by Robert Gelfand
American Reporter Correspondent
San Pedro, Calif
June 13, 2005
SCIENCE WRITING IS A FINE SCIENCE
SAN DIEGO -- The annual meeting of the Endocrine Society over the June 4 weekend was a chance for yours truly, the amateur media critic, to consider the difficulties of presenting science to the lay audience. It was also a chance to see how well it works in practice.
For that vast majority of humanity who have never heard of the Endocrine Society, suffice it to say that it is an organization devoted to communicating the latest in basic science and clinical practice to the scientific and medical communities. It publishes learned journals and holds an annual meeting. The meeting is split about equally between basic science and medical practice.
Just to give an idea of how big this meeting is, the "Program and Abstracts" book provided to participants holds 723 pages of abstracts about subjects ranging from islet biology (those cells that you need to make insulin) to obesity to intracellular signaling (a huge topic, central to modern research and little known to the public), and that is just a brief sampling of one morning's presentations. To the scientifically-untrained reporter, it must come across as a bewildering flood of technical jargon. To the scientist or the scientifically literate visitor, it is like being a hungry kid in a giant candy store. There were several thousand of those hungry kids at the meeting, about equally split between basic science and medical practice.
Before considering what the society presented to the press, let's take note of just a couple of items among all the plenary talks and "new technology" lectures.
Gerald Shulman from the Yale medical school gave a lecture titled "Unraveling the Cellular Mechanisms of Insulin Resistance: Potential Role of Mitochondrial Disfunction." This must sound terribly technical to the nonscientist, but it is critical to millions and millions of Americans (not to mention Europeans, Asians and pretty much the rest of humanity) who will become pre-diabetic as they age. Many of us will eventually become diabetic (or already have), and how we will deal with it both medically and behaviorally depends a lot on what works.
Here's the crux: It's a lot harder to figure out the best treatment if you don't know quite what it is that causes the illness. In the case of adult-onset diabetes, the condition is generally preceded by something that the medical community refers to as "insulin resistance." To put it simply, in some people the body makes plenty of insulin, but it doesn"t work as well as it used to. For some reason, muscle tissue that needs to soak up sugar from the blood in order to function becomes less efficient at doing so. The body has to pump out more and more insulin in order to keep the system working right. Eventually the insulin-producing machinery gets tired, and the level of sugar in the blood starts to go up. When it gets high enough and stays high, we call that condition diabetes.
The problem for researchers and medical practitioners alike has been ignorance about the mechanism that creates insulin resistance. It is well known that obesity leads to insulin resistance, and that weight loss results in improvement, but the details of why this happens have been slow in coming.
Shulman's talk presented experiments which start to explain the actual molecular events that cause insulin resistance. His results are not only consistent with observations about the role of body fat in the onset of diabetes, they tend to explain them. At the risk of gross oversimplification, let me summarize this way: Shulman argues that molecules of fat that build up in the muscle cells cause them to lose the ability to import sugar from the circulation. If Shulman's work is right, researchers and clinicians will have a better understanding of what they are up against, and perhaps will develop better ways to treat it.
A talk by Joseph Nevins of the Duke University Medical Center explored a new technology that will prove to be extraordinarily useful in tracking down the causes and effective treatments of serious cancers. Just to satisfy your curiosity, the title of the lecture was "Gene Expression Phenotypes of Oncogenic Pathways and Cancer." Without going into a detailed explanation of what the various terms mean ("phenotype," for example, just means the kinds of cells that a gene-mutation creates), the talk explained how clinical researchers are starting to use the results of the human genome project to sort out the different subtypes of particular cancers. It would not have been practical before the arrival of this new capability.
Nevins" talk was about a technological system known as the DNA microarray, a mouthful of jargon to be sure. It refers to a technique that allows researchers and cancer doctors to look more closely at genetic changes that may have occurred in their patients" cells. It is beginning to allow doctors to figure out which patients will respond best to standard therapies and which ones will require different or more aggressive treatments. (It is better to know these things early on, before the disease gets out of control and the likelihood of remission gets worse.)
There were many more presentations to be sure, but aside from pasting in the 723 pages of abstracts right here, this little snippet is about all I can communicate here.
