Tuesday, July 6, 2010

Political Science! - The Politics of Medical Science and Research

The Politics of Science (Part 1)

The following last chapter in Robert O. Becker's book, The Body Electric" should give some insight into the politics of science. How and why some researchers and their research gets funded while others don't. Maybe, it will explain why many researchers in CFS continue to bark up the wrong tree and will not dare delve into truth of the matter - into the Big Lie - since this might very well cut their funding, ruin their reputations, and even end their careers. This has happened to many honorable and brilliant scientists such as Dr. Antione BeChamp, Dr. Livingston Wheller, Dr. Royal Rife, Dr. Gunther Enderlien, Dr. Duesburg, Dr. Robert Becker, Dr Nassens and finally Dr. Robert O. Young.

Postscript: Political Science

An important scientific innovation rarely makes its way by gradually winning over and converting its opponents: it rarely happens that Saul becomes Paul. What does happen is that its opponents gradually die out and that the growing generation is familiarized with the idea from the beginning.-Max PlanckDispassionate philosopher inquiring into nature from the sheer love of knowledge, single-minded alchemist puttering about a secluded basement in search of elixers to benefit all humanity - these ideals no longer fit for most scientists. Even the stereotype of Faust dreaming of demonic power is outdated, for most scientists today are overspecialized and anonymous - although science as a whole is somewhat Mephistophelian in its disregard or the effects of its knowledge. It's a ponderous beast, making enormous changes in the way we live but agonizingly slow to change its own habits and viewpoints when they become outmoded.

The public's conception of the scientist remains closest to its image of the philosopher - cold and logical, making decisions solely on the basis of facts, unswayed by emotion. The lay person's most common fear about scientists is that they lack human feelings. During my twenty-five years of research I've found this to be untrue yet no cause for confort. I've occasionally seen our species' nobler impulses among them, but I've also found that scientists as a group are at least as subject to human failings as people in other walks of life.It has been like this throughout the history of science. Many, perhaps even most, of its practitioners have been greedy, power-hungry, prestige-seeking, dogmatic, pompous asses, not above political chicanery and outright lying, cheating, and stealing. Examples abound right from the start. Sir Francis Bacon, who in 1620 formulated the experimental method on which all technical progress since then has been founded, not only forgot to mention his considerable debt to William Gilbert but apparently plagiarized some of his predecessor's work while publicly belittling it. In a similar way Emil Du Bois-Reymond based his own electrical theory of nerve impulse on Carlo Matteucci's work, then tried to ridicule his mentor and take full credit.

Many a genius has been destroyed by people of lesser talent defending the status quo. Ignaz Semmelweis, a Hungarian physician who practiced in Vienna during the mid-nineteenth century, demanded that his hospital colleagues and subordinates wash their hands, especially when moving from autopsies and sick wards to the charity childbirth ward he directed. When the incidence of puerperal fever and resultant death declined dramatically to well below that of the rich women's childbirth ward, proving the importance of cleanliness even before Pasteur, Semmelweis was fired and vilified. His livelihood gone, he committed suicide soon afterward.

The principle figure who for decades upheld the creed that dedifferentiation was impossible was Paul Weiss, who dominated biology saying the things his peers wanted to hear. Weiss was wrong, but along the way he managed to cut short a number of careers.

For many years the American Medical Association scorned the idea of vitamin-deficiency diseases and called teh EEG electronic quackery. Even today that august body contends that nutrition is basically irrelevant to health. As the late-eighteenth-century Italian experimenter Abbe Alberto Fortis observed in a letter chiding Spallanzani for his closed-minded stance on dowsing, "... derision will never help in the development of true knowledge."In the past, these character flaws couldn't wholly prevent the recognition of scientific truths. Both sides of a controversy would fight with equal vehemence, and the one with better evidence would usually win sooner or later. In the last four decades, however, changes in the structure of scientific institutions have produced a situation so heavily weighted in favor of the establishment that it impedes progress in healthcare and prevents truly new ideas from getting a fair hearing in almost all circumstances. The present system is in effect a dogmatic religion with a self-perpetuating priesthood dedicated only to preserving the current orthodoxies. The system awards the sycophant and punishes the visionary to a degree unparalleled in the four-hundred-year history of modern science.

This situation has come about because research is now so expensive that only governments and multinational corporations can pay for it. The funds are dispensed by agencies staffed and run by bureaucrats who aren't scientists themselves. As the system developed after World War 2, the question naturally arose as to how these scientifically ignorant officials were to choose among competing grant applications. The logical solution was to set up panels of scientists to evaluate requests in their fields and then advise the bureaucrats.

