My author interview with Geri. G. Taylor on her Blog: The Delete Key
Hi everyone, I’d like to introduce Bonnie Gail Carter, and her debut book of poetry, The Chill Turned Warm. The title comes from one of her poems in the book.
I’ve asked her to provide some information about herself, her poetry, and her inspirations to share with my readers.
Bonnie Gail Carter:
I was born in Bay City, Michigan in 1954. That makes me sixty years old. My parents got divorced when I was around five years old. I lived in Bay City and Saginaw, Michigan until I was 15 years old then I moved to Lafayette, Indiana where I lived until 2 years ago. My residence is in Peru, Indiana now. I graduated from William Henry Harrison High School in 1972. I have two years of College at Purdue University in West Lafayette, Indiana where I studied Sociology and Psychology.
Some of my poems are about intense subjects like divorce, alcoholism, when…
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Editor’s note: This poem kicks off a new “Question Worth Asking” series: “How weird will the future be?” First up: a piece from poet and TED Fellow Ben Burke.
[Dear Helen- So sorry. Didn’t have time to write that poem. But my future self sent me one yesterday. So we’re good. Crazy, right? It’s totally legit and actually from the future, so no need to double-check, you’re probably too busy anyway. Also included is the typewritten note that was taped to the package. Happy New Year! – Ben Burke]
THE TRANSHUMANIST’S LAMENT
TOO MANY RIVERS, NOT ENOUGH LAKES
OH, FUTURE — YOU SO CRAZY
I arrived in the basket that was weaved here before me
And I stayed in any place with a roof that would store me
I have lots of belongings
But didn’t pack for the trip
I got here, they put pants on me
And then the world gave me the slip
I’ve lived as slowly as I could
Because there was no time to waste
But then things just got so weird
That I just had to grab your ear
And give the tongue inside your mind a little taste:
The wallpaper can see that you’re stressed,
So it turns a lovely shade of blue
The thermostat has thought things over
And is ready to have a word with you
And your closet picked out your outfit
for the party Friday night
Whilst the blender and the toaster
made vindaloo by candlelight
And Doctor mailman robot
Printed your pills in quite a hurry
Your vitamins were running low
Now there’s B12 in your curry
But your personality algorithm
was accidentally miswritten
You forgot your fingernails were all encoded
and you bit them
Now the discs of your thumbnails
are gangrene, corrupted
The chip that was slipped
twixt each digit erupted
Your sensors and servos
Implants and additions
All bent towards a personal program of precision
Your body’s expanded
Your spirit is failing
The row boat got a motor but wants to be sailing
Yes every Thing now is thinking
We are each our own king
But there’s no kingdom here to speak of
It’s a pot luck, but we’ve nothing to bring
For the air now is as thick as the sea
With every thing we created, each idea we have dreamed
Yes we screamed and filled the skies with drones and clones of drones
Now they’re crashing on our couches as they move into our homes
And taking in some old stray nanobots
Now the drones have a family
Now the drones have a dog
There’s so many drones, we all miss having cops
Yes life never stops, there’s no room to start over
Though we have deftly fashioned countless walls
Every thing that you want or you need or just hoped for
Is always round the corner, and just down the hall
We are tubes inside of tubes inside of tubes inside of more
We are a sinking ship that’s filled with valves, and pouches, switches, doors
A whirling servo for your heart-
It no longer beats, it hums
Every poem will be disposed of that once compared our hearts to drums
We are a hurricane that just built a fountain
A pile of rocks with an eye for the mountain
But keep your ears to the ground for the counting
For the number of hooves that are rumbling round it
Numb to the sound of the sirens surrounding
For we will stretch ourselves further
Than we ever have before
And one day, there’s no doubt, we will snap
With our nose to the grindstone
We’ll all make our way
to the top, then collapse
For though we’ve imagined where it is we’re all headed-
We do not yet know where we stand
The future can’t hold for us a promise, my friend
It’s a ghost with a pair of clouds for hands
Yes the future isn’t waiting there for us-
It is quietly being pulled through us
It’s an illustration of our secret ways
and yet we cannot say who drew us
For as soon as the word is pronounced
There’s a parade!
The new product arrives!
In your ear
On your finger
Up your nose
In your eyes
Yes we’ve figured out a way to make you all feel MORE alive
(side effects may include
shortness of breath
thoughts of suicide or death
but most likely just
You’ll be a walking coral reef
You’ll be the tide pools filled with teeth
You’ll be a mouth that’s always chewing
You’ll be a tongue that’s underneath it all
You’ll be the roof, the ceiling, and all the papered walls
You’ll be prefixed
As they watch you
And poke you
And cut you
And shoot ya
Let us mend every seam with some sutures
Let them sew up the holes in your life with the future
But who are we inside of this thing that we’ve built?
We’re a bowl full of milk that’s about to be spilt
For there is always a storm that is coming
The word on the tip of all tongues now is fear
We’d all love to cry out, but we’re too filled with doubt
That’s no diamond, my friend, it’s a tear
That’s no animal, in fact-
No we’ve all just learned
each of them is a sentient being
Why there’s so many facts
That are all in the past
It’s unbelievable- the things that we weren’t seeing
It turns out that Reiki is real
And meditation’s no longer a joke
We’ve all been such fools, but now we teach it in the schools
And yes the hippies are all pretty stoked
And the universe, it just so happens,
Is just the way Tesla found it-
It’s all about frequencies… and vibrations….. and things
We just had to wrap our little heads around it
Yes, we still don’t like the unknown
We need to have things defined
We want our world to make sense
We like it when nature rhymes
Even if only slightly
Even if we must bend
What we see and we hear to fit the means to our end
We all just spend our lives
Trying to overcome our births
Trying to get along with Death
And then untie ourselves from Earth
Now we vacation on the moon
And yes, we’ve flown beyond the stars
And can you guess where I just sent this from?
I’ll give you a hint- It’s Mars
Now we can grow your bones for you
And buildings build themselves, for free
But there’s still work for you to do:
You must remember how to be-
Just like the ocean when it’s thinking
Just be that storm that’s always brewing
You’re an idea
Just one idea
Of what one person on earth could be doing
And what animal doesn’t love
Going out to chase wonder?
Only to learn of the lightning
just before there is thunder?
Look above you- it’s raining
Look around- there’s a flood
Who can say when it started,
but now the ghost is in our blood
We can only move forward
Only turn back for a time
Now the only sacred space left
In the world
Is our mind
And it’s running away with itself and the others
Like the wind through the trees-
Phantom sisters and brothers
Have gone the way of the bees
And the birds and the lovers
Yes they’ve all been drawn and quartered
A million horses left the track
The future will take your mind off of itself-
So I suggest you start stealing it back
For our time here, like the twilight
Is precious and fading
And while there’s certainly nothing new under the sun-
Under the moon, there is waiting
Good day and good luck and good bye
Oh that’s right,
I nearly forgot-
Everyone in the future says H
From Erin Brown Conroy’s Blog for Entrepreneurs and Creatives
Well. I’m letting you (and me) off the hook.
This isn’t about our personal character. (You know, the interior part of us, the part where integrity sits.)
And I’m not going to ask you where you’re from — your physical geography — the point on the map where you lay your head at night (as in the state of Michigan, where I live in the US, called “the mitten state” because it looks like a mitten).
This is about your story — your characters in that story.
Their personal, emotional states.
As in how we feel at any given moment.
Oh — and if you’re not a writer — keep reading, because
there’s something important here…
(it all makes sense when you read to the end).
There’s a not-so-secret secret to help you create compelling characters (and a compelling plot line, too).
State doesn’t come from outside influences
(what people say or…
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Although there is a blanket of snow on the ground,
you keep me warm.
You lead me to a stream of water when I am thirsty.
You stand by my side through all kinds of weather.
We eat together and we sleep together.
