The Art and Politics of Science, Part I

GUEST: Dr. Harold Varmus
VTR: 04/14/2009

I’m Richard Heffner, your host on The Open Mind.

And a decade ago in the New Yorker magazine, star journalist James Fallows authored a particularly insightful
Profile of my guest today titled “The Political Scientist”…an apt descriptive of Nobel Laureate in Medicine Harold Varmus, then Director of the National Institutes of Health, where he served brilliantly for the greater part of the Clinton Presidency, and now for nearly a decade President of the world-renowned Memorial Sloan-Kettering Cancer Center here in New York.

Nor does Dr. Varmus shy away from James Fallow’s lovely descriptive. Indeed, his own new W. W. Norton memoir is titled The Art and Science of Politics … and he calls that most readable Part Three simply: “A Political Scientist”, quite appropriate for a Nobel Laureate who has now been appointed to co-chair President Barack Obama’s Council of Advisors on Science and Technology.

Well we’ll get to that later, however. But first, Parts One and Two, on “Becoming A Scientist” and “Doing Science”. And I particularly want to know what Dr. Varmus means by “Doing Science”. What do you mean?

VARMUS: Well, I would try to get away from the conventional view of scientists as someone who are working—by themselves—in a kind of abstract ivy tower world. And I wanted to convey the excitement of modern science in the study of cancer that all too often is an account of successes and without some dose of the failures and the difficulties of getting things done.

And I wanted to show, in a narrative, in that section of the book what it’s like to move from an era in which we had a really very poorly informed sense of how a normal cell becomes a cancer cell and show how, as a result of a series of, of serendipitous events and brilliant leaps by some of my colleagues and some very lucky science in our own lab how we changed the, the landscape and learned how, how cancer actually arises through the action of mutant genes.

So, it was an effort to show science as a process rather than as an accumulation of facts. One of the things that makes our society and our, our citizens less excited about science than they ought to be is that they receive science as a, as a package of alleged facts, when in fact science is a dynamic process in which most interesting moments are at that intersection between what we think we know and what we’d like to know. And it’s there that the battles get fought out in a highly experimental way. And without going into all the details of how our work was done, I try to give a flavor for what it’s like to make discoveries.

HEFFNER: Well, why haven’t scientists been successful at … or have they even tried to … interpret what the process is that you describe and that you think the public needs to understand?

VARMUS: Well, it’s interesting. I mean there is a lot of attention given by sociologists of science, philosophers of science to the scientific process. Traditionally scientists who actually do the work … (laughter) … the people who are in laboratories running experiments … tend to be fairly uninterested in what that process means and what the analysis looks like.

So, I think, perhaps one of the attributes of aging is developing a … more of a historical perspective, greater interest in what it means to do science … if you’re young—and we were all young once—you plunge in and you enjoy it … and you learn from your mentors how you should do it. You may learn the right way or the wrong way, but the idea is to do and not to think about it too much … you think about the substance of what you’re doing, but not about what the process means as an intellectual exercise.

HEFFNER: You make it sound as though it were a sport.

VARMUS: It is. (Laughter) In many ways.

HEFFNER: Tell me about that. What do you mean?

VARMUS: Well, look … there are, there are challenges. There’s competition. There is exertion. There is excitement. There, there … there is … even in fields where people are working collaboratively together and enjoy the, the spirit of the competition, it is still an adventure. And in many ways not dissimilar.

I wrote an essay recently to accompany a portrait taken of me by Mariana Cook with my bicycle … so I’m … I’m quite an avid bike rider.

I wrote a little essay about how bike riding is like, is like doing science. And it’s true. There are up hills and down hills. There is perspiration, there is exhilaration, there’s competition, there’s friendly camaraderie among cyclists. Getting to the top of a hill does not mean the end of a race, it just means seeing another hill in the distance and running downhill for a little while because you’ve accomplished something and then climbing the next one.

And there, there’s a sense in which science has a sports-like quality to it.

HEFFNER: Much is made in everything that is written about you, and so much has been written about you and I think the best thing is the Fallow’s piece …

VARMUS: I’m disappointed to hear that … I would have like to have thought that the best thing was The Art and Politics of Science … (laughter)

HEFFNER: Oh now … come, come, come … I used the word “about” …

VARMUS: (Laughter) Oh, okay. Well this is a book written by me about myself …so, in many ways …

HEFFNER: It didn’t just come, it was … you sat at a distance and wrote about Harold Varmus?

VARMUS: Well, at times I tried to do that, yeah. I, I think so.

HEFFNER: Could you do that as a scientist?

VARMUS: How, how do you mean?

HEFFNER: Move yourself that far away from what it is that you’re doing?

