The Hollow Heart of Medical Science

Why are neuroscientists, molecular biologists, geneticists, and developmental biologists – men and women whose discoveries have forever changed the way we understand ourselves – so uneasy about their futures? The crisis in morale among today’s medical scientists stems not from money problems, nor from the stage of development of their fields, nor from the level of research that is being conducted, but from these scientists’ failure to form themselves into proper, humane communities.

Low morale results from too little kindness and decency; it is a failure of custom and manners, a loss of social purpose, a diminution of the ability or the will to distinguish right from wrong and then to act rightly. At root, low morale is just a consequence of the indifference of medical scientists, busy in their labs, allowing the social and emotional foundations of their field to rot away beneath them.

The vulnerability of the sciences that focus on the human body and mind lies in the obligation all scientists have to observe their systems with dispassion. In these fields, dispassion requires that the medical scientist ignore his or her own vulnerability of mind and body. The strain of trying to meet this impossible standard of cool curiosity about one’s own fate imposes an unbearable distance between the scientist of the body and mind, and the body and mind of the scientist. Under this strain, medical research scientists are susceptible to the dream that their instruments and procedures have somehow freed them from the limitations of their minds and bodies.

The conscious expression of this dream is an obsessive response to the certainty of biological death: the belief that a big enough win in the game of science will beat death itself by conferring a form of immortality on the winner. Nothing but the thinnest membrane of denial separates the notion of scientific immortality through priority of discovery from this deeper, older, and wholly non-scientific dream of escaping one’s own inevitable death.

Though today’s biomedical science claims to search for repairs of nature’s defects, too many of its practitioners behave as if their real purpose were only to gain the mythical immortality of precedence, at whatever cost to themselves or others. Denial of the fear of mortality and projection of the suppressed wish to transcend nature are the marks of a masked effort to create a biomedical science at war with its own stated purposes.

The problem is not that science and medicine wish to avoid finding cures; it is that they are too strongly motivated by an irrational, unconscious need to cure death to be fully motivated by the lesser task of preventing and curing disease in order to delay their patients’ – and their own – inevitable ends. The irrational, obsessive promises made by scientists and physicians in the past few decades have, in a way, institutionalized the denial of death.

But these promises are not sustainable. A humane version of the biomedical sciences would, for instance, acknowledge that it is not about to transcend the limits of the human body, and so it would no longer make promises that it cannot keep. Beyond that, a science that acknowledges an unconscious component in its operations, if not in its methodology, will best serve its practitioners as human beings, as well as being most likely to generate lasting value for the rest of us.

Such a change cannot happen unless scientists themselves first take the time to consider the consequences of their own behavior toward each other. We should begin our reforms in the most conservative way, by rediscovering and rededicating ourselves to the meaning of the title we professors hold. “To profess” has a spectrum of meanings: to affirm openly; declare or claim; to make a pretense of; pretend; to claim skill in or knowledge of; to affirm belief in; to receive into a religious order or congregation; to make an open affirmation; or to take the vows of a religious order or congregation.

Rather than choose among all these current meanings, we might begin by returning to the word from which they all evolved, the Middle English “professen,” to take vows. Professors do not deserve the title unless they are willing to take the time and make the effort to openly affirm something beyond their data.

Affirmations and vows are not data-dependent; they are matters of the heart. To be a professor, it seems to me, one must first have something of importance to oneself that needs affirming, and then one must affirm it. Morale among professors in science will remain low until they decide that their strongest feelings, as well as their best data, should determine professional behavior and professional status.