In the world of betting on the future, life sciences find themselves in a storm, with huge opportunities, like CRISPR gene editing, and immense obstacles, such as soaring drug prices, that call for leaders of extra intensity who are imbued with a sense of crisis.
Most people agree that the life sciences today, more than 60 years after two cocky young men found a structure for DNA, point toward amazing things. These include faster prevention, detection, palliation, and cure of many diseases rather than a few. And when we see ourselves in an economy where capabilities multiply exponentially, you might think the bioscience buzzword would be: optimism.
Let me try another word: fear. By that I mean mad-as-hell, fight-back fear.
Not surprisingly that word leads straight back to Franklin Roosevelt, who made the word his own. He told us in his first inaugural in 1933 that the only thing we had to fear was fear itself. This was an injunction to himself and the entire nation. It came a dozen years after he suddenly faced the terror and despair of a crippling disease. In an ultimate personal crisis, he started fighting back. After years of flailing about looking for a reasonable answer, he used much of his personal fortune to create a health resort in Georgia where he and other “polios” could strive together in the equalizing neutral buoyancy of swimming pools. He gained enough strength to defy his mother and re-enter politics.
Just the other day I reread a passage from volume 3 of Frank Freidel’s biography of FDR. After a narrow victory at the polls amid the crushing defeat of his fellow Democrat Alfred P. Smith for the Presidency, Roosevelt was sworn in as Governor of New York (Smith’s old job) on Jan. 1, 1929. A day later, he appeared at a reception in the capitol in Albany. On the arm of his Secretary of State, Roosevelt began walking across a large room. It took a long time. About halfway across, Roosevelt jerked his head up, smiled broadly, and told the crowd of uneasy onlookers, “It’s all right, I’m going to make it.”
This is the same man who as President in 1940 confronted what looked like the end of civilization. In weeks, motorized German forces had swept aside the armies of western democracy in a blitzkrieg. On the very day when defeated Allied soldiers began climbing into boats at Dunkirk, Roosevelt made a telephone call to General Motors president William Knudsen in Detroit, summoning him immediately to Washington to “work on some production problems.” Roosevelt wanted immediate help to energize the crucial element in crushing a triumphant Hitler—production. It’s a bit uncanny that Roosevelt, after a decade of fighting the Depression, knew what the world’s top problem was, and whom to call to his side.
Today, it seems clear that the problems biologists and medical people are tackling are pretty close to the top challenges faced by the world—with three times more people than 75 years ago. And then as now, a lot of people talk about our problems as too tough for fractious humans.
Yes, the techniques of modern biology, which I’ve been covering as a journalist for over half a century, are immensely more numerous and powerful than they were. But the social and technical challenges, including food, environmental protection, and human health, are also overwhelming.
Which diseases are more important? Infections striking the young particularly hard, or the chronic diseases that afflict an aging population? Which are the really crucial insights that deserve urgent attention? Which are the most important tools for asking the right questions?
The other day, I was reminded that we need to appreciate that genes are as important as electrons. Such issues, which are sure to reshape such institutions as research universities, are bigger and more urgent than most realize. We need leaders who feel the heat of the blowtorch, who are determined to achieve focus—just as we did in World War II.
When we confront health crises today, I think there’s a case for being afraid, very afraid. Besides the onset of genetically influenced dementia as the world’s population ages, we can think of an infectious disease like AIDS, which has killed 30 million in 35 years, but which also has been managed so that 30 million more live with the disease—thanks to a triumph of modern biology. There are frightening numbers of people who don’t know they carry HIV and can infect others.
So we need leaders in the life sciences who can describe, frame, and focus on the crises. These leaders have to help the rest of us to hold in our minds two things at once: urgency, and patience for the work of decades.