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In the second episode of the second season of the “Saturdays at Seven” conversation series, Todd Ream talks with Francis S. Collins, physician-scientist and former director of the National Institutes of Health (NIH). Collins begins by describing the day in November 2020, when he and his colleagues at the NIH unblinded the data related to the clinical trial for the COVID-19 vaccine and found its efficacy rate was 94.5%. In addition to describing his response and the responses of his colleagues to what was an unprecedented success, Collins offers details concerning previous scientific achievements upon which he and his colleagues depended when making such a successful vaccine in such a short period of time. Ream then asks Collins to step back and describe how he came to embrace serving as a physician-scientist as his vocation. While Collins was fortunate to work with several mentors while a medical student, a doctoral student, and an undergraduate, he offers the greatest credit to a high school teacher, Mr. House, who introduced Collins to scientific research as being comparable to being a detective. Collins describes his hopes for his most recent book, The Road to Wisdom, and his desire for people to come together during such a polarized season. Collins then closes by describing his work with operatic-soprano Renée Fleming and how the relationship shared by music and science enhances human health and flourishing.
- Francis S. Collins’s The Road to Wisdom: On Truth, Science, Faith, and Trust (Little, Brown, & Company, 2024)
- Renée Fleming’s (Editor) (Foreword by Francis S. Collins) Music and Mind: Harnessing the Arts for Health and Wellness (Viking, 2024)
- Franics S. Collins’s The Language of God: A Scientist Presents Evidence for Belief (Free Press, 2006)
- Thomas D. Gelehrter, Franics S. Collins, and Divid Ginsburg’s Principles of Medical Genetics (Williams & Wilkins, 1990)
Todd Ream: Welcome to Saturdays at Seven, Christian Scholar’s Review’s conversation series with thought leaders about the academic vocation and the relationship that vocation shares with the Church. My name is Todd Ream. I have the privilege of serving as the publisher for Christian Scholar’s Review and as the host for Saturdays at Seven. I also have the privilege of serving on the faculty and the administration at Indiana Wesleyan University.
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Our guest is Francis S. Collins, physician-scientist and former director of the National Institutes of Health. Thank you for joining us.
Francis Collins: I’m glad to join you today on Saturdays at Seven.
Todd Ream: I’d like to ask you to revisit a day in November 2020. You and your colleagues at the National Institutes of Health had just unblinded the data and found according to the Food and Drug Administration briefing that was dated December 17th, 2020, that quote, “Efficacy in preventing confirmed COVID-19 occurring at least 14 days after the second dose of the vaccine was 94.5%.” End quote, which I’ll note here too, 94.5% was not in italics, was not in bold, was not underlined. It was just a detail that went by as all the other details did. But I want to ask you, if you would, to please describe your immediate reaction to the data that you and your colleagues encountered on that day.
Francis Collins: That was a day I shall never forget. I had prayed about this. I had stayed up more hours than I could count that whole year of 2020 trying to be sure the vaccine design and the vaccine trials were as rigorously achieved as possible and hoped that maybe we’d end up with efficacy as good as maybe 50 or 60 percent, which would be pretty good for most vaccines. And when the unblinding of the data happened, it was 94. 5%. I cried. I didn’t know what else to do. I cried. I gave thanks. I was supposed to say something to the assembled groups and I was too choked up to talk for a while.
It was such an astounding moment of seeing how this remarkable team of people everywhere from NIH and our Vaccine Research Center to the companies that got engaged right away, Moderna, Pfizer-BioNTech, to the people who ran those trials, each of which had to involve at least 30,000 volunteers, and especially those volunteers who agreed to sign up for this, a highly diverse group to make sure that this vaccine had some promise, with no promise that it would. And then to have this finding.
And also essentially no safety signals that we worried about at that point at all, everything looked really safe and highly effective and I felt like this might be the greatest achievement of science to assist humanity, maybe ever. To have in 11 months, the development of a vaccine with this kind of safety and efficacy had never been achieved, not even close before. And there it was.
Todd Ream: Thank you. Would you please describe the immediate reactions of your colleagues with whom you were sharing time on that day when you unblinded the data?
Francis Collins: I think everybody shared the same sense of amazement, of awe, and of gratitude that it had turned out this way. I had spent many hours with Tony Fauci, who was reporting to me during that whole year of 2020 and the infectious disease expert of probably the greatest reputation in the world.
And we had talked about what would be a good outcome. And I would say, well, you know, I’m hoping for 60%. And he would say, well, I’m going to hope for 70. And then we would both say, but remember, most vaccines fail so got to be prepared for the fact that something’s really wrong here. It didn’t work or there was a bad safety problem.
So Tony was also over the moon, like although he’s a very restrained person, he was still completely just carried away with what this could mean. And that was true for the whole team. I mean, the people that worked on this was the year with no sleep. This was 24/7, hundreds of people dropping everything to make this happen. And we all shared that moment of celebration and relief.
Todd Ream: Thank you. As you noted just a few seconds ago, that day came less than 11 months after initial reports began to surface that a virus of the likes of which we’d not experienced at least in our lifetimes was beginning to circulate. Would you please describe, at least, as you’ve sort of started to do so, the nature of the scientific efforts that took place leading up to that day, the magnitude and the scale and the scope of them?
Francis Collins: In the last couple of days of 2019, we were hearing stories that something was really wrong in Wuhan, China. The Chinese were not particularly forthcoming about it, so we weren’t quite sure, but they were certainly acting as if there was a serious risk to millions of people.
On January 10th, 2020, the genome sequence of the responsible virus was posted on the internet. You could look in a moment and see this was a coronavirus. It was not influenza, which is maybe what many people would have predicted was going to be the next pandemic. It was a coronavirus. And of course, we knew something about coronaviruses because SARS, 20 years earlier, that was a coronavirus and MERS around 2015, also a coronavirus, and both of those were pretty scary, but they never broke out into a full blown pandemic.