VARMUS: I think you have to. I mean especially working on, on problems of health that are highly emotional problems …

HEFFNER: Highly emotional?

VARMUS: … well, I think all of us working on cancer recognize that the impact of cancer on individuals and families is, is an immensely disturbing and emotional one. And, and it’s very difficult to work on problems that take years to approach, let alone solve … without some sense of distance from the problem.

That is … I, I think we all try to find the right balance between our sense of urgency … cancer is an incredibly important disease to try to conquer. And, and the recognition that working in a lab day by day … you really can’t rush it. If you rush it, you make mistakes and you do things that are probably not the right experiments to do. So there is a, an objectification, a removal of the, of the emotive forces to, to be able to work in an analytic fashion on a problem that does hold the seeds of tragedy.

HEFFNER: Is … does that difference prevail in the movement from, let’s say, the National Institutes of Health to as specific an organization and institution as where you are now at Sloan Kettering?

VARMUS: Oh, I don’t … ??? are different between the NIH and, and Sloan Kettering. I mean we are, we are an institution that’s supported to a very significant extent by grants from the NIH.

The NIH carries out a somewhat different set of functions in its extramural funding … grant-making organization … we don’t … for the most part make grants. Although we do make internal grants, we have money given to us from donors … Starr Foundation, the Atlantic Philanthropies, from the Bean—from the Bean Legacy. And we use that money to support the work of our scientists through a peer review process.

And so, in some ways, you know, we operate very much like the NIH. And we have to balance our own internal grant portfolio in a way that supports basic science and also science that’s much closer to the patient interface.

HEFFNER: You’ve made much of the point of basic science.

VARMUS: Well, I … it’s, it’s a … it’s a more important thing to defend. I don’t say it’s more important, but it’s very easy for people who are concerned about disease to say, “I want to see this money going into efforts to prevent and cure the disease I care about.”

And that is the end point. That’s incredibly important. But it’s sometimes more difficult for people to understand how truly revolutionary steps toward treatment and prevention require the basic knowledge that we often don’t have. And, it sometimes … it requires instruction for people to understand that working with simple model systems … worms or flies … using cells from an animal in culture … using methods in molecular biology to understand fundamental mechanisms of disease may be just as important if not more important than doing another clinical trial.

But everything should be in the portfolio. It’s just a question of a, achieving the right balance, which I don’t think anybody ever does perfectly because there is no perfect answer. And the reason that I spend, perhaps, more time talking about the importance of basic science is that the basic science doesn’t have its very public defenders the way disease-oriented science does.

HEFFNER: How would you describe basic science?

VARMUS: Well, it’s science that’s directed toward understanding fundamental mechanisms by which living organisms and I’m talking about your biology and medicine way of living organisms … survive and undergo the process of aging and, and, and develop disease.

So, it’s an address to an understanding of the kinds of maladies we’re trying to ultimately control rather than a focus on the acts of prevention and treatment or diagnosis.

So there … but there is an important element to all of these aspects of disease-related research. It’s just that the basic part doesn’t have, in its immediate charge, the, the directive to have a practical outcome.

We all say when we defend basic research and we say this, not just as a kind of platitude, but with specific examples in mind that an understanding of how things work is fundamental to the advances that we make later.

I mean just take the most simple example. If we didn’t understand the, the fundamental principles of how information is encoded in our cells, how it’s expressed through the fundamental dogma of molecular biology … things that were learned in the fifties and sixties … we wouldn’t have had the recombinant DNA revolution; we wouldn’t have … we wouldn’t have a picture of the human genome, we wouldn’t understand how genes contribute to disease; we wouldn’t be able to make a lot of vaccines and, and diagnostic kits and, and new therapies that are so important today.

HEFFNER: You were, I gather, quite successful in explaining this to your constituents in those years when you were in Washington … that you were awfully good at that.

VARMUS: Well …

HEFFNER: Do you take claim for that?

VARMUS: Well, I, I … you know, I put some effort into it … the main feature of the appropriation hearing each year, from my point of view, was to tell Congress … which represents the people in funding the NIH in a pretty healthy way … that, that we have made some progress this year … here’s what we’ve done, here’s what it means to the people who have disease. And I do see that as a very important method of convincing people that putting public trust in government science funding agencies is a good thing.

I think it is one of the great things our government does. We don’t always support it at the level that’s appropriate, but nevertheless the investment we’ve made is, is a good one for our nation and for the world. It’s made a big difference to us economically. Made a big difference to our health system and to the ability of people around the world to combat disease. And it’s one thing that Americans can universally be proud of.

HEFFNER: Your neighbor, Paul Nurse, head of the Rockefeller University … when he’s been here, he’s talked about science’s obligation to understand what its paymaster is interested in and wants. Is that the philosophy that guided you, too?

