Funding: to Harriman

Alexander Berezin berezin at MCMAIL.CIS.MCMASTER.CA
Sun Dec 24 14:42:43 EST 1995

(to make easier: single summarily reply)
Dear Gregory,

Reading word-by-word what you are saying, I can 
see a point in almost everything you say. Yes,
there are 'good' and 'productive' big labs.
(question still 'good' and 'productive' for
what ?). Yes, not all go there 'for money' (although 
I do know quite few young fellows, both genders, who 
recently dropped half-way their biomedical PhDs 
to go to, etc.

But being 'insider' of the biomedical research 
you may (slightly or strongly - I don't know)
overestimate what people outside of it think about 
the importance of it for the real progress and
improvement of medicine. You may be very enthusiastic
about how much molecular biology and genetic engineering
can do for cancer, Alzheimer, AIDS, or whatever. 

But people 'out there' not necessary see it this way.
What people see is that there is NO real progress on
cancer despite all the billions spend on it (try to argue 
overwise to a mother whose child just died of leukemia). 

What people see ON THE GROUND are largely broken promises. 
And yes, that's why people go (often in desparation) 
to 'faith healers' and other likes. And paradoxically,
more and more people see the MAINSTREAM medicine as a 
just a form of highly sophisticated quackery which really 
can't do too much. In short, its geting more and more
clear (like in my earlier example with undelivered 
thero-nucler fusion) that Big Biomedical Establishement 
simply does not delievr. I personally, very sorry to say you
this, but it seems to me rather unlikely that BBE can 
continue on the same gears for too much longer on the 
basis of promises.   
Alex Berezin

On 24 Dec 1995, Gregory R. Harriman wrote:

