The fictitious (he or she?) French researcher Camille Nούς, with a very rich CV, acquired within a year or so, attracted the interest of the journal Science [1]. The surname Nούς relies on a collegial “We” (“nous” in French) but referring above all to the concept of “mind” or “intellect” (“νοῦς”) inherited from Greek philosophy [2]. Nούς is the Greek word for “mind”. However, Nούς is far richer since it is linked with philosophical notions e.g., “νούς υγιής εν σώματι υγιεί”, which means “a healthy mind in a healthy body”. Αccording to the inventors, Camille Nούς is a collective individual who symbolizes our deep attachment to the values of ethics and probation through contradictory debate, insensitive to the indicators elaborated by the institutional management of research, and conscious of what our results owe to collective construction [2]. However, the real roots of the fictitious Camille Nούς are immersed in the credit that comes with authorship [2] and its poor quantification based on the number of citations. The ethical dimension accompanying this credit, calls for a closer consideration of Camille Nούς case.
The need for specifying the contribution of each one of the authors of published papers was first pointed out by Professor Spyridon Moulopoulos and his group in 1983 [3]. Moulopoulos, who invented the intra-aortic balloon pump in 1962 [4], was fed-up with his colleagues, directors of the clinics of the Greek University hospitals, who claimed extensive research work without actual participation in the studies published. Moulopoulos used an intriguing title “For debate … Individual contributions to multiauthor papers” for his famous work [4]. This article concludes as follows: “It is suggested that the journals require authors to state their specific contribution to a paper, such as original idea, planning, collecting data, writing up, etc.” thus requiring each of the co-authors to specify his/her contribution to the article. We believe that this is the critical starting point for the link between the responsibility and accountability which accompany the credit that comes with authorship. Undoubtedly, scientists, including the creators of Camille Nούς, agree with Moulopoulos suggestions. Indeed, almost all journals, have now adopted Moulopoulos’ suggestions and the contribution of each author is an obligatory element of the manuscript’s initial submission.
Over the years, and with the development of electronic recording of citations (such as Google Scholar), the quantification of the contribution of every author to science became “easier”. However, a lot of biases were identified in the assessment of each individual based on the number of citations, and the h-index became one of the metrics for classifying the scientist’s impact [5]. This is so, despite the use of the authors’ contribution requirement from journals. This is the fundamental reason for the creation of Camille Nούς and the concern of many scientists around the world who cannot accept the present system based on mere numbers which do not capture the substance of the scientific work.
We suggest that we now need an additional qualitative reform. To this end, we consider Figure 1, which shows the three sides of the coin; the flat sides of the coin include the scientists who are happy or unhappy with the present system. The former category includes scientists who have many thousands of citations and they likely belong to scientific disciplines with a very large number of members who perform easily repeatable work. This category also includes scientists who write systematic reviews or participate in complex multi-authored papers, leading to very large numbers of citations and high h-indexes. The category of the unhappy scientists includes scientists from small disciplines; here, one can find Camille Nούς and a large number of scientists who have reservations about the present system and therefore support the Nούς notion. The scientists of this category have relatively low number of citations and h-indexes.

The three sides of the coin.
On the heads side you will find the happy Apollonians; on the tails side you will find the unhappy Apollonians, including Camille Nous. The edge side represents the risk-taking Dionysians. For more discussion see text.
The qualitative reform we are proposing relies on the Albert Szent-Györgyi’s concept, who realized that “a discovery must be, by definition, at variance with existing knowledge” [6]. He won the Nobel Prize in Physiology or Medicine in 1937 and divided scientists into two categories: the Apollonians and the Dionysians. For Dionysian scientists he used the following definition “scientific dissenters, who explored the fringes of knowledge.” According to him, the Apollonians tend to develop established lines to perfection, while the Dionysians rely on intuition and are more likely to open new, unexpected alleys for research. In the same vein, we place the Dionysian scientists at the edge of the coin (Figure 1), while Apollonians lie at the two flat sides of the coin, including both happy and unhappy scientists with the present system. It is suggested, therefore, that scientific journals of different disciplines create a Dionysian section for publishing novel work which “explores the fringes of knowledge” i.e., a study which refutes a long-held theory or opens an entirely new theory, or discipline, or methodology. This will also allow for the qualitative classification of scientists. A Dionysian scientist will have a very limited number of papers in his/her entire career and maybe a large number of papers in the Apollonian section of the journals. This is so, since ideas for a Dionysian article are usually limited for each individual during their entire life. However, the comparison of scientists will not depend any more on the number of citations [5]. Each of the disciplines can create their own classification of scientists using the Apollonian and the Dionysian categories, while today’s ugly interdisciplinary comparisons in terms of citations will end. We also quote the wise words of Szent-Györgyi [6]: “The future of mankind depends on the progress of science, and the progress of science depends on the support it can find. Support mostly takes the form of grants, and the present methods of distributing grants unduly favor the Apollonians”. This is an additional reason for implementing the Apollonian and the Dionysian classification system, in order for Dionysian scientists to enjoy the recognition they deserve.
