This is the second of a group of articles that concern science, commerce, and society in the case of medicine. The first outlines the relationships between the three components. This one focuses on the process of scientific research itself. Each has a podcast created by AI (notebooksLM, Google). One might want to listen to it first. They are charming and remarkably accurate. In some instances they have shown me things in my own work I had not thought of myself.
CLINICAL RESEARCH AIMS TO IMPROVE HEALTH
Any scientific research is a search for new knowledge. In the case of medicine, that knowledge must somehow aim at improving health. Whose health will it improve? How will it improve health? How much? Three good questions.
It seems obvious new knowledge comes from a search. And reasonably intuitive that new facts, inventions or theories might help improve health. It is reasonable, at first glance, to say that scientific research must proceed in a ‘scientific manner’. But what is that ‘manner’? How does one go about performing science?
THE OBJECTIVE OF A RESEARCH
The thing we are after, the new knowledge that some people need, is called the ‘objective’ of the research (colored yellow). We don’t have it. if we had it, we would not be searching. Since we don’t have it, we don’t know what it is. All we do know is that it stands among the three great domains of knowledge: facts, inventions, theory.
Role of Imagination
This leaves us with imagination.
A scientists can only imagine that there exists in the real world some cluster of facts which, once obtained, would improve health. Likewise for a new invention or new theory. That explains why the word ‘imagined’ appears inside the box for each of the three kinds of new knowledge.
Is this not worth a moment of reflection? Pause and challenge what I said. Can you find a fault in it?
The imagining somehow must arise from a deep knowledge about some disease. Is that not true? And to be more specific, about what facts we have in hand, or what invented thing could mitigate the disease, or where gaps are in prevailing theory. But at the same time the imagining depends upon a deep knowledge of the natural world within which the disease has arisen, for that is where the new most likely dwells.
So one might say the scientific imagination must be as informed as it is vivid, yet, despite its weight of knowledge, lively, energetic, and fearless enough to leap across a chasm of unknowns.
Role of Mastery
This is to say that the imagining mind must have already mastered most or all of what is known about the area of nature, and mastery is not mere knowledge. It is knowledge in use, available for thinking about things, ready to hand within the mind. But at the splice where knowledge gives way to imagination, as in a conversation one extends the meaning of the other, at that place all is mystery. Some, more than others, skillfully deploy what they know to catch the brief winds of imagination. That is surely true, and adequate for our purposes here.
THE AIMS OF A RESEARCH
Specific Aims
To search is to act, and the acts of a scientific research are called it’s ‘specific aims’. ‘Aims’ refer to individual acts, ‘specific’ to the achievement of the research objective. Specific aims involve the use of techniques, guided by established methods. Techniques are skilled acts, like beating egg whites into a soufflé. Methods are recipes, like that for the soufflé. Scientists are indeed much like chefs, their laboratories not so very different from a kitchen, and perhaps their imaginings as well – though this may be too much of a stretch.
Like those chefs who create cuisines not seen before, scientists do not spend most of their time working at their bench. Their assistants do most of it. Instead, they supervise the work, reserving their own time for reflection. Like the achievement of new knowledge, the making of a new cuisine requires a special kind of integrative imagination. That imagination consists in an ability to envision how one might best use such techniques and methods as are at hand, use them in ways that can achieve a novel result, something desired but not as yet a reality.
Role of Imagination In Achieving an Objective
Etymologically, the word ‘hypothesis’ means placing (thesis) under (hypo), a verb – ‘placing under’. But we use it noun like, a “thing” (an idea, proposition, or explanation) that we place under (our investigation or argument). It’s the underlying assumption we start with.
I placed the word between the objective and specific aims. It is in green, what you get by mixing blue and yellow.
Think about it. You have imagined new knowledge you want to get, and you have mastered certain techniques and methods. Now you have to select those specific techniques and methods that can get the new knowledge for you and work out the exact manner of their use.
