randombio.com | science commentary
Monday, February 11, 2019

How to kill twenty million people without really trying

A new treatment for Alzheimer's disease has been devised, and it's headed for the trash bin

A n old episode of Twilight Zone (“Time Enough At Last”) has a guy played by Burgess Meredith who's the only survivor of a nuclear war. Finding an abandoned library, he makes a pile of things to read for January, a pile for February, and a pile for March. He focuses on the only thing he can do in order to put all those dead people out of his mind.

Scientists are a bit like that. We're trained not to think about the suffering of our patients so we can focus on the specific scientific problem. It's not easy, but really, sometimes I think people must like dying or they'd change the system.

There's a vast gulf between bureaucrats and scientists: to a bureaucrat, imagination is a handicap. Everything is just letters on a piece of paper. To a scientist, a lost cure is twenty million souls who could have been saved. They're technically not my patients, and I'll never know their names, only their coded identification numbers, but to me they are real people.

Last year I stumbled on a viable treatment for Alzheimer's disease. It's a completely novel concept that's never been tried, but you'll never hear about it. Why? Because some university bureaucrat killed the project out of spite.

Frankenstein's lab
The politicians kill 'em, and we bring 'em back to life, one way or another.

If my treatment works (and there are, of course, no guarantees), it will save half the patients, which means it will save more lives than were lost in the first world war. Getting a chance to undo the worst catastrophe in history is not something that happens every day, and it's why scientists always seem so dedicated. That's the system: the politicians kill 'em, and we bring 'em back to life.

I worked in an institute that had been set up by a state senator whose mother had died of Alzheimer's. Its mission was to find a cure. For reasons that aren't interesting, the institute ran out of money. The six scientists were handed off to a nearby university. The twenty-four board members, the director, CEO, CFO, and the five administrators left (yes, we were a tad top-heavy). The bankruptcy was very painful, and the university harbored great animosity toward our former director. Ironically, the senator's idea succeeded only after it was destroyed.

Thanks to the NIH, which funded my R01 grant, I found a position at a rare school that was willing to overlook the fact that, in their eyes, I am an old geezer barely clinging to life who spends his days wheezing pathetically and shaking his fist at the sky. I started setting up collaborations with fellow scientists, who were intensely excited about my idea. Several people approached me after my talk to propose collaborations. Writing down all these email addresses was like being a rock star.

Then the bureaucrats at my old university, still burning with hatred for our former director (who had since moved far away and was therefore out of their reach) decided to take their anger out on the staff and canceled my grant. With no active grant to cover my salary, the new position evaporated. With it went the possibility of saving those lives.

And yes, I was shaking my fist at the sky while I typed that, and believe you me, that's not easy at my age, especially while trying to type. And I might have mumbled something about whippersnappers. But the fact is, it was unheard-of for a university signing official, or SO, to do this to a grant.

As for my career, I wouldn't care—it would be so much easier to retire early. But then I think about our patients. Do I have some obligation to them? Maybe when society puts up so many bureaucratic obstacles, it is a clue that society is perfectly content with the status quo, and I'm being obtuse—fighting city hall, as people used to say—for not seeing it.

When I feel optimistic, I think that maybe that it's just the system that's corrupt. In real life, ethical quandaries often don't have a clear solution like we see in the movies. They're messy, and there's enough blame for everyone to have their share. Eventually it always comes down to a simple fact: power corrupts, and therefore any system that gives power to somebody who wants it will itself become corrupt.

Science is undergoing a phase transition

At universities, more and more of the important discoveries are being made by big labs. Physics papers often have hundreds of co-authors; biology papers aren't far behind. This means the system is undergoing a phase transition. Instead of small labs making discoveries, universities are increasingly putting one person—a superstar, aka the big cheese—at the top, with everybody else working for the top person. We call it a factory lab. The top person gets the credit for all the ideas of the group, and the Nobel Prizes go to the leader, who may or may not have a clue what he's doing. (Usually they do understand some of it after the peons explain it to them, but their role is to sell the product, not create it.)

Universities love this. Government funds most medical research in the USA. Government is composed of bureaucrats, so they see university bureaucrats, not scientists, as their peers. As a result, the bureaucrats are the only ones with any real power at a university. With fewer big labs, the bureaucrat's job is easier: they have only one guy to deal with, and they can get rid of a hundred people at a time if they feel like it.

Broken lab glass
Vacutainer tubes and sample vials in a broken glass disposal box

Industry has a different problem. If you're on the cutting edge of science, they aren't interested. They're too busy following up on theories that were disproven ten or twenty years ago. Some of these companies are still testing antibodies against beta-amyloid, a therapy that's been shown to be ineffective again and again. One time an investor asked me to do a “proof-of-principle” experi­ment for something I invented fifteen years ago. When I told him that would be a waste of money, and I had a possible treatment for a disease, he stopped calling.

I can't really blame him. Curing a disease is cost-prohibitive these days. It takes over a decade and billions of dollars to bring a cure to market. Only giant corporations can afford to do this, and the higher the barriers to entry, the more they like it. And the public, constantly stirred into blind outrage by the news media about some company having an adverse event when they test a drug, or some treatment that has an unexpected side effect, makes sure it stays that way. A little piece of obsolete technology is profitable; a new treatment isn't.

Does society really want cures?

I laugh at those conspiracy theorists who think industry has a cure for cancer but won't release it. Fer cryin' out loud. If industry wanted to cure things they'd have research departments that tested new ideas once in a while. Instead we get things like Viagra, Rogaine, and Listerine.

Well, most people only care about money and power, which is why they invented bureaucrats. To the bureaucrat mind, if they can't get revenge on the one they hate, they'll get revenge on somebody else. The problem as I see it is that bureaucrats have far too much power about too many important things, and sooner or later that's going to hurt a lot of people. From where I stand, it looks like it just did.

feb 11 2019, 5:14 am. last edited feb 28 2019, 5:48 am

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