Science on the mall

It was truly stirring to be in Washington DC on the national mall during the inauguration. No matter what your politics, it’s difficult to not be moved by the presence of so many people who want the best for their country.

I slipped in the back, near the Lincoln memorial, where the crowd was happy but low-key. No huge “Obama” chants, like the hard-core fans pressed in closer to the capitol, but a lot of rapt listeners, cheering at lines like Obama’s pledge to uphold the bill of rights.

I had my own cheers. Funny, nobody joined me in the chant for Steve Chu, our new energy secretary, when he appeared in the lineup before the speech. Then he said it: “Science!”

Obama said the word right up front, when he laid the groundwork of what his new administration would be about:

We will restore science to its rightful place and wield technology’s wonders to raise health care’s quality and lower its costs.

I started the science-O-meter during the presidential debates. Obama handily beat McCain, using the word “Science” at least twice as often. But while the inauguration was historical in many respects, it was not as measured by the Science-O-meter. The word has been used in inauguration speeches before, for instance by Woodrow Wilson and John F. Kennedy, who wielded it with more sinister undertones:

Finally, to those nations who would make themselves our adversary, we offer not a pledge but a request: that both sides begin anew the quest for peace, before the dark powers of destruction unleashed by science engulf all humanity in planned or accidental self-destruction.

Let both sides seek to invoke the wonders of science instead of its terrors.

I like to think by using the word Obama also meant something broader, that his policies will be driven more by facts than ideology. That seems evident in the phrasing he used to convey his core governing philosophy:

The question we ask today is not whether our government is too big or too small, but whether it works, whether it helps families find jobs at a decent wage, care they can afford, a retirement that is dignified.

After the inauguration I walked along the river towards Georgetown. Waved goodbye to Bush’s helicopter and went and ate lunch at Clyde’s restaurant. I drank and talked late into the night with my friends, wondering how anyone could manage to go to one ball, much less ten.

Now the work begins—and the science-O-meter keeps on ticking.

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What were they thinking?

There were lots of ways to make it to the inauguration festivities. You could brave the crowds on the metro. You could take one of the eerily empty buses heading downtown. It took ten minutes to drive across town, since cars were scared from the roads. Entire families bundled up to cycle on the trails to the national mall.

Or, you could try and kayak. Oops. Oh yes, except the weather was below freezing.

But that didn’t seem to stop these two idiots who thought that they could paddle down a treacherous river of ice. I passed by them-and their massive rescue operation-when I was cycling down by the Potomac River on the day of the inauguration concert.

Fortunately the city was ready for any disaster. At least six fire engines screamed down to the shore, two police boats cleaved through the mush ice at top speed and helicopter zoomed to the scene. Thankfully Obamania didn’t make most people this stupid.

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Day of service—for Science

President Kennedy once famously declared Washington, DC a city of “Southern efficiency and Northern charm.” Something happened the last few days. Despite the crowds, people have not only been amazingly civil, but outright friendly—strangers strike up conversations, locals take the time to point out-of-towners in the right direction. I’d be happy if this relaxed courtesy courteous lingered but I suspect it might be due to the influx of people from more polite locations—not to mention what I’ve observed to be the euphoria-inducing effects of Obama-mania.

That mania translated on Monday into a mass of people across the country taking part in community service—in response to a call from Obama to observe the intent, declared by Congress, of Martin Luther King Day. In Philadelphia alone 60,000 people volunteered, and in Washington DC thousands wanting to help were turned away from food banks and schools. On the subway I met a family from New York city carrying plastic bags so they could pick up random litter they found on their trek through the city.

I was less imaginative with 21-month old in tow. So my biggest contribution to the collective good was to direct a woman from Illinois to a decent place for lunch (Ben’s Chili Bowl, of course). She pinned an inauguration button onto my daughter, who was spinnning around happily to a rendition of “This little light of mine” as part of a concert at the Smithsonian of American spirituals.

So, what’s all that have to do with science? It seems someone with an eye on science has been shining their light for the larger community in the last few weeks. That’s evident in the boon for science in the economic stimulus plan crafted by Obama’s transition team and Democratic congressional leaders.

