On the origin and prevention of PAIDS (Paralyzed Academic Investigator's Disease Syndrome).

In my Presidential address, I will depart from the traditional philosophical discourse. Instead, I will take this occasion to describe a newly recognized clinical syndrome. This devastating disease afflicts our brightest and most promising physician-scientists, crippling them just when they should be maturing into major investigators. The syndrome is called PAIDS-Paralyzed Academic Investigator's Disease Syndrome. The recognition of PAIDS, with its characteristic signs and symptoms, has come about as a result of my five years of service on the Council of this Society. Members ofthe ASCI Council have two duties-one pleasant and the other not so pleasant. The pleasant duty is to attend this meeting and to hear reports of exciting research with implications far beyond the boundaries ofmedicine. The Council's less pleasant duty is to review each year the careers of250 clinical investigators who have been nominated for membership. Selecting 80 members from this pool is difficult and often unsettling-for the Council as well as for the candidate. Having one's career reviewed by the ASCI Council is like having a mid-career checkup-only the sigmoidoscopy is omitted. Each candidate is examined in intimate detail. The following questions are always asked. 1) Is the science original or derivative? 2) Is the work designed to elucidate mechanisms or is it merely descriptive? 3) How independent is the investigator? 4) Is the candidate a committed scientist actively seeking new knowledge or is he or she writing papers simply to enhance an academic position? As a member of the Council for five years, I have examined the credentials ofmore than 1,000 physician-scientists who have come up for their mid-career checkups. Some of the candidates are exciting investigators of the type you've heard today. They are the "shoo-ins" for the Society. But there is another type of nominee who is much more troubling and all too common. These physicians are afflicted with PAIDS. Let me present a typical case report.