1 00:00:00,320 --> 00:00:03,840 Speaker 1: Since you're a subscriber to this Bloomberg podcast, we thought 2 00:00:03,880 --> 00:00:07,320 Speaker 1: you'd be interested in a six episode sponsored podcast called 3 00:00:07,760 --> 00:00:12,760 Speaker 1: Targeting the Toughest Diseases produced by Vertex Pharmaceuticals and Bloomberg 4 00:00:12,800 --> 00:00:17,720 Speaker 1: Media Studios. It explores the innovative tools, methods, and unique 5 00:00:17,720 --> 00:00:22,479 Speaker 1: philosophy Vertex Pharmaceuticals is using to search for treatments for 6 00:00:22,560 --> 00:00:29,600 Speaker 1: some of humanity's most challenging diseases. Here's a recent episode. 7 00:00:29,320 --> 00:00:32,400 Speaker 2: That's Damian Sanchez, or if you are a jazz fan 8 00:00:32,520 --> 00:00:35,520 Speaker 2: living in Miami, Damian jy Well. 9 00:00:35,560 --> 00:00:38,080 Speaker 3: I play all types of music, but yes, my passion 10 00:00:38,159 --> 00:00:42,640 Speaker 3: lies in the jazz genre. The history of jazz inspires 11 00:00:42,640 --> 00:00:46,120 Speaker 3: me to create. I get very passionate about talking about 12 00:00:46,120 --> 00:00:49,000 Speaker 3: the history of jazz from its very beginnings until today. 13 00:00:50,200 --> 00:00:52,360 Speaker 2: His passion started when he was twelve years old. 14 00:00:53,000 --> 00:00:55,440 Speaker 3: I saw a picture in a magazine that changed my life. 15 00:00:55,480 --> 00:00:57,320 Speaker 3: When I was young. It was a picture of a 16 00:00:57,360 --> 00:01:00,680 Speaker 3: young man who was holding every single would win because 17 00:01:00,680 --> 00:01:02,840 Speaker 3: he could play them all, and so I wanted to 18 00:01:02,880 --> 00:01:03,640 Speaker 3: be like that kid. 19 00:01:04,080 --> 00:01:07,639 Speaker 2: Damien started with the obo, then the flute, the alto, sacks, 20 00:01:07,680 --> 00:01:09,720 Speaker 2: the clarinet, and even the bassoon. 21 00:01:10,640 --> 00:01:13,600 Speaker 3: I also play guitar. I also play piano, and I 22 00:01:13,640 --> 00:01:17,760 Speaker 3: also play various percussion instruments, mainly Latin percussion stuff because 23 00:01:17,800 --> 00:01:20,560 Speaker 3: it's part of my project to perform Latin jazz. 24 00:01:23,360 --> 00:01:25,679 Speaker 2: But on a day that should have been a musical celebration, 25 00:01:26,520 --> 00:01:28,360 Speaker 2: Damien's life took a terrible turn. 26 00:01:30,360 --> 00:01:30,679 Speaker 3: Hi. 27 00:01:30,920 --> 00:01:34,279 Speaker 2: I'm Jordan Gospore, a member of the University of Southern 28 00:01:34,319 --> 00:01:38,720 Speaker 2: California's Center for Health Journalism. This is Targeting the Toughest 29 00:01:38,720 --> 00:01:43,800 Speaker 2: Diseases a podcast produced by Bloomberg Media Studios and Vertex Pharmaceuticals. 30 00:01:45,040 --> 00:01:47,920 Speaker 2: In this series, we look at some of humanity's most 31 00:01:48,080 --> 00:01:52,520 Speaker 2: challenging diseases and how Vertex, a Boston based biotech company, 32 00:01:53,000 --> 00:01:57,160 Speaker 2: is using innovative tools, methods, and a unique philosophy to 33 00:01:57,200 --> 00:02:04,680 Speaker 2: search for treatments and cures. Today, we're looking at a 34 00:02:04,680 --> 00:02:08,919 Speaker 2: cute pain. You might think pain is just a sign 35 00:02:09,000 --> 00:02:12,040 Speaker 2: that something else is wrong in your body, but Vertex 36 00:02:12,160 --> 00:02:15,880 Speaker 2: is looking at pain as its own unique condition. They're 37 00:02:15,919 --> 00:02:17,560 Speaker 2: researching it as a disease. 