greg goebel / public domain
* VECTORS is an original newsletter of fact and commentary on aerospace, technology, science, and historical topics.
* Modern hospitals are full of leading-edge tech, but in general they are massively behind the times in the use of computing. Medical records of patients are still kept in scattered files of paper documents, with no way to easily search them all. This means that considerable time and money is wasted in, say, repeating tests if records cannot be found. Worse, it leads to potentially disastrous misprescriptions, misuse of drugs, or erroneous treatments of patients.
The backwardness of the medical profession in information technology (IT) is all the more shocking because IT is in common use almost everywhere else. However, there are economic and political problems restraining the use of IT in medicine; in addition, building a usable, interoperable medical IT system is a horrendous challenge. The US is now working towards a comprehensive medical IT system, with other countries -- including Australia, Canada, Denmark, Finland, Germany, and the United Kingdom -- also working on the concept. The Finns expect to have their system working in 2007. The British, however, have been working on a medical IT system for four years and have accomplished very little.
The US effort is a private-sector project, supported by and with some funding from the US Federal government. The goal of the "National Health Information Network (NHIN)", as it's called, is to provide immediate access to a patient's full medical history, any time and any place. Not only will this help patients and hopefull reduce medical costs, it will also provide epidemiological data to show which treatments are effective and which are not. It would also be able to monitor the population to spot the emergence of pandemics or terrorist poisonings. The US government has set a target date for NHIN for 2014.
The problem in reaching that date is that building a comprehensive medical IT system is very difficult, with some estimates of the costs of NHIN running to hundreds of billions of dollars. It is not a trivial piece of technology, involving a network of hundreds of thousands of separate nodes that have to work more or less seamlessly to provide access to patient data. This vision immediately suggests potential security and privacy issues. Any serious analysis of how to build such a system immediately leads to a runaway proliferation of issues and design considerations -- and the worry that even if a system can be designed to more or less meet the spec, it will be too cumbersome and clumsy to be workable.
* The idea of a medical IT system has been around a long time, with efforts going back to the 1960s, and most of them ending in disaster. In the early, naively optimistic days of computer science, few had any idea of how difficult implementing such a complicated system would really be.
One of the first organizations to actually come up with a workable medical IT system was the Mayo Clinic of Rochester, Minnesota. The Mayo Clinic has actually long been a pioneer in medical IT systems: early in the 20th century, Dr. Henry Plummer, a partner in the clinic, decided that the traditional approach of doctors writing up patient data in a ledger book, in which daily entries for different patients were all entered together, was clumsy. Plummer came up with the idea of a "patient dossier", a file in which all the paperwork was consolidated, with the patient linked to the file by a unique registration number.
In 1993, the Mayo Clinic decided to automate the process. The effort involved upgrading the clinic's fiber-optic network, installing 16,000 workstations, and setting up a software system with a database and code written both by GE Healthcare and in-house. It went online in 2004, and is now being used to support the clinic's 1.5 million patient visits and 60,000 hospital admissions a year.
Each patient is, as before, assigned a unique registration number, which identifies the patient's account on the system. The record is updated by doctors and other staff for each patient visit. Test results are automatically put into the system and prescriptions are automatically routed to the hospital pharmacy, with checks automatically performed for conflicts between drugs and patient allergies. The system also is used to schedule visits, perform billing, and perform other administrative tasks. Cost of the system is estimated at $80 million USD, with savings of up to $40 million USD a year due to elimination of record-keeping overhead and improvement in service.
The Mayo Clinic system was obviously not easy to build, since it integrated so many different sources of data and performed so many tasks, and it took time to train the 17,000 staff of the clinic to make use of the system. In fact, the Mayo Clinic has two other facilities, one in Jacksonville, Florida, and the other in Scottsdale, Arizona -- and though all three facilities are automated, they aren't interlinked. A doctor at one site can view data from another, but that's it. Attempting to interlink the three sites was simply judged too ambitious.
The US Veteran's Administration also has had a very highly regarded medical IT system called "VistA". There is an even bigger medical IT system for the active US military, covering over 9 million personnel, named the "Armed Forces Health Longitudinal Technology Application (AHLTA)" system. Right now, in Iraq and Afghanistan, a US Army medic can punch in data on a wounded soldier into a commercially-available PDA to obtain important health data about the soldier, and also alert the nearest aid station to prepare to treat the soldier. All inputs to the system are entered into the soldier's medical record.
AHLTA not only integrates data for all field medical operations, but also the 70 hospitals, 411 medical clinics, and 417 dental clinics run by the US military worldwide. AHLTA's design faced three major challenges: scalability, integration, and system availability. It had to run seamlessly, reliably, and quickly on everything from hospital servers to laptops in field hospitals to PDAs in the hands of combat medics, with information being accessed at computing nodes all over the globe. Although AHLTA has used commercial software and hardware whenever possible to keep down costs, it still hasn't been cheap, running to $800 million USD for development and deployment, and $100 million USD in yearly upkeep. However, the military believes that every dollar spent on AHLTA saves $1.29 in other expenses, and it simply does a better job.
