Your view of the process of medical discovery may be considered controversial. How would you summarize it?
In my book Happy Accidents: Serendipity in Modern Medical Breakthroughs, I reveal that many of the major medical discoveries have occurred simply through chance—through a surprising, unexpected finding or observation that led research in a different direction, which resulted in a discovery of far greater value than the original goal.
What are major examples?
I describe about one hundred instances. But most people—scientists included—are astonished to realize that most of our antibiotics to combat infections, chemotherapy drugs against cancer, psychotropic drugs which modify mood disorders, and many advances in cardiovascular treatments and procedures were stumbled upon. So many of these chance discoveries, such as Valium, Lipitor, and Viagra, have become household names
These fields cover much of modern medicine. Are these advances the results of specialized teams with large federally supported grants?
The astonishing answer to that is a resounding “No!” Rather, they were typically discovered by individual curiosity-driven researchers with modest resources and funding. They had the sagacity to pursue a surprising finding or an incidental happenstance. For instance, in going down a false trail while testing the toxicity of a product, an unknown scientist working alone stumbled upon the effectiveness of lithium as a treatment for bipolar disorder. In another case, a researcher made what he thought was a frightening mistake only to discover that he had pioneered a revolutionary approach that enabled bypass surgery for heart disease. While conducting animal experiments for a surgical procedure, a young resident chanced upon a new treatment for abdominal aneurysms. Major cancer drugs have been discovered by independent self-motivated researchers from unexpected sources: from chemical warfare, nutritional research, medicinal folklore and bacteriologic research. A tumor in a chicken led to the discovery of cancer-accelerating genes and a contaminated polio vaccine led to the discovery of cancer-breaking genes. And the source of the mysterious adult stem cells was unexpectedly revealed in the course of investigating radiation effects.
Why is this generally unknown?
Scientific articles are very cut and dry, following a traditional format indicating a rigid, logical sequence. This is very often misleading. Understandably, researchers and clinical investigators are loathe to admit the element of chance for fear of compromising their status, tenure, and ability to generate research funds. Only years later, toward the end of their careers, after awards have been received, might the phenomenon of serendipity be openly acknowledged. I have interviewed a number of Nobel laureates and recipients of other prestigious awards who now feel they can speak with refreshing candor.
Why is it important for us to know the true contribution of serendipity in medical research?
Mainstream medical research stubbornly assumes that new drugs and other advances will follow exclusively from a predetermined research path. Many, in fact, will. Others, if history is any indication, will not. They will come not from a committee or a research team but from individual scientists and mavericks who view a problem with fresh eyes and who may find what they’re not looking for, who may stumble upon something and inquire, “I’ve found a solution. What’s the problem?”
We must reconsider our allocation of research funds, now directed almost exclusively to centrally directed programs. We must take a chance on chance. We as a society need to take steps to foster the kind of creative, curiosity-driven research that cultivates openness to serendipity and has the potential to accelerate medical discovery as never before.
What specific steps can you recommend?
Education at all levels should encourage creative thinking and prepare minds to be open to the unexpected. We must recognize and support the unconventional researcher and allow scientists to pursue surprising findings. Big Pharma should return from being primarily marketing machines to its roots as an engine for truly innovative research.