Science in the Community

Female Hormone May Help Heal Brain Injuries

I’m just not sure what my reaction should be to this piece from Morning Edition on NPR. Dr. Art Kellerman has published a piece in the Annals of Emergency Medicine relaying results of an initial study into the use of the female hormone progesterone as an emergency treatment for brain injury patients. It appears that progesterone, being a steroid, acts as an anti-inflammatory and protects brain cells. This first round of testing has shown the results to be significant and promising. Obviously, this wonderful news for emergency medicine and for all of us who come to rely on it from time to time. To this point, there has been no really promising treatment for traumatic head injuries and they kill thousands every year.

The problem for me arises in the race and gender issues that Dr. Kellerman was forced to work through before he could consider carrying out his tests. It wasn’t enough to leave the decision to the families of victims; Kellerman felt compelled to turn to the community at large for permission. Why? In the Doctor’s words: “This is a female hormone being used to treat a condition that occurs primarily in men; men get hurt critically much more often than women do…what in the world are they doing at that hospital?” Saving lives? Isn’t that enough? Isn’t that what we ask them to do? To think that the fact that progesterone is a “female” hormone could have potentially prevented groundbreaking medical science from moving forward is disgusting to me. How are these gender stereotypes still so engrained in our collective psyche? Kellerman feared the community reaction. Will this treatment “feminize” these young men of our community? Is the implication here that it is better for these young men to be dead or maimed than to be “feminized?”

And then the racial angle…Because this study would be carried out in a trauma unit in a hospital that serves a predominantly black community the Tuskegee experiments had to be raised. We’re talking about good science done out in the open by respected researchers working with a respected university; should they feel the need to get political and community approval before conducting their research? “Well in the black community you just don’t mix male and female hormones,” said Rev. Timothy McDonald, when asked of his first reaction. This line is still drawn. He didn’t say he was worried of the reaction or worried of the consequences of giving progesterone to a male patient. He said “you just don’t” do it “in the black community.”

But then I have to ask myself, is my gut reaction the scary one? Do I sometimes give “good science” too much credit? Shouldn’t science that affects the lives of people have to answer to the community? I think, to a degree, it should. If science is striving to find explanations and answers to make the world a more livable place, it should take into consideration the culture, the community, the atmosphere in which the experiments are being conducted. Dr. Kellerman indeed made a bold move in asking permission first, as there was a good chance he would not get the answer he sought. But in making that move, he enlightened the community to the science behind what his ideas. He broke down some barriers and he made some new allies.

What do you all think? Should science have to answer to the community in this way? And if it should not, would you agree that it might be helpful if it chose to do so?