We will stand side by side forever.
We will be lovers until the end.
A History Of Medicine
- Medieval & Renaissance Medicine
- Modern Medicine
What Is Medicine?
Ancient Egyptian Medicine
Ancient Greek Medicine
Ancient Roman Medicine
Medieval Islamic Medicine
Medieval & Renaissance Medicine
What Is Modern Medicine?
Economic activity grew rapidly during the 18th Century in Western Europe and the Americas. It was the beginning of the Industrial Revolution. During the 19th century economic and industrial growth gathered pace; it was also a period of scientific discovery and invention.
Old ideas of infectious disease epidemiology (incidence, distribution, and control of diseases) made way to virology and bacteriology. Microbiology made advances, a science that started with Antonie Philips van Leeuwenhoek (1632 – 1723), who first observed microorganisms with a microscope.
Enormous development s were made in identifying and preventing illnesses. However, one problem still persisted, and that was treating and curing infectious diseases.
During the 19th century the world changed dramatically:
- Industry expanded enormously, and with it came various work-related diseases, such as “phossy jaw” (jaw necrosis among those working with phosphorous, usually in the match industry), lung diseases and dermatitis.
- Hygiene – Ignaz Semmelweis (1818-1865) brought down the childbed fever death rate among new mothers by insisting that doctors wash their hands before touching women during childbirth. It was not until 1865 when Joseph Lister, a British surgeon proved the principles of antisepsis in wound treatment. Even then, it was an uphill struggle to convince all the “conservative” doctors.
- Cities started to grow rapidly, and so did urban sprawl. Health problems, such as typhus and cholera became more common
- Some European countries had empires, including the UK, Spain, Portugal, France and some others. People travelled to and from various parts of the world, bringing back with them various diseases, such as yellow fever.
- Scientific breakthroughs appeared all over Europe and the Americas, including the electrocardiograph.
- Postal services and communications in general improved, allowing medical knowledge to spread rapidly.
- Democracy grew in several countries in Europe and the Americas. This led to people demanding health as a human right.
- Innovative scientists advanced forward despite resistance from the clergy, examples include Charles Darwin (evolution) and Gregor Johann Mendel (genetics).
- Wars – as technology developed, wars became more devastating, causing mass injuries, which required new surgical and medical techniques.
Louis Pasteur (1822-1895), a chemist and microbiologist from France, is known as one of the founders of medical microbiology. After working for several years as a teacher in Strasbourg and Dijon, he became professor of chemistry at the University of Lille in 1854. The science faculty had among other things, been asked to find solutions to some of the problems that existed in local industries, such as the manufacture of alcoholic beverages.
Pasteur demonstrated that bacteria caused the souring of wine and beer, and later on showed that a similar process occurred in milk. He also explained that by boiling and the cooling a liquid, such as milk, the bacteria could be removed. The process we know as pasteurizationcomes from his surname.
He then set out to determine where these bacteria originated from, and eventually proved that they came from the environment. Initially, the scientific community disagreed with him, saying that germs could appear out of nowhere (spontaneously generate). However, in 1864, his findings were accepted by the French Academy of Sciences.
Later on, as head of scientific studies at the École Normale, he was given the job deciding what to do about an epidemic among silkworms in the silk industry in the south of France. He eventually determined that parasites were the cause and that only healthy silkworm eggs (with no parasites) should be used. The epidemic was resolved and the silk industry recovered.
His subsequent research convinced him further that pathogens attack the body from outside (germ theory of disease). Many scientists could not conceive that microscopic beings could harm and even kill comparatively huge ones, like us. He went a step further and said that many diseases, including TB, cholera, anthrax, and smallpox are caused by germs that come into the body from the environment. He believed they could be prevented with vaccines.
He went on to develop vaccines for rabies, for which he is probably the most famous.
In 1888 the Institute Pasteur was founded. He was director there until 1885, when he died. Louis Pasteur was given a state funeral. In France he is a national hero.
Louis Pasteur worked closely with Claude Bernard (1813-1878) a physiologist; together they perfected pasteurization of liquids. Bernard was the first to define milieu intérieur(homeostasis – a healthy state that is maintained by the continuous adjustment of biochemical and physiological pathways). Bernard was the first to suggest using “blind” experiments when aiming for maximum objectivity in scientific observations. Harvard University Professor, Bernard Cohen says that Bernard was “one of the greatest of all men of science”.
Florence Nightingale (1820-1910) was a British nurse, statistician and writer. Her pioneering nursing work during the Crimean War, where she cared for wounded soldiers, brought her to prominence. Nightingale was thea daughter of wealthy parents who were in Florence, Italy, as part of a tour when she was born – hence her name.
In 1837 she sensed a “calling from God”, telling her to do some work, even though at the time she said she had no idea what that work was. She was interested in nursing, but well-to-do women in those days did not go into the medical professions. Her parents did not allow her to study nursing. She had been expected to marry well and have children.
Nightingale eventually got her way and went to Kaiserwerth, Germany, in 1851 to do a three-month nursing course. By 1853 she became superintendent of a hospital for well-off women in Harley Street, London (a street famous for top doctors).
The Crimean War broke out a year later. Nightingale read reports of dreadful lack of medical facilities for British soldiers who had been wounded in action. Nightingale, who already knew Sidney Herbert, Minister for War, was asked by Herbert her to be in charge of a team of nurses in the military hospitals in Turkey. She arrived in Scutari, Turkey in 1854 with 38 women volunteer nurses who had all been trained by her, including her aunt Mai Smith.
Nightingale was shocked by what she saw at Scutari – wounded soldiers in unbearable pain, many of them dying unnecessarily, being tended by overly-tired medical staff and official indifference. There was a serious shortage of medications, hygiene standards were shocking, and there were mass infections. There was nothing to process food for the patients; no equipment at all.
She sent a pleas to The Times asking the government to do something about the atrocious conditions in Scutari. A prefabricated hospital was built in England and transported to the Dardenelles. When it was built it was called the Renkioi Hospital, which had a death rate 90% lower than what existed before in Scutari.
The presence of Nightingale and her team of nurses resulted in a significant drop in the mortality rate of wounded soldiers.
In 1860 Nightingale founded the Nightingale Training School for nurses at St Thomas’ Hospital, London. It was the first secular nursing school in the world. Nurses who trained there worked all over the UK, and spread what they had learnt.
Her book Notes of Nursing was published in 1860. In it she stressed the importance of sanitation and hygiene, good hospital planning, and the best ways to achieve optimum military health – many of her practices are still in force today.
Nightingale reduced death rates from 42% to 2%, according to the 1911 edition of theDictionary of National Biography.
The arrival of Florence Nightingale is seen as a turning point for women in the medical profession. Before she came onto the scene, women in hospital and medical settings possibly worked as midwives, cleaning ladies and sitters, and not much else.
Timeline of medical milestones during the 19th century
- 1800 – Humphry Davy (1778- 1829), a British chemist and inventor, described how nitrous oxide (laughing gas) has anestheric properties. It is said he was addicted to the stuff.
- 1816 – Rene Laennec (1781-1826), a French doctor, invented the stethoscope. He also pioneered stethoscope use in diagnosing chest infections.
- 1818 – James Blundell (1791-1878) was a British obstetrician. He performed the first successful blood transfusion on a patient who had a hemorrhage.
- 1842 – Crawford Long (1815 -1878), an American pharmacist and surgeon, now recognized as the first doctor to have used inhaled ether anesthesia on a patient for a surgical procedure. For many years only a few colleagues in his inner circle knew about this achievement.
- 1847 – Ignaz Semmelweis (1818 -1865), a Hungarian doctor, known as the savior of mothers. He found that childbed fever (puerperal fever) incidence could be considerably reduced if doctors, midwives and nurses disinfected their hands before touching the mother during childbirth or a miscarriage. Childbed fever was common in the 19th century; between 10% and 35% of mothers who became infected died.