38 00:02:21,480 --> 00:02:26,280 Speaker 3: It's December twenty twenty two. I just finished about a 39 00:02:26,400 --> 00:02:30,000 Speaker 3: month of rehearsals with a symphony, a very specific symphony 40 00:02:31,240 --> 00:02:37,600 Speaker 3: made up of nonprofit organizations sponsoring young musicians and professional 41 00:02:37,680 --> 00:02:41,440 Speaker 3: musicians here that play classical music that is of unheard 42 00:02:41,480 --> 00:02:42,919 Speaker 3: of composers of color. 43 00:02:43,919 --> 00:02:46,160 Speaker 2: This was the day of the inaugural performance. 44 00:02:47,080 --> 00:02:48,960 Speaker 3: I wake up early that day. It was a Saturday. 45 00:02:49,000 --> 00:02:51,440 Speaker 3: We're performing at the Broward Set of the Performing Arts, 46 00:02:51,480 --> 00:02:55,120 Speaker 3: this wonderful hall in Fort Lauderdale, Florida. I live in Miami, 47 00:02:55,240 --> 00:02:57,000 Speaker 3: so I grab my scooter. 48 00:02:58,639 --> 00:03:02,080 Speaker 2: See, Damien doesn't like driving. He's not a guy that 49 00:03:02,240 --> 00:03:06,079 Speaker 2: likes sitting still, and South Florida's traffic can be bad, 50 00:03:07,080 --> 00:03:10,600 Speaker 2: so instead of a car, he uses an electric kickscooter 51 00:03:10,720 --> 00:03:15,000 Speaker 2: and public transit. Getting to Fort Lauderdale means riding his 52 00:03:15,080 --> 00:03:18,240 Speaker 2: scooter to the train station, taking the train up the coast, 53 00:03:18,600 --> 00:03:21,120 Speaker 2: and then using the scooter again to get to the venue. 54 00:03:22,000 --> 00:03:24,880 Speaker 3: I have my English horrant and my olbow and my 55 00:03:25,000 --> 00:03:27,359 Speaker 3: music and my backpack on my backstrapped on. I had 56 00:03:27,360 --> 00:03:27,880 Speaker 3: my helmet. 57 00:03:28,800 --> 00:03:31,000 Speaker 2: He's also wearing a brand new tuxedo. 58 00:03:32,480 --> 00:03:34,840 Speaker 3: And I remember looking to the left and looking to 59 00:03:34,840 --> 00:03:39,040 Speaker 3: the right and saying, ha ha ah, traffic sucks. 60 00:03:41,400 --> 00:03:44,160 Speaker 2: Damien was in the bike lane going down a steep 61 00:03:44,240 --> 00:03:47,600 Speaker 2: hill when a driver apparently attempting to get out of 62 00:03:47,600 --> 00:03:51,920 Speaker 2: the gridlock suddenly turned into the bike lane. 63 00:03:54,320 --> 00:03:56,480 Speaker 3: I hit the front of her car with my scooter, 64 00:03:57,040 --> 00:03:59,880 Speaker 3: which I do not let go of, which actually ends 65 00:03:59,920 --> 00:04:02,680 Speaker 3: up flipping me over the front of her car. I 66 00:04:02,800 --> 00:04:04,960 Speaker 3: fly into the air and I land on my ribs, 67 00:04:05,000 --> 00:04:08,080 Speaker 3: which get cracked, and my foot, my right foot get 68 00:04:08,200 --> 00:04:12,880 Speaker 3: caught up in the accident, and my tibia and my 69 00:04:13,000 --> 00:04:16,719 Speaker 3: fibria both are shattered in many many places, and my 70 00:04:16,839 --> 00:04:22,679 Speaker 3: leg is completely discombobulated, disjointed to the side. 71 00:04:23,680 --> 00:04:27,880 Speaker 2: Damien didn't lose consciousness. In fact, he tried to stand up. 72 00:04:28,600 --> 00:04:31,680 Speaker 3: And as soon as I put one ounce of pressure 73 00:04:31,839 --> 00:04:35,400 Speaker 3: on that right foot, then the pain started coming in, 74 00:04:36,160 --> 00:04:38,440 Speaker 3: very very strong. As you can imagine. I have all 75 00:04:38,440 --> 00:04:41,400 Speaker 3: these broken bones in my right leg, and I'm trying 76 00:04:41,480 --> 00:04:43,320 Speaker 3: to walk on it and walk it off like and 77 00:04:43,360 --> 00:04:44,320 Speaker 3: nothing ever happened. 