People at the Vaccine Research Center at NIH had been working on coronaviruses because of that, and they swung into gear in less than a day, to basically design the first mRNA vaccine, based upon everything they knew about how to do this. mRNA vaccines had also been studied for 25 years, but had never previously been brought all the way forward to a human vaccine.
But because it had the ability to move so quickly, we didn’t have access to the virus at that point. We just had the letters of its code, but that was enough to be able to design and then synthesize the mRNA that was going to be the first effort to see if we could raise an immune response.
Within 63 days after a lot of testing in mice, it was time to try this in the first phase one trial. And that is an astoundingly short period of time. And so a few volunteers signed up for that, got the immunization and then tested them afterwards to see, did they raise antibodies to this virus or to its spike protein, which is what the mRNA was designed to produce. And they did.
So then it was on in an unprecedented speed with support financially from Operation Warp Speed to try to scale this as quickly as possible. I had the opportunity to convene a group of industry, of FDA, of academics, and of NIH, and design the master protocol that would be necessary to be sure that if we were going to test these vaccines in large scale, that it was done as rigorously as possible so we could really believe the results.
And by July, that very large scale trial was getting underway. But again, had to be blinded, had to be randomized. Even the people getting the shot didn’t know if they were getting the vaccine or the dummy control. The people administering it didn’t know either. That is the way you have to do this if you’re going to be absolutely confident that what you see is a result of the vaccine and not some other random events.
And then you wait, because you wait to see with the virus still running around a lot around the world and certainly here in the U.S. in the fall of 2020, who gets sick and who doesn’t and how sick do they get? And then that night came in November, where the unblinding happened and that 95 percent was against serious illness and it was almost 100 percent against hospitalization and death, which was astounding.
Todd Ream: Thank you. Well, as someone who benefited and someone whose family benefited from the vaccine I’ll just say thank you and extend my appreciation in that way. You’ve echoed this detail here, but if I may ask, upon what previous scientific advances were you and your colleagues most dependent when working through this, and perhaps also most grateful?
Francis Collins: Oh, a lot. And of course the whole science of vaccinology has been around for decades, even centuries. Let’s go back to, to smallpox and Edward Jenner, where you recognize that there’s a way to prime the immune system to be ready to take on other, an otherwise dangerous pathogen.
The mRNA approach, which turned out to be just critical for success. We all owe, I think, a debt of gratitude to two scientists at the University of Pennsylvania, Katalin Karikó and Drew Weissman, who pursued this approach when many others thought it just wasn’t going to work and doggedly kept trying this and trying that.
The problem was mRNA tended to be rapidly degraded as soon as it got into a cell in the body. It was like, oh, we don’t want this here. So they had to figure out how to modify it so that it was resistant to degradation long enough to be able to get translated into a protein, the spike protein, which could then raise the immune response. And that was hard slog work that just required a great deal of patience and persistence.
And then many thanks to people who built on that, tried it. And I again, have to say, particularly our own vaccine research center, Barney Graham and Kizzmekia Corbett working there almost immediately after the finding of the sequence pointed to a coronavirus were major players in figuring out how to turn this into a successful vaccine with some little twists and turns that most people haven’t heard about, which probably were critical for its success.
Todd Ream: Thank you. As a scientist, and in some ways you’ve already also echoed these details here too, but would you please describe how you interpret the significance of that day in November?
Francis Collins: Well, remember what it was like in 2020? Oh my gosh. Some of us, I think, are not so good at retaining memories that are just so frightening and terrible, but let’s force ourselves to think back by the spring of 2020, April and May. Remember those trucks that were pulling up outside hospitals because there were too many dead bodies for the morgue? The ICUs that were overflowing the emergency rooms full of people coughing and dying.
We don’t like to think about that, but that was the reality. And then there’s a big push to say we have to do something here to flatten the curve so at least we can spread out the infection so the hospitals don’t go under, which is why a lot of draconian measures had to be put in place in terms of closures. Things that people now resent as if, well, that was overreaching. I don’t think it was at that point to try to keep our healthcare system to be able to still help people.
And that went on during the summer. And then in the fall, there was another big push of additional infections. So by November, the desperation we all felt for something to try to help people was extreme. And to have this outcome seemed like, yes, an answer to prayer and a scientific achievement that was going to get us somehow past one of the darkest years that our world had seen in a century.
So yeah, one felt this sense of optimism finally. That we have something that’s going to help, and particularly so because Operation Warp Speed, knowing that there was going to be a possibility of success, not at all a certainty, had agreed to up the manufacturing process even before knowing the vaccine was going to work. Let’s not end up with a six or nine month delay while we try to figure out how to make these things at scale.
So within weeks, remember those trucks rolling out of the parking lot in Michigan with the Pfizer-BioNTech mRNA and the whole country cheering? And by January, February, March, vaccines becoming available by May of 2021, pretty much anybody who wanted the vaccine could get access to it for free. And I thought, we’re going to be okay.
Todd Ream: Which had to have been a great relief then.
Francis Collins: It was, although as we’ll come to, that relief got tempered as it became more clear that not everybody accepted this as the answer they were looking for. And a lot of tragic things happened as a result.
Todd Ream: As a Christian, would you please also unpack for us, how you interpret the significance of that day in November, and in what ways is it connected to your response that you just detailed as a scientist?
Francis Collins: I am a Christian. I have been so since age 27. I was not raised that way and I was an atheist in graduate school and then became a Christian in medical school. And so I see God’s hand in a lot of what we see around us and the beauties and awesomeness of creation. And I certainly find for myself that prayer is an opportunity to try to learn more about what God’s plan is for me.
And I prayed earnestly during that entire incredibly wrenching year of 2020 as so many people were dying around us for some kind of help from God and from science together, because I think God answers prayer through human action. And so I prayed for the scientists that were working on this so intensively, prayed for myself that I would not make bad decisions because you had this feeling every day that everything is hanging in the balance of whether you’ve done something that might cost another month and therefore, cost a lot of lives.
