Discredited


I’m gonna cut and paste an entire article from The New York Times here. A professor sent me the article which is an interesting read about the discovery of Streptomycin which was effective (still is, in most cases) in treating tuberculosis. The discoverer was later awarded the Nobel Prize in 1952.

This article highlighted the discovery of a notebook which cast doubts on the claim by Selman A. Waksman (right) that he was the sole discoverer of Streptomycin and there is evidence to suggest that he knowingly took action to suppress the claims of his graduate student, Albert Schatz (left) who insisted that he was the one who first discovered the precious antibiotic.

Here’s the story:

NEW BRUNSWICK, N.J. — For as long as archivists at Rutgers University could remember, a small cardboard box marked with the letter W in black ink had sat unopened in a dusty corner of the special collections of the Alexander Library. Next to it were 60 sturdy archive boxes of papers, a legacy of the university’s most famous scientist: Selman A. Waksman, who won a Nobel Prize in 1952 for the discovery of streptomycin, the first antibiotic to cure tuberculosis.

The 60 boxes contained details of how streptomycin was found — and also of the murky story behind it, a vicious legal battle between Dr. Waksman and his graduate student Albert Schatz over who deserved credit.

Dr. Waksman died in 1973; after Dr. Schatz’s death in 2005, the papers were much in demand by researchers trying to piece together what really happened between the professor and his student. But nobody looked in the small cardboard box.

The story of streptomycin is no ordinary tale of discovery. It began in August 1943, when Dr. Schatz, a 23-year-old graduate student at the Rutgers College of Agriculture, isolated the powerful antibiotic produced by a bacterium, Streptomyces griseus, that had been found in a pot of farmyard soil.

His supervisor, Professor Waksman, arranged for the Mayo Clinic in Rochester, Minn., to test the substance in guinea pigs, and then in humans. It worked. Streptomycin, cleared up infections, including TB, that had defied even the first wonder drug, penicillin.

As word of the discovery spread, reporters flocked to Rutgers to record the amazing event. But in telling and retelling the story, Dr. Waksman slowly began to drop Dr. Schatz’s name and claim sole credit. He also arranged with Rutgers to receive hundreds of thousands of dollars in royalties from the patent that he and Dr. Schatz were awarded; Dr. Schatz received nothing.

Dr. Schatz became aware of the deal when Dr. Waksman started sending him $500 checks — $1,500 altogether — that he said came from funds he had been receiving for the sales of streptomycin. Dr. Schatz wanted to know more, but the professor wouldn’t tell him.

So he turned to an uncle, who found a sharp Newark lawyer willing to take on his nephew’s case. In 1950, Dr. Schatz, who had by then earned his Ph.D., sued Dr. Waksman and Rutgers, and after a year of legal back-and-forth, the professor and the university agreed to a settlement that recognized Dr. Schatz as “co-discoverer” of streptomycin and gave him a share of the royalties.

But the scientific establishment sided with Dr. Waksman, scolding Dr. Schatz for having the effrontery to challenge his professor. And two years later Dr. Waksman alone was awarded the Nobel Prize for the discovery. Dr. Schatz protested, but the Nobel committee ruled that he was a mere lab assistant working under an eminent scientist. Dr. Schatz disappeared into academic obscurity and died with the full story still untold.

Among the Waksman papers is a court transcript from the lawsuit, in which the professor charged that Dr. Schatz might not have told the truth about his experiments because he had removed a page from his notebooks.

“One fine day,” Dr. Waksman said in a deposition, “one of my assistants reported to me that [Schatz’s uncle] broke into the laboratory and carried off Schatz’s notebooks,” which, he continued, were returned 48 hours later.

“I didn’t pay any attention and, of course, I wouldn’t go over every page,” Dr. Waksman went on, adding that later he looked at the notebook and discovered that a page covering a crucial experiment had “been very neatly taken out, and worse than that, Schatz with his own handwriting very carefully corrected all the corresponding pages.”

“Well, then,” he concluded, “there is a question for Sherlock Holmes.”

