Stephen E. Hyman is a professor of stem cell and regenerative biology and directs the Stanley Psychiatric Research Center at the Broad Institute. He served as the director of the National Institute of Mental Health from 1996 until 2001, and then from 2001 until 2011 as president of Harvard University. This interview has been edited for length and clarity.
FM: Your research addresses the genetics of mental illness. Why is it an important topic to study?
Sehee: The truth is, we have to get better at both preventive interventions and treatments for mental illness. We have very helpful psychotherapies, especially cognitive behavioral therapy. However, sometimes referred to as upper limits of treatment, people do improve, but these are not cures and mean that many people relapse. Most of the medicines we have are chemical descendants of his 1950s prototype, which was discovered by chance. There are several new drugs, all of which stem from a deep understanding of what puts people at risk for mental illness.
The Broad Institute studies genetics because genetics provides clues to the molecular mechanisms underlying mental disorders. Genetics can help predict risk to some extent, but I wouldn't overestimate it. Genes are not destined to cause these symptoms. What we want to do is understand these mechanisms in order to develop new treatments.
FM: What made you want to study this and make this your research specialty?
Sehee: I decided a long time ago that the brain and what excites us is what matters most.
I majored in philosophy at Yale University and then received a fellowship at Cambridge University, where I studied history and philosophy of science. But this was in his mid-1970s, and he wasn't really interested in the empirical world. So I thought, if I don't understand these things in the trenches, I'll be miserable. So I decided to go into a completely new field called neuroscience.
I realized that I could major in anything and go to medical school. I used medical school as a way to get into research. I was very moved by and fascinated by people with psychosis, bipolar disorder, and schizophrenia. I was also frightened by the prevailing theories, the theories that the faculty believed. They were psychoanalyst scum who were blaming the mother for her unconscious, so-called schizophrenia, which was unbelievable and sadistic.
After my training in psychiatry, I entered the lab for a five-year postdoctoral fellowship in molecular biology.
FM: Was the history and philosophy of science your first academic interest?
Sehee: I had a Ph.D. My thesis plan was that I would probably end up staying at Cambridge.
I didn't think about mental illness at the time. I was seriously thinking about how the brain creates a mind. But in the 1970s, it was hard to find people who were really interested in it. And that's when I decided, out of sheer fear and not really knowing what I was doing, that I wanted to do neuroscience.
FM: How do you think your background in history and philosophy has influenced your practice as a scientist?
Sehee: In a way I didn't expect.
It turns out that the ethics of neuroscience have been surprisingly under-scrutinized. When I was his NIMH director, I was already blindsided by serious ethical issues. Although the issue of treating children with ADHD with stimulants remains controversial today, it was very topical at the time. And people had a pretty unexamined and rigid view that giving drugs to young children would change their brains and change their personalities. But people don't think about what would happen to these kids if they were talented but didn't do well in school, or if they ran around and got yelled at all the time, or if they were rejected by their peers. did. How do we decide what is good and what is right?
When we intervene in people's brains, it's not just the usual ethics of “do they understand what we're doing, do they agree with it, do we really care about their safety?” Questions such as “Are we thinking about personal identity?'' are also considered. , narrative identity, thinking about how a person's personality changes and what that means to them and what it means to their family and friends as well. ” I don’t think the world thinks about these things enough. That philosophical background supports me and contributes to much of what I actually do.
FM: What do you think is the biggest ethical issue that neuroscientists should be paying attention to right now?
Sehee: There are several. Although still in its infancy, some form of mind-reading is actually not far-fetched, especially with the help of AI. I think the ethics of brain privacy will become very important.
But right now, 200,000 people around the world are receiving deep brain stimulation to treat Parkinson's disease. And a certain number of those people actually undergo significant personality changes.
People start gambling. People begin to engage in risky behavior very late in life. It's really changing the way people are, their relationships with their families, and so on. And as these procedures become more routine and are developed to treat depression and OCD, which they are, medical institutions and the general public are increasingly concerned about their sense of identity. I don't think you're really grappling with the fact that you're not necessarily right. Persistent and stable. It is malleable and the treatment you receive for the right reasons can change your situation.
FM: Do you think these ethical issues are not being considered enough?
Sehee: Yeah. It is very realistic, yet looks very exotic to most people. It's like science fiction.
FM: You served as director of the National Institute of Mental Health for many years. What are you most proud of during your tenure?
Sehee: I was hired and had the temperament to modernize it. It was really confusing. Many jobs were hopeful. Social determinants of mental health are really important. But because we recognize, as we all do, that living in extreme poverty can cause depression and anxiety and make everything else worse, doctors around the world They are not good at curing poverty. we can claim. I testified before Congress. But just as an example, I moved my portfolio from extensive documentation on social factors that were worth documenting but couldn't change, to neuroscience.