All that prayer surrounding this project, at least for me, then coming to that night in November and to have the prayers answered. It was just an astounding moment. And again, this sort of interesting mix of being incredibly grateful for the scientists who’d done all this work, but even more grateful to God who somehow made it possible.
Todd Ream: Thank you. I want to ask you now about the development of your calling as a scientist, and also then, you know, how it intersects more with your faith. You grew up in Staunton, Virginia, and earned an undergraduate degree in chemistry from the University of Virginia, a PhD in chemistry from Yale University, and then an MD from the University of North Carolina, which I have to say, as someone who spent a considerable amount of time in Durham, I’m glad to know that people come to Christ in Chapel Hill, North Carolina.
Francis Collins: Surprised you, did it?
Todd Ream: Yeah, I’m glad you got the sarcasm on that one. But at what point did science begin to captivate your interest and what individuals, if any, had the greatest impact on how you came to understand your vocation as a physician-scientist?
Francis Collins: Well, as you’ve just outlined, I did not travel a linear pathway.
Todd Ream: But your parents were very proud, I’m sure, nonetheless. That’s quite an education.
Francis Collins: And it went on a long time. My parents taught me at home until the 6th grade. I grew up on this farm outside of Staunton and I was the youngest of four boys. My parents were educators. They had met at Yale in graduate school in 1931. And had done a lot of interesting things until I came along, at the last moment of their deciding, oh yeah, let’s have one more kid.
And so they were gifted in teaching me the joy of learning but they were not scientists or even particularly well versed in science. My dad was a college professor who taught drama. My mother was a playwright. My dad had also been a folk song collector, so my life growing up as a kid was surrounded by theater and music and arts and literature, science not so much.
But then we moved in town because my grandmother had a stroke and needed somebody to be in the house with her and my parents. I think, you know, at that point, like, okay, we’ve done the homeschooling thing. Let’s let this one go to public school and see how that goes. And it was perfect because it was a pretty good public school.
And my moment of realizing science was calling to me was 10th grade, in a chemistry class, by a very gifted teacher named John House, who taught us almost from the first day that science is a detective story. This isn’t stuff where you memorize a lot of things that you don’t really care about. This is like trying to figure out how things work. And so you have various scientific tools and you do experiments and then you assess the results and you discover stuff.
And why wouldn’t you want to do that for the rest of your life? Cause it is so inspiring. Yeah, sure. It’s frustrating. And sometimes your experiments fail and sometimes you think you have the answer and then your hypothesis blows up, but there is truth there. Science is about finding truth about how nature works. And if you do it right, you’re going to discover that. So, I was sold.
And because it was a chemistry class, I figured, okay, that means I’m supposed to be a chemist, which is why I majored in chemistry at the University of Virginia. And it’s why I went off to Yale to get a PhD in physical chemistry. And I loved all that, but I had narrowed my horizons very sharply early on and ignored life science because it just seemed kind of messy. And it didn’t seem to have the same satisfying sort of mathematical principles undergirding it that I saw in chemistry and physics.
But I found out as a graduate student, I had missed out on biology that actually did have fascinating undergirded principles like DNA and the information molecule of all living things, sort of a wonderful digital way of transferring information between generations and across evolutionary time. It’s like, oh wow, how did I miss this? This is so fantastically interesting. And it also feels like it’s at a point in history where a lot of exciting things are going to happen. And maybe I want to be part of that too.
So I had this crisis at that point. I’m already on this path towards being an academic physical chemist. And now I decide maybe that’s not what I want to do after all. After a lot of internal debate, I decided to make a really big leap and go to medical school, which must have surprised the admission committee at UNC when I explained that this was a rather recent realization, but somehow they bought it and they let me in. And then I loved it. The guy who hated to memorize stuff turned out, if it was about the human body, it was actually pretty interesting, and I didn’t mind that.
But then I did discover that this hope that I had, that somehow the digital part of my dreams with find an intersection with medicine, they did, and it was in the field of genetics. And genetics that are going to have a role in people’s health and disease. This is like putting it all together for me.
Todd Ream: Well, while they may have been surprised by your application, I’m guessing they are grateful for choosing to admit you then and bringing to Chapel Hill.
Francis Collins: Oh, you could ask them. I think they are, yeah. I think it turned out alright.
And meanwhile, my faith journey also happened rather dramatically in the course of medical school. I entered as an atheist because I’d not really had any training in religion and I was skeptical and kind of liked the idea of not having to be responsible to anybody except me.
But in medical school, seeing what happens to good honorable people who are stricken by diseases and watching how they handled that, I thought of myself in those roles and thought I wouldn’t know what to do. And seeing the patients who had a deep faith in God and how that brought them a whole lot more peace and reassurance than our medical assistance was offering really made me curious.
And at one point, one of my patients challenged me to tell her what I believed about this after she had shared her faith and I realized I had no answer. I hadn’t given really any significant time to the most important question that any of us are ever asked. What do you believe? And I had to work on that. And over a two year period, sort of trying to understand why do believers believe, discovering that there are pointers to God actually from science, like the Big Bang and the fine tuning of the universe and the moral law, ultimately came to the point of realizing atheism was the least appealing of all the options. Agnosticism seemed, sort of like a cop out, not really trying to make a decision.
And Jesus emerged as an answer to so many of the problems I was having about how do I approach God? How do I know what God is about? How does a holy God deal with unholy Francis Collins? And I thought Jesus was a myth when I was growing up because I didn’t know any theology and to discover this was a historical figure, who had not only been a great teacher but also claimed to be the Son of God, who was crucified, and who literally rose from the dead, required a response.
And I fought with that for a while because I didn’t expect that to be the answer. And then the moment came where I couldn’t fight anymore. I didn’t want to fight anymore. I, you know, went on a hike in the Northwest of the United States and the Cascades. Natural beauty has a nice way of clearing your head from a lot of distractions. And I felt I’m ready. And I knelt in the dewy grass and became a Christian in my 27th year.
Todd Ream: Yeah. It’s a beautiful story and how grace can begin to find its way through a patient’s question. That’s significant. Thank you for sharing that.
