Wednesday, March 12, 2008

Serendipitous science

Well, actually, much of scientific process does happen as a result of the "prepared mind" being ready to respond to the chance occurrence (as noted by Pasteur.) Here is one such story.

It all started when two BIDMC clinician-scientists found themselves in an airport waiting for a delayed flight. They knew each other a bit, but had not had a chance to explore clinical and scientific interests before the bad weather made it possible to spend four hours together in the coffee shop.

One physician, Steve Freedman, is a GI specialist who treats people with pancreatitis. The other, Alvaro Pascual-Leone, is a neurologist who studies the use of repetitive transcranial magnetic stimulation (rTMS) as a therapy in several types of neurological disorders.

While waiting for the flight, Freedman discussed the tragedy of pain suffered by people with pancreatic disease, a type of pain that is among the most debilitating known. He allowed as how interventions in and around the pancreas were often unsuccessful in alleviating this pain. This prompted Pascual-Leone to hypothesize that the perceived pain was instead centered in the brain. Together, they wondered if rTMS could be used to alleviate this type of pain.

Clinical trials ensued, and the two doctors, along with several colleagues, published reports that indicate promising possibilities. Here's one, which to my dismay, is not available without payment, but which I offer for those who might be interested in following up. Here is another, which at least offers a free abstract. Ditto, for another.

But my main point is this: A chance meeting of two highly dedicated physician-scientists creates new avenues for treatment of a debilitating disease. For those of us who spend time trying to raise funds and otherwise support the activities of academic medical centers, this is what it is all about.

5 comments:

Tom said...

Isn't this an ideal scenario for a (private, by invitation, no crowdsourcing) wiki where leading physicians and scientists could have these "accidental" collaborative sesions? Seems like the key to success here was the lack of politics and process.

Dr. Val said...

Great story. At Columbia University (my alma mater), Lee Bollinger is moving the art and engineering departments into the same building, hoping to orchestrate some serendipity himself. You never know what might happen! :)

Paul Levy said...

Tom, great idea. Anyone out there know of such sites and how they've worked?

Alvaro P-L said...

Serendipity is critical for scientific discovery, and establishing an environment that makes chance encounters and exchanges increasingly likely would surely be desirable.

However, my guess is that serendipitous exchanges among different specialists are not that rare in a hospital and yet often nothing comes out of the good ideas generated.

What made this instance work so well for us is that I had a brilliant postdoctoral student, Felipe Fregni (now Assist Prof of Neurology) who took this idea seriously and conducted the crucial experiments to test it, and that Steve and I were able to support his initial work.

So, we need to create an environment that promotes serendipitous exchanges among people of diverse fields, but we also need to be able to engage and support promising physicians and scientist to pursue novel ideas.

Anonymous said...

Indeed, that is exactly how advances are made. I find that the "frontal assault" mode where you come up with an organized plan to attack a disease, rarely works. More often, the major advances come from a chance interaction with another field, where a totally new and often unexpected piece of the puzzle drops into place, and suddenly a great deal of progress is made. Thus, having a critical mass of very bright minds in one place makes all the difference. This is what separates us from a community hospital, and it is the potential source of greatness for BIDMC.