Assessing the Roberts Rule for the Nobel Prize in Medicine, 2014
Seth Roberts died in April this year. I had wanted to write some sort of post about his work but found myself lacking. With this year’s Nobel Prize announcements, I couldn’t help but be reminded of him and what he had said of the award:
The most interesting thing about the Nobel Prize in Medicine is its predictable irrelevance to major health problems. Year after year, the prize-winning work has failed to reduce heart disease, cancer, depression, stroke, diabetes, schizophrenia, and so on. [emphasis added]
Photo credit: Wikimedia Commons
I think this criticism goes beyond the Nobel and applies to some extent to medicine in general. Go to a bookstore and count how many MDs have contradictory advice about what you should be eating. The discrepancies cannot be blamed on different doctors wanting to optimize on different criteria, because even when the main aim is weight loss there are as many approaches proposed as there are types of food. The situation does not improve much when you look at only books written by researchers.
Stents were supposed to be a breakthrough for heart disease, but subsequent epidemiological studies seem to suggest they don’t actually do anything (assuming you trust those studies).
Seth Roberts noted that the single biggest contribution of medicine to actual health, the discovery that smoking is linked to lung cancer, has so far won a total of zero Nobel Prizes. Instead, prizes are regularly handed out for research that provides insight into mechanisms that might someday somehow turn out useful someday provided someone else actually follows through.
Not everyone agreed with Roberts. They point to the 2008 award for the discovery that HPV cause cervical cancer. I think it is already somewhat damning that combing through decades of prizes provides only one possible counterexample, but Roberts also noted several issues with upholding the 2008 prize as proof that the Nobel values practicality.
Now, we have a new prize for 2014:
John O´Keefe[, w]hen recording signals from individual nerve cells in a part of the brain called the hippocampus, in rats moving freely in a room, O’Keefe discovered that certain nerve cells were activated when the animal assumed a particular place in the environment (Figure 1).
…
May-Britt and Edvard Moser were mapping the connections to the hippocampus in rats moving in a room when they discovered an astonishing pattern of activity in a nearby part of the brain called the entorhinal cortex.
…
Knowledge about the brain´s positioning system may, therefore, help us understand the mechanism underpinning the devastating spatial memory loss that affects people with [Alzheimer’s].
The prize was awarded for studies in rats. Subsequent studies also found the cells identified by the researchers in humans. (Those studies, being closer to useful, did not merit any awards, or even mention by name.)
Alzheimer’s seems to be mentioned in the press release solely to half-heartedly justify why the research is considered “medicine” and not biology. The studies themselves don’t sound like they relate to Alzheimer’s any more than any other brain studies on rats would. They have as much to do with Alzheimer’s as this post has to do with vocabulary.
Perhaps the writers of the release themselves felt this was not enough, so they conclude with
The discovery of the brain’s positioning system represents a paradigm shift in our understanding of how ensembles of specialized cells work together to execute higher cognitive functions. It has opened new avenues for understanding other cognitive processes, such as memory, thinking and planning.
Understanding one thing has opened up new avenues for understanding other things. It’s always the same sign-off for the Nobel Prize in Medicine. Seth couldn’t have called it any better.
When someone does actually figure out a cure for Alzheimer’s, she shouldn’t hold her breath waiting for a call from Stockholm.
Edit: Commenter KatherineMW disagrees below.
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I don’t know… if one handed out Nobels only for capstone medical developments; as in researchers/doctors making the final connection that turns a working theory into a practical medical application; then would you not be consigning all the foundational research to develop that working theory to being ignored?Report
Are researchers in foundational areas so sensitive that they would all just give up if one prize in one year went to the discovery that smoking causes cancer?Report
Why not give the prize to discovering what PREVENTS cancer?
(In particular, that work on dark beer preventing carcinogenic smoke from causing cancer).