When you were serving as a faculty member at the University of Michigan, which is where you went next, what experiences contributed to your mounting expertise and interest in human genetics? Perhaps the space and place where that chemistry and that biology intersect.
Francis Collins: I had started to get interested in human genetics as a medical student. Went all the way through four years of medical school and four years of internal medicine training, then off to do a fellowship back at Yale again to try to learn the science of molecular biology and molecular genetics, which I was really pretty unprepared for but gradually began to catch on.
And then ultimately got a faculty position at Michigan and had to decide, okay, what are you gonna work on? And I’ve always had this desire to tackle a problem which I have seen in a patient in the clinic that nobody seems to have an answer to and maybe again going back to that 10th grade chemistry class of science is a detective story. I want to be a detective for that story.
And one of the diseases that I felt so drawn to was cystic fibrosis, relatively common, affecting tens of thousands of people in the U.S. then and now, and a just dreadful disease for the kids who at that point really didn’t have much except a lot of chest physical therapy and some increasingly toxic antibiotics to try to keep them alive when their lungs were just filling up with this terribly infected set of secretions, which was the main part of cystic fibrosis that took people’s lives. And in the 1980s, when I started working on this, the average survival was only about age 15 or 16. And I saw a lot of those kids in the clinic. And it was heartbreaking, and you just wanted to do something.
We knew it was a genetic disease. We knew it was inherited in what’s called a recessive fashion, where if parents are carriers of a cystic fibrosis gene, they’re fine, they don’t know they are, but one out of four of their children is going to have the disease. There was no genome project at that point. We knew so little about all of the human DNA instruction book, the genome, and so to try to find the cause in terms of some misspelling in the genome seemed hopelessly difficult. But it also seemed like it was time to try.
So I started down that path with my small lab in Ann Arbor. It was really hard. We had a technique that maybe made it go faster than the traditional way, something called chromosome jumping but it was still really, really slow. And after three years of that, I recognized that there was another competitor in Toronto Lap-Chee Tsui who was pursuing the same goal to try to find the cystic fibrosis gene.
The way he was approaching it and the way I was approaching it were actually really beautifully complementary. So he and I got together and we decided this is a really important problem. We’re both pretty frustrated. Let’s just merge our two labs and we’ll just do this completely together. And that’s what we did.
We had a lot of lab meetings in London, Ontario, which is sort of halfway between Toronto and Ann Arbor in a very down and out Holiday Inn. But our lab teams got so motivated. They got to know each other and we could go faster this way. And it really felt like, okay, this is the right thing to do. This taught me something about the importance of collaboration that I’ve never forgotten.
And it worked. And in 1989, we had the answer. And it was an amazingly subtle finding. It was just three letters of that Human Genome Instruction Book, which has three billion letters in it. So three letters, a C-T-T in a vulnerable place in a gene that nobody had ever noticed was there before. That’s the main cause of cystic fibrosis.
So that was a remarkable experience to sort of see that emerging, and even more remarkable now that that finding has led us to the point where there’s now a very effective therapy for people who have that C-T-T deletion, which is most people with CF, that allows them, as of now, to live almost a normal lifespan. They’re planning for retirement instead of planning for early death. It’s astounding to see how that’s happened. So I was hooked. I figured that’s what I should do.
But I also figured that was really hard. And you could say cystic fibrosis was one of the more straightforward of the genetic diseases because it’s relatively common. It’s inherited in a very clear cut way. Are we ever going to be able to do that for the thousands of other diseases where we know there are hereditary factors? Not unless we have better technology, and not unless we really have a copy of our own instruction book, instead of a bunch of little oases of information in the midst of a sea of ignorance, we’ve got to really have the whole book. That was the motivation for the Human Genome Project.
Todd Ream: Yeah, in terms of that whole book that you and your colleagues eventually developed, can you talk about, as you made progress there, what findings proved perhaps more predictable than others? In what ways did it progress as you thought, or take turns that you may never have estimated when you first started?
Francis Collins: Yeah. Well, I did get asked to come to NIH and lead the Human Genome Project. In 1993, I arrived somewhat with a lot of trepidation. This meant becoming a federal employee. That was not part of the, part of my life plan. And my mother, for one, said, oh, I never wanted one of my sons to be one of those, but I was like, come on now, this is a scientific enterprise. This is the only way it can get done.
And so, you know, we started with this promise we were going to read out these 3 billion letters in a 15 year period with no idea about how to do it so there was a huge effort to invent the technology to actually read out those letters of the code. I mean DNA is in some ways very simple. It just has four letters in its alphabet. And they’re actually chemical bases, and so they’re abbreviated A, G, C, and T. So all you need is something that can read out three billion As, Cs, Gs, Ts in the right order, and you’re done.
But at the time we started, on a really good day, you might get a hundred letters done. And we got to go to three billion. That’s going to take centuries. So we had to come up with all kinds of engineering ideas, bring people into the field who hadn’t planned to work on this and get them excited about what the opportunity is. This is historic. We only have to do this once. We’re going to read our own instruction book. Don’t you want to be part of it? I gave that speech a lot and people came.
And so a lot of the promise depended on that. And by 1996, 1997, it kind of looked like we might actually start to have the tools to do this. And the real production of the human genome sequence mostly was done in the last 18 months. That’s how it works, you know? You build up all of the technology and you practice on simpler systems and then you’re finally ready to go. And at that point, we’re reading a thousand letters of the code every minute, seven hours, seven days a week, 24 hours a day to basically crank out the whole thing. And there were a lot of surprises.
One was, how many genes are there in the human genome? Nobody knew. At one point, there was a sort of tongue in cheek competition that was held, and the average guess was, I think, 150,000 genes. We were driven by the fact that in simpler organisms like the roundworm, where the genome was small enough to have been actually read out already, there were 20,000 genes. Well, we’re a lot fancier than a roundworm, so let’s just say we have to have at least seven or eight times that number.