Later in the deposition, Dr. Waksman acknowledged that he did not know what the missing page contained. And Dr. Schatz angrily rejected the insinuation that he or his uncle had done anything wrong. “Not true, incredible,” he wrote on his personal copy of the transcripts. “Nonsense.”

But Dr. Waksman’s damaging allegation was now on the record. When the professor’s papers were transferred to the archives, his own sand-colored, clothbound 5-by-8-inch notebooks, which covered the period of the streptomycin discovery, were included in the 60 boxes. But Dr. Schatz’s notebooks were not there.

In 2010, in researching my book on the discovery of streptomycin, I began looking for the notebooks in the university’s libraries and laboratories, but found nothing. Douglas E. Eveleigh, a professor of microbiology at Rutgers, took up my cause; the missing notebooks represented “a major, even classic loss,” he said, and issued a campus alert to search “every cubbyhole.”

Thomas J. Frusciano, the head archivist of the Alexander Library special collections, recalled that the Waksman papers had been acquired in 1983, 10 years after the professor’s death, and had even included a vial of streptomycin. He asked a member of his team, Erika Gorder, to search the stacks.

She remembered seeing the small box next to Dr. Waksman’s papers. “I must have passed by it a million times,” she said, “but I always thought it must contain miscellaneous material from the Waksman papers when they were cataloged.”

When she pulled down the box and carefully opened it, however, there, loosely piled inside, were five clothbound notebooks — just like Dr. Waksman’s, but marked “Albert Schatz.”

In the notebook for 1943, on Page 32, Dr. Schatz had started Experiment 11. In meticulous cursive, he had written the date, Aug. 23, and the title, “Exp. 11 Antagonistic Actinomycetes,” a reference to the strange threadlike microbes found in the soil that produce antibiotics. Underneath the title he recorded where he had found the microbes in “leaf compost, straw compost and stable manure” on the Rutgers College farm, outside his laboratory.

The following pages detailed his experiments and his discovery of two strains of a gray-green actinomycete named Streptomyces griseus, Latin for gray. Each strain produced an antibiotic that destroyed germs of E. coli in a petri dish — and, he was to find out later, also destroyed the TB germ. The notebook shows that the moment of discovery belongs to Dr. Schatz.

One of the pages in Experiment 11 had indeed been cut out, but the page was toward the end of the experiment, after Dr. Schatz had made his discovery. There was no evidence of a break in the experiment to suggest that Dr. Schatz might have removed the page to conceal something he didn’t want the rest of the world to know.

And in Dr. Waksman’s own papers — in the 60 boxes — there was confirmation that the professor knew the missing page was not a real issue. His legal advisers had told him bluntly that it was a distraction. As one lawyer wrote, the missing page was “insignificant.”

As for the professor’s story that Dr. Schatz’s uncle had carried off the key 1943 notebook, Dr. Waksman’s own documents make clear it could not have been true. At the time the key notebook was not at Rutgers; it was with university-appointed agents who were preparing the streptomycin patent application. Here, indeed, was evidence that Dr. Waksman had deliberately spread doubt and confusion about Dr. Schatz’s Experiment 11 in a campaign to belittle the work of his student.

Whether the small cardboard box had come to the archives at the same time as the other Waksman papers, or was somehow added after they were cataloged, is not clear. When Ms. Gorder found the notebooks in the box, she was thrilled but not altogether surprised.

“When papers are accessioned,” she said, “all sorts of things are thrown into cardboard boxes.”

Why am I sharing this story? it’s because I believe credit should be given to whom it is due. In the dog-eat-dog world of academics, and in the pursue of fame (and maybe fortune), many important people who plated crucial roles in a discovery or a research have often been sidelined or even maligned.

Personally I am still miffed that my supervisor claimed all the credit for the work done solely by me for my Masters dissertation. I swear never to inflict such cruelty on those I supervise in research.

Seven things you must not do when presenting a poster in a conference


I’m in Bangkok to attend the 15th International Congress on Infectious Diseases (ICID) which concluded today. The ICID is arguably one of the better meetings on infectious diseases in the Asia Pacific Region and it is held once every 2 years. This year, we were given the opportunity to present our research in a poster. The instructions given were clear – the time and date when the poster should be mounted and dismounted, the size and dimensions of the poster was to be no bigger than 90 x 130 cm and the poster should be in portrait and not landscape in orientation.

