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Cordial Tone Set for New Chair
Zerhouni Welcomed, Kirschstein Lauded at 84th ACD Meeting

By Carla Garnett

Photos by Bill Branson

On the Front Page...

Just moments after 8:30 a.m. on June 6 and a scant 2 ½ weeks after his first day on the job, new NIH director Dr. Elias Zerhouni was formally handed the gavel at the 84th meeting of the advisory committee to the director (ACD), which he now chairs as head of the agency.


"I think we should have a ceremony that allows Dr. Zerhouni's previous home institution to turn the gavel over to our new chairman," said NIH deputy director Dr. Ruth Kirschstein, who had chaired the twice-yearly ACD meetings as acting NIH director since 2000. She called on ACD member Dr. William Brody, president of Johns Hopkins University, to introduce Zerhouni to the 36-year-old gathering of physicians, researchers, lawyers, professors and business executives that assembles on campus to consider the NIH enterprise every June and December.

Dr. Elias Zerhouni at ACD

"I sort of feel like the father of the bride," Brody quipped, before launching into an abbreviated biography of the new director that was sprinkled liberally with personal notes about the friendship and high level of professional respect that have developed over more than 20 years between himself and Zerhouni. "When President Bush announced his intention to nominate Elias as director of NIH, a colleague of mine from the West Coast called me and said, 'Gee, they appointed a radiologist. That's kind of unusual.' And I said, 'Well, describing Dr. Zerhouni as a radiologist is like describing Bill Gates as a computer programmer.' Elias is one of the most broad-gauged people that I know in the field of medicine and biomedical science."

Warm Welcome

Himself an expert in the field of radiology, Brody continued, "Many of us in biomedical science strive to have an important discovery or invention, but Elias has had a number of them. I think in that regard, he's quite unusual. Early in his career, Elias discovered that there was a way to differentiate benign from malignant nodules on computer technology, which then sparked a tremendous controversy because people couldn't reproduce the work. So Elias then went into the detailed physics of computer tomography and showed why — depending on the type of scanner and how the method was conducted — you could come up with erroneous results. I think it was this work that made Elias a consultant to the Reagan White House during President Ronald Reagan's illness."

Noting more of Zerhouni's breakthrough inventions, Brody said, "I could go on and on. He has a great sense of humor, he plays the lute and the piano, loves to scuba dive and listen to opera...It's a great loss for Hopkins, but I think it's a wonderful gain for NIH. Congratulations, Elias."

Immediately revealing the quick sense of humor alluded to in the introduction, Zerhouni began his remarks, smiling broadly: "First let me say thank you to Bill Brody for all his nice comments. Bill, if you had said all those things to me before, I would have stayed."

Sobering, Zerhouni acknowledged, "There are few things that happen in one's life that are important and critical to what happens to you. [For me], one of them was meeting Bill Brody. If I have to count the three or four things that have been determining, I would say that crossing paths with Dr. Brody was one of them."

In a brief ceremony beginning the 84th ACD meeting, NIH deputy director Dr. Ruth Kirschstein passes the gavel to the group's new chair, NIH director Dr. Elias Zerhouni. Introducing the new leader and joking that he felt "like the father of the bride" is the head of Zerhouni's previous place of employment, ACD member Dr. William Brody, president of Johns Hopkins University.

The new NIH chief then contrasted his last position with his current. Describing the various hats he wore at JHU, Zerhouni joked about what he called "the Hopkins reengineering method — four jobs for the price of one. The difference here though is I have one job and many bosses — Congress, White House, the Administration. It's quite a daunting position. With that as a preamble, I'm very honored and excited to be here. I saw the composition of the committee and I am very impressed and thankful for having your advice and support."

Zerhouni said he'd had a lot of job offers over the years that he had "declined within 10 seconds," but that he'd once acknowledged in a meeting that "probably the only one I would consider is an NIH job, because I admire NIH." He had expressed similar feelings in a May 17 farewell message to colleagues at Hopkins, writing, "You took me in and exposed me to an extraordinary environment for innovation and discovery. More than that, you provided me with great mentors who nurtured me and helped me become the physician, teacher, researcher and executive I am today...I wouldn't have left Johns Hopkins for any other job."

Accountability, Communication Top Priority List

Zerhouni then briefly touched on three overarching priorities he said he gleaned from his meetings in Congress, his experiences during the confirmation process and his 14 days on the job.

"The first and foremost message I received from every senator, every congressman, everyone in the administration and outside the NIH community," he said, "is the doubling of the budget and questions about whether or not it is well used. 'How do we know it is well used?' 'What does the public gain for it?' There is a huge cry out there for accountability and transparency. This I think is going to be a constant theme over the next few years. This is a concern that really comes across every layer of the many bosses that I'm talking about."

The second issue that Zerhouni said he "heard over and over again" from everybody is "science policy being influenced more and more by earmarks. This is something we need to grapple with" and perhaps curb in some way.