VARMUS: Well, I wouldn’t say it was that specific rendition, but I think Paul and I are on the, the same page here. That we, we recognize that, that whereas hundreds of years ago rich people and royalty supported science by inviting scientists to the court or giving them small donations to work in a, on a English country estate. But that’s changed dramatically, especially over the last 50 years.

The government, as Paul says, is our paymaster … they, they pay the bills and the government and the people the government represents should understand what they’re getting. So we have a responsibility to, to explain what we do and to, to ensure that what we are attempting to do with a very large amount of taxpayer’s money is consistent with the public’s interest.

HEFFNER: That rather modest point of view … and I think it’s not unfair to call it a modest point of view on the part of a scientist … stood you in very good … stood you very well when you were in Washington. Is that a philosophy that continues to dominate your thinking?

VARMUS: It does. I just … I have, I have a slightly different set of paymasters being at Sloan Kettering … I’m no longer just working for the government. We obviously use government money in our research to a very large extent … but we also receive a lot of money from, from very well-intentioned donors who support our effort and I, actually, unlike what is commonly the public perception, I enjoy fundraising. It’s a chance for me to explain to well-intentioned people what we do and how we could use their money in a very effective way … for public good. And I think the exercise of explaining what we do is a kind of educational process which most of us enjoy. I like to bring my best young investigators together with, with our patrons and, and have the, the scientists first of all make a connection with donors and secondly have the donors understand that the money is not going out into the stratosphere, it’s going into the hands of bright, energetic people who have really important and exciting ideas about how to understand biological processes and, and improve our ability to control cancer.

HEFFNER: Is that why you call this wonderful memoir The Art and Politics of Science?

VARMUS: Well, in part. There, there is an art to explaining it. There is an art to doing it. And there’s a political process whether it’s with government or with other parts of the body politic to making it successful.

As I try to explain in the very last section of the book, there are many things that we do as scientists whether in the area of stem cells or with respect to our publication practices or our attitude toward developing countries that has a very important global political component to it. And that, to me, is another dimension to science that is much more influential in my life now and over the 15 or 20 years than it was when I was starting out and, you know, focused entirely on my own laboratory exploits.

HEFFNER: Is that what you meant before about the maturation of scientists …the growing up, the growing out of …

VARMUS: Well, it …

HEFFNER: … that early gung-ho state?

VARMUS: … it’s another aspect of it. I think people get more reflective about things. One thing they don’t … you know, if, if one’s been reasonably successful in science, you have the luxury of not worrying day-to-day about the, the success of one’s own experiments and you can think instead about how the field is progressing, what our relationship is to the people who support us, the people who benefit from our work. And you begin to think about applications of science in other parts of the world … so … and then you may think, as I mentioned earlier … about what the science process actually is and what we’re doing as scientists day by day … how we’re viewing the world and how we try to understand it.

HEFFNER: Did that wonderful, wonderful event … receiving the Nobel Prize … make a great difference in this, this maturation and your ability to do the things you want?

VARMUS: Well, I think the big difference for me … and I, as I try to recount in the book, was, you know, not the congratulatory aspect of it, but the fact that the Nobel Prize … which is one of many prizes given for many kinds of activities in the world, but it’s one that’s achieved a certain kind of status that’s almost mythical … gave me the opportunity to do what I probably otherwise would have had a lot of difficulty doing.

That is, becoming the head of a government agency and, and being a spokesperson for the scientific community because people in general and scientists as well, ten to turn to people who win things like the Nobel Prize and especially the Nobel Prize to represent the community because there’s instantaneous recognition and, you know, as I mention in this book several times there were occasions when I was Director of NIH, when I was pretty vulnerable to public or Congressional attack … when things had gone wrong at the NIH. And, and they may have seemed like minor things but they were violations of rules or laws and without having the protection of, of the Nobel aura, it would have been … the outcome would have been less good. So, there’s no doubt that there was a protective strategy at hand here, too.

HEFFNER: Yeah, but it’s quite clear that you have added, both in your present position …

VARMUS: MmmHmm.

HEFFNER: … at Sloan Kettering and those years in Washington … you added to the prestige of the Nobel …

VARMUS: Well, that was kind of you …

HEFFNER: … Prize.

VARMUS: … to say. But you were asking does the Nobel Prize itself make a difference? And I think that yes there are many people who have done work just as important or more important that the work for which we received our prize … who, you know, have the talents … and … but, you know, this, this … the Prize confers on you some ability to do things that you might not otherwise be able to do.

