “what if we get more aggressive?” Cue: Halstead, a name who is almost synonymous with radical surgery. A study done by English scientist Charles More demonstrated that cancer often relapsed around the edges of the excised tumor, leading one to think that it hadn’t been excised enough. With this in mind Halstead and his students began removing more and more of the body, determined to leave it empty if that meant the cancer was gone. Patients were completely disfigured, their entire chest muscles and lymph nodes removed, unable to stand up straight or even move their arms correctly anymore. Halstead would soon conduct his own experiments to realize that his operations were not foolproof. More surgery did not mean more survival. If a cancer was removable then it could be removed by a limited surgery – as is done today but if it wasn’t – if it had spread to the blood let’s say— all the surgery in the world wouldn’t do any good.

Luckily not all of Halstead’s disciples inherited his brutal destroy all attitude, some went on to pioneer innovative approaches that involved meticulously removing the cancer from the skin but not taking out all the muscles around it. However, these were not well received at all. Anything that wasn’t radical was thought of as weak and wrong. Well thanks for being weak and wrong Cushing – your technique for removing brain tumors keeps thousands alive today.

Chemotherapy: Killing you not so Softly

On March 29, 1896 Emil Grubbe began to bombard Rose Lee – a breast cancer patient- with X ray radiation and so began chemotherapy. The idea that we can kill cancer by finding that one thing that would just eliminate all of these rapidly dividing cells. In this hunt, once again, people took it to the extreme. If a little bit of poison got rid of a tumor, surely increasing the dosage would lead to even better results, right? This was exactly South African scientist Bezwoda’s thought when he created a “megadose” treatment of chemotherapy, showcasing results of 90% success rate. His name shot up to fame in the mid 1990s. But it was based on false data, he was in fact a faker. Unclear if it was his intention to deceive or not but science wasted years praising this before finally getting clear results back it was not the way.

Here we can see that progress in an area can be held up by fakers, by fear of ruining a great reputation and by lack of empirical data. Just because you have to right idea doesn’t mean you’re confident enough to pursue it, but you should be.

The Opposite of Peacocking: Gregor Mendel

Peacocking, here, means showing off. Perhaps you think a scientist is the smartest kid in the class, destined for greatness from the get go. Well maybe he is, or maybe he’s Gregor Mendel. You may remember his name from your grade-school genetics course.

Mendel failed his teaching exam in 1850, after 2 years of rigorously studying he returned to Vienna in 1853 to try one more time. Unfortunately his anxious temperament got the best of him, he fought with the proctor the first of the three day exam and did not even finish. The Augustine monk never tried again and instead went back home and began breeding peas, keeping special track of their traits and eventually crossing them to create hybrids. Mendel desperately tried to communicate his findings to the greater scientific world – but no one listened. He had demonstrated no socially admirable qualifications, not even managing to pass a teaching exam.

In 1900, over a decade after his death three different papers converged on his genetic principles. One having been clearly plagiarized. Lucky for Mendel, English scientist Bateson found and read Mendel’s original paper and made it his personal mission to ensure that Mendel’s work, idea and discovery become popularized. Without this strangely kindhearted individual, we might have never known about Mendel. There was no reason for Bateson to do it – he could have, just as the other 3 scientists did, try to pass of Mendel’s work as his own. But he didn’t. Buried for 44 years, Bateson gave life to Mendel’s work because it was the right thing to do.

Here we can see that Gregor Mendel having neither identifiably remarkable intelligence nor power in the intellectual community – still made his place in history as one of the founders of modern genetics, a household name in some houses at least. Persistence was key and of course a large share of good luck.

Eugenics, Hitler and The Soviets: History and Politics

If there’s a doubt in your mind that science is not intertwined with politics, recall that the Nazi and Soviet states were literally based on the fixity and pliability of the genetic self. Both states rejected mendelian genetics and Darwinian evolution and murdered/ tortured its proponents.

The word genocide has “gene” in it for good reason. “Never before in history had the concept of genetics been so closely acquainted with identity as in Nazi Germany.” Genetics was commonplace language and was consistently used to justify an increasingly hateful political agenda. The idea was that Jewish, handicap, gypsy, etc people were all genetically inferior, they could not overcome their genetic make-up and thus would forever be a weight on society, the only solution being to extinguish them.