- 1849 – Elizabeth Blackwell (1821-1910), an American, was the first woman to become a fully qualified doctor in the USA, and also the first female to be on the UK Medical Register. Blackwell dedicated much of her time to promoting the education of women in medicine.
- 1867 – Joseph Lister, 1st Baron Lister OM, FRS, PC (1827-1912), a British surgeon and a pioneer of antiseptic surgery. He introduced phenol (then known as carbolic acid) successfully to clean wounds as well as sterilizing surgical instruments. His work contributed greatly towards a reduction in post-operative infections. He published a bookAntiseptic Principle of the Practice of Surgery, which was strongly influenced by Louis Pasteur’s work.
- 1870 – The Germ Theory of Disease is established by Louis Pasteur and Robert Koch.
- 1879 – Louis Pasteur produced the first laboratory-developed vaccine – the vaccine for chicken cholera.
- 1881 – An anthrax vaccine developed by Louis Pasteur. Pasteur made a public demonstration with 50 sheep. He tested his vaccine, created by attenuating the anthrax bacterium with carbolic acid. All the 25 unvaccinated sheep died, while only one of the vaccinated ones perished, which was probably due to a miscarriage.
- 1882 – The first rabies vaccine. Louis Pasteur managed to prevent rabies in Joseph Meister, a 9-year old boy, by post-exposure vaccination.
- 1890 – Emil von Behring Emil Adolf von Behring (1854-1917), a German physiologist, discovered antitoxins and utilized them to develop diphtheria and tetanus vaccines. He received the Nobel Prize in Physiology or Medicine; the first time the prize was ever awarded.
- 1895 – Wilhelm Conrad Röntgen (1845-1923), a German physicist. He produced and detected electromagnetic radiation in a wavelength range; what we call today Röntgen rays or X-rays. In 1901 he received the Nobel Prize in Physics. The International Union of Pure and Applied Chemistry named element 111, Roentgenium after him.
- 1897 – Aspirin was invented. Chemists working in the German company Bayer AG produced a synthetic version of salicin, which was derived from the species Filipendula ulmaria (meadowsweet). This synthetically altered version was easier on the stomach than pure salicylic acid. Bayer says that the invention of aspirin should be attributed to Felix Hoffmann; however, Arthur Eichengrün, a Jewish chemist later said that he was the lead researcher, but records of his participation were erased under the Nazi regime.
Bayer AG named the new drug Aspirin. Within two years Aspirin became a global blockbusting drug.
Timeline of medical milestones during the 20th century
- 1901 – Different human blood types were discovered by Karl Landsteiner (1868-1943), an Austrian biologist and physician. He identified the presence of agglutinins in blood and developed the modern system of classifying blood groups. He received the Nobel Prize in Physiology or Medicine in 1930.
- 1901 – The first case of Alzheimer’s disease was identified by Alois Alzheimer (1864-1915), a German psychiatrist and neuropathologist. He called it “presenile dementia”. His colleague, Emil Kraepelin, later called the it Alzheimer’s disease.
- 1903 – The first practical electrocardiogram (ECG or EKG) was invented by Willem Einthoven (1860-1927), a Dutch doctor and physiologist. In 1924 he received the Nobel Prize in Medicine in 1924.
- 1906 – Vitamins were discovered by Frederick Hopkins (1861-1947), an English biochemist. He also suggested that scurvy and rickets were caused by a lack of vitamins. Along with Christiaan Eijkman, he received the Nobel Prize in Physiology or Medicine.
- 1907 – A chemotherapeutic cure for sleeping sickness was developed by Paul Ehrlich (1854-1915), a German doctor and scientist. Ehrlich’s lab also discovered Arsphenamine (Salvarsan), the first treatment for syphilis that was effective, and thus initiated and named the concept of chemotherapy.
- 1908 – The stereotactic method (stereotactic device) was invented by Victor Horsley (1857-1916) and R. Clarke. It allows experimental and surgical intervention in deep-seated structure of the brain.
- 1910 – The first laparoscopy performed on a human was done by Hans Christian Jacobaeus (1879-1937), a Swedish internist. Jacobaeus became a professor at the prestigious Karolinska Institute in Stockholm, and was also a member of the Nobel Prize Committee.
- 1921 – Vitamin D discovered by Sir Edward Mellanby (1884-1955), a British physician. He also explained Vitamin D’s role in preventing rickets.
- 1921 – Insulin was discovered by Sir Frederick Banting (1891-1941), a Canadian medical scientist, and Charles Herbert Best (1899-1978), an American-Canadian medical scientist. Banting received the Nobel Prize in Medicine in 1923 (along with John James Rickard Macleod) when he was 32 years old. He is still the youngest ever Nobel Laureate for Medicine.
- 1921 – The technique of epidural anesthesia was pioneered by Fidel Pagés (1886-1923), a Spanish military surgeon.
- 1923-1927 – The first vaccine for diphtheria, pertussis (whooping cough), TB (tuberculosis) and tetanus were developed and used successfully.
1928 – Penicillin from the mould Penicillium notatum was discovered by Sir Alexander Fleming (1881-1955), a Scottish biologist and pharmacologist. He was awarded the Nobel Prize in Physiology or Medicine in 1945, along with Howard Florey and Ernst Boris Chain.
The discovery of penicillin changed the course of history and saved hundreds of millions of lives.
Fleming said: “When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionized all medicine by discovering the world’s first antibiotic, or bacteria killer ……. But I suppose that was exactly what I did.”
- 1929 – Human electroencephalography was discovered by Hans Berger (1873-1941), a German doctor. He was the first to record brain waves or EEGs (electroencephalograms). He discovered the alpha wave rhythm in the brain, which is also known as “Berger’s wave”.
- 1932 – A chemotherapeutic cure for streptococcus was developed by Gerhard Domagk (1895 -1964), a German pathologist and bacteriologist. He is credited with discovering Sulfonamidochrysoidine (KI-730), the first antibiotic to go on the market (brand name: Prontosil). He was awarded the Nobel Prize in Physiology or Medicine in 1939.
- 1933 – Insulin shock therapy for patients with some mental illnesses was discovered by Manfred Sakel (1900-1957), a Jewish Austrian neurophysiologist and psychiatrist who later became an Austrian-American.
- 1935 – The first successful vaccine for Yellow Fever was developed. The yellow fever virus was isolated in West Africa in 1927; this led to the development of two vaccines in the 1930s. 17D was developed by Max Theiler, a South African microbiologist at the Rockefeller Institute. He used chicken eggs to culture the virus. Theiler was awarded the Nobel Prize in 1951.
- 1943 – The world’s first dialysis machine was built by Willem J Kolff (1911-2009), a Dutch doctor. He is known as a pioneer of hemodialysis and artificial organs. In 1950, Kolff emigrated to the USA.
- 1946 – The first effective cancer chemotherapy drug – nitrogen mustard – was discovered by Alfred G. Gilman (1908-1984) an American pharmacologist, and Louis S. Goodman (1906-2000), also an American pharmacologist, while doing research together at Yale University. They discovered that the blood of soldiers who had been exposed to nitrogen mustard had exceptionally low levels of white cells.
- 1948 – Acetaminophen (paracetamol, Tylenol) was invented by Julius Axelrod (1912-2004), an American biochemist, and Bernard Brodie (1907-1989), an American chemist, considered by many to be the founder of modern pharmacology.
- 1952 – The first polio vaccine was developed by Jonas Salk (1914-1995), an American medical researcher and virologist. The vaccine came onto the market in 1955.
Salk set up a field trial to test the vaccine – a trial of immense proportions; it included 20,000 doctors, 64,000 school staff, and 220,000 volunteers. More than 1,800,000 school kids took part in the study. When news of the trial’s success became public in April 12th, 1955, Salk was hailed a “miracle worker”. After WWII polio became a serious public health problem in the USA.
