Neurochemistry: Then and Now
C.F.B.: The last speaker for this Oral History session was to have been John Blass, His assignment was to trace the impact of social, economic and political changes of the past 30+ years upon the research environment for the Neurosciences and Neurochemistry in particular. Unfortunately John was called away from the meeting to take care of an administrative emergency at Burke Hospital. At the time, I briefly summarize a few of his thoughts. However, his contribution entitled "Neurochemistry: Then and Now" is included here in its entirety, just as if it had been presented verbally at the session.
Neurochemistry: Then and Now - John P. Blass
Claude asked for my thoughts on how the actual practice of Neurochemistry has changed since I started slicing brains in 1956. From my viewpoint, the most important change is that I am forty-five years older. Three other differences are likely to be of more general interest: the increase in the amount of information available; the greater prestige of being a scientist; and the increased economic importance of knowledge including that of neurochemistry. A priggish coda at the end of this article emphasizes that the practice of science must look immaculate to the wider public, to avoid unfortunate constraints on how we practice our profession.
1. The Amount of information Available. The amount of information available about the molecular make up of the nervous system has increased amazingly since I was a student. The accelerating rate at which new knowledge is being generated is even more amazing. Reference books are now often out of date by the time they are printed. For up to date data, most of us now go on line to continually revised computer repositories.
When I started graduate school in 1958, one could still hope to keep up with most of neurochemistry. Nowadays that goal would be laughable. One still hopes to keep up with one's own and closely related areas, but knowledge of the rest of neurochemistry is necessarily superficial compared to what we thought we could do forty years ago. Collaborations have become increasingly important, both to efficiently incorporate powerful new methods into one's own work and to avoid rediscovering the wheel.
There is, however, nothing new about feeling overwhelmed by the amount of information available. The first line of the Latin translation of the Hippocratic writings is, "Ars longa, vita brevis," ie. the art is long and life is short. The Hippocratic writings are thought to have been written about a half millenium before the birth of Jesus. My guess is that one could find similar expressions of scholarly woe in the ancient biomedical writings of Egypt, China, and the Indus Valley civilization.
2. The MD-PhD Rivalry. When 1 was a student and for a couple of decades thereafter, there was a common belief among scientists that society denied PhDs advantages given to MDs including MDs in full-time research. Prominent among those advantages were higher salaries. The PhD-MD wars that resulted are now clearly out of date. Some MDs still make outsized incomes, notably some surgical Sub-specialists, but it is not clear how much longer our society will let the sun shine on their making that particular kind of hay. The big bucks are now associated with scientific inventions and the founding of companies. Think Hewlett-Packard. I live in a suburb of New York that is largely a dormitory for the financial district. At local cocktail parties, my neighbors are much more interested in questioning scientists about "hot new findings" than they are in hearing practicing physicians go on about how hard and bureaucratized the noble practice of medicine has become. What my neighbors want to hear from me is whether any company is close to bringing a good new medication for Alzheimer's Disease to the market, not how my colleagues and I care for demented patients. My PhD impresses them much more than my MD.
3. The Economic Importance of Biology and Neurochemistry. When I was a graduate student, biology in general and neurochemistry in particular were not particularly important to the larger economy. My college course in Economics taught that the three critical components of an economy were capital, labor and land. Nowadays, knowledge is clearly the important factor supporting a developed economy. Places like Singapore and Denmark prove that resources in the heads of the people are more important economically than resources in the ground. Modern universities are, in addition to their educational functions, among the most important generators of the high added value activities that keep a modern economy prosperous. In dollars, educational activities now often account for only a minority of the activities of a major university - a so-called "multiversity." Neurobiology including neurochemistry is an important area of modern knowledge, as the many members of the A.S.N. who work in industry or consult for industry demonstrate. We neurochemists have become important to the society as well as to ourselves. That brings other changes in its wake, some good and some not.
The good changes include that we are better paid, even without founders' shares. When I entered graduate school, one expected that as a professor one would drive a little old car and put patches on the sleeves of one's sweaters. We looked forward to a cultured life relatively untrammeled by materialism in part because we expected to have relatively little. Academic salaries are no longer punitively low compared to plumbers or electricians. Another good change, discussed above, is that pure science is more respected by the general public. Investors enamored of high tech do not sneer at the ivory tower. Yet another good change is the increase in the number of dollars with which the larger society now supports our efforts. I submit that Neurochemistry is a Good Thing and more Neurochemistry an even Better Thing.
