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Biomedical Science Has Sold Its Soul

I always wanted to be a scientist. But I didn’t want to be a scientist so that I could ask questions and investigate answers; rather, I asked questions and investigated answers and so I became a scientist. Being a scientist is not a choice as much as it is a born identity. I think most scientists were born asking questions. It’s not something we learned. Family lore has it that my own first sentences demanded explanations of mysteries rather than more basic desires. “Mommy, why is that fire hot?” I asked. Knowing only the obvious, in this case that the fire was hot, was not enough. I wanted to know why. And so I became a scientist.

As a scientist, observations are not enough. Observations are just data – information with no context, random letters with no language. The scientist’s task is to interpret meaning from Nature’s maddening babble. We are not authors but linguists forever cracking the infinite, cryptic code of Nature’s lexicon. The reward we seek is dialog. What elation it is to feel as though we’ve conversed with Nature, if even just a few words, to receive a new primer that helps us towards curing a disease, fabricating an atomic-sized transistor, or discovering a new planet! Deciphering Nature’s meaning gives us meaning. This is why we ask “Why?”. This is why we are scientists.

Yet, only five years since earning my PhD in neuroscience and I already know more graduate school peers that have abandoned science than are currently doing science. Given the enormous commitment it takes to become a scientist, this is significant. After their PhD work some of my peers became real estate agents, patent consultants, bartenders, business and sales representatives, or are even unemployed or have decamped into obscurity. Now, I respect the choices people make regardless of their background and training. It takes a diverse workforce of interests and talents to make our complex economy function. And many of those who left science did so intently and gracefully to pursue something they thought would make them happier. That said, it’s unlikely that most of these scientists upon finally receiving their PhD and/or Masters after a lifetime of investment suddenly realized that they were not a scientist. We are born scientists, after all. We don’t discard that identity any more than we ask for it. On the contrary, I’d posit that it is science that decided it doesn’t want scientists. Therein lies a serious problem.

The institution of science, with Academia as its CEO, has abandoned scientists because this institution has abandoned scientific ideology. This is an ideology that defies belief in the name of reason, defies convention in the name of creativity, and defies pragmatism in the name of risk. Science is a culture of counter-culture. We have always been iconoclasts, skeptics – antagonists to dogma because we reason with creative deduction that observations and beliefs are often illusions. Consequently, the meaning discovered in Nature’s language is rarely palatable. It’s simply not easy for our corporeal human brain to accept that we are but a lonely blue marble spiraling through spacetime among a vacuumed sea of unanswered prayers. Naturally, this unforgiving reality litigated by scientific scripture has been the subject of persecution, sometimes even resulting in imprisonment and death to its disciples. But centuries of grit committed to learning and accepting nature’s language eventually transformed incredulity into trust as diseases were eradicated, industrialized energy was unlocked, and an ambitious new human agenda was realized. Such success built the academic institutions that stand to this day – the very institutions by which young scientists such as myself accepted the PhD torch with humility. But alas, the soul of science isn’t the skeleton of an ivory-boned institution; rather, the soul of science is an abstract institution of ideas that seeks the observable truth. From this truth, however ephemeral in our possession, we as scientists all contribute. And we all extract. This communion of ideas is the soul of science. But our modern day academic skeleton has no flesh to house a soul.

Perhaps the most nefarious pathogen infecting modern science is corporate ideology. Academia has become a business. Except here it is data, not dollars, that are bundled, hedged, and managed with the irresponsibility of an unregulated trading firm. The preferred product in this academic sector: positive results. Positive results – those data that support a hypothesis – have become the unfortunate gold standard in science assigning inflated value to institutions, investigators, publications, grants, and spin-off companies. Like any product, positive is “good” and negative is “bad”. And when Academia increasingly flirts with marketing itself as a product of good fortune through flashy new buildings, quixotic panacea initiatives, and fund-raising billboards and infomercials, then it doesn’t have time for the often drudgingly slow, sometimes discouraging process innate to quality science. Consequently, experimental results are groomed in favor of the desired outcome so that papers can be published, grants secured, tenure installed, and endowments retained. The product – the data – must remain “good” despite its actual integrity. Under this paradigm the goal of science research is more about preserving stock value and expanding operations rather than objectively testing hypotheses.