Along with money for other agencies, the plan calls for $3.5 billion for NIH and $3 billion for NSF—half of its annual budget. That’s pleased science advocacy groups who, along with us at Nature Medicine, have argued that investing in science not only lays the groundwork for future prosperity it also creates jobs in the short-term (message to John Boehner, minority leader of the House—scientists have to eat too). It also helps, of course, that the new administration is receptive to such ideas.

We’ll see if the plan survives the congressional gamut. Keep shining that light.

Providing information or promoting drugs?

On 12 January, US Food and Drug Administration (FDA) officials released finalized recommendations for drug makers that wish to provide medical literature to doctors about unapproved uses of their products. It’s no small matter, since over 20% of US prescriptions are written for ‘off-label uses’.

Earlier guidelines required companies to commit to submitting an application to the FDA for the unapproved use before sharing peer-reviewed journal articles or reference publications about it. However, the new recommendations permit sales representatives to share data about uses that companies don’t plan to submit for FDA review.

Additionally, the finalized version of the new guidelines does not require that drug companies provide peer-reviewed materials that reach different conclusions about the unapproved use.

The revised policy recommends that that peer-reviewed materials given to doctors are not “marked, highlighted, summarized, or characterized by the [company] in any way”. Such actions could be considered ‘off-label promotion’ of drugs, which is what US pharmaceutical giant Eli Lilly did when it used catchy slogans to persuade doctors to prescribe the antipsychotic Zyprexa for unauthorized use in elderly patients (Lilly pleaded guilty to violating US law on 15 January). This practice is still illegal. However, I doubt the relaxed guidelines will help companies provide an unbiased view of their drug’s safety and clinical effectiveness—something that certain companies apparently need help with.

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Photo by zimpenfish

Obama-mania and the science appointments

The masses have converged here in DC for the inauguration—and for many partygoers it kicked off on U street on Saturday night.

Vendors, two to every block, plied their Obama T-shirts and blinking fluorescent Obama buttons. In front of Ben’s Chili Bowl—almost as much of a DC icon as the Jefferson Memorial—a crowd of hungry onlookers gathered. Business must be booming since Mayor Adrian Fenty took Obama there last week for a half-smoke. At 3 a.m. people were still straining to take pictures.

At “Town” a giant club on 9th street, hundreds—maybe thousands—of sweaty dancers celebrated “DC’s Official Gay Inauguration Dance Party.” There was no sign of Rick Warren—the controversial evangelist chosen to give the invocation at the inauguration. But Barack Obama was omnipresent. Dancers scoped each other out underneath giant images of the president-elect, projected on every video screen. Tinsel and red white and blue bunting were everywhere. “He’s the best we have,” said one club-goer of the surreal mix of earsplitting techno, bare chests and political fervor.

At the 7-Eleven someone was selling “Obama water.” Said one woman in purple, “It’s better than Kool-Aid!”

That was just the beginning of inauguration frenzy. We’ll see how much more of the frenzy, and the freezing weather I can take, but I will probably be threading my bike through the crowds on the way to the national mall on Tuesday to check out the scene.

Meanwhile, here is my personal lowdown on the science- and health-related Obama nominees and appointments. What is yours?

Steven Chu—a scientist to head the Department of Energy? Wow. Chu seems to round out a line-up that takes the science on global warming seriously, including John Holdren, his pick for science advisor, Lisa Jackon, his nominee to head the Environmental Protection Agency and Carol Browner, who will act as White House czar on climate and energy. You can complain about some of Obama’s appointments being more of the same, or more of the Clinton era, but when it comes to global warming issues it looks like change to me.

John Holdren, science advisor (Holdren will be a co-chair of PCAST, the President’s Council of Advisors on Science and Technology, Director of the White House Office of Science and Technology Policy and—the Assistant to the President for Science and Technology, a position restored to its former glamour, before Bush eliminated it). As former head of the Woods Hole Research Center, Holdren is known to have a grasp of issues that concern biologists. I also hope he has had the opportunity to look at a few marine embryos under the microscope—super cool.