When the dust finally settled when we had the answer, we humans have 20,000 genes. The same number, but obviously, they must be regulated in some very complicated, fancy way to create this remarkable organism, including the brain. It’s all got to be in there. We all start out with that one cell, with that one copy, and look at us now. So that was also a revelation that the genes are interesting, but it’s the regulatory stuff that tells the gene whether it’s supposed to be on or off in a given space and how that all plays out in development. That’s going to be fascinating.
So we also had the chance, because we could read genomes from other humans to start to see, how related are we? And the answer was profound. Take any two humans from anywhere on the planet and sequence the parts of the genome that are well behaved, which is most of it, 99.9% the same. And that’s true if I’m talking about an African and a European, or an Asian, or a South African, or a South American, 99.9%.
We are all one family. Let no one try to say otherwise. If there was a scientific answer to the idea that it’s us versus them, it’s no, it’s all us. And racism will never be defensible on the basis of scientific data. That was good to see. I’m glad that was the answer. So, and it kind of fits with my faith as well. We are all part of God’s family.
Many other things came out of that, but of course it was just a start. The human genome sequence was in a draft form announced in June of 2000 and a big fancy event in the East Room of the White House with President Clinton. And then three years later, we basically said, we did it. We have the final version, two years ahead of schedule and 400 million under the predicted budget, which made me fairly popular in the United States Congress.
Todd Ream: Yeah, no, and perhaps with parents too.
Francis Collins: Yeah, they were okay.
Todd Ream: Yeah, yeah. Thank you.
You used the word profound when looking at that, and one of the descriptions that I was fortunate enough to watch you offer was, you know, for laypersons, non-scientists like myself, you compare the intricacy and the beauty of the human genome sequence if you were looking at it from the top down as being comparable to a rose window occasionally found in a cathedral, can you say a little bit more about that in the profound sense that you see as a scientist with the training that you have but also as a person of faith?
Francis Collins: I’m glad you brought that up because I think people who maybe are not so engaged in the scientific process are concerned that science takes the awe out of things because it explains what seemed to be a mystery. We can tell you why that sunset is so beautiful because of Rayleigh Scattering and so maybe it’s not as exciting anymore. Well, it sure is. It’s even more so. And certainly that has been true for those of us who are believers and non-believers.
When you look at the intricacy of the human genome, you talk about that particular image, I’m very fond of that. You know, when you look down the long axis of DNA, it has this beautiful radial complex structure and you can put that right next to the rose window of some major cathedral and you can’t help but notice the similarity. I’m not saying that somehow that has some fundamental, profound religious meaning, but it is an emphasis of the fact that we have beauty all around us.
And I think beauty is one of those things that draws us towards God. There’s no reason why from a purely materialistic perspective, we should be moved by beauty, why we should find ourselves touched by the strains of a particular musical piece that touches our hearts. I’m one who’s very susceptible to that, or to some particular thing you’ve seen in nature, or to some scientific discovery that just strikes you as so exquisitely complex and beautiful, or even to the realization that nature follows these beautiful, simple, organized equations that determine the nature of matter and energy.
I mean, look at Maxwell’s equations. And if you’re a mathematician and a physicist, you’re in awe because they’re beautiful. They’re simple, they’re elegant. They just like call out for a sense of falling on your knees and giving thanks to the Creator who must be an amazing mathematician in order for this all to be the way in which our universe acts so that, I think, is part of the joy of being a scientist who’s also a believer.
And I think that also means if you’re in the laboratory, you’re kind of in a cathedral. You are studying what God has given us as a gift of creation. And we are given the privilege of being able to study it and explore it and look deeply into the complexities and learn stuff that God knew all along, but as a scientist, you’re just getting a glimpse of, for the first time. What a joy that is.
Todd Ream: Thank you. Thank you very much. I want to ask you now about, if I may, about your writing. You’re the author, co-author of seven books, the first being Principles in Medical Genetics, which was originally, the first edition was published in 1990, and perhaps the most widely read of your books being The Language of God, published in 2006.
I’d like to turn our conversation to your most recent book, The Road to Wisdom: On Truth, Science, Faith, and Trust. In what ways, if any, would you have imagined anticipating writing this book on that day in November 2020?
Francis Collins: I don’t think I would have although I felt this incredible desire to share with anybody who could listen to the joyful moments of answered prayer and scientific achievement. But it’s what came after that that caused me to feel the need to say something else.
What did come after that, after those first six or seven months of remarkable assessment of relief as people rolled up their sleeves and more and more people across the world were able to take advantage of this protection against this terrible pandemic pathogen, by the summer of 2021, the number of new injections was starting to drop off rather steeply and it became clear that in the U.S. about 50 million Americans who had access to free vaccines were saying no. I didn’t expect that.
I knew there was going to be some resistance about the idea of whether this really was safe and effective, but I was so compelled by the actual data, which was then made public in all kinds of ways that I thought that would sway people, and except for maybe a very small minority, everybody would say, of course I want this for myself, for my family. But for 50 million people, that did not happen.
And the problems were legion. There was a lot of misinformation that was passing around through social media and talk radio and cable news and sometimes politicians suggesting that maybe these vaccines were actually more dangerous and that somebody was holding back information. There were some fairly wild conspiracy ideas that maybe the vaccines had chips in them so that Bill Gates could track you. People of faith were particularly vulnerable, I think, to some of these stories that maybe there were, you know, fetal cells inside the syringes, or maybe this was the mark of the beast, in terms of Revelation and you therefore, should spurn it.
The group that was most likely to say no to the COVID-19 vaccines were white evangelicals. I’m a white evangelical Christian and this is my people and it was so hard to see that. These are good, honorable people, but who were swayed by a lot of this misinformation and who maybe had a bit of a history of being less confident that scientists were actually people that they could trust, going all the way back to evolution and the battle that has happened there about whether that’s compatible with the Bible, which I think it’s entirely compatible with the Bible, but others don’t always see it that way. Christians were tending, I think, to look at scientists as maybe, anti-faith elitists that couldn’t necessarily be trusted.
