Happy Accidents: Serendipity in Major Medical Breakthroughs in the Twentieth Century

HAPPY

ACCIDENTS

HAPPY

ACCIDENTS

Serendipity in Major
Medical Breakthroughs
in the Twentieth Century

MORTON A. MEYERS, M.D.

Arcade Publishing
New York

Copyright © 2007, 2011 by Morton A. Meyers

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Library of Congress Cataloging-in-Publication Data is available on file.

ISBN: 978-1-61145-162-7

Printed in the United States of America

To my wife, Bea,
my greatest serendipitous discovery

Contents

Preface

Introduction: Serendipity, Science's Well-Guarded Secret

P
ART
I:
T
HE
D
AWN OF A
N
EW
E
RA
: I
NFECTIOUS
D
ISEASES AND
A
NTIBIOTICS, THE
M
IRACLE
D
RUGS

 1. How Antony's Little Animals Led to the Development of Germ Theory

 2. The New Science of Bacteriology

 3. Good Chemistry

 4. The Art of Dyeing

 5. Mold, Glorious Mold

 6. Pay Dirt

 7. The Mysterious Protein from Down Under

 8. “This Ulcer ‘Bugs’ Me!”

P
ART
II:
T
HE
S
MELL OF
G
ARLIC
L
AUNCHES THE
W
AR ON
C
ANCER

 9. Tragedy at Bari

10. Antagonists to Cancer

11. Veni, Vidi, Vinca: The Healing Power of Periwinkle

12. A Heavy Metal Rocks: The Value of Platinum

13. Sex Hormones

14. Angiogenesis: The Birth of Blood Vessels

15. Aspirin Kills More than Pain

16. Thalidomide: From Tragedy to Hope

17. A Sick Chicken Leads to the Discovery of Cancer-Accelerating Genes

18. A Contaminated Vaccine Leads to Cancer-Braking Genes

19. From Where It All Stems

20. The Industrialization of Research and the War on Cancer

21. Lessons Learned

P
ART
III:
A Q
UIVERING
Q
UARTZ
S
TRING
P
ENETRATES
THE
M
YSTERY OF THE
H
EART

22. An Unexpected Phenomenon: It's Electric!

23. What a Catheter Can Do

24. “Dottering”

25. A Stitch in Time

26. The Nobel Committee Says Yes to NO

27. “It's Not You, Honey, It's NO”

28. What's Your Number?

29. Thinning the Blood

P
ART
IV:
T
HE
F
LAW
L
IES IN THE
C
HEMISTRY
, N
OT THE
C
HARACTER
:
M
OOD
-S
TABILIZING
D
RUGS
, A
NTIDEPRESSANTS,
AND
O
THER
P
SYCHOTROPICS

30. It Began with a Dream

31. Mental Straitjackets: Shocking Approaches

32. Ice-Pick Psychiatry

33. Lithium

34. Thorazine

35. Your Town, My Town, Miltown!

36. Conquering the “Beast” of Depression

37. Librium and Valium

38. “That's Funny, I Have the Same Bug!”

39. LSD

Conclusion: Taking a Chance on Chance: Cultivating Serendipity

Acknowledgments

Notes

Selected Bibliography

Illustration Credits

Index

Preface

“My God, it moves!” I was astonished at what I saw on the X-ray screen. As an academic radiologist, I was trying several years ago to visualize anatomic structures and features never seen before. I was directing my research efforts to the abdominal cavity, the largest potential space in the body, which encloses complex organs and structures. To do this, I introduced liquid contrast material (“dye”) in volunteers to fill its recesses and outline its contents on X-ray images. Surprisingly, I discovered that the contrast agent “spontaneously” flowed. Rather than being static and pooling, over time the fluid spread in a specific pattern. I would come to understand that this dynamic circulation was influenced not only by anatomy but also by factors such as gravity and pressures within the abdomen. This serendipitous epiphany provided the stepping-stone to understanding how cancers metastasize to specific remote body sites: cancer cells, shed into the fluid evoked, are carried by the circulating fluid to be deposited at distant sites of pooling. The malignant cells become attached at these points by adhesions and continue to divide to form what is referred to as a secondary deposit, or metastasis. It became clear that the spread of a disease throughout the body is not a random, irrational occurrence but rather follows a predictable pattern. Analysis of a large volume of patient data corroborated this conclusion. This insight regarding
cancer was universally adopted and now serves as the basis of modern-day detection and management.