* It might seem like systems such as VistA and AHLTA would make good models for the civilian US NHIN. However, the military has the advantage of being a single organization, and all the patient records of VistA and AHLTA are centralized. It should be noted that efforts to try to link VistA and AHLTA have proven troublesome, since they weren't designed at the outset to work together. The challenge faced by the military to try to link two systems is nothing compared to the challenge faced by NHIN. Not only would a US civilian medical IT system cover two orders of magnitude more patients, but it would have to integrate every independent hospital, nursing home, pharmacy, and private medical practice in the country.
At present, only about a quarter of the 5,000 or so community hospitals even have an electronic medical records system, and as a rule no one of these systems is accessible from or interoperable with any other. The Finns, Norwegians, and Swedes claim that 90% of their hospitals have online record systems, but these systems still can't communicate with each other.
One of the mad aspects of US health care is that as costs keep skyrocketing everybody seems to be going broke, and it's a hard sell to get a hospital to adopt an online records system even if estimates show that it should pay itself off and then some in a few years. Small practitioners are even worse off. To be sure, it's hard to find any small business that doesn't have an online accounts and billings system, but such things can be obtained off-the-shelf at relatively low prices, and they have no real optimizations for medical use. Obtaining something more sophisticated is a bigger job. Richard Baron, who runs a small clinic with four doctors in Philadelphia, decided to go digital and obtained software from General Electric, along with tablet PCs for data entry. The installation wasn't troublesome, but it took a half year for the staff to figure out how to use the system while continuing to treat patients. The learning curve involved a lot of clumsiness, with some patients simply leaving in disgust. Initial costs were $80,000 USD for the software and $40,000 USD for the hardware; licensing and technical support runs to $44,000 USD a year.
Such costs are typical, and so it's not surprising that only about a tenth of the 112,000 private-practice offices in the USA have gone digital. Baron and his partners did eventually decide they liked the software system, but Baron warns that there is "not a good business case" for physicians installing such systems: "The costs are real, but the benefits are less so." The government has offered to make the VA's VistA system available to anyone who wants it, but that would not eliminate the hardware and supports costs, or the difficult learning curve.
* The biggest problem of a system like that installed in Baron's office is that it's just an "island of automation", with little reach outside the office walls. The real need is a for a national system that breaks down the barriers, in which a patient has a consolidated, well-organized record on a system that can be accessed by anyone with the need to know.
Everyone agrees that the first step towards this goal is to come up with a set of data standards to allow patient information to be exchanged over the medical IT network. This is another thing that isn't as easy as it sounds; people have been working on it for two decades, but not only has no universal standard system been defined, as one participant in the effort puts it, "no one has identified what's missing." Even agreeing on medical terminology is troublesome, another participant saying: "When you say 'gross profit,' everyone in finance knows what that means. In medicine, there are 126 ways to say 'high blood pressure.'"
The Healthcare Information Technology Standards Panel, which is chartered to set technical standards for the US nationwide record system, has now listed an initial set of 90 medical and technology standards, out of an original list of about 600, with the standards specifying such things as how physicians will electronically exchange lab reports, enter reports into a patient's electronic record, and request past lab results. Although all these sound like straightforward tasks, about 190 different health-related organizations -- representing consumers, health care providers, US government agencies, and standards organizations -- are involved in developing the specifications, and it's no surprise that it's time-consuming. There is no organization with the authority to simply dictate a specification, and even if there was, without getting a consensus the end result might well be a spec that is more or less unusable.
Once the specifications are available, then the software and networking has to be put together to implement them. Building such huge systems in a workable and reliable way is notoriously difficult. Over four years ago, the British government decided to implement a national medical IT system, the "National Programme for IT (NPIT)" to cover the nation's 60 million residents. The initial estimate was that the NPIT would take three years and the equivalent of $4.3 billion USD. Now it's slipped out to over a decade, with projected costs of $23.5 billion USD.
Some parts of the system are now in operation, and the results have not been encouraging. A hospital in Oxford found patient records simply disappearing, and security systems are both clumsy and easily bypassed. Some doctors don't want to enter patient data into the system for fear of errors or compromising patient privacy. Support for the NPIT among the medical profession has been plummeting.
In April 2005, 23 British computer scientists wrote an open letter to the Parliamentary Health Select Committee to recommend an independent review of NPIT, with the reviewers trying answer questions such as: Does the system have a comprehensive, robust technical architecture? Project plan? Detailed design? Have these documents been reviewed by experts with the appropriate qualifications? The fact that such basic questions are being asked more than four years into the project is particularly unsettling, with unpleasant implications for the US NHIN. Since the UK has a much smaller population than the US, the integration job is not as big a challenge -- all the more so because Britain has a National Health Service (NHS) that one might think would be able to push through standards. The US has no NHS.
The road to national medical IT systems continues to be littered with booby traps. The US military's AHLTA system suggests it can be done and done well, but the slow and painful progress towards a civilian system remains frustrating. What makes it all the more frustrating is that high tech seems to charge forward on its own momentum in so many other domains, delivering products that provide more functionality at lower cost. However, for whatever reasons the learning curve that governs the rapid evolution of cellphones does not apply to medical IT.
