Mind, Brain, Body, and Behavior: Foundations of Neuroscience and Behavioral Research at the National Institutes of Health (review)

The creation of the National Institutes of Health (NIH) in the years after World War II, with federal funds for training investigators and supporting research, transformed biomedical research in the United States from a puny philanthropic effort into a vast network. Victoria Harden, appointed NIH Historian in 1986, has had problems keeping track of the investigators' work because investigators would rather do research than write autobiographies. About 85 percent of NIH research funds are assigned to "extramural" grants to investigators at universities and research centers, and these investigators outnumber those at the "intramural" program in Bethesda, Maryland. Dr. Harden and her associates set out to document contributions from the intramural program. They convened a meeting in September 2003, focusing on brain science at the National Institute of Mental Health (NIMH) and the National Institute of Neurological Diseases and Blindness (NINDB—later renamed National Institute of Neurological Disorders and Stroke, NINDS). The twelve speakers were alumni who had served in either institute during the 1950s. Their comments are provided in the book, amplified by a narrative history and a detailed analysis of every annual report from every laboratory, a monumental contribution of Ingrid Farreras. The achievements of these laboratories are listed in detail but they can be summed up succinctly: drug therapy, molecular biology, and imaging and other technical advances that have transformed neuroscience.

At first, Seymour Kety directed basic research for both NIMH and NINDB because the neurology institute was given no funds. Investigators came from universities, attracted by Kety himself and the outstanding group he recruited as well as by new facilities, assured research support, and opportunities for collaboration. Many of these intramural researchers became members of the National Academy of Sciences. Five won Lasker Awards (Nancy Wexler, Seymour Kety, Louis Sokoloff, Roscoe Brady, and William F. Windle), and Nobel Prizes came to Julius Axelrod (NIMH) and D. Carleton Gajdusek (NINDB). Nobelist Eric Kandel also worked in the laboratory of Wade Marshall (both NINDB and NIMH).

The drafting of physicians persisted after World War II and into the 1950s for the war in Korea. Physicians had been deferred to complete medical education but a payback was required for those who had received deferments in order to complete their medical education, and some were allowed to serve at NIH as officers of the Public Health Service. Talented MDs thus entered the intramural program. For some it was their first research, and the experience led to outstanding academic careers. The bidirectional traffic between NIH and the universities led to the development of modern psychiatry and neurology, specialties that had previously been in a parlous state.

The twelve individual essays in this volume differ in approach. All are autobiographical, but some document research progress and some discuss the organization and philosophy of the intramural program. They do not all agree. For instance, David Hamburg, chief of the Adult Psychiatry Branch (1958–61), was impressed by the then five-year-old Clinical Center and expressed a widely held view that the physical proximity of basic scientists and clinical investigators was one of its greatest strengths (p. 245). In contrast, Robert Cohen, director of Clinical Research at NIMH (1952–68) and deputy director of NIMH Intramural Research (1968–81), noted that Kety never invited him to meet with laboratory chiefs in the basic research program, and Cohen never invited Kety to attend meetings of the clinical branch chiefs (p. 199).

The picture at NIH is different now, as analyzed by Guy McKhann (who was clinical associate 1957–60, and associate director, NINDS, for Clinical Research, 2000–2002). The intramural program is ideal for long-range projects, such as Roscoe Brady's study of Gaucher's disease and other metabolic diseases of the brain: these were first tackled via...