top of page

Innovators by Donald Kirsch

Anecdotes from a “Reader’s Digest” summary of some famous innovators in science, and lessons they bring.


To be successful in the sciences is tough: consider that in finance, music, the arts, and tech, people can be both famous and rich by the time they are in their thirties, (see recommendations this month on Sam Bankman-Fried) if not before. Typically people famous in the sciences are recognized relatively late in life. Nobel Prizes are given to people either in or approaching retirement, more often than not.


On another tract, Malcolm Gladwell’s FHC series, #43 points out that innovation in medicine comes with a cost and requires a certain personality. He discusses Dr. Emil Freireich who proposed that rather than provide hospice care to kids afflicted with Leukemia (for lack of any realistic treatment in the 1950’s and 60’s), they should be treated with toxic medications that suppress the immune system. His idea was counter-intuitive. Imagine working that proposal through a modern ethics committee at the university hospital now. His personality apparently begged conflict when he presented this concept—over and over. He was labeled a monster, a “Nazi doctor” for his efforts and faced barriers to attempting to do the experiments needed to prove his theory. But prove it he did and the science of treating cancer made a quantum leap, conceptually, much to the happiness of many a parent ever since. The “quantum leap” nature of progress in the sciences is a major theme of this book.


The first scientist discussed, Max Planck, was a conceptual physicist that demonstrated the problem with innovating in science: His ideas were thought incredible and impossible, yet with time, experiments supported his ideas. His lesson on this was that new ideas in science don’t take off or catch fire, but rather, come to be as the old guard scientists, resisting the ideas, die off—“Science advances, one funeral at a time.”  In turn, Dr. Planck would resist revisions and remodeling of his own concepts in physics to his death.


A number of important scientists were either obscure and ignored or under-appreciated as they presented their ideas. Gregor Mendel was a priest had a background in Physics —which had no application in a monastery— so he applied his quantitative oriented mind to the study of peas and the passing  of genetic information in manner that no botanist of the time would have considered. His work was published and discovered when his experiments were reproduced a generation later. Barbara McClintock proved a rigorous scientist who by virtue of being a woman, “under credentialed,” and calling for a genetic theory that was radically at odds with the then-current models. Within her lifetime when the technology caught up with her ideas, she recognized for getting it right before anyone else could even consider the idea; this story was astounding as she proposed that segments of genetic material could “jump” strands—-indeed at odds with the genetics I was taught in 1972. With time I was aware that bacteria trade genes in this fashion all the time —and this is the basis for antibiotic resistance rapidly evolving among bacteria not yet exposed to antibiotics. Also, I was unaware that 45% of human genes are capable of such “jumping.”


Gallileo’s story is well known—and he was kept under house arrest for his last eight years of life for repeatedly engaging with the theory that the earth revolves around the sun. I was aware that the Catholic Church revisits scientific issues in conflict with traditional church doctrine and of interest, has reconciled itself to this modern science officially. If only some Protestant sects could to the same……Of interest, in 1990, Cardinal Ratzinger ie Pope Benedict XVI wrote: “the Church at the time of Galileo kept much more closely to reason than did Galileo himself, and she took into consideration the ethical and social consequences of Galileo’s teaching too. Her verdict against Galileo was rational and just, and the revision of this verdict can be justified only on the grounds of what is politically opportune.”  And THAT is where the church’s stand remains.


Ignaz Semmelweis: A favorite of mine—1840 Vienna had two hospital wards attending to poor women delivering babies—they  alternated days for admitting these women: one  run by midwives and the other by doctors—-all in training. The difference in sepsis (blood born infections) after delivery was 2% and 18% midwives vs doctors.  Being curious, he watched deliveries at both sites trying to sort out why the difference and his inspiration came when one of his colleagues was cut by a scalpel blade during an autopsy. His friend subsequently died of sepsis—and the autopsy findings were identical to woman dying of post delivery infections. He connected the duty of performing autopsies—done by all doctors attending births vs midwives who never did autopsies and suggested particles were being transferred by hand with internal exams. He intervened (hand washing with bleach) and corrected the problem. But he had no accepted  theory to guide his empiric treatment and was thus labeled unscientific—it would take a generation or two for the discovery of bacteria to close the loop on Germ Theory.  Until then, “invisible particles” causing infection was the 19th century version of microchips being injected with Covid vaccines. In addition, his notion that doctors in the course of their work were causing death was socially unacceptable and lastly he was accused of being Jewish (trifecta!) so his position was not renewed and he was rendered obscure. With time his behavior became erratic—he may have had tertiary syphillis, and he was incarcerated involuntarily to an asylum. He died of the beating he got resisting that admission. Like Planck, a term was coined:   The Semmelweis reflex: the human behavioral tendency to stick to preexisting beliefs and to reject fresh ideas that contradict them despite adequate evidence….. This notion that he died of syphilis brings forth two points, one a day dream I had and one a story from UCLA.  I love Civil War medicine stories and I had a day dream that someone suggesting a surgeon performing amputations at Gettysburg wash his hands and change his gown from case to case would respond after a long pull on his cigar, “Time is critical! Washing hands if for pussies…..”  My first year at UCLA Medical school, there was a story of an OBGYN in Beverly Hills after WWII who was eventually tied to a syphilis epidemic among the rich and powerful women of that city. He had acquired syphilis from doing vaginal exams without gloves and even when they became a mainstream tool, he rejected them noting his fingers lost the sensitivity to truly feel the pathology on these exams when gloved. And so, he passed syphilis along to his patients over time. And of course, in my daydream, once more, “Gloves are for pussies…….”


