pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

10 Medical Breakthroughs Unaccepted At First – Part Two

July 31, 2017

In part one I already confessed to being in a profession full of egos which, like it or not, sometimes get in the way of rational consideration of things new or which are going against long used practices.

And I even asserted that pediatricians don’t have as much trouble with that as other specialists; proposing, somewhat tongue-in-cheek, that it was because we were all used to dealing with adolescents whose very body language conveys that every adult around them “just doesn’t have a clue.”
Medical breakthroughs often meet resistance from the ‘arrogance within.’
I’m in the middle of listing ten instances I can think of where ego’s, stubbornness and sometimes downright hatefulness attacks anyone who has “discovered” a better way or something new.

We’ve covered Ignatz Semmelweis who actually died because he suggested colleagues wash their hands between autopsies and seeing patients; Martin Arthur Couney who couldn’t get anyone to think that isolettes for premature newborns were worth using; Andreas Roland Grüntzig personally belittled for proposing balloon angioplasty; Francis Peyton Rous driven out of research for thinking viruses could cause cancer; and Barry Marshall ridiculed for thinking bacteria caused ulcers.

Medical Breakthroughs Initially Ridiculed or Rejected

Of course every one of them has been vindicated now, but some too late to personally realize that their career was worth living.

But wait, there’s more! Medical history is chock full of wonderful, game-changing, world-shattering, profession-altering breakthroughs which met with stiff—and often downright vile— opposition instead of the thoughtful consideration they deserved.

Germs Cause Disease

Germs cause disease

Although this next issue might have initially begun due to stubborn arrogance it has morphed at least twice into something much more irresponsible and destructive.

Even most school children today know enough to associate Louis Pasteur as being the father of “germs causing disease.”

He wasn’t the first to propose it but he was the one who meticulously conducted convincing experiments over and over which proved that micro-organisms caused diseases instead of being “spontaneously generated” as then thought.

What is not remembered as well (or at all) is that a guy, Pierre Béchamp, took it upon himself to wage battle against Pasteur for as long as he lived afterwards. He had come up with the false notion that there were tiny “things” which were already present in all living things (what he called “microzyma”) which caused the disease and stubbornly waged a personal vendetta against “germ theory” and Pasteur.

His public tactics drew a few unexpected followers from the un-informed, un-thinking and somehow disenfranchised; and when it did, he became emboldened in his attacks and persisted, reveling in the notoriety—even when every other scientist proved him wrong. Well known at the time, he died in relative obscurity amounting to a mere “footnote” of history—excepting the fact that he eventually became used as a figurehead for a separate movement entirely of “denialists,” which continued through the 20th century and still exists today.

Infectious Proteins

Even proteins can be infectious

The longer a “profession” exists the more people are in it. The more people in it, the more opinions and “vested interests” that are in it. The more “vested interests,” the less those people want someone else to be right and them to be wrong. The more of that, the more cut-throat the arguments become!

Such was the landscape in which neurologist Stanley Prusiner became embroiled in 1982 over the cause of Mad Cow disease. The cadre of scientists staking their careers on finding the cause of the disease already knew it wasn’t caused by a virus (as they new them), a bacteria or a fungi.

Prusiner happened to be the one that stumbled (a bit skeptically) on a simple and otherwise inert protein as the culprit. Knowing, and admitting, that the finding was “clearly heretical” he repeated and repeated his work before publishing it… let the firestorm begin!

Especially his fellow colleagues (with the most to loose) had to defend why they had not thought of it themselves—and their attacks were personal and vicious and (with the new internet) very public!

To his credit (and those funding him) he continued characterizing prions and gradually publishing his findings adding several other diseases which fit the “mold” of “infectious proteins”; and very slowly, others in the medical community began to accept his notions.

Finally, over a decade later, in 1996 the first human form of mad cow disease was reported in Britain and determined to be from consuming contaminated meat. The same Bovine Spongiform Encephalopathy was Prusiner’s “prion disease” (that’s what he called them).

A year later… the Nobel Prize, for prions.

Heredity

Gregor Mendel was not a physician, he was a monk. His discovery was not (initially) for humans, it was for plants; BUT, I list him here because it is a classic instance of the topic I’m describing: “progress has no greater enemy than doctors with ‘vested interests masquerading as moral principles.’“

Heredity, as outlined by Gregor Mendel

In fact, Mendel suffered several varieties of that prejudice and rejection. He was born to a German-speaking family living in what is now the Czech Republic on their 130-year-old family farm; so, struggled greatly to obtain an education merely due to his circumstances.

He was a gardener and a bee-keeper then entered the local “gymnasium” (place of education) but required a time off for several months to deal with what became a life-long illness. Eventually he did study practical and theoretical philosophy and physics at the university but still had to deal with his illness and finding financial assistance.

His younger sister gave him her dowry to continue studying (he later helped support her three sons, two of whom became doctors.) Finally he joined the Augustinian friars to obtain an education without having to pay for it himself and was given the name Gregor.

He taught physics and conducted extensive studies on inheritance with the meticulousness and compulsiveness monks are known for; but, that only served to excuse the bigotry of the scientific community who were “vested” in proving their pet theory of “blended inheritance” (parental traits being averaged in offspring).

Rejection progressed to ridicule as he seemed to persist in his findings which would overturn their entrenched notions.

Ridicule turned to personal attacks because he was “just a simple monk” living in a back-water town. How could a mere bumpkin ever understand such weighty scientific questions?

Criticism turned to vitriol because he had the bold-faced gall to blend botany with mathematics—two separate disciplines with egos of their own not allowing that any “outsider” (not in their discipline) could ever hope to “understand” how things really were—let alone a farmer-monk! What is now considered simple statistics was too obtuse for the “enlightened” scholars of the time to give credence.

Over three and half decades later, in 1900, and long after he had died of his chronic nephritis, someone had the integrity to merely repeat Mendel’s studies and verify their veracity—much too late to give him any peace within his life.

Cancer Immunotherapy

Using immunotherapy against cancer

Which is worse, abuse or neglect? Criticism, rejection and ridicule or disregard and stonewalling?

In the case of new knowledge and progress they both achieve the same end, just ask immunologist James Allison.

New researchers and physicians emerge from formal education into an extensive corridor lined with “mentors” and “good ole boys” who, by virtue of time-in-grade and experience are already entrenched in key spots on committees controlling publication, research ideas, funding authorizations and proposal evaluations. None of this is either new or unique to the medical profession.

Without some “connections” even the best of ideas withers without the nurture of funding; unless, someone has a “fire in his marrow” enabling them to continue in SPITE of all the “well-intentioned advice.”

Dr. Allison wanted to work with “T Cells” because something was telling him that they just could have something to do with cancer and its treatment; but, “tumor immunology had a bad rep” and “many (most) people thought that the immune system didn’t play any role in cancer.”

He “wandered in the wilderness for a while,” he said, but eventually developed an antibody which he felt was ready for pharmaceutical development. On the weight of the opinions of the profession’s “mentors” however, biotech companies repeatedly turned him down with the excuses: “anybody can treat cancer in mice,” and “you think you can treat cancer by just removing a negative ‘signal’ on a T-Cell?”

Yep, that’s exactly what he thought; and, just so you know, Dr. Allison’s perseverance has now led to immunotherapy being heralded as a revolution in cancer treatment and poised some drugs to become the most successful cancer drugs on the market.

No Nobel Prize… yet.

☤

I wasn’t planning on making a part three to this series; but, the tenth example I can think of takes deliberate hatefulness to a level which I think should have involved prison time! In addition part one generated a question which just DEMANDS explanation and clarification… so I will. In part three.