Many medical advances are made through collective effort, but it is the individual pioneer who catches our imagination.
The stereotype of the pioneering scientist is a man in a white coat in a laboratory wielding a Petri dish or a test tube and experiencing a 'eureka' moment. However medical pioneers also include amateurs such as Florence Nightingale, who with no formal medical training overhauled military medicine and nursing in Victorian Britain, and Robert Ross, who struggled for years in India with basic equipment and an intermittent supply of mosquitoes to prove the link between them and malaria.
Some pioneers, particularly in the age before mass media, could not or did not get their ideas circulated into the scientific community and thus went unrecognised for years, if at all. In the 1770s, Dorset farmer Benjamin Jesty experimented with smallpox vaccination 20 years before Edward Jenner, but did not publicise his findings, and so lost out on the fame and rewards which eventually went to Jenner. In the 1860s, Austrian monk and scientist Gregor Mendel published his findings on the inheritance of certain traits in pea plants. They were not widely read and it was only at the start of the 20th century that his work was rediscovered and formed one of the foundations of the modern science of genetics.
Since the late 19th century, mass media has expanded public awareness of pioneering scientists, and their ideas. In 1896, the German physicist Wilhelm Rö ntgen sent his scientific colleagues copies of his article on his discovery of what he called X-rays. He included an X-ray of his wife's hand to illustrate this. Within a few days, the world press had picked up on the discovery and Rö ntgen became an instant celebrity. He hated the attention, and when he won the first Nobel Prize in Physics in 1901, he refused to give the obligatory lecture. X-ray technology itself, however, was quickly adopted all over the world, a development that Rö ntgen had anticipated by not patenting his invention.
Pioneers frequently have to go against the grain of current medical thinking and fight to get their ideas accepted. Joseph Lister had to work hard to convince his medical peers that cleaning and dressing wounds with carbolic acid would prevent infection. In 1997, American neurologist and biochemist Stanley B Prusiner won the Nobel Prize in Medicine for his work on Creutzfeldt-Jakob disease (commonly known as mad cow disease). In this work he coined the term 'prion' (proteinaceous infectious particle) to describe an infectious agent made of protein that did not contain DNA or RNA, previously thought to be necessary for particles to reproduce. His Nobel Prize was belated recognition for an idea that was treated with scepticism for a decade.
Elizabeth Garrett Anderson is noted as a medical pioneer not for any scientific breakthrough but for changing attitudes within the medical profession. In the face of enormous opposition from the male medical establishment, she became the first English woman to qualify as a doctor. Her determination paved the way for other women keen to study and practice medicine, and in 1876 an act was passed permitting women to enter the medical professions. Now 40 per cent of doctors and around 60 per cent of medical students are women, although they remain under-represented in other branches of science, in technology and in engineering.
The scientific research community has changed dramatically since Nobel Prizes were first awarded in 1901. That was an era before collaborative projects on a global scale, such as the Human Genome Project, and before the development of competing research groups in areas like biomedicine and microelectronics. Pioneering science is now usually conducted as part of a formal, highly structured enterprise, often linked to other research projects in different countries or continents. Research is frequently governed by funding and focused on more tightly defined aims, which some argue leaves less room for serendipity and creative thinking.