What happens then?

The practical consequences of losing a country’s commitment to science

André Malraux was a French novelist whose most durable contribution was perhaps his decade as France’s minister of cultural affairs in the 1960s. Malraux was convinced of the importance of promoting French culture among the masses and, during his tenure in the ministry, made his hallmark the restoration of older national landmarks such as art galleries, museums, and older French villages that had fallen into disrepair. During a period of time marked by postwar reconstruction and enormous pulls on national resources, Malraux argued — successfully in the main — for the importance of culture at the heart of the very idea of France, a theme built on his writing, particularly “The Psychology of Art.” The result of this work is a country whose cultural heritage lies at the heart of its identity. And, that identity has enormous practical implications for the well-being of the country. France is by far the world’s most visited country, with nearly 100 million annual tourists, contributing about 10% to the country’s GDP. That culture is now unquestionably central to the country’s national ideal is validation of Malraux’s approach to lean into the country’s strength — in this case, its cultural heritage — and to use that very advantage to make the country better.

And this brings us to the current state in the U.S., where a core national idea as core to the country as culture is to France — the United States’ preeminence in research and innovation — is being threatened by challenges to funding by the current federal administration. And it brings us to the question of, what do we really stand to lose if we lose science as the heart of our idea of ourselves?

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It bears conversation

On the value of engaging with difficult ideas from disagreeable sources

The U.S. health-care system, and research that has aimed to study this system, has long been stymied by challenges in sharing personal records over different platforms and systems. Scholars have observed the potential of research using shared data access platforms, including, for example, efforts in Europe to track persons across different health systems. In some ways this has felt like yet another intractable problem that is insoluble and that challenges U.S. health care.

But what if there were a solution? And what if that solution were announced by a sitting president who has, in his first six months in office, done much to undermine the cause of health? Well, that is exactly what President Trump announced recently, i.e., a health-care records system that would allow the sharing of personal health information for providers, including across different systems. Clearly there are many details that would need to be worked out — that is true of any new idea that tackles a long-standing status quo — but surely one would expect that we might have a chorus of enthusiasm from those in health and health care for the effort to address a difficult problem?

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In praise of diligence

On showing up when there is much to be done

I am back to writing The Healthiest Goldfish after a few weeks during which time I finished my upcoming book, “Why Health?” (more on that later), and took some time away, which was restorative. Naturally when one takes some time away, it creates an opportunity for some reflection, a chance to read a bit more broadly than usual, and to think, to look ahead. This was no different, and for that I am grateful.

As I was shuffling through my mental slide deck, I came upon a vivid memory: attending a lecture in October 1991 — I looked it up, it was October 24, to be precise — at the Faculty of Medicine, University of Toronto. It was the Gairdner Foundation International Award Lecture, and the speaker was someone I had never heard of: Kary Mullis. I was then a medical student, and I went because it looked interesting.

Mullis, as I would come to learn, had developed polymerase chain reaction (PCR), a method that would revolutionize molecular biology, diagnostics, and forensic science. He was just a year away from winning the Nobel Prize in Chemistry, in 1993 at the age of 49. But on that autumn day in Toronto, he was just a quite-evidently eccentric American scientist with a surfer swagger.

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What we really lose if we do not fund discovery

Science funding and the national imagination

Raj Ladher, a professor at the National Center for Biological Sciences in Bangalore (now known as Bengaluru), recently called the U.S. “the best research ecosystem in the world.” The phrase is somewhat bittersweet, appearing as it does in an article in The New York Times about how the current administration is creating an unwelcoming climate for international researchers to come to this country to pursue their work, a development that threatens America’s capacity to remain a global leader in scientific research. Since taking power, the federal administration has pursued cuts to the funding of scientific institutions, threatened the autonomy of universities, and, on the issue of immigration, embraced exclusionary rhetoric and policies that threaten to close America off from the rest of the world, including from international students and those who seek to come here to participate in, and enrich, its research ecosystem.

It is difficult to see this happening and not think of the many who have come to the U.S. to be part of our scientific ecosystem, and how much we stand to lose by closing the door to those who wish to do so now. I think, for example, of Benoit Mandelbrot. Born in Poland and raised in France, he developed a new visual approach to math, exploring irregular shapes and patterns in nature. In the 1950s, he moved to the U.S. and took a position at IBM, an unusual choice for a theoretical mathematician. At IBM, he was given space to develop his science, including his work on fractals, leading to his 1982 book, “The Fractal Geometry of Nature,” which sparked widespread interest across disciplines, from physics and biology to economics and art. Today, fractal geometry has influenced fields including computer graphics, financial modeling, medicine, and environmental science. There are countless examples like that of Benoit Mandelbrot — of scientists who came to the U.S. to do their work — from Albert Einstein, to Katalin Kariko, to Rita Levi-Montalcini. Such scientists, and many others, chose to pursue their work in this country because this has long been a place that welcomes discovery science.