In a TV interview, Salk was asked about who owned the patent for the polio vaccine. He answered “There is no patent. Could you patent the sun?”
- 1953 – The Heart-Lung Machine was invented by Dr John Heysham Gibbon (1903-1973), an American surgeon. He performed the first open heart surgery ever, repairing an atrial septal defect.
- 1953 – Medical Ultrasonography (echocardiography) was invented by Inge Edler (1911-2001), a Swedish physicist.
- 1954 – The first human kidney transplant (on identical twins) was performed by Joseph Murray (born 1919). During the following years, as immunosuppressive agents came onto the market and science understood the mechanisms of rejection better, Murray managed to performed transplants with donor organs from unrelated people.
- 1955 – Tetracycline was produced by catalytic reduction by Lloyd Conover (born 1923), an American chemist. He and his team substituted hydrogen for chlorine chlortetracycline. He was the first scientist ever to make an antibiotic by chemically modifying a naturally-produced drug. Within three years, tetracycline became the most popular broad spectrum drug in the United States. Conover has nearly 300 patents in his name.
- 1958 – The first implantable pacemaker was developed by Rune Elmqvist (1906-1996), a medical doctor who later worked as an engineer and inventor. Elmqvist also developed the first inkjet ECG printer.
- 1959 – In vitro fertilization led to the first “test tube baby”, by Min Chueh Chang (1908-1991), a Chinese American reproductive biologist. M.C. Chang is also famous for contributing towards the development of the combined oral contraceptive pill (“The Pill”).
- 1960 – Cardiopulmonary resuscitation (CPR) was invented by James Jude, Guy Knickerbocker, Peter Safar, William Kouwenhoven and Joseph S. Redding, all Americans. CPR was originally developed at Johns Hopkins University. They first tested CPR successfully on a dog. Not long afterwards, a child’s life was save using the technique.
- 1960 – The first combined oral contraceptive pill (COCP), often referred to as the birth-control pill or informally as “The Pill” was approved by the FDA. “Combined” refers to the two hormones within it – estrogen and progestin. Hundreds of millions of women use COCP today.
- 1962 – The first beta blocker was invented by Sir James W. Black (1924 – 22 March 2010), a Scottish doctor and pharmacologist. After founding the physiology department at the University of Glasgow, Black became interested in how adrenaline might impact on the functioning of the human heart. While working for ICI Pharmaceuticals, he developed Propranolol, a beta blocker, which was used to treat heart disease. Black also developed Cimetidine, a medication used in a similar way for the treatment of stomach ulcers. He received the Nobel Prize for Medicine in 1988.
- 1963 – The first human liver transplant was performed by Thomas Starzl (born 1926), an American physician and researcher.
- 1963 – The first human lung transplant was performed by James Hardy (1918-2003), an American surgeon.
- 1963 – Valium (diazepam) was discovered by Leo H Sternbach (1908-2005), a Polish chemist. Sternback also discovered chlordiazepoxide (Librium), trimethaphan (Arfonad), clonazepam (Klonopin), flurazepam (Dalmane), flunitrazepam (Rohypnol) and nitrazepam (Mogadon).
- 1964 – The first measles vaccine came out. It was developed by Maurice Hilleman (1919-2005), an American microbiologist/vaccinologist. Hilleman developed over 36 vaccines, more than anybody else ever.
- 1965 – The rubella vaccine was developed by Harry Martin Meyer (1928-2001), an American pediatric virologist.
- 1966 – The first human pancreas transplant was performed by C. Walton Lillehei (1918-1999), an American surgeon. Lillehei also pioneered open-heart surgery, as well as new equipment, prostheses, and techniques for cardiothoracic surgery.
- 1967 – The first human heart transplant was successfully performed by Christiaan Barnard (1922-2001), a South African cardiac surgeon.
- 1970 – The first vaccine for rubella (German measles) came on the market. It was developed by Harry Martin Meyer (see 1965).
- 1970 – the first effective immunosuppressive drug, Cyclosporine, became used in organ transplant procedures. The active ingredient was first isolated from the fungus Tolypocladium inflatum (Beauveria nivea), which had been collected in a soil sample by Dr. Hans Peter Frey, a biologist who was working at pharmaceutical company Sandoz. Cyclosporine is also used to treat psoriasis, pyoderma gangrenosum, chronic autoimmune urticaria, and less often for severe cases of rheumatoid arthritis.
- 1971 – Magnetic Resonance Imaging was invented by Raymond Vahan Damadian (born 1936), an Armenian-American medical practitioner and inventor.
- 1971 – The CT Scan, also known as CAT scan (Computed Tomography) was invented by Sir Godfrey Hounsfield (1919-2004), an English electrical engineer. He was awarded the Nobel Prize for Physiology or Medicine in 1979 (with Allan McLeod).
- 1972 – The insulin pump was invented by Dean Kamen (born 1951), an American entrepreneur and inventor.
- 1973 – Laser eye surgery (LASIK) was performed for the first time by Mani Lal Bhaumik (born 1941), an Indian-born American physicist. Dr. Bhaumik demonstrated the world’s first efficient excimer laser – this application would eventually do away with the need for contact lenses or glasses in many cases.
- 1974 – Liposuction was carried out successfully for the first time by Giorgio Fischer (born 1934), a gynecologist from Rome, Italy.
- 1978 – The last recorded fatal case of smallpox (Variola minor).
- 1979 – George Hitchings (1905-1998), an American doctor, and Gertrude Elion (1918-1999), an American biochemist and pharmacologist, made important breakthroughs with antiviral medications. Their pioneering works eventually led to the development of AZT, the AIDS drug.
- 1980 – Hepatitis B diagnostic test and vaccine developed by Dr Baruch Samuel Blumberg, an American doctor. Dr. Blumberg received the Nobel Prize in Physiology or Medicine (with Daniel Carleton Gajdusek).
- 1981 – The first human heart-lung combined transplant procedure was successfully performed by Bruce Reitz (born 1939), an American cardiothoracic surgeon.
- 1985 – Kary Banks Mullis (born 1944), an American biochemist, author, and lecturer, invented improvements to the polymerase chain reaction (PCR), a biochemical technology in molecular biology which amplifies one or some copies of a piece of DNA across various orders of magnitude, to generate thousands and possibly millions of copies of that particular DNA sequence. In 1993 he was awarded the Nobel Prize in Chemistry (with Michael Smith).
- 1985 – A surgical robot was created by Dr Yik San Kwoh (born 1946), a Chinese-American Bioengineer and inventor. Initial experiments were tried with a watermelon; a BB was shot into it, the robot had to locate it and remove it (which it did).
- 1985 – Sir Alec John Jeffreys (born 1950), a British geneticist, developed techniques for DNA fingerprinting and DNA profiling which every competent forensic department in the world uses today. The technique is also used to resolve immigration and paternity disputes.
- 1986 – (Prozac) (fluoxetine HCl), a selective serotonin reuptake inhibitor (SSRI) class antidepressant was launched by Eli Lilly after being approved by the US FDA for the treatment of major depression. It went off patent in August 2001. Fluoxetine is also approved for pediatric depression, bulimia nervosa, panic disorder, obsessive-compulsive disorder (adults and children), and premenstrual dysphoric disorder.
In 2010, 24 years after fluoxetine’s approval and nine years after it went off patent, it was the third most prescribed antidepressant in the USA (after sertraline and citalopram) – 24.4 million prescriptions were written that year.
- 1987 – The first statin ever, Lovastatin (Mevacor), was approved by the US FDA. Merck & Co had isolated the active ingredient lovastatin (mevinolin MK803) from Aspergillus terreus, a fungus. Clinical trials had shown that lovastatin reduced LDL cholesterol by 40%; far more than any other treatment at the time.