Radiology is a medical specialty in which the trained eye reaps enormous benefits in diagnosis. Every radiologist is certainly familiar with uncovering incidental findings in daily practice that may redirect the course of an investigation. Such a finding is sometimes called a “corner-of-the-film diagnosis.” Based on a clinical suspicion, an X-ray is requested to search for a specific abnormality, but the results often reveal disease in the periphery of the original area of interest. The value of accidental discoveries is deeply rooted in diagnostic imaging. Indeed, it is the basis upon which the specialty was founded. When Wilhelm Röntgen was experimenting with a cathode-ray tube in 1895, he noticed a fluorescent glow in the darkened room of his laboratory and thought at first that the effect was caused by the sunlight beyond the wooden shutters. Röntgen had made an unexpected discovery: the X-ray. Equally unexpected was the discovery of radioactivity by Henri Becquerel in the following year.

My own serendipitous experience set me on a quest to understand the role of chance in scientific research and its contribution to medical advances in the past century. I was amazed at the findings.

Most people have had at least one experience in which an unintentional action or inadvertent observation, or perhaps even simple neglect, led to a happy outcome—to something they could not, or would not, have been able to accomplish even if they had tried. Surprising observations that led to the development of several commercial products have been well described, including champagne, synthetic sweeteners, nylon, the microwave oven, and Post-it notes. In scientific research, such incidents happen all the time, but they have generally been kept secret. In fact, they occur way more often than most researchers care to admit or are even aware of. Accidental discoveries have led to major breakthroughs that today save the lives of millions of people and to drugs and procedures whose names have become household words. Lithium, Viagra, Lipitor, antidepressants, chemotherapy drugs, penicillin and other antibiotics, Coumadin—all were discovered not because someone set out to find a specific drug that did a specific thing but because someone found something he or she wasn't
even looking for. Similarly, the use of surgical gloves, the Pap smear, and catheterization of the heart's arteries leading to bypass surgery were all stumbled upon.

This is the essence of serendipity. Although the term has become popularized to serve as the synonym for almost any pleasant surprise, it actually refers to searching for something but stumbling upon an unexpected finding of even greater value—or, less commonly, finding what one is looking for in an unexpected way. Discovery requires serendipity. But serendipity is not a chance event alone. It is a process in which a chance event is seized upon by a creative person who chooses to pay attention to the event, unravel its mystery, and find a proper application for it.

Many of the most important breakthroughs in modern medicine have routinely come from unexpected sources in apparently unrelated fields, have often been the work of lone researchers or small close-knit teams operating with modest resources and funding, and have depended crucially on luck, accident, and error. With luck, the essential human factor is sagacity.

While serendipity is essential to discovery, it is nothing without the human beings who know an opportunity when they see one. Lucky accidents or happenstance that could point the way to great discoveries occur every day, but few people recognize them. Successful scientists may have the insight and creativity to recognize a “Eureka!” moment when it happens, see the potential, and know what to do to take it to the next step.

The scientific literature very rarely reflects this reality. The dominant convention of all scientific writing is to present discoveries as rationally driven and to let the facts discovered speak for themselves. This humble ideal has succeeded in making scientists look as if they never make errors, that they straightforwardly answer every question they investigate. It banishes any hint of blunders and surprises along the way.

Consequently, not only the general public but the scientific community itself is unaware of the vast role of serendipity in medical research. Typically, a discoverer may finally admit this only toward the end of his or her career, after the awards have been received. Memoirs,
autobiographies, and Nobel Prize acceptance speeches may reveal the true nature of the discovery. From personal interviews with several Nobel laureates and winners of the prestigious Albert Lasker Award, I have come to understand the factors that have driven many of the critical medical advances of the twentieth century.

This book is intended to be a comprehensive account, for a general or scholarly readership, of the importance of serendipity in modern medicine. It reveals the crucial role of chance in each of the four major fields of medical advances in the past century: infectious disease, cancer, heart disease, and mental illness. These pivotal discoveries are part of our everyday culture; most of us are familiar with or directly benefit from the products and procedures that have resulted.

Casting a critical eye on the way in which our society spends its research dollars,
Happy Accidents
offers new benchmarks for deciding how to spend future research funds. We as a society need to take steps to foster the kind of creative, curiosity-driven research that will certainly result in more lifesaving medical breakthroughs. Fostering an openness to serendipity has the potential to accelerate medical discovery as never before.

HAPPY ACCIDENTS