And a lot had gone wrong over the course of that first year and a half of COVID-19, with the communication about what to do and recommendations about masking and about the vaccines and social isolation had not always gone well. I was part of that. And I have to look back and look at myself and say, I wish we had been more clear all the way along about how the recommendations we were making in the midst of this crisis were based on imperfect information and might need to be changed.
And they often were changed, but people didn’t really understand why that was and began to conclude, that you know, these people don’t know what they’re talking about. They’re flip flopping and they’re just jerking us around. And we lost the confidence of a lot of people along the way, people who were fearful about what was happening around them, looking for some reason to trust somebody. And if they couldn’t trust the government voices, well, maybe that posting on Facebook is what I really need to pay attention to. And there was a lot of that. And there were some truly evil people out there who were passing disinformation and making money on it that caused people to lose their confidence in the vaccines.
And the consequences were truly tragic. The Kaiser Family Foundation estimates that between June of 2021 and April of 2022, 230,000 Americans died unnecessarily because of vaccine misinformation. That’s just an astounding number. That’s like four times the number who died in the Vietnam War, Americans. And all of this unnecessary, the culture wars were killing people. I couldn’t look at this and not feel an urgent need to do something. And I decided if I have any credibility as a scientist, as somebody who has a fair amount of public visibility as a spokesperson for science and as a person of faith, then I feel like I need to do something with that.
And that became the motivation to try to first examine myself and see all the things that I’ve done wrong, and then try to put forward some kind of an exhortation about how we can re-anchor ourselves to the fact there is such a thing as objective truth, and we should figure out how to find that, and that science is a reliable way to discern objective truth about nature. And that faith is a reliable way to discern truth about other transcendent matters. And that trust becomes an important way for us all to decide how to proceed in a time of a lot of confusing information. And all of that you could put together and say, it’s something about wisdom. And we’re all on a road, me too, trying to find wisdom.
And right now it’s hard to find. Our culture has gotten so divided, so polarized. There’s so much vitriol, so much really uncivil discourse going on that it’s hard to come together and say, can we find the truth as Jesus called us to because that will set you free. We have less truth, we have more lies, and we’re not being set free by those lies.
So that’s what this book is about, trying to take my own personal experience, telling a lot of personal stories, but also trying to fit it all together in a way that maybe one or two readers will read and say, okay, it’s not enough to say, it shouldn’t be like this. I can also say, I shouldn’t be like this. I can be part of the solution because the solution’s going to come from each of us. It’s not coming from politicians or, I’m sorry to say, probably not even from the church leaders who are all embattled. It’s got to come from each of us.
But we have a chance to do that. If we anchor ourselves back to those fundamentals of faith, all of the things that we learned about what Jesus calls us to do, then we have a chance to become part of the rediscovery of the city on the hill, that right now, it’s kind of lost its lights.
Todd Ream: Thank you. Yeah, I think we are, we’re at a critical moment where hopefully what you have lobbied we will heed and take action on.
If I may, I want to ask you about one of this, you mentioned, you know, what defines your book in part are stories. And you open with a story while you are a graduate student at Yale, and you realize that failure was not only acceptable, but at times even a necessary dimension in terms of the pursuit of truth. And to that end, you wrote, quote, “Through this early wrenching experience, my commitments to truth, science, and faith were strengthened. As was my willingness to trust in all three of those. Wisdom was acquired. Yes, painfully. But gainfully,” end quote.
In your estimation, what virtues were cultivated by that experience, and what virtues do we need to foster in order to make the changes that you’re lobbying for in your book?
Francis Collins: Well, that was a wrenching experience. The first six months of my time as a fellow at Yale trying to learn how to do molecular genetics and that first project turned out to be an utter failure. There was really nothing that could be recovered from it. And I almost quit. I was talked out of that by my mentors who said, no, this is an experience that you learn from. Yeah, you can grieve a little bit, but now figure out how it happened. That was a really critical lesson.
And I could look back and say, well, you know, I think it happened because I approached this project with this optimistic sense of, “Well, because I want it to work, it’ll work.” That’s not how it goes. Science isn’t like that. If you’re going to design a project, you better think about all the ways it can fail and be fully prepared for that before you plunge in. So I learned that.
And that’s true in life as well. If you’re going to tackle something that really matters, look around you carefully and see whether there’s something that’s likely to trip you up that if you’re unaware of is going to go much worse for you. But it was also a matter of figuring out how to have some resilience. We’re not granted here on this earth a life where everything’s going to go smoothly. People listening to this, if there’s anybody out there where everything has always gone smoothly, I’d love to hear how that goes, because that’s not the universal human experience.
So how do you handle that? And for me, it was thinking hard about it, talking to my science mentors, but talking to my pastor and having him remind me of all those heroes of the faith from Moses down through Paul, who failed and then failed again, and then yet still kept their devotion, their determination, their vision about serving God.
Okay, I guess it’s not all about me, is it? It’s about trying to figure out what my calling is. If this is it, then I need to be even better at it. And failure is a way to get better. And that was getting me a little closer to this idea of wisdom, but it was painful, although it was gainful.
Todd Ream: Thank you. When you think about it, this moment, and the ability to address it is in many ways up to us, what practices do you believe will help us foster that common commitment to truth, science, and faith, and ultimately to wisdom?
Francis Collins: Yeah. Well, I think, first of all, to say it is up to us. I think a lot of surveys would say about two thirds of Americans have kind of almost checked out right now because of all the nastiness and the divisiveness. And it’s like, I just don’t want to deal with this. The two thirds are now called the exhausted middle. They’re exhausted. They’re in the middle. They’re a little bit blue or a little bit red, but they’re not really the fringes that are making all the noise. We need to have the exhausted middle take up this chance of opportunity to reshape our culture in a more loving way. And then there’s a hope for us.