"The last but not least concern," he concluded, "is the level of expectation of the public such that there is now a cry for effective translation of the discoveries into tangible benefits."

Elaborating, Zerhouni related a phenomenon that was described to him to illustrate the point: "A hypothesis says, 'You know, the cure can be here in 5 years, if we only had X amount of dollars.' One of the fundamental difficulties we have is that the research enterprise is often compared to the moon shot strategy. 'Why is it that President Kennedy can say we'll go to the moon in 10 years and we did it, and you scientists tell us you can't get a cure in 10 years for one thing or another?'"

Zerhouni said the issue proves why basic discourse is needed with the public regarding "the realities of science." He said people involved in biomedical science need to spread the word to the public: "When we talk about going to the moon, we're really talking about an incremental technological challenge. We know where the moon is. We see it every night. Fundamentally, we knew we could get there. We knew the laws of physics. We knew the laws of gravity. We knew escape velocities. That kind of project was a technological challenge. People need to convey the message that in biomedical research we're not just dealing with a technological challenge that has a well-defined endpoint and scientists clear on just how we get there. We have a knowledge challenge in many of these enterprises. That message is just not verbalized enough to make the many bosses we have understand that this is the challenge for us. And, we're not communicating that effectively. That is why we have this phenomenon of 'the cure will be here in 5 years if we spend X dollars.' In the minds of many people, it makes an analogy between the moon shot and the War on Cancer and the Manhattan Project and medical research, when in fact there are fundamental gaps in knowledge that do not allow one to make those predictions."

Getting Up to Speed

As is customary, the first business of the ACD meeting is to provide an update on major occurrences at NIH in the last 6 months. Kirschstein offered such a report, highlighting the congressional budget hearings and the status of search committees for each of six vacant institute directorships. The committee for the head of NIDA is poised to begin interviewing candidates, NIMH's committee has interviewed already, NIAAA's is "moving apace" and NINDS's is being reinstalled for a new search. At NIBIB, Dr. Roderic Pettigrew, currently of Emory University, has been appointed and will start in early fall. Dr. Marvin Cassman's departure from NIGMS since the last ACD meeting was acknowledged; a committee to fill the job there is under way. Kirschstein also noted that several vacancies on the ACD roster had been deliberately left open in anticipation of Zerhouni's arrival and subsequent input on nominees.

As members introduced themselves individually to Zerhouni, none could resist offering salutes to Kirschstein. Observing their affection for his predecessor, the chair quipped, "On my last day, I wish there would be as much unanimous sentiment."

NIH deputy director for extramural research Dr. Wendy Baldwin then gave a short briefing on the stem cell registry and announced that three more memoranda of understanding and six new stem cell lines meeting President Bush's criteria had been added to the registry.

For the remainder of the morning session, the agenda turned to the topic of science education and career development. About a dozen students who participate in the CityLab at Boston University, a program underwritten largely by the National Center for Research Resources, delivered a unique presentation about their experiences there. Lively and often punctuated with humor, the youngsters' enthusiasm was palpable, prompting Zerhouni to inquire whether ACD meetings were always so much fun.

"No," replied Dr. Thomas Cech, president of the Howard Hughes Medical Institute, with a wry smile, drawing laughter from the other members.

Also offering details about NIH's forays in stimulating even the youngest age groups to consider science for their futures were Dr. Bruce Fuchs, director of NIH's Office of Science Education, who discussed the NIH curriculum supplement series, and Dr. LaShawn Drew, acting director of the NIH Academy, who talked about the possibility of expanding the academy.

By the meeting's midpoint, the cordial tone of Zerhouni's ACD initiation had been well established, primarily by the warm greetings that began the day.

"We've known each other for years, so I don't need to introduce myself to you," said ACD member Dr. Donald Wilson, vice president for medical affairs and dean of the School of Medicine at the University of Maryland, addressing Zerhouni during the greeting period and leading the first of many of the group's personal tributes to Kirschstein. "For at least the last 30 years, I've been an employee of the NIH for several days a year, and over this time it's been my privilege to work with our Ruth Kirschstein and I just want to thank her for all she's done over the years."

Attempting to stave off the barrage of similar laudatory comments she sensed would follow, a noticeably embarrassed Kirschstein ordered that the verbal thanks cease. Still, as members introduced themselves individually to Zerhouni, none could resist offering small salutes to Kirschstein. Observing their affection for his predecessor, the chair quipped, "On my last day, I wish there would be as much unanimous sentiment."

Breaking slightly with his fellow ACD colleagues, but accurately reflecting another sentiment, Cech said, "At a time when one gets this type of position, Dr. Zerhouni, everyone says 'Congratulations.' I would instead like to say 'thank you,' which is a very different step, but I think that we appreciate the leadership that we are about to receive."

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