Morton Meyers M.D. Interview, plus links to author biography, book summaries, excerpts and reviews

Morton Meyers M.D.

Morton Meyers M.D.

How to pronounce Morton Meyers M.D.: mor-ton my-ers

An interview with Morton Meyers M.D.

A Q&A with Morton A Meyers about his book Happy Accidents: Serendipity in Modern Medical Breakthroughs, followed by some fun facts from the book.

Your view of the process of medical discovery may be considered controversial. How would you summarize it?

In my book Happy Accidents: Serendipity in Modern Medical Breakthroughs, I reveal that many of the major medical discoveries have occurred simply through chance—through a surprising, unexpected finding or observation that led research in a different direction, which resulted in a discovery of far greater value than the original goal.

What are major examples?

I describe about one hundred instances. But most people—scientists included—are astonished to realize that most of our antibiotics to combat infections, chemotherapy drugs against cancer, psychotropic drugs which modify mood disorders, and many advances in cardiovascular treatments and procedures were stumbled upon. So many of these chance discoveries, such as Valium, Lipitor, and Viagra, have become household names.

These fields cover much of modern medicine. Are these advances the results of specialized teams with large federally-supported grants?

The astonishing answer to that is a resounding "No!" Rather, they were typically discovered by individual curiosity-driven researchers with modest resources and funding. They had the sagacity to pursue a surprising finding or an incidental happenstance. For instance, in going down a false trail while testing the toxicity of a product, an unknown scientist working alone stumbled upon the effectiveness of lithium as a treatment for bipolar disorder. In another case, a researcher made what he thought was a frightening mistake only to discover that he had pioneered a revolutionary approach that enabled bypass surgery for heart disease. While conducting animal experiments for a surgical procedure, a young resident chanced upon a new treatment for abdominal aneurysms.

Why is this generally unknown?

Scientific articles are very cut and dry, following a traditional format indicating a rigid, logical sequence. This is very often misleading. Understandably, researchers and clinical investigators are loathe to admit the element of chance for fear of compromising their status, tenure, and ability to generate research funds. Only years later, toward the end of their careers, after awards have been received, might the phenomenon of serendipity be openly acknowledged. I have interviewed a number of Nobel laureates and recipients of other prestigious awards who now feel they can speak with refreshing candor.

Why is it important for us to know the true contribution of serendipity in medical research?

Mainstream medical research stubbornly assumes that new drugs and other advances will follow exclusively from a predetermined research path. Many, in fact, will. Others, if history is any indication, will not. They will come not from a committee or a research team but from individual scientists and mavericks who view a problem with fresh eyes and who may find what they're not looking for.

We must reconsider our allocation of research funds, now directed almost exclusively to centrally directed programs. We must take a chance on chance. We as a society need to take steps to foster the kind of creative, curiosity-driven research that cultivates an openness to serendipity and has the potential to accelerate medical discovery as never before.

What specific steps can you recommend?

Education at all levels should encourage creative thinking and prepare minds to be open to the unexpected. We must recognize and support the unconventional researcher and allow scientists to pursue surprising findings. Big Pharma should return from being primarily marketing machines to its roots as an engine for truly innovative research.

A Few Fun Facts

Pathologist Looking at Slides Happens to Notice Undetected Cancer

In 1928, the Greek-American pathologist George Papanicolaou was investigating the reproductive cycle by using vaginal smears, when he happened to observe the presence of cancer cells in people who were not known to be sick. This accidental discovery of a way to detect a cancer so early in its development was groundbreaking. Thanks to the now-famous Pap smear test that was routinely adopted in the 1940s, cervical cancer, once the leading cancer killer among women, is now a distant seventh.

Castration of Dogs Leads to Discovery of Hormone Therapy

Charles Huggins, a professor of surgery at the University of Chicago School of Medicine, was collecting fluid from the prostates of dogs in whom malignant prostate tumors had spontaneously arisen. His interest was in the biochemistry of seminal fluid. After castrating some of the dogs to see what effect testosterone injections might have on their production of prostate fluid, he noticed something totally unexpected: Castration caused their tumors to regress. Realizing that castration would, of course, not be a desirable option for treating humans, he injected estrogen into some of the dogs, producing, in effect, chemical castration, which also caused the tumors to regress. His work led to a synthetic estrogen drug shown to work against cancer, and Huggins, who had not been originally working on cancer, was awarded the Nobel Prize in 1966 for an invaluable finding that saved many lives.