* The sequencing of the genetic code of humans and other life-forms were remarkable achievements. Such feats couldn't have been performed without the development of advanced biotechnology. One of the technologies used in these efforts, the "DNA microarray" or "DNA chip", is now proving revolutionary in its own right. A DNA chip is a glass slide marked with a grid of thousand of samples of different DNA fragments. The DNA chip permits a rapid examination of a genetic sample. The chips are now used in almost every field of biology, including toxicology, virology, and diagnostics. So far, they have been a lab tool, useful for determining which genes are activated or "expressed" during normal or pathological cell operation -- but gene chips are now finding their way into the clinic.
In 2004, American and European regulatory bodies approved for the first time a medical test based on a DNA chip. The chip, the "AmpliChip CYP450", made by pharmaceutical giant Roche in collaboration with DNA chip-maker Affymetrix, can identify 31 different genetic variations in two genes that affect how individuals react to a range of commonly prescribed drugs. This allows physicians to determine the appropriate drug and its dosage level for a particular patient.
* The origins of the DNA chip go back to the late 1980s. In those days, analysis of genes was a laborious lab process. Work was underway towards miniaturizing and automating analytical tools, with Edwin Southern, a well-known professor of biochemistry at Oxford Univeristy in the UK, obtaining a pioneering patent on microarrays in 1988. However, the real push towards DNA chips was provided by an American researcher named Stephen Fodor.
In 1989, Dr. Fodor was a new hire at Affymax Research in Palo Alto, California, a company that was working on analytical tools for drug development. Fodor and his colleagues came up with a scheme for a tool that borrowed technology from the semiconductor industry, and published a paper on the concept in the journal AAAS SCIENCE in 1991. The paper envisioned using photomasking techniques to set up a microarray of different biomolecules on a substrate coated with light-sensitive chemicals. The substrate would be flooded with a particular biomolecule; light passing through a hole or holes in a photomask would cause the biomolecule to stick to the substrate in the appropriate pattern. The process could be repeated with different biomolecules and photomasks to build up the microarray. The paper focused on building microarrays of short protein fragments called "peptides", but Dr. Fodor had his eye on developing DNA microarrays.
In the meantime Patrick Brown, a professor of biochemistry at the school of medicine of Stanford University in California, was thinking along similar lines. He worked with Dari Shalon, a grad student from the engineering department, to develop a robotic process for placing an array of different single-strand DNA sequences on an ordinary microscope slide. DNA, as is generally known, is normally a "double-strand" molecule, the famed "double helix" or "twisted ladder", with its information for assembly of protein and other life functions coded by arrangements of the four DNA "bases" -- A, C, T, G. A half-strand of DNA will mate up with another half-strand of DNA, or its similar cousin RNA, that has the mirror or "complementary" sequence of bases, just a key will fit into a specific lock.
Such a DNA microarray could be flooded with DNA or RNA segments marked with fluorescent molecules. The segments would then mate with any of the array elements in the microarray that had a complementary sequence of bases. After the DNA microarray was washed clean, the matches would be retained, and the locations where they occurred could be spotted by exposing the microarray to ultraviolet, with the matches fluorescing in response.
* Both Dr. Fodor and Dr. Brown applied to the US National Institutes of Health (NIH) for grants. NIH officials didn't know what to make of the microarray concept and were not enthusiastic. Dr. Fodor did get a grant, mostly because influential biochemist Leroy Hood liked the idea and pushed it through; armed with millions of dollars of grant money, Dr. Fodor and a group of colleagues set up Affymetrix in 1993. Dr. Brown also got a grant, but only by writing around the microarray concept in his grant application. The two efforts then went forward in parallel.
Affymetrix's first product was a chip for detecting mutations in HIV, the AIDS virus. In the meantime, Dr. Brown and Dr. Shalon were investigating use of microarrays for analysis of gene expression, working with another Stanford group to analyze the mustard plant Arabidosis thaliana, a common "guinea pig" for studies of plant biology. The effort produced a paper published in AAAS SCIENCE in 1995, reporting that 45 genes of the mustard plant were observed and showed major differences in gene operation between root and leaf tissue -- that is, the same genetic "program" was being executed in different ways. The paper attracted considerable attention, and helped drum up business for Systeni, a company founded by Dr. Shalon to provide gene-expression analysis services to clients.
Affymetrix began to sell gene-expression arrays in the mid-1990s, which were generally purchased by pharmaceutical companies and research labs. Demand was rising outside of those niches, but Affymetrix didn't have the production capacity to fill that demand, and the company's products were expensive anyway: the DNA chips cost thousands of dollars each, and the chip reader cost $175,000 USD. At this point, Joe Derisi, at the time a grad student in the service of Dr. Brown who had something of a classic "hacker" mentality, posted detailed instructions to the Internet to show others in the community how to "home brew" their own DNA chips and readers for a fraction of the cost of Affymetrix's products.