- 1989 – The birth of the WWW (World Wide Web); a major milestone in the way humans globally behave, gather information, express themselves, make friends,work, and go about exchanging data on medical and pharmaceutical issues and innovations. Sir Timothy John “Tim” Berners-Lee, (born 1955), an English computer scientist and MIT professor invented the World Wide Web. With the help of Robert Cailliau (a student at CERN), they implemented the first successful communication between an HTTP (Hypertext Transfer Protocol) client and server through the internet.
- 1998 – James Alexander Thomson (born 1958), an American developmental biologist, derived the first human ES (embryonic stem) cell line. Later in 2007, he derived induced pluripotent (iPS) stem cells. Thomson’s breakthrough in 1998 generated controversy because the technology involved destroying human embryos. At the same time as Dr. Shinya Yamanaka, in 2007 Thomson wrote that he had discovered a method for creating stem cells which closely resemble human embryonic stem cells from human skin cells; this breakthrough was much more widely accepted because it ended the ethical controversy regarding embryonic stem cell research.
Timeline of medical milestones from 2000 to the present day
- 2000 – The Human Genome Project (HGP) draft was completed. The HGP is a project involving collaborators from all over the world; their main goal being to determine the sequence of chemical base pairs which make up DNA, and to identify and map the circatwenty-to-thirty thousand genes of the human genome from both a functional and physical perspective.
The Human Genome Project has other objectives, apart from understanding the genetic makeup of human beings. It has also focused on other species, such as the laboratory mouse, E. coli, and the fruit fly. The HGP continues to be one of the most important single investigative projects in modern medical science.
- 2001 – Dr. Kenneth Matsumura, of the Alin Foundation, created the first bio-artificial liver. The liver removes toxins from blood and manufactures nearly 1,000 proteins, metabolites and other crucial substances; it is a very complex organ, and one of the most difficult to replace. Dr. Matsumura and team found a way around the liver’s complexities by letting rabbit liver cells sort out the issues.
Dr. Matsumura’s bio-artificial liver had a two-part chamber – one side contained the patient’s blood, while on the other he placed live rabbit cells suspended in a solution; there was a semi-permeable membrane separating the two chambers. The toxins from the human blood passed through the membrane and were metabolized by the rabbit cells; the resulting proteins and other needed substances were then sent back to the other side. The likelihood of the rabbit cells causing infection or being rejected were minimized because they never came into direct contact with the human blood.
The artificial liver was intended as a bridge to an eventual liver transplant for people with acute liver failure, as well liver transplant recipients whose bodies have rejected the organ. There is even the possibility that damaged livers may be given time to health themselves, doing away with a transplant requirement altogether.
- 2001 – Jacques Marescaux, a French doctor, carried out the first ever TeleSurgery; he operated on the gallbladder of a patient who was in Strasbourg, France, while he was in New York, USA (The Lindbergh Operation). A remotely-controlled robot, guided by Dr. Marescaux, carried out the procedure.
- 2002 – HemCon Medical Technologies Incorporated, of Portland, Oregon, USA, invented Chitosan Bandages. Chitosan is a substance found in the shells of crabs, shrimps and other crustaceans. They have been used extensively by the American army in Iraq and have been shown to save many lives. Chitosan bandages seal massive bleeding wounds amazingly quickly, in most cases within 30 seconds. The positively charged chitosan material bonds with red blood cells, forming an artificial clot which stops bleeding. HemCon scientists pointed out that chitosan derives it superiority from nature.
- 2005 – A partial face transplant was performed by Jean-Michel Dubernard, a French transplant specialist. The partial face transplant was carried out on Isabelle Dinoire, whose face had been very badly mauled by a dog. Dubernard had been a Deputy in the French National Assembly.
- 2006 – Gardasil became the first HPV vaccine to be approved by the US FDA; by the end of 2007 it was approved in 80 countries, according to Merck & Co. In 2009, GSK’s (GlazoSmithKline’s) Cervaris (another HPV vaccine) was approved by the FDA.
- 2007 – A bionic eye (a visual prosthetic), the Argus II Retinal Stimulation System, was created. It provides visual function to blind patients with severe to profound retinitis pigmentosa.
Dr. Robert Greenberg of Second Sight Medical Products Inc., Drs. Mark Humayun,and Eugene DeJuan at the Doheny Eye Institute (USC), and Dr Wentai Liu at University of California, Santa Cruz, invented the original prototype api-retinal prosthesis.
The first generation implant consisted of 16 electrodes and was implanted in 6 completely blind volunteers. After implantation, they were able to perform a surprising number of tasks. A trial of its second generation, 60 electrode implant, called Argus II, was started in 2007 in Europe and the United States. Thirty volunteers took part in the studies which spanned 10 sites in four countries.
Argus II was approved in Europe, and the product was launched in 2011.
- 2010 – the first full face transplant was carried out by Spanish doctors on a male adult who had injured himself in a shooting accident five years previously. The patient had been left unable to breathe or swallow as a result of the accident. The 20-hour operation was performed by a team of 30 doctors, led by Dr Joan Pere Barret, at Vall d’Hebron University Hospital, Barcelona, Spain.
In March 2011, Dallas Wiens underwent a full face transplant at Brigham and Women’s Hospital, Boston, USA; the first such procedure ever in the USA. Wiens had had his face severely disfigured in a power line accident. The 30-strong medical team, led by Bohdan Pomahac, replaced the patient’s nose, lips, facial skin, movement muscles and nerves.
In March 2012, the largest face transplant ever was successfully performed at the R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center, USA. The 36-hour operation, led by Eduardo D. Rodriguez, replaced the entire face, including tongue, both jaws and teeth of Lee Norris, a 37-year old male who had been severely injured in a gun accident.
Targeted Cancer Therapy – seen as a major advancement in cancer treatment. Cancer treatment had focused on destroying rapidly dividing cells, which also destroyed a number of healthy rapidly-dividing cells. Cancer patients had to endure some extremely unpleasant side effects from radiation therapy and chemotherapy because of this.
Targeted cancer therapies focus just on specific molecules; the ones that cause tumors to grow. Only the cancer cells are hunted down, resulting in considerably less damage to healthy cells, and subsequently fewer and less severe side effects.
At the moment, this technology is only effective for some forms of cancer. However, experts are sure that eventually most cancers will be effectively treated with Targeted Cancer Therapy.
Anti-smoking legislation – several countries, initially in Western Europe and North America introduced legislation forbidding smoking in public places. Despite resistance from the smoking lobby and organizations representing bars and restaurants, there has been a considerable drop in national smoking rates in several countries, as well as non-smokers’ exposure to second-hand smoke (passive smoking).
A Scottish study found that since the country introduced a national comprehensive smoke-free legislation, rates of preterm deliveries and small-for-date infants have fallen dramatically.
A European study found that smoking bans may even encourage smokers to consume fewer cigarettes at home.
HIV survival extended with combination drug therapy – a 20-year-old AIDS patient in 1996 had an expected survival time of three to five years, today he/she is expected to live till the age of 69 years (average). This is thanks to the introduction of HAART (highly active retroviral therapy), a combination therapy, which has turned HIV/AIDS from a deadly disease into a serious but chronic one with good long-term survival.
Combination drug therapy has also improved treatment outcomes for patients with cancer, heart disease and other illnesses.
Harvard researchers find protein that could reverse the aging process
By Anthony Wood
May 7, 2014
Researchers from the Harvard Stem Cell Institute (HSCI) have shown that injections of a protein dubbed GDF11, when administered to older mice, appear to cause a reversal of many signs of aging. Analysis showed that every major organ system tested displayed signs of improvement, with the protein even appearing to reverse some of the DNA damage which is synonymous with the aging process itself.