And that is the problem, or the dark little secret if you will, for trying to write about science to the nonscientist. There is no way that I can manage to communicate the true depth of any of these stories, because to appreciate them or even to fully understand them requires not only a scientific education but familiarity with the subject matter.
It's therefore necessary to summarize, to simplify, to analogize. I used explanations such as "molecules of fat that build up in the muscle cells cause them to lose the ability to import sugar from the circulation." It would have been more precise to explain that "the Glut4 glucose transporter system is inhibited by fatty acid concentrations, rather than the toxic effects being mediated through effects on the Krebs cycle or other known pathways." It seems unlikely that more than one in a thousand readers would understand a line like that, just as I would not understand military jargon or much of what the tax accountant tells me.
In scientific writing for the layman, it is always necessary to write down to the reader. It is always necessary to find some way of putting things in plain English. Even for the writer who understands the subject, it is not always easy.
An aside: It is pretty clear that many working journalists don't begin to understand the science that they are trying to write about. This is what drives me crazy about newspaper science writing. An article about the latest breakthrough in cancer research will refer cryptically (and sometimes incorrectly) to "molecules that control cell growth" or the like, and I want to know which particular molecules they are. Is it the p53 gene? Is it src? They don't tell you. In newspaper articles that deal with biochemical topics, it would be a courtesy for the writers to mention at least the names of the molecules in question. Imagine if all the journalists writing about global warming never used the term "carbon dioxide," but referred instead to "an invisible gas that humans and other life forms breath out." The attempt to keep things at the sixth-grade level can make an otherwise interesting story into meaningless mush.
So point number-one is this: There are fascinating new scientific discoveries that are very hard to explain without condescending. The writer always writes down to some extent. This should not be surprising considering that the education that goes into understanding such results depends on studying chemistry, biology, biochemistry, and then the more advanced material. Even to use the word "sugar," as I did above, is to oversimplify; the subject of carbohydrate chemistry is a central part of biochemical education and typically takes several hours to teach as well as dozens of hours to learn.
I suspect that for the average journalist who is asked to cover the Endocrine Society or the AAAS meeting (American Association for the Advancement of Science), it is difficult or impossible to know which of the presentations is truly newsworthy, because most working journalists are not also active research scientists. The journalist is at the mercy of the society's public relations apparatus.
It is a two-way problem. The press officers of the scientific society have lots of experience in dealing with reporters who are on deadline, and it is not always a productive experience.
Whatever the reason, the press conferences at the Endocrine Society were fun, but they were not up to the lofty scientific reaches of the best science that was presented. "Effects of a Chinese Herbal Preparation on Vascular Cells in Culture: Mechanisms of Cardiovascular Protection" was on the schedule but for some reason was not presented. I was curious because the title is reminiscent of high school science fair projects I have judged. There were press conferences about whether or not we should inject Growth Hormone into the elderly, on the cholesterol-raising effect of coffee, and on the ability of soy to help post-menopausal women. These are all of some interest, but they aren't as deeply important as many other presentations that were given such as the two I mention above.
There was a press conference which featured talks on endocrine disrupting chemicals. This was probably the best session because it dealt with a clear danger to public health. Even so, there were better presentations in the regular sessions that were given to the scientific audience.
I was curious as to how knowledgeable the press would be. It was mixed to be sure. Reporters from a major newspaper and a wire service asked reasonable reporter-type questions. "If polycistic ovary syndrome is so prevalent, how come I've never heard of it?" This allowed the presenter to explain that there is a new society dedicated to the problem. One young man asked totally flakey questions full of obsolete terms and chaotically-placed jargon. The scientists being questioned rephrased his questions into something that made sense, then answered their own formulations. In a way, it was reminiscent of political debate.
Probably the best thing the Endocrine Society provided the working press was a list and summary of some of the scientific sessions that went on during the meeting. It included a release on a session about sexual differentiation of the brain and its relation to sexual preference and behavior. It highlighted talks on embryonic stem cell research and the ethics of using them. In every case, the actual scientific talks were well above the press conference presentations, and the reporters who figured this out were well rewarded for their efforts.