One consequence of being on sabbatical is never having to say TL;DR, and feeling free to read things that would normally accumulate in my pile of things to get around to one day. Another, less unambiguously positive consequence is a mild disorientation with respect to time. I was recently able to experience both of these at the same time when reading Sinclair Lewis’s Arrowsmith.
Lewis was writing in an age when alarming names like Inchcape Jones and Almus Pickerbaugh could exist, even as obvious clues to that the characters they’re attached to are satirical ciphers — the first a bumbling colonial surgeon general on the fictional Caribbean island of St. Hubert, the second the director of Public Health in city of Nautilus, Iowa (also fictional) who is so resolutely stupid and committed to boosterism that he is a shoo-in for a seat in Congress. It was also a time an otherwise deeply progressive text can hold up a woman who knows how to make herself scarce when her Man is Doing His Thing as an ideal wife. And yet, there are cutting bits of satire here that could as easily be aimed at today’s scientific world, for example this description of the University of Winnemac:
The University has a baseball field under glass; its buildings are measured by the mile; it hires hundreds of young Doctors of Philosophy to give rapid instruction in Sanskrit, navigation, accountancy, spectacle-fitting, sanitary engineering, Provencal poetry, tariff schedules, rutabaga-growing, motor-car designing, the history of Voronezh, the style of Matthew Arnold, the diagnosis of myohypertrophia kymoparalytica, and department- store advertising. Its president is the best money-raiser and the best after-dinner speaker in the United States; and Winnemac was the first school in the world to conduct its extension courses by radio.
It is not a snobbish rich-man’s college, devoted to leisurely nonsense. It is the property of the people of the state, and what they want–or what they are told they want–is a mill to turn out men and women who will lead moral lives, play bridge, drive good cars, be enterprising in business, and occasionally mention books, though they are not expected to have time to read them. It is a Ford Motor Factory, and if its products rattle a little, they are beautifully standardized, with perfectly interchangeable parts. Hourly the University of Winnemac grows in numbers and influence, and by 1950 one may expect it to have created an entirely new world-civilization, a civilization larger and brisker and purer.
Public discourse about higher education today certainly reflects a view of the university that has something of this flavor to it.
Student debt is often discussed in terms of what students get for their money, i.e., whether their investment in an education has paid off in terms of providing them with the skills and credentials they need for the workforce. The system more often criticized, not because it has taken education, which is a basic human right, and turned it into a commodity that people must go into indentured servitude to obtain, but because universities are not adapting fast enough to meet the demands of the labor market. The proliferation of à la carte certification options that promise just the monetizable parts of professional programs or bachelor’s degrees are ways of credentialing people so that they can be more easily sorted by human resources departments, rather than providing them with an education. There is a good impulse here, to give people cheap and readily available access to the training they need to make a living, but it accepts — sometimes with resignation, sometimes with distressing enthusiasm — the premise that universities function primarily as advanced vocational schools for the “new economy.”
An alternative view going back to the ancient Greeks since at least the Epicureans, that learning is an important part of life, an end in and of itself, rather than a means toward gainful employment, remains well outside the mainstream. Consider this gem from Buckminster Fuller, addressing a teach-in on the environment in 1970, which still sounds radical today: “We keep inventing jobs because of this false idea that everybody has to be employed at some kind of drudgery because, according to Malthusian-Darwinian theory, he must justify his right to exist…The true business of people should be to go back to school and think about whatever it was they were thinking about before somebody came along and told them they had to earn a living.”
Happily, this spirit is alive and well despite attempts to marginalize even the more moderate notion of a liberal arts education by writing it off as anachronistic or elitist or too expensive (generally some combination of the three). This week, for example, New York City’s Madison Square park will be the site of a Free University with a combination of teach-ins, seminars, and regularly scheduled courses from colleges around the city. I’m chipping in by facilitating a discussion about science and capitalism at 4:00PM Friday.