78 00:04:44,560 --> 00:04:49,039 Speaker 2: A crowd gathered and someone called for an ambulance. Within minutes, 79 00:04:49,120 --> 00:04:51,560 Speaker 2: he was in the emergency room of a nearby hospital. 80 00:04:52,600 --> 00:04:54,919 Speaker 2: The pain in his leg was unbearable. 81 00:04:58,160 --> 00:05:00,360 Speaker 3: This one guy says, we're gonna give you more, and 82 00:05:00,400 --> 00:05:03,360 Speaker 3: we're gonna manipulate that leg until they're ready to operate, 83 00:05:03,440 --> 00:05:06,360 Speaker 3: because it needs to be manipulated. I said, I've never 84 00:05:06,400 --> 00:05:09,400 Speaker 3: had any drugs. I don't take drugs. They said, well, 85 00:05:09,400 --> 00:05:12,840 Speaker 3: you're gonna want it. I said okay, and they gave 86 00:05:12,880 --> 00:05:14,919 Speaker 3: it to me through my ivy and I felt like 87 00:05:14,960 --> 00:05:17,960 Speaker 3: I was really drunk. And then he grabbed my foot 88 00:05:18,000 --> 00:05:24,839 Speaker 3: and put it back in place. I ready didn't feel inebriated. 89 00:05:24,920 --> 00:05:28,000 Speaker 3: I was laughing. I was joking, you know. I was 90 00:05:28,040 --> 00:05:31,480 Speaker 3: being very bubbly, which I usually am anyways, but I 91 00:05:31,560 --> 00:05:32,480 Speaker 3: was kind of scared. 92 00:05:34,760 --> 00:05:37,720 Speaker 2: After a few hours, the drugs were off and the 93 00:05:37,760 --> 00:05:41,000 Speaker 2: pain returned. It was time for a second dose. 94 00:05:41,839 --> 00:05:45,400 Speaker 3: I wasn't gonna take anything. I didn't want to get hooked. 95 00:05:46,320 --> 00:05:50,279 Speaker 3: My family has a lineage of substance and alcohol abuse. 96 00:05:51,000 --> 00:05:54,000 Speaker 3: My brother fights it, and my uncles fought it, and 97 00:05:54,040 --> 00:05:55,919 Speaker 3: I've always had that trauma in my brain. 98 00:05:56,680 --> 00:06:00,760 Speaker 2: It's a horrible decision many patients face, choosing between pain 99 00:06:01,080 --> 00:06:04,760 Speaker 2: and the risk of addiction. The doctors tried their best 100 00:06:04,760 --> 00:06:05,520 Speaker 2: to persuade him. 101 00:06:05,920 --> 00:06:08,000 Speaker 3: They were all about it. They were all about it. 102 00:06:09,080 --> 00:06:10,880 Speaker 3: Now you sure, are you sure? You don't want to 103 00:06:10,920 --> 00:06:13,599 Speaker 3: think nothing? What are you going to do? I'm just 104 00:06:13,600 --> 00:06:14,360 Speaker 3: gonna deal with it. 105 00:06:16,440 --> 00:06:19,120 Speaker 2: And that's what many patients do when faced with acute pain. 106 00:06:19,640 --> 00:06:21,120 Speaker 2: They just deal with it. 107 00:06:22,160 --> 00:06:26,360 Speaker 3: I never took any pain medication, no matter how bad 108 00:06:26,400 --> 00:06:29,040 Speaker 3: it hurt. But yeah, the first three months were hel Man. 109 00:06:30,320 --> 00:06:33,600 Speaker 2: Pain isn't entirely a bad thing. It's actually an important 110 00:06:33,600 --> 00:06:36,960 Speaker 2: warning system. It's our body's way of telling us something 111 00:06:37,040 --> 00:06:37,440 Speaker 2: is wrong. 