Blog | Monday, January 14, 2013

Three doctors' choices earn them scorn, accolades

Mega-blogger/tweeter Kent Bottles wrote a great post entitled "The Battle for the Souls of American Doctors."

In it, he juxtaposed two articles about doctors that appeared in the NY Times on the same day:
1) A news story about once-esteemed University of Michigan neurologist, Sidney Gilman, MD, who "sold out" late in his career for money, stock, and lavish trappings. Gilman crossed the line into insider trading when he advised clients to dump stock in anticipation of an announcement of a trial drug's ineffectiveness in slowing Alzheimer's.
2) An obituary of a real Dr. House, William House, MD, who is credited as being the inventor of the cochlear implant, among other medical and surgical innovations.

I find both stories compelling, because they show men of achievement, fortitude, and vision.

Dr. Gilman's story is of a man at the pinnacle of the profession being seduced by the temptations of money, fame, and influence. He seeks redemption by cooperating with authorities to avoid jail time, yet is disgraced in the eyes of his profession.

Hearing to the deaf: Dr. House

Dr. House's story is that of the dogged innovator, who continues on in spite of protests from naysayers: "... for 27 years, Dr. House had faced stern opposition while he was developing the [cochlear implant]. Doctors and scientists said it would not work, or not work very well, calling it a cruel hoax on people desperate to hear. Some said he was motivated by the prospect of financial gain. Some criticized him for experimenting on human subjects. Some advocates for the deaf said the device deprived its users of the dignity of their deafness without fully integrating them into the hearing world."

His invention allows the deaf to hear. How valuable an asset is that? How much would a patent for such a device bring? Licensing fees? Royalties?

"Neither [his] institute nor Dr. House made any money on the implant. He never sought a patent on any of his inventions ... because he did not want to restrict other researchers. A nephew ... said his uncle had made the deal to license it to the 3M Company not for profit but simply to get it built by a reputable manufacturer.

Reflecting on his business decisions in his memoir, Dr. House acknowledged, 'I might be a little richer today.'"

Such humbleness is truly astounding. I am reminded of my friend the late Gene Goldwasser, discoverer of erythropoietin, the hormone that makes red blood cells. It's now a cloned molecule, and biosynthesized in giant industrial vats to the tune of billions of dollars in annual drug sales for companies like Amgen and Johnson & Johnson.

Gene explained to me that he had no inclination to apply for a patent on EPO. For one thing, no one did that in the 1970s. For another, all of his research had been funded by Federal grant dollars, i.e., our tax dollars at work. "I could no sooner patent my research than stop paying taxes," he explained.

As Bottles concludes at the end of his post, "A major challenge for 21st century American medicine is to cultivate the culture epitomized by Dr. House and avoid the mistakes of Dr. Gilman."

I agree.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.