Those of us who are upset by the incursion of market logic into the world of education and scholarship sometimes imagine that this is a new threat to an established tradition, but reading Arrowsmith reminds us that forces behind the University-as-factory model have probably been around at least as long as factories themselves. Satire can be an incredibly effective weapon against institutions who depend on their reputations for survival. Arrowsmith itself likely deserves some credit for the fact that the 21st century university is not essentially Winnemac with the Internet.
Another force that Lewis captures quite devastatingly is the drive to make one’s work seem more important than it is in order to ensure the continued influx of funds for future work. Consider this sequence in which the results of a heroic, but poorly run and inconclusive clinical trial using bacteriophage to control bubonic plague are transformed into a medical breakthrough by the power of advance press and face-saving:
He had already made a report of his work to the Director and the Trustees of the Institute, with no conclusion except “the results await statistical analysis and should have this before they are published.” But Holabird had run wild, the newspapers had reported wonders, and in on Martin poured demands that he send out phage; inquiries as to whether he did not have a phage for tuberculosis, for syphilis; offers that he take charge of this epidemic and that.
Pearl had pointed out that his agreeable results in first phaging the whole of Carib village must be questioned, because it was possible that when he began, the curve of the disease had already passed its peak. With this and the other complications, viewing his hot work in St. Hubert as coldly as though it were the pretense of a man whom he had never seen, Martin decided that he had no adequate proof, and strode in to see the Director.
Holabird was gentle and pretty, but he sighed that if this conclusion were published, he would have to take back all the things he had said about the magnificence which, presumably, he had inspired his subordinate to accomplish. He was gentle and pretty, but firm; Martin was to suppress (Holabird did not say “suppress”– he said “leave to me for further consideration”) the real statistical results, and issue the report with an ambiguous summary.
Then Holabird published officially, under the Institute’s seal, Martin’s original report to the Trustees, with such quaint revisions as a change of “the results should have analysis” to “while statistical analysis would seem desirable, it is evident that this new treatment has accomplished all that had been hoped.”
This impulse is also alive and well today, and animates discussion about, for example, whether the initial publications from ENCODE project provide insufficient context for their results in a bid to be granted press-release-level credit for findings most biologists seem to view as confirmatory rather than transformative. The accumulation of cases of out-and-out fraud in the social sciences is another obvious symptom of careerism run amok.
Lewis’s characterization of how professional scientists behave is highly cynical, unfair to most people in the field, and occasionally laugh-out-loud funny. It captures, in an outsized way, some of the real pressures and incentives that still shape people’s careers. It gets at a kind of novelistic truth, dI was interested to learn, then, that Lewis’s drinking buddy and collaborator Paul de Kruif was at one point offered 50% of the royalties for the book as co-author (there is even some confusion about whether his name was ever supposed to appear on the cover).
De Kruif is best remembered for his popular account of early work in microbiology, The Microbe Hunters, but prior to that he was a scientist at the Rockefeller Institute, where we worked on Streptococcus bacteria for two years before being asked to resign. His dismissal is widely understood to be the result of an essay published anonymously in the portentously titled, but actually sort of delightful Civilization, a collection of critical essays on “American Civilization.” De Kruif’s entry was on medicine, and contains a combination of cogent critiques of the evolution of medical practice, some loaded arguments against the Temperance movement, and a bit of intemperate name-calling.
In the piece, de Kruif bemoans the formation of “group practices,” which he sees as an unwelcome incursion of industrialization into the “art” of the general practitioner. His gripe is not at all with the injection of science into medicine, but with the use of scientism to justify increased specialization among physicians, and with it the increased cost of treatment. He reserves particular scorn for surgeons, whom he calls “higher carpenters,” lamenting that “we lead the world — to use an apt Americanism — in the production of surgeons, just as we do in that of automobiles, baby carriages and antique furniture.”
