Who HASN’T gotten the Nobel Prize in Physiology or Medicine (and why)?

By Sheeva Azma

I’ve always been excited about the Nobel Prizes. To me, they have always been a celebration of scientific accomplishment and of humanity’s ability to understand themselves and the world better and achieve better living through science. However, I’ve only recently begun to understand the ways that toxic science culture has contributed to the lack of diversity among this highest echelon of scientists, and the damage this does to the broader public image of science.

Winning the Nobel Prize in Physiology or Medicine is a rare accomplishment in the life sciences. Yet, just as much as it celebrates science, it highlights the inherent problems of science culture.

I look forward to the Nobel Prizes every year, and always have

Alfred Nobel established the Nobel Prize in Physiology or Medicine in part due to his own interests in the life sciences. Though he was an engineer and inventor, he had an informal interest in physiology and even performed his own laboratory experiments.

I was always excited to learn about Nobel Prize winners growing up; it was possibly one of my earliest exposures to science and scientific achievement. As an undergrad at MIT, Nobel Prize week was especially exciting; our professors seemed to win it often. As a freshman, a few weeks into my studies, MIT celebrated Wolfgang Ketterle’s Nobel Prize in physics. A year later, Robert Horvitz’ won the 2002 Nobel Prize in Physiology or Medicine, and I attended his talk at MIT. 

With all the MIT Nobel Prize momentum in my college years, I assumed that some day one of the labs I worked in or professors and researchers who I’ve met over the years would get the Nobel Prize…but that hasn’t happened. 

In 2013, I left academic science due to circumstances out of my control. In those first few post-science days, I took my first steps into the world of freelance science writing. These days I’m an academic outsider, but my excitement about the Nobel Prizes hasn’t subsided. Actually, I added to my love of high prizes. Now, I also get excited for the Pulitzer Prizes – which have actually been awarded to some of my talented colleagues for their excellent pandemic science reporting!

Anyway, every year, in the first week of October, I hope that my former professors, research supervisors, and colleagues are on the list of Nobel Prize winners, and every year, it’s not the case. Maybe it’s not entirely bad, since I’ve also heard, informally, from my grad school colleagues that, when you win the Nobel Prize, that’s the end of your career – your research is no longer productive. Perhaps it’s because, as a Nobel Prize winner, you realize that you now have a global platform and can use your energies differently, as 2022 Chemistry Nobel Prize winner Carolyn Bertozzi (who shared the prize with two men) recently said.

I even met a Nobel Prize winning scientist, once

Indeed, judging by the one Nobel Prize winner in Physiology or Medicine that I have ever actually talked to, Nobel Prize winners seem to mellow out once they have received this prestigious honor. I was lucky to meet Stanley Prusiner, MD, as part of my grad school education at Georgetown. A few students organized a journal club discussing a couple of his papers, with him as our guest. 

Prusiner was in town for the Society for Neuroscience conference, which was in our home city of Washington, DC that year. He was pretty chill for someone who had literally won the Nobel Prize. He did not seem like the type of researcher that spent days and nights in the lab trying to make the next big discovery (but he was pretty old by the time I met him in 2008). By that time, his contributions to science were widely celebrated, so it was probably quite easy for him to continue his research, get grants and attract grad students and postdocs, and so on.

Prusiner won the prize in Physiology or Medicine in 1997 for his work discovering prion disease – the protein misfolding that comes about in diseases such as Mad Cow Disease. At the journal club, when I asked a question about the intricacies of protein misfolding, he replied that, if prion disease ever got cured, my question wouldn’t matter. I was stunned by his response – I had never been able to think about the big picture of disease in that way. Looking back, I wonder if he had ever wished that someone else would have been able to make advances in the field at the level that he had; while a cure for prion disease might have made his work irrelevant, it would have also been huge, as prion diseases are “usually rapidly progressive and always fatal,” as the Center for Disease Control and Prevention writes on their website.

After journal club, my colleagues and I made small talk with him in the elevator and we discovered that he shared my love of old school computers and what is now called retrogaming…to this day, that’s probably the only thing I really have in common with Nobel Prize winners, besides our love of science (and perhaps also of the Nobel Prizes).

The Nobel Prize is person-centric, but today’s science is team-centric

Do I think Dr. Prusiner shouldn’t have gotten the Nobel Prize? No way; he had a huge role in the discovery and understanding of prion diseases. It’s just that a Nobel Prize for one person doesn’t make sense the way science labs are run these days. Once someone is an established scientist, usually around age 50, postdoctoral fellows and grad students do all the actual research. So, they should at least get the credit, too. The way the Nobel Prizes are set up, though, a Nobel Prize in a given subject can only be awarded to three people at once. As a result, a lot of people who were instrumental to scientific discovery are never recognized. Postdoctoral fellow Devang Mehta, writing in Massive Science, suggests the Prizes move from a person-centric to a discovery-centric model, in which a scientific discovery, rather than specific people, are honored.