Another change is that the old boy system is being replaced by a more open, transparent, and egalitarian system. There are more committees, more forms, and more participation in decision-making by women and ethnic minorities. These differences parallel changes in the larger society. In my experience, however, the old boy system that co-opted me also emphasized the duty of older scholars to mentor able younger scientists, independent of sex or race. I can not imaging telling Henry McIlwain or Dan Steinberg that I had refused a graduate student because she was a woman or was not white. I do not want to imagine what either one would have said to me. The new system certainly appears more transparent than the old system and has more obvious procedural safeguards. My subjective impression is, however, that it may now take longer to pull a rotten apple out of the barrel, and it is harder to keep it out.
Changes that appear to be bad or less than good. Our increased economic importance inevitably has drawbacks. The Lancet once published translations of academic medical speech into English. "It is a matter of principle" translated to "Money is involved." "It is a matter of fundamental principle" translated to "A large sum of money is involved." When I was a graduate student, I believed - perhaps naively - that scholarly considerations trumped financial ones in my chosen profession. Nowadays, in moments dank and grim, I wonder.Types of scientific opportunism that were previously sanctioned, can now be openly rewarded. For instance, I recently attended a meeting where a scientist who raises lots of grant money proudly described a phone call from the editor of a prominent journal. The editor said, roughly, "Our journal is going to publish three short papers in an area I know you've been working on. Why don't you send me a paper as well, so that we can publish all four together?" The reaction of most of the audience to that story was (more or less), "Wow! What clout he [the speaker] has!" My reaction, reflecting my age and training, was not positive. I had been taught that such gamesmanship had no place in science. About 20 years ago, a professor in a prominent American medical school was voted out of his chairmanship and his endowed professorship by the University Senate because one of his post-doctoral fellows had held a paper in review until he and the professor could submit their paper on the same topic. My indoctrination when I was a student was that it would cost a joumal editor his job to be caught making the kind of telephone call described above, just as it would have cost a nineteenth century Englishman his club memberships to be caught cheating at cards. Perhaps I am romanticizing about how science really worked when I was young. That may fit with myother gilded memories of my youth, when I remember the sun being warmer, beer tasting better, and women wearing more flattering fashions. But, there has also been a real change. People today do not even bow in the direction of the ethical standards I was taught.
Another unfortunate consequence of the current focus on the "bottom line" is the way universities now treat junior faculty. The university medical centers with which I am familiar now insist that junior faculty generate money, normally NIH grant money, usually including money for their salaries. That requirement is enforced with draconian zeal. A Nobel laureate has expressed the present day principle succinctly. "A university medical school is a place where scientists raise grant money to rent space in which to practice their profession." Today, many administrators act as if the real reason medical schools hire faculty is to generate indirect funds.
A Priggish Coda. The two professions I've practiced in my life are physician and scientist. The changes society has imposed on physicians can be an object lesson for scientists including neurochemists. If the American people stop trusting us scientists, our working lives may be made miserable. Fifty or sixty years ago, American society trusted the medical profession and left the control Of the medical enterprise largely to doctors. Society recognized then, as now, that no one else really understands medicine. However, society has significantly taken the control of medicine away from doctors, because of a wide-spread belief that we MDs cannot be trusted with running our own business.(*) Today, American society largely trusts the scientific profession and leaves the control of the scientific enterprise to scientists. Society recognizes that no one else really understands science. However, cracks in public confidence in scientists are widening. Consider the current regulations on the welfare of experimental animals or on the use of infectious or environmentally hazardous materials in the laboratory. Think of the glee with which the media seize on instances of scientific fraud. Ask whether scientists are portrayed as heroes or villains in popular TV shows. It would be a shame if the larger society were to conclude that scientists can no longer be trusted with the regulation of the scientific enterprise. The best way to ensure that others do not feel a need to clean our house is to keep it immaculately clean ourselves.
(*) The view that experts including physicians are self-serving has an honored tradition in the English speaking world. Lord Salisbury, a prime minister of Great Britain about a century ago, wrote, "No lesson seems to be so deeply inculcated by the experience of life as that you should never trust experts. If you believe doctors, nothing is wholesome; if you believe theologians, nothing is innocent; if you believe soldiers, nothing is safe." There are already people in the USA who say the equivalent of: "If you believe scientists, support is never adequate."