Monoclonal Antibodies to Migraine: Witnesses to Modern Biomedicine, an A–Z

263 Pages·2017·3.49 MB·English

WITNESSES TO MODERN BIOMEDICINE, AN A–Z

Edited by E M Jones and E M Tansey
Volume 50 2014
©The Trustee of the Wellcome Trust, London, 2014
First published by Queen Mary, University of London, 2014
The History of Modern Biomedicine Research Group is funded by the Wellcome Trust, which is
a registered charity, no. 210183.
ISBN 978 0 90223 895 4
All volumes are freely available online at www.history.qmul.ac.uk/research/modbiomed/
wellcome_witnesses/
Please cite as: Jones E M, Tansey E M. (eds) (2014) Monoclonal Antibodies to Migraine: Witnesses to
Modern Biomedicine, an A–Z. Wellcome Witnesses to Contemporary Medicine, vol. 50. London:
Queen Mary, University of London.
CONTENTS
Acknowledgements
E M Tansey and E M Jones v
Foreword
Sir Mark Walport vii
Introduction
E M Tansey ix
Titles of Witness Seminar volumes xvii
Dramatis personae xxi
Abbreviations xxxvii
Monoclonal Antibodies to Migraine:
Witnesses to Modern Biomedicine, an A–Z 1
Index 185
Illustration credits 215
Witness Seminars: Meetings and publications 218
iii
This volume is dedicated to Dr Peter Williams CBE (1925–2014),
first Director of the Wellcome Trust, 1965 to 1991.
ACKNOWLEDGEMENTS
Extracts from the Witness Seminar volumes have been suggested by many
people in addition to the editors. In particular, we would like to thank Dr Julie
Hartley, Ms Caroline Overy, Dr Tom Quick, Mrs Lois Reynolds, Mr Adam
Wilkinson and Mr Alan Yabsley for their input. Additionally, Dr John Ford,
Professor David Gordon, Professor Richard Himsworth and Mrs Lois Reynolds
have advised and commented on the final selection.
This volume would also not have been possible without the work of the former
members of the History of Modern Biomedicine Group over some twenty-
one years: Professor Sir Christopher Booth (co-founder, with Tilli Tansey);
Dr Daphne Christie; Ms Stephania Crowther; Mrs Wendy Kutner and Ms Sonia
Willhoft.
For the photographic portraits, we are most grateful to the Wellcome Trust’s
photographers over the years, and to the staff at Wellcome Images. We also
thank the contributors who have provided additional illustrative material for
our volumes.
Thanks are also due to Mr Akio Morishima for the design of this volume; the
indexer Ms Liza Furnival; and Mrs Sarah Beanland and Ms Fiona Plowman for
proof reading.
As ever, we are most grateful to the Wellcome Trust for financially supporting
this programme. The first Director of the Wellcome Trust, Dr Peter Williams,
was closely associated with the creation of the History of Modern Biomedicine
Research Group, and attended and contributed to several early Witness Seminars.
Sir Mark Walport, Director 2003 to 2013, was equally enthusiastic and often
contributed directly, as his generous foreword makes clear.
Finally, we thank all those who have participated in our meetings over the years,
whether or not their words are included in this volume.
Tilli Tansey
Emma M Jones
School of History, Queen Mary, University of London
v

FOREWORD
Governments around the world obsess about how they can ensure that basic
research is turned into human benefit. And governments do what governments
can do, which is to provide catalysis through funding, tax breaks and a policy
environment that facilitates rather than hinders innovation. But if you really
want to discover how to innovate, read this volume, published in the 21st
anniversary year of the first Witness Seminar on monoclonal antibodies.
This is a master class on how to innovate in medicine. It is people who innovate
and it is the people who scintillate in this extraordinary anthology. Their values and
personalities come to the fore: humane, free-thinking, always wanting to try new
things, to innovate. Their personality traits are also apparent, a cast of individualists
and eccentrics, stubborn and cussedly single-minded, accompanied by a strong
common denominator of caring and humane compassion. The vignette on cystic
fibrosis reminded me of six months as John Batten’s SHO in the adult cystic fibrosis
unit at the Brompton – an extraordinary clinician leading an equally extraordinary
team. The Witness Seminar on cystic fibrosis reminds us that the substantially
increased survival of people with cystic fibrosis is due to the dedication of John Batten
and his counterparts around the world. The innate curiosity of clinical scientists
shines through the vignettes; being both clinician scientist and naturalist is a common
association, for example Cyril Clarke, Estlin Waters and Christopher Andrewes.
This volume also acts as a reminder of what it means to be professional – to be
scholarly and rigorous in rooting out and applying evidence, to apply judgement
in clinical decision making, to be prepared to innovate, and to be responsible and
accountable for decisions. I was transported in an instant to the Royal Postgraduate
Medical School of my youth – and to many of the characters who passed through its
doors. It also reminds us how values, ethics and innovation are intertwined. There
are examples from intensive care and leukaemia and from the deliberations of the
London Medical Group and from innovators in public health and population studies.
I have always enjoyed the Witness Seminars – the witnesses are alive and their
recollections vivid. They are always entertaining, not least because the participants
sometimes disagree or have different recollections of the same events! Like all the
best anthologies, this is full of gripping vignettes and stories. It should be read by
all inquisitive doctors, which should give it a large circulation, since all doctors
should be inquisitive.
Sir Mark Walport, Government Chief Scientific Adviser, UK
vii

