Nobel Prize Oversight

 

The Medical Tribune, January 2, 1974 had a full page spread.  The headline said “Radioimmuno­assay’s Impact on Medicine Revolutionary.”  I read it to Lapius.  For once he showed an immediate interest.

 

“Read on, Harry,” Lapius commanded.

 

I read on as follows.  “The word radioimmunoassay is not defined in medical dictionaries (c. 1968) still on active duty, and has also been skipped by Webster’s Third. Yet, in the nearly two decades since two New York Investigators discovered the principle of radioimmunoassay (RIA) this tech­nique has had tremendous impact on both clinical medicine and basic research.  Its uses range from the diagnosis of digitalis intoxication to the screening of unsuspected drug abusers, and the list of applications is expanding.

 

“The late Dr. Soloman A. Berson, together with Rosalyn S. Yalow, PhD., performed the landmark re­search leading to RIA at the Bronx Veterans Administration Hospital and Mount Sinai School of Medicine.  Their personal evaluation of what the technique can accomplish was described suc­cinctly in a lecture they had prepared just before Dr. Berson’s death last year.

 

“’In brief,’ they summed up ‘RIA or other competitive radioassays are likely to be adapted for the measurement of any substance of interest that is difficult to measure by other means.’”

 

Lapius waved his arm at me, a substantive signal to shut up immediately.  The great man wanted to speak.  I stopped reading, but he only sighed.

 

“That sigh was meant to convey a message, I presume?”  I asked.       

 

“Yes it was, Harry.  The sigh was a lament.”

 

I was somewhat miffed that all that reading had evoked naught but a sigh.  “The article doesn’t seem to be sad.  What’s to sigh about?”  I asked.

 

Lapius ignored the question.  “Do you realize, Harry, that the technique of Berson and Yalow en­ables us to measure substances down to a trillionth of a gram.  They have indeed revolutionized medicine.  They should receive the Nobel Prize for that work.  Up until their investigations we could only surmised at gross hormone interactions.  Now they can be proved, measured, and evaluated.”

 

“And that’s what the sigh was about,” Lapius continued.  “Solly died last year, alone, while attending a medical meeting at Atlantic City.”

 

“You know him?”

 

“Of course.  But the Nobel-Committee has a policy that it has adhered to throughout the years with only one exception, never awarding the prize posthumously.”

 

“Who was the exception?”

 

“There were rumors that Berson was to be nominated but that he stipulated that unless Yalow was included, he would turn it down.”           

 

“But who was the exception?”  I asked.

 

“It’s not important,” Lapius said impatiently.  “However, there is now a possibility that Yalow and Berson as a team will receive the prize, because Yalow is still alive, and can accept it in behalf of Solly.”

 

“Who received the prize posthumously?”

 

“What difference does it make?  How well I remember Berson.  He reminded me of John Garfield.  He crackled and shot sparks like a high voltage line.  I knew him before he got into medical school, which was a long time because it took him four years after graduating college to get in.  He was re­jected by 30 medical schools.”

 

“Simon, never mind that, who was awarded ---?”

 

“Yes 30 medical schools rejected him.  I hope he receives the Noble Prize for that alone, so that their inglorious decision can be emblazoned in brass in their hallowed halls.  Berson and an entire gen­eration of Bersons were refused entry to medical school because they were Jews.  In those days there was a lot of racism in the school system.

 

“There was a saying that Jews were aggressive, Italians lazy, Irish ambitious, and thus, with these undesirable characteristics, shouldn’t be given first choice to medical school.”

 

“Well, that’s a thing of the past now, Simon.”

 

“Not entirely.  Now there is a sort of reverse racism.  Schools tend to deny admission to deserving students to accept instead marginal students from the ghettos.”

 

“Well, we owe it to them.”

 

“Yes.  But not to marginal students.  Only to the best.  Otherwise the quality of doctors will deterio­rate.”

 

“But we need more black doctors.”

 

“Harry. We need more doctors.  Period.  No man should be denied admittance for his race.  No man should be admitted for his race.  His credentials alone are what must count.  Actually we should probably follow the lead of many European Universities.  Admit anyone who wants to be a physician into the first year of medical school, and then graduate those only who have met the educational standard.  This would be fair and eliminate all the nonsense with respect to admission committees etc.  And there would be less risk of losing a Sol Berson by that practice.  Think, Harry.  Berson had to struggle for four years with a fearsome singleness of purpose to thwart the system that tried to exclude him from medical school.  Yet look what a tremendous contribution he made.  No one person, no committee can decide in advance who will be great.  The answer, Harry, is open admis­sion to medical school.”