112 00:06:38,560 --> 00:06:40,960 Speaker 4: Typically, you expect a broken limb to hurt a lot 113 00:06:41,000 --> 00:06:44,360 Speaker 4: when you injure it gradually get better. It'll be a 114 00:06:44,480 --> 00:06:47,919 Speaker 4: key for a few weeks, but as it heals after 115 00:06:47,960 --> 00:06:50,560 Speaker 4: three months, you would not expect someone to still have 116 00:06:50,640 --> 00:06:52,080 Speaker 4: pain from that broken limb. 117 00:06:53,000 --> 00:06:55,560 Speaker 2: Doctor Norman Buckley is the director of the Michael G. 118 00:06:55,720 --> 00:06:58,679 Speaker 2: Degrout National Pain Center in Hamilton, Canada. 119 00:06:59,120 --> 00:07:03,360 Speaker 4: There certainly are a settings where people continue to report pain. 120 00:07:03,760 --> 00:07:07,080 Speaker 4: Then you have to consider what's the reason for that, 121 00:07:07,560 --> 00:07:07,960 Speaker 4: he says. 122 00:07:08,040 --> 00:07:12,160 Speaker 2: Doctors have used medicine to manage pain for centuries. Opium 123 00:07:12,200 --> 00:07:15,920 Speaker 2: in the sixteen hundreds, ether and chloroform in the eighteen hundreds, 124 00:07:16,400 --> 00:07:20,720 Speaker 2: then morphine and even heroin in the nineteen hundreds. More recently, 125 00:07:21,200 --> 00:07:26,400 Speaker 2: insets have been used. Those are nonsterodal anti inflammatory drugs 126 00:07:27,040 --> 00:07:30,600 Speaker 2: and of course opioids, which can be effective but bring 127 00:07:30,680 --> 00:07:35,280 Speaker 2: tolerability concerns and carry the risk of addiction. Innovation and 128 00:07:35,360 --> 00:07:39,120 Speaker 2: pain management has been slow, in part because pain is 129 00:07:39,120 --> 00:07:44,600 Speaker 2: both common and complex. It affects individual people differently. Those 130 00:07:44,640 --> 00:07:49,200 Speaker 2: differences might be influenced by gender, genetics, and age, as 131 00:07:49,200 --> 00:07:54,480 Speaker 2: well as other factors. Pain represents exactly the kind of 132 00:07:54,560 --> 00:07:58,360 Speaker 2: medical problem Vertex likes to target. There's a long history 133 00:07:58,360 --> 00:08:02,080 Speaker 2: of research to build on, there's new technology available or 134 00:08:02,360 --> 00:08:05,800 Speaker 2: Vertex thinks they can develop it. There's a large unmet 135 00:08:05,840 --> 00:08:08,880 Speaker 2: need and Vertex thinks it may be possible to make 136 00:08:08,920 --> 00:08:09,920 Speaker 2: an impact. 137 00:08:10,240 --> 00:08:13,920 Speaker 1: We've picked a set of diseases, cystic fibrosis, type one, diabetes, 138 00:08:14,480 --> 00:08:17,080 Speaker 1: sickle cell disease, also pain. 139 00:08:18,040 --> 00:08:21,680 Speaker 2: That's doctor David Altschuler. He's the chief scientific officer at 140 00:08:21,760 --> 00:08:25,600 Speaker 2: Vertex Pharmaceuticals. What he's really on is a quest for 141 00:08:25,720 --> 00:08:29,680 Speaker 2: something innovative. He's in search of new ways to think 142 00:08:29,720 --> 00:08:31,160 Speaker 2: about old problems. 143 00:08:31,760 --> 00:08:34,200 Speaker 5: The real question in our mind is can we succeed? 144 00:08:34,480 --> 00:08:38,800 Speaker 5: Can we make a difference? Pain itself can be a disease. 145 00:08:39,520 --> 00:08:44,160 Speaker 2: That's doctor Paul Negelescu. He's leading Vertex's research in this area. 146 00:08:44,280 --> 00:08:47,679 Speaker 6: So while pain is a symptom of diseases, many diseases, 147 00:08:47,880 --> 00:08:50,400 Speaker 6: it can also be a disease in and of itself. 