on June 17, 2007
Let me preface my remarks by mentioning that I am a practicing radiologist and I also serve as Editor in Chief for the American Journal of Roentgenology (AJR), a scholarly, scientific journal that has been in existence for more than 100 years.
In 1995, an article titled "Science, Creativity, and Serendipity" by Morton A. Meyers was published in the AJR . This was the Glen W. Hartman Lecture of the Society of Gastrointestinal Radiologists of that year. The AJR's Editor at that time, Robert Berk, believed it to be one of the most outstanding papers published during his tenure and commented that "Residents will be fortunate to have this information at the beginning of their careers" (M. A. Meyers, personal communication). Fortunately for us, Dr. Meyers has maintained a continuing interest in the role of serendipity as it applies to major medical breakthroughs, and he published a book on this very topic in March 2007, titled "Happy Accidents: Serendipity in Modern Medical Breakthroughs--When Scientists Find What They're NOT Looking For" .
It was my good fortune recently to pick up Dr. Meyers' book and casually begin to leaf through it. To my astonishment, almost everything important in medicine that has developed over the past two centuries came about, to a large extent, through pure serendipity. The book is divided into four parts. Let me list them here in order so you can appreciate Dr. Meyers' approach to this topic:
Part I: The Dawn of a New Era: Infectious Diseases and Antibiotics, the Miracle Drugs
Part II: The Smell of Garlic Launches the War on Cancer
Part III: A Quivering Quartz String Penetrates the Mystery of the Heart
Part IV: The Flaw Lies in the Chemistry, Not the Character: Mood-Stabilizing Drugs, Antidepressants, and Other Psychotropics
Dr. Meyers draws some conclusions at the end of the book that are extremely thought provoking and left me wondering about the current system that exists at the National Institutes of Health (NIH) for supporting research and funding specific programs. What is most enjoyable about this compelling book is that Dr. Meyers writes this story with exceptional literary skill and without bogging down into highly technical jargon. While this book will be absolutely fascinating to everyone in the medical field, it can be equally appreciated and enjoyed by the interested layperson as well.
Over the years, I have heard a few of the stories to which Dr. Meyers alludes, but never in their entirety and never appreciating how purely serendipitous was the outcome of a particular diverted research project. The author reflects on his own personal experiences during his distinguished career as an abdominal radiologist. Let me quote directly from Dr. Meyers' Preface, page xii: "Most people have had at least one experience in which an unintentional action or inadvertent observation, or perhaps even simple neglect, led to a happy outcome--to something they could not, or would not, have been able to accomplish even if they had tried."
Quoting further from the Preface, page xiii: "This is the essence of serendipity. Although the term has become popularized to serve as the synonym for almost any pleasant surprise, it actually refers to searching for something but stumbling upon an unexpected finding of even greater value--or, less commonly, finding what one is looking for in an unexpected way...But serendipity is not a chance event alone. It is a process in which a chance event is seized upon by a creative person who chooses to pay attention to the event, unravel its mystery, and find a proper application for it."
In the Introduction of the book, page 6, Meyers reflects on "accidents and sagacity." "Sagacity--defined as penetrating intelligence, keen perception, and sound judgment--is essential to serendipity. The men and women who seized on lucky accidents that happened to them are anything but mindless. In fact, their minds typically had special qualities that enabled them to break out of established paradigms, imagine new possibilities, and see that they had found a solution, often to some problem other than the one they were working on. Accidental discoveries would be nothing without keen, creative minds knowing what to do with them." As stated by Louis Pasteur and quoted by the author, "In the field of observation, chance favors only the prepared mind."
In reading this book, I learned of the very common and recurring theme that the discoverers of major breakthroughs were often reluctant to reveal the chance events that led to their ultimate breakthrough. The true story of what actually occurred often did not surface until late in the investigator's career, sometimes during a Nobel Laureate's acceptance speech. By revealing to us the critical role that chance plays in four major fields of medical advances, infectious disease, cancer, heart disease, and mental illness, Dr. Meyers raises important fundamental questions about how the nation's research dollars are currently spent. In his concluding remarks, he emphasizes the need to foster rather than stifle creativity and for the funders of research not to be so rigid and proscriptive in the way research studies are conducted and research dollars allocated.
For those of you who are involved with medical students and physicians during the formative years of their training, I urge you to obtain this book, read it, and absorb the message, and incorporate it into your views of how creative research should be stimulated and supported. This remarkable book by a fellow abdominal imager will change the way you think as well as provide you with a wonderful reading experience.