Practical stuff ought to occasionally get some mention. Just like physics, often the big questions come with big answers that take a while to actually become relevant.Report
With physics, fundamental research is rewarded, but it often is for things that actually did create something worthwhile eventually, e.g. LED lamps. So, it is possible to reward fundamental research that has practical significance. They simply choose not to do so in the medicine and physiology category.Report
Are researchers in non foundational areas so sensitive that they would all just give up if one prize in one year didn’t go to the discovery that smoking causes cancer?Report
They could award the prize to the researchers who did the foundational work that eventually led to the treatment, after it proved its usefulness by actually leading to a treatment. Or they could share it among several researchers along the chain.Report
It’s worth noting that the prize is technically for “Physiology or Medicine”, rather than just medicine.Report
Good point.Report
What about Barry Marshall’s Nobel in 2005? That ulcers are caused by bacteria strike me as super practical. Does the fact that there are (at least) two in the last 10 years cut against the idea that there is only one practical counterexample in decades? Perhaps 2008 was chosen because it was the most recent.Report
And we’ve got one on IVF (test tube babies). That’s practical too.Report
And one on MRI, which has profound implications both diagnostic and researchwiseReport
Just recently, researchers working with Stem cells have demonstrated a technique that could potentially restore a pancreas to working order, thus curing Type 1 Diabetes (so far, in mice, but still).
If the Roberts Rule holds, these people will be overlooked next year.Report
From what I understand, the Nobel prizes tend to be awarded many years after the discoveries which they honor. This year’s prize, for example, seems to award research from the mid nineties, and that sort of time gap is not uncommon.Report
Which makes sense because you want to make sure that they can be replicated and hold up to scrutiny. And note, this is a method that could potentially restore a pancreas to working order and cure diabetes. Maybe we should wait a few years to see if it actually does any of that.Report
@alan-scott
Hrmmm, quite true.
Still, if viable, a cure for Type 1 Diabetes is certainly Nobel worthy.Report
From what I understand, the Nobel prizes tend to be awarded many years after the discoveries which they honor.
I can only competently speak of the economics prize, for which this is definitely true. It’s kind of like getting into the Hall of Fame. It’s not like anyone who was paying any attention at all didn’t know that Michael Jordan was a really good player before he got in. Getting into the Hall just recognizes the fact well after the fact.Report
Stem cells may also be used to regrow penises (don’t giggle too hard, this will be useful for battle injuries and sex reassignment surgeries):
http://io9.com/5944628/your-lab-grown-penis-is-almost-ready
Apparently they’ve already demonstrated functionality in rabbits, restoring their ability to f**k like, well, you know, and father baby rabbits.Report
Medicine’s final cause is clear to me now.Report
This is so good to know! Because now I can stop obsessing over where it is safe to stick that thing, for fear I will lose it forever.
(Yes, the boot camp VD slide show still haunts me, the image of the stump of the guy who failed to get his VD treated is forever burned into my brain).Report
In all seriousness, I wonder if they can do the same thing for breasts. I imagine such a thing would be valuable to women who had to have mastectomies.Report
Obviously IANAD but if they can do working penises, I’m not sure why breasts would theoretically be a problem? I *think* (don’t know) that breasts might be slightly less-complex organs structurally/mechanically (since penises have to, ah, elevate to perform one of their signature functions)?
OTOH, I think all the ductwork for milk production and the adjacent lymph nodes and stuff are pretty complicated, and in general it’s just a larger organ so the re-attachment process may be more involved and traumatic, so maybe it’s not a slam dunk…Report
I *think* (don’t know) that breasts might be slightly less-complex organs structurally/mechanically
Thanks for the mansplanation.Report
My assumption is that the Nobel Prize is given out to folks who change the game. People whose discoveries change the way we think about medicine and physiology.
The discovery that smoking causes cancer is one of those things that I’m pretty sure is merely a confirmation of something that everybody knew. (“Coffin Nails” is a term that predates WWI, for example.)Report
There can be multiple debates on what to eat because there are probably multiple versions of what counts as a healthy diet. Avoiding processed foods seems to be universal across the board though.
There is probably a lot of cynicism about the Nobels in general. I think it depends on interpretation. The Peace Prize has not reduced the amount of war-mongering but they are generally quite good at recognizing people with substantial achievements towards asserting human rights and trying to end or mediate various conflicts. This sentence is to preempt Jaybird or anyone else making a comment about President Obama’s Peace Prize.