This method is based on the naive assumption that scientists really are more impartial than other people, so the result could have been predicted decades ago. In general, projects that propose a search for evidence in support of new ideas aren't funded. Most review committees approve nothing that would challenge the findings their members made when they were struggling young researchers who created the current theories, whereas projects which ponder to these elder egos receive lavish support. Eventually, those who play the game beome the new members of the peer group, and thus the system perpetuates itself. As Erwin Chargaff has remarked, "This continual turning off and on of the financial faucets produces Pavlovian effects," and most research becomes mere water treading aimed at getting paid rather than finding anything new. The intuitive "lunatic twinge," the urge to test a hunch, which is the source of all scientific breakthroughs, is systematically excluded.

There has even been a scientific study documenting how choices made by the peer review system depend almost entirely on whether the experts are sympathetic or hostile to the hypothesis being suggested. True to form, the National Academy of Sciences, which sponsored the investigation, suppressed its results for two years.

Membership on even a few review boards soon establishes one's status in the "old boys' club" and leads to other benefits. Manuscripts submitted to scientific journals are reviewed for validity in the same way as grant requests. And who is better qualified to judge an article than those same eminant experts with their laurels to guard? Publication is accepted as evidence that an experiment has some basic value, and without it the work sinks without a ripple. The circle is thus closed, and the revolutionary, from whose ideas all new scientific concepts come, is on the outside. Donald Goodwin, chairman of psychiatry at the University of kansas and an innovative researcher on alcoholism, has even put it in the form of exasperation: "If it's trivial, you can probably study it. If it's important, you probably can't."Another unforeseen abuse has arisen, which has lowered the quality of training in medical schools. As the peer review system developed, academic institutions saw a golden opportunity. If the government wanted all this research done, why shouldn't it help the schools with their overhead, such as housing, utilities, bookeeping and ultimately the salaries of the researchers, who were part of the faculty? The influx of money corroded academic values. The idea arose that the best teacher was the best researcher, and the best researcher was the one who pulled down the biggest grants. A medical school became primarily a kennel of researchers and only secondary a place to teach future physicians. To survive in academia, you have to get funded and then get published. The epidemic of fraudalent reports - and I believe only a small percentage of the actual fakery has been discovered - is eloquent testimony of the pressure to make a name in the lab.There remain today few places for those whose talents lie in teaching and clinical work. Many people who don't care about research are forced to do it anyway. As a result, medical journals and teaching staffs are both drowning in mediocrity.

Finally, we must add to these factors the buying of science by the military. To call it a form of prostitution is an insult to the oldest profession. Nearly two-thirds fo the 47-billion 1984 research budget was for military work, and in the field of bioelectricity the proportion was even higher. While military sponsors often allow more technical innovation than others, their employees must keep their mouths shut about environmental hazards and other moral issues that link science to the broader concerns of civilization. In the long run, even the growth of pure knowledge (if there is such a thing) can't flourish behind this chain link fence.

If someone does start a heretical project, there are several ways to limit this threat. Grants are limited, usually for a period of one or two years. Then the experimenter must reapply. Every application is a volumous document filled with fine-print forms and meaningless bureaucratic jargon, requiring many days of data compilation and "creative wriiting." Some researchers may simply get tired of them and quit. In any case, they must run the same gauntlet of peers each time. The simplest way to nip a challenge in the bud is to turn off the money or keep the reports out of major journals by means of anonymous value judgements from review committees. You can always find something wrong with a proposal or manuscript, no matter how well written or scientifically impeccable it may be.

Determined rebels use guerrilla tactics. There are so many funding agencies that the left hand often knoweth not what the right hand doeth. A proposal may get by an obscure panel whose members aren't yet aware of the danger. The snowstorms of paper churned out by the research establishment have required the founding of many new journals in each subspecialty. Some of these will accept papers that would automatically be rejected by the big ones. In addition, there's an art to writing a grant proposal that falls within accepted guidelines without specifying exactly what the researchers intend to do.