By the late 1990s, DNA chips were in widespread use, with high-profile research establishing their value. In 1997, Dr. Brown's lab provided 100 chips that covered the entire yeast genome for the first "whole genome expression" study. Such was the excitement in the community that in 1999 the journal NATURE GENETICS published an issue dedicated to DNA chips, with the cover titled "Array Of Hope".
* In the meantime, work on sequencing the human genome was accelerating towards completion, and the bioscience industry was becoming very excited, with share prices of companies either involved or expected to benefit from the human genome project skyrocketing. The beneficiaries included Affymetrix, which saw product demand soar. It soared enough to bring competitors into the fray.
Anyone familiar with high tech could easily recognize the potential for patent litigation in this scenario, and indeed might be puzzled as to why it took so long. In any case, in 1997 Incyte Genomics bought out Systeni for $90 million USD, and Affymetrix sued Incyte for patent infringement -- on the basis that Affymetrix's patents covered the entire concept of a DNA microarray, not any specific implementation. Many in the field found this overreaching, and the lawsuit also chilled investment by venture capitalists in DNA chip technology.
While this suit went on, Affymetrix ended up being on the receiving end of a lawsuit as well. In 1995, Dr. Southern of Oxford had set up a firm named Oxford Gene Technology (OGT) to pursue his ideas on gene chips. Affymetrix then bought out a division of a company that had obtained a technology license from OGT, and Affymetrix officials claimed that gave their company a right to OGT technologies as well. OGT did not agree and sued Affymetrix in 1999. The lawsuits with Incyte and OGT were both settled for undisclosed sums in 2001.
Today, Affymetrix remains the leader of the pack, but there are major competitors in the DNA chip business -- including Agilent, a Hewlett-Packard spinoff; General Electric Health Care; and Illumina, which has focused on DNA chips to characterize genetic variation, providing information about predisposition to disease and response to therapy. Such arrays are becoming increasingly popular, and in 2004 Affymetrix sued Illumina for patent infringement, despite the fact that Illumina's DNA chip technology is very different from that used by Affymetrix. In 2006, Illumina retaliated with a set of countersuits, and the fight is still going on.
* The litigation is obnoxious to researchers in the field, but they have good reason to be pleased with the progress of DNA chip technology. Prices are now reasonable due to volume, competition, and improved manufacturing processes: in the mid-1990s, the production yield of Affymetrix's DNA arrays was only about 10%, but it's close to 100% now.
People keep finding new uses for the chips. In 1999 Todd Golub, then at the Whitehead Institute for Biomedical Researcher in Cambridge, Massachusetts, and his colleagues published a paper that classified cancers on the basis of their gene-expression profiles or "signatures". This allowed the identification of different cancers, such as leukemias, that looked identical under a microscope. Researchers have gone on to catalog a wide range of cancer signatures. Roche, the pharmaceutical giant, is working on DNA chip diagnostics based on the AmpliChip, and has several in clinical trials. One chip can sort out about 20 different variants of leukemias, and another will spot mutations in the p53 gene, which can affect a patient's inclination towards cancers.
Big pharma companies like Roche and Merck also used DNA chips in drug-discovery research. In 2001, Merck bought up Rosetta Inpharmatics, a software firm that specializes in the interpretation of gene-expression profiles. Merck researchers are now performing 40,000 DNA chip analyses a year, with the results put into a database that now has more than 200,000 entries and is interpreted using Rosetta's software. The microarray data has helped flag drug candidates that could have nasty side-effects, allowing the drugs to be modified or dropped. According to Merck officials, about 20% of the Merck drugs now in clinical trials have been developed with the help of DNA chips.
The Broad Institute, a collaboration of the Massachusetts Institute of Technology and Harvard, is working on a similar project in the public arena. Institute researchers recently published a paper in AAAS SCIENCE describing a new database concept, which they call the "connectivity map". The idea is to express the action of drugs, genes, and diseases in the common language of gene expression profiles. Database software will then be able to sift through the profiles to identify matches and patterns. The project aims over the next two years to identify profiles for all approved drugs in the USA. The resulting comprehensive dataset will be useful for identifying new uses for existing drugs and for identifying previously unknown responses to drugs.
Researchers believe that they are only scratching the surface of what DNA arrays can do. Says Dr. DeRisi: "We're at the beginning of genomics-based diagnostics and therapeutics."
* INVENTING THE CHAIN REACTION: The discovery of nuclear fission had dramatic consequences. The story began several years previously.
On 12 September 1933, Leo Szilard, very annoyed at reading a newspaper article that cited Rutherford's "moonshine" remark, went for a walk through London to think things out. Crossing a street, he realized that nuclear fission might be the key to building an atomic bomb through a "chain reaction": the fission of one atom by neutrons would release more neutrons to perform fission on other atoms, leading to a cascade that released a vast amount of energy. His abstracted walk had produced one of the most literally earth-shaking ideas in history.