Routine Lab Animal Experiment Leads to Discovery of Stem Cells

In the 1960s, Canadians Ernest McCollough and James Till were researching the use of radiation and subsequent bone marrow transplants as a treatment for cancers of the blood. During one of their experiments, they discovered several clumps of cells on the spleens of their animal subjects. These nodules turned out to be colonies of cells all derived from a single blood-forming cell. McCollough and Till had serendipitously stumbled upon the first stem cell, a discovery that set the stage for current research on adult and embryonic stem cells and all of their great potential for curing diseases. Investigations on the likelihood that stem cells may underlie some cancers are currently underway. In 2005, the two men were given the Albert Lasker Award for Basic Medical Research (often a precursor to the Nobel Prize)

Dirty Plates and Good Weather Bring the World Penicillin

Returning from a long summer vacation in 1922, Alexander Fleming, a bacteriologist at St. Mary's Hospital in London, was cleaning up piles of old bacterial growth plates, when he made an extraordinary observation in one. A mold had settled on the surface and killed all the surrounding lethal bacteria. The event had unfolded in this way thanks to an awesome sequence of lucky circumstances, including the timing of the seeding of the original bacteria, the likely moment of the accidental mold deposit, the type of mold, and fortuitous weather changes during the interval. Miraculously, Fleming had discovered penicillin, the first antibiotic.

Catheter Mishap Allows Doctors to See Circulation in Heart for First Time

In 1958 a terrifying event occurred in the life of Mason Sones, a cardiologist at the Cleveland Clinic. Readying his patient for a heart X-ray, he had introduced a catheter into the heart chamber and was injecting the dye that would allow the heart to be visible on the X-ray. To his horror, he watched as the tip of the catheter flipped around, allowing a large amount of the dye to flow directly into a coronary artery, which doctors had never dared enter for fear of causing immediate cardiac arrest. Assuming the worst, Sones prepared to open his patient's chest to massage the heart but instead found, to his great relief, that the man was fine. Sones is credited with discovering an invaluable technique for obtaining clear and detailed pictures of the heart's circulation system, opening the way to coronary bypass and angioplasty operations.

An Overzealous Radiologist Jams In a Catheter and Unblocks an Artery

In 1963, Charles Dotter, a radiologist at the University of Oregon in Portland, was inserting a catheter through the skin into a major artery in the pelvis of a patient for the purpose of taking X-rays of an arterial obstruction. Being a little aggressive, he jammed the catheter in farther than was standard practice and cleared up the obstruction. When it was made public that arterial obstructions could be not only diagnosed but also treated directly by radiologists, vascular surgeons in the United States, whose livelihoods were threatened by the discovery, openly ridiculed Dotter. But European radiologists enthusiastically embraced the technique and began referring to the new approach as "dottering." The amazing discovery eventually led to the life-saving technique known as angioplasty.

Effort to Increase Blood Flow to Heart Brings About Interesting Side Effect

In England in the early 1990s, men were undergoing a clinical trial for a new medication for angina. Unfortunately, the medication did not quite do what it was intended to do, which was to increase blood flow to the heart. However, it did increase blood flow to another organ: the penis. Miraculously, the drug restored erectile function to men who were experiencing dysfunction, and Viagra was born.

A Psychiatrist Investigating the Wrong Cure Stumbles Upon the Right One

In 1948, John Cade, a psychiatrist in a mental institution in Australia, hypothesized, incorrectly, that the manic depressive state might be due to either an excess or lack of some metabolite. His crude experiments indicated the culprit was most likely uric acid, so Cade began experiments with uric acid's most soluble salt, lithium urate. As he administered the salt to manics, he watched, thunderstruck, as their raging moods subsided. In time, the truth emerged, that it was the lithium that was responsible for the positive effect, not the uric acid. Lithium became, and remains, the first-line treatment for manic-depressive illness, now more commonly known as bipolar affective disorder.

Tuberculosis Treatment Leads to First Anti-Depressants

In the early 1950s, a new drug, a nicotine derivative, called iproniazid had been shown to be effective in treating tuberculosis, and studies to further validate its usefulness were being conducted in Europe. What emerged was the fact that it had one rather "troublesome" side effect, at least from the doctors' point of view. The patients taking it felt too good. The result was that they overexerted themselves and generally ignored the medical safeguards their condition required. Nathan Kline, an American psychiatrist, upon learning about the odd effect, saw the potential, and conducted a clinical trial that quickly established iproniazid as the very first anti-depressant.

Unless otherwise stated, this interview was conducted at the time the book was first published, and is reproduced with permission of the publisher. This interview may not be reproduced or reprinted without permission in writing from the copyright holder.

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