Saturday, April 23, 2016

"Pushing Air" : pushing my agenda

Yep, surely no surprise here : I have a personal agenda I am pushing.

And it is not just air.

In my view, no matter how useful, science that is merely 'published' is frequently ignored, and forever --- only when the new becomes 'popularly scientifically published' does it start doing things and changing things.

Determined wannabe scientific article writers are never successfully denied the right to be published by scientific editors, viewed as a as a collectivity.

We read all the time about how future Nobel Prize winning work was turned down by the editors and reviewers of 15 major journals.

Yes but a sixteenth journal, a journal with a respected but narrow and small readership did take to it, largely as original written.

Yes, the large funding agencies can turn the original request for funding down, but then they turn down a lot of worthy and unworthy requests, usually in favour of what is currently trendy.

But some funds, often via self-funding, can be found.

Exciting, expensive and unproven scientific ideas are like exciting new and unproven movie ideas - they are never going to be quickly or easily funded.

Scaling back to a small, initial ,self-funded "proof of concept" effort usually works.

The most effective censorship of daring new ideas is usually the informal and un-documented "quiet talk" pressure on untenured grads and postdocs, from potential future colleagues and from current lab bosses and thesis supervisors : think of it as being the dark side equivalent of science's "invisible college".

Again, sometime an idea must be delayed until a move is made to work under a semi-established tenured professor at a lower status university in the rural boondocks.

No scientific  consensus is ever 100% complete - there always a few established figures who refuse to swallow the current party line.

So Science can always defend itself - 'we allow even the most 'out there' ideas get their chance in the sun' - be published' it proclaims.

But scientifically public is not scientifically popular : the published article, questioning the current paradigm in a particular field, is lucky if it even gets put down for being 'intriguing but lacking sufficient confirmation'.

(When is there ever enough data --- the answer is never, not if you opposing something. Think of the current debate over man-made climate change.)

Usually it gets just dead silence and eyes that look away when the author turns up at conferences.

Established, comfortable, middle aged elite scientists are just as likely to bury their heads in the sand as are ostriches : no one wants to see a lifetime of research suddenly discredited, their funding and prestige reduced or to have to start learning new techniques and concepts late in life.

The editorial pages of top journals won't push these too-new too-threatening concepts onto the majority of their general readers who never read any articles beyond their own field.

Major conferences won't be organized to evaluate this exciting and wholly new concept and top scientists in their dotage won't write big articles in the prestige non-scientific newspapers and magazines, alerting the powerful outside science to this breakthrough.

Department heads and deans won't demand it be added to course material and the big standard textbooks won't add even a small chapter on it.

The author must be prepared for half a lifetime of slogging : usually beginning by giving the concept an attractive catchy name claiming it to be a new field of scientific endeavour .

Next by organizing a new journal and a new society around this  would-be field, pushing to get a course on it added somewhere, anywhere.

Taking it to the corridors of ever possible conference, seeking to attract grad students to the field, seeking an definite experiment that will convince doubters.

Failing all this, yes many new good ideas are published but not popular and so go on being ignored and unused.

Case in point ---- basic research from the 1920s to 1950s had shown constant positive ventilation was superior to the current use of brief and negative ventilation to save lives in many many situations.

This material was published but was ignored and no doctors were taught it.

Even when two doctors in California tried it in a small polio outbreak and found it worked and published this  fact in a major American west coast medical journal (which rarely got any attention in New York and other points easy, let alone in London or Paris.)

But a Danish doctor happened to be over working in a major American east coast medical centre with an excellent medical library, read the Californian article, put it in the back of his head and went onto other things.

On the boat trip home, his wife impressed the wife of a much more senior danish doctor, while chatting on about her husband's new found skills.

A few years later, unexpectedly asked by the same senior doctor to give advice to the nations' leading medical lights about the nation's huge polio crisis, this young doctor dared to contradict his seniors as to the nature of the crisis (!) and offered an equally radical way (!) to implement his very radical solution (!)

He then displayed both courage under fire and an unexpected skill in organizing the massive effort.

His dramatic and unexpected (because no working doctor had actually read all that research from twenty years earlier) solution to an equally dramatic crisis excited doctors worldwide, along with all the globe's scientific and popular media editors.

Overnight, the idea of pushing, not pulling air won popular scientific favour, not just dutiful scientifically published status --- along with the totally new idea of very expensive but life-saving ,purpose-built ICU units.

Henry Dawson pushed the importance of HGT as hard as he could, as long as he could but it never did burst on the scene as a popular scientific - it still hasn't almost ninety years later.

By contrast, he pushed the wartime use of natural penicillin now over  synthetic penicillin maybe tomorrow without much success.

Until, literally overnight,the sympathetic actions of two of Dawson's former patients combined with a former ally of his to make it all happen.

The actions of the first, a young medical resident made penicillin-in-any-form suddenly greatly sought after the world over.

The other patient (mega-industrialist Floyd Odlum) moved a massive government agency to take up Dawson's vision of providing  natural penicillin for everybody in a war-torn world in need of it.

The third, the usually highly cautious head of a small manufacturer decided to break ranks with its much more established competitors and thrown everything into natural penicillin production on a massive and untried scale.

Penicillin went from published to popular overnight, thanks to Dr Dante Colitti and a baby girl called Patty Malone --- then Odlum's WPB , the usually much maligned war agency, moved mountains to secure a supply sufficient to save not just the infected of America, but also the infected of an entire world, and in record time.

The third was Brooklyn housewife Mae Smith and her husband, John L Smith, head of then tiny Pfizer, both moved by the saving of little Patty Malone because it reminded them of Dawson's long claim that their own daughter needn't have died of Meningitis in 1934, if only doctors and drug companies had seen the potential of penicillin back in 1928-1929.

I think Dawson's HGT is a much bigger story than even penicillin but it seems too diffuse to ever become scientifically popular, unlike the dramatic stories of wartime penicillin and 1952's pushing air to saving polio victims.

But actually the story of Dawson's dramatic penicillin success in WWII and the dramatic story of microbial resistance to Dawson's penicillin today is infused with Dawson's interest in HGT.

But that is a story for my next post ...

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