The problem was that nobody had even demonstrated fission at the time, and so few in England were enthusiastic about Szilard's big idea: he approached Ernest Rutherford and was sent packing. Szilard was still convinced he was on the right track, though had misgivings. Reflecting on the Japanese occupation of Manchuria in that year, 1934, he wrote: "The discoveries of scientists have given weapons to mankind which may destroy our present civilization if we do not succeed in avoiding further wars." He actually meant bomber aircraft, atomic bombs not having been "given" to mankind just yet, but he could have hardly avoided the dire thought of bombers carrying atomic bombs. He also knew perfectly well that there were plenty of good physicists left in Germany who might also be thinking about atomic bombs, and that his misgivings would have to be swallowed for the duration of the emerging crisis.
Szilard made contact a British physicist, Frederick Lindemann, who became something of Szilard's patron. The fact that Lindemann was a close confidant of and a scientific advisor to the well-known politician Winston Churchill, at the time out of office but making his voice heard about the ugly events in Germany, was also a plus. Lindemann tipped Szilard off to the fact that patents could be kept secret if they were filed with the British military, and helped prod the British Admiralty into granting a secret patent to Szilard for explosives "very many thousands of times more powerful than ordinary bombs."
Szilard remained in England for the time being, though he was establishing contacts in the United States; he was curious about events on the continent and wanted to see which way events pushed him before jumping across the Atlantic. Following Hitler's occupation of Czechoslovakia, he went to the USA in late 1938, taking a position at Columbia University and eventually becoming an American citizen. There, Szilard accelerated his work on chain reactions. His experiments with beryllium hadn't gone anywhere, but Lise Meitner's paper on nuclear fission in uranium opened the door. Fermi's discovery that slow neutrons provoked fission more easily than fast neutrons opened the door a bit wider.
When Fermi arrived, Szilard pitched the chain reaction to him. Fermi was skeptical that the idea would work, regarding it as a long shot -- but not such a long shot that it wasn't worth investigating, even if just to put the idea to rest. Nuclear research at Columbia accelerated.
There was the question of what material might best support a chain reaction. Szilard was still interested in beryllium, but Niels Bohr, then still in the US and temporarily working at Columbia, thought over three alternatives: thorium-232 (Th<232/90>), uranium-235 (U<235/92>), and uranium-238 (U<238/92>). He concluded that uranium-235 was the best candidate -- but it's only 1% of natural uranium, with the rest being uranium-238, and Bohr didn't think it would be practical to separate the two isotopes since their chemical properties were effectively identical, except for a slight difference in atomic weight.
The result of the theoretical and experimental work began to show that a chain reaction might well be possible, and that an atomic bomb might be practical. Enrico Fermi, watching out from the window of his upper-story office at Columbia over the streets of Manhattan, pretended to hold a ball in his hands and told a colleague: "A little bomb like that, and it would all disappear."
On 17 March 1939, in the wake of the dismemberment of Czechoslovakia, Fermi briefed US Navy officials on the possibility of the atomic bomb. He wasn't completely convinced about the concept himself about the time and didn't pitch it with great enthusiasm. The presentation unsurprisingly fell flat.
Szilard was much hotter about the issue than Fermi. He tried to persuade his colleagues to not publish results of experiments into fission processes, but the physics journals were full of papers on the subject at the time and it was like holding back the tide. In late April, THE NEW YORK TIMES reported on the debate among the physicists over the possibility of an atomic chain reaction, or more colorfully the "probability of some scientist blowing up a sizeable portion of the Earth."
Szilard was working energetically with two long-time colleagues, Eugene Wigner and Edward Teller -- both Hungarian Jewish physicists who had been chased out of Europe by Hitler -- on the basic physics of the chain reaction, with Fermi working in parallel, providing crosschecks. Fermi didn't care much for actually doing experiments in collaboration with Szilard; Szilard was a theoretician and flatly said he didn't like getting his hands dirty, which made a poor impression on Fermi, who was just as or more happy in the lab as in front of a blackboard.
The work gradually converged on the possibility of demonstrating a controlled chain reaction in what would be called an "atomic pile", a layered structure made up of modules of uranium -- to provide the reaction -- embedded in graphite, that is carbon, to act as a "moderator", absorbing neutron emission to prevent the chain reaction from going into "runaway". "Heavy water" -- that is, water incorporating the heavy deuterium isotope of hydrogen instead of ordinary hydrogen -- was also considered as a moderator. Incidentally, ordinary water wouldn't work, because it had a stronger tendency to absorb neutrons -- had a higher "cross section", as the physicists put it -- and would damp out the chain reaction. In any case, heavy water was regarded as a backup plan, since carbon seemed like the better option.
* THE EINSTEIN LETTER: Progress was being made, but Szilard felt that more progress demanded financial backing from the US government. Unfortunately, the dud presentation Fermi had made to the US Navy left Szilard unsure of what might be done for the moment. He did have another worry, about Belgium of all places -- the Congo was a Belgian colony, uranium was being mined there, and there was the uncomfortable prospect that uranium ore might find its way into Nazi hands via Belgium.