Roger Revelle: As opposed to others in the book, this scientist had evidence and a process that was hard to refute, scientifically, but politics and short term economic issues continue to sabotage efforts to control carbon dioxide in the atmosphere.  It is known that the earth has had warm and cold periods prior to any human involvement having any impact.  In the early 2000’s, I read that Mars is getting warmer and that raised my sense that there was a variable not well understood as we focussed on earth. His science is compelling. He was able to show that percentages of specific isotopes of carbon in atmospheric carbon dioxide have changed with the burning of petroleum products and no other variable can be found to explain this.


Rachel Carson: is of interest because she was not exactly a scientist the way we usually think of them. Her fame came to be writing readable books on the biology of ocean ecosystems. The use of pesticide by the industrial giants after WWII led to an interest on how this affected flora and fauna in many environments. She wrote Silent Spring and in doing so had more influence than thousands of talented scientists. It made her an enemy to many: Dupont and Velsicol chemical companies threatened legal action (? For libel?). Former US secretary of agriculture Ezra Taft Benson argued that Carson was “probably a Communist” because she was unmarried despite being physically attractive…….A prominent anti-communist, Richard Nixon nonetheless initiated the work of the EPA under whose regulations one has seen smog disappear from the LA basin, Acid Rain has been reduced, rivers and harbors with toxic effluent rendering them nearly sterile now harbor fish and recreation venues…..Despite being single, she ushered in a revolution in thinking.


Stanley Prusiner: He discovered prions—-this was a brand new idea presented in medical school: it was identified as an infectious agent that had no DNA/RNA, could not be eliminated by disinfectants or heat—we joked about it being an agent from another world. He is famous for suggesting this infectious agent had no DNA or RNA. As such, he was proposing something seemingly impossible according to an understanding of biological systems during our lifetimes. Within 15 years ( a short time) he turned the scientific community on its head when experiments confirmed that prions exist and are a cause for Mad Cow Disease, Scrapie (in sheep) and the human equivalents, Jacob Creutzfeld Disease (CJD).


David Cushman and Miguel Ondetti:  During Medical School, one learned the term, “essential hypertension” which was taken to mean, idiopathic. The root of the expression was the belief in the past that blood pressure increased to meet the needs of under-perfused tissue—hence, “essential”. Before the Framingham studies that laid out “normal” blood pressure targets and diseases associated with elevated pressures, we lost a president to uncontrolled hypertension. FDR had blood pressures at the end of his last term of 150/150 while suffering from Heart and Renal failure—he was truly on borrowed time before the stroke that killed him. Looking at pictures of FDR during 1943, 1944, and 1945, one can see the deterioration. There was no effective treatment in those years and smoking did not help. Blood control medication was just emerging from its infancy when I graduated from Medical School. After residency, I became aware of a new class of medication for use in heart failure, captopril. In my private practice, I refused to take calls from pharmacy techs, but a persistent one caught Kernie’s attention in the office at the end of a long day. The company that made captopril (Squibb) was getting a doctor from each county in California, among other states to attend a weeknd conference in Montreal, all expenses paid. Kernie, showing initiative, suggested that, “Dr. Moeller never travels without his wife.”  Some money was allocated to accommodate her and I learned in Montreal that while not licensed for high blood pressure in the US, captopril was going to be licensed for this within a year and they wanted me to know all about its mechanism of action. Ace inhibitors (captopril being the first) became a game changer for blood pressure control and the researchers that found it deserve credit because the non scientific business leaders at Squibb were quite satisfied with their market share for Nadalol used for hypertension and did not want to market it. These two men did the work and changed their minds. This class of drugs to this day is the foundational treatment for mass control of Hypertension.



Robin Warren and Barry Marshall: They arrived on the scene when the problem of stomach ulcers appeared to be solved with pharmacology: the well known H2 blockers like Tagamet and PPI’s like Prilosec made the all too common surgery of ulcer removal that our grandparents faced a thing of the past. Their observation of bacteria in biopsies of stomachs with ulcers led to a paper that defied a foundational principle in medicine and mammalian physiology: the stomach is a toxic environment and no bacteria could survive it. They published in the Lancet as despite the dubious conclusion—in conflict with mainstream thinking—, their techniques were flawless though one portion of their work found Marshall experimenting on himself (no ethics committee would have permitted it) and developed peptic ulcers rapidly. Skeptics abounded but results were reproduced and the rest is history. A bacteria, not stress, is the most common cause of peptic ulcers.




Comentarios


bottom of page