Tag: NIH Funding

The Crawfish Chronicles: An NIH Fixed Cost Cap Parable

Jun 4, 2025

By GREGORY HOPSON

T-Maître Pierre’s Family Restaurant was a Louisiana institution. The kind of place where generations gathered over steaming mountains of boiled crawfish, spicy corn, and seasoned potatoes. A place where Clifton Chenier’s Louisiana Blues & Zydeco played in the background and the waitstaff wore starched white shirts with bright-colored bow ties. The walls were plastered with faded photos of people smiling. Nobody knew who they were anymore, but they felt like family.

Pierre Thibodeaux, the founder, made sure every customer was treated as if they were indeed family. So it was a bit ironic that when he passed away, he had no heirs.

Within the week, the restaurant was acquired by multi-million-dollar developer O. B. Noxious, who addressed reporters beneath a banner that read:

MAKE CRAWFISH AMAZING AGAIN
“They call these little lobsters crawfish. Very smart. I like that. We’re keeping that name. Everything else? Outdated. Inefficient. Sad. We’re going to take this failing shack and turn it into the greatest restaurant the world has ever seen. People will come from everywhere and say, ‘Wow! I’ve never had crawfish this good. It’s the best anyone has ever tasted.’”

To oversee the transformation, Noxious brought in Otto Maladore, a consultant known for running billion-dollar companies and doing math in his head (where he also did all of his research).

Maladore spent thirty minutes walking the property, leaning over this, pressing on that, and stepping back from things while shaking his head. It wasn’t long before he issued his report to the press:

Excess Labor: “Wait staff, custodian, dishwasher? None of them cook so we’re wasting money on them. Eliminate all of those positions.”
Menu Simplification: “Boiled crawfish outsells everything. Eliminate everything else. Eliminate the menu itself. Menus are nothing more than administrative bloat.”
Décor: “We will have the best of everything. Those photos are faded and were low quality when they were new. Remove them.”
IT Modernization: “Found an IBM 5150 still running their books. This fascinates me-and concerns me-on so many different levels.”
Fixed Costs: “This place is hemorrhaging due to indirect costs. Forty percent of revenue on facilities and administration? That’s insane. Ten percent is more than enough for a place like this! But we’re far more generous and much more compassionate than people give us credit for. So we’re not going to cap it at 10%. We’re going to bump it all the way up to 15%!”

The changes happened quickly-literally overnight.

The next day when customers showed up, they found no music. No waiters. No ambiance. Just folding chairs, a beat-up old card table, and flickering fluorescent lights (they were told the remodeling would be done later). The walls were bare except for a sign that read:

T-MAÎTRE PIERRE’S CRAWFISH

READ CAREFULLY!!!!!!

Proceed to the back parking lot and sign in.
You will be assigned a ten-minute time slot for boiling.
You will receive:
a. Live crawfish
b. Unshucked corn
c. Potatoes (with high-quality dirt: pH between 6 and 6.5)
Boiling pot pre-heated to exactly 212°F.
DO NOT ADD OR REMOVE WATER!!!!!!
Spice levels are pre-set.
Extra napkins: $0.25 each
IMPROPER DISPOSAL OF CORN HUSKS: 10% surcharge
Failure to remove crawfish on time results in meal forfeiture.
NO EXCEPTIONS, NO REFUNDS!!!!!

A middle-aged man in a Ragin’ Cajuns hat read the instructions aloud. Then he looked around at the solemn-looking patrons waiting in line behind him. The place was quiet except for a few muffled noises from the kitchen. He removed his cap, looked heavenward, paused, and muttered:

“Mais, ça, c’est pas bon.” (Man, this is no good.)

By the end of the week, two of the three chefs had had enough of renting pots and pans and arguing over burner rights. They moved to California, where a Chinese restaurant offered a fully equipped kitchen and covered indirect costs. Within weeks, they’d introduced Admiral Pierre’s Crawfish, featuring crawfish imported from China-descendants of Louisiana crawfish accidentally introduced there in the 1930s.

Back in Louisiana, the rain was coming down harder and the lone remaining chef was standing ankle-deep in a puddle, scolding a water-logged customer for being thirty seconds late getting his crawfish into the pot.

The Moral

This is what happens when outsiders impose arbitrary cost caps in the name of “efficiency.”

T-Maître Pierre’s didn’t fail because of bad crawfish. It failed because it lost the infrastructure that made the meal possible-pots, burners, tongs, and the people. The chef, once celebrated for his recipes and skill, now stands in the rain, powerless to cook without the tools he depended on. The recipes remain, but customers must now struggle to bridge the gaps themselves, leaving behind the joy and ease of a shared meal.