148 00:08:51,160 --> 00:08:53,680 Speaker 2: Vertex has been working on that puzzle for decades. 149 00:08:54,640 --> 00:08:57,360 Speaker 6: There are tens of millions of people in the US 150 00:08:57,440 --> 00:09:02,800 Speaker 6: that get pain experience every year, either acute or chronic pain. 151 00:09:03,320 --> 00:09:06,160 Speaker 7: One thing that really interested me is why does it 152 00:09:06,280 --> 00:09:10,320 Speaker 7: seem like some people are more sensitive to pain than others. 153 00:09:10,760 --> 00:09:15,520 Speaker 6: It's a very subjective thing pain, and it's actually we 154 00:09:15,559 --> 00:09:20,000 Speaker 6: don't understand what makes different people sensitive or not to pain. 155 00:09:20,840 --> 00:09:23,479 Speaker 5: I would say though, that there are outliers. 156 00:09:23,520 --> 00:09:25,760 Speaker 6: I mean, there are definitely some people that are way 157 00:09:25,800 --> 00:09:28,880 Speaker 6: off the charts in terms of their ability to detect 158 00:09:28,880 --> 00:09:29,520 Speaker 6: pain or not. 159 00:09:29,920 --> 00:09:32,520 Speaker 7: Would you be able to break down for me a 160 00:09:32,520 --> 00:09:34,840 Speaker 7: little bit further into what exactly is pain? 161 00:09:35,520 --> 00:09:39,760 Speaker 6: It's a really good question. So pain is an unpleasant sensation. 162 00:09:40,360 --> 00:09:43,560 Speaker 6: It's something that you experience, and so therefore it is 163 00:09:43,600 --> 00:09:47,640 Speaker 6: something that has been processed by your brain and depending 164 00:09:47,720 --> 00:09:52,679 Speaker 6: on your state of mind, literally that affects your ability 165 00:09:52,720 --> 00:09:57,760 Speaker 6: to sense pain. So it's a complicated process by which. 166 00:09:57,880 --> 00:09:59,199 Speaker 5: We perceive pain. 167 00:10:00,559 --> 00:10:03,000 Speaker 6: Now the way that we're trying to approach it, which 168 00:10:03,200 --> 00:10:05,480 Speaker 6: is to kind of take it out of the brain part, 169 00:10:06,160 --> 00:10:09,080 Speaker 6: because we know it starts in the periphery. 170 00:10:09,240 --> 00:10:10,679 Speaker 5: In most cases it's due to. 171 00:10:10,600 --> 00:10:14,560 Speaker 6: An injury or a surgery or damage to a nerve 172 00:10:15,120 --> 00:10:18,320 Speaker 6: that's outside the brain, so that part of the body 173 00:10:18,400 --> 00:10:22,080 Speaker 6: is sending signals to the brain. It hurts, It hurts, 174 00:10:22,280 --> 00:10:24,920 Speaker 6: and then you're processing those signals, and depending on whether 175 00:10:24,920 --> 00:10:27,560 Speaker 6: you're awake a sleep distracted, you feel. 176 00:10:27,320 --> 00:10:28,319 Speaker 5: Different levels of pain. 177 00:10:29,320 --> 00:10:31,120 Speaker 6: Our goal is to try to cut it off so 178 00:10:31,160 --> 00:10:35,000 Speaker 6: it never really gets to the brain. Opioids work at 179 00:10:35,000 --> 00:10:35,800 Speaker 6: the level. 180 00:10:35,520 --> 00:10:36,840 Speaker 5: Of the central nervous system. 181 00:10:36,880 --> 00:10:41,240 Speaker 6: They actually suppress the inputs that are coming into the brain, 182 00:10:41,280 --> 00:10:43,920 Speaker 6: and so we're trying to work from the outside of 183 00:10:43,960 --> 00:10:46,880 Speaker 6: the brain to reduce the pain signals into it. 184 00:10:47,840 --> 00:10:51,920 Speaker 2: That's the unique aspect of Vertex's approach to research, innovative 185 00:10:51,960 --> 00:10:55,360 Speaker 2: approaches based on the underlying mechanism of the disease. 