Monthly Archives: December, 2014

Genuine confidence comes from experience

A lot of books are written about confidence. Confidence is a purely acquired, trained quality, not an inherited one. I remember reading a book about a true eyewitness account of one of the JFK’s speeches wherein during the process of evidently confident public speaking, JFK’s hands were trembling behind the podium. How revealing is that, just think.

If you are in a science field, the most dreaded task is giving presentations or articulating your opinions in front of your esteemed peers. You are continuously thinking: am I voicing something clever or stupid? How is my presentation perceived? Dull or exciting? You seek validation from number of questions asked to gauge the audience engagement level. Even the most seasoned scientists are nervous about it. My former science boss, for example, Polly Matzinger, probably the most brilliant mind in immunology since Niels Jerne, said to get GI tract upsets prior to every presentation, even though she would go on to mesmerize the audience afterwards.

Many science laboratories with 6+ postdoctoral researchers usually run science journal clubs to share recent research development in the field. If you are a PhD student or postdoc and your lab does not have such system, find a way to establish it. Go and ask your supervisor about it. In my opinion, journal clubs are must for young scientists. It is the only venue available where you do not have a personal standing in the work and can discuss and debate research results objectively, thus sharpening your skills as a thinker, not a doer.

I remember my first journal club presentation. I had no idea how to choose a paper for a journal club. I chose the paper that was published 2 years earlier, a clear indication of my lack of understanding how science research operates. I thought I had a confidence but this confidence was clearly based on ignorance rather than experience. I just have chosen the paper because I thought it was telling something “new”. I had no prior experience in lab environment and I did not receive any formal PhD training prior to my postdoctoral research. Honestly, it took me close to 3 years before I started to understand the principles of scientific reasoning relevant for the successful journal clubs.

I even started a blog, called NIHilist’s Immunology where I post my analyses of new research in immunology so young scientists who want to learn the principle of scientific reasoning can go and view my discussions and if it make sense to adopt them for their own purpose. I wish I had opportunity when I was doing my first steps in science.

A true measure of confidence comes when you are convinced and are able to convince others. Such feedback reinforcement happens only with the experience and multiple efforts, not naturally or out of blue.

posted by David Usharauli

Future of Medicine should not be Elysium

To have a long and healthy life was and is a dream of humankind since the inception of human civilization. Based on current pace, within 20-50 years medical science will achieve level where many difficult to manage diseases, like cancers and some infectious diseases become easily treatable.

Most recent example is hepatitis C virus story. Just 5 years ago, it seemed that there was no hope for people affected by Hep C. There was no approved vaccine or approved drugs capable of stopping this virus that causes extensive liver fibrosis. However now, if completely unexpectedly, we have anti-viral medicine that show up to 99% effectiveness rate (in some combination) and with less side effect (double benefit). No one could imagine this.

What about recent success in cancer therapy? Treatments with patient’s own tumor-specific re-engineered T cells or with antibodies to awaken the body’s own immune system had achieved an unprecedented level of success reaching up to 50% effectiveness rate.

These are all amazing news for anyone and especially for individuals with these medical conditions. However, even though the future seems bright, there is something unsettling in all this. It is the price tag.

Costs are so prohibitively high that almost 95% of world population would not able to afford it on their own (for example, tumor immuno-therapy with the patient’s own immune cells can cost more than 500,000$ , and Hep C treatment can cost between 50,000 – 120,000$ per treatment ).

More worrisome is the fact that unlike small molecules used in conventional pharmacology that can be easily manufactured in mass scale with minimal investment as generics, many advanced new treatments now days are based on large, complex molecules, called biologicals like humanized antibodies, or even more complex procedures like harvesting and re-engineering patient’s own T cells. These are completely different categories of medicine with no real way for mass scale production.

How can we afford this costly medicine to live longer and healthier?

Movie, Elysium, shows one such scenario. In this movie, society are divided into super rich and everyone else. Super rich live on a giant orbital station and are completely free of any disease thanks to medical technologies. These medical technologies are inaccessible to regular earthly people.

In my opinion, with the few rare exceptions, we do not control our medical health trajectory. Hence, every human should have an inherent right to have an access to the most advanced medical technologies. However, no federal or state budget can afford medical cost so high.

So what is the solution? how to make cutting edge medical technologies affordable to average person? The solution can lie in technology but in different kind of technology that is in infancy right now. It is gene therapy (gene silencing, cutting, replacing, modifying). Gene based medical technologies has two major advances over other type of biologicals: (a) gene therapy will be much cheaper (everyone who worked with PCR or RT-PCR can verify that costs for primer nucleotides are way cheap compared to antibodies), (b) gene therapy will treat the cause (genes) rather than outcome (proteins) of medical conditions.

Current medicine is based on repeated engagement with body’s proteins (receptors, cytokines, transcription factors). Gene therapy will be based on single or a few engagements with body’s DNA or RNA for long-term effect (for example, using CRISPR-Cas9 system). Such intervention can produce permanent fixes. An Overall cost will be low and majority will be able to afford it.

posted by David Usharauli

Genuine politeness should come out of respect not out of fear

Today’s public space is dominated by the idea of “political correctness”. This basically means that everything one says or does are extensively monitored and analysed. New rules of social interactions are developing and are introduced for the public use with such speed that it outpaces majority of human’s natural ability to adopt and adapt to it.

Many evolutionary conserved reactions to stressful situations such as expression of anger, yelling, shouting, even simple direct, blunt talking are considered socially unacceptable and inappropriate.