The Nobel Prizes like all other prizes also probably have a fair bit of politics though maybe less so. The Literature Prize seems to be the one most bound in controversy and talk of politics, followed by the Peace Prize. For the last few years, the Nobel Literature committee has seemingly went out of its way to find writers that are not actually that well known out of their native countries. Many speculate that this is an intentional snub against the Americans in general and Philip Roth specifically. Alice Munro and Mo Yan were legitimate winners.
http://www.buffalonews.com/columns/jeff-simon/maybe-the-nobel-prize-for-literature-is-more-anti-american-than-internationalist-20141007Report
There’s politics, and then there’s politics. Physics has quite a few fields… I can see the high energy folks wanting to pull for a high energy nobel… Then there’s “einstein needs a nobel” style politics, which I hope isn’t occurring anymore.
I rather agree that the Nobel for Literature ought to cover… world literature, as best as it can. Not that I’m going to say I know enough to judge who ought to be considered, or not.Report
Of course when you award something once a year, there are going to be plenty of deserving candidates that never win.
I do find the idea that American literature is “too insular” to be highly snobby and anti-American
http://www.slate.com/articles/arts/culturebox/2008/10/nobel_gas.html
A.S.Byatt is also known for making similar claims about American literature with no idea that we contain the most diverse literature in the nation. Both Toni Morrison and Philip Roth are writers of American literature. So are Amy Tan, Michael Chabon, Marilynne Robinson, Michael Cunningham, John Irving, Jess Walters, etc. We are pretty diverse.Report
How many of these literati frequently put offhanded references to popculture from other lands in their works?Report
Haruki Murakami does it all the time! A.S. Byatt does not.
Philip Roth was instrumental in getting wider exposure for Central European writers during the 1960s and 70s with the Writers from the Other Europe volumes:
http://www.amazon.com/Writers-From-Other-Europe-Volume/dp/B000HVXTM8Report
Saul, you say that they’re a diverse bunch, but I notice that all of those writers are American.Report
Well playedReport
How well do those authors play outside of the U.S. I admit that I read very few novels by American authors, so I can’t say much about American literature after, say, Dos Passos, but I get the impression that the criticism is less that they have references to books by mid-century Poles than that they don’t speak to non-Americans in the way that they do to Americans.Report
I think most of them sell fairly to very well outside of U.S. and Canadian borders but would need to do more research.
Philip Roth is certainly a fixture in the Anglophone world. I brief search found that his novels are also translated into French.
That being said it was noted that this years winner’s books are often hard to find outside of France.Report
Less that they don’t that’s references… that is.Report
Ugh I hate typing on a phone.Report
True, and French literature was widely thought to be in decline, even in France.Report
Though perhaps a more illuminating example is Tournier, who has been wildly popular in much of the non-English speaking world, but not at all in the U.S. If he’d won (and many believe he should have), a lot of Americans would be having the same conversation, which may be a sign that our literary culture is pretty insular.Report
Garrison Keillor went off on the guy who actually won the literature prize this year on this weekend’s A Prairie Home Companion. He said he was a terrible, terrible writer and even read a few lines to demonstrate.
So, I assume it must have done well enough for someone in the US to have read him. Granted, Garrison Keillor is probably a pretty well-read guy.
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To be honest, I’ve never taken the Nobel Prize in Literature that seriously. I always felt like they were pretentious in their choices, always selecting that which was more obscure and difficult. I feel the Pulitzer organization typically does a much better job of selecting things I’d actually want to read (though you do lose the international angle if you rely on them).Report
There have been some great literature winners over the last couple decades. Munro, Llosa, Coetzee, Naipaul, and Saramago come to mind. Accessible and not at all obscure.Report
I have to admit that I don’t actually read that much fiction in the first place.Report
Well, if you were looking for novels, you couldn’t go wrong with Llosa, Naipaul, Coetzee, or Saragamo. They are, in fact, some of my favorite writers of the last 50 years. Saramago is the only one who might take some effort to get into, because his writing style is odd (but beautiful), but there are ways to ease into his writing. Coetzee and Llosa can be a bit brutal (my mom, an avid reader, stopped reading Coetzee’s Disgrace because “it was just too depressing”), but Naipaul and Saramago are unqualified treats (even when Saramago’s subject matter is brutal, as it was in Blindness, which is a very good book and his most well known, but outshined by its sequel, and probably in the second tier of his novels).Report
I always felt like they were pretentious in their choices, always selecting that which was more obscure and difficult….I have to admit that I don’t actually read that much fiction in the first place.
