Telling Lies to Children: The NIH Chaos Edition

Way, way back I was introduced to the communication concept of Lying to Children in the context of the friction between scientists and science journalism. My take on that was related to the recreational use of drugs and messaging about the likely harms of such drugs, where my default stance is on the side of the facts as best we know them.

The idea of Lying to Children actually has its own wikipedia page:

A lie-to-children is a simplified, and often technically incorrect, explanation of technical or complex subjects employed as a teaching method. It is usually not done with an intent to deceive, but instead seek to ‘meet the child/pupil/student where they are’, in order to facilitate initial comprehension, which they build upon over time as the learner’s intellectual capacity expands.

Another way to look at this is to view it in terms of outcome goals. So, in the case of drug misuse disorders, drug dependence, etc there is a public health goal of trying to reduce the demonstrated harms to self, family, community. Does it matter if we subvert the most accurate depiction of the known knowns in service of convincing people not to start using, to use less, to seek help with cessation, etc?

I’ve previously touched on the frightening possibility that perception is everything in changing drug use epidemiology. I say “frightening” because it suggests that the real risks, the subject of my professional life, are somewhat tangential. I touch on our most fundamental lies-to-children in that post as well. Namely that “Drugs are bad”, meaning that if you try recreational drugs, even just a little you are going to be hooked into a spiral of drug dependency and despair. The Nancy Reagan “Just Say No” version of the “truth” about drug use.

I still do not have great answers to that. No matter how much time and effort I spend on trying to determine things related to “the real risks”.

The assault on NIH funded science that is now in a second year has a certain resonance with the Lies-to-Children friction between strict accuracy and outcome goals. Or perhaps it is between the complexity of reality and the outcome goals. I have observed more than once to people that the traditional petty complaints of scientists about one or other aspect of the NIH system have come back to bite us on the ass. Strict accuracy and/or complexity has a way of serving many masters, some of whom are frankly malign.

The IDC / overhead issue had, shall we say, a certain resonance with working academic scientists. People who should know better have contributed a lot of support to the notion that overhead inevitably means “waste”. We seem to have at least temporarily dodged a nasty bullet pointed at these very real costs of doing science, thanks mostly to academic institutions convincing key Republican Congress Critters it would be bad for their districts.

Complaints about supposed power cartels on study sections that hold back true innovators is being deployed at every turn by the representatives of the regime, including the current NIH Director. These sentiments are fueling the appointment of high level IC staff without the input of extramural scientists under the rationale that anyone with credibility in the present system is automatically suspect as a hide bound, anti-innovation, suppressor of new truths. A champion of group think. These sentiments are behind the decimation of NIH ICs’ Advisory Councils and intramural Boards of Scientific Counselors. These sentiments are, presumably, behind recent warnings that serving as an ad hoc reviewer on a study section is a problem for future appointment to a panel for a term of service.

Gripes about supposed ZIP code bias in grant award are traditional, and it is absolutely the case that some areas of the country receive a lot more NIH funding than do others. This reality is fueling both demands for geographical affirmative action from Congress Critters [see ~1:05 of this testimony of NIH Director Bhattacharya before Congress*] and proposals for block grants awarded to States.

The impact of other lies to children about the way NIH has worked are less clear. It is traditional, and has a lot of resonance politically, to wring hands about the future of science. To highlight decreased support for graduate students and postdocs. To insist we are about to lose all new Assistant Professors and therefore we need to double down on ESI support. Will this have positive or negative impact for our goals? Bhattacharya has himself mentioned the plight of younger scientists. It is, of course, unclear which early career scientists he will plan to support- perhaps this is all part and parcel of the agenda to support maverick scientists. AKA, COVID deniers, anti-vaxxers and those keen to “prove” political ideas favored by the current regime such as the causes of autism, the new food pyramid, healthy living instead of medicine, etc.

Diversity, Equity, Inclusion are other thorny issues. After all, this is the reddest of red meats for the present regime in their attacks on the NIH; this was Day One business. As you know, Dear Reader, I’ve been comparatively muted on these issues and in particular the Ginther Gap over this past year. Part of this was that there is no sense in trying to make headway on this issue right now, given the stance of the regime. Part of this was that the backlash against tepid, halting, foot-dragging NIH fixes was already happening prior to the election of the current regime. Some of it was that even I have limits to banging my head against a brick wall.

Most of this is that the various lies we tell to children on this issue, including about the NIH’s responses to the Ginther and Hoppe publications, have come around to harm the goal. In some cases, however, I fear that communicating the complicated story isn’t much better. There does not seem to be any level of truth that will not ultimately serve the wrong agenda when it comes to the racial bias in NIH grant funding. Any forthright effort to redress the bias, whereby Black PI’s applications were at a significant disadvantage, was made into grist for the assertion that any Black PI that was funded lacked merit.

This gained support from, you guessed it, voices inside the house. All of NIH’s excuse making was victim blaming. The cherry picking of results to show their glass was half full. The pipeline strategies which said the subjects of the reported bias were the real problem, meritless, and new Black PIs were needed in the um…far off future. The NIH’s protracted refusal to be forthright about how systemic features of review lead to circular, grinding conservatism floated the regime’s agenda. Their refusal to back down from their ridiculous assertions that peer review outcomes reflect Platonic merit with high fidelity (laughably down to the 5-percentile level of resolution) likewise fueled the attack.

In such an environment, is there any point to doubling down on sober factual analysis? Of pointing out that when 20% of a funding disparity is “explained” this leaves 80% of it unexplained? Of showing how many grants with white PIs were funded at percentiles far below that of any funded Black PI application? Is there any point in showing how NIH efforts on DEI fall far, far short of redressing the bias that was reported and replicated?

Is there any point in getting down to brass tacks about outcomes, regardless of any fine talk from Collins or Lauer and regardless of character testimonials from their biggest fans?

The policy currency, in Congress and without, appears to be the simple anecdote. Research trials on cancer patients in which cessation of NIH funding can be trivially tied to at least one patient dying. This is not the time for complicated discussion of whether a causal arrow can be clearly drawn from halted grant funding to one patient outcome, or how long it will take for experimental cancer trials to move toward medical success in a broad population.

The simple version of reality seems to be the strategy. The Lies-to-Children version.

As is the throwing of sure-lose agendas under the bus. For now. Because we pinky swear we will get back to that juuuuust as soon as we turn the corner on the current regime’s chaos. On the real problems. Because we need to move forward. On what is really important.

For some.

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*Note that the exchange with the Indiana Senator finishes with the assertion that a lack of geographic diversity of NIH grant funding leads to “group think” by Bhattacharya [see 1:07 of the hearing]. Which, of course, the regime finds to be the only aspect of homogeneity of funding that leads to such invariant thinking. Despite the fact that a large number of the scientists currently employed in lesser-funded geographic regions received the bulk of their scientific training in the “group think” geographic regions [hat tip].