But unlike a product, data are neither good nor bad. They are simply observations. Negative data is just as revealing as positive data, as it tells us that our hypothesis is incorrect, incomplete, or simply statistically underpowered, and that readjustments may be needed to reach the truth. Unfortunately, our current paradigm ignores negative data as an aberration in protocol (“you’re doing it wrong”) or simply unmarketable (“that’ll never get published”). But those aren’t legitimate dispositions because we proudly created a self-governed system of peer review and self-critique, and so we’re choosing to accept these excuses at the expense of scientific integrity. For example, study sections at the National Institutes of Health (NIH), the largest public-funded reservoir for biomedical research, now expect much of the proposed work in a grant to be completed before the grant to do that work is even awarded; publications shove negative findings into “Supplemental Results” sections, if not out of the report entirely; and – perhaps most egregious – experiments are sometimes repeated only until the intended results are obtained. When such favoritism is placed on positive data then the focus shifts from testing a hypothesis to simply advertising one. The problem magnifies exponentially when others then build their own hypothesis based on these falsely advertised hypotheses, and now they too perpetuate false expectations based on previous expectations (“Because how could years of work in an entire field be wrong?!”). All the while the product, no matter its integrity, is advertised and sold to the consumers, who are ultimately the public. This is not scientific ideology. This is corporate ideology. There is no real exchange of currency, and no real investment – just a shell game of false promises and expectations. It fact, it looks a lot like a market bubble. And all bubbles eventually pop.

The evidence is mounting that science is experiencing a “market correction” through a dramatic, albeit alarming decline in public support for science. And this isn’t just reflected in ever-declining NIH funding (correcting for inflation). We live in a new age of vogue anti-intellectualism where scientists are no longer the heroes of my parents’ generation, but rather villainous conspirators plotting to swindle the public in pursuit of fame, power, and money (which sounds a lot like the current public opinion of Wall Street bankers). In an ironic twist of fate, scientists have become the spurious spiritual healers distrusted for their voodoo and ersatz prescriptions, whereas the local medicine man has regained the trust of the public placebo. Indeed, scientists are again facing persecution; we are refugees fleeing the indictments of a reigning mythological order that has no regard for facts. It’s downright inexcusable in 2016 that evolution and climate change are still debated (let alone dismissed in some cases), or that vaccines can be more feared than the return of deadly, once-eradicated diseases, or that fluoride is considered a “toxic chemical” poisoning our water supply. Furthermore, there seems to be a resurgent appeal of unproven homeopathic and “transcendent healing” approaches such as reiki, dietary “cleansing,” acupuncture, or nonsensical portmanteaus like “cryotherapy” that are used to treat conditions – some serious – that instead demand scientifically proven intervention. Admittedly, mysticism is a pill that has long been swallowed by human kind, and living in Portland, Oregon may skew my perception of the broader public’s acceptance of such nonsense, but there is undoubtedly a growing disregard for facts and science-based health care in America. The ramifications of this antediluvian mindset could be disastrous.

The responsibility for our brave new fact-free world lies mostly with us, the scientists. The scientific community increasingly sold its promises and cures like commodities until the public’s consumption became impossible with expectation. We promised too much too quickly and delivered too little too late, all the while cashing in on the public’s trust to make our ivory towers taller and wealthier. But science doesn’t cure diseases quickly, nor does it do so as a linear function of funding. The relationship between scientific output and funding has an efficiency asymptote that simply cannot be overcome with more buildings, more equipment, and more talent. Data integrity, skepticism, and patience are what ultimately deliver real scientific progress. Yet, these are the ingredients currently receiving little institutional investment. Instead, the institutional priority seems to be recruiting inordinate amounts of money by peddling impossible promises. But what happens when those promises fall short due to the innately slow pace of quality science? Well, they simply don’t fall short: “Of course progress is being made by our world-class team of experts and their state-of-the-art equipment! Just look at our positive results!” There’s simply too much money at stake to renege on the promises that recruited the money in the first place. Ultimately, the actual investment of Academia seems to be in showboating the icons of science – the science itself is secondary. But like in any committed relationship, a deceitful façade eventually collapses and the victim, in this case the public, leaves the relationship. And they’ll demand alimony.