This reminds me of a contradiction that always occurs to me (and I’m not picking on Vikram, everybody does this, to people whom they view as having tastes more obscurantist/less-populist than their own – even me!)…
I have, on more than one occasion, been called a ‘music snob’ (less frequently, ‘TV/film’ or ‘food’ or ‘book’, but the same principle still holds, regardless of topic).
The implication of ‘snob’ often seems to be that *my* experience is being unnecessarily self-limited or circumscribed, because I am denying myself the pleasures of [mainstream pleasure A] in favor of delighting in [obscure pleasure B].
But this makes no sense; often, I have sampled [mainstream pleasure A] (or something similar) and found it lacking to my taste, compared to [obscure pleasure B].
Moreover, since I am interested in the larger [topic], I have ALSO sampled [C-N], which the person calling me ‘snob’ (and thus implying *my* experience is limited) has not, because they are fully satisfied with [A]; so on any realistic measure, I have experienced more [topic] and thus my experience is presumably *less* limited than theirs.
Someone who is an oenophile has almost certainly tasted more wines than I ever will. Why would I assume *their* experience is limited, rather than *mine*?
(Did I just make a Saul comment?)Report
Glyph,
With many over-hyped things (and wine is an overhyped thing), people DO self-circumscribe. I drink award-winning Concord wine (they’ve won International competitions). Wine snobs don’t drink foxy grapes, and they don’t like sweet.
So, yes, they really aren’t terribly open.
Offtopic: Can you hear the shruti box in the DS9 theme?Report
Huh, I had the opposite reaction- I preferred Blindness to Seeing. Was just discussing that with a friend, in fact, because I picked up a used copy of Blindness and have been trying to find a home for it. (I bought it because it was only a couple bucks and is a great intro to Saramago. It was my own intro, in fact, which may account for why I like it so much.)
That said, I heartily endorse all things Saramago- his worst stuff is still pretty damn good, and as you said, his writing is beautiful, even in translation. Makes me wish I could read Portuguese.Report
@gingergene : My Brazilian friend (I love to hear her speak Portuguese, it’s musical to me) expresses frustration with her native tongue sometimes: she calls it ‘pillowy’, meaning it can sometimes be hard to express certain precise meanings or concepts in it.
Depending on the story, I could see that be an asset or a liability.Report
Brazilian and European Portuguese can be pretty different, particularly in pronunciation. I think a lot of European speakers find the Brazilian version to be harsher, or sharper… I’m having trouble thinking of the correct adjective, since I don’t speak Portuguese at all (unless you needed to find a bathroom or a library). To me, Brazilian Portuguese has moments that sound almost Eastern European in pronunciation, while European Portuguese sounds very similar to the other European Romance languages.
Saramago was, of course, from Europe. I wonder if Portuguese and Brazilian readers of him in Portuguese have different opinions of his style based on the differences in pronunciation and in some cases even sentence structure between the two dialects.Report
Brazilian and European Portuguese can be pretty different, particularly in pronunciation.
I have a friend who is a working ethnographer for Intel who speaks fluent European Portuguese. When Intel sent him to Brazil to do field work, he reported that he and his Brazilian colleague spent 20 minutes or so trying to use Portuguese, then gave up on it and agreed to use English.Report
Michael, I have a friend who had precisely the opposite experience. She learned Brazilian Portuguese in college, including a full year down there, and now works as the liaison for all things Brazilian at her company (which means she gets to travel to Brazil 5 or 6 times a year). She went to Portugal last spring for vacation, and stayed with a family there. She said hat after a few minutes of conversation in Portuguese, they asked her to please speak English, and they spoke English for the rest of her visit.Report
Somewhat OT but not totally, it was perhaps (or perhaps not) surprising that my (limited) Spanish (though learned from South American speakers, not European ones) was enough to allow me to muddle through as a tourist in Portugal based on the similarities.
All these comments are also reminding me of the hyperintelligent characters in Blindsight that would just rapidly just switch back and forth between various languages, based on whichever one was best suited to expressing the current concept at hand.Report
Also, if anyone wants to read The Cave, All the Names, The Stone Raft, or The Year of the Death of Ricardo Reis, I will read them with them, ’cause I’d read those again anytime, any place.Report
Chris,
Germans always want to speak English (they want more practice).
French always want you to speak French (it’s some sort of chauvinism).
Japanese will make you pay if you don’t speak Japanese.