INTRODUCTION*
Dr Georges Köhler,
Sir Christopher
Booth, Dr César
Milstein (left to
right) at the first
Witness Seminar on
Monoclonal Antibodies,
1993
In September 1993 the Wellcome Trust’s History of 20th Twentieth Century
Medicine Group held its first Witness Seminar on the topic of monoclonal
antibodies, for which the main witnesses, César Milstein and Georges Köhler,
had shared the 1984 Nobel Prize in Physiology or Medicine. Our intention was
to use the occasion to examine the events behind the headlines and accolades; to
explore what did or didn’t happen; identify who were the influential players (not
always synonymous with the best-known names); and to hear the voices and
perspectives of a wide group of people who were ‘there at the time’ in different
capacities. The success of that meeting, as assessed by the frankness of the
participants on the day and their ready and enthusiastic engagement with the
subsequent editorial and archival processes, compounded by several requests for
copies of the edited transcript, encouraged us to develop a modest programme of
four further meetings to record and reflect on recent biomedical history.
Fast forward 21 years and we have now organized in excess of 60 Witness
Seminars attended by more than 1400 people, and have advised several other
groups and individuals on developing similar programmes. We have edited
and published 58 transcripts of those meetings, most, but not all, in the freely
* Page numbers refer to this volume; volume titles refer to the published Witness Seminars (see
pages xvii–xx, 218–21 for full lists)
ix
available series now entitled ‘Wellcome Witnesses to Contemporary Medicine’.
The 49th volume in that series, Migraine: Diagnosis, treatment and understanding
c.1960–2010, appeared recently.
Some volume titles may seem obscure, even off-putting, to the non-specialist
reader. For example, The Discovery, Use and Impact of Platinum Salts as
Chemotherapy Agents for Cancer and Population-based Research in South Wales:
The MRC Pneumoconiosis Research Unit and the MRC Epidemiology Unit do not
immediately suggest the range and depth of human interest stories they actually
contain. Thus, as we approached our 50th volume we decided to collect together
edited ‘highlights’ taken from all the volumes, to illustrate the diversity and richness
of many individual experiences of, and contributions to, recent biomedicine. The
main objective of the Witness Seminar programme has always been to hear and
record the authentic voices of our contributors; for this anniversary volume we
want to introduce some of those less well-known voices to fresh audiences.
Selection and editing
Several people listed in the acknowledgements were involved in selecting suitable
extracts. Some selectors read only one or two volumes; others read rather more;
and between us the two editors have read, or re-read, all the volumes. There were
no restrictive criteria – all were invited to select extracts that intrigued or amused
them; that seemed representative of a theme, specialty, or period; or conversely,
something that was unique. Consequently, these stories and snippets vary widely
– some quirky, some moving, some amusing, some thought-provoking. We have
not imposed a word length – some are short and pithy, one or two are rather
more expansive.
Our first selection of extracts was over 500 pages long, and we have gradually
refined, reduced, and edited our choices to produce a more manageable volume.
For each extract, repetitions and discursive material have been removed, and
sometimes sentences have been run together from adjacent paragraphs or pages
to provide a continuous narrative. Dates or other explanatory material have been
added where appropriate. Strictly speaking therefore, few of these extracts are
verbatim quotes, and in the interests of readability we have intentionally avoided
the large-scale use of ellipses, parentheses, and footnotes to identify our editorial
work. For those who do want to read the unexpurgated text, each extract is
carefully referenced to the original publication. Where absolutely necessary,
editorial introductions have been added to a few extracts.
We hope that enough introductory or editorial material has been provided
to make each extract understandable, even if some of the precise technical
x