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]
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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