In all things international, it is far more important to understand subtext and subterfuge than to actually understand the words being spoken. (Although it takes some rather interesting talents to manage that trick).Report
I’m way out of my zone of expertise or even passable knowledge, but I wonder if the Nobels have become one of those things that needs to be viewed as primarily — if not exclusively — an ‘in-group’ award. Basically, you win the Nobel for medicine not by actually changing the state of medicine, but by impressing other medicine workers.Report
Well, yes, but I wouldn’t hold that against them in particular. The people who are best able to determine whose work is worthy are people who themselves work in the field.
In the case of the Medicine or Physiology awards, I’ve noticed a tendency to give awards to those who came up with clever techniques for coming up with a result. They tend to be more methodologically interesting than the awards in other areas.
Said differently, I think the medicine folks seem to want to reward cleverness. The economics folks want to reward academic influence. The physics folks reward based on a combination of academic and practical influence. (These are very vague generalizations based on random readings.)Report
I can never resist… economics is the only science field where two people can win the Nobel (yeah, yeah, but you know what I mean) for results that contradict each other.Report
The economics prize isn’t even really a Nobel Prize. Posers.Report
The other scientific Nobel Prizes are in chemistry and physics, so it would be consisted to just re-name the medicine one as Nobel Prize in Biology. And, in fact, it is called “The Nobel Prize in Physiology or Medicine”, and ‘physiology’ can cover pretty much any type of human biology. So just think of it as the Nobel Prize in Physiology if that makes you happier with it.
Still, if HPV one was the only example people can come up with for a ‘practical one’, that might be an issue about the relevance of the prize. However, it’s not even close to the only one. Based purely on a quick skim through Wikipedia’s list of winners, here are ones with clear practical applications to medicine:
1901: Emil Adolf von Behring, “for his work on serum therapy, especially its application against diphtheria, by which he has opened a new road in the domain of medical science and thereby placed in the hands of the physician a victorious weapon against illness and deaths”[10]
1902: Sir Ronald Ross, “for his work on malaria, by which he has shown how it enters the organism and thereby has laid the foundation for successful research on this disease and methods of combating it”
1905: Robert Koch, “for his investigations and discoveries in relation to tuberculosis“[14]
1907: Charles Louis Alphonse Laveran, “in recognition of his work on the role played by protozoa in causing diseases”
1908: Ilya Ilych Mechnikov and Paul Ehrlich, “in recognition of their work on immunity”
1913: Charles Richet, “[for] his work on anaphylaxis”
1919: Jules Bordet, “for his discoveries relating to immunity”
1923: Frederick Banting and John MacLeod, “for the discovery of insulin”
1924: Willian Einthoven, “for the discovery of the mechanism of the electrocardiogram”
1926: Johannes Fibiger, “for his discovery of the Spiroptera carcinoma”
1928: Charles Jules Henri Nicolle, “for his work on typhus”
1929: Christiaan Eijkman, “for his discovery of the antineuritic vitamin” and Sir Frederick Gowland Hopkins, “for his discovery of the growth-stimulating vitamins”
1930: Karl Landsteiner, “for his discovery of human blood groups”
1933: Thomas Hunt Morgan, “for his discoveries concerning the role played by the chromosome in heredity” (one of the most important developments in medical science in the 20th century, and relevant to the study of every existing genetic disease)
1934: George Minot, George Hoyt Whipple, and William Murphy, “for their discoveries concerning liver therapy in cases of anaemia”
1943: Karl Dam and Edwad Doisey, “for [their] discovery of vitamin K”
1945: Sir Ernst Boris Chain and Howard Walter Florey, “for the discovery of penicillin and its curative effect in various infectious diseases”
1948: Paul Herman Müller, “for his discovery of the high efficiency of DDT as a contact poison against several arthropods” (yes, now we know it kills birds; it also kills the mosquitoes that cause malaria, among others)
1951: Max Theiler, “for his discoveries concerning yellow fever and how to combat it”
1952: Selman Abraham Waksman, “for his discovery of streptomycin, the first antibiotic effective against tuberculosis”
1953: Sir Hans Krebs and Fritz Lipmann, “for the discovery of the citric acid cycle” (this one’s highly important to a great deal of metabolism – it’s a major part of how we make energy, and thus how we’re able to stay alive)
