What About the Mozarts of Science?

A decade ago, Bernadine Healy, then director of the National Institutes of Health, spoke of the "need to discover the new medical Mozarts among the many Salieris in biomedicine."1 For Healy, the popular play and movie Amadeus, which depicted the rivalry between Antonio Salieri and Wolfgang Mozart, makes an important statement about talent. Salieri, Healy recalled, was talented in a "workmanlike sort of way. He could compose and get the job done with competence. By contrast, Mozart was a mercurial, brilliant, difficult genius. The music he composed was not merely competent; it was sublime." The contrast between Mozart and Salieri raised a question for Healy about policy: "Can science and medicine flourish ... if we cultivate only the Salieris?" Her answer, of course, was no: "The talent base we need requires more Mozarts. Energetic, talented and irreverent youth must be encouraged .... The cost of finding, educating, and sending the medical Mozarts to the frontier is not cheap. But the cost of the only alternatives--ignorance and scientific stagnation--is incalculably higher." Healy's question--and her answer--remain compelling. Who would not welcome the scientific equivalent of The Magic Flute? Unfortunately, no one has hit upon a way to find, cultivate, and sustain the Mozarts. Despite the best intentions of government research institutions and private foundations, the relentless flow of "new initiatives" designed to provide research support for young investigators, Mozart remains out in the cold. Not all Mozarts, mind you. Some creative, unconventional thinkers possess--along with their other gifts--the tact necessary to acquire funding and work successfully with the right mentors; they have the discipline, determination, and shrewdness to put together a fundable grant application and the fortitude to persevere in the face of rejection. But some creative, brilliant folks do not possess all of the above. More than a few are quirky, irreverent, arrogant, and--in part because of their creative drive--unable to be the good sons or daughters valued by mentors. Some have sufficient charm to secure a mentor but find the drudgery of grant application unbearable. Others can bear the grant writing but find the pink sheet's demands insufferable. Unwilling--or, perhaps more accurately, unable--to make the requested modifications, they throw in the towel. It's difficult to even contemplate how Mozart might react when advised to change the key of the clarinet concerto from A to C or to shorten the adagio. "Advances in science often come from unconventional thinkers," says Healy, "from scientists who discern wider patterns of connection among diverse fields, or from those who replace cause-and-effect hypotheses with revelatory analogies that uncover entirely new horizons." A significant proportion of these sorts of thinkers don't survive the scientific environment. There are clear advantages to allowing natural selection a free rein. In this instance, it provides a group of investigators endowed at the very least with determination, some ability to put their ideas on paper (or to find people who can), a good grasp of their fields, and command of suitable methodology--in short, investigators who have what it takes to get grants. A few of these folks make break through discoveries; most are Salieris, doing necessary and important clean-up operations, dotting the Is and crossing the Ts, adding incrementally to knowledge. The cost of this particular Darwinism is more difficult to calculate. How many Magic Flutes do we lose, how many Clarinet Concertos in A? Conversely, how much should we pay for the remote possibility that a scientist who can't work the current system will, with a bit of sustenance, make a momentous discovery. Is it as worthwhile to promote this type of diversity in the scientific community as it is, let's say, to preserve the ferns, lizards, rodents, and wolves who, without intervention, would succumb to the forces of natural selection? Here's my proposal. Secure in the knowledge that it will never be implemented, I am not limited by the troublesome constraints of reality. The NIH budgets $44.6 million to provide five to 10 years of support to promising Mozarts. Applicants are both solicited and unsolicited. The application is a letter describing what the applicant intends to accomplish. The selection committee comprises eminent senior scientists from different disciplines. Each committee member reviews every proposal (limited to two pages). Committee members will regularly call their colleagues with questions such as "How crazy does this sound?" The committee interviews each nominee in person. By what calculus do I arrive at $44.6 million? The 2001 budget for NIH's Center for Complementary and Alternative Medicine is $89.2 million. That money will be used to "investigate" and yes, promote, snake oil and hocus-pocus. Surely it is worth half that to keep alive the possibility, however remote, that someday, from an unlikely and unconventional corner, might come the scientific equivalent of Mozart's music. Walter A Brown, M.D., is a clinical professor of psychiatry at Brown Medical School and Tufts University School of Medicine. He has received--and failed to receive--research grants. He does not consider himself to be a scientific or any other kind of Mozart, but he likes to think that if he came across one he would know it. 1. Speech given by Bernadine Healy, M.D., to the Science Diplomats Club, Cosmos Club, Washington, D.C., Oct. 7, 1992.

What About the Mozarts of Science?

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