So first step, decide, okay, I’m going to be part of the solution. And then look around your own worldview circumstance and make sure that it’s anchored where it should be. If you’re a person of faith, there’s so much you can go on. Start with the Sermon on the Mount and just walk through what Jesus is saying there about the Beatitudes and about how you’re supposed to love your neighbor and also love your enemies. That’s in there too. Not a lot of that going on right now.
And then try to implement that in your own life. That also means taking responsibility for discerning truth and not being taken in by things that sound plausible, or maybe they even make you angry, so you want to spread them around to everybody else. But they aren’t true. Truth really matters. And we’ve stepped away from that with things like alternative facts. We’ve got to step back there, or there’s not much hope for us.
And then begin to become one of those bridging forces that we need more of. Reach out to somebody, maybe it’s in your family or a friend, who you know has a very different view about a particularly hot button topic and say, you know, I’d really like to understand where you’re coming from. Can we get together for a coffee or a glass of wine? I want you to teach me something about your perspective and maybe I can teach you something about mine. I’m not going to try to change your mind. I just want to know how it is that you’ve arrived at your point of view.
People will be surprised by that because we are right now kind of off in our corners and avoiding those conversations because we’re afraid they’re going to go badly. But if we don’t start, how will we ever get there? I’m part of Braver Angels, a group that has systematically figured out how to do this and I’ve learned a lot from that setting and I’ve become much better informed about the perspectives of people who disagree with me profoundly about things like public health. And I’ve realized my own shortcomings and my own blind spots as a result.
We all need to do more of that in a fashion where you have a real civil discourse. And you’re not just trying to come up with a snappy response to what the other person said. You’re listening to what they said, really listening, almost to the point of being able to say back to them, here’s what I heard you say. Kind of like marriage counseling for our country is sort of what it feels like.
And then take that to a larger scale, maybe in your church, maybe in your community. Find a small group of folks who can get together who have different perspectives. It’s not just all in the same bubble. And begin to make this a normal kind of conversation. Braver Angels can help. There’s lots of chapters, a hundred of them, around the country and other groups like that that do bridging. Join up with one of those.
And then insist that our leaders are also interested in this kind of peacemaking. We can’t keep electing people who simply are performers in front of cameras. They’re supposed to be governing. And we can’t simply say, it’s okay if this person has lousy character, as long as they support my political views. Character really matters. None of this will happen quickly, but I think we’re kind of feeling like we’re down in the bottom of the well here. Maybe we could start one by one to begin to find our way back up again. That’s what I hope to do.
And the last part of this book actually asks people to do something specific, to take a pledge. A pledge that I think most people would agree is sensible about trying not to demonize people who don’t agree with you, about trying not to spread information unless you’re quite sure it’s true, about basically loving your neighbor and then make that a public pledge. Braver Angels has agreed to host that, so it’s a place where all of those signatures can be collected. I hope, a few months from now, there will be millions of people who have signed onto that pledge in a public way saying this is who I am. Now hold me accountable.
My first recruit for that is the alter ego I had at Braver Angels, Wilk Wilkinson, who is on a totally different place from me in terms of the views about public health. But totally agrees that we’ve got to figure out how to learn our way through this together. So he’s signature number one and I’m signature number two and we’ll see what happens after that.
Todd Ream: That’s great, yeah. Thank you for mentioning your relationship with him and your relationship with Braver Angels. I was going to ask about that and make sure that was noted during our conversation. So I appreciate you bringing that up and yeah, strongly encourage people to consider, which you’re referencing here. So thank you.
As we begin to close our conversation, I’d like to ask you to look back over the course of your career. Your service as the leader of the National Human Genome Research Institute was followed by your service as the director of the National Institutes of Health. Would you please describe the discernment process that led you from your role as a faculty member at Michigan to your role leading the National Human Genome Research Institute and then to leading the National Institutes of Health? What was the decision making or discernment process and what could it offer perhaps others who are committed to science and public service in a comparable way?
Francis Collins: None of those particular developments could have been anticipated by me when I was a high school student, a college student, a medical student, or even in a junior faculty position at Michigan. These were doors that opened that I hadn’t expected and in some ways tried to resist because they seemed somewhat terrifying in terms of the responsibility but they were opportunities to try to serve.
I shifted from physical chemistry to medicine because I felt like I had a better chance there to do something that would serve humanity, even though at the time, from my atheist perspective, I felt that’s what I am probably supposed to do with the time I have here. And when I became a Christian, that became much more compelling. Okay, this is not about you, Collins. You are here. You’ve been given this incredible gift in this country with the opportunities that have been put in front of you. You should use that in whatever way you can to help people.
And the combination of internal medicine and genetics felt like it was in a place where that might come true, but I wasn’t quite sure how. And so chasing after causes of diseases like cystic fibrosis or Huntington’s disease, or right now, I’m in my lab working on diabetes. That feels like what I’m supposed to be doing here to try to find answers for diseases that cause a lot of people to suffer.
But opening a door that said, Human Genome Project, we want you to lead that? Ah, I said no to that the first time it was offered. It just felt it was too much. It was not in my sweet spot. And then I realized, what are you nuts? You’re about to walk away from what could be the most significant scientific project of our era. And with some reluctance, figuring that the project might very well fail. But if it succeeded, something really powerful would happen, then I said, yes.
Being NIH director, I had not expected either. I was kind of moving on to some other chapter. I didn’t quite know what it was and then got this call at that time from President Obama. And that was a big reach because that meant you sort of have to be knowledgeable about everything that has to do with medical research, not just the stuff you already know about. You have to know about, you know, neuroscience and immunology and things that I had a little bit of familiarity, but hadn’t really worked deeply in, but that was also an opportunity to try to see with the resources that NIH has, how can you invest them in ways that they’re going to help people as quickly as possible.
And there was a chance to do things like start new initiatives that weren’t going to happen for many years, like the brain initiative. We’re really trying to figure out how the brain works and all the ways that will help people with brain diseases or the All of Us Initiative, which is lining up a million people to be part of a prospective study of health and disease. Those are all possible when you’re in that kind of role reporting to the president. But I couldn’t have planned any of that.