We close by mentioning that the qualitative classification of individuals for their contributions is not limited to science but can be applicable in many other fields such as sports, the arts, business etc. An example from the world of sports illustrates our point. In boxing, there two categories of fighters. The “punchers” deliver very few punches during a fight but even if one lands, it is usually a knock-out. The “boxers” deliver 10–100 times more punches, in hopes that the damage is inflicted by accumulation, not a knock-out.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
References
1. O’Grady, C. Who is Camille Noûs, the fictitious French researcher with nearly 200 papers? Science 2021. https://doi.org/10.1126/science.abi5504.Search in Google Scholar
2. Anonymous. Cogitamus Laboratory. Camille Noûs (Cogitamus Laboratory | Camille Noûs).Search in Google Scholar
3. Moulopoulos, SD, Sideris, DA, Georgilis, KA. For debate … Individual contributions to multiauthor papers. Br Med J 1983;287:1608. https://doi.org/10.1136/bmj.287.6405.1608.Search in Google Scholar PubMed PubMed Central
4. Moulopoulos, SD. Intra-aortic balloon counterpulsation 50 years later: initial conception and consequent ideas. Artif Organs 2011;35:843–8. https://doi.org/10.1111/j.1525-1594.2011.01284.x.Search in Google Scholar PubMed
5. Pavlou, M, Diamandis, EP. The athletes of science. Nature 2011;478:419. https://doi.org/10.1038/nj7369-419a.Search in Google Scholar
6. Szent-Györgyi, A. Dionysians and Apollonians. Science 1972;176:966. https://doi.org/10.1126/science.176.4038.966.Search in Google Scholar PubMed
© 2021 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- From Camille Nούς to Apollonian and the Dionysian scientists
- Review
- The role of D-dimer in periprosthetic joint infection: a systematic review and meta-analysis
- Mini Reviews
- Updated picture of SARS-CoV-2 variants and mutations
- Systematic review and cumulative meta-analysis of the diagnostic accuracy of glial fibrillary acidic protein vs. S100 calcium binding protein B as blood biomarkers in observational studies of patients with mild or moderate acute traumatic brain injury
- Opinion Papers
- The 6C model for accurately capturing the patient’s medical history
- Webside manner: maskless communication
- Original Articles
- Ways that nurse practitioner students self-explain during diagnostic reasoning
- Diagnostic reasoning: relationships among expertise, accuracy, and ways that nurse practitioner students self-explain
- Perspectives on the current state of pre-clerkship clinical reasoning instruction in United States medical schools: a survey of clinical skills course directors
- Use of a structured approach and virtual simulation practice to improve diagnostic reasoning
- Analyzing diagnostic errors in the acute setting: a process-driven approach
- Morning report goes virtual: learner experiences in a virtual, case-based diagnostic reasoning conference
- Stroke hospitalization after misdiagnosis of “benign dizziness” is lower in specialty care than general practice: a population-based cohort analysis of missed stroke using SPADE methods
- Discrepancy between emergency department admission diagnosis and hospital discharge diagnosis and its impact on length of stay, up-triage to the intensive care unit, and mortality
- Automated capture-based NGS workflow: one thousand patients experience in a clinical routine framework
- Short Communication
- Characterizing the relationship between diagnostic intensity and quality of care
- Case Reports – Lessons in Clinical Reasoning
- Lessons in clinical reasoning ‒ pitfalls, myths, and pearls: a case of confusion, disequilibrium, and “picking at the air”
- Hickam’s dictum, Occam’s razor, and Crabtree’s bludgeon: a case of renal failure and a clavicular mass
- Letters to the Editor
- Three learning concepts to improve diagnosis and enhance the practice of medicine
- Distributed cognition: a framework for conceptualizing telediagnosis in teams
- Performance of Fujirebio Espline SARS-CoV-2 rapid antigen test for identifying potentially infectious individuals
Articles in the same Issue
- Frontmatter
- Editorial
- From Camille Nούς to Apollonian and the Dionysian scientists
- Review
- The role of D-dimer in periprosthetic joint infection: a systematic review and meta-analysis
- Mini Reviews
- Updated picture of SARS-CoV-2 variants and mutations
- Systematic review and cumulative meta-analysis of the diagnostic accuracy of glial fibrillary acidic protein vs. S100 calcium binding protein B as blood biomarkers in observational studies of patients with mild or moderate acute traumatic brain injury
- Opinion Papers
- The 6C model for accurately capturing the patient’s medical history
- Webside manner: maskless communication
- Original Articles
- Ways that nurse practitioner students self-explain during diagnostic reasoning
- Diagnostic reasoning: relationships among expertise, accuracy, and ways that nurse practitioner students self-explain
- Perspectives on the current state of pre-clerkship clinical reasoning instruction in United States medical schools: a survey of clinical skills course directors
- Use of a structured approach and virtual simulation practice to improve diagnostic reasoning
- Analyzing diagnostic errors in the acute setting: a process-driven approach
- Morning report goes virtual: learner experiences in a virtual, case-based diagnostic reasoning conference
- Stroke hospitalization after misdiagnosis of “benign dizziness” is lower in specialty care than general practice: a population-based cohort analysis of missed stroke using SPADE methods
- Discrepancy between emergency department admission diagnosis and hospital discharge diagnosis and its impact on length of stay, up-triage to the intensive care unit, and mortality
- Automated capture-based NGS workflow: one thousand patients experience in a clinical routine framework
- Short Communication
- Characterizing the relationship between diagnostic intensity and quality of care
- Case Reports – Lessons in Clinical Reasoning
- Lessons in clinical reasoning ‒ pitfalls, myths, and pearls: a case of confusion, disequilibrium, and “picking at the air”
- Hickam’s dictum, Occam’s razor, and Crabtree’s bludgeon: a case of renal failure and a clavicular mass
- Letters to the Editor
- Three learning concepts to improve diagnosis and enhance the practice of medicine
- Distributed cognition: a framework for conceptualizing telediagnosis in teams
- Performance of Fujirebio Espline SARS-CoV-2 rapid antigen test for identifying potentially infectious individuals