When celebrating science for science’s sake becomes a problem

Historically, recipients of the Nobel Prizes have been overwhelmingly white and male. Because the Nobel Prizes are one of the few ways the general public interacts with the scientific community, the Nobel Prizes’ diversity problem is actually a huge problem for science. As Mehta writes, “Nobel Prize-winning discoveries are often some of the most covered scientific advances in the popular press. However, they can only be offered to scientists working in a particular set of disciplines. As a result, most of the public – and more importantly, budding scientists – have a skewed view of what constitutes “important” science.”

What do I mean by this? The Nobel Prizes are amplifying science culture problems for the world stage. Maybe nobody realizes this or cares, but it matters a lot. For one thing, very few Nobel Prize winners look like me, even though I am a scientist. So, to every day people whose only exposure to science is from Nobel Prize news coverage on television, I don’t look like a scientist at all. Even worse, perhaps young people, including girls, discount their own science skills and knowledge and opt out of a science career because they don’t think they have what it takes.

The Nobel Prizes have historically excluded women and other marginalized scientists on the world stage. This reinforces harmful “who looks like a scientist” stereotypes that undermine the relationship between science and society.

Nobel Prizes don’t always go to the right people

It’s important to recognize everyone who made a given discovery in the Nobel Prizes. Just take the discovery of DNA, for instance. Rosalind Franklin, a woman scientist who developed the x-ray crystallography method used to image DNA for the first time, was left off the 1962 Nobel Prize in Physiology or Medicine. Instead, it went to three male scientists: Francis Crick; the now notorious James Watson; and Maurice Wilkins. Watson has a long history of being racist and sexist. In 2003, he apparently was quoted as saying: “People say it would be terrible if we made all girls pretty…I think it would be great.”

WTF? I can’t imagine what it was like to attend lab meetings with James Watson as a woman in science. As a woman in STEM, given the choice to work in Watson’s lab, I definitely would not…even though, since he is a Nobel Prize winner, it would be huge for my career.

Being a scientist in a world that tells you you don’t look like a scientist is hard, but it’s even harder to tolerate harassment and abuse, feeling invisible in your field, and facing endless barriers to success.

Here’s the dilemma: because science culture is broken and unequal, only the most privileged can succeed, which just makes the problem worse. For example, PhD students who are most likely to get a science and engineering doctorate are those whose parents have achieved advanced degrees, according to the National Science Foundation. The Nobel Prize winners, mostly white men, are the people we see succeed in science as a society. This tells society that those are the only people that can be good scientists, which is obviously false. I’m happy for Nobel Prize winners and proud of them for advancing science, but I think we can do better.

.@SheevaAzma: “Science culture is broken and unequal, [so] only the most privileged can succeed, which just makes the problem worse…I’m happy for Nobel Prize winners and proud of them for advancing science, but I think we can do better.”

The Nobel Prizes reinforce sexist stereotypes

Women in science constantly have to prove themselves, deal with isolation in science, and navigate the academic world to avoid toxic principal investigators (PIs) and collaborators. If they’re lucky, these women’s local institutional “whisper network” can help them know which PIs are toxic and mean (like James Watson), and opt to work with the PIs who are cool to work with. It all takes a toll: on women’s mental health, their careers, and so much more. That’s part of the reason I left academic science.

It’s no secret that women are cited less often than men. According to Nature, Women are credited for their contributions far less often, across all scientific fields and stages. Some women scientists have gone so far as to call citations and impact factors a “sexist and racist” metric by which to judge scientific quality. In academia’s “publish or perish” culture, fewer citations of your work means fewer grants, less funding, and fewer opportunities to do science.

While science culture has a long way to go to become equitable, I see small progress more and more lately. The firing of Eric Lander from the White House Office of Science and Technology Policy, and his replacement with sociologist Alondra Nelson and former National Institutes of Health director Francis Collins exemplifies a culture shift in science. The scientific community is slowly moving away from blindly celebrating people’s scientific accomplishments and finally holding scientists accountable for their sexist and racist behavior.

Still, badly behaving scientists can leave an institution where they’ve been called out for their behavior, and set up shop somewhere else. I have definitely heard some sexism horror stories from fellow women in science.