Harold Varmus, co-chair of PCAST. The coolest thing about Varmus is that as NIH Director he declared “to support and defend the Constitution against anyone who says I can’t bring my bicycle into the building.” I am not sure exactly what PCAST does, but surely that depends on whether Obama takes his science advisors seriously—and according to his address in December, he plans to. Advocates of open-access publishing will surely get some extra clout from the appointment of Varmus, a co-founder of the Public Library of Science. The third co-chair, Eric Lander must know everyone in the business and he does think big.

Tom Daschle—head of the Department of Health and Human Services. Healthcare reform is more politics than policy—and surely Daschle knows the lay of the land. As I crushed out my (rare but savored) cigarette before getting into a cab Saturday night, I thought of the scolding I would get from Obama’s probable pick for Deputy Secretary of HHS, William Corr, currently the executive director of the Campaign for Tobacco-Free Kids. Given that tobacco remains our nations number one killer—and kids the front-line consumers—the possibility of Corr’s nomination has deservedly resulted in cheers from the public health sector. Maybe he can also help Obama stay away from the evil drug.

Sanjay Gupta: Seems like nobody has listened to surgeon general since the bearded Reagan-era Dr. Koop (I don’t think he even has a first name). But if Obama wants to give the office a voice again, it makes sense to choose someone people know—such as this CNN commentator, rumored to be Obama’s top pick.

Tom Vilsack, to head the Department of Agriculture. I am waiting for politicians to show some spine and eliminate the incredible waste of taxpayer money that goes to prop up wealthy industrial farmers. Writers such as Michael Pollan convincingly argue that billions spent on crops like corn help keep our diet rich in high fructose corn syrup and low in actual fruit—and contribute to our epidemic of obesity. Meanwhile, most small farmers, like the one who delivers fresh organic vegetables to my neighborhood each week, get nothing. It’s unclear whether this former governer of Iowa has the will, desire, or mandate to put our agricultural system back on course.

Jane Lubchenco, head of NOAA (National Oceanographic and Atmospheric Association). A bone fide fish-hugger.

I know there is someone I’m forgetting. But I have to go sleep off that Obama cocktail…

To find out more about these nominees and for actually astute commentary, read Nature’s coverage.

Missing hope

The New York Times, which has the kind of web tools that some of us can only dream about, published a couple of days ago an interactive feature called “”https://www.nytimes.com/interactive/2009/01/15/us/politics/20090115_HOPE.html?partner=permalink&exprod=permalink">I hope so, too". The newspaper asked 200 people to state their greatest hopes for what Barack Obama might accomplish during his presidency, and then invited readers to choose the hopes they agree with.

I was surprised to see that science was nowhere to be found among the 29 “hopes” catalogued by the Times. The closest it got was “Education” and “Environment”. Is it the case that science is so far below the radar of the average person on the street to not be mentioned by 200 random people sufficiently enough to become category # 30? Fortunately, the Times also invited readers to comment in case their hope was not represented, and a fair number of people who took the time to add their two cents called for increased respect for and support of science.

Although the indications so far are that Obama will take science and technology seriously, it’s a bit disappointing that science didn’t rank particularly high in people’s priorities. Having said that, and considering the tough times that the US and the whole world are going through, many people could be excused for having other things in their minds, asthere was no shortage of things to hope for. That’s the only bonanza we can expect to see in the immediate future.

Defrosting Cold War restrictions

Now that the US is no longer the undisputed world technology leader, rules devised during the Cold War to prohibit the export of certain technologies and restrict foreign scientists from immigrating to the US are outdated and harmful to economic competitiveness, the US National Research Council (NRC) reported last Thursday.

Back in 2003, the scientific community protested the strict post-9/11 visa rules, citing that many students and scholars could not obtain visas. While it is now comparatively easier for students to obtain visas, professional researchers applying for US work visas still face many regulatory obstacles, the NRC report notes.

The report urges the president to issue an immediate executive order that—in addition to easing high-tech export restrictions—would also expedite the visa process for foreign scientists and engineers. The report also suggests new rules that would automatically allow foreign students to remain in the US for a year after obtaining advanced scientific or technical degrees.