HEFFNER: Yeah, but you know, I’ve been watching and listening to you in recent weeks as you’ve been plugging the book …

VARMUS: (laughter)

HEFFNER: … as you should because it’s a great book. I’ve been interested in …to the degree to which people try to draw you into being a crusader, taking a position on the science or the non-science of the Bush years. In contrast to the role you’re going to play now as one of the Chairs in the President’s …

VARMUS: MmmHmm.

HEFFNER: … Council. And you’ve always seemed and it comes out in the, in this book … willing to do the politics …

VARMUS: Well …

HEFFNER: … of science and to respect others.

VARMUS: Sure. But recently you’ve heard me say that, that, you know, I did a lot of Bush bashing during the Bush years and that’s over. What I said and what many others said has been said. It’s time … not to forget those years … but now to concentrate on what we can do with a new … with a new administration that’s much more receptive to what science has to offer.

So I just have shied away from spending a lot of time in interviews like this talking about what was wrong during the Bush years. It’s important to remember a few key things and to congratulate President for Obama for, for example his memorandum which was recently issued on scientific integrity that protects the science advising process, requires agencies to put in place guidelines that will prevent tampering with scientific reports that have been commissioned; insures that the scientific advice that is given to the Administration be seen in an unadulterated form by the public.

Then the Administration can make policy. The, the policy is not necessarily dictated by the scientific advice it receives. It’s influenced by it, but it’s not determined by it. And the public ought to have a right to judge what has been done with respect to legislation and other administrative actions based on the information it receives. And that information should not be tampered with.

And I think one of the things we’ve learned from the era just closed is that it is bad for the country if we tamper with that information.

HEFFNER: But you know, I’m interested that, like the President himself, you seem to draw a lot of sustenance from understanding the positions of others. In the stem cell …

VARMUS: MmmHmm.

HEFFNER: … battles … I’ve heard you not want to get out there and be so negative about others, put your emphasis upon moving forward.

VARMUS: Yeah. But it’s also important to remember at the time that, you know, at the same time that the Bush policy was flawed, it was the first time that the Federal government spent money on stem cell research. It was a bad policy, as I wrote in the Wall Street Journal, just after it was issued …”this is not going to be a good policy for very long because clearly the stem cells that, that can be used with Federal money are going to be surpassed by other stem cell lines developed in other countries and with private money. And we will regret this policy in the very near future.”

And that did come to pass. But I think it’s also important to say that, that President Bush could have slammed the door on all stem cell research very easily. He could have argued for legislation that did much more detrimental things. And, at least for the first few years that he was in office, he continued to increase the budget of the NIH. So there were some things … I think we have to acknowledge the good part the same time that we are very harshly critical of the many bad parts.

HEFFNER: Do you see, it’s just that … just the last 60 seconds worth of what you had to say that impresses me so much …

VARMUS: MmmHmm.

HEFFNER: … because I generally hear, from well-placed persons, a much less modest, a much less concerned with let’s-really-get-the-job-done expression.

VARMUS: MmmHmm.

HEFFNER: Now, have we been hampered in a disastrous way?

VARMUS: I think that there’s no doubt that the Bush Administration set back science in this country for a variety of reasons. And I think it’s always very difficult to say exactly how much damage was done. But there was damage done, no doubt about it. And people turned off from entering scientific careers. The, the lack of attention to science budgets … very unfortunate.

One could argue that, that much of the damage that was done was done because of much more non-specific, non-science specific policies in that era. The, the lack of regulatory rigor led to the financial crisis which now is a much more … a long term danger to the scientific community.

The atmosphere of suspicion, the war in Iraq … all these things, you know, contributed to a sense that the country is in trouble and that we’re hostile to our international partners and all these things affect the way science is done in this country.

HEFFNER: We have a half a minute left … something you just said … the financial crisis … badly affects science. Explain.

VARMUS: Well, there are, of course, a couple of sides to this, it’s not a simple issue. But, and many people have noted and we appreciate the fact that in the stimulus package that was recently passed by Congress, there was over 20 billion dollars for science, including about 10 billion for the NIH. That’s good, but it’s difficult to spend money in science effectively over the course of only a couple of years. What we really need to see is increase … gradual, sustained increases in the base budgets for these agencies and a sense for somebody who’s in college now or in high school, that science is not only honored, but supported by the government.

HEFFNER: And that’s something we’ll discuss next time. Thank you for joining me today, Harold Varmus.

VARMUS: My pleasure, thank you.

HEFFNER: And thanks, too, to you in the audience. I hope you join us again next time. If you would like a transcript of today’s program, please send $4.00 in check or money order to The Open Mind, P. O. Box 7977, FDR Station, New York, New York 10150.

Meanwhile, as an old friend used to say, “Good night and good luck.”

N.B. Every effort has been made to ensure the accuracy of this transcript. It may not, however, be a verbatim copy of the program.

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