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Equanimity in a fraught moment

Is staying calm in challenging times complicity?

In the past few months, I have written about how I am organizing my thinking in the context of changes being brought about by the new federal administration. While I have been clear about the importance of calling out cruelty, and have noted where I see federal actions risking or harming health, I have tried very hard to be open to new perspectives and ideas, recognizing that a new administration has a remit to do things differently, and that we should both give space for that and have capacious tolerance and generosity of spirit with respect to the motives of those involved in this effort. That has seemed the right approach to me and still does. I have, however, in the past weeks received notes from several colleagues that more or less ask, “How can you suggest that we should be open-minded, accepting, when we see terrible things happening?” and, “Are you not being complicit in allowing bad things to happen?” Inspired or informed by these challenges, I thought I would here address these questions — in particular, why I have tried to lean into equanimity in thinking and writing — and also address the perhaps uncomfortable additional questions: Is a measured, calm approach in the moment helpful, or does it verge on complacency? When is equanimity a moral virtue, and when does it slip into complicity with actions that harm?

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The underrated value of sincerity

Reflections on a quiet revolutionary value

We live in what can often feel like insincere times. In this world of spin, “fake news,” and performative social media, sincere honesty can feel like it is in short supply. Much of what is said is said for effect—to drive online engagement, to be liked, to gain advantage—rather than for the purpose of sincerely expressing something. This is particularly true in today’s charged political climate, where words may or may not correspond to the true feelings of those who speak them, and the purpose of speech can just as easily be to obfuscate or confuse as it can be to convey deeply held principles. As individuals, we can sometimes find ourselves avoiding sincerity in favor of projecting irony, cleverness, or some other trait we deem more socially attractive. We may also avoid sincerity simply to avoid the vulnerability that can come with it, echoing Shakespeare’s Iago when he said:

“For when my outward action doth demonstrate
The native act and figure of my heart
In complement extern, 'tis not long after
But I will wear my heart upon my sleeve
For daws to peck at…”

We, too, may hesitate to wear our hearts on our sleeves, avoiding the daws (which, by the way, refers to Jackdaws, birds in the crow family), and preferring to keep our sincere feelings safely unexposed. Yet, even as we may drift away from sincerity, most of us have an ineffable sense that this drift is not good, and that sincerity is a virtue to which it is worth aspiring. At some core level, we do not like encountering insincerity, or even well-faked sincerity. This is clear in the world of politics, where voters place a high premium on “authenticity,” and it is frequently the candidate who best conveys a sense of speaking with sincerity that wins elections.

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Open Science, Open Access

In 1665, the Royal Society in London published its first installment of Philosophical Transactions. This new journal signaled a novel commitment to the idea that all new scientific discoveries should be circulated as widely and freely as possible and that secrecy slowed progress. This was open science, the first defense of the idea that scientific knowledge is nonproprietary and a public good, like clean water or highways.

Over the next 350 years, this commitment has been chipped away at. The production of science has been commercialized, often to protect information rather than disseminate it, and the publication of scientific knowledge has likewise become big business. The current annual subscription price for Philosophical Transactions, amazingly still in print, is about $6,000, mostly paid for by library-based subscriptions, although subscribers get access to the journal online now, as well.

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Learning from disasters

A reflection on the EF-3 tornado that hit St. Louis on Friday.

Last Friday, an EF-3 tornado struck the city of St. Louis, where I live, and tornados struck other parts of the central US, including Kentucky and Wisconsin. The Missouri storm, which was the strongest to hit St. Louis since 2011, cut through the city at 55 mph, with winds up to 152 mph, destroying thousands of homes, injuring 38 people, and killing five. As of last Sunday, 23,000 homes and business were without power.

The heart of these events is always in the stories of the people who are most affected—stories of loss of loved ones, of homes destroyed, of the challenge of coping, as a community, in the near- and long-term. And, in particular, such stories are, here in St. Louis today, and always after such events, more acute in already economically precarious neighborhoods, including, today, neighborhoods like Fountain Park and the Greater Ville that have long faced a range of challenges before the storm struck, now made worse by the moment.

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