Barry Blackwell: Adumbration: A History Lesson

Dr. Blackwell describes an interesting step of scientific discovery that he baptizes Adumbration. As a 37-year-old young professor and investigator, I can imagine the excitement of a ten years younger resident, as Blackwell was in his story, experiencing an important scientific discovery.. That time, in the middle of the 20^th century, clinical psychopharmacology was a landscape with many things to be discovered. Nowadays, other areas like genetics and neuronal regeneration seem to be the unexplored new world of psychiatry. However, those scientific fields demand high technology to be explored and such technology is naturally suited to well established research centers with their well-endowed professoriate. This reinforces the process described by Robert K. Merton, the main reference cited by Dr. Blackwell in his essay. Merton analyzes the behavior of scientists, recognizing the role of competition as a central driving force for scientific production. These motivations cause conflictual priorities, as Blackwell asserts. As an example, Merton describes the of the trend in modern science is to award well-recognized research leaders while overlooking junior contributors. Who is awarded with the Nobel Prize when a worldwide consortium makes an important discovery? It seems analagous  to Steve Jobs being glamorized by the creation of his innovative gadgets. Perhaps in science, this is also the era of CEOs more than master craftsmen. Not a problem if you are aware of it, but beginners in science never are.

Although important findings in clinical psychiatry might still be possible for the beginner - the one who looks at everything with the privilege of unacquainted eyes - insights that could lead to Adumbration are usually followed by frustrations over priorities of society. These experiences make me remember one of the professors I had during psychiatry residency, who used to say, “Every genius idea that you think you had, someone already had before”. With the availability of PubMed I can now easily attest to his observation…

…but my professor forgot to say that not all these previous ideas had the same intention. If the bad news is that there are not so many entirely new ideas to be thought, the good news is that there are infinite ideas that can be used in different ways. Moreover, as a translational researcher, I could certainly agree with this perspective. In Blackwell`s description of his discovery process, there is a moment he goes to the laboratory. There, he starts to live with researchers from different fields, where he (and every translational scientist will) identifies the infinity of inspiring ideas that “someone already had before”, but for another purpose. More than seeing translational research as the act of bringing insights from clinical research and practice to the laboratory and vice-versa, it can be broadly seen as the act of bringing knowledge from one field to the other. Adumbration may be identified as in the past, as Dr. Blackwell highlights, but it may also viewed as the transition of knowledge between two fields of enquiry.

Pharmaceutical companies have made impressive advances, while pushing psychiatric treatment forward, although not always based on patients` needs; but the pharmaceutical industry has to keep looking in the rear-view mirror while driving, as Dr. Blackwell recommends. Besides, taking into consideration the debate raised in this comment, my additional recommendation is that pharmaceutical companies be more cautious with, and even more interested in, the crossroads of science.

André Barciela Veras

October 1, 2015