And I guess when I talk to young people who are always like, well, how did you plan your career? I have to say, kind of didn’t. I got called in some way to work on something and thought that was probably what I would do. And then a door opened that I hadn’t expected. And I had to think about it. Is that really the next thing or should you basically say no to that?
And that will happen to everybody. Nobody these days starts down a professional pathway and stays on that same path for a whole lifetime. That’s not the way it goes. But I’ve been greatly blessed. That is for sure. None of the things that I’ve had a chance to do, I could have possibly come up with on my own.
Todd Ream: Thank you. I want to ask you about your investment in BioLogos, if you would, and where that fits and how others can benefit from the work that they’re doing.
Francis Collins: I’m glad you asked cause I did want to put that forward to people listening to this. When I wrote the book, The Language of God, back in 2006, which was my own effort to explain how I see a rigorous science and scriptural analysis from the Bible as being entirely compatible I got a lot of responses from that. In fact, that book still seems to be out there with a lot of people looking at it, but people wanted to go deeper. And they said, your book was great. I could see from your perspective how evolution is not necessarily an evil force, it’s actually answering how God carried out the amazing experiences that we all get to benefit from in creation. But what about this? And what about that?
So in order to try to create a civil meeting space for those kinds of conversations between people who are serious Christians and also interested in serious science, BioLogos is a foundation that my wife and I started.
Shortly after it started, I was called to be the NIH director, and at that point, you have to resign from any other connection to any other entity, including your own foundation. Fortunately, other people came alongside rather quickly, and BioLogos has flourished ever since now with about two million people who are regular visitors to their very rich and varied and interesting website, which is biologos.org, B-I-O-L-O-G-O-S dot org.
And they run meetings, both regional and national. They have a curriculum for high school kids that blends science and faith in the way that many Christian high schools or homeschoolers don’t have real access to. They have a podcast called the Language of God which is very interesting and very worth listening to. I just did an episode myself as a guest host with Jonathan Haidt who wrote this book called The Anxious Generation about what’s happening to our kids. So lots of resources there.
And it’s just a joy to see how that has evolved, now led by an astrophysicist named Deb Haarsma. So anybody listening to this, if you want to really see some of the exciting things that are happening in this dialogue between science and Christianity, go to BioLogos.
Todd Ream: Thank you. For our last question, I want to ask you what may seem to be somewhat afield from science, but your efforts and the wisdom of others would say that music and science are not so disparate from one another.
The public has recently become aware of your abilities as a musician and you’ve been spotted accompanying artists such as operatic soprano Renée Fleming with your efforts as a guitarist. Now, one manifestation of those abilities is expressed in Fleming’s recently released Music and Mind, for which you contributed the forward. But would you please say a few words about what that project offers, but also as we close a few words about how building bridges between domains of knowledge, and in this case, music and science, can foster the kind of wisdom you’re lobbying for in the book?
Francis Collins: Well, I love that question. I think I mentioned earlier that I grew up in a family where music was really considered a pretty important part of the joy of being alive. My dad having been a folk song collector and was also a pretty good violinist. So I learned music from an early age, both keyboard and guitar. And I’ve always found that to be a joyful part of any particular day or week experience.
But it sort of seemed as if music and my scientific part were often different parts of my existence. It’s true that scientists as a group tend to be much more musical maybe than the average group of non-scientists. Many of them play an instrument. Many of them love that.
With the advances that are now happening in neuroscience, the opportunity arose to see how music and rigorous science of the brain could come together about how is it that musical information which comes to you as sound waves and then gets translated into electrical information in your brain, how is it that it can have such powerful impact and how can it be used for healing for people who have conditions like chronic pain or PTSD, or a variety of other serious considerations.
There’s this whole field of music therapy, which has been around since World War II, but is largely anecdotal and doesn’t get much respect, which it probably deserves. Could we get music therapy and neuroscience together and really have some sparks fly and great things happen?
Renée Fleming became my great partner in this. We met rather accidentally at a dinner party and discovered we both had this dream. And so started this whole project which began with a big workshop at NIH in 2017 and has now resulted in an additional 35 million dollars of research funding that’s teaching us a lot about this interface, which makes me very excited. So yeah, it’s not necessary anymore to have these parts of my brain kept off in separate corners. They can actually get together.
And her book, Music and Mind, which is well worth perusing, has a wide variety of perspectives about this issue but certainly would inspire anybody who’s trying to figure out how science and music could talk to each other to see this is the moment. So we’re hoping, in fact, to expand that workforce of young scientists and musicians and music therapists to come alongside and see what we could do here. Both in terms of understanding critical things about how the brain works, but applying it beneficially for health purposes. So it’s been great joy to be part of this.
And yeah, to answer your question about bridging, I think this is a great example of something that I have learned and tried to apply right from the earlier stages, that when you bring together people who maybe didn’t talk to each other or maybe didn’t want to talk to each other and try to see what you could learn together, it always turns out to be exciting.
And whether that’s music therapists talking to neuroscientists, or whether it’s people on the blue side of the political spectrum talking to the red side in a Braver Angel setting, or whether it was me reaching out to my competitor in Toronto saying, why don’t we work together cystic fibrosis instead of competing with each other? Those are the things that we should do more of, especially now.
We have such gifts and such talents and such visions and opportunities. We have to get past this limited ability to tap into that by all of the polarization that’s all around us. It’s up to us. We can figure out how to do this, but it’s going to take every one of us determined to be part of the solution.
Todd Ream: Thank you, thank you very much. Our guest has been Francis S. Collins, physician-scientist and former director of the National Institutes of Health. Thank you for taking the time to share your insights and wisdom with us.
Francis Collins: It’s been a joy being with you. Thanks a lot for the chance to have this conversation.
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Todd Ream: Thank you for joining us for Saturdays at Seven, Christian Scholar’s Review’s conversation series with thought leaders about the academic vocation and the relationship that vocation shares with the Church. We invite you to join us again next week for Saturdays at Seven.