1954: Frederick Robbins and Thomas Weller, “for their discovery of the ability of poliomyelitis viruses to grow in cultures of various types of tissue” (if you can culture a virus, you can study it far more effectively)
1959: Arthur Kornberg and Severo Ochoa, “for their discovery of the mechanisms in the biological synthesis of RNA and and DNA”
1960: Sir Frank Burnet and Sir Peter Medawar, “for discovery of acquired immunological tolerance”
1962: James Watson and Maurice Wilkins, “for their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material”
1965: André Lwoff and Jacques Monod, “for their discoveries concerning genetic control of enzyme and virus synthesis”
1966: Peyton Rous, “for his discovery of tumour-inducing viruses” and Charles Huggins “for his discoveries concerning hormonal treatment of prostatic cancer”
1968: Robert Holley, Har Gobind Khorana, and Marshall Nirenberg, “for their interpretation of the genetic code and its function in protein synthesis”
1969: Alfred Hershey and Salvador Luria, “for their discoveries concerning the replication mechanism and the genetic structure of viruses”
1972: Gerald Edelman and Rodney Porter, “for their discoveries concerning the chemical structure of antibodies”
1975: Renato Dulbecco and Howard Temin, “for their discoveries concerning the interaction between tumour viruses and the genetic material of the cell”
1976: Baruch Blumberg and D. Carleton Gajdusek, “for their discoveries concerning new mechanisms for the origin and dissemination of infectious diseases”
1978: Werner Arber, Daniel Nathans, and Hamilton O. Smith, “for the discovery of restriction enzymes and their application to problems of molecular genetics” (vital for well-nigh any studies of the genetics of anything human, animal, plant, parasitic, or pathogenic, and for a vast array of biological research, and for the ability to create genetically modified organisms.)
1980: Jean Dausset and George Snell, “for their discoveries concerning genetically determined structures on the cell surface that regulate immunological reactions” (specifically, the major histocompatibility complex, which identifies foreign materials [like bacteria and viruses] is absolutely central to understanding the immune system)
1983: Barbara McClintock, “for her discovery of mobile genetic elements” (central to our current understanding of how DNA works, and a sea change from how it was previously understood)
1984: George Kohler and César Milstein, “for theories concerning the specificity in development and control of the immune system and the discovery of the principle for production of monoclonal antibodies”
1987: Susumu Tonegawa: “for his discovery of the genetic principle for generation of antibody diversity”
1988: Sir James Black, Gertrude Elion, and George Hitchings, “for their discoveries of important principles for drug treatment”, including (from Nobel website):
– “Sir James W. Black realized the great pharmacotherapeutic potential of receptorblocking drugs and developed in 1964 the first clinically useful beta-receptorblocking drug, propranolol. This type of drug is now being used in the treatment of coronary heart disease (angina pectoris, myocardial infarction) and hypertension.”
– “Gertrude Elion and George Hitchings, who have collaborated since 1945, demonstrated differences in nucleic acid metabolism between normal human cells, cancer cells, protozoa, bacteria and virus. On the basis of such differences a series of drugs were developed that block nucleic acid synthesis in cancer cells and noxious organisms without damaging the normal human cells…During 1950-51 they developed thioguanine and 6-mercaptopurine against leukemia and pyrimethamine against malaria. Azathioprine, a drug that prevents rejection of transplanted organs and allopurinol which is used in the treatment of gout were developed in 1957 and 1963, respectively…A recent, successful application of their research ideas is exemplified by acyclovir (1977), the first effective drug in the treatment of herpes virus infections”
1989: J Michael Bishop and Harold Varmus: “for their discovery of the cellular origin of retroviral oncogenes”
1990: Joseph Murray and E. Donnall Thomas, “for their discoveries concerning organ and cell transplantation in the treatment of human disease”. Specifically:
Joseph E. Murray discovered how rejection following organ transplantation in man could be mastered, and E. Donnall Thomas managed to diminish the severe reaction that the graft can cause in the recipient, i.e. the so-called “graft-versus-host” reaction (GVH). In addition, Thomas could show that intraveneously infused bone marrow cells were able to repopulate the bone marrow and produce new blood cells.
– “Murray successfully transplanted a kidney between homozygous twins for the first time. He pioneered transplantation of kidneys obtained from deceased persons and could show that patients with terminal renal insufficiency could be cured. The field was then open for transplantation of other organs such as liver, pancreas and heart.”
