A Decade of Perspective

Thomas R. Insel, M.D., notes in his blog he has been the director of NIMH for ten years. "In leadership, longevity is not necessarily a virtue but it does guarantee perspective."

The perspective that comes with longevity is really about understanding how to balance the urgent public health need of patients and families with the slow and serendipitous path of science. Science sometimes seems to produce more questions than answers. In a world of mental anguish where “time matters,” it may be hard to accept that science is a marathon not a sprint. But a decade of leading NIMH only confirms my belief that rigorous, unbiased science is the best answer—really the only hope—for delivering the preventions and cures needed so urgently for people with mental disorders. It takes more than a decade, but there are no reliable short cuts. http://www.nimh.nih.gov/about/direct...spective.shtml

Insel goes into more of his perceptions ((3) mothers have cells in their brains that appear to be from the babies they have carried in utero3. This last discovery—described with the wonderful name of “microchimerism” in the brain--is astonishing.) and concludes:

But there is a more fundamental role for science, which is nothing less than the quest for understanding our world. The homeless man with schizophrenia, the non-verbal child with autism, and the soldier with PTSD need services and treatment, but also understanding—because the quest for understanding spawns compassion, intimacy, and even wonder. The past decade at NIMH has been all about this quest, recognizing that after six decades, we are still at the very beginning of understanding the world of mental illness. There really are no short-cuts.

But I believe we are on the right path, trying to solve mysteries from neurons to neighborhoods and the vast landscape in between, with tools that get better every year. Medicine recently has had spectacular successes: brilliant science has transformed how we can prevent or cure heart disease, AIDS, and now several forms of cancer. We are not there yet for any of the serious mental disorders that NIMH has pledged to prevent and cure. But make no mistake, these are mysteries with a solution. Genomics and neuroscience are revolutionizing the search with powerful new tools that will yield biomarkers, new diagnostics, and better treatments. It is when we hit a new level of understanding measured by patients, not papers, that there is truly a breakthrough. I know that “time matters.” I also know that science is not a sprint. But the marathon is not endless. At this ten-year mark, when I am breathless, it is not from the distance traveled or seeing the distance ahead, but from the challenge of keeping up with the progress around me.

There is an old story, no doubt apocryphal, that President Kennedy asked a White House gardener to plant a great oak tree outside the rose garden. The gardener hesitated, explaining it would take decades for the oak to grow into a great tree. Kennedy responded, “Then there is not a moment to waste. Plant it now.”

Because “time matters” for people with mental illness and because there are no shortcuts for our science, there is truly not a moment (or a dollar) to waste.

While there may not be the instant gratification we seek, Insel plants the seed of hope. Positive news is quite welcome.