The Soviets, however, took a similarly incorrect route and went to the other extreme that everything could be changed, given the right conditions and incentives –mainly torture. This was based on the very fake results of Lysenko who performed shock therapy on wheat strains on cold Siberian farms. By repeatedly exposing them to the cold he believed he was toughening them up, making them more resistant to it, creating heritable change. In an attempt to solve the widespread of famine the Soviets were facing in the 1930s Lysenko took over the Institute of Genetics to develop these super crops. Stalin however, took this concept and applied it to politics – creating a strategy of removing, brutally retraining and re-inserting political dissidents. Through shock therapy and other forms of torture, the Soviets believed they could retrain an individual to give up materialistic pleasures and devote themselves wholeheartedly to the Soviet State.

Faulty science was used to prop up two brutal regimes and the regimes themselves propped up this faulty science. Only with the defeat of Nazi Germany were its scientists able to escape and put their talent to good use in other countries. Further, the ultimate interplay between morality, culture and science can be seen in the complete loss of funding in Eugenics in the USA starting in 1939. Perhaps it wasn’t wrong to better humans, but the way the Nazi’s had done it was definitely wrong. Eugenics became tainted with the Nazi’s image and fell away from the funding and interests circles. However, over 70 years later designer babies are here now and some countries have already passed laws to know/choose eye color. We’re back into the realm of Eugenics and the discussions around it in this century will be far more important than they were before as they are actually backed by knowledge.

Farber, Nixon and Lasker: Connections for the Ages, Informed or Not

They say modesty is a virtue but in the case of Mendel if he had been a more outgoing businessman/networker/presenter perhaps he could have gotten a bit further during his own lifetime. An example of the benefits of combining business, science and policy can be seen in the great friendship of Sidney Farber and Mary Lasker.

A brilliant, Harvard trained doctor, Farber was often characterized as insufferable, arrogant and egotistical. Thus, while his passion for leukemia was unlimited, his budget was not and he was forced to tone down some of the most negative traits to make some friends.

I had a close friend who manage to float through 3 different Harvard labs with a good reputation at hand, how do you do it, I would ask him. “I’m likeable, personable I know how to explain things and how to coordinate people and that’s something that’s missing from a lot of people here,” truer words had never been spoken. A C-student, failed pre-med at a mid-level state school he had never experienced high level academic success, but he was an experienced doer. A different kind of scientist, he is well rewarded today and is exceptional all around. Unluckily for Farber, my friend wasn’t around then to help him out, but Bill Koster was.

Koster was the director of a new dining club, looking for a charity project to support and saw Farber’s obsessive focus on childhood leukemia. More than that, arrogant or not, Farber knew what he wanted and what he needed and he wasn’t afraid to say it, he wasn’t shy or awkward about it, and it worked. Together they launched the Jimmy Fund, advertised for in a commercial in which a young child meets a baseball star and a reporter says he has cancer (no specificity) and needed help. $231,000 rolled in. Just like a political campaign the Jimmy fund succeeded due to its use of icons, mascots, images, slogans and the strategies of advertising. Was Farber the best, smartest, most qualified person to receive all that money? We’ll never know. But he got it because of his outspokenness, confidence in himself and lucky business connections.

However, he would soon run out of funds once more. Cue: Mary Lasker. Originally born in Wisconsin, Mary graduated from, Harvard’s Radcliffe College and created mass produced professional clothes for women joining the workforce – she became an incredibly powerful businesswoman. In 1939 she met and married Albert Lasker the, then president of Lord & Taylor, and launched into even greater wealth, now turning her ambitions towards philanthropic causes. For personal reasons she focused on cancer. She started off her project by visiting the director of the American Society of the Control of Cancer. Lasker was appalled to find a small annual budget, lack of organization, lack of motivation and lack of anything really being done. She launched massive advertising campaigns quickly raising $300,000, bringing the organization to the public eye, deposing the former director and taking over the society itself. They created a high stakes, well-funded, visible, strategic machine set out to fight cancer. And did you hear any mention of anyone being scientists? Nope. Science needs money to fund it and business people know money, that morally ambiguous thing that people characterize you as a sell-out shark if you go into. But there’s a need from both sides. It’s a careful game though, as we’ll see in the next story. However, apart from business savviness, Lasker had ambition – she wanted to see Cancer on the public stage, with the White House as the end game.