On de Kruif’s view, the hyper-specialization of surgeons naturally lead to the formation of expensive clinics, with several surgeons who specialized in different types of operations, an internist whose job was essentially to figure out which surgeon to assign a given patient to, and a set of laboratory technicians — pathologists and bacteriologists — to aid in the process. The support of this infrastructure incurs costs that must be raised somehow, mostly by identifying and operating upon sources of focal infection, if necessary “until all organs not necessary for mere existence have been removed.” De Kruif clearly got a bit carried away in his assessment of the business model for the incipient medical-industrial complex, but it’s easy to see in this description the germ of our current dysfunctional health care system. As with the parody of the modern university, de Kruif’s (and, later, Lewis’s) skewering of the modern hospital hits its satirical mark amazingly well nearly a century later. We are clearly still dealing with the consequences of treating health care as an industry.
De Kruif’s views on the science behind the health effects of alcohol have not similarly stood the test of time. I don’t know what the state of the science was in 1922, but I do know that de Kruif had a dog in this fight, as he famously loved a drink. Few of the accounts of his collaboration with Lewis that I found fail to mention their prodigious drinking, especially during their research trip to the Caribbean. He advances two counterarguments to contemporary condemnations of alcohol. First, the contention that alcohol consumption leads to insanity is taken apart as an example of mistaking correlation for causation. The notion that there is a link between alcohol consumption and insanity just doesn’t have the same currency today as it did during the Temperance movement, although substance addiction is firmly ensconced in the Diagnostic and Statistical Manual for psychiatrists. In his discussion of the effects of alcohol consumption and pregnancy, de Kruif really had his money on the wrong horse. He cites a study by Elderton and Pearson (yes that Pearson!) that failed to find a relationship between alcoholism and “the stigmata of degeneracy” in children.
We can take de Kruif’s criticism of the pro-Temperance science with a grain of salt, and we can tut-tut at his spectacularly misguided defense of heavy drinking during pregnancy, but his point was that policy arguments driven by “scientific evidence” had gotten way out ahead of what the science itself could say with any confidence, and yet had nonetheless taken on moral dimensions. Here again, he’s describing an early version of the apparatus of scientific-medical communication that is very familiar to anyone who has tried to make any sort of rational health decisions based on science reporting. Go to a health food store, and you will be confronted with a wide array of gluten-free products, accompanied by a wide array of supposedly healthy meat substitutes made almost entirely of gluten (seitan). You will not find any high fructose corn syrup, but you will find agave syrup, which is mostly fructose. I dare you to figure out whether eating eggs will kill you or not without advanced training in statistics. Ditto red meat, soy, whole grains, and, to complete the circle, alcohol. Whatever the facts, the 21st Century has no shortage of Almus Pickerbaughs who see it as their duty (and their meal ticket) to raise awareness about how to eat, how to exercise, how to raise children, etc.
For all its snark — and who doesn’t enjoy a few good rounds of sticking it to the man, especially when the targets are so well-chosen? — Arrowsmith ends with a strikingly romantic gesture — the protagonist leaves his post at Rockefeller to work at an lab established by a colleague in rural Vermont, funded independently by a small business they run selling horse serum. This image of the scientist as gentleman farmer bears further consideration. Because while it solves the problem of providing the scientists with time to think, and freedom to do whatever experiments their equipment and budget permit, it also endorses a kind of Great Man model of scientific discovery (also evident in The Microbe Hunters).
I’m not sure that anything like the combination horse serum plant / bacteriology lab described at the end of the book ever existed, but today there are places like GenSpace, a “community biolab” in an old bank building on Flatbush with a sign in the elevator defining “info-biological inadequacy syndrome”. There is also LottoLab, which does experiments on perception out of the Science Museum in London, and has published a paper in collaboration with a group of 8-10 year old schoolchildren. These are creative responses to pressures that have existed since the time of Rippleton Holabird and Almus Pickerbaugh. Rather than wandering off into the woods, they involve engaging directly and seriously with a broad public. Is that, finally, something like progress?
Image credit: pulp cover for the novel, linked from this NY Post piece about Sinclair Lewis in Hollywood, which is, like, a whole other thing to contemplate.