And I was able to tolerate a lot of people being angry at me.
FM: A 1999 New York Times profile of you said you had “a remarkable habit of speaking your mind, even if what you had to say was unpopular.” Do you think that's a fair characterization?
Sehee: that's right. That can be a disadvantage in some cases and an advantage in others. people don't like it. But humans are sick, right? And this is the people's tax. That's what I kept saying.
We owe it to those who suffer from these diseases, and we also owe it to our taxpayers to do our best.
FM: You then took on another administrative position as president of Harvard University. You were in charge of academics at Harvard University and worked on several collaborative scientific initiatives. Can you tell me a little bit about what that was?
Sehee: One of the characteristics of Harvard University is that it is relatively decentralized. The problem, however, was that modern knowledge structures were not necessarily compatible with schools and faculties. Let's think about environmental policy. Because of the effects of climate change on agriculture and immigration, a lot of chemistry, engineering, economics, policy analysis, and indeed many other disciplines will be needed.
We have developed a program for this interfaculty initiative. The biggest person I negotiated with on the Harvard side was the Broad Institute. It was exactly Eric Lander's vision to bring together Harvard University, MIT, and Harvard Hospital to fulfill the promise that the genome can transform human health.
FM: On the topic of these types of collaborative initiatives, I think there's a sense at the moment that perhaps STEM fields are on the rise, while humanities fields are actually in decline. During your time as provost, what kind of work did you do to balance the interests of these different academic communities?
Sehee: I don't think I was able to do what I really wanted to do. What I did was support the humanities. I helped Homi J. Baba, former director of the Mahindra Humanities Center, raise funds, including a trip to India, to ensure the humanities are included in these important interfaculty efforts. Ta.
But what I really wanted was to develop a more substantive kind of collaboration. Because many problems cannot be solved by his STEM fields alone. Let's imagine that human performance could be increased through enhancement, through better drugs, amphetamines, and perhaps a little brain-computer interface. The question then becomes, what was the purpose of life in the first place? Is it to be as productive as possible until you collapse? Is there anything else I should be aware of? Answers can be found in history, literature, theater, and art. It's not in science textbooks.
How do we give moral status to animals and other things, not just humans? People will now be asking about AI — do some AIs deserve moral status? ?Again, this cannot be subdivided solely within STEM fields.?
It was not successful. Many humanists were worried that I might want to use them as a means to serve the needs of scientists dealing with these difficult problems. I think these are some of the most interesting and pressing issues we face. And indeed, we need humanists to help us think about these issues in compelling and deep ways.
FM: What keeps you going to classes?
Sehee: We think we understand things until an undergraduate asks us a difficult question. You can really keep learning. And that's not a throwaway statement. That's really true.
FM: If you had to give a lecture tomorrow on a non-academic topic of your choice, what would it be?
Sehee: What I do outside of school is traveling, cooking, and gardening. I often spend time with my family. I might be able to give an interesting lecture about my travels.
FM: What is your favorite place you have ever traveled to?
Sehee: I don't know if I have a favorite. I think it is very important to meet various people and have various experiences. I think what I like best is focusing on the differences and diversity of human cultures.
Because of my commitment to global genetics, I also travel frequently for work. I've been to Asia 3 times in the past 6 months. We have received a large grant from the NIH on the genetics of bipolar disorder. Although people of European descent make up 15 to 16 percent of the human population, perhaps even less, more than 90 percent of medical genetics and medical research is done on people of European descent.
Therefore, as the number of people we study increases, complex genetics requires very large cohorts, and we felt we needed to achieve that number by studying the world's population. .
We have completed large-scale studies on mental illness in Kenya, Uganda, Ethiopia and South Africa. One of Kenya's medical directors warned us in advance about something called a “safari study” where Americans or Europeans show up, take samples, disappear, write papers, and are never heard from again. . But, of course, they went on safari while in Africa.
Of course, the goal in this case is to learn about mental illness in the population as a whole, but also when we retire, the goal is for the people we trained and helped develop the infrastructure to continue doing advanced research that is not needed. It is to do. for us. That's why business travel is tiring, but very attractive.
FM: Are you continuing your research these days?
Sehee: The genetics and neurobiology of schizophrenia have advanced considerably, and we thought it was time to begin serious research on biomarkers.
Industry has abandoned new research in psychiatry as too difficult. That's why we live partially dependent on these drugs of the 1950s and their descendants. Without these biomarkers, they won't grow back. So we're involving the industry. And we're working with industry scientists to get them excited about the idea that schizophrenia and bipolar disorder can be targets for successful treatment development.
FM: How do you balance everything?
Sehee: I'm sure they dropped a lot of balls. People must be mad at me.
— Io Y. Gilman was Magazine Chairman of the 150th Guards. Contact her at io.gilman@thecrimson.com.
