Science, Serendipity, and the Intentional Life

As a philosophy major back in college, I recall spending hours in class debating the state of our collective future as viewed through the lens of the centuries-old argument on fatalism versus free will. Do we actually control our destiny, or was everything predetermined after the creation of the universe millions of years ago? Is it possible that, despite what we think our independent decisions are, the world, our fate, and the future are already decided?

As we wrap up another year, these are heady questions that are perhaps too esoteric for us to consider as the days get shorter and colder, but I am going to ask you to reflect on them, nonetheless. You see, while I attribute some of my greatest moments to serendipity (meeting my wife and switching my focus to myeloma after planning to be a leukemia doctor, to name a couple), I have to believe that we all have some impact on where our lives go, whom we meet, and our direction. There are obvious tragic events that innocent bystanders are inadvertently harmed by (mass shootings and the wars in the Middle East and Ukraine are examples). The other side of the coin suggests that there is no destiny, that we all make our way, and that good luck is just a consequence of hard work—there is no luck and no serendipity at all. This doesn’t seem very satisfying either.

At this point, the reader is probably wondering where this is all going and why there is such philosophical blather in this December blood cancer publication. Here is the link: as I look over the past 10 issues of Blood Cancers Today, what strikes me the most is the enormous amount of purpose, intentionality, and hard work our community has brought to bear on the topic of often fatal blood cancers. This isn’t just good luck or fate; this is a concentrated and curated global team effort to make a difference. We wouldn’t have things like CAR-T or T-cell engagers, antibody-drug conjugates, and so many molecularly driven, targeted therapies in blood cancers if we didn’t do all this work together.

This doesn’t mean that many trialists or scientists didn’t have their “Eureka” moment (recall the serendipity of Archimedes in the bathtub). The inspiration of a new target or mechanism of action requires hard work and perseverance, and bringing something novel and life-changing to the public eye requires doing the work such that this new target will become a therapy that can impact patients all over the world. This is not chance, fate, or good luck; this is hard work, sometimes disappointing work, sometimes failed work. And yet we keep trying, keep testing, keep designing trials, keep on. Perhaps more daunting than the postman’s creed (neither rain, nor sleet, nor snow…), for we know that if we don’t succeed, if we don’t keep trying, there are many lives that depend upon us in the balance.

So, as we close 2023, which began with saying goodbye to two long years of COVID isolation, fear, and hesitancy (vaccine or otherwise), it feels like we are all back, at full speed ahead, meeting in person, presenting great data, and doing the work that draws us together and to our field. To all those who wrote or edited or helped at BCT this past year, thank you, we couldn’t be here without your tireless efforts. For all of you who are part of the movement, THANK YOU for your hard work, perseverance, and commitment to those we all serve. Take a few weeks to rest and relax with family and friends, and then get ready for a great 2024 together. With sweat and toil, and some serendipity, we will continue to make great strides in our work, and hopefully for the benefit of our patients.