Interestingly, on the other hand, popular TV shows are popular exactly for opposite reasons for showing what society lacks and aspire to have: an opportunity for natural reactions to challenging social situations.

It is obvious that our society did not develop a heightened tendency for “political correctness” or “artificial politeness” out of genuine respect to a fellow human being as in Kant’s philosophy, but rather as a consequences of real, perceived or imaginary fear of getting ostracized, isolated, or even sued.

Fear, however, produces superficial interactions and artificial social norms with weak bonds. Moreover, since our natural reactions cannot be blocked, they must be expressed someway and somehow. In fact, rather than helping, such re-channeling of natural reactions further diminishes societal harmony by producing chronic “mean” behaviors.

In my opinion, a genuine politeness should be derived out of genuine respect. Genuine respect develops when there is a trust. Trust, in turn, develops when people’s verbal or non-verbal communications are matched with their actions.

posted by David Usharauli

Rise of autocratic science research

Advances in Science comes when there is a free exchange of accumulating knowledge. Thus, Science, by definition, should be a democratic institution by its nature.

As organization of family units is a foundation for modern states, organization of research laboratory units is a foundation for modern science. So analysis of laboratory units can give us a clue of how science advances or stumbles.

In contrast to popular belief, organization of modern research laboratory units is clearly and unequivocally autocratic in nature rather than democratic. Simply put, an absolute majority of research laboratories in both academia and industry do not and cannot contribute to the advancement of science, period. Of course, such labs do publish research articles at the end of the calendar year or submitting quarterly reports to justify their existence, but that all.

So a natural question is why is it the case? Almost everyone is starting their science journey as an idealist democrats and are ending up as a fearful autocrats. Why? This is because there is no separation between laboratory research and laboratory management. When the same Principal Investigator (PI) are required to conduct high quality scientific research as well as to procure the funds for the same research, there is a little tolerance to different ideas and opinions. Fear of losing funding prevent PIs to be courageous in science and follow their gut instincts. In the end, fear reduces the diversity and chances of great discoveries and such PIs become career scientists with more knowledge in bureaucracy than science.

This was a one reason why the US Government originally had created an intramural research labs with a secure funding where scientists were just asked to focus on science. The same idea was behind HHMI funding. When PIs are released from the fear of loosing financial support, and only requirement to them is that they will produce high quality research that can be published in journals like Nature or Science (or at least in top 5 journals in their subject field), then PIs would become open-minded and more democratic because high quality research needs a democratic environment to become a reality.

Actually, HHMI Investigators do publish in top journals. However, intramural biomedical research funded by the US Government did not fare well since Government did not put the requirement that the research should be of high quality, not just any kind of research conducted at leisure. Without such balancing approach, system becomes easily distorted.

posted by David Usharauli

Two myths I used to believe

Myth # 1. All scientists are brilliant or even clever or competent

If you grow up in a developing country where only way to “experience” science is through old books and occasional science journals published in English, you could easily start to imagine that people with a pipette in their hands who are working in the bio-hoods, with the richly stocked lab shelves in the background, are all professionals, basically geniuses in their field, especially if they are working in countries like USA (since you constantly hear that science awards, like Nobel Prize, are given to scientists for discoveries carried out in the USA).

You read or watch on TV the young people in the lab coats discussing how they love and enjoy doing science and how they want to make the difference. You actually believe that it is true until….

Until you end up as a postdoc yourself in a science lab in one of the most prestigious academic centers. Suddenly you realize you have no idea why some of the members of the lab have chosen to be here in the first place. They do not participate in science discussions, journal clubs, seminars or ask any questions. You wonder if they are capable of scientific reasoning and rationalization. Maybe not. They are just sitting there and after 5:00 pm leave for home. Nothing related to science excites them. And without excitement and true interest in experimental results, it is absolutely impossible for someone to do a 12 hour workday. Why are they occupying positions that could go to persons who at least are eager and excited about science?

I do not believe anymore that if someone is working in a science lab, even in the best labs, that they are smart, bright or even clever or competent. I do not believe in CV/Resumes either. I do not believe in personal interviews because it never works.

I only believe in how a person describes what he/she has done. In my experience people with a genuine interest in their science work have a wider vocabulary describing their own work and frequently use synonyms to easily adapt to the level of their audience, in contrast to people who are in science from reasons other than science itself.

Myth # 2. Private sector is more efficient than Government

I remember when I was working in the academic environment (that was a part of federal government), we had one scientist who joined the lab from the industry (one of the biotech company). He used to mention that he become disillusioned about the biotech industry since it allowed too much wastefulness. He was telling us how many of the company’s employees were not doing anything all day long, spending all of their time in the tea room in idle conversation with colleagues. Honestly, I did not believe him then. I was asking how come a private company was tolerating such behavior, did the company not care about its employees’ productivity? Why would the company keep such people? He would just laugh at me and tell that the company knew about these people but was doing nothing.

Now I know that he was absolutely correct. There is no difference between private, governmental or academic efficiency in science. Every lab has people who do nothing and this is tolerated. If you ask me why it is the case, I have no idea. I just know that it is true. It appears that majority of people prefer to pretend rather than have a constructive confrontation with their bosses, employees or colleagues. Many times, employers compensate the lack of productivity from such “do nothing” employees by dumping extra burden on other employees or hiring more people. Of course, in the long run, this will not work. No wonder that the company the guy came from to our lab does not exist anymore.

posted by David Usharauli