If these methods succeed in prolonging the apostasy, the establishment generally exerts pressure through the schools. Successful academics are almost always true believers who are happy to curry favor by helping to deny tenure to "questionable" investigators or by harassing them in a number of ways. For example, in 1950 Gordon A. Atwater was fired as chairman of the American Museum of Natural History astronomy department and curator of the Hayden Planetarium for publicly suggesting that Immanuel Velikovsky's ideas should receive a fair hearing. That same year Velikovsky's first book, Worlds in Collision, was renounced by his publisher (MacMillan) even though it was a best seller, because a group of influential astronomers led by Harvard's Harlow Shapley threatened to boycott the textbook department that accounted for two thirds of the company's sales. No matter what one may think of Velikovsky's conclusions, that kind of backstairs persuasion is not science.As the conflict escalates, the muzzled freethinker often goes directly to the public to spread the pernicious doctrines. At this point, the gloves come off. Already a lightning rod for the wrath of the Olympian peers, the would-be Prometheus writhes under attacks on his or her honesty, scientific competence, and personal habits. The pigeons of Zeus cover the new ideas with their droppings and conduct rigged experiments to disprove them. In extreme cases, government agencies staffed and advised by the establishment begin legal harrassment, such as the trial and imprisonment that ended the career and life of Wilhelm Reich.

Sometime during or after the battle, it generally becomes obvious that the iconoclast was right. The counterattack then shifts toward historical revision. Establishment members publish papers claiming the new ideas for themselves and omitting all references to the true originator. The heretic's name is remembered only in connection with a condescending catchphrase, while his or her own research programs, if any remain, are defunded and the staff dispersed. The facts of the case eventually emerge, but only at an immense toll on the innovator's time and energy. To those who haven't tried to run a lab, these may seem like harsh words, unbelievable, even paranoid. Nevertheless, these tactics are commonplace, and I've had personal experience with each and every one of them.

I got a taste of the real world in my very first foray into research. After World War 2, I continued my education on the GI Bill, but those benefits expired in 1947. I'd just married a fellow student named Lilian, who had caught my eye during our first orientation lecture, and I needed a summer job to help pay expenses and set up housekeeping. I was lucky enough to get work as a lab assistant in the NYU School of Medicine's surgical research department.I worked with Co Tui, who was evaluating a recently published method for separating individual amino acids from proteins as a step toward concentrating foods for shipment to the starving. Dr. Cok, a tiny man whose black, spiky hair seemed to broadcast enthusiasm, inspired me enormously. He was a brilliant researcher and a good friend. With him I helped develop the assay technique and began to use it to study changes in body proteins after surgery.

I was writing my first scientific paper when I walked to work one morning and found our laboratory on the sidewalk - all our equipment, notes, and materials in a junk pile. I was told neither of us worked there anymore; we were welcome to salvage anything we wanted from the heap.

The head secretary told me what happened. This was during a big fund drive to build the present NYU Medical Center. One of the society surgeons had lined up a million-dollar donation from one of his patients and would see that it got into the fund, if he could choose a new professor of experimental surgery - now. As fast as that, Co Tui and his people were out. I vowed to Lilian: "Whatever i do in medicine, I'm going to stay out of research."I'm happy that I wasn't able to keep my promise. The research itself was worth it all. Moreover, I don't want to give the impression that I and my associates were alone against the world. Just when hope seemed lost, there was always a crucial person, like Carlyle Jacobson or the research director's secretary to help us out. However, right from my first proposal to measure the current of injury in salamanders, I found that research would mean a constant battle, and not only with administrators.Before I began, I had to solve a technical problems with the electrodes. Even two wires of the same metal had little chemical differences, which gave rise to small electrical currents that could be misinterpreted as coming from the animal.

Also, the slightest pressure on the animal's skin produced currents. No one understood why, but there they were. I found descriptions in the older literature of silver electrodes with a layer of silver chloride applied to them, which were reported to obviate the false interelectrode currents. I made some, tested them, and then fitted them with a short length of soft cotton wick, which got rid of the pressure artifact. When I wrote up my results, I briefly described the electrodes. Afterward I received a call from a prominent neurophysiologist who wanted to visit the lab. "Very nice," I thought. "Here's some recognition already." He was particularly interested in how the electrodes were made and used. Some months later, dammed if I didn't find a paper by my visitor in one of the high-class journals, describing this new and excellent electrode he'd devised for measuring direct-current potentials.

A couple of years later, while Charlie Bachman and I were looking for the PN junction diode in bone, I was asked to give a talk on bone electronics at a meeting in New York City. The audience included engineers, physicists, physicians, and biologists. It was hard to talk to such a diverse group. The engineers and physicists knew all about the electronics but nothing about bone, the biologists knew all about the bone but nothing about electronics, and the physicians were only interested in therapeutic applications. At any rate, I reviewed some bone structure for the physicists and some electronics for the biologists, and then went on to describe my experiments with Andy Bassett on bone piezoelectricity.