The protein GDF11 is found in humans as well as mice, and is now being considered for possible human testing due to its surprising and apparently regenerative properties.
A previous study had focused on examining the hearts of mice the equivalent of 70 human years old. The mice were regularly exposed to the blood of younger mice whose blood carried a higher concentration of GDF11. Ordinarily the hearts of older mice are enlarged and weakened, however results from the previous study displayed that, thanks to the GDF11 protein present in the blood of the younger mice, the hearts of the elderly mice reduced in size, making them appear younger and healthier. The changes were not purely aesthetic however, with the mice displaying an increased ability to exercise for prolonged periods of time.
The most recent set of experiments tested the protein in two ways. The first stage of the testing involved linking the circulatory systems of an older and a younger mouse through what is known as a parabiotic system. This allowed the protein-rich blood from the younger mouse to flow through the elder’s system continuously, maximizing the effect of the protein. The second method involved injecting the older mice with a concentrated dose of GDF11.
Results from the second study showed that the protein had positive effects reaching far beyond the heart. It was found that, having been exposed to increased levels of the protein, all organs examined by the researchers displayed a heightened level of function. Furthermore, whilst previous studies on the protein had focused on regenerating damaged muscle in mice, the most recent study focused on the repair of cells damaged by the aging process. The GDF11 protein was found to reverse some of this damage, allowing muscle to function as effectively as that of a much younger mouse.
Analysis of the brains of the older mice via MRI imaging displayed an increase in neural stem cells along with the development of blood cells in the brain. “There seems to be little question that, at least in animals, GDF11 has an amazing capacity to restore aging muscle and brain function,” states Dr. Doug Melton, co-chair of HSCI. The team believes that due to the increased blood flow exhibited in the brain of the elderly mice, it may be possible to reverse some of the cognitive effects of aging. The protein was also found to improve the olfactory system of older mice, greatly heightening their sense of smell.
In terms of human applications, it is hoped that a drug derived from GDF11 will lead to a cure for conditions such as diastolic heart failure. This condition is a defect which eventually causes one or more of the ventricles of the heart to deteriorate while attempting to fill the heart with blood, in order to pump it around the body. There is also a possibility that a GDF11-inspired drug could be used to combat Alzheimer’s, a condition synonymous with the aging process.
Looking to the future, the team will continue studies of the GDF11 protein, with a view to begin human medical trials within three to five years.
The research papers regarding the discoveries surrounding GDF11 are available in the journal Science.
Source: Harvard University
‘Splitting an Order’ offers poetry that outshines dark days
Wisdom, compassion, and dignity continue to mark the poems of Ted Kooser.
DECEMBER 31, 2014
As December draws to a close, many people think about endings, the future, and celebrating light during the darkest days of the year. If that includes you, consider greeting 2015 with a copy of Ted Kooser’s Splitting an Order, a quiet collection that honors small victories and gives reasons to be hopeful.
The book – Kooser’s 13th full-length collection of poems – introduces all of those elements in the first pages before exploring them at length in the next three sections.
Kooser fans will recognize his trademark compassion and plain-spoken wisdom in the initial poems, which form a series of gray- and white-haired portraits. Here, an elderly father and son walk down stairs together, their fingers interlaced in affection and strength. A long-married couple shares a simple meal, along with practiced patience. A woman celebrating her 110th birthday glides to the celebration “in a chair with sparkling carriage wheels,” riding “inches above/ the world’s hard surface, up where she belongs,/ safe from the news.”
Those stories, tinged with melancholy, show the dignity and perseverance of their subjects. Every poem contains several lines that uplift both the anecdote and the reader. Kooser also intersperses more youthful scenes – a little girl swinging between her parents, a young woman swooshing by on inline skates – creating a rich canvas where experience and innocence are equally moving.
From there, Kooser shifts his attention from people to things and animals. The second section explores time and the past, beginning with a long poem called “Estate Sale.” As the speaker moves from one item to another, he ponders ideas and tools that have been discarded through passing decades. A broken bird feeder, a baseball split at the seams, a wristwatch with “a cracked leather band” have all lost their former glory. Yet Kooser’s careful, compassionate view gives them and other forgotten items a different kind of worth and dignity. Wing imagery and ocean references help transform the scene, little by little, until readers and the poem arrive at an antique gilded harp, “its dusty strings like a curtain/ drawn over the silence,/ stroked by fingers of light.”
The third section starts gloriously, as if Kooser’s willingness to see beyond the surface in previous parts has led to new beginnings.
The poem “At a Kitchen Table,” one of the best in the book, opens like a new year with stories that “arrive at dusk,/ in pairs, quietly/ creating themselves/ in the feathery light.” These tales arrive not with fancy plumage but “with a plain little song./ Theirs are the open wings/ we light our table by.”
Readers will feel that light in the next poem as well, as Kooser describes the natural world coming to life in early spring and realizes more than once that there will be “No other day/ like this one, not ever again.” That bittersweet recognition leads to the poem’s powerful last sentence: “This is my life,/ none other like this.” The speaker then shifts direction again, recalling childhood memories of his father, the way people create the past in their own minds, and his unsuccessful first marriage.
Some readers might wish for more light at this point, or wonder why the poet has reverted to sad memories. The book’s final pages answer that question and make a point everyone should remember as 2014 draws to a close: Feeling hopeful is easy when there are no big losses or shocks to challenge one’s perspective. But when major cracks weaken a person’s foundation, he or she must decide what kind of outlook will guide moving forward.
Much of the fourth section is a prose piece, recounting the horror and grief Kooser felt after learning that a teenage boy had been murdered in the house where he, his first wife, and their baby used to live. That violent act seemed to taint key memories and destroy part of the past.
As the speaker describes the cellar he used as a study, the orange shag carpet, and the couple’s “most ordinary unhappiness,” he mentally inhabits those familiar rooms again and restores, in some measure, the place he knew.
Yet Kooser, always full of surprises, doesn’t end with that. Instead, he closes “Splitting an Order” with a short poem in which he compares his right hand to a chicken that pecks her way across the paper and pulls him along “across more than seventy years, a sometimes/ muddy, sometimes frozen barnyard/ where, looking back, it seems that every day/ was rich with interest, both underfoot/ and just an inch or two ahead of that.”
The Innovative State
Governments Should Make Markets, Not Just Fix Them
The conventional view of what the state should do to foster innovation is simple: it just needs to get out of the way. At best, governments merely facilitate the economic dynamism of the private sector; at worst, their lumbering, heavy-handed, and bureaucratic institutions actively inhibit it. The fast-moving, risk-loving, and pioneering private sector, by contrast, is what really drives the type of innovation that creates economic growth. According to this view, the secret behind Silicon Valley lies in its entrepreneurs and venture capitalists. The state can intervene in the economy—but only to fix market failures or level the playing field. It can regulate the private sector in order to account for the external costs companies may impose on the public, such as pollution, and it can invest in public goods, such as basic scientific research or the development of drugs with little market potential. It should not, however, directly attempt to create and shape markets. A 2012 Economist article on the future of manufacturing encapsulated this common conception. “Governments have always been lousy at picking winners, and they are likely to become more so, as legions of entrepreneurs and tinkerers swap designs online, turn them into products at home and market them globally from a garage,” the article stated. “As the revolution rages, governments should stick to the basics: better schools for a skilled workforce, clear rules and a level playing field for enterprises of all kinds. Leave the rest to the revolutionaries.”
That view is as wrong as it is widespread. In fact, in countries that owe their growth to innovation, the state has historically served not as a meddler in the private sector but as a key partner of it—and often a more daring one, willing to take the risks that businesses won’t. Across the entire innovation chain, from basic research to commercialization, governments have stepped up with needed investment that the private sector has been too scared to provide. This spending has proved transformative, creating entirely new markets and sectors, including the Internet, nanotechnology, biotechnology, and clean energy.