> In article
> <Pine.SOL.3.91.951223174106.29911A-100000 at mcmail.CIS.McMaster.CA>,
> berezin at MCMAIL.CIS.MCMASTER.CA (Alexander Berezin) wrote:
> > My ground-level demarcation criteria to tell if the area is
> > overfuned is to look at the employment and reward structure in it.
> > Take some scholarly areas where there is clearly very liitle money
> > (like, say, medieval history or paleonthology). People go to these
> > areas usually well aware of personal limitations and certainly
> > not to 'get rich'. They go thre because this is where their heart 
> > is. And scientists in these areas almost invariably do all the work 
> > themselves. 
> > 
> > Not so for Big Biomedical Research (BBR). Reward structure is
> > such that empire building, emplyment of cheap research labor and
> > grantsmansip is the primarily way of life. If you don't play it,
> > you are (almost always) kicked out. Why this all happen ?
> > Becasuse people are getting enough money to became sub-employers
> > and in many cases buy themselves out. So, its not the matter
> > of total budget ($ 11 billions, or whaeever) but the 
> > disrtibution and reward system which is in place.   
> > 
> > I don't deny that most medical resaerch requires technician(s).
> > However, anything beyond 1 technicain and 1 grad. student per
> > prof is almost invariably a sign of overfunding and LOSS (not
> > increase) of the efficiency. (personally, I know many examples). 
>      You appear to have such a limited knowledge of biomedical research,
> yet such strong biases against it, that it is difficult to carry on a
> meaninful discussion.  Are there a _few_ biomedical scientists with large
> labs and remarkable amounts of funding?  Yes.  Is this wrong?  No, not
> necessarily.  Many of them are successful because they have consistently
> demonstrated the ability to generate important, creative and valid ideas
> which they have proceeded to prove.  This advances our knowledge of
> medicine and has been to the benefit of society.  I don't see anything
> wrong with this.  When one analyzes your statements, your complaint simply
> seems to be they are too successful.  Sorry, but I don't buy the argument
> that just because someone is successful, rich, powerful or whatever, they
> are necessarily bad or evil.  Just to keep the record straight, I am
> definitely not one of these big, "fat cat" biomedical researchers.
>      Are there some people in research who have exploited the system or
> gotten there by means other than based on creativity, hard work, etc? 
> Undoubtedly!  I'm sure many of us could come up with the name of at least
> one person who falls into that category.  But, this flaw is not limited to
> biomedical research.  Similar individuals can be found in every area of
> research.  For that matter, there are always some individuals in any
> societal institution (university, business, government, medicine, you name
> it) who act unethically or illegally.  You don't have to condemn the whole
> institution (ie. biomedical research) just because there are a few bad
> apples.  What needs to be done is to ensure that adequate processes are in
> place to expose and deal with such people.
>      As an aside, I find it remarkable, given the fact that you are not a
> biomedical researcher, that you feel you have the necessary wisdom to
> decide how many technicians or grad students a professor doing biomedical
> research needs to carry on his/her research.
> > I am not saying this, although I do believe that many potentially
> > very bright minds which could be instrumental in solving many other
> > acute problems, are unnecessarily tied-up (usually for life-time)
> > in many dead-end BBR areas.
>      Your last statement is arguable, but even if you were right, isn't it
> their choice to make regarding what area of research they pursue?  Maybe
> they are doing it because they are fascinated by the research.  Even if
> they don't make a lot of money and don't get the Nobel prize, maybe they
> enjoy what they are doing.  If not, they can always change what they are
> doing.  You have a very paternalistic attitude about what you think is
> best for other people.  
>      Besides, who's to say what is a dead-end in biomedical research. 
> It's possible that if you were around in the 1950s, you would have looked
> at the people doing obscure research on bacterial enzymes that chop up DNA
> and pronounced that this is not "solving many other acute problems" in
> medicine.  Little would you (or anyone else at the time) have known that
> such research on restriction enzymes was instrumental in the development
> of the fields of molecular biology, molecular genetics and gene therapy. 
> You can't predict or dictate which research or discovery is going to be
> fundamentally important in the future.
> > What I am saying is that present funding structure makes BBR
> > much less efficent than if the budget be REDUCED by the factor
> > of several and there will be clear limitations imposed on the 
> > size of research groups and budget per researcher. Such Spartan 
> > measures will raise the total efficiency of BBR because:
> > 
> >  (1) it will be no longer a place to catch for the personal
> >  fortune and many people who should not be there at first 
> >  place will not enter the system. Only truly dedicated 
> >  enthusiasts will remain, same as in the science of the past.
> > 
> >  (2) people will largely work themselves, and this means
> >   more careful choice of priorities, more thinking and 
> >   much more personal creativity (you can't be too creative 
> >   having group of 10 people - all your creativity goes for
> >   grantsmanship).     
>      This is one of the most ridiculous statements (ie. 'no longer a place
> to catch for the personal fortune") I have ever heard!  Somehow you
> believe that because significant amounts of money are provided in
> biomedical research grants, that means it all goes into the pocket of the
> principal investigator.  Again, your lack of knowledge about biomedical
> research is profound, yet you feel compelled to make grandiose
> pronouncements about what is wrong with biomedical research.  The money in
> biomedical research grants goes to pay technician, grad student and
> post-doc salaries/stipends, lab suppplies, animal housing/maintenance
> costs and yes, the principal investigator's salary.  You might find it
> interesting to know that M.D.s who work in biomedical research at academic
> institutions could readily go out into private practice in the U.S. (even
> under managed care) and make a lot more $ than they do in academics.  It's
> certainly not the "personal fortune" that one gets in biomedical research
> that keeps us here.  It's because we enjoy doing research and exploring,
> discovering and advancing scientific knowledge. 
> Stuff deleted.
> > I would say, that "faith healing" or alternative therapies
> > have at least as good chances to succeed than BBR (perhaps,
> > likely better).
>      I'm not sure how to respond to this, except to say that I know you're
> not a biomedical researcher, but I was always under the impression you are
> a scientist.
> > >(HARRIMAN):
> > > 
> > >      While one may or may not agree that biomedical research has lived up
> > > to its promise (and I'd be happy to debate that with you), one can't
> > > rationally argue that success in biomedical research would ultimately be
> > > highly cost-effective and beneficial for society.
> > 
> > If you are prepred to broaden the base (e.g. including preventive
> > along with curative) and make the process researcher-centered
> > (rather than funding-centered), than our dialogue may indeed
> > show promiss of constructiveness.
>      I'm perfectly willing to broaden the discussion to include preventive
> medicine.  However, the discussion was never narrowed to begin with.  I
> previously discussed vaccines, which are by definition preventive
> medicine.  Here's another example.  Over the last year or so two genes
> BRCA1 and BRCA2 have been identified and cloned.  Mutations in these genes
> are responsible for 5-10% of all breast cancer in women.  In these
> instances the mutations are inherited and the female offspring will be at
> great risk of developing breast cancer as adults.  Breast cancer is one of
> the major cancers causing large numbers of deaths every year, and even
> 5-10% of this is a large number (I'm afraid I don't have the exact
> numbers).  Because these genes have now been discovered, we can screen
> people from families with a history of breast cancer.  If individuals are
> found to have inherited the mutated form of BRCA1 or BRCA2, their doctor
> will know they are at great risk for developing breast cancer. 
> Consequently, the person at risk can be followed very carefully, with
> exams and mammograms, in order to detect breast cancer at an early stage. 
> Some women might even want to consider prophylactic mastectomies if the
> risk is great enough, but that would be an individual choice.  So here's
> an example of how your "Big Biomedical Research" has done something which
> is advancing preventive medicine.  I can give you other examples if you
> are still having difficulty with this.
> Greg Harriman

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