Moments
A quantum leap
It was 1998. I had prepared for my aggregation exams a proposal for a new optional subject in Molecular Medicine to include in year six of the Medical Degree. I believed that once in possession of clinical training, the student-doctor would be well prepared to absorb the impact of the "new biology" in his clinical practice and thus put it at the service of the patients.
To my chagrin, the proposal did not to merit more than vague circumstantial compliments by the panel, chaired by João Lobo Antunes, so I immediately foresaw that it was destined to oblivion in some obscure file in the depths of the house.
What I could never have predicted was what ensued. As usual, João Lobo Antunes had read the course report carefully, particularly the laborious argument in its favour, contained in the introduction. Horrified for having stumbled somewhere across the detested word "holistic" (I confess that I never used it since), he showed no enthusiasm for the hypothetical new subject. He just told me that the important thing was not to teach what soon would be forgotten, the important thing was, rather, to create the conditions so that molecular medicine was practiced in a sustainable manner, at the highest level, in the School itself. He said that creating an "Institute of Molecular Medicine" at the Faculty was what had to be done.
I remember the astonishment I felt at the time. It was like witnessing a quantum leap, a phenomenon I thought was invisible and reserved to the realm of the theoretical abstraction of physics. And yet it was, by representing an abrupt discontinuity of "energy states".
He immediately created a small group to advance the matter. Initially we were three, Rui Victorino, Domingos Henrique and myself, later joined by Carmo Fonseca. It was an interesting and intense time of comprehensive analysis of similar international models, conversations with colleagues from other countries who had long lived similar experiences, of meetings he conducted with his admirable and unforgiving lucidity.
However, there were two problems that had to be solved first. The first was, of course, to create the operational conditions that would enable such an institute. At the time, the only way to do it was to get access to the exclusive club of Laboratories Associated with the Ministry of Science, which were structures with privileged public funding, meta-university entities with agile management rules, free from the bureaucratic corset of the University. The Associated Laboratories, however, could only see the light of day based on the ministry’s sole discretion, which was why I was in charge of "probing the FCT on the subject. I did probe, and Luis Magalhães, at the time the President of the FCT, immediately showed what is now customary known as "openness". Yes, the Ministry would welcome a new Biomedical Associate Laboratory in Lisbon, based on the "CEBIP", an FCT centre created years earlier by David-Ferreira.
A second problem still needed to be addressed: to convince the school to welcome, without rejecting it, a "foreign body" attached to it, but independent from it. Lobo Antunes, a negotiator as skilled as pragmatic, knew well what to expect. But he knew also that freedom, coupled with an uncompromising qualitative requirement, are the values that support good science and, therefore, are not negotiable.
And he made it! In 2002, the Institute of Molecular Medicine was formally established as an Associate Laboratory and occupied the (little) space remaining in the new Egas Moniz building, already (generously) occupied by some basic sciences institutes of the faculty.
Under his strategic direction, as President, assisted by the strong and effective hand of the Executive Director Maria do Carmo Fonseca, the Institute of Molecular Medicine has quickly become a bustling environment of young researchers, some of them coming from international paths of excellence.
Ten years later, when he decided to pass the baton to Carmo Fonseca and assign the new Executive Directorate to Maria Mota, Bruno Silva Santos and Henrique Veiga Fernandes, themselves young rising stars in the science world, the Institute of Molecular Medicine was already considered to be one of the best biomedical research centres in the country.
I say "considered" because, as we know, in science what matters is not the subjective and "local" perception of value. The absolute and relative value of an institution may only be determined by external evaluation, which is free and competitive. Thus, consideration would only become an unquestionable fact when, in 2014, the IMM was recognized as excellent by independent international evaluators, under a comprehensive assessment of all R&D l units in the country.
What this evaluation could not show, however, was the impact of the institution on the University itself. In October 2015, when I was still in government functions, Maria Mota invited me to say "a few words" at a public presentation ceremony of an ERA-CHAIR of the IMM (CAML).