I probably should have sat down at that point, but I thought it would be nice to talk about our present work. The rectifier concept was tremendously exciting to me, and I thought wwe might get some useful suggestions from the audience, so I described the experiments showing that collagen and apatite were semiconductors, and discussed the implications. After each talk, a short time was set aside for questions and comments, generally polite and dignified. However, as soon as I finished, a well-known orthopedic researcher literally ran up to the audience microphone and blurted out, "I have never heard such a collection of inadequate data and misconceptions. It is an insult to this audience. Dr. Becker has not presented satisfactory evidence for any semiconducting property in bone. The best that can be said is that this material may be a semi-insulator."

Semiconductors are so named because their properties place them between conductors and insulators, so you could very well call them semi-insulators; the meaning would be the same. My opponent was playing a crude game. Where saying these derogatory things about me, he was actually agreeing with my conclusion, merely using a different term.This man's antagonism had begun a couple of years before. When Andy Bassett and I had finished our work on the piezoelectric effect in bone, we wrote it up, submitted it to a scientific journal, and got it accepted. Unbeknownst to us, this fellow had been working on the same thing, but hadn't gotten as far in his experiments as we. Somehow he learned of our work and its impending publication. He called Andy, asking us to delay our report until he was ready to publish his own data. Andy called me to talk it over. What counts in the scientific literature is priority; he was asking us to surrender it. There was no ethical basis for his request, and I would never have thought of asking him to delay had the situation been reversed. I said, "Not on your life." Our paper was published, and we'd acquired a "friend" for life.

Now there he was at the microphone trying to scuttle my presentation with a little ambiguous double-talk. I thought, "He must be doing the same work as we are again. If he wins this encounter, I'll have trouble getting my data published, and he'll have a clear field for his." Instead of defending the data, I explained that semi-insulator and semiconductor were one and the same. I said I was surprised he didn't know that, but appreciated his approval of my data! Someone else in the audience stood up in support of my position, and the crisis was past. The lab isn't the only place a scientist has to stay alert.In 1964, soon after the National Institutes of Health approved the grant for our continuing work on bone, I received the VA's William S. Middleton Award for outstanding research. That's a funny story in itself. The award is given by the VA's Central Office (VACO), whose members had already decided on me, but candidates must be nominated by regional officers, and the local powers were determined I shouldn't get it. Eventually, VACO had to order them to nominate me.

The award put me on a salary from Washington instead of Syracuse, and due to the pressure from VACO I was soon designated the local chief of research, replacing the man who signed all the papers at once. I was determined to put the reseach house in order, and I instituted a number of reforms, such as public disclosure of the funding allocations, and productivity requirements, no matter how prominent an investigator might be. Many of the reforms have been adopted throughout the VA system. They didn't make me popular, however. Over the next several years there was continuous pressure from the medical school to allocate VA research funds for people I felt were of little value to the VA program itself; thus the money would have constituted a grant to the school. I knew that if I didn't deliver I would eventually be removed from my position as chief of research. In that case, I would go back on a local clinical salary and my research program would again be in jeopardy. Therefore, at the beginning of 1972 I applied for the position of medical investigator in the VA research system, a post in which I would be able to devote up to three fourths of my time to research. I was accepted. The job was to begin a few months later; in the meantime I continued as chief of research.

Apparently, my new appointment escaped the notice of my local opponents. I'd accepted several invitations to speak at universities in the South and combined them all into a week's trip. I left the office a day early to prepare my materials and pack. While I was still home, my secretary called. She was crying, and said she'd just gotten a memo firing me as chief or research and putting me to work as a general-duty medical officer in the admitting office. This not only would have closed our lab, but also would have kept me from practicing orthopedic surgery.

It was a nice maneuver but, fortunately for me, it wasn't legal. As medical investigator, I could be fired only by Washington, and the local chief of staff soon got a letter from VACO ordering him to reinstate me. Soon I began to get on some "enemies lists" at the natinal level too. In December 1974 I got word that our basic NIH grant (the one on bone) hadn't been renewed. No reasons were given. This was highly irregular, since applicants normally got the "pink sheets" with at least the primary reviewer's comments, so they could find out what they'd done wrong. Instead I was told I could write to the executive secretary for a "summary" of the deliberations.