An executive order to fix these visa woes might help foster innovation in the US. However, in addition to the executive order that the NRC suggests, I think the next US Congress should devise permanent legislation—that will stay in place during future presidential administrations—that eases export and visa restrictions, in order to promote US-foreign collaboration in the long-term. Do you think it’s time the US rework its visa rules for biomedical researchers?

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Photo by Elaron

Using antibiotics as a bandage

A recently released Dutch study involving nearly 6,000 adult subjects found that giving antibiotics to patients in intensive care units (ICUs) to prevent infections increases the chance these patients will survive. The article reports that after four weeks, patients who received oral antibiotic had an absolute reduction of mortality of 2.9% compared to those who did not receive this preventative treatment. Moreover, those who received both oral and intravenous antibiotics had an absolute reduction of mortality of 2.9% compared with the control group.

These results add a new twist to the debate over the use—or overuse—of antibiotics by medical professionals: Drug-resistant bacteria are a growing problem in health care centers worldwide. To reduce deaths from these ‘superbug’ infections, experts have urged doctors to use antibiotics judiciously instead of prescribing them willy-nilly.

So is prophylactic administration of antibiotics the best solution for preventing ICU patient deaths from hospital-acquired bacterial infections? While this may be a good short-term solution, I think that it merely puts a temporary bandage on underlying problems with hospital protocols. Better cleaning and testing for drug-resistant infections should be the first actions we take, rather than pumping patients with antibiotics as a precaution.

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Photo by markhillary

In memory of Henry

The legendary amnesiac HM — Henry Molaison — died last month at 82 years of age.

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Photo: The New York Times

Together with Leborgne (also known as “Tan”, Broca’s first aphasic patient) and Phineas Gage, HM is surely one of the three most fascinating cases in the history of neuroscience.

I’m sure that a lot has been written on what HM taught us about the organization of human memory – the existence of short and long-term forms, as well as the divide between declarative and procedural memories. I’m not inclined to repeat what others can say about HM with a lot more authority than I could. (Here, for example, is an audio from NPR that tells you everything you may want to know about him.) Instead, I prefer to write about that HM meant to me as a young guy wondering whether to pursue a scientific career and in what discipline.

Just like so many students decided they wanted to become scientists after reading “The Microbe Hunters” or “The Double Helix”, my personal epiphany came when I learned about HM’s inability to form new memories and the fact that he was, as it were, trapped in the present. To discover that there was a patient like him inspired me to believe that there was some logic to the workings of the brain, a logic that could be experimentally deciphered. I decided there and then that understanding this logic is what I wanted to do with my scientific career.

I grew older and began to know better, but my interest in memory and in HM in particular never disappeared. In fact, I always hoped I would have a chance to meet him in person. The closest I ever got was during my tenure at Nature Reviews Neuroscience, while editing this article by Suzanne Corkin on what was new with HM. As part of the article, she sent us the originals of these drawings made by the patient (read the article if you want to know what they mean):

When Eric Kandel, my PhD mentor, got the Nobel Prize, I remember a lab mate saying that it felt as if a distant relative had got the prize. To me, as delighted as I was for Eric, HM’s death evokes more strongly that feeling of familiarity; it really feels like the passing of a distant relative, one that now I can never hope to meet. May these few words serve as my personal tribute in memory of the man with no memory.

Reality check

At the risk of being guilty of a non-sequitur, they froze my salary for 2009. I will therefore write more on this blog than last year. Besides, it’s been a while since we heard about “Biophysical Semeiotics” and “Inherited Real Risk”, don’t you think?

To get things started, a little something that came in the mail the other day, after I rejected a submission:

——-Original Message——-

From:

Sent: Wednesday, December 31, 2008 7:26 AM

To: Medicine

Subject: Re: Decision

Dear Dr. Lopez,

thank you for the fast decision. I agree, we will find another journal for publishing our results.

After all, neither Temin´s reverse transcriptase nor the first PCR description of Mullis found acceptance by a nature journal.

I wish you more luck for your future decisions.

Kind regards

I don’t know if the author is right that those papers were rejectd by the Nature journals, but is it too much to ask for some modesty when talking about one’s own research? Or does the author really think that his/her submission will have the same impact as those studies? Only time will tell, but I’m sure you can bet where I’m putting my money.