Moments of progress in a firehose of upheaval
I haven’t posted in a while. Things have been…busy. And unprecedented. And a little overwhelming. At the start of last week, I thought I might open this essay by sharing some of the science-y work that has been keeping me away from writing. Now, as I sit down to write, I don’t think this last week fits neatly into a single story. It has felt more like a series of moments, each harder to process than the last. It has been a rollercoaster for sure. Let’s start at the beginning.
Still showing up for science
The past month was spent largely on grant writing. Me, sitting at my desk typing, is not the most exciting thing to share, but it is at the core of how science gets done. I’ve been revisiting a project I first submitted a few years ago that was not funded. I’ve been reworking it from the ground up, rethinking the framing, and hopefully building something stronger. I started outlining it in January, and then, as often happens, the real work compressed into a few intense weeks in May. It was a push, but I made it to submission day.
And then I almost didn’t submit it.
Not because I wasn’t prepared, I was ready a week before the deadline. Not because I didn’t love it, I desperately want to do this science. I was one proofread away from finishing when I learned about proposed changes to the NIH peer review process. Specifically that scores would no longer be shared with applicants or program officers (science experts at NIH). This felt like a gut punch. While this would clearly devalue transparency and merit in funding decisions, it has even broader consequences for scientists.
For context, grant proposals are typically reviewed by three experts in the field, who give a score prior to review panel discussion. Roughly the top half of these grants would then be individually discussed for merit in a full review panel of science experts. The final scores are then ranked and passed on for funding decisions. Funding generally goes to the top scoring grants, with some exceptions. These scores, along with published funding ranges (typically the top ~10%), help us to navigate and prioritize our ideas and time: if a score is close to the funding line, that is well worth a resubmission. If well-outside the range on the third submission it may be time to pivot to another idea. When funding is tight, these signals matter. They help us make decisions about where to invest months of work. How do we evaluate and prioritize ideas if the feedback system is not transparent?
Recently, however, timelines for funding have stretched considerably, which you may recall from this essay. And scoring well within that funding range is no longer a strong indicator of funding to come. I’m currently waiting on two top-scoring grants (one for more than a year), and one of my trainees has been waiting on her top scoring proposal as well. To be clear, my work does not fall into what might be considered “controversial.” I study early predictors of obesity and diabetes in the context of human nutrition and metabolism, using a novel human model system rather than animal models. This work aligns quite closely with the types of research currently described as priorities. Yet the funding has not arrived.
So in that moment, with my proposal in front of me, the question quickly became: What is the point? What is the point of spending my time meticulously preparing these proposals? The early mornings, late evenings, and weekends. Less time spent with my children. The stress. And as a reviewer of these proposals, what is the point of using my expertise and time to review, unpaid time not spent with my family, if the scores will not used for funding guidance.
With one proofread left, I almost gave up and didn’t submit. But in the end I did. I did it for the people who helped along the way: my lovely grants manager, my colleagues who sat through chalk talks on how to improve the science, and then critically reviewed my summary page. Not to mention the decades of mentors and colleagues who have supported me. But ultimately, I did it for the science. I have not yet given up on science.
Shifting Terrain
This had all happened before the week really began. I finished my submission, welcomed two new summer interns into the lab, and prepared to leave to New Orleans for a conference and pre-conference meetings. But just before leaving, the Office of Budget Management published a 400-page proposal outlining potential changes to how federal grants would be funded and managed.
There are many excellent summaries of what this means for science and federally funded programs like medicaid and transportation, here and here, and I won’t try to reproduce them. But broadly, the proposed changes would have sweeping impacts nationwide in most sectors (See Box below). The most impactful are that all grants would be subject to administrative approval and any grant could be cancelled at any time for any reason. A big stick to force compliance and silence.
Proposed Changes to Federal Research Funding (Selected Highlights)
- Administrative approval of all grants. All federal grants would require approval from political (rather than scientific) appointees, introducing decision-making by individuals without subject-matter expertise. (Keep reading for a very real and timely example of how funding decisions made without expertise can play out in practice.)