This process can only be imagined. The knowledge sought is new, meaning that no one has as yet obtained it. One may have excellent reasons to believe a particular approach will succeed, but belief is a vision of what may be, not what surely will transpire. So the linkage of aims to objective, like the objective itself, is imaginary until the work is done and the results become facts.
So to do scientific research is to sequence two different kinds of imagination – about the world, to imagine the objective, and about the means that will achieve the objective. Essentially, it is to concatenate them, to multiply the one by the other.
What the Word ‘Hypothesis’ Means
Because two different kinds of imaginings work together, this word can be confusing. Just what is it one ‘puts under’ the investigation – as its support, its basis, its foundation?
I call for semantic caution here. The actual process is not susceptible of analysis, because we really don’t know how people identify missing knowledge – the objective – and the way to achieve it given a suite of techniques and methods. They are presented here as two different kinds of imagining, which is accurate so far as description goes, but may not be accurate in the way the mind really works. The two may merge.
So I say that as a working use of the word, ‘hypothesis’ probably should include the imagining of the objective and the imagining of the means of its achievement as one construct.
THE LADDER OF OBJECTIVES
Most of the time the real objective, the one that will bring benefits to people, is far off and will only be achieved through a set of intermediary objectives, like steps on a ladder. This ladder of objectives is not here. It is an imagined and plausible series of linked objectives that will progressively achieve beneficial results for patients.
I chose the image of the ladder because in Plato’s Symposium it stood for the gradual assumption from the mundane to the transcendent, and from oneself (one’s own work) to the good of others (achievement of a better health through research).
THE FOUR KINDS OF IMAGINING
Scientists are commonly portrayed among their beakers and pipettes, brewing rare, possibly dangerous, and certainly exotic mixtures with miraculous properties. My portrayal is quite different. Technicians and a scattering of post-doctoral students stand or sit at benches conducting experiments whereas the scientist is a brooding presence, an imaginative mind, an adventurer seeking benefits, in the case of medicine, for those with some illness.
At heart, science is mastery and dreams. The mastery is taken for granted. It is the dreams that are often slighted. For this reason, I have returned to the imaginings and enumerate them, so the four stand as separate and distinct contributions.
Am I repeating myself?
Yes.
It is deliberate and, to me, essential. Not because enumeration will enable someone to dream successfully about science, but because it will – I hope – keep imagination a vivid thing in all our minds as we struggle to achieve the new, and improve the lot, thereby, of those who are sick.
Imagining Objectives
One of them has to do with the objective itself. Out in the world, I imagine a thing of value is waiting. It is a cluster of valuable facts. Alternatively, something can be made that will do things that benefit people, and a vision of that thing is clear enough one could make it. Or I imagine nature does this that way, and if that is the case the knowledge could help patients. It is as if fruitful scientific objectives appear when a masterful erudition is illuminated by a momentary vision, as when a flash of lightning reveals the mouth of a hidden cave.
Imagining How Techniques and Methods Can Achieve An Objective
The other kind of imagining has to do with achievement of the objective. With my methods and my techniques I can imagine a way of proceeding that will obtain, by measurement, such facts in the world at large that are my objective. Alternatively, with these means I can imagine how to make the thing that is my objective. In the final case, I can imagine a way to test my vision of how nature does what I believe it does and prove thereby whether the vision be right or wrong.
Imagining Logical consequences – The Testing of Theory
This final case brings to light yet a third kind of imagination: How nature causes what we can clearly observe – a mountain, a cell behavior, a disease. Because it requires this extra step, theoretical science can be especially difficult. Count them: Imagine how nature does something and imagine a logical consequence if nature does indeed work that way.
In other words, in the plainest possible speech, I believe it is not difficult to distinguish between these three kinds of imaginations and thereby specify their individual roles in scientific research.
To imagine a ladder of objectives so clearly differs from the other three I do not believe it requires additional comment except that it brings to four the number of separable imaginative steps involved in scientific research.