The summary was half a page of double-spaced typing. It said my proposal had been lacking in clarity and direction, and that the experimental procedures hadn't been spelled out in enough detail. The main problem seemed to be that I was planning to do more than the reviewer thought I could do with the money I was requesting. In addition, my report on the perineural cell research with Bruce Baker was criticized as "data poor." The statement concluded: "On the other hand, there are some areas which appear to be worthy of support and are reasonably well described, e.g., bone growth studies, regenerative growth, and electrical field effects."

I was, to say the least, puzzled. The subjects "worthy of support" were precisely the main ones we were working on. It didn't make any sense until I reflected that this was just after I'd helped write the first Sanguine report and had begun to testify about power line dangers before the New York Public Service Commission. Perhaps the Navy was pressuring the NIH to shut me up.If someone at the federal level was trying to lock me out as early as 1974, he forgot to watch all the entrances, for my proposal of that year on acupuncture was approved. I'd originally tacked this on to the main NIH application, where is was criticized as inappropriate. I merely sent it off to a different study section, which funded it. After a year we had the positive results described in Chapter 13, and I presented them at an NIH acupuncture conference in Bethesda, Maryland. Ours was the only study going at the problem from a strictly scientific point of view, that is, proceeding from a testible hypothesis, as opposed to the empirical approach of actually putting the needles in and trying to decide if they worked. To the NIH's basic question - is the system of points and lines real? - our program was the only one giving an unequivocal answer: yes.

Nevertheless, when the grant came up for approval in 1976, it, too, was cut off. The stated reasons were that we hadn't published enough and that the electrical system that we found didn't have any relation to acupuncture. The first was obviously untrue - we'd published three papers, had two more in press, and had submitted six others - and the second was obvious pettifogging. How could anyone know what was related to acupuncture before the research had been done? I happened to know the chairman of the NIH acupuncture study section, so I wrote him a letter. He said he was surprised, because the group itself had been pleased with our report. By then it was obvious that something was up.As of October 1976 we would have no more NIH support. As the money dwindled, we juggled budgets and shaved expensese to cover out costs, and with the help of Dave Murray, who was now chairman of the orthopedic surgery department at the medical school, we kept the laboratory intact and enormously productive. We actually published more research than when we hadn't been under fire.Early in that same year, however, my appointment as medical investigator had expired, and I had to reapply. Word came back that my application had been "deferred," that is, it had been rejected, but I had the option of reapplying immediately. In her accompanying letter, the director of the VA's Medical Research Service wrote, "While your past record and strong letters of support [the peer reveiws of my application] were considered favorable, the broad research proposal with sketchy detail of technique and methodology was not considered approvable." Now, the instructions for medical investigator applications clearly stated that I was to spell out past accomplishments and indicate future directions only in broad outline. Instead, the director was applying the criteria for first-time grant applications just entering research. She invited me to resubmit the proposal in the other format. But that would not have helped. Even if the second application was approved, the money would arrive six months after the lab had been closed and we had gone our separate ways.

There was another strange thing about the rejection. By that time all federal granting agencies had to provide the actual reports (with names deleted) of the peers who had done the reviewing. Three out of the four were long, detailed, well-thought-out documents in the standard critique format; they'd been neatly retyped, single spaced, on "reviewers's report" forms with an elite typewriter. One was absolutely lavish in its praise, saying that the VA was fortunate to have me and that the proposed work would undoubtedly make great contributions to medicine. Another was almost as laudatory.One name had inadvertently been left on one page of the third review. It was the name of a prominent orthopedic researcher with whom I had disagreed for years about commercialization of bone-healing devices. Since our mutual disregard was well known in the orthopedic service, I feel it was indefensible for the director to ask him to review my application in the first place. Perhaps she expected a more damaging critique from him. He did complain that the proposal was insufficiently detailed. However, his appraisal was quite fair and even said my proposed work was of "fundamental importance to the field of growth and healing." It obviously led up to a recommendation for approval, but the last sentence of that paragraph had been deleted.The last review was half a page of vague objections, typed double-spaced on a pica machine with no semblance of the standard format. There was a revealing mistake ("corrective" tissue instead of connective tissue) that showed the writer had glanced at my proposal for cues but really didn't know what it was about. Strangest of all was the phrasing of this pseudoreview: "[Becker's proposal] is broad and sweeping in scope and contains little documentation for technique and methodology. However, in view of his past record and strong letters of support, a decision should be deferred..." The director had used it almost word for word in her letter.

She certainly had no motive for such conduct herself. I'd met her briefly a few years before. In 1966 she'd been appointed chief of research at the Buffalo VA Medical Center and had visited Syracuse to see how I'd organized the program there. Our conversation was pleasant but quite innocuous....

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