An agenda of snobbery

Earlier this month we attended a boating get-together of (mostly) Norwegians who are interested in wooden boats. It’s always an interesting and enjoyable time when I’m together with them. The majority are men in their late 50s, 60s and early 70s. Some attend these get-togethers with their wives and kids/grand-kids, whereas others are there without their families. All of them are very wealthy and fairly conservative. When they first meet me, I’m the one who stands out from the crowd, because they hear that I'm an American the minute I open my mouth. I speak Norwegian fluently, but with a decidedly New York accent. Most of them are nice people and friendly to me, if a bit skeptical because of what they’ve heard or know about America. Most of what they know about the USA is based on what they read in Norwegian newspapers or what they hear on TV. I for my part am open and willing to talk to them; I don’t shy away or retreat from the social doings. My conversations with them are usually about how long I have lived in Norway, what I do for a living, and where I work. I end up talking to some of the wives; this year, one of them, a 73-year old woman who had traveled quite a bit around the world, told me about her very enjoyable cross-country tour of the USA some years ago. She loved it and mentioned that her husband did as well (which was not exactly true as I later discovered—she was speaking for him). It was quite interesting to talk with her, and we ended up having a very nice conversation. Eventually her husband joined us, and she told him how nice it was to have met me and conversed with me. It didn’t take long for me to discover that he had an agenda that he wanted to share with me. He had traveled in the USA by himself, he told me, and he had never met so many stupid people in his life (dumme amerikanere). By stupid, he meant untraveled and uninterested in the rest of the world. Since he was easily 73 or 74 years old, his traveling (for business) had been done when he was in his 40s, which meant back in the 1980s. He seemed quite keen on imparting that information to me--that many Americans were stupid. It always strikes me as quite odd that some few Europeans have that particular agenda that they wish to share with me, as though they think that I will immediately agree with them or try to do something about their complaint. Or perhaps he was hoping that I would get my hackles up (I didn't, I kept my cool). What struck me most was the dissimilarity between him and his wife—he was a snob and his wife was not. He clearly did not like that his wife had enjoyed talking to me (a commoner) and was in a hurry to end the conversation. Whenever I meet Europeans like that, it always reminds me of why I am glad to be an American. I am so used to meeting different people from different countries and cultures, and it would never cross my mind to tell a Norwegian whom I had just met that in my opinion, many of his or her countrymen were stupid. I was raised to be a respectful person, and if there is one thing I am not, it’s a snob. In any case, he behaved rudely because he wanted to end the conversation, and not surprisingly, it ended. When I saw them the next day, they both ignored me. I gathered that he had probably put his wife in her place. 

I no longer take these snubs personally as I did when I first moved here. It is no longer a surprise to me that some Europeans really do not like the USA. When I look at how the media present the USA to them, it is no surprise at all. In the Norwegian tabloid media at least, the USA is a gun-loving, gun-toting, aggressive, imperialistic, capitalistic country, bent on world domination. It sounds almost silly, but that is the picture painted of the USA. The serious media present specific issues (e.g. gun control, health insurance) in an in-depth manner, so at least the nuances are discussed. It is surprising to me how preoccupied Norwegian media are with what goes on in the USA. Our politicians, political situations, debates and conventions are big news here. Sometimes I think Europeans are more concerned about the problems in the USA than they are about the problems in their own countries. Or perhaps they think that their countries are problem-free. Rest-assured that the latter is not the case; Europe has real problems with terrorism/extremist activities that are only going to get worse before they get better, unfortunately. 

I have given up trying to explain to skeptical Europeans that most of the Americans I know are no different than they are—educated, married, raising or have raised families, healthy and unhealthy, hard-working, thinking about retirement, wanting to travel, and so on. It surprises me that well-educated Europeans have not figured this out yet. Apparently they believe everything they read or hear in the media, and their protests notwithstanding, many of them get most of their news from the tabloid media. Or maybe they just don't want to broaden their minds, because if they did, they would no longer be able to see the world in black and white. Perhaps it scares them to think about broadening their perspectives. That surprises me most of all, since it is exactly what they criticize Americans for. 