MASTERY, REDUX
Because so important and so often slighted or misunderstood, I have given the four kinds of imagining a prominent place here. But the mundane, if profoundly difficult, mastery of a field cannot be left in the shadows. Though imaginative by nature, what can I imagine about a star, or a mountain, or sub-atomic particle? It is silly to speak of. Mere imaginings outside the precincts of mastery have nothing to do with science. Poetry, perhaps, and even there risky, at the verge of vacuous.
This holds for all four imaginings I have mentioned. For objectives, mastery of what is known and of that portion of human biology in which the relevant diseases arise. For the link between aims and objective, mastery of techniques and methods. And that comes from practice, like the chef who has prepared thousands of meals.
About finding the test for an imagined behavior of nature, the same – mastery of what can be measured. And add to that a mind trained in logic to be sure the thing measured is indeed a logical consequence of the theory one is testing. For the ladder of objectives it is everything combined at once, for how else to gaze outward over an uncharted ocean and predict correctly that unknown but thought of land wherein lies the final goal of the journey.
PEER REVIEW
Within certain limits, science governs itself. Almost as a matter of citizenship, scientists donate their time to reviewing the work of their colleagues, on behalf of society in general through funding agencies and the journals in which new science becomes public knowledge. The process has its weaknesses and drawbacks. Prejudice and politics are endemic, and ineradicable arbitrariness as well. But in broad sense it is a reasonable system, and I would be at a loss to imagine a better one.
Objectives.
Objectives are reviewed when scientists apply for money through granting agencies of which the most famous and most important in the United states is the National Institutes of health. The white arrows on my picture point in both directions – take a look. This is to denote that investigators can reply to a review in the form of revision. It is here the qualities of the objective are assessed, and in general – I believe – those most valued concern potential for improved health.
The ladder of objectives can be critically important at this stage. The immediate objective may itself be some detail with no immediate value to health. It is only the ladder that confers on the immediate objective is ultimate significance and, being imagined, the ladder is justified only with great difficulty.
Although I may be chided for making a personal comment, I noted during the many years that I taught science it was most difficult for young scientists to specify their objective. When asked, they would almost always write about their aims.
The hypothesis and aims.
This is perhaps the most crucial area where proposed research undergoes the greatest scrutiny. For this is the most difficult area. It is where action and desire meet each other, and the fitness of the aims to achieve the objective is judged.
Publication.
When the final work is submitted to a journal, the review is much the same but what was once imagined is now a reality. The consequentiality of the objective, now known, can be judged in a direct manner. It is no longer a question of whether the aims can achieve the objective but whether or not the objective was indeed achieved. To what extent do the data provided establish the truth about the facts, the utility of the invention, the plausibility of the theory?
DECEPTION.
Whatever the motives, from time to time working scientists lie. They make up numbers for their tables or falsify figures and pictures. Peer review is not rarely deceived. People who fabricate often work just as hard to create the false as they might have worked to provide true answers, so the results presented can be convincing unless one looks very carefully.
The practical consequence of deception is obvious. Others will base their work on falsity and in turn be led down false paths. It is a waste of time, a futility. Sometimes, it is evil, when the results affect health care and patients are treated improperly.
In all cases, especially those most flagrant and most public, the tragedy is a loss of faith. Society, always suspicious about ‘experts’ has reason to deny them. Scientists themselves wonder, when work is novel. To lie in the practice of such a craft as science, a craft driven to discover what is true in the world, such a lie violates the very origins of the work itself, negates them, as if truth, as best one can know it, was not among its final purposes.
Although one is supposed to feel anger about scientific deception, I must confess it arouses in me a great sense of sorrow and confusion. Those who practice it have usually achieved some elements of mastery and are imaginative enough to falsify. So much effort and self-discipline wasted. And the reasons why lie far beyond my understanding, as I am not a novelist, or a poet, or philosopher of moral virtue.