– “Thomas was successful in transplanting bone marrow cells from one individual to another. Bone marrow transplantation can cure severe inherited disorders such as thalassemia and disorders of the immune system as well as leukemia and aplastic anemia.”
– 1993: Sir Richard J. Roberts and Phillip A. Sharp, “for their discoveries of split genes” (vital to our understanding of genetics, and any genetic studies on genetic disease, or pathogenic bacteria, viruses, etc.)
1996: Peter Doherty and Rolf Zinkernagel, “for their discoveries concerning the specificity of the cell mediated immune defence”
1997: Stanley Prusiner, “for his discovery of prions – a new biological principle of infection”
2003: Paul Lauterber and Sir Peter Mansfield, “for their discoveries concerning magnetic resonance imaging (MRI)”
2005: Barry J. Marshall and J. Robin Warren, “for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease”.
Marshall is one of my favourite scientists, because when the rest of the field mocked him for arguing that ulcers were caused by bacteria, he drank a culture of H. pylori to prove it – and immediately developed severe ulcers. Thus gaining credence for his theory by disobeying the first laboratory rule that every student learns: “Don’t drink the stuff in the flasks.”
2006: Andrew Fire and Craig Mellow: “for their discovery of RNA interference – gene silencing by double-stranded RNA”. (This is hugely important as a technique for studying genes, because by ‘silencing’ a gene, researchers can find out what it does. This is extremely applicable to research on a wide variety of diseases, as well as research on, well, basically anything else that involves genes.)
2008: Francois Barre-Sinoussi and Luc Montagnier, “for their discovery of human immunodeficiency virus (HIV)”
2009: Carol Greider and Jack Szostak, “for the discovery of how chromosomes are protected by telomeres and the enzyme telomerase” (i.e.: discovering, in essence, why people age. The importance of this for medicine needs no explanation.)
2011: Bruce Beutler, Jules Hoffman, and Ralph Steinman, for their discoveries relating to innate and adaptive immunity.
“Scientists have long been searching for the gatekeepers of the immune response by which man and other animals defend themselves against attack by bacteria and other microorganisms. Bruce Beutler and Jules Hoffmann discovered receptor proteins that can recognize such microorganisms and activate innate immunity, the first step in the body’s immune response. Ralph Steinman discovered the dendritic cells of the immune system and their unique capacity to activate and regulate adaptive immunity, the later stage of the immune response during which microorganisms are cleared from the body.”
2012: Sir John Gurdon and Shinya Yamanaka “for the discovery that mature cells can be reprogrammed to become pluripotent”. (Pluripotent stem cells are the key to cures for a great many illnesses, and making them from mature cells means that we could grow organs from a person’s own cells, avoiding all of the issues around transplant rejections, as well as the ones around a shortage of donated organs.)
Based on these, it looks to me like the Nobel Prize in Medicine is highly successful at rewarding relevant and important discoveries, and has recognized many of the most important ones of the last century. Many of these discoveries are relevant to specific diseases; many more are relevant to they study of all, or huge categories of, diseases, and provide us with new tools to study them and new understanding of their mechanisms.
While the discovery that smoking causes lung cancer is absolutely important and should have been rewarded, the discovery of penicillin, the discovery of insulin, the discovery of blood groups (without which we wouldn’t have blood transfusion), discoveries of how DNA works, the discovery of the major histocompatibility complex, the discovery of HIV, and the creation of new antimicrobial drugs are all also of vast importance and relevance to medicine.Report
To summarize: it appears that that Nobel Prize for Medicine/Physiology mixes recognition for work on a specific disease with work that relates strongly to studies on every disease.
Arguing that the latter shouldn’t be recognized makes no sense to me. It’s like saying that developing the iPhone 6 is more important/significant than the original invention of the computer. Some of the discoveries Roberts is dismissing influenced and enabled massive amounts of research on huge numbers of different illnesses and pathogens. Is he under the impression that we’d have most modern advances in medicine if we still didn’t understand how DNA worked?Report
As a (very limited) counter, we still weren’t treating diabetes competently up until the 1970’s (where we were still looking at urine samples). So, yeah, we might have figured out what insulin did, but we weren’t very good at even managing diabetes for 50 years after the Nobel was awarded.Report
Why is any of this surprising? Look at last couple of noble peace prize winners.Report