GUEST

EBB TIDE IN MEDICAL RESEARCH'

EDITORIAL

The academic physician has always struggled to find
a balance between the pursuit of scientific research and
his devotion to social needs. Today the pressures that
drive him from the traditional disciplines of research
to urgent medical problems in society seem overwhelm-
ing. This issue should be examined with as much per-
spective and reason as we can muster.
The practice of science in medicine has undergone its
most extensive development during the past two dec-
ades. These changes, virtually revolutionary in their
proportions, have not been in the nature of medical re-
search but rather in the scale of its support. This dis-
tinction is the point on which I want to dwell.
Goals and attitudes in research in the physical or
medical sciences have not changed in a fundamental
way for hundreds of years. The essence of the scientific
culture remains a stepwise extension of previous in-
vestigations. The process, seen with any perspective,
always moves forward. Science is thus unique among
human endeavors in the polarity of its overall move-
ment which we call progress. The flow of science thus
resembles the movement of rivers. Rivers have a fixed
direction and continuity as they flow down to the sea.
Like rivers, the pace and dimensions of scientific
movement vary enormously. But shallow or deep, broad
or narrow, sluggish or swift, the movement is inexorably
forward.
There may be eddies in science as in rivers; and
there may even be apparent reversals of direction. In
recent memory, Lysenkoism stifled Soviet genetics and
molecular biology for a whole generation, but eventual-
ly, even this death grip was released. Neither a tyrant
nor an organized group can long withstand the de-
termination of men to explore and to describe their
observations to one another. The facts of nature
emerge from our probings and cannot be denied. What
is so startling, as Einstein once observed, is that man
can fathom so much of the intricacies of nature.
In contrast to the forward movement of science, the
support of science by society has no direction. Through-
out history this support has risen and fallen. The atti-
tude of society toward science does not resemble a
river but rather the movement of tides. In our genera-
tion we have seen a strong high tide which now is be-
ginning to ebb.
In the nineteen thirties, the practice of science in
medical schools was barely tolerated. There were few

1. Based on remarks made at the Markle Scholars' meeting,

September, 1970.

52

jobs and even fewer resources. In only a handful of
schools was there a firm commitment to research. There
were no research grants, no training programs. All of
this changed in the fifties. Research became fashionable
in medical institutions. Everyone was encouraged,
even urged to do research. The federal support of medi-
cal science training and research eventually exceeded
a billion dollars annually. The tide was rising.
What brought about this phenomenal post-war sup-
port of science? The influence of personalities and
political and economic factors is difficult for me to eval-
uate. But of one thing I am sure. This expansion of
science supported by tax dollars, industry, and private
philanthropy was not due to the persuasive efforts of
scientists. Far from it.
Some scientists objected to this new scale of support
of science almost from the outset. They argued that
men with talent and motivation would do research
under any circumstances. A few petri plates, test tubes
and home-built apparatus were all that one needed
to make important discoveries. This rising tide of sup-
port would populate science with mediocre people
and inundate the literature with trivial data.

On the contrary, the results of the massive support
of science in the United States during the past twenty
years have exceeded even the most optimistic predic-
tions. Technology advanced far beyond our expecta-
tions. No one imagined that we would acquire so quick-
ly the firm grasp we have today of the basic designs
of cellular chemistry and its regulation. The nature of
heredity, clouded in abstract language only twenty years
ago, can now be described in the simplest chemical
terms. In the next twenty years the chemistry of genes
will become more precise, varied and extensive. Ge-
netic therapy is no longer science fiction. Attempts are
underway to cure children of a fatal inborn error of
metabolism. The missing gene is being administered
with a harmless virus as the vehicle. Difficult problems
of viral and degenerative disease will soon be solved.
I believe that we could, by enlarging the scale of our
studies of the chemistry of man, begin to understand
many aspects of human behavior as well.
Despite the spectacular success of this scientific ef-
fort, there is now an increasing retrenchment of sup-
port for research and training of scientists. I never
expected this reversal of support. What I had failed
to anticipate, too, was that public apathy or hostility
to science would be evident so quickly among scientists
themselves. It has become painfully clear to me that

the PHAROS, January 1971

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Ebb Tide in Medical Research

        (Continued from page 52)
the attitude of most scientists toward the support of
science simply reflects that of the society around them.

Let me summarize. Science is extraordinary but
scientists are not. Science enables ordinary men to ex-
press their creative talents in a global and purposeful
way. Their humble probing, so picayune individually,
combine to exert irresistible forces in exposing the
grand designs of nature. Scientists for the most part
have no deep dedication to the culture of science. They
shift quickly to areas of science that have public ap-
probation or away from science entirely when the
pressure becomes too strong.
But science is very important to society. The esthetic
value of understanding nature, including the basic fab-

ric of man, justifies an even greater support of science.
Among the tangible benefits are improvements in the
quality of human life by control of the old diseases
and an ominous new one, overfertility.
The support of science is too important to be left to
scientists. Few of them have the insight or the talent
to interpret science for society. We need men who have
this perception, and skill in persuading people. There
must be a few among the large numbers of men who
market cars, cigars and whiskey who can and would
turn their talents to advertising a more wholesome
product, the pursuit of science. This country supports
many billion-dollar industries. Surely medical research
deserves to be among them.

ARTHUR KORNBERG, M.D.
Department of Biochemistry
Stanford University

54 tiic PHAROS, January 1971