Szilard knew that his old colleague Albert Einstein was on close terms with Queen Elizabeth of Belgium, and thought Einstein might be a good way to pass on a warning about the potential of uranium and the danger of it being passed on to Germany. Szilard made an appointment with Einstein and went to Einstein's summer house in Peconic, Long Island, on Sunday, 16 July 1939, to talk with the great man. Since Szilard didn't have a car, Wigner drove him there; they got lost but a local boy showed them the way to Einstein's house.
Szilard told Einstein about the work on chain reactions; Einstein was intrigued, exclaiming in German: "I never thought of that!" Einstein was perfectly willing to help them get the message about the potential of the atomic bomb, even if there were still doubts that such a weapon could be made to work. As Szilard said later: "The one thing scientists are afraid of is to make fools of themselves. Einstein was free from such a fear and this above all is what made his position unique on this occasion." Wigner did suggest that they "should not approach a foreign government without giving the [US] State Department a chance to object." Einstein dictated a letter to the Belgian ambassador, who he judged more appropriate a contact than the queen, with the letter to be passed on through the State Department.
However, within days a Dr. Alexander Sachs -- a prominent Russian-born American economist from Harvard who was a personal friend of US President Franklin Delano Roosevelt -- got in touch with Szilard. Sachs had got wind of Szilard's desire to get US government backing for atomic bomb research, and Sachs politely suggested that he might be able to make a pitch to Roosevelt for backing. Szilard was uncharacteristically taken aback by the offer, but went over to Peconic again on Sunday, 30 July, to talk the matter over with Einstein. Wigner was out of town, so Edward Teller played chauffeur to Szilard instead; Szilard wanted to introduce Teller to Einstein anyway, telling Einstein in advance: "He's very nice."
The meeting that day led to a debate between Szilard and Einstein over the next two weeks on whether Sachs was the best courier for the job -- Sachs himself had suggested a number of alternatives, including the famous aviator Charles Lindbergh, though Roosevelt couldn't stand him -- and how the letter originally intended for the Belgian ambassador should be modified for presentation to Roosevelt. Sachs was judged satisfactory, and in mid-August Szilard handed him the final draft of the letter for Roosevelt.
* Sachs felt he needed an hour of the president's time to give a proper sales pitch -- there was no sense in just handing Roosevelt a letter that would go into the other piles of paper on the desk in the oval office -- but Roosevelt was unusually busy at the time. Although Hitler had promised during the Munich crisis that his claims on Czechoslovak territory were to be "the last territorial demand I have to make on Europe", by the summer of 1939 he was making the same sort of loud, threatening noises once more, this time against the Poles. Nobody was going to try to make a deal with Hitler this time around, and he didn't want one anyway: he wanted a war.
On 23 August 1939, about a week after Sachs received the letter, Nazi Germany and the Soviet Union signed a nonaggression pact. The news was an absolute shock to most, since the Nazis and Soviets had been denouncing each other in bitter terms for years. It was a particular shock to Communist parties outside the USSR, who now had to proclaim that Hitler was a friend of the world proletariat -- a turnaround so drastic that it led to the defection of many from the ranks of the Communist International. Astute observers saw it for what it was, a cynical and temporary marriage of convenience between Hitler and Soviet dictator Josef Stalin. Considering Hitler's hostile talk against Poland, the immediate result of the pact was easy to guess: the dismemberment of Poland.
After trumping up a Polish attack on a German town -- with a political prisoner shot to provide "evidence" -- Hitler invaded Poland on 1 September 1939. Britain and France declared war on Germany on 3 September: World War II had begun. Roosevelt was up to his eyebrows in the crisis, in particular lobbying for assistance to Britain. Sachs couldn't even arrange an appointment until a week into September. Szilard and Wigner visited Sachs late in the month and were upset to find out that he hadn't spoken to the president yet, naively unable to understand that getting an audience with an American president wasn't trivial even in calmer times. Sachs promised to go to the White House in a week, and in fact was admitted to the oval office on Wednesday, 11 October 1939.
Roosevelt greeted Sachs with: "Alex, what are you up to?" Sachs gave Roosevelt a carefully prepared little lecture based on Einstein's letter, At the end of his pitch, Roosevelt replied: "Alex, what you are after is to see that the Nazis don't blow us up." Sachs replied: "Precisely." Roosevelt turned to his aide, General Edwin M. "Pa" Watson, and said: "This requires action."
Roosevelt, a politician to the core, was well-known for seeming pleasantly and broadly agreeable to visitors who then would find out that nothing specific actually ended up getting done, but Watson arranged a meeting of the "Advisory Committee for Uranium" on Saturday, 21 October, at the Carleton Hotel in Washington DC. Sachs, Szilard, Teller, and Wigner showed up to present their case; Fermi was still feeling sore about the Navy presentation and absented himself, with Teller acting as his emissary. The foursome met with five government representatives of the US Army, Navy, and National Bureau of Standards (NBS). The government committee was led by Lyman J. Briggs, head of the NBS, and would become known as the "Briggs Committee".
