The Dissonance Between Medical Research And Human Health

In 7 Things I Learnt About My PhD Degree, I noted a problem with research culture:

The publish-or-perish culture is pervadingly strong in PhD life. If one wants to become an academic, they have to be in a rat race to get noticed. Get more articles published, get more readership and citations, and get noticed. Of course, this rat race is heavily rooted in the concept of social Darwinism, and academia is not exempt from it. This concept is also common among Medium writers, Instagram influencers, content creators and business operators. It’s all about getting noticed and turning viral.

Seminal research papers, therefore, are just like any other viral Youtube video or Instagram story. They are meant for academic consumption, however. Researchers are evaluated based on the impact factor of their publications and their own personal H-index, in the very same vein that Instagram influencers are evaluated on their engagement metrics and their number of followers.

So even though the PhD project is not meant to be 100% of your life, it can damned well take up at least 99.99% of it. Having a consistent theme and direction to the project is also necessary, because sometimes a new research idea can come in — but is it relevant to the thesis at hand? That must be evaluated very carefully — because the idea, if successfully executed and researched, can land a publication in a journal with a high impact factor and boost one’s H-index… but it can lengthen one’s graduation timeframe too, if it isn’t that relevant to the thesis.

With a pervasive publish-or-perish culture, it is much easier to do incremental research instead of innovative research these days, where a researcher dives deep into a topic of interest. Jorge Cham at PhDComics.com highlights the life of a PhD holder, who happens to know a lot about a little bit:

What does incremental research entail?

As a PhD researcher, I focused on a broad topic: the development of more energy efficient techniques for the capture of carbon dioxide, with the grand aim of mitigating emissions and climate change effects. I was to use membranes, which are semi-permeable filter materials that allow some things to pass through, but which prevent other things from passing through.

The membrane would act as a barrier between the carbon dioxide gas and a liquid solvent that was used to capture the gas. The gas would permeate through the membrane into the liquid, but the membrane would prevent the permeation of the liquid into the gas.

In my first year, I investigated the effects of attaching enzymes onto a membrane surface that could speed up the rate of gas permeation into the liquid (Surface Engineering of Polypropylene Membranes with Carbonic Anhydrase-Loaded Mesoporous Silica Nanoparticles for Improved Carbon Dioxide Hydration).

In my second year, I investigated the effects of attaching the enzymes onto a more efficient membrane unit that approximated the common industrial processes being used for carbon dioxide capture (In Situ Layer-By-Layer Assembled Carbonic Anhydrase-Coated Hollow Fiber Membrane Contactor For Rapid CO2 Absorption).

In my third year, I investigated the long term effects of enzyme survivability under harsh operating conditions (The Resilience of Carbonic Anhydrase Enzyme For Membrane-Based Carbon Capture Applications).

These topics were incremental. Were they groundbreaking? Not exactly. But they were publishable, and I could graduate eventually after my thesis was passed, based on the data that I had obtained.

How do we conduct incremental research?

Conducting incremental research can be as easy as breaking down one big topic into several sub-sections. For example, if I were going to do my PhD in immunology and see how the immune system responds to various stimuli, it could be in the form of:

1. How does Vitamin C affect the immune system?

2. How does Vitamin D affect the immune system?

3. What effect does zinc have on the immune system?

And so on. Until I have enough research data to populate a thesis.

These research experiments do require proper controls, however. Meaning that I must keep everything else constant, while I change up the variable input. If I do want to look solely at the effects of Vitamin C on the immune system, then I do need to minimise the errors that can come out of other places. In a person's diet, therefore, I would have to look at only changing up the Vitamin C intake levels while keeping their intake of Vitamin D and zinc constant throughout the investigation period, for instance.

Unfortunately, we do know that human health isn't that straighforward...

The complexity of the biochemical pathways in the body is extremely intricate. If we were to look at Vitamin C's impact on the immune system, we'd find it highly concentrated in the neutrophil cells, which are the primary defenders against any invaders.

Hence, as a little knowledge is a dangerous thing, and marketing strategies will make use of the fact that Vitamin C can support the immune system, a lot of people will tend to increase their Vitamin C intake during the flu season via an increased consumption of fruits and/or nutritional supplements - in essence treating Vitamin C as if it were a drug.

However, if we were to actually take a step back and look at our immune system as a whole (Making Sense Of Our Immune System), we'd see that the immune system functions as a conglomerate of various different cells, all contributing their own efforts towards protecting the body from invaders and making appropriate repairs for the body to heal.

It's not just Vitamin C alone.

Therein lies the dissonance.

The non-scientists, for the most part, do not have the analytical skills or the academic journal subscriptions (and these papers are expensive to access!) to completely understand the big picture of human health.

The researchers and scientists, on the other hand, are pressured by the existing publish-or-perish research culture to come up with results quickly.

The quickest results that can be yielded come from incremental research.

Over time, these scientists do build up a formidable body of work. but the non-scientists do not have the means or the ability to piece the increments from various bodies of work together into a jigsaw puzzle to understand what really constitutes human health.

Neither do the medical experts really take time to analyse and synthesise a coherent piece for the non-scientists to understand. It cannot fit into a 160 character tweet. It's much easier for a renowned medical doctor to tweet a short paragraph about how Vitamin D supports immune system function, and if most of us were interested in superficial conclusions, we'd buy into it and go get ourselves extra Vitamin D support for this COVID-19 season.

Unfortunately, that doesn't really paint the complete picture of health, does it?

Joel Yong, PhD, is a biochemical engineer/scientist, an educator and a writer. He has authored 1 ebook (which is available on Amazon.com in Kindle format) and co-authored 6 journal articles in internationally peer-reviewed scientific journals. His main focus is on finding out the fundamentals of biochemical mechanisms in the body that the doctors don't educate the lay people about, and will then proceed to deconstruct them for your understanding - as an educator should. Do visit his website here to connect.