I asked to be given disaggregated statistical data on the University of Lisbon, concerning the capture of funds as part of Horizon 2020, the most competitive European programme for science funding. I confess to my surprise (and that of all) that 45% of around EUR 33 million from the University of Lisbon in the first two years of that programme (2014 and 2015) had been obtained by the Institute of Molecular Medicine.
What was the reason for this unique success? The international competitiveness in science is obviously a proxy of quality, and the quality, in turn, always derives from the activity of individuals. I looked for it, and the explanation came, cut and clear: The Institute of Molecular Medicine was, at the time, the public research centre with more grantees of the European Research Council, and one of the institutions with the highest number of FCT Researchers, themselves selected by competitive international tender. The Institute of Molecular Medicine had become unequivocally a talent attractor pole.
These figures tell us little, however, about the immateriality of the influence of the Institute on the actual Faculty of Medicine. I have no data that allow me to have an objective judgment. I only know that the Institute of Molecular Medicine is now a source of pride for the Faculty, and that several of its lecturers are leading researchers, that students enjoy contact with laboratories and scientists, and that clinical research gradually acquires the strength derived from multidisciplinary research. For its part, the Hospital, a key element of the CAML trinity, systematically invokes the "partnership" with the IMM as the distinctive curricular component of the national hospital centres.
My perception, as an external observer who does not belong to the IMM, is to look at the way you have trodden (and when you look back you see that you will never tread on that path again), and realize that Lobo Antunes’ biggest aim - the fruitful and harmonious cooperation between basic science and clinical medicine, based on impeccable ethical values and institutional ethos - has not yet been fully achieved.
This is the challenge, and the moral imperative, of the current leaders in the years to come.
Is it an easy task with guaranteed success? Certainly not and he knew it better than anyone. But as Edward O. Wilson in his bright book Consilience. The Unity of Knowledge says, "The moral imperative of humanism is the endeavour alone, whether successful or not, provided the effort is honourable and memorable failure. If those committed to the quest fail, they will be forgiven. When lost, they will find another way".
Leonor Parreira
Lisboa, 30 October 2016
To my chagrin, the proposal did not to merit more than vague circumstantial compliments by the panel, chaired by João Lobo Antunes, so I immediately foresaw that it was destined to oblivion in some obscure file in the depths of the house.
What I could never have predicted was what ensued. As usual, João Lobo Antunes had read the course report carefully, particularly the laborious argument in its favour, contained in the introduction. Horrified for having stumbled somewhere across the detested word "holistic" (I confess that I never used it since), he showed no enthusiasm for the hypothetical new subject. He just told me that the important thing was not to teach what soon would be forgotten, the important thing was, rather, to create the conditions so that molecular medicine was practiced in a sustainable manner, at the highest level, in the School itself. He said that creating an "Institute of Molecular Medicine" at the Faculty was what had to be done.
I remember the astonishment I felt at the time. It was like witnessing a quantum leap, a phenomenon I thought was invisible and reserved to the realm of the theoretical abstraction of physics. And yet it was, by representing an abrupt discontinuity of "energy states".
He immediately created a small group to advance the matter. Initially we were three, Rui Victorino, Domingos Henrique and myself, later joined by Carmo Fonseca. It was an interesting and intense time of comprehensive analysis of similar international models, conversations with colleagues from other countries who had long lived similar experiences, of meetings he conducted with his admirable and unforgiving lucidity.
However, there were two problems that had to be solved first. The first was, of course, to create the operational conditions that would enable such an institute. At the time, the only way to do it was to get access to the exclusive club of Laboratories Associated with the Ministry of Science, which were structures with privileged public funding, meta-university entities with agile management rules, free from the bureaucratic corset of the University. The Associated Laboratories, however, could only see the light of day based on the ministry’s sole discretion, which was why I was in charge of "probing the FCT on the subject. I did probe, and Luis Magalhães, at the time the President of the FCT, immediately showed what is now customary known as "openness". Yes, the Ministry would welcome a new Biomedical Associate Laboratory in Lisbon, based on the "CEBIP", an FCT centre created years earlier by David-Ferreira.