The meeting was somewhat confrontational, with outspoken skepticism from some of the government men -- though Sachs, more used than his physicist associates to government committees, was willing and able to lead the charge. The Army representative even suggested that weapons take decades to come to maturity and so atomic power would not be particularly important for winning the current war, adding that "it isn't weapons that win wars, but the morale of the troops." He went on at length in this vein until Wigner, normally a model of Old World decorum, interrupted to suggest that if morale was the only deciding factor in a war, then the weapons procurement budget of the Army should be promptly cut. The Army man digested this for a moment and then grudgingly answered: "All right, all right, you'll get your money."
Teller only asked for six thousand dollars to obtain graphite for investigation of its use as a moderator. He would soon regret specifying such a pittance, much later commenting that "my friends haven't forgiven me yet." However, on 1 November the Briggs Committee handed a report back to the president, describing the potential of atomic power not only for bombs but also for powering submarines, and recommended "support for a thorough investigation." The report would gather dust in the president's files for several months -- but it wasn't forgotten.
* In the meantime, Poland had fallen to the Nazis. German troops had occupied Warsaw on 1 October, and by 6 October 1939 organized Polish resistance had faded out. The Soviets had cooperated with the destruction of Poland, invading on 27 September and carving out their own chunk, whose borders had been specified by secret provisions of the Nazi-Soviet Non-Aggression Pact. About 100,000 Polish troops escaped, mostly throwing in their lot with the British as "Free Polish" forces.
While the German Wehrmacht -- armed forces -- crushed Poland, the wheels were turning in Germany on investigation of an atomic bomb. Back in the spring of 1939, excitement over the emerging possibilities of nuclear weapons had led to the establishment of a military research office under the direction of Kurt Diebner, a physicist working for the Wehrmacht on explosives research. He obtained a deputy named Erich Bagge, and the two men set up a secret conference on atomic power in Berlin on 16 September 1939.
Prominent physicists, included Otto Hahn, were invited; they seemed at loggerheads on matters, so Bagge contacted Werner Heisenberg, who had sufficient stature to impose order on the herd of physicists, to a second conference on 26 September. The second event had the desired results: in the aftermath, formal research went ahead, with theoretical work to be directed by Heisenberg and experiments to be conducted by a number of other teams. More space was found for the effort at the Kaiser Wilhelm Research Institute.
TO BE CONTINUED
* DARWINISM IN CONFUSION: For all the weaknesses in Darwin's ideas at the time, he had still managed to obliterate for good the notion of fixity of species. By the early 1870s, there were few naturalists who didn't think he was on the right track, with the well-known American paleontologist Edward Drinker Cope (1840:1897) writing that the data accumulated in the wake of the publication of THE ORIGIN OF THE SPECIES had placed "the hypothesis on the basis of ascertained fact." The Darwin faction in Britain was well-organized, even founding the science journal NATURE in 1869 in part to push evolutionary views. To this day, any publication in NATURE is prominently displayed in a researcher's resume.
Along with Huxley, there were other warriors for the evolutionary cause. If Alfred Russell Wallace had been upstaged in the discovery of evolution by natural selection, he still remained very much a prophet for the idea, publishing a series of popular books, from the MALAY ARCHIPELAGO in 1869 to ISLAND LIFE in 1880, that reinforced Darwin's assertions about the distribution and variation of life-forms. In Germany, the zoologist Ernst Haeckel (1834:1919) focused on studies of morphology -- the structures of life-forms -- and in particular embryology to make a case for evolution. In his embryological studies, Haeckel showed the similarities between the embryos of different life-forms, and how these embryos had features at one time or another of ancestral life-forms, such as rudimentary gill structures. He was also on the right track, though he ended up exaggerating his argument.
However, although both Wallace and Haeckel were evolutionists, they by no means whole-heartedly accepted Darwin's ideas. Wallace said that though he believed in evolution by natural selection, the development of the human consciousness demanded the efforts of an "Overruling Intelligence". Haeckel had strongly Lamarckian views, and he wasn't alone in this, not everyone being impressed by the idea of natural selection, suggesting that embryos actually retraced their ancestry in detail during development.
In fact, in later editions of THE ORIGIN OF THE SPECIES, Darwin himself began to backtrack from it. The problem was that the prominent British physicist William Thompson, later Lord Kelvin (1824:1907), had calculated from the principles of physics known at the time that the Earth wasn't more than a few tens of millions or hundreds of millions years old. Huxley suggested that the calculations were based on faulty premises, but other physicists backed up the estimate. Huxley was right, but he couldn't prove the point at the time, and so the estimate stuck. Even the upper limit would have made the evolution of life by the process of natural selection implausible, and so Darwin kept adding more and more Larmackian tendencies to compensate. This is one of the reasons why all the later editions of THE ORIGIN OF SPECIES are rarely reprinted.
Darwin had made evolution respectable, but his concepts for evolution by natural selection were increasingly scrambled by his own waffling and the proliferation of alternative ideas that incorporated Lamarckism or theistic concepts in various forms. His thinking also led to other lines of thought that would do much to taint his ideas over the coming century.