Thanks to their clearly obsessive passions, Farber and Lasker had a beautiful friendship that landed them in the Nixon White House together. On December 9, 1969 a full page advertisement appeared in the Washington Post and would run in the NY Times on the 17th that started with “Mr. Nixon: You can cure cancer” and mentioned that “Dr. Sidney Farmer believed – ‘we are so close to a cure for cancer. We lack only the will and the kind of money and comprehensive planning that went into putting a man on the moon.” Brutally pointed ads such as this one were begging President Nixon for funding, making it bad publicity for him to deny.

Impulsive and fast-paced, President Richard Nixon was tired of the slowness of science, its ambiguous goals and its open- ended funding. Not particularly a man of science of himself, it was much easier for him to get behind science that the public wanted: public support = high approval ratings = better legacy + more time in office. All positives. Nixon changed the way science was managed from typical top tier University professors to more hardline bureaucratic managers that focused on fixed goals rather than discovery the endless mysteries of science. Nixon needed a win and so he poured millions into funding, his two goals were to end the war in Vietnam and the war with cancer. The former – something I’ll touch on in a shortly upcoming post and the latter made difficult by lack of mechanistic cancer knowledge.

From 1972-74 the administration released 1.2 billion dollars to fund the war on cancer. Mary Lasker was there, leading the charge, pulling her connections in the Senate, with donors and with scientists. But while you can swing politicians to vote your way and NY society to loosen their purse strings, you cannot force learning and innovation. Her crusade ended its full force in 1975, when science had done little to advance despite the tremendous funding, her friends in the senate retired and few saw reason to continue spending huge sums on research with such minimal results.

Lasker’s attempt to destroy cancer was premature. However, I still consider it one of the most legendary and beautiful interdisciplinary, collaborative efforts to eliminate one of humanities greatest plagues. This high force, strategic, business-like, networking and policy approach should be taken to really tackle problems we’re serious about solving in the near present; granted it would have been more effective if scientists – informed of the potential results and timelines – had taken the lead a bit more in setting expectations. While the initial discovery of the cure for cancer may start in the labs and be pioneered by scientists, in order to actually get it scaled up, through clinical trials and implemented around the world there is a need for those polished in the areas of business and policy to enter the arena.

Warning Breakthrough Discoveries May Cause Stomach Ulcers: Money Moves

Did you know hundreds of potentially life-saving drugs have been discovered and have been awaiting clinical trials for years, with no real shot of getting tested out in the real future? I definitely didn’t, and while solutions have been proposed (TED talk on investing for drug discovery) here we can take a look at why.

Science is slow and Ethically Charged

Science is an art, and like any art it is reliant on thousands of perfectly spinning pieces to work – one move in the wrong direction and you might have to start a 500 step procedure all over again. Rather than being the fast paced smoke and explosion experiments often showcased on TV, hard science research is generally people working 16+ hour days in complete silence, preforming repetitive tasks. There’s always something that can wrong and even if everything goes right and the experiment works you have try it again, and again, and again to make sure it actually works and you didn’t just get lucky. This is good in that it means that any drug that makes it to the clinical phase for humans has been tried over and over again, so the drug is worth trying out. After all if you’re willing to put a human life on the line it better be proven to have some sort of potential of having potential. But it’s not so good because it means you need a lot of time and resources. Today, you generally get those by working your way up the grueling ladder of academia into a University/ corporation/institution of prestige who will help you get that money.

Barry Marshall was born the son of a boilermaker and a nurse and studied at Perth. In 1979 gastroenterologist Robin Warren, set out to investigate gastritis. Together Marshall and Warren discovered H pylori, they tested it on pigs but analyzing them was difficult and no ulcers were discovered. Their experiments were progressing slower than expected, funding was running out and they didn’t have the needed results to procure more funds or to continue to humans. But they were convinced the bacteria had some tie to stomach cancer. So in July of 1984 Marshall drank a culture of the bacteria. Within a few days he was violently ill and several biopsies later revealed an ulcer filled stomach. They published a paper on it shortly after and began to work on the eradication of H pylori to prevent stomach cancer. Marshall died of stomach cancer due to this experiment.

Imagine that, he believed in his idea so much and money was so difficult to get his hands on that he literally died for it. His sacrifice and ballsy move are the reasons that millions of stomach cancer cases are shut down before they even start today. Ethics aside, that was an incredible move, thanks Marshall.