- Termination of funding at any time. Any federal grant could be cancelled at any point, for any reason. For research labs, which operate much like small businesses, this makes long-term planning nearly impossible, particularly when it comes to supporting trainees and staff. Committing to graduate students requiring 4-5 years of sustained support would be nearly impossible.
- Restrictions on international collaboration. Proposed limits on global partnerships would significantly constrain collaborative work needed to address complex health challenges, from metabolic disease to emerging infectious threats like Ebola. Just yesterday, I heard about an early‑career researcher who was told by their university to immediately stop work on a joint publication with international collaborators, slated for Science. A career‑defining opportunity in jeopardy, not because funding or resources changed hands, but because it involved sharing ideas and summary data. And the rules are not even in effect yet.
- Limitations on open-access publishing. Federal mandates and NIH policies require publicly funded research to be published open access so that you, the public, can read it, often at costs exceeding $5,000–$10,000. These expenses may no longer be supported by grant funds. Who will pay for them? I can’t afford that out of pocket. Which means you cannot read the research your tax dollars support.
- Constraints on scientific communication. Researchers may be restricted from communicating work in broadly defined “sensitive” areas. The lack of clear definition introduces substantial uncertainty around what can be shared, with potential chilling effects on scientific dialogue.
The proposed rules are open for public comment until July 13th. I encourage you to comment here on how this would impact you, our nation, and our society. Anyone can comment. You don’t need to be a scientist or work in any of the areas impacted. If you’re unsure how to prepare a response or what exactly this all means, you can find some general guidance here or take a deep dive here.
In the midst of this, I arrived in New Orleans and participated in a wonderful day of NIH-funded science discussion. Scientists who have dedicated their life’s work to helping those with diabetes, all sharing their incredible work. Collaborative work that cannot be done without concerted funds from such federally-funded programs. It was a potent reminder of what these systems make possible. Discovery and progress cannot happen in isolation or without support.
The next day, one of my trainees texted me. Her first R01 (NIH project grant) had been funded!! It was an incredible moment. I’m so excited for her to get to do this project. The juxtaposition has been difficult to ignore: hope in discovering new ways to improve the lives of those living with chronic diseases like diabetes, alongside growing uncertainty about the systems that support that work.
A moment that shouldn’t have been
The week did not slow down. It was only getting ramped up. Friday marked the first day of the American Diabetes Association annual conference. Jay Bhattacharya had been scheduled to speak at the opening session in a “fireside chat.” I hadn’t planned to attend, but several colleagues did. As it turned out, he did not appear and sent a representative in his place. According to colleagues in attendance, the remarks began somewhat unexpectedly discussing fluoride, sparking wonder at whether he thought he was at the other ADA, the American Dental Association.
Outside the session, colleagues were sharing printed copies of an editorial published in Diabetes Care, the Association’s own journal. Dr. Steven Kahn and others, several of whom I know personally and hold in very high regard, were asked to leave the premises while doing so. First off, distributing a paper at a conference is normal. In the days before search engines and Pubmed, that was how you got your research out there: you brought paper copies to conferences and handed them out.
Secondly, these are not fringe voices or casual participants. For context, Dr. Kahn is the lead author of the editorial and the Editor‑in‑Chief of Diabetes Care. These are deeply respected leaders in the diabetes research community. People who have shaped the field over decades. One is a former ADA president, and Dr. Kahn himself received the Banting Award, the Association’s highest honor, just last year. Seeing how the situation unfolded was striking, and for many, difficult to reconcile with the norms of scientific discourse. I have great respect for these brave colleagues who engage thoughtfully and speak openly in moments like this.
I have supported the ADA for years as a member and grant reviewer. I have published my work in their journals, they even funded my first independent research project. But the immediate escalation, threatening arrest, is a bad look for the Association, and they continued to bungle the response leading to several high level resignations. Many scientists and community members have been standing up together with these brave scientists. That editorial that had about 500 views prior to the event now has over 111,000. Please read this and their other editorials on the impacts of federal changes on science and diabetes care here and here.
What to screwworms have to do with anything?
If you’re outside of science, it might feel like these changes are distant or slow-moving. Unlikely to affect your daily life, or certainly not anytime soon. But the connection is often more immediate than it appears. And it did appear this week.
