What not to ask a veteran...
Always my favorite - beats "I'm with Stupid –>"
“The capacity to blunder slightly is the real marvel of DNA. Without this special attribute, we would still be anaerobic bacteria and there would be no music.”
The pedigree of human beings, Thomas wrote, probably traces to a single cell fertilized by a lightning bolt as the Earth was cooling. Fortunately, genetic “mistakes” — mutations — eventually made us. But they also have made illnesses. Almost all diseases arise from some combination of environmental exposures and genetic blunders in the working of DNA. Breast cancer is a family of genetic mutations.
The great secret of doctors, wrote Thomas — who was a physician, philosopher and head of Memorial Sloan-Kettering Cancer Center— “is that most things get better by themselves; most things, in fact, are better in the morning.” But many things require intelligent interventions — cures. So, to see the federal government at its best, and sequester-driven spending cuts at their worst, visit the 322 acres where 25,000 people work for the National Institutes of Health.
The pedigree of human beings, Thomas wrote, probably traces to a single cell fertilized by a lightning bolt as the Earth was cooling. Fortunately, genetic “mistakes” — mutations — eventually made us. But they also have made illnesses. Almost all diseases arise from some combination of environmental exposures and genetic blunders in the working of DNA. Breast cancer is a family of genetic mutations.
The great secret of doctors, wrote Thomas — who was a physician, philosopher and head of Memorial Sloan-Kettering Cancer Center— “is that most things get better by themselves; most things, in fact, are better in the morning.” But many things require intelligent interventions — cures. So, to see the federal government at its best, and sequester-driven spending cuts at their worst, visit the 322 acres where 25,000 people work for the National Institutes of Health.
This 60th anniversary of the Clinical
Center, the NIH’s beating heart, is inspiriting and depressing:
Public health is being enhanced — rapidly, yet unnecessarily slowly — byNIH-supported research here, and in
hundreds of institutions across the country, into new drugs, devices and
treatments. Yet much research proposed by extraordinarily talented physicians
and scientists cannot proceed because the required funding is prevented by
the intentional irrationality by which the sequester is
administered.
A2 percent reduction of federal spending
would be easily manageable. It has, however, been made deliberately dumb by
mandatory administrative rigidities intended to maximize pain in order to
weaken resistance to any spending restraint. Spending on basic medical research is being starved as
the river of agriculture subsidies rolls on.
For Francis Collins, being the NIH’s director is a
daily experience of exhilaration and dismay. In the past 40 years, he says, heart attacks and strokes have declined 60 percent and 70 percent,
respectively. Cancer deaths are down 15 percent in 15 years. An AIDS diagnosis is no longer a death sentence.
Researchers are on the trail of a universal flu vaccine, based on new
understandings of the influenza virus and the human immune system. Chemotherapy
was invented here — and it is being replaced by treatments developed here. Yet
the pace of public health advances, Collins says, is being slowed by the
sequester.
He entered federal service to oversee decoding of the human
genome, which he describes as “reading out the instruction book for human
beings.” We are, he says, at the dawn of the era of “precision medicine,” of
treatments personalized for patients’ genetic makeups.
This will be, Collins believes, “the century of biology.” Other
countries have “read our playbook,” seeing how biomedical research can reduce
health costs, produce jobs and enhance competitiveness. Meanwhile, America’s
great research universities award advanced degrees to young scientists from
abroad, and then irrational immigration policy compels them to leave and add
value to other countries. And now the sequester discourages and disperses
scientific talent.
In the private sector, where investors expect a quick turnaround,
it is difficult to find dollars for a 10-year program. The public sector,
however, with its different time horizon, can fund for the long term, thereby
drawing young scientists into career trajectories and collaborations impossible
elsewhere.
Collins is haunted by knowledge that the flow of scientific talent
cannot be turned on and off like a faucet. Unfortunately, recent government
behavior has damaged the cause of basic science. It has blurred the distinction
between fundamental research and technical refinements (often of 19th-century
technologies — faster trains, better batteries, longer-lasting light bulbs). It
has sown confusion about the difference between supporting scientific research
and practicing industrial policy with subsidies — often incompetently and
sometimes corruptly dispensed — for private corporations oriented to existing
markets rather than unimagined applications. And beginning with the
indiscriminate and ineffective2009 stimulus, government has incited
indiscriminate hostility to public spending.
NIH scientists seek intensely practical, meaning preventive and
therapeutic, things that can save society more than any sequester can. The
scientists also know, however, that the enchantment of science is in the phrase
“You never know.” You never know where things might lead. Sixty years ago,
James Watson and Francis Crick published a
paper in the journal Nature describing the double-helix
structure of DNA and noting almost laconically that it “suggests a possible
copying mechanism for the genetic material.” They could not have known that
this would lead to Collins’s career, which has led him here to days of dismay
about exhilarations postponed.
