The atom, outer space and the malignant cell are all aspects of the natural world of deep significance to our lives.Separately important, they nevertheless share one common feature: Each in turn has been the focus of a concentrated effort in basic research or applied technology unerpinned by lavish public expenditures.
The third program - the cancer crusade - is still in operation and though in principle a successful outcome is just as likely, this program could be scuppered by impatience, unrealistic demands and a failure to appreciate both that the scientific enterprise is quite different from the business and managerial enterprise, and that techniques successfully applied in one context may prove deadening and self-defeating in another. I am not sure that the author of "The Cancer Crusade" realizes this.
His book is the most detailed examination of the genesis of the cancer crusade that we are likely to have for quite some time. Richard Rettig, a senior social scientist with the Rand Corporation, has meticulously dissected out all the component threads in this story. The result is an exact, thorough, revealing and dull account, written undoubtedly for our edification rather than our enjoyment. A careful study of this material - and a study rather than a reading is what the book demands - enables us to grasp the three essential stages of the story up to the present: the general antecedents to the legislative prominence of the issue; the legislative history of the National Cancer Act of 1971; and the implementation of the Act itself.
It is all here, from the skilful activities of the single most potent force in this story, Mary Lasker and her cohorts in the early years, to the unbelievable process whereby "the recommendations of an obscure panel, working in close and largely private sessions, reporting in a poorly covered hearing to a defeated Senate committee [were] transformed into a matter receiving attention in a State of the Union message for 1971."
But there are several weakness. First,this is a curiously dead book. Rettig likens "legislative history to a dramatic production," and so indeed it is. But in this case the stage seems to be occupied by puppets. Mary Lasker apart, the human vitality, which forms a crucial element in the interplay of political and social forces, is totally absent. This not only detracts from the fluency and interest of the book, but also from the validity of Rettig's thesis, which is curiously historical. We are invited to draw several conclusion, such as how American can reasonably expect their government to respond to the threat of serious diseases. But it is not at all obvious that future responses will mirror past ones.
Another element missing from this book is a sense of science and of its creative process. Though Rettig occasionally genuflects to the view that management techniques may not after all be the recipe for success, one gets the impression that this is only a token obeisance. Nowhere is the suggestion made that we might look at something as simple and fundamental as the nature of scientific invention and the conditions for its full flowering and ask whether we are paying careful attention to this. For it is becoming increasingly clear that the present system of funding, where that which is either known, conservative or "safe" gets funded way ahead of that which is uncertain, imaginative or daring, will have a stifling effect on young scientists and deadening effect on the whole program. (For two analyses of this problem, see R. C. Ringler's article in Federation Proceedings, Vol. 36 And Charles McCutcheon in The Sciences, Nov. 11, 1977.) Morale among the young is nearly at an all-time low, and these are the people whose ideas will count, but not because they want more money or a meal ticket for life. They don't. It is low because they are not being given a chance to develop their ideas quietly, for a definite period of time, free of psychological and competitive pressures. It isn't only, as one of them said to me, that you wonder what would have happened to Mozart or Picasso had they had to write 40 grant applications for each symphony or painting. (Picasso's comments would have been unprintable.) But if, in addition, the very choice of sonata form, or painting method were prescribed, and each stage in the development of the work had to be approved, we might well have inherited a series of tinkling tunes but no Requiem Mass. What is terribly lacking in the implementation of the present cancer program is vision, as well as boldness, daring and a willingness to be wrong.