Today, however, it has become harder and harder for governments to think big. Increasingly, their role has been limited to simply facilitating the private sector and, perhaps, nudging it in the right direction. When governments step beyond that role, they immediately get accused of crowding out private investment and ineptly trying to pick winners. The notion of the state as a mere facilitator, administrator, and regulator started gaining wide currency in the 1970s, but it has taken on newfound popularity in the wake of the global financial crisis. Across the globe, policymakers have targeted public debt (never mind that it was private debt that led to the meltdown), arguing that cutting government spending will spur private investment. As a result, the very state agencies that have been responsible for the technological revolutions of the past have seen their budgets shrink. In the United States, the budget “sequestration” process has resulted in $95 billion worth of cuts to federal R & D spending from 2013 to 2021. In Europe, the eu’s “fiscal compact,” which requires states to drop their fiscal deficits down to three percent of gdp, is squeezing educational and R & D spending.
What’s more, thanks in part to the conventional wisdom about its dynamism and the state’s sluggishness, the private sector has been able to successfully lobby governments to weaken regulations and cut capital gains taxes. From 1976 to 1981 alone, after heavy lobbying from the National Venture Capital Association, the capital gains tax rate in the United States fell from 40 percent to 20 percent. And in the name of bringing Silicon Valley’s dynamism to the United Kingdom, in 2002, the government of British Prime Minister Tony Blair reduced the time that private equity funds have to be invested to be eligible for tax reductions from ten years to two years. These policies increase inequality, not investment, and by rewarding short-term investments at the expense of long-term ones, they hurt innovation.
Getting governments to think big about innovation is not just about throwing more taxpayer money at more activities. It requires fundamentally reconsidering the traditional role of the state in the economy. Specifically, that means empowering governments to envision a direction for technological change and invest in that direction. It means abandoning the shortsighted way public spending is usually evaluated. It means ending the practice of insulating the private sector from the public sector. And it means figuring out ways for governments and taxpayers to reap some of the rewards of public investment, instead of just the risks. Only once policymakers move past the myths about the state’s role in innovation will they stop being, as John Maynard Keynes put it in another era, “the slaves of some defunct economist.”
THE FAILURE OF MARKET FAILURE
According to the neoclassical economic theory that is taught in most economics departments, the goal of government policy is simply to correct market failures. In this view, once the sources of failure have been addressed—a monopoly reined in, a public good subsidized, or a negative externality taxed—market forces will efficiently allocate resources, enabling the economy to follow a new path to growth. But that view forgets that markets are blind, so to speak. They may neglect societal or environmental concerns. And they often head in suboptimal, path-dependent directions. Energy companies, for example, would rather invest in extracting oil from the deepest confines of the earth than in clean energy.
In addressing societal challenges such as climate change, youth unemployment, obesity, aging, and inequality, states must lead—not by simply fixing market failures but by actively creating markets. They must direct the economy toward new “techno-economic paradigms,” in the words of the technology and innovation scholar Carlota Perez. These directions are not generated spontaneously from market forces; they are largely the result of deliberate state decisions. In the mass-production revolution, for example, the state invested in both the underlying technologies and their diffusion across the economy. On the supply side, the U.S. military-industrial complex, beginning in World War II, invested in improvements in aerospace, electronics, and materials. On the demand side, the U.S. government’s postwar subsidization of suburban living—building roads, backing mortgages, and guaranteeing incomes through the welfare state—enabled workers to own homes, buy cars, and consume other mass-produced goods.
As Michael Shellenberger and his colleagues at the progressive think tank the Breakthrough Institute have documented, despite the mythmaking about how the shale gas boom is being driven by wildcatting entrepreneurs operating independently from the state, the U.S. federal government invested heavily in the technologies that unleashed it. In 1976, the Morgantown Energy Research Center and the Bureau of Mines launched the Eastern Gas Shales Project, which demonstrated how natural gas could be recovered from shale formations. That same year, the federal government opened the Gas Research Institute, which was funded through a tax on natural gas production and spent billions of dollars on research into shale gas. And the Sandia National Laboratories, part of the U.S. Department of Energy, developed the 3-D geologic mapping technology used for fracking operations.
Likewise, as the physician Marcia Angell has shown, many of the most promising new drugs trace their origins to research done by the taxpayer-funded National Institutes of Health, which has an annual budget of some $30 billion. Private pharmaceutical companies, meanwhile, tend to focus more on the D than the R part of R & D, plus slight variations of existing drugs and marketing.
Silicon Valley’s techno-libertarians might be surprised to find out that Uncle Sam funded many of the innovations behind the information technology revolution, too. Consider the iPhone. It is often heralded as the quintessential example of what happens when a hands-off government allows genius entrepreneurs to flourish, and yet the development of the features that make the iPhone a smartphone rather than a stupid phone was publicly funded. The progenitor of the Internet was ARPANET, a program funded by the Defense Advanced Research Projects Agency (DARPA), which is part of the Defense Department, in the 1960s. Gps began as a 1970s U.S. military program called Navstar. The iPhone’s touchscreen technology was created by the company FingerWorks, which was founded by a professor at the publicly funded University of Delaware and one of his doctoral candidates, who received grants from the National Science Foundation and the CIA. Even Siri, the iPhone’s cheery, voice-recognizing personal assistant, can trace its lineage to the U.S. government: it is a spinoff of a darpa artificial-intelligence project. None of this is to suggest that Steve Jobs and his team at Apple were not brilliant in how they put together existing technologies. The problem, however, is that failing to admit the public side of the story puts future government-funded research at risk.
For policymakers, then, the question should not be whether to pick particular directions when it comes to innovation, since some governments are already doing that, and with good results. Rather, the question should be how to do so in a way that is democratically accountable and that solves the most pressing social and technological challenges.
A SMARTER STATE
State spending on innovation tends to be assessed in exactly the wrong way. Under the prevailing economic framework, market failures are identified and particular government investments are proposed. Their value is then appraised through a narrow calculation that involves heavy guesswork: Will the benefits of a particular intervention exceed the costs associated with both the offending market failure and the implementation of the fix? Such a method is far too static to evaluate something as dynamic as innovation. By failing to account for the possibility that the state can create economic landscapes that never existed before, it gives short shrift to governments’ efforts in this area. No wonder economists often characterize the public sector as nothing more than an inefficient version of the private sector.
This incomplete way of measuring public investment leads to accusations that by entering certain sectors, governments are crowding out private investment. That charge is often false, because government investment often has the effect of “crowding in,” meaning that it stimulates private investment and expands the overall pie of national output, which benefits both private and public investors. But more important, public investments should aim not only to kick-start the economy but also, as Keynes wrote, “to do those things which at present are not done at all.” No private companies were trying to put a man on the moon when NASA undertook the Apollo project.
Without the right tools for evaluating investments, governments have a hard time knowing when they are merely operating in existing spaces and when they are making things happen that would not have happened otherwise. The result: investments that are too narrow, constrained by the prevailing techno-economic paradigm. A better way of evaluating a given investment would be to consider whether it taught workers new skills and whether it led to the creation of new technologies, sectors, or markets. When it comes to government spending on pharmaceutical research, for example, it might make sense to move past the private sector’s fixation on drugs and fund more work on diagnostics, surgical treatments, and lifestyle changes.
Governments suffer from another, related problem when it comes to contemplating investments: as a result of the dominant view that they should stick to fixing market failures, they are often ill equipped to do much more than that. To avoid such problems as a regulatory agency getting captured by business, the thinking goes, the state must insulate itself from the private sector. That’s why governments have increasingly outsourced key jobs to the private sector. But that trend often rids them of the knowledge necessary for devising a smart strategy for investing in innovation and makes it harder to attract top talent. It creates a self-fulfilling prophecy: the less big thinking a government does, the less expertise it is able to attract, the worse it performs, and the less big thinking it is allowed to do. Had there been more information technology capacity within the U.S. government, the Obama administration would probably not have had such difficulty rolling out HealthCare.gov, and that failure will likely lead to only more outsourcing.
