The Missing Moment

How the Unconscious Shapes Modern Science

Houghton Mifflin, 1999

Posted December 10, 1999 · Issue 68

While this scene is played for laughs in the movie, in his new book The Missing Moment: How the Unconscious Shapes Modern Science, Robert Pollack makes a similar, more serious point in regard to the motives of researchers and how they influence the agenda of modern biomedical science. In his previous book on the past, present, and future of genetics and medicine, Signs of Life: The Language and Meanings of DNA, Pollack displayed a lucid writing style and a gift for metaphor, both of which are on display in his new book, in the service of a potentially more controversial, but equally compelling argument. His central point is that the behavior of scientists, like that of everyone else, is in part determined by unconscious memories, desires, and fears, and that these unconscious fears - especially the fear of death - deflect the goals of today's research establishment away from the most pressing human needs.

The first three chapters of The Missing Moment comprise a brief neurological and psychological analysis of how we perceive the world. Informing each of Pollack's discussions - on the senses of smell and sight, on the electrical underpinnings of consciousness, and on the fact that the past is always, quite literally, with us - is one powerful and undeniable fact: the manner in which each of us perceives the self and the outside world is restricted both by the biology of our nervous systems and by the history of natural selection that shaped those nervous systems. People come to science, Pollack argues, with the belief that their senses can "measure natural phenomena objectively." But of course, as Pollack points out, our senses do no such thing. Our senses of smell and sight are limited by the repertoire of odorant receptors and cone cells, respectively, that are encoded by our genomes.

Our sense of touch is also not quite as objective as we believe it to be. Pollack recounts the work of the physician Benjamin Libet, who demonstrated that there is a half-second delay between a painful stimulus and a conscious response. Pollack explains that:

Our sense of the present instant, the sense of being awake and aware, requires the brain to connect the present with the past. . . . In the missing half second, the brain blends information received by the cortex from all its sensory organs with its own version of the past, its stored memories of earlier experiences, including its memories of earlier emotional states. Only then does consciousness emerge. . . .

Thus Pollack concludes that all mental activity, including the supposedly objective method of scientific inquiry, is suffused with unconscious memories, emotions, fears, and desires.

It is at this point that the book takes an original turn. In three successive chapters, Pollack outlines what he believes are some of the unconscious factors that have defined today's scientific research program, preventing it from fully contributing to the betterment of the human condition. In "The Fear of Invasion," he suggests that programs that offer vaccination and sound public health measures have taken a back seat to persistent and misguided efforts to eradicate infectious agents with one antibiotic after another. Scientists and physicians have taken this approach, he argues, because "the thought of infectious microbes penetrating our bodies against our wishes can arouse deep fears of losing control over the primary boundary that separates us from the outside world."

In "The Fear of Insurrection," Pollack takes aim at the emphasis on the identification of cancer susceptibility genes and the rush to develop genetic tests that can detect mutations in such genes. Again, he favors public health campaigns to change habits and lifestyles that are known to be risk factors for cancer.

For the most part, these two chapters are compelling and beautifully written. Relatively "low tech" programs in universal vaccination, research into new vaccines, campaigns to promote breast feeding and to discourage smoking are undoubtedly undervalued and underutilized. Pollack's suggestions in regard to cancer prevention comprise an approach that some have termed "euphenics" (as opposed to eugenics) - the effort to make the environment (air, water, diet, and other factors) as conducive to cancer-free lives as possible, rather than focusing on repairing genetic lesions or eliminating tumors after they have developed.

The most eloquent chapter in the book is probably "The Fear of Death," in which Pollack makes a plea to physician-scientists to pay more attention to the process of dying. The universal desires to be free of pain and to have social contact lead him to praise the hospice movement, which is dedicated to providing just such an environment for those in the final stage of life.

The difficulties in Pollack's arguments arise from his insistence that these aspects of science's research agenda are necessarily shaped by the unconscious motivations of scientists, both individually and collectively. At times, other explanations seem equally plausible. For example, why is it not possible that the overuse of antibiotics stems from their spectacular success and their historical reputation as "miracle" drugs? As for the failure of the pharmaceutical and medical communities to come to grips with the problem of antibiotic resistance, this could equally well be attributed to widespread ignorance of Darwinian principles, rather than unconscious fears of invasion.

In his discussion of cancer, Pollack suggests that the current emphasis on cancer-related genes helps scientists assuage their own fears of getting cancer. As he puts it: "The tools that detect inherited propensities pick up very rare events, so the scientists who develop them are unlikely to be given a bad prognosis by their own hand; it is only a little bit magical for them to think that they have warded off the disease." But as Pollack points out earlier, these mutated genes are the same ones that are associated with nonhereditary sporadic cancers to which each of us is susceptible. Geneticists know this better than anyone, suggesting that a great deal of magical thinking would be required for them to believe that they are off the hook after having diagnosed an inherited risk in someone else.

Robert Pollack's voice is an important one in the scientific community; it urges scientists and physicians to examine what they do and why they do it. In The Missing Moment, he has made an original contribution to the ongoing debate surrounding the direction of science and medicine in the molecular era. His book might have been more satisfying had he discussed the degree to which sociological and economic factors might interact with psychological factors in the actions of scientists. Still, one can't fault an author for narrowing his focus to what seems most important to him, and one hopes that the book will reach a wide readership of both general readers and scientists willing to take a look inward.

Alan I. Packer is currently a postdoctoral fellow in the Center for Reproductive Sciences and Department of Genetics and Development at the Columbia University College of Physicians and Surgeons.

Scientists and doctors know more clearly than most people . . . that their individual mortality is no more negotiable than that of our species or any other. But knowing this, they too often make one last mistake - an avoidable one, after all - by ignoring their knowledge, suppressing it, and acting as if death, even their own death, were not worth the effort to consider. Attempts to escape from mortality are nothing new, but it is surprising to find medical scientists trying to get away from death by climbing a DNA ladder, even though they know such tricks of the mind cannot work.

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