Women and minorities are historically overlooked for the Nobel Prize in Physiology or Medicine

The Nobel Prizes were established in 1901, but the first woman to win a Nobel Prize in Physiology or Medicine was in 1947. That was the year Gerty Cori won it with her husband Carl together with Bernardo Houssay for figuring out how carbohydrates are metabolized in the body, which was an important step forward in diabetes research.

photo of gerty cori, first woman to win the nobel prize in physiology or medicine
Gerty Cori was the first woman to win the Nobel Prize in Physiology or Medicine in 1947. She shared it with her husband and another male scientist. Image credit: Wikipedia

While women have more often won the Nobel Prize in Chemistry – with Jennifer Doudna and Emmanuelle Charpentier winning for CRISPR/CAS9, a form of “cut and paste” gene editing, in 2020 – that’s not the case for the Physiology or Medicine prize category. Also, as we’ve previously blogged, racism is a problem for the Nobel Prizes: no Black scientist has ever won a Nobel Prize in Physiology or Medicine – ever, and only seven Asian people have ever won (all men), according to Wikipedia.

Are a diverse group of scientists being nominated for the Nobel Prize but not making it to the final round? Well, there’s no actual data

Being a scientist myself, I actually tried to explore the Nobel Prizes’ diversity problem further by looking into who has been nominated over the years. My optimistic hypothesis was that maybe a more diverse group of scientists are being nominated, but are not making it to the limelight. I did not have much success testing this hypothesis, and looking at the facts on who faces barriers in pursuing science, it makes less sense in retrospect. Demographic information is not widely available for Nobel Prize nominees, and per the Nobel Prize’s guidelines, nominee information is kept secret for 50 years after nomination. As of this writing, it is 2022, and so Nobel Prize nominee information is not available after 1972.

For years, I saw the fact that I didn’t know any Nobel Prize winners in my circle as a reflection of the quality of my science. That was before the #MeToo and #BlackLivesMatter social movements that exposed racism, sexism, and other -isms in the world, and before we scientists started to pay attention to the sociological aspects of what we do every day.

Even beyond the social aspect of toxic science culture, there’s the fact that most science is performed by postdocs and grad students who are overworked and underpaid. It’s entirely normal for a postdoc to work 12 hour days and make relatively little money; last I heard, in science, most people do two (or more) postdocs before they embark on their search for a faculty job. Why are we giving the Nobel Prize to the people who are possibly just good at making this abusive system work for them, who are themselves also a product of this toxic culture?

Improving science culture starts from the top

The fact that sexism and racism is implicitly rewarded by the highest honor in science is a barrier for advancing science. It makes us think that making scientific discoveries trumps being a good person. At the same time, the Nobel Prizes tell society that huge scientific discoveries can only be made by a certain type of person who has not faced structural barriers to success, a person who has, since the Nobel Prizes were founded, usually been a white, male scientist. That’s terrible for science and the next generation of scientists. It makes people think that science is not something that everyone can do. Worse, it makes scientists look unrelatable, eroding public trust in science.

We are more likely to understand and empathize with people who have had similar life experiences as us; maybe we’d be more willing to listen to scientists here in the US if they looked more like us. That’s just on the level of public perception of science, but the discoveries themselves would be more inclusive and useful to the whole society as well. Right now, most clinical trials are 95% white and heavily male, for example. Is it because males are seen as the default scientists? Women’s health is not well-studied in science because the male gender is often the ‘default’ in science research studies.

Let’s consider this problem another way: would you trust a poverty researcher who grew up rich and never experienced being poor to understand the true challenges and nuances of the impacts of poverty?

The lack of people from diverse backgrounds in science, especially at the highest levels, is actually hurting the quality of the science because important perspectives have been excluded before any of the work has happened.

The result is a toxic culture that, more and more, women are opting out of. Women leave because they keep facing barriers, and taking their insightful research questions with them. This is bad for science and bad for science culture. Think of all the women and other marginalized scientists who have left science because they could get paid more elsewhere and were tired of dealing with the every day crap in science. If these people hadn’t been forced out, science would have advanced so much more and the culture would be a lot more inclusive.

Science is shaped by the people who perform it, and the truth is that anyone can do science and even make huge discoveries.

The culture problems showcased by the Nobel Prizes are just the issues we know about in science, elevated to a world stage. Science doesn’t happen in a vacuum, and toxic scientists should not be awarded with grants and high-profile papers if they spend their time ruining other people’s careers and lives. Science is shaped by the people who perform it. If we want to do better science, that starts with making sure everyone has the keys to success.

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