A second problem still needed to be addressed: to convince the school to welcome, without rejecting it, a "foreign body" attached to it, but independent from it. Lobo Antunes, a negotiator as skilled as pragmatic, knew well what to expect. But he knew also that freedom, coupled with an uncompromising qualitative requirement, are the values that support good science and, therefore, are not negotiable.
And he made it! In 2002, the Institute of Molecular Medicine was formally established as an Associate Laboratory and occupied the (little) space remaining in the new Egas Moniz building, already (generously) occupied by some basic sciences institutes of the faculty.
Under his strategic direction, as President, assisted by the strong and effective hand of the Executive Director Maria do Carmo Fonseca, the Institute of Molecular Medicine has quickly become a bustling environment of young researchers, some of them coming from international paths of excellence.
Ten years later, when he decided to pass the baton to Carmo Fonseca and assign the new Executive Directorate to Maria Mota, Bruno Silva Santos and Henrique Veiga Fernandes, themselves young rising stars in the science world, the Institute of Molecular Medicine was already considered to be one of the best biomedical research centres in the country.
I say "considered" because, as we know, in science what matters is not the subjective and "local" perception of value. The absolute and relative value of an institution may only be determined by external evaluation, which is free and competitive. Thus, consideration would only become an unquestionable fact when, in 2014, the IMM was recognized as excellent by independent international evaluators, under a comprehensive assessment of all R&D l units in the country.
What this evaluation could not show, however, was the impact of the institution on the University itself. In October 2015, when I was still in government functions, Maria Mota invited me to say "a few words" at a public presentation ceremony of an ERA-CHAIR of the IMM (CAML).
I asked to be given disaggregated statistical data on the University of Lisbon, concerning the capture of funds as part of Horizon 2020, the most competitive European programme for science funding. I confess to my surprise (and that of all) that 45% of around EUR 33 million from the University of Lisbon in the first two years of that programme (2014 and 2015) had been obtained by the Institute of Molecular Medicine.
What was the reason for this unique success? The international competitiveness in science is obviously a proxy of quality, and the quality, in turn, always derives from the activity of individuals. I looked for it, and the explanation came, cut and clear: The Institute of Molecular Medicine was, at the time, the public research centre with more grantees of the European Research Council, and one of the institutions with the highest number of FCT Researchers, themselves selected by competitive international tender. The Institute of Molecular Medicine had become unequivocally a talent attractor pole.
These figures tell us little, however, about the immateriality of the influence of the Institute on the actual Faculty of Medicine. I have no data that allow me to have an objective judgment. I only know that the Institute of Molecular Medicine is now a source of pride for the Faculty, and that several of its lecturers are leading researchers, that students enjoy contact with laboratories and scientists, and that clinical research gradually acquires the strength derived from multidisciplinary research. For its part, the Hospital, a key element of the CAML trinity, systematically invokes the "partnership" with the IMM as the distinctive curricular component of the national hospital centres.
My perception, as an external observer who does not belong to the IMM, is to look at the way you have trodden (and when you look back you see that you will never tread on that path again), and realize that Lobo Antunes’ biggest aim - the fruitful and harmonious cooperation between basic science and clinical medicine, based on impeccable ethical values and institutional ethos - has not yet been fully achieved.
This is the challenge, and the moral imperative, of the current leaders in the years to come.
Is it an easy task with guaranteed success? Certainly not and he knew it better than anyone. But as Edward O. Wilson in his bright book Consilience. The Unity of Knowledge says, "The moral imperative of humanism is the endeavour alone, whether successful or not, provided the effort is honourable and memorable failure. If those committed to the quest fail, they will be forgiven. When lost, they will find another way".
Leonor Parreira
Lisboa, 30 October 2016