NIH’s Facilities and Administrative (F&A) cap is no different. It slashes funding for the very essentials that enable research to thrive: lab space, equipment, compliance staff, and the humans who know how to maintain complex machinery like autoclaves. Researchers, once empowered by infrastructure and expertise, are left to watch their innovations stall as benefactors scramble to piece together what’s missing.

At T-Maître Pierre’s, you’re stranded in the rain, struggling to figure out how to get crawfish boiled properly. And when you ask for help, the chef responds:

“Je suis l’uniq qui reste, pis ça c’est tout ce que j’ai.”
(I’m the only one left and this is all there is.)

Under NIH’s 15% cap, your research institution is trying to fund an autoclave by tearing its couch apart to find any loose change that may have fallen out of visitors’ pockets. And even that source is drying up-since PayPal and Venmo don’t have loose change.

Gregory Hopson works remotely from Baton Rouge, Louisiana as a Business Intelligence Developer for Emory Healthcare in Atlanta, Ga.

Emory, Balloon Angioplasty, and the Musk Attack on Medical Diplomacy

Mar 28, 2025

By MIKE MAGEE

“The recently announced limitation from the NIH on grants is an example that will significantly reduce essential funding for research at Emory.”

Gregory L. Fenes, President, Emory University

In 1900, the U.S. life expectancy was 47 years. Between maternal deaths in child birth and infectious disease, it is no wonder that cardiovascular disease (barely understood at the time) was an afterthought. But by 1930, as life expectancy approached 60 years, Americans stood up and took notice. They were dropping dead on softball fields of heart attacks.

Remarkably, despite scientific advances, nearly 1 million Americans ( 931,578) died of heart disease in 2024. That is 28% of the 3,279,857 deaths last year.

The main cause of a heart attack, as every high school student knows today, is blockage of one or more of the three main coronary arteries – each 5 to 10 centimeters long and four millimeters wide. But at the turn of the century, experts didn’t have a clue. When James Herrick first suggested blockage of the coronaries as a cause of heart seizures in 1912, the suggestion was met with disbelief. Seven years later, in 1919, the clinical findings for “myocardial infarction” were associated with ECG abnormalities for the first time.

Scientists for some time had been aware of the anatomy of the human heart, but it wasn’t until 1929 that they actually were able to see it in action. That was when a 24-year old German medical intern in training named Werner Forssmann came up with the idea of threading a ureteral catheter through a vein in the arm into his heart.

His superiors refused permission for the experiment. But with junior accomplices, including an enamored nurse, and a radiologist in training, he secretly catheterized his own heart and injected dye revealing for the first time a live 4-chamber heart. Two decades would pass before Werner Forssmann’s “reckless action” was rewarded with the 1956 Nobel Prize in Medicine. But another two years would pass before the dynamic Mason Sones, Cleveland Clinic’s director of cardiovascular disease, successfully (if inadvertently) imaged the coronary arteries themselves without inducing a heart attack in his 26-year old patient with rheumatic heart disease.

But it was the American head of all Allied Forces in World War II, turned President of the United States, Dwight D.Eisenhower, who arguably had the greatest impact on the world focus on this “public enemy #1.” His seven heart attacks, in full public view, have been credited with increasing public awareness of the condition which finally claimed his life in1969.

Cardiac catheterization soon became a relatively standard affair. Not surprisingly, less than a decade later, on September 16, 1977, an East German physician, Andreas Gruntzig performed the first ballon angioplasty, but not without a bit of drama.

Dr. Gruntzig had moved to Zurich, Switzerland in pursuit of this new, non-invasive technique for opening blocked arteries. But first, he had to manufacture his own catheters. He tested them out on dogs in 1976, and excitedly shared his positive results in November that year at the 49th Scientific Session of the American Heart Association in Miami Beach.

He returned to Zurich that year expecting swift approval to perform the procedure on a human candidate. But a year later, the Switzerland Board had still not given him a green light to use his newly improved double lumen catheter. Instead he had been invited by Dr. Richard Myler at the San Francisco Heart Institute to perform the first ever balloon coronary artery angioplasty on an awake patient.

Gruntzig arrived in May, 1977, with equipment in hand. He was able to successfully dilate the arteries of several anesthetized patients who were undergoing open heart coronary bypass surgery. But sadly, after two weeks on hold there, no appropriate candidates had emerged for a minimally invasive balloon angioplasty in a non-anesthetized heart attack patient.

In the meantime, a 38-year-old insurance salesman, Adolf Bachmann, with severe coronary artery stenosis, angina, and ECG changes had surfaced in Zurich. With verbal assurances that he might proceed, Gruntzig returned again to Zurich. The landmark procedure at Zurich University Hospital went off without a hitch, and the rest is history.