Minime Physics

Cancer and Quantum Mechanics - Parallel Universes

Bethesda, Maryland, 1997

Early in my career I received a call from the White House, a formal request to attend the kickoff announcement of a research program.  The Vice President of the United States was scheduled to officially launch the project in a ceremony in the Old Executive Office Building, located in Washington, D.C., right next to the President’s residence.

One would think it was a happy day for me, an especially satisfying day because I had contributed to an important element of the program, a component borne of much frustration over the previous several years.

But I was not happy.  I was suffering through a dark night of the soul, science style.  The science had me worried.  Very worried.  Terribly worried.

Can’t sleep at night worried

Several of us from the research team boarded the Metro train in suburban Maryland in the mid-morning, rode into the District, and then walked over to the White House.  We proceeded through a security check at the entrance of the Old Executive Office Building and were led by several aides to the front section of a small auditorium for a picture taking session.  After the photos we were seated in the front row and told the Vice President would arrive soon.

I remember being impressed by the many national and international news crews located in the rear of the auditorium, with a whole bank of television cameras and lights along the back wall.  More people filtered into the auditorium, young staffers and aides I presumed, and a quiet din of conversation could be heard throughout the room as we waited for the Vice President.

I was excited.  It felt neat.  But still, I was worried about the science.

One of the objectives of the project the Vice President was announcing was to build a unique bridge between the scientific and medical communities.  The hope was to enable basic scientists in the laboratory to have immediate and easy access to clinical and molecular information about patients and diseases, particularly cancer.  The rationale was as follows.

Imagine that a young, smart, and ambitious biochemist discovers a novel interaction among biomolecules in tumor cells grown in a plastic flask in her laboratory, a finding that could be important in a particular type of cancer.  The results suggest a new way to medically intervene and treat the disease depending on if and how the molecular interaction occurs clinically, in other words depending on if and how the process occurs in actual tumors in patients, not just in her laboratory model.

So, she decides to build a bridge to the nearby university hospital to study patients and patient tumor specimens, as the gold standard against which to compare her new laboratory data.  But for cultural reasons the bridge to the clinic never materializes.

Not doable

Silo Problem

Eventually she gives up and decides to just stay in the laboratory and continue her work there.  Her new biochemical results are never fully evaluated in the clinic.  She never finds out whether her model is accurate and true for tumors in patients or is providing a false lead due to artificial growth conditions in a plastic flask.  She never knows for certain whether she is on the right track and should move forward quickly to develop a new drug or diagnostic or is on the wrong track and should alter her strategy in some way.

Dots not connected

But imagine a different scenario.  Imagine that folks in the clinic appreciate her dilemma, the same problem faced by many thousands of basic scientists in laboratories in the US and internationally and try to be helpful.  They decide to study patient tumors in the hospital using all the latest and greatest technologies, all the coolest gizmos and gadgets, and then assemble the DNA sequencing results and molecular data sets and make them freely available (with patient privacy protected) to all laboratory scientists via the Internet, a relatively new invention at the time of our trip to the White House in the late 1990s.

Instead of the young biochemist spending several years unsuccessfully trying to build an old-fashioned bridge from the laboratory to the hospital, based on physically traveling to the clinic, the research arrow is flipped, not the usual ‘from laboratory-to-clinic’ strategy, but to a new mode, ‘from clinic-to-laboratory.’

She is now able to easily retrieve the patient tumor data she needs on her computer, while sitting at her desk, drinking a warm cup of coffee, using the Internet as a new electronic bridge.  The incoming clinical information allows her to assess the real-world validity of her laboratory results and proceed accordingly, to help develop a new drug, or a new diagnostic, or to expand upon a line of scientific investigation that will eventually assist pharmaceutical or biotechnology companies in creating new clinical interventions.

Or, equally importantly, perhaps more importantly, the electronic bridge and incoming clinical data may help her realize the tumor cell results in the laboratory flask do not occur the same way in patients, to realize they are only an artificial feature of the model system, to fail fast in today’s vernacular, to not spend the next many years and extensive resources chasing down a false lead, a critical insight since it takes 10+ years to develop a new drug, at a cost of a billion dollars or more.

That was our first hope – Clinically validate/invalidate laboratory data.

Even more excitingly, though, the electronic bridge could grow further, beyond just authenticating results already generated with her model.  Having access to vast clinical and molecular data would allow the young biochemist to generate new ideas and hypotheses, too, sophisticated new ideas and hypotheses, by integrating her many laboratory results with a whole range of molecular information from patients, in real time, to electronically go back and forth between the laboratory and clinical data, at almost light speed, to quickly and efficiently compare and contrast the cells in her plastic flask with patient data, to ask new questions, to validate or invalidate whole reams of laboratory results, to employ novel computer algorithms, to rapidly follow novel leads in silico, to perform queries that would be unimaginable using traditional old fashioned physical bridges between the laboratory and the clinic.

The electronic bridge could transform the laboratory-clinic relationship into a new lightning-fast dynamic, ‘laboratory-to/from-clinic.’  That was our second hope.

Dots connected – quickly

New connections identified – quickly

Laboratory results validated/invalidated – quickly 

Providing an electronic bridge between the laboratory and clinic was an element of the program the Vice President was announcing in the Old Executive Office Building.  It was only an early-stage demonstration project, just to test out the new Internet-bridge concept.  We were aware, of course, the electronic bridge would not solve all the problems that laboratory researchers encounter, nor would it be useful for all types of projects.  But it was a start, a potentially important new way to move the field forward.

I should have been happy.  But I was not.  I was suffering a hangover from my dark night of the soul.  I was still worried about the science.

After the ceremony we all walked back to the Metro, boarded the train, and rode back to Maryland.  Everyone on the research team was thrilled and happy about the morning’s event.  The excitement among the group was palpable.  Having the White House formally invite you to an event, and then having the Vice President of the United States announce your research project, with cameras rolling, was heady stuff for all of us, but especially for someone like me at that early career stage.  It made me feel like a real member of the club.

Very honored, very grateful

But still, I was not happy.

We all suffer through dark nights of the soul.  This is just part of the human experience, they are unavoidable.  The dark nights come in many forms and flavors.  They can be long and agonizing or they can be short and brutish.

Mine was both

Slowly unsettling – then jarring

As we rode the train back from the District the science kept going back and forth in my mind.  I could no longer deny reality.  The science had disturbed me for a long time and then a few months earlier the truth had hit abruptly, like a bolt of lightning.  Everything was fine, until suddenly it wasn’t.  There was something seriously wrong.  The field was in trouble.  I had to be honest with myself.

We were on the wrong track

But it was not the project the Vice President had just announced that had me concerned, my day job.  The biomedical research work was fine, and I was excited about the possibilities for moving cancer research and cancer therapies along more quickly using the new electronic bridge.

My concern was my night job – my hobby – my parallel universe – physics – atomic physics – quantum mechanics.  I could no longer ignore the obvious.

Quantum mechanics was suffering from the same problem we struggled with in biomedicine, the one the Vice President had just tried to help fix, and was traveling down a dangerous and murky path.

Physics was a separate universe from biomedicine.  The names and faces were different.  But the story was the same.  A major problem was the same.  There was a theme that resonated through both universes.

Silos in the Dark

Everything crystallized for me.

A river was crossed.

An irreversible sea change occurred.

The murkiness dissipated.

I saw the issue clearly.

We are on the wrong track.

And I need to leave the club