In order to create and shape technologies, sectors, and markets, the state must be armed with the intelligence necessary to envision and enact bold policies. This does not mean that the state will always succeed; indeed, the uncertainty inherent in the innovation process means that it will often fail. But it needs to learn from failed investments and continuously improve its structures and practices. As the economist Albert Hirschman emphasized, the policymaking process is by its nature messy, so it is important for public institutions to welcome the process of trial and error. Governments should pay as much attention to the business school topics of strategic management and organizational behavior as private companies do. The status quo approach, however, is to focus not on making the government more competent but on downsizing it.
PROFIT AND LOSS
Since governments often undertake courageous spending during the riskiest parts of the innovation process, it is key that they figure out how they can socialize not just the risks of their investments but also the rewards. The U.S. government’s Small Business Innovation Research program, for example, offers high-risk financing to companies at much earlier stages than most private venture capital firms do; it funded Compaq and Intel when they were start-ups. Similarly, the Small Business Investment Company program, an initiative under the auspices of the U.S. Small Business Administration, has provided crucial loans and grants to early stage companies, including Apple in 1978. In fact, the need for such long-term investments has only increased over time as venture capital firms have become more short term in their outlook, emphasizing finding an “exit” for each of their investments (usually through a public offering or a sale to another company) within three years. Real innovation can take decades.
As is the nature of early stage investing in technologies with uncertain prospects, some investments are winners, but many are losers. For every Internet (a success story of U.S. government financing), there are many Concordes (a white elephant funded by the British and French governments). Consider the twin tales of Solyndra and Tesla Motors. In 2009, Solyndra, a solar-power-panel start-up, received a $535 million guaranteed loan from the U.S. Department of Energy; that same year, Tesla, the electric-car manufacturer, got approval for a similar loan, for $465 million. In the years afterward, Tesla was wildly successful, and the firm repaid its loan in 2013. Solyndra, by contrast, filed for bankruptcy in 2011 and, among fiscal conservatives, became a byword for the government’s sorry track record when it comes to picking winners. Of course, if the government is to act like a venture capitalist, it will necessarily encounter many failures. The problem, however, is that governments, unlike venture capital firms, are often saddled with the costs of the failures while earning next to nothing from the successes. Taxpayers footed the bill for Solyndra’s losses yet got hardly any of Tesla’s profits.
Economists may argue that the state already receives a return on its investments by taxing the resulting profits. The truth is more complicated. For one thing, large corporations are masters of tax evasion. Google—whose game-changing search algorithm, it should be noted, was developed with funding from the National Science Foundation—has lowered its U.S. tax bill by funneling some of its profits through Ireland. Apple does the same by taking advantage of a race to the bottom among U.S. states: in 2006, the company, which is based in Cupertino, California, set up an investment subsidiary in Reno, Nevada, to save money.
Fixing the problem is not just a matter of plugging the loopholes. Tax rates in the United States and other Western countries have been falling over the past several decades precisely due to a false narrative about how the private sector serves as the sole wealth creator. Government revenues have also shrunk due to tax incentives aimed at promoting innovation, few of which have been shown to produce any R & D that would not have happened otherwise. What’s more, given how mobile capital is these days, a particular government that has funded a given company might not be able to tax it since it may have moved abroad. And although taxes are effective at paying for the basics, such as education, health care, and research, they don’t begin to cover the cost of making direct investments in companies or specific technologies. If the state is being asked to make such investments—as will increasingly be the case as financial markets become even more focused on the short term—then it will have to recover the inevitable losses that arise from this process.
There are various ways to do so. One is to attach strings to the loans and guarantees that governments hand out to businesses. For example, just as graduates who receive income-contingent student loans get their repayments adjusted based on their salaries, the recipients of state investments could have their repayments adjusted based on their profits.
Another way for states to reap greater returns involves reforming the way they partner with businesses. Public-private partnerships should be symbiotic, rather than parasitic, relationships. In 1925, the U.S. government allowed AT&T to retain its monopoly over the phone system but required the company to reinvest its profits in research, a deal that led to the formation of Bell Labs. Today, however, instead of reinvesting their profits, large companies hoard them or spend them on share buybacks, stock options, and executive pay. Research by the economist William Lazonick has borne this out: “The 449 companies in the S&P 500 index that were publicly listed from 2003 through 2012 . . . used 54% of their earnings—a total of $2.4 trillion—to buy back their own stock.”
An even bolder plan would allow the state to retain equity in the companies it supports, just as private venture capital firms do. Indeed, some countries adopted this model long ago. Israel’s Yozma Group, which manages public venture capital funds, has backed—and retained equity in—early stage companies since 1993. The Finnish Innovation Fund, or Sitra, which is operated under the Finnish parliament, has done the same since 1967, and it was an early investor in Nokia’s transformation from a rubber company into a cell-phone giant. Had the U.S. government had a stake in Tesla, it would have been able to more than cover its losses from Solyndra. The year Tesla received its government loan, the company went public at an opening price of $17 a share; that figure had risen to $93 by the time the loan was repaid. Today, shares in Tesla trade above $200.
The prospect of the state owning a stake in a private corporation may be anathema to many parts of the capitalist world, but given that governments are already investing in the private sector, they may as well earn a return on those investments (something even fiscal conservatives might find attractive). The state need not hold a controlling stake, but it could hold equity in the form of preferred stocks that get priority in receiving dividends. The returns could be used to fund future innovation. Politicians and the media have been too quick to criticize public investments when things go wrong and too slow to reward them when things go right.
THE NEXT REVOLUTION
Past technological revolutions—from railroads to the automobile to the space program to information technology—did not come about as the result of minor tinkering with the economic system. They occurred because states undertook bold missions that focused not on minimizing government failure but on maximizing innovation. Once one accepts this more proactive state purpose, the key questions of economic policy get reframed. Questions about crowding out private investment and unwisely picking winners fall by the wayside as more dynamic questions—about creating the types of public-private interactions that can produce new industrial landscapes—rise to the top.
Today, many countries, from China to Denmark to Germany, have settled on their next mission: green energy. Given the potential benefits and the amount of money at play, it is crucial that governments back this mission the right way. For starters, they must not only pick various technologies or sectors to invest in but also ask what they want from those sectors. For example, if what governments want from the energy sector is a stable energy supply, then shale gas will do, but if the mission is to mitigate climate change, then it won’t. In fact, mission-oriented policies need to foster interactions among multiple fields. NASA’s mission to the moon required the interaction of many different sectors, from rocketry to telecommunications to textiles. Likewise, the green energy revolution will require investment not just in wind energy, solar power, and biofuels but also in new engines, new ways of more efficiently maintaining infrastructure, and new ways of making products last longer. Accordingly, the state should take its cue from the venture capital world and diversify its portfolio, spreading capital across many different technologies and enterprises.
In making green investments, governments should fund those technologies that the private sector has ignored and provide a strong, clear direction for change, letting various entrepreneurs experiment with the specifics. Governments should provide ambitious targets, not in the old command-and-control style but through a combination of carrots and sticks. The German government has followed this approach in its energy-transition initiative, or Energiewende, which is designed to phase out nuclear energy and substitute it with renewables; it is doing this by setting lofty goals for carbon emissions reductions and subsidizing technological development of wind and solar power.
More broadly, governments should strike agreements that allow them to share in the profits from their successful investments. And most of all, they should build the public agencies of the future, turning them into hotbeds of creativity, adaptation, and exploration. That will require abandoning the current obsession with limiting the state’s intervention to fixing problems after they have happened—and smashing the popular myth that the state cannot innovate.