Our so-called post-modern age appears devoted to the undoing of the distinction between a 'good theory' and a 'mere story,' a distinction which (as Victoria Voytko points out) Western culture has worked hard to create and preserve ever since its beginnings in ancient Greece. Tom Borg's presentation dealt with a different kind of contemporary challenge to 'basic' theoretical research: it comes from an unlikely place, namely some of the very institutions that are to support and fund science. To provide context, Tom began by introducing us to his research on the human heart, how it forms, beats, develops, and stops. (Did you know, for example, that the number of heart-cells is fixed shortly after birth and that in its later development the heart evolves ways for dead cells to function?) Since it is virtually impossible for me to translate into a readable text Tom's vivid gestural illustrations of how the heart works, I refer you to an article he co-authored with Louis Terracio: "Factors Affecting Cardiac Cell Shape" (Heart Failure, vol. 4:4 and 5, 1988, pp. 114-124). The article provides a very readable general overview of Tom's research-interests and, if you will, his scientific orientation. It explores a crucial link in a long causal chain: normal development and disease can change the so-called extracellular matrix, the extracellular matrix can change the shape of the cardiac Maced., and a changed shape of the cardiac Maced. translates into a change in function. The paper calls for future experimentation "to relate the precise processes measured in vitro to those measured in vivo."
Obviously, this kind of research takes the long view, it looks for the cause of heart disease as we imagine cancer-researchers looking for the cause of cancer on a cellular or even genetic level. By the same token, it is at odds with the common (mis-)conception that advances in the treatment of cardiovascular disease derive from speedy hospital-admission, improved surgical techniques, pace-makers, transplants, and pharmacological attempts to influence blood-pressure. A productive confluence of 'basic research' and 'applied interventions' appears to lie in a fairly distant future.
In this situation, what are we to make of the three new criteria used by the NIH to score proposals for experimentation: impact, feasibility, and the investigator-environment? Tom led us in a discussion which focused on the first and last of these criteria. If research is awarded to those best-equipped institutions which provide the best environment for conducting the proposed experiments, this might further strengthen the so-called (by Robert Merton) Matthew-effect in science: those who have, to those will be given. This criterion is conservative, consolidating long-established research-traditions. Even more troubling (and puzzling) is the first criterion 'impact.' It appears that a grant-proposal cannot argue merely for the theoretical interest or relevance of experiments. Somehow, it is to assess the potential of the research, its ability to advance knowledge. Since the researchers are thereby forced to guess at an unknown, the funding agencies have to go by their faith in the researcher to correctly predict the potential of the research. This criterion may therefore also function conservatively, helping those scientists who have an established record of producing significant research. Why is it not enough to 'add to the body of knowledge,' 'to conduct interesting or relevant experiments'? Does the notion of 'impact' derive from the domain of technical innovation, is it modeled on immediate practical interventions in the medical marketplace, and does it therefore signal an ill-disguised distrust of basic causal research? Is it therefore a category-mistake of sorts, a conceptual confusion, to use 'impact' as a criterion to judge basic medical research? We raised these questions, but the word is still out on how these new criteria will actually change the funding-practices of the NIH. I hope that Tom will keep us posted on future developments . . .
Alfred Nordmann
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