When I was a post-doc in the late ‘90s, the NIH budget was doubling. Our lab grew quickly from 4 people to 14. I told my friends, family and students that I had the best job in the world–there was no way in the foreseeable future that research budgets would be cut. How quickly things change! Like many of us, I’ve been dismayed by the deterioration of research funding in the US over the past several years, and have lamented that the era of US leadership in science is over.
I hosted a Chinese physician in my laboratory last year, and two weeks ago, in return for his cancer research experience, he invited me to his hospital to give a lecture on multiple myeloma and do some sightseeing. I had last been in China before, just after college, over 25 years ago, and I was eager to see how much had changed. Before I left, my head was filled with reports of China’s economic and scientific growth. Senior investigators are being wooed there and pharmaceutical companies opening R&D labs. China, I’d heard, is increasing, not decreasing its investment in research funding and with the funding situation so bad in the US, the “declining America, rising China” meme made sense. My in-laws recently returned from a sightseeing trip last month to Shanghai and Beijing and were impressed with signs of prosperity. The day before my trip, I had lunch with my former post-doc, born and raised in China, now working in Little Rock. He surprised me by saying the New York Times, CNN and Bloomberg were biased against China. “You never hear any good news about China!” he insisted. “There are still many poor people, but 100s of millions have been lifted out of poverty…you never hear that.” I realized he was right. We hear a steady drumbeat of stories on worker abuses, pollution and political repression. Maybe I would see in China additional signs of the economic boom that we aren’t told about. The US economy has been struggling for years, and perhaps the good times for US science are in the past. I went to China last week thinking I would see the future. We in the US are out of cash, out of optimism and enthusiasm. Maybe I would see what research would look like in the 21st century…but I came back with a renewed sense that the US remains in a privileged position and is likely to lead the world in scientific research in years to come.
I was invited to Nanning, capital of the Guangxi province in central China, to give a talk on multiple myeloma, the cancer we study in my lab. Usually, my talks focus on my lab research, but I was told that the doctors in the audience would not be interested in basic science. “You are different that way, doctors in the US care about the science.” I’m not sure I agreed with that assessment, but thought it interesting. New drugs developed in the US over the past decade have transformed myeloma treatment but these miracle drugs are not affordable to the vast majority of Chinese. In China, cancer patients must pay out of pocket for their chemotherapy–drugs that are notoriously expensive. Lenolidomide (Revlimid(R)) can cost $400 / pill (and require daily doing for years) so most Chinese myeloma patients receive thalidomide, which has worse side effects).
“These days, the relationship between doctors and patients is strained.” I was stunned to hear that there have been a series of incidents across China of dissatisfied patients attacking and stabbing their doctors.
Medical care in China seems like a free-market system like libertarian-leaning conservatives suggest replace Obamacare. And it looks to me like a nightmare.
After my talk, I took a road trip to see sights in Guilin. Nanning is a medium-sized city away in the Southwest away from the tremendous prosperity of the coasts. It was easy to see signs of rapid urbanization in the form of newly constructed high-rises, but often these were unfinished or unoccupied. The economic miracle of modern China has not yet reached all areas of the country. There is a widening gap between rich and poor (like in the US) and if the growth of the Chinese economy slows (as it must) there may be difficulties ahead for China’s poor and middle class.
This past year, I started participating in social media and find myself increasingly enjoying the immediate information access, the camaraderie and dialogue on the internet. But while in China, there was no access to Twitter or Facebook, not to mention the New York Times or CNN. In China, the social media free-for-all that exists in the US is carefully controlled. Truthfully, I’ve been sypathetic to some anti-twitter essays that appeared lately, and I admit it felt good to get away from the Twitter maelstrom for a while and get back to writing letters for a few days. There’s a pleasure in taking time to read, think and write. And yet…when curtailed by the government, I couldn’t help but wonder whether China’s information flow control is having effects on the creative process there. The electronic salon is invigorating. Twitter’s “hive-mind” is undeniably useful for personal and professional support, feedback and networking. (Not to mention frequent hilarity!) It’s their loss that they are barred from this community.
Another striking feature of Chinese work life is a lack of professional mobility. That is, daunting hurdles exist to changing geographic location, making professional moves near impossible. Colleagues can’t easily move to Shanghai or any other city in their own country. Not only are government benefits tied to their province, but the personal networks are critical–without contacts even a talented professional can not succeed due to bureaucracy. In the US we take for granted that connections can be made rapidly and that our credentials are portable. In China, deep personal connections that take years to develop are key. Promotions are given on the basis of long work history under senior faculty.
As a post-doc, I had the view that science was how we found objective truth. The post-modern philosophy that said that even scientific truth was a social construct annoyed me. Dr. Rubidium teased me a few weeks ago on a Pub-Style Science for espousing this perhaps naive view of science — transcending fallible human foibles like racism and gender issues. Fair enough. And yet, in China the ubiquity of the State, the necessity of political thinking, may have an effect on the process of science and scientific thought. The effect of this politicization is that the work of science is seen as performing tasks for the Boss, rather than as a creative process. Although I agree with Rubidium that the sociology of science can’t be ignored, at the same time, I believe it important when we focus on uncovering nature’s truths. The truth and beauty of science are beyond the political.
Hundreds of millions of Chinese have been lifted from poverty and the economy has had a spectacular boom, which should give pause to free market fundamentalists in the US who insist that government is incapable of helping people or business. My post-doc said that he thought that rather than be enemies, China and the US should be “married.” A strange expression, I thought at the time, but now I understand. We do have a lot to learn from each other and the competition can and should be friendly and mutually beneficial.
The contraction of US spending on research continues to be painful. But we still have the organizational infrastructure, a lack relative lack of corruption (believe it or not), and a culture of optimistic progress that the world still looks to. In Doris Kearns-Goodwin’s “The Bully Pulpit” she quotes magazine editor and muckraker S.S. McClure on his casting about for answers to America’s woes at the turn of the last century: “There is no one left, none but all of us.”