* SOCIAL DARWINISM & EUGENICS: One of Darwin's many correspondents was the English scholar Herbert Spencer (1820:1903), regarded by some as the first sociologist. Even before the publication of THE ORIGIN OF SPECIES, Spencer had been considering evolutionary ideas and their implications to human behavior and society. In 1855, he had published the groundbreaking PRINCIPLES OF PSYCHOLOGY, which postulated that the workings of the mind were rooted in the biology of the brain and body, a radical idea at the time.
Of course THE ORIGIN OF THE SPECIES buttressed his ideas, and in 1862 he published FIRST PRINCIPLES, in which he created a theory of evolution that covered social and ideological structures and not just the biology of organisms. In fact, it was Spencer who came up with the phrase "survival of the fittest", not Darwin. Spencer's notion of applying evolutionary thought to society would prove popular, the main result being a doctrine known as "Social Darwinism", which would generally come to be thought of as an endorsement of remorseless capitalism and imperialism.
His defenders insist this is unfair, that he never advocated the extreme positions of the Social Darwinist movement, and was not a political reactionary. Whatever the actual facts, by the 1890s Social Darwinist ideas were popular and were making themselves felt, influencing social policies in the United States and elsewhere. They also dovetailed with racist thinking: American segregationists used the idea to promote the second-class status of black folk as a positive good. In Germany, Ernst Haeckel took the idea even farther, using it as a framework to propose Aryan race-supremacy notions and German militarism.
* Social Darwinism was not the only questionable doctrine to emerge from the ferment of Darwinism. A second path, "eugenics", was largely the creation of one of Darwin's cousins, Francis Galton (1822:1911), another grandson of Erasmus Darwin.
There was a undeniable streak of genius in Francis Galton. He learned to read at age two, aced his studies at Cambridge without trying, liked to tinker with inventions, and made scientific contributions to a wide range of fields, including meteorology and in particular statistical analysis. Even modern fingerprinting was invented by Galton. He was also as arrogant and self-superior as an upper-class Englishman could have been thought to be. When the explorer Henry Stanley spoke to the British Association for the Advancement of Science in 1872, Galton pointedly questioned Stanley's parentage -- Stanley had been born illegitimate -- and sneered at Stanley's talk about his adventures in Africa, saying it was irrelevant to the deliberations of a scientific society. Stanley, it appears, was the kind of explorer who dealt with restless natives by shooting them, and it was probably fortunate for Galton that Stanley wasn't armed.
Galton's work on statistics largely focused on the characterization of various human traits, such as height, weight, strength, and so on, with the goal being the improvement of the race. In his 1869 book HEREDITARY GENIUS, he examined the geneologies and brilliant achievements of prominent families -- the descendants of Erasmus Darwin were a case in point -- and attributed them to a hereditary superiority. Since natural selection had managed to achieve such marvelous feats, Galton suggested that artificial selection could do even better. The obvious implication was to establish breeding programs to capitalize on successful lines of "breeding stock", a concept that he named "eugenics" -- from the Greek "well-born" -- in his 1883 book INQUIRIES INTO HUMAN FACULTY & DEVELOPMENT.
The idea of improving the human race sounds superficially appealing and not objectionable in itself, but it leads to two difficulties: first, determining what "improved" means, and second, figuring out how to get from here to there. Galton did his very best with his analyses to try to deal with the second problem, but as far as the first problem went, he didn't see it as an issue. It was obvious to him who the superior peoples were, and they were to be found among the white Europeans, not the inferior other human races of the Earth. It may not have been inevitable that eugenics would be a racist philosophy, but in practice it would have a strong tendency to devolve into one.
It should be emphasized that Galton's focus was on breeding "superior" individuals, not on forcibly preventing "inferior" beings from breeding themselves. (Somewhat embarrassingly, his marriage was childless.) However, the issue of "inferior" individuals wasn't ignored elsewhere. In 1874, a New York sociologist named Richard Dugdale (1843:1881) performed an inspection of a jail in rural New York state and was surprised to find that six of the inmates there were related. He performed a geneological study of the family, who he referred as "the Jukes", going back five generations, to find out that fully half of the family were criminals, prostitutes, or impoverished. He published his findings in 1877 as THE JUKES: A STORY IN CRIME, PAUPERISM, DISEASE, & HEREDITY, with the book concluding that the degeneracy of the family was a hereditary condition.
The work of Galton and Dugdale created a bit of a public sensation, but at the time the matter was academic, with nobody seriously attempting to convert such ideas into laws. In those days, the upper classes generally bred among themselves anyway, and Galton's message simply suggested that what they were doing was along the right track. As far as the degenerate Jukes and their like went, the poor understanding of heredity of the time had the odd effect of cancelling out the damning verdict of Dugdale's book. In the modern view, the degeneracy of the Jukes would not be attributed to any genetic fault, but to the impoverished and unhealthy environment in which the family existed. Dugdale had exactly the same view, phrased in Lamarckian terms: improve the environment of the Jukes and their heredity would improve as well. As Dugdale put it: "The correction is to change the environment." It would take some time for attitudes to change for the worse.
TO BE CONTINUED
* Website additions for the month include:
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