Making Drugs is a Business – Like it or Not

There’s a lot of controversy surrounding the pharmaceutical industry and many ways it can be improved/changed, so if you already know that, skip ahead. If you don’t, then let me just say that like any business market and profit margins matter when it comes to funding drugs –however it is also fair to say that to fund even one life saving drug millions of dollars are needed, so in order to keep that business going profit is important and no one else seems to be undertaking the monumental task of creating life-saving drugs. Thus a question that arises from this particular dilemma is: should I fund a drug for a disease that only affects 100,000 people in the world vs one that could save 100 million lives?

This was the situation that Druker faced when rolling out his program of CGP57148, commonly known as Gleevec, a targeted drug against CML leukemia. This was a drug that specifically and uniquely targeted cancer cells in the bone marrow by blocking a specific pathway and killed them. It worked remarkably well and Druker wanted money to roll it out world-wide. But, it wasn’t that simple. The pharmaceutical company that had funded his original research – Ciba Geigy— was merging with pharma giant Sandoz to create Novartis pharmaceuticals, with a net revenue of $50 billion in 2017. Novartis is a huge player in the pharma and drug discovery world. With a mountain of administrative and management duties piled up the newly funded Novartis had no interest in funding a clinical trial for a drug that they expected could cause little impact. Nonetheless, they finally relented and Gleevec worked. Yes, the number of people who develop this disorder is small. However, the impact that this made was huge. It changed the way people saw cancer treatment, it gave them hope that they could cure cancer, perhaps not through the one bullet for all approach but rather figuring out specific cures for each particular form of cancer. It was an incredibly transformative drug that changed the landscape of cancer completely and it almost wasn’t funded.

Over 200 Years to a Smoke Free World, For now at Least

In 1761 amateur scientist and apothecary John Hill of London published a pamphlet entitled Cautions against the Immoderate Use of Snuff. Here he argued that the use of tobacco was associated to lip, mouth and throat cancer, and no one really cared. But he was right. So why, in 1953 was the average American consuming 35 cigarettes a day?

It wasn’t because doctors didn’t try to investigate this. They did, but many were brushed off saying how can you prove that it’s the cause, if everyone does it? However, by the mid 1970s enough scientist had gotten on board to show through conclusive studies that smoking did cause cancer. Tobacco companies did not go down without a fight, funding their own corrupt studies to prove the that tobacco did not cause cancer and pouring millions into ads that minimized the cancer causing claims. Policy intervened and mandated graphic, public warning symbols on tobacco packages, the skill and strength of the anti-tobacco advertising shining. Of particular note in my memory, was this ad that ran about a decade with former smokers/current lung cancer victims on a parade car, singing with tubes out of their throats. These visual and audial attacks woke America up. And so tobacco moved on to the developing world and is currently ravaging lives there. However, it is coming back here. Tobacco is trying to make a come-back in the younger generations and has begun running ads in magazines with new, appealing images and words like “pure” and “organic.” Further, if you invest in bonds through your company make sure you take a close look at where those bonds are. One oncologist was not pleased to discover that most of hers were invested in the tobacco industry (full TED talk here).

The force that industry has on our health in this world is astonishing, and one does well to be aware of it. Only with knowledge can we truly take command of our own health and lives.

More about Perspective than Empiricism

Now we’ve learned all about how science is very complex and needs more than just super intelligent, awkward nerds and their all-consuming passion for revealing the secrets of the universe. It’s up to you to figure out how to interpret it. I think it’s a great thing because it means there’s plenty of room and ways to help, but it also may be disheartening because something so pure as science shouldn’t be so subject to the forces of money and politics. But that’s life.

Further, there’s so much left that we have to learn in this world and that’s an incredible thing –but once again that’s my perspective. Einstein once said that those who pursue science need to believe in God, because they need to believe that there is some sort of logic in this world, some sort of reason to why it exists because without this logical order then everyone’s just wasting their time trying to figure it out. Einstein believed that there was a God who created the world and then just left it for us to figure out. What a beautiful gift. Or not, depends on you really.

Now that you know all the ups and downs of science you have all the power in the world to learn more, do more or at least be well informed.

Thanks for the read and as always message me for any questions! Have a lot more stories like the ones above and definitely check out Dr. Mukherjee’s works.


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