Abstract
The sessions were well received and very well attended, even the early morning sessions, which is apt testimony to a growing interest and acceptance of the science and practice of photobiomodulation. It is also fitting that the overtone of the entire conference centered on innovation and inspiration. This theme was brought into brilliant focus by former astronaut Story Musgrave, who provided a riveting keynote address for the annual conference. His speech was an account that I have been privileged to hear on two separate occasions. His “story” chronicled his personal journey from the wide-eyed enthusiasm and unbridled inquisitiveness of a child raised on a farm to one of continuous self-improvement; unparalleled accomplishment; and an unquenchable thirst to develop, explore, solve, and teach. This quest to continue to progress and expand one's personal abilities and understanding while at the same time providing new possibilities and benefits for humanity are paralleled in many ways by our own professional journeys as we work in our disciplines and interact with other professionals. Those of us who provide clinical care also enjoy the wonder and satisfaction of synthesizing and applying our expanded knowledge and tools to our patients, who entrust their health and well-being to us.
Story Musgrave's message is timeless. Moving forward is arguably best facilitated by developing the attributes of open-mindedness and at a level of inquisitiveness unfettered by preconceived notions and dogma that is innate in the small child. Musgrave also intertwined a second and equally strong message that success demands precision and an unwavering attention to detail. He provided several real-world examples from his own career as he was tasked with developing, writing, and implementing the procedures to be used during the course of space missions, such as the repair of the Hubble Space Telescope. He used the creation of Hubble's mirrors and the decision to launch Challenger on the day of the infamous disaster as cautionary tales of the consequences of taking shortcuts and the failure to follow or to otherwise ignore procedure. More about this amazing surgeon, scientist, and explorer can be found on one of his web sites. 1,2
This brings me to the second nugget for your consideration. That is, the consideration of the degree to which dogma and philosophies creep into our discussions at scientific gatherings or into the scientific literature itself. We first must recognize that although science asserts itself as being based on principles and proof as demonstrated by reproducible evidence and experimentation, those making, recording, and interpreting the observations are, alas, human beings. This means that there is inevitably the opportunity for personal biases and philosophies to color the types of observations conducted and the interpretation of the results. Such knowledge filters are most commonly to be found in the introduction and discussion sections of scientific publications and certainly also play some role in the entire editorial and scholarly review and publication process. After all, rationalization and contextualizing are well-known phenomena of normal human behavior. The theory of cognitive dissonance proposes that people reduce dissonance, by adding new cognitions to create a belief system consistent with their own way of thinking, or by minimizing the importance of any one of the dissonant elements in their sphere of observation. 3,4 This is aptly illustrated in the Aesop Fable of the Fox and the Grapes. The fox concludes that the grapes beyond his reach are sour, as he can't reach them, and justifies his lack of success by creating the belief that the grapes are inedible anyway. The only way he could prove or disprove this belief would involve actually reaching and tasting the grapes. He has in effect created a dogmatic belief.
Consider the issue of defining the mechanism of action of photobiomodulation. Work from our own group and other investigators has demonstrated that mitochondrial respiratory chain enzymes, and cytochrome C oxidase in particular, are photoacceptors in the cell and that exposure of cells and tissues to specific red and near infrared wavelengths is indeed capable of upregulating cellular metabolism and proliferation. 5 –12 This has led some to conclude that it should be possible to stimulate all cells with these golden recipes of parameters and others have begun to speak in dogmatic overtones and infer that this singular pathway is the sole mechanism for the photobiomodulation phenomenon. However, it should be readily recognized that not all cells and tissues respond to phototherapy, and that one size does not fit all when it comes to determining the dose or time course of treatment in different tissues and scenarios. 13 So why, then, do learned scientists speak so dogmatically about the mechanism of action when an exhaustive study of the various possibilities has not been conducted?
Perhaps cognitive dissonance is at least a partial explanation for our collective penchant to attempt to reduce complex systems and mechanisms to overly simplified singular mechanisms. Biologists and biology watchers should recognize the fact that life and biological systems are complex and capable of responding and adapting to the changing environment. This attribute is certainly quite useful in self-preservation and in the propagation of the species. One need only consider a few examples in the microbiological realm wherein organisms have adapted to thrive in hostile extremes of temperature, chemical gradients, and even using compounds that are toxic to other life forms in their “routine” pathways. If one considers the numerous pathways and intermediaries that have been described for eukaryotic cells, it would be difficult to conclude that cells utilize a singular pathway 100% of the time for any cellular process. It is also readily observed that cells and organisms utilize alternate pathways in adverse circumstances or when conditions otherwise warrant same. Another glaring example of diversity of response can be found in the oceans. Consider the fact that organisms existing at various depths respond to differing wavelengths and intensities of light. This phenomenon is mirrored in tissues to the extent that nervous system tissues respond to much lower irradiances than do skin and connective tissues.
Musgrave is right. We should adopt a philosophy and discipline to explore, learn, and consider the possibilities. We must always remember that the details are important. Dogma has little place in advancing our understanding and expanding our horizons.