During the poster viewing time, I took some time to view posters mounted by other researchers. Here are SEVEN things you should not do when presenting a poster:

1. Do not print your poster on A4 size paper and mount the pieces in a jigsaw fashion. No one will be interested to read it. it also shows your lack of either funding to print the poster (which is unlikely) or your apathetic attitude.

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2. Do not print the poster too small – people will have a hard time reading it.

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3. Do not print your poster in landscape orientation when the instruction is to print in portrait mode Not only does it show you are unable to comprehend simple instructions, your mounted poster will look unsightly and takes up spaces of the adjacent display panels.

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4. Mount your poster at a level where the audience can read it comfortably. No one wants to bend to read what is on the poster.

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5. Take great care to keep the condition of your poster pristine. No one wants to read a poster which looks like a herd of bulls has trampled on it. After the conference you are free to trample on it if you wish but not before.

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6. Always proofread your poster over and over again to avoid glaring mistakes.

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7. Trim the sides of your poster if it is too big.

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Here’s to better posters in the future! :)

Never Say Never?


I was taking a few students for their end-of-posting exam recently. Each of these students were assigned a patient in the ward and they were each given an hour to clerk the patient as well as perform the necessary physical examination on the patient. During the exam, the typical flow of a session would be to discuss the history, possible diagnosis and differential diagnoses and a bit on investigations.

One student was assigned a patient who had been admitted for sudden onset of left sided weakness of his body. Here was what happened during the exam:

Me: What is your provisional diagnosis?

Student: The patient had a right fronto-parietal infarct. (not the correct answer but not entirely wrong either)

Me: Do you have any other differential diagnoses?

Student: Seizure disorder.

Me: Hmmm, okay… any other?

Student: Hypokaleimia?

Me: Hmm, what made you think of hypokaleimia as a diagnosis?

Student: Well, hypokaleimia is associated with limb weakness.

Me: True, but your patient only had weakness on ONE side of his body? Does that mean the potassium in his body suddenly all decided to shift to the right side, leaving the left side of his body weaker than the right?

Student: I was taught in Medicine to say “Never Say Never”!

Me: Whoever taught you that is wrong. There are certainly conditions in medicine where you cannot give diagnosis such as this. Your diagnosis of hypokaleimia to explain one sided weakness is beyond logic!

I only know of two time-tested dictum in Internal Medicine:

1. Common things are common. (Meaning, if a patient presents with fever and petechiae, I think of Dengue Fever before I think of meningococcemia!)

2. Think of one unifying diagnosis before considering two different diagnoses. Only rarely will be there be more than two diagnoses in a single patient.

As for ‘Never Say Never’, only Justin Bieber says that. :)

The benefits of pilgrimage


Recently I saw a patient of mine who had just returned from performing the Umrah in the clinic. The patient looked different – she was cheerful and talkative, very different from who she was just a few months ago before her pilgrimage.

Back then, she had uncontrolled high blood pressure and complained of severe pain in both of knees which made her day-to-day living a nightmare. I started her on some analgesics and high blood pressure medication.

But when I saw here recently, her blood pressure was well controlled and her knee pains are gone! She was happy – almost joyful. I noticed she had lost 10 kg in weight since the last follow-up and she told me that she did not eat well during the Umrah because, according to her, the “food was different”.

She attributed her feeling of well-being to the blessings she received from performing the ‘minor’  pilgrimage, which I am sure, was a highly significant spiritual moment for her.

The medical mind in me, on the other hand, can easily attribute her well-being to the fact that she lost so much weight, her knees did not have to bear such a heavy burden anymore and ceased to be painful. The weight loss together with the anti-hypertension medication probably brought her blood pressure under control. :)

Should I say my piece to her and deprive her of her own extraordinary explanation for the renewed health?

Of course not!

I believe the pilgrimage had changed her into a better person, physically and spiritually and when patients are happy, I’m happy.

:)