A few months ago, I listened to a wonderful RadioLab piece about screwworms and the great scientific and financial efforts that went into eradicating them from the United States and most of North America in the 1960’s (I make the carpool kids listen to RadioLab on the way to school and we were all fascinated by this story). If you did not know, screwworms are a flesh eating parasite, devastating to livestock, and yes, they can infect humans too. The success of that program, and the maintenance since, depended on sustained monitoring programs and international cooperation.
It may have gone under your radar at the time, but this was one of the programs slashed by DOGE, deemed a waste. At first glance, that may seem straightforward: why invest resources to help Central America and Mexico control a parasite? But I often wonder, weren’t these people curious at all? About 15 minutes of ‘research’ into why these programs existed would likely have surfaced a very compelling rationale for maintaining them. But this is what happens when arrogant, unserious people override expertise. Many international programs cut were not just humanitarian (which should justify their funding alone), but they protected US interests: financial, health, safety.
And sadly, the screwworm is now back in the US. Even higher beef prices are headed your way. Let this serve as a reminder that many systems we quietly rely on: public health surveillance, agricultural protections, global monitoring. These programs only work when they are continuous. The consequences of interruptions can be both real and rapid. The cost of fixing this will be much more substantial than the maintenance program we had in place. Not to mention the massive funds that were spent on eradication in the first place, now wasted.
Still Learning
If you made it this far, I do want to end on a higher note. Alongside everything else this week, I learned that my promotion to full Professor and the award of tenure were approved. I remember when I was just starting my faculty position in 2013. After years of graduate training and years of postdoctoral training, I was now working on yet another assistant professor ‘training.’ My dad asked me when I was going to have a ‘real job.’ When I would no longer be an assistant (I don’t come from academics, first generation college graduate here). I explained that this was finally a ‘real’ job, but that I wouldn’t be a professor without qualifiers for maybe another 15 years (the average for women in academic medicine is 12-18 years!).
I’m happy to report that I beat that timeline. But nothing has really changed. I’m still training. I’m still learning every day. Scientists never “arrive,” they are always asking questions, always learning. Because science never finishes. That’s also why expertise matters. Not as a marker of status, but as a reflection of time spent learning how to ask questions and evaluate evidence carefully and objectively. And most importantly, how to remain both cautious and curious. To ask why something exists before deeming it unnecessary.
And even now, in a week of small wins in the midst of upheaval, this part remains the same: we keep learning, we keep doing the work. For science.
Kristen Boyle, PhD
Dr. Kristen Boyle is Associate Professor of Pediatrics at the University of Colorado School of Medicine, where she leads the Molecular Health Lab. Her work examines how early life shapes lifelong health. She writes about how science works, how we interpret evidence, and how we can make sense of uncertainty.
References
- Anderson CAM, Buse JB, Kahn SE, Selvin E. The Forces Reshaping America’s Health Landscape for People With Diabetes-This Is Not About DEI, This Is About Whether People Live or DIE. Diabetes Care. 2026 Jan 1;49(1):5-6. doi: 10.2337/dci25-0100. PMID: 40779300.
- Kahn SE, Anderson CAM, Buse JB, Selvin E; Misguided Brushes of a Pen Continue to Dismantle and Destroy Biomedical Research in the United States: We Can No Longer Afford Complacency and Fear. We Must All Act Now!. Diabetes Care 20 May 2026; 49 (6): 901–905. https://doi.org/10.2337/dci26-0068 PMID: 42053433.
- Kahn SE, Anderson CAM, Buse JB, Selvin E, Aroda VR, Berkowitz SA, Crowley MJ, Fitzpatrick SL, Gadgil MD, Gallagher EJ, Haller MJ, Hughes A, Kandula NR, Kovesdy CP, Laiteerapong N, Nadeau KJ, Pettus J, Pop-Busui R, Posey JE, Rebholz CM, Sims EK, Atkinson MA, Kirkman MS, Rich SS, Seaquist ER. Please Tell Me It Is Only a Nightmare-The Proposed Dismantling of the United States Federal Research Infrastructure. Diabetes Care. 2026 Jun 8:dci260089. doi: 10.2337/dci26-0089. Epub ahead of print. PMID: 42258706.
