This chapter discusses the history, structure, dynamics, and incentive structure of the biomedical research community. We examine how the Idols of the Mind, as set of cautionary conditions described by Francis Bacon in the seventeenth century, are currently manifest and perpetuated in the biomedical research community. We describe the impact of professionalization of academic biomedical research on promoting stagnation with respect to innovation and discovery within the community and how current academic metrics of success have led to an incentive structure that has produced a diversion from the end-goals of biomedical research. We also explore the structural, organizational, and operational challenges facing the pharmaceutical industry, and how these factors contribute to the perpetuation of the Translational Dilemma.