Exploitation of good scientists and the perpetuation of lies

Yesterday was one of those days that tested my patience big-time and I don’t think I passed the test. The day started out with a seminar (sponsored by Forskerforbundet) dealing with the problem of the lack of permanent positions for research scientists in Norway. Some of the lectures were good, others were not. I left the seminar during the early afternoon feeling a bit provoked by several of the lectures. One of the speakers (who belongs to an elite group of MD scientists that are well-funded with big research groups) was trying to defend his (and the new hospital conglomerate’s) position concerning keeping non-MD scientists working in temporary positions in biomedical research. His line of defense was that the lack of permanent (‘tenured’) positions keeps scientists competitive and on the cutting-edge and that to ‘reward’ them with a permanent stable job would take that edge away and lead to mediocrity. He also said that there was no fate worse than being a poor to mediocre scientist—that this was a fate worse than death in his estimation. I am sure he managed to alienate a good number of scientists sitting in the audience who perhaps have had problems recently producing enough articles to qualify for the status of good scientist. Because that is how this speaker defines a good scientist—as a researcher who produces a good number of articles per year. How lucky for him—he has a huge group while the majority of the scientists sitting in the audience do not. It was easy for him to reveal his arrogance and it was infuriating to listen to because he displayed no understanding whatsoever for the current situation that many non-MD scientists find themselves in these days.

I realize that when I talk about academic biomedical science in Norway, there is no possible way for those outside of the system and the country to understand how unbelievably elitist the system has been for so many years. It is not possible to understand it without knowledge of the history that underlies the elitism. Biomedical research science has mostly been done by MDs for years, and the system is set up so as to prioritize, promote and to reward MDs who want to do research. Years ago this meant that MDs who had hospital jobs could do research on the side; it perhaps would be better to say that they were provided with technicians who did the lab work for them and provided the doctors with data so that they could write articles. If they accumulated enough articles they could submit a thesis with these articles and defend it, obtaining the degree of doctor of medicine (corresponding to a PhD degree in other countries). Doctors could go into the lab and do some of the research work if they wanted, but they did not have to—it was not a requirement for the degree. They could take as long as they wanted to finish the degree and they were often in their forties when they finished. This was the way it was done when I started working at my hospital’s research institute twenty years ago. The PhD system has changed over the years, but doctors are still prioritized when they start PhD programs from the standpoint that they are often offered technical help while non-MD PhD students are not. This has never sat well with me because as far as I am concerned, if both groups start a PhD program and are doing it full-time, as is the case with the new system, I don’t understand why the MD-PhD students should get preferential treatment. But they still do, at least at my hospital. At one point they also got a slightly higher salary than non-MD PhD students, although this is not the case anymore. All of this was and is done to encourage MDs to get interested in research and to take PhD degrees. That looks good for a hospital trying to present itself as a research hospital. The sad thing is that my hospital has never been particularly interested in promoting its non-MD PhD students or scientists. I find it sad because implicit in this philosophy is the idea that MDs have a better grip on biomedical research problems than non-MDs. I simply don’t buy into this philosophy. It has gotten better in the past five or so years, such that non-MDs who are doing biomedical research have better chances at making it in the system than they used to. But there is still a long way to go. It is strange that already during the 1980s in New York City at Sloan-Kettering Cancer Research Institute it was not a problem for non-MDs to lead major biomedical research programs. The same was and is true of the University of California at San Francisco during the early 1990s. There were a number of non-MD staff scientists at both places working on biomedical/cancer research projects and/or leading those programs. MDs and non-MDs also worked together in teams and it worked just fine. That’s how it should be—teamwork—a team of equals. I could continue on down the list of institutions where this worked. In Norway, I just don’t get it. I’ve been told that non-MD researchers cannot teach in medical school—again I don’t understand why they couldn’t teach histology or pathology or cell biology, if they’ve specialized in these fields and taken their PhDs in them. I know non-MD scientists in the USA who taught medical school courses and who were appointed to professorships in clinical specialties without having an MD. But that’s the USA. No matter how many times I’ve been told that the USA is elitist, capitalistic, competitive (ad nauseum) in its approach to most things, I can tell you that I have never experienced as much elitism in biomedical research science as I have in Norway. The discrimination is against non-MD biomedical research scientists.

