Judah Folkman and the Filtration System of Science

Judah Folkman, the cancer researcher, is probably the most – one of the two or three most inspiring human beings I’ve ever met.  I only spent two or three hours with him once but it was a moment I’ll – you know, two or three hours that I’ll remember for the rest of my life.

So he was the most extraordinary man.  He went to Harvard Medical School at 20.  They had to actually change the rules of Harvard Medical School ’cause you weren’t allowed to be that young when you went.  Between his second and third years he took a year off to do research, which was normal.  Harvard – a lot of Harvard med students will spend a year – take a year off to do research.  Of course, in his year off he invented the implantable pacemaker.

So that might not be so normal.  Then he graduated and he ended up as Chief of Surgery at Boston Children’s Hospital at 34, which again remarkable achievement.  Amazingly, and he had many other sort of equally sort of remarkable achievements over the course of his career, but amazingly he’s not known for any of them.  That’s not what he’s most famous for.  What he’s most famous for is his brilliant work on cancer where he had this idea that tumors became dangerous if they emitted a chemical that caused capillaries to grow in to the tumor and feed it.

And only if this capillaries grew in to the tumor and fed it could the tumor grow and become dangerous.  And if they didn’t, it would never be a threat at all.  You’d never even know that you had such a tumor.  And so when Folkman had this idea the problem was that cancer research community had sort of decided that blood vessels were just tubes, just dumb tubes and nothing interesting was happening in them.

And so he had this idea but he couldn’t identify the chemical that caused the capillaries to grow.  He just had this hypothesis and no one listened to him.  And he spent 24 years trying to prove his idea.  That’s how long it took.  It got to the point where he could not get grants approved, so he could not fund his research because the government would not give him money to do it.  Where he spoke at a cancer research conference and people walked out in protest at the conference because he was wasting their time with such a crackpot hair-brained idea.

But Folkman persevered until finally Boston Children’s, where he was Chief of Surgery, launched – had an outsider investigation look at his lab and look at his work and these outside investigators decided that the work was of no value and Children’s came to him and said, look, you’re embarrassing us, you need to either stop doing the research or resign as Chief of Surgery.  We can’t go on like this.  And Folkman, remember Chief of Surgery since the time he was 34, Folkman resigned.

And a couple years later, it was finally proven that he was correct.  When he died in 2008, 1.2 million people were being treated base – with drugs based on his ideas.  I think a legacy that most of us could only imagine.  But the thing to remember about Folkman is – so how is this relevant to the theory, right?  It’s that the book is that what is filtration is not just about companies or countries.  It’s about the way we think about what good ideas are and bad ideas are because when you’re evaluating leaders, you’re evaluating their ideas.  And scientists were evaluating Judah Folkman they were saying, well he’s a brilliant surgeon and he’s brilliant inventor but these are bad ideas.

And the filtration system of science, this idea that you submit grant proposals and other scientists review them and say, well, this is a good experiment, this is a bad experiment.  We’ll fund this one but not that one.  The filtration system said this is a bad idea and pushed him out.  And so he had to do all sorts of other things that allowed him to bypass the filtered; for example, Folkman convinced the company Monsanto to fund his medical research, and that sounds perfectly normal.  Companies – you know, biotech companies fund universities for medical research all the time.

Well the thing is, Folkman was the first person to ever do that.  He invented that entire practice of medical companies funding research at universities just because he couldn’t get research convention – funded conventionally because everybody thought he was crazy.  And so this idea, again, that this sense of how we evaluate ideas, right, that Folkman was an unfiltered scientist, even though he didn’t lead a large or powerful organization, he was part of a community of sciences that evaluates ideas.  And this was how he moved through it.  So the last legacy of the theories exemplified by this most extraordinary man is this idea that when we were thinking – making our decisions we are consciously or unconsciously trading off variance and mean, by which I mean risk and reward, in ways that we don’t always understand that we are doing.

The risk, right, is that we – if you’re doing science research, the risk that you give money to a bad idea, a bad experiment and it fails.  And the reward is you give money to an experiment and it succeeds, right.  So what they were saying is these experiments were – it was really improbable that they would tell us anything worth knowing.  So it’s not worth giving them money.  So instead we’ll fund conventional experiments where it’s really, really likely that they will tell us something that we’ll know.

Of course, the problem there is that conventional experiment – the experiments that are really, really likely to succeed are ones that might tell us a little bit new but they won’t tell us that the really important thing, which is that everything we thought we knew was wrong.  But of course most experiments that will tell you everything you thought you know is wrong are a waste of time.  How do you know the ones that aren’t a waste from the ones that are?  That’s a problem.

So it seems likely, in fact, that the people who were making these decisions, who decided not to fund Folkman’s work never even understood the fact that they were trading, right.  They were trading certainty for – of success and by doing so sacrificing the possibility of great success.  So I think in our lives as we make decisions, we do this all the time.  We think that by evaluating more thoroughly and by being much – putting things through five filters instead of three we’re just improving our outcomes.  And what we are doing is improving our average outcomes.  All those things matter but we’re not improving our extreme outcomes.

And sometimes what you want is the extreme outcome.  And so more and more I think the last and greatest legacy of this is think about where you are.  Think about what you need.  Do you need to do well or do you need to do extraordinarily because the process that gets you one is very different from the one that gets you the other.  And you need to decide which one you – where you want to be.

In Their Own Words is recorded in Big Think’s studio.

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