Hamlet may not have had detective TV in mind when he said, "For murder, though it have no tongue, will speak with most miraculous organ," but NBC's premiere of "Medical Investigation" did just that when its dramatization of the CDC's Epidemic Intelligence Service (EIS) assigned organizational ownership to NIH Bethesda instead of CDC Atlanta, i.e. terrific publicity going to the other guy.

Sometimes called the "medical CIA" or the "virus hunters," CDC is justifiably proud of the EIS established in 1951 at CDC Atlanta, Georgia, as a combined training and service program in domestic and international applied epidemiology. Staff that pass through its 2-year program go on to become its eyes and ears, much like retired FBI staff at Kroll became a farm team for serving FBI agents, and can be recalled to support an essential mission.

Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) are but two units of Department of Health and Human Services (DHHS) whose mission is to protect the health of Americans and provide essential human services. Just as with law enforcement fault lines between federal, state, and local units, so do barriers and competition exist among our health care guardians. On a variety of issues and disease preventions and interdictions, "both the NIH and CDC continue to behave as if on-campus interests were all that mattered." That competition is mirrored across a swath of states and universities beyond the federal patch, and those institutions have relationships that are stronger with one federal entity than another.

While the AMA article is kind enough to speak of the series as a "hybrid NIH and CDC agency," the Post article can only allude to the competition, even partisanship, that is propelled by zero-sum contributions to ego, professional recognition, and funding.

At the kindest level, some CDC members and supporters in the wider public health community see a tilt to the wealthier NIH, a tilt sanctioned by DHHS Secretary, Tommy Thompson. It is true that:

The CDC, part of the U.S. Department of Health and Human Services, has long had to beg for help in its investigation of mysterious death and disease. It acquired the property for its main Atlanta campus only after Coca-Cola Co. baron Robert Woodruff helped give the agency land on the cheap in the 1940s.

NIH says no slight is intended, that they "never said they wanted it this way" and after all, "the show is not a documentary but entertainment." The struggle has continues at a low boil to prevent retribution. NIH says that it tried to tell NBC that the "show's heroes were on the wrong federal payroll." Opponents say that NIH did not try very hard. 

Personally, I think that some at NIH feel that they were fortunate to get something for nothing, i.e., that the bland NIH acquired a bit of the macho CDC image, never a bad thing in the gentle battle for funding before Congress, a process that I think modeled the funding presentations of the military intel units to NSA, a process that the Air Force won handsomely, followed by the Navy, with the Army taking the hindmost.

NBC says that they will mention CDC more in future episodes. Vigilant eyes will continue to survey the epidemiological fault line in our biological defense structure.

A CDC Drama, Starring the NIH
Some See Conspiracy in NBC Show's Inaccuracies
By Rick Weiss
Washington Post Staff Writer
September 8, 2004

Taking medical mysteries to prime time
By Susan J. Landers
AMNews staff. Aug. 23/30, 2004
American Medical Association

Vying for biodefense dollars
By Peg Brickley
The Scientist
January 15, 2003

The Epidemic Intelligence Service in the United States
Stephen M. Ostroff
Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Eurosurveillance, Vol 6, #3, March 2001

Gordon Housworth