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AT THE MILLENNIUM Three Deans Call for Collaboration to Spur Discovery, Gain Better HealthPut the deans of the Medical, Dental, and Public Health Schools under a big tent on the Quad. Provide an audience of medical alumni from '31 to '95. Throw in Boston's highly unsettled June weather. And hear the three deans call for their disciplines to mix and meld under a bigger tent of science and public service for the new millennium.
Three Harvard deans under canvas on Longwood Quad for Alumni Week 2000: (l to r) R. Bruce Donoff of the School of Dental Medicine, Joseph B. Martin of the Medical School, and Barry R. Bloom of the School of Public Health. Photo by Steve Gilbert Such a metaphorical gathering place is needed, they said, to make the unexpected connections between basic science, clinical application, and clear-eyed public policy that will extend biology's promise and tackle the grim realities of global health. And Harvard, the deans assured the alumni, will do its part to bring together today's fractured disciplines. Dentists must become true scientists and "physicians of the mouth" to stay relevant in this new research-driven world of biomedicine, said R. Bruce Donoff, dean of the Harvard School of Dental Medicine. "Dental research is no longer caries and periodontal disease, but genetics, molecular biology, and tissue engineering." Laser drills, a "biologic" replacement tooth, computer-performed orthodontics, and an anticaries vaccine—all promise to change dentistry. Yet Donoff wondered, "Will all these very exciting discoveries lead to a dentist who can think like a scientist or at least appreciate the value of discovery to everyday practice?" The public health perspective is almost like "a second set of glasses," said Barry Bloom, dean of the Harvard School of Public Health, and this particular vision is vital to the new mix of basic research and clinical medicine. At HSPH, a new set of lenses means a new set of numbers. Ask any Harvard medical student for the leading causes of death, Bloom said, and you will learn that of the 2 million Americans who die each year, 33 percent die of heart failure, 24 percent of cancer, 7 percent of stroke, and 14 percent of injuries. "If you asked the same question of one of my charges, you would hear a different answer," Bloom said. His students would say that the "real" causes of death are 19 percent from tobacco, 15 percent from poor diet and inactivity, 5 percent from alcohol, 1.8 percent from firearms, and 1 percent from motor vehicles. "When you look at it my way, 49 percent of all deaths each year in the U.S. are preventable." Advances in bioscience have never been so sweeping yet the scientific cultures that produce them have never been so isolated, said Joseph Martin, dean of Harvard Medical School. Martin said that even around the Quad, those in fundamental science have little to do with those in biomedical research. Both groups have too little contact with researchers at HMS-affiliated hospitals, who also teach and practice. In the post-genomic world of this new century, Martin said, HMS must work to break down this "Quad vs. hospitals" division so that cross-pollination of ideas and techniques can occur. "What I see as a dark cloud on our horizon, however," Martin warned, "is the extent to which the translation of discoveries into clinical settings has been marred by recent reports of failure to monitor properly our institutional review boards." These problems have emerged where conflicts-of-interest were not fully disclosed, said Martin, or where clinical therapies were pushed forward "at a pace that was perhaps inappropriate considering the science that underlies it." HMS, he said, has chosen to take the high road and maintain its "rather strict code" of ethics for researchers and faculty. —John Fleischman |