186 00:10:56,600 --> 00:11:00,240 Speaker 6: The way we're approaching pain is by targeting the these 187 00:11:00,280 --> 00:11:03,480 Speaker 6: proteins that have been identified through human genetics as playing 188 00:11:03,559 --> 00:11:07,880 Speaker 6: a key role in the transmission of pain signals in 189 00:11:07,920 --> 00:11:11,440 Speaker 6: the pain sensing neurons. If you think about the pain 190 00:11:11,480 --> 00:11:16,000 Speaker 6: sensing neuron as a wire, it's transmitting a signal that 191 00:11:16,080 --> 00:11:18,520 Speaker 6: says I've got pain in one part of my body 192 00:11:18,800 --> 00:11:21,440 Speaker 6: to the other part of your body, and for that 193 00:11:21,600 --> 00:11:25,600 Speaker 6: signal to get transmitted, it has to be conducted along 194 00:11:25,640 --> 00:11:29,920 Speaker 6: that wire to conduct that electrical signal through that sensory nerve. 195 00:11:30,320 --> 00:11:33,400 Speaker 6: It's kind of like a bucket brigade. One channel opens 196 00:11:33,400 --> 00:11:35,640 Speaker 6: at one end and it passes the electrical signal to 197 00:11:35,720 --> 00:11:38,520 Speaker 6: the next and that gets passed to the next one 198 00:11:39,000 --> 00:11:41,840 Speaker 6: and so on, and that's how the signal gets propagated. 199 00:11:42,000 --> 00:11:45,760 Speaker 6: And so you know, we're trying to interrupt that transmission. 200 00:11:46,200 --> 00:11:49,160 Speaker 2: The work is focused on researching the mechanism of how 201 00:11:49,160 --> 00:11:51,839 Speaker 2: a pain signal travels in the body, with the hope 202 00:11:51,880 --> 00:11:59,720 Speaker 2: of making a difference for patients. It's been two years 203 00:11:59,720 --> 00:12:03,600 Speaker 2: since Damien's accident, and other than walking with a slight limp, 204 00:12:04,000 --> 00:12:07,080 Speaker 2: he's moved on with his life. He doesn't dwell on 205 00:12:07,120 --> 00:12:10,880 Speaker 2: those pain filled months after his surgery. In fact, he 206 00:12:10,960 --> 00:12:13,200 Speaker 2: says he really doesn't remember most of it. 207 00:12:14,480 --> 00:12:17,760 Speaker 3: You tend to block out memories that you don't want, 208 00:12:18,400 --> 00:12:22,440 Speaker 3: you really do. They're painful, So I think that's why 209 00:12:22,520 --> 00:12:25,040 Speaker 3: I don't remember more about that time in the hospital. 210 00:12:25,559 --> 00:12:28,280 Speaker 2: What he does remember is that when the pain was 211 00:12:28,400 --> 00:12:30,960 Speaker 2: so bad it made it difficult to even stand up, 212 00:12:31,720 --> 00:12:33,120 Speaker 2: he never lost his passion. 213 00:12:33,400 --> 00:12:35,000 Speaker 3: I don't want to give up on music. I don't 214 00:12:35,000 --> 00:12:37,080 Speaker 3: want to give up on my music. As long as 215 00:12:37,120 --> 00:12:39,800 Speaker 3: I'm close to the music and keep playing music, I'm 216 00:12:39,880 --> 00:12:42,120 Speaker 3: very happy. So that's what I want to know. I'm 217 00:12:42,120 --> 00:12:42,840 Speaker 3: want to be at peace. 218 00:12:50,200 --> 00:12:53,560 Speaker 2: This is Targeting the toughest diseases. A podcast from Bloomberg 219 00:12:53,600 --> 00:12:57,640 Speaker 2: Media Studios and Vertex Pharmaceuticals. If you like what you hear, 220 00:12:58,040 --> 00:13:02,520 Speaker 2: subscribe and leave us a review. I'm Jordan Gospore. Thanks 221 00:13:02,520 --> 00:13:03,079 Speaker 2: for listening.