Prize Fight: “This Shameful Wrong Must Be Righted!”
On October 10, 2003, readers of the New York Times were startled to come across a full-page advertisement with this declaration trumpeted in big bold letters. As if any question of injustice remained, prominently pictured at the top of the advertisement was an upside-down prize medal with Alfred Nobel’s image. At issue was the announcement four days before by the Nobel Prize Academy that the award in physiology or medicine was going to Paul Lauterbur of the University of Illinois at Urbana – Champaign and Sir Peter Mansfield of the University of Nottingham in Britain. The $1.3 million – dollar award was given for their work that “led to the applications of magnetic resonance in medical imaging.” MRI (magnetic imagining resonance) by this time had become a household phrase.
However, it was Raymond Damadian who first envisioned NMR’s potential as an enormously valuable medical tool and attracted the attention of the medical community. Damadian’s claims are based on several of his seminal contributions: the original conception of using magnetic resonance (MR) for whole-body screenings of living humans; the fundamental discovery of MR differences among normal tissues and between normal and cancerous tissues, which provides the biological basis for MRI; and the construction of the first full-body human MRI machine, albeit using a crude scanning method.
The thirty-year dispute between Damadian and Lauterbur illuminates two men who in their similarities, differences, and self-contradictions embody the conflicts inherent in scientific discovery. How is credit established? By what measure is priority determined? Is scientific research as driven by elements of human character, particularly ego, as many other endeavors? Does scientific rivalry drive the development of a life-saving technology?
Written Out of History
The long controversy regarding the development of MRI, some felt, kept the Nobel committee from acting earlier. Lauterbur, 74, was in declining health, however, and the Nobel Prize cannot be awarded posthumously. If the contribution of MRI was to be acknowledged, as Richard Ernst urged it must be, the time had come.
For the past ten years, Damadian had been actively lobbying the Nobel committee, providing loose-leaf documents with letters of endorsement from eminent figures, including several Nobel laureates, and magazine articles and books detailing his contributions to the history of MRI. “Their decision,” he ruefully told me, “doesn’t occur accidentally at night. I heard they were thinking of giving the prize to the MRI and I wanted to be sure they understood that it was my idea.”
Most letters to the Nobel committee testified solely to Damadian’s discovery, but, interestingly, a few recommended that the prize should be shared by Damadian and Lauterbur and one went further to dispel any bias generated by Damadian’s conduct: “[Their] contributions are so interrelated that it would be an injustice to single one over the other. I also trust that Dr. Damadian’s . . . idiosyncrasies will not prove to be an obstacle, as many brilliant and productive scientists do sometimes exhibit unorthodox behavior.”
As a major step in averting “being written out of history,” Damadian supported, if not commissioned, an impressive 838-page volume on the history of the discovery and the development of NMR and its modern applications in medicine. The act can be viewed as one of either forceful initiative and resourcefulness or shameless self-promotion. The book profiles nine pioneering scientists from the fields of physics, chemistry, and medicine, including such luminaries as I. I. Rabi, Edward Purcell, Felix Bloch, and Richard Ernst. Unsurprisingly, Damadian shares a place in this pantheon as does Lauterbur.
In addition, during this time, two distinguished Swedish physicians involved with diagnostic imaging had visited Damadian separately: Hans Ringertz, a self-assured pediatric radiologist and scion of a distinguished family, and Bjorn Nordenstrom, a retired thoracic radiologist widely respected for his judgment. Were they on a mission from the Nobel committee? According to Damadian, they did not present themselves as the committee’s emissaries of the Nobel committee.
But his hopes were dashed in the early morning of the sixth of October. Aware of international time differences, the Nobel committee informs the winners by telephone before announcing them to the media. At 3:30 a.m. CDT Lauterbur’s phone in Illinois rang and he was prodded awake by his wife from a deep slumber with the words every researcher dreams of: “It’s Stockholm calling.” Damadian got no such call.
Two hours later, the Karolinska Institute announced to the world that Lauterbur and Mansfield had won the 2003 Nobel Prize in physiology or medicine, deemed the most coveted and celebrated honor of human achievement, “for their [seminal] discoveries concerning magnetic resonance imaging.” The wording, with its emphasis on imaging, was carefully chosen.
Alfred Nobel’s will allows up to three individuals to be honored and specifies only that the selection be for the discovery that has “conferred the greatest benefit on mankind.”
In the pre-dawn darkness in Long Island, Damadian logged on to the Internet, as he had done in recent years, and was, in his words, “in anguish. I thought: ‘No, I cannot live with this.’” It was like a knife in his heart to see not only that he had not been named but that the third position was simply left open. To Damadian as well as his supporters, the omission was clearly purposeful.