 

“Simon, for goodness sakes.  Tell me, who was awarded the Nobel---.”

 

“Dag Hammarskjold.” *

 

Author’s Note:

 

*The Nobel Prize was for RIA was awarded to Roslyn Yalow. Correspondence with the Nobel Committee resulted in a copy of Nobel Foundation Code of Statutes that stated the rule for the award.  “Work produced by a person since deceased shall not be considered for an award ---“.  However, in this case the prize WAS awarded for the work of someone who had died, but his name was excluded. I expanded on this in the following acddendum:

 

 Nobel Catch 22: Genius Forgotten. Printed Daily  Obesrver June 30, 1980 

 

The 1977 Nobel Prize for Medicine was awarded to Roslyn S. Yalow for work she did in conjunction with Dr. Soloman Berson in developing the  radio-immune-assay techniques which has revolutionized the science and practice of medicine. Briefly, this technique enables laboratories to measure all hormones and other substances in quantities as small as a billionth of a gram (or 1/30 billionth of an ounce, for those not yet converted to the metric system). 

 

Until this epochal work of Yalow and Berson, hormones were roughly quantitated by injecting a sample of blood or serum from a patient into a laboratory animal and judging its biologic effect by the crudest of standards, then translating the result into international units. For most hormones biologic endpoints were not available to do even rough assays. Only after the RISA technique evolved did scientists appreciate the minute quantities of the substance that made the endocrine system work.  

 

Unfortunately Dr. Berson died in 1971, and therefore he became, according to interpretation of the will of Dr. Nobel, ineligible for the prize. Dr. Yalow in her acceptance speech acknowledged that had Dr. Berson been alive he would have been right there with her in Sweden sharing the prize. 

 

In his speech awarding the prize, Professor Rolf Luft of the Karolinska Institute, Stockholm, fully described the work of Berson and Yalow in the opening paragraphs, but towards the end of the dissertation Dr. Berson’s name gradually faded into the background and the award was made to Dr. Yalow. 

 

In a fateful way the award does a disservice to history, because in the genesis of the development of RIA it is impossible to separate the contributions of Yalow and Berson. The unique intellectual qualities of each of the doctors dovetailed over a collaborative period of more than 15 years to produce the phenomenal scientific by which medicine thrives today. All publications during this period are either Berson-Yalow or Yalow-Berson. Thus to award the prize only to Dr. Yalow fails to perpetuate the historical truth of the discovery.  

 

My interest in this event stems from the fact that I was casually acquainted with Dr. Berson before he entered medical school, and that Dr. Yalow, prior to receiving the Nobel Prize was gracious enough to address the Ocean County Medical Society, so I had a chance to meet this brilliant lady as well.  

 

Distressed that Berson’s name is omitted from Nobel archives, I wrote the Nobel Committee to point out that the development of RIA was so monumental that the omission of Berson’s name perpetuated a historical distortion. I do not recall having received a satisfactory answer.  

 

I thought that perhaps the King of Sweden might be interested in this unique situation, and having had nothing to do one afternoon, dropped him a line. He forwarded my letter to the Nobel Committee where it received prompt attention. The committee stated that it had acted in accordance with the will of Dr. Alfred Nobel, and sent me a copy of that portion which alluded to the Nobel Prize. 

 

I had always understood that no Nobel award could be made to a person who had died, although an exception was of course made in the case of Dr. Dag Hammerskjold, former Secretary General of the United Nations, who received the Nobel Peace Prize after he had been killed in an airplane accident. 

 

The Nobel Committee obviously felt that Nobel’s will preclude giving the prize to the deceased Berson. Imagine then my surprise to read that the Code of Statutes for the Nobel Foundation states “Work produced by a person since deceased shall not be considered for an award ---“. 

 

And there’s the rub. In awarding the Nobel Prize in Medicine for 1977, the Nobel Committee did award the prize for the work “of a person since deceased”, since the scientific contributions of Berson and Yalow are so intertwined as to be indistinguishable. By awarding the prize to Dr. Yalow the Nobel Committee was also awarding the Prize for the work of Dr. Berson. Only it forgot to mention it.

 

It is a unique situation and the Nobel Committee should acknowledge the fact that the award of the prize to Dr. Yalow is indeed official recognition of the work of Dr. Berson also. His name should be on  the plaque.