Happy Accidents: Serendipity in Modern Medical Breakthroughs—When Scientists Find What They Are NOT Looking For, by MortonMeyers (2007) New York, Arcade Publishing

Abstract

Morton A Meyers, M. D., is an emeritus professor of radiology and medicine at the School of Medicine of the State University of New York at Stony Brook where he was the chair of radiology and a leading expert on the radiology of the abdomen. He has been interested in serendipity in science and medicine ever since a chance discovery led him to better understanding of the passage of contrast suspensions (and presumably cancer cells) within the peritoneal cavity. The experience prompted Meyers to examine the stories of accidental discovery by well- and lesser-known biomedical scientists from Leeuwenhoek, who first described bacteria and protozoa, to Hofmann, who accidently discovered and then deliberately ingested LSD in the process of synthesizing a series of ergot derivatives of which lysergic acid is a core constituent. Meyers is a good story teller and many of these pithy tales of accidental discovery are extremely interesting and illuminating. In addition, Meyers patches in boxed explanatory notes that are very useful and entertaining. The book is well researched, cleverly illustrated, and copiously annotated. Meyers is a serious student and practitioner of the history of science who writes informally but lucidly. The stories are truly worth reading, not only by physician scientists but also by sophisticated high school and college students. Unfortunately Meyers loses his way when he attempts to draw lessons from the stories he reports. The rarity of critically important accidental discoveries persuades him to conclude that the scientific method is some sort of cabal that imprisons the minds of scientists and prevents them from either seeing or taking advantage of the “Aha!” moments that are uncommon in most scientific careers. He inveighs against the peer review system that awards grants based largely on what has been done rather than on what might be done— conveniently forgetting that future productivity is far more likely to occur in individuals with a track record of productivity. He believes that the present peer review system selects for boring routine experiments that add tiny increments to our knowledge base, forgetting that science moves incrementally until an “Aha!” moment moves it suddenly to a new plateau. Absent the base, there would be no sudden peaks. It is most assuredly true that some scientists are far more creative than others, but even among the most creative there are long periods of relative boredom until the next big step is made. Indeed, absent a steady output of well measured data, sudden insights would never occur. One must be measuring something in order to perceive a result that is unusual or unexpected. Good science provides the basis for a brilliant observation. Everyone in science, particularly biomedical science, wishes that he or she had not bothered with dull experiments and had focused only on the experiments that had a substantial payoff. But that is wishful thinking. The dull experiments provided the platform for the brilliant ones. The best scientists have relatively high brilliant to boring ratios, and their absolute ratios are still quite low. It is true that science and religion share the burden of dogma, and nothing is more stultifying than dogma. It is very hard to challenge long held scientific beliefs that have been supported by independent data gatherers. Such new ideas often face withering criticism from the establishment of journal editors, reviewers, and grantmakers, and that is no sin except when the obstruction to change is motivated by those who have a stake in the old order and hate change because it diminishes their stature. The fact is, however, that most so-called “breakthroughs” turn out to be “Uh-oh!” rather than “Aha!” moments. Only a few revolutionary ideas actually work out to be practical additions to diagnosis and therapy. Most of our great advances have been based on the steady accrual of excellent experiments that lead the discoverer to the next small step and (rarely) to a very big one. That may be a boring prescription for a biomedical research policy, but a strong base of first-class basic and clinical research provides a necessary environment for a sudden leap forward. Meyers wants quantum leaps without the dull infrastructure. Thankfully, he is not in charge of US research policy. But he is a very good tale bearer, and this book is well worth reading whether or not one agrees with the author's conclusions.