So that leads me to the current problem with lack of job stability for non-MD biomedical research scientists. It’s a complicated situation. Over the past twenty years, common practice was that non-MD PhD students finished their PhDs and started their post-doctoral positions, often in the same lab or in the same institute because mobility was not encouraged and there were too few corporate/industry jobs available anyway (unless they wanted to work in marketing or sales). They were encouraged to continue on an academic track because the MDs leading the research programs saw an opportunity to utilize their competence to help new PhD students and MDs who wanted to do some research but did not want to commit full-time at the outset. The non-MD post-docs wanted to please their group leaders and they wanted some sort of job because they liked biomedical research, so they stayed put and did what they were told and did not react when they realized they were being misused. The group leaders could extend their post-doc positions (via external funding) so that many of them ended up working three post-doc periods in a row (a total of 9 to 12 years). This is not done in the USA. Some of them were told they could work as scientists (also up to 9 years split over three periods). For many non-MD scientists this could mean up to 21 years in untenured positions. This is what happened to many of the non-MD scientists in my generation. When they reached middle age they were out of a job because external funding for their positions ran out. It was ‘expected’ that the hospitals would employ them permanently full-time. When they appealed to their hospitals for help, they were told that there was not enough money to employ them all in permanent positions (which was the case from the start point but they were not told this). Or they were told that they were ‘good but not good enough’, in other words, mediocre--the ‘fate worse than death’ according to the elitist lecturer—whose suggestion would then be to ‘run along’ and find something else to do and let the ‘best’ scientists run the show.  Along the way some of the non-MD scientists figured this crap out and started new jobs elsewhere, perhaps working as salespeople in industry (there were very few possibilities outside of academic research science to do research if you had a PhD during the 1990s). This led to the current situation in some hospital research institutes—at one institute alone there are almost fifty scientists ‘waiting’ for a job, all of whom have done very good work. It’s not that they cannot leave and find another job elsewhere. But perhaps they don’t want to because they’ve invested twenty years in one field—or they have students for whom they are mentors, or a number of reasons, all of which make sense in one way or another except to hospital leadership who now want to be rid of them. I think the system as it has been in Norway is a brutal one, much more brutal  than in the USA, where you are often finished with your PhD in your mid-twenties and your post-doc period by the time you are thirty years old. By that time, your mentor has essentially given you an indication of whether or not you should continue in academia or not, or maybe you’ve figured it out for yourself. If you don’t want to continue in academia, you have many jobs to move into in the corporate and R&D world. Or you can work in civil service, or in pharmaceutical firms. It is not a problem to find a job outside of academia. That has not been the case in Norway. Norway did not plan on having so many non-MDs take PhD degrees and then want to actually use those degrees afterwards.

So what are non-MD scientists who want to do academic biomedical research facing these days? Budget cuts, very few jobs, defensive hospital leadership who know they have a real problem on their hands, a cutthroat competitive environment that in and of itself competes with a socialist undercurrent telling the scientists that they can make it because everyone is equal (such crap—everyone cannot be the best). But do they hear this from the (MD) group leaders they work for? No, because these leaders don’t want to lose their gravy trains—a pool of slave labor that is afraid to open its mouth because if it does, the individual scientists will be labeled as difficult and not team players and they will lose their ‘chance’ at any permanent position that arises. It is an unfair system and it needs to be ripped wide open and exposed for what it is—exploitation of good scientists and the perpetuation of the major lie—that there is a permanent position for each of them—‘just wait around long enough and it will happen’. But it doesn’t and the longer one waits the harder it gets to find something else—because when you are in your fifties, you are considered old in terms of being hired for a new job. My advice to the younger students—know what you are choosing if you choose to remain in academic biomedical research science—you are choosing a dearth of jobs, an uncertain future, a cutthroat environment, competition with MDs for program leaderships and an essentially anonymous identity and existence to hospital leadership.