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William T. Talman, MD Headshot

What Will I Be When I Grow Up?

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"What will I be when I grow up?" All of us with kids have heard that question, and all of us have at one time or another asked it ourselves. But when do we really start to give its answer serious thought? Early life experiences may make some career opportunities appealing. As we approach career decision time, realities of life may overcome that appeal and lead us in different directions. Why do we care? Does it really matter to the country what motivates a person to follow one career path vs. another? The answer is a resounding "yes!" This blog addresses motivations and impediments to a career in science, in other words a career devoted to discovery. It also touches on what members of the public can do to encourage the best and brightest to pursue such careers. As a biomedical research scientist, I will focus on that area of discovery, as it is the one that sparked my own career choice years ago and still motivates me to this day.

As an elementary and high school student I was fascinated with living creatures -- what made them do what they did, and what allowed them to do what they did. Not only did grade school teachers stimulate my attraction to biology but my parents, a housewife and a civil engineer, respectively, always found ways to encourage my interest so that, even between school sessions, my inquisitive flame kept alive. In college the kindling of my mind met the heat and oxygen of discovery, and my desire to contribute to discovery really ignited. One of my college professors reinforced that desire when he warned our class that the bulk of knowledge did not lie in books. It remained to be discovered, and what was written was already behind the times of ongoing discovery.

I wasn't the brightest student in my classes, but I did well enough to have a number of career choices. Each possibility did have some appeal, but on balance they had to compete with my love of science in general, and of physiology (quite literally the study of life) in particular. At that time the National Institutes of Health was only 35 years old, having been formed by Congress through the Ransdell Act, named after Louisiana Senator Joseph E. Ransdell, who recognized the imperative that the United States government must commit to public funding of biomedical research. In short, Ransdell came to his recognition of that need because efforts to get private industry to fund an institute for basic discovery had failed. Fortunately for me and others like me, it seemed possible for one, even one with modest talents, to make a living as a scientist. In the 1970s, though even then it was not easy to be awarded a grant by the NIH, creative, innovative research proposals were being reviewed by a body of peers, and awards were being given even for research that may have seemed risky. Indeed, often the most innovative research should seem risky when it is first considered. One such research proposal, submitted by Dr. Thomas Cech, was considered to lie within only the top 35 percent of proposals reviewed by peers, but it was funded. Work from that proposal led to Cech's discovery of the way genetic information may be handled by living cells. For his work Cech won the Nobel Prize in Chemistry in 1989. Keep in mind that his first grant was considered only in the top 35 percent of grants reviewed at that time. Today he would not have been funded!

That was Thomas Cech. Now back to a less promising but aspiring scientist: me (and others like me). I saw others who were struggling but who were able to put their ideas into research that was contributing to new understandings in my area of interest: how the nervous system controls the heart and blood vessels. So the prospect of a career, though clearly a challenge, still held out reasonable expectations of success. Before becoming a scientist I first became a physician and had job offers in private practice, where I could have tripled or quintupled the salary that I could make as a scientist, but, as is the case with scientists in general, I was not attracted to the field for the money. The attraction was the opportunity to test my innovative ideas while providing a stable income. Furthermore, being a physician who cared for people, I found that my science helped me stay abreast of the latest findings that might help those patients I hoped to serve. What would I have done had the situation when I was making my career decision been as it is now for young people who are attracted to science but who realize that they have less than a 10-percent chance of putting an idea into funded work when that work is submitted to NIH? I do not know what the answer would have been for me. But I do see young people with great promise as scientists making career decisions based in no small measure on economic considerations. Despite their desire to contribute, they must face the reality that the odds are stacked against them in being able to provide for themselves and their family as working scientists. Even senior scientists, ones who have been funded by NIH for 25 years, are leaving science due to their now being unable to obtain funding. You will hear that the NIH budget doubled over the five years between the end of the Clinton administration and the first years of the Bush administration, but since then that budget has stagnated, failing even to keep up with inflation. There is no lack of ideas. In fact, the NIH system receives more grant applications than ever to study new ideas, but those ideas are facing a solid wall that blocks their being put into action.

Is there a Thomas Cech amongst those who simply give up when what would have been their Nobel Prize-worthy work is never funded? That is highly likely. What will our losing them to other professions mean to us as a society? All we need do is to consider what has happened in medicine alone over the past 40 years. There are many examples, but I will mention only three here. A basic understanding of how a cell divides has led to cures for some cancers (take Hodgkin's disease and some leukemias, for example) and huge strides in treating others (take breast cancer, for example). Understanding the physiology of the heart and its blood flow has allowed us to reduce fatalities from heart attacks. Finally, understanding how the blood clots and how mechanisms of clotting can be modified has led to our being able to reverse the damaging, debilitating effects of strokes in many patients. As former NIH Director Elias Zerhouni pointed out, cardiovascular research has led to a 70-percent reduction in the mortality rate from cardiovascular disease since 1970, and that achievement has come at an average cost of $4 per U.S. citizen per year.

Absent a commitment by our government to the direct support of basic biomedical research, our country will be unable to inspire young people to choose science as a career, will lose the ideas those young people could bring to future discovery, and will lose the possibility of translating discoveries to treatments of human disease. Some will tell you that industry will fund basic research if our government doesn't. Don't believe it! We tried that approach in the 1930s. When it didn't work, then Senator Ransdell's bill led to the NIH. Let's learn from history and not repeat the mistakes of the past. Industry is driven by finding ways to apply treatment to disease with the justifiable main impetus being profit motive. Industry cannot be in the business of basic discovery, which carries too much inherent risk and thus the threat of not providing returns for stockholders. In fact, Congress has recently let the business research and development tax credit expire. That tax credit had been in place for 30 years, so there is even less incentive for business to enter the field of basic discovery. Even before the tax credit expired major research laboratories such as Bell Labs and the Dupont labs ceased to exist. We, the American public, are the stakeholders in our country's research and development effort. Considering that every dollar spent on NIH R&D leads to substantial return on investment, we also benefit as if we were stockholders.

If we don't encourage the best and brightest of our young scholars to see the attraction in science through their educational experience and through sufficient financial incentives so that they are not turned away from science as a career, those potential scientists will go elsewhere in their career or elsewhere to pursue science. Yes, that means outsourcing our talent. Our elected representatives must hear from scientists and from the general public. We must advocate for federal funding of research. It must be seen as a priority for now and for our future if we are to avoid leaving the upcoming younger generation with "definitely not science" as the answer to the seminal lead question that started this blog.