The NIH is the quintessential public trust fund for biomedical research in the United States. Its mission is “to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability,” with a specific goal to “exemplify and promote the highest level of scientific integrity, public accountability, and social responsibility in the conduct of science”. This is not the language of a business plan. This is the language of a social service pact. It is our duty to apply our awarded public dollars with utmost respect towards the betterment of society through quality science. Any other appropriation is a breach of contract. As such, when the public feels betrayed they’ll pull out of the contract, which is what we’ve witnessed in NIH funding over the past decade. The resulting resource limitations in turn further increase internal biases towards positive data and false promises, which ultimately further disillusion the public towards even more resource limitations. This insatiable spiral feeds off itself until, as mentioned above, the goal of science becomes to simply preserve existences rather than to justify them. All the while, the older generation of scientists will continue to sequester more and more of the available funds because they’ve been around long enough to preserve their existence regardless of whether their ideas are still relevant. This leaves the younger scientists with little options but to conform to the corrupted conventions because that’s what gets published (which has become a hyper-inflated benchmark of “success” anyway), which preserves their nascent career, which reinforces further perpetuation of this voracious ouroboros. And in the meantime the independent-minded, creative scientists are marginalized because they inject too much risk into the system.

This is not how the institution of science should work. Science is foremost a creative endeavor that embraces risk to conjure cleaver solutions to problems. Conservatism, while certainly pragmatic as follow-up on initial big discoveries, is not inherently scientific. Nor is it inspiring. Being a scientist in a vapid, conservative business climate is not where we found inspiration to risk big ideas of how the human brain prescribes consciousness, or how dark energy accelerates the expansion of the Universe, or how Mr. Schrödinger’s cat is both dead and alive.

The risks required by science are not just abstract. We also take literal social and economic risks by choosing to be scientists. The educational investment from our pocket and the public’s (i.e. NIH training grants) is significant, as is the time investment. Many of us delay our lives, putting off marriage, children, home buying, and other significant milestones so that we can arduously lay the foundation for a science career. Moreover, we delay (if not surrender) the expectation of reasonable pay given the importance of what we do and the hours we work, all the while maintaining sight of an ever-narrowing career path ahead. Yet we do it. We do it because it’s who we are – because we can’t not do it. What a valuable workforce! There are few fields that could claim the committed workforce like that of science. Scientists pursued their line of work because they were inspired. Yet, I don’t hear that word in the lab much these days: “inspired”. If I do, it’s in jest as the conversation distills to cynicism, “Well, inspiration doesn’t get a grant anymore”. But it can.

Inspiration drove our young minds into the science fairs, then the books, then the lab benches, and eventually the ivory halls. Without inspiration, we are not scientists. We only have to take risks to employ it again. In fact, science is going need most the very people it’s currently marginalizing. These are the risk-takers that no longer recognize their robotic peers or mentors, nor feel invited to express their creative wonder and potentially ingenious ideas; these are the people with talents of art, communication, politics, humility, grit, and, of course, raw scientific prowess. I challenge senior investigators to rediscover the inspiration that once motivated them by rewarding at their next study section the creative risk crammed into an applicant’s Aim 3; I challenge administrators to look beyond a heavily curated CV to promote and hire minds that are also full of creative wonder and bold ideas; and I challenge students and postdocs to do that clever experiment you thought about during your bike ride or your late-night bar-bender simply because it inspires you.

We as scientists built Academia and so we can restore it. If we are currently relegated as mystics by popular culture then we must accept our responsibility to confront this difficult reality. We need to reclaim our identity by becoming scientific disciples. It is our duty to spread the word of The Truth – the observable, repeatable truth of science – and again make the public believers. This starts with rediscovering ourselves as scientists. We are proud of our academic system and it has been an enormous success for our species. But that can only continue if our peers truly behave like peers: like scientists, not business people. The only product we should be selling is the truth. Yes, the truth is often the hardest of hard sells, but that’s what gives it such value. This value is bigger than any one of us alone – bigger than a publication in Science, a federal R01 award, tenure, or our spin-off company. More than dollars, it was the value of the scientific process that purified water, eradicated diseases, put satellites in space, developed the internet, and – most importantly – inspired us as kids to risk our own investment in the bank of scientific discovery. Let’s take the risk to be inspired again. The science will follow.

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