WEBVTT - Targeting Pain (Sponsored Content) 0:00:00.320 --> 0:00:03.840 Since you're a subscriber to this Bloomberg podcast, we thought 0:00:03.880 --> 0:00:07.320 you'd be interested in a six episode sponsored podcast called 0:00:07.760 --> 0:00:12.760 Targeting the Toughest Diseases produced by Vertex Pharmaceuticals and Bloomberg 0:00:12.800 --> 0:00:17.720 Media Studios. It explores the innovative tools, methods, and unique 0:00:17.720 --> 0:00:22.479 philosophy Vertex Pharmaceuticals is using to search for treatments for 0:00:22.560 --> 0:00:29.600 some of humanity's most challenging diseases. Here's a recent episode. 0:00:29.320 --> 0:00:32.400 That's Damian Sanchez, or if you are a jazz fan 0:00:32.520 --> 0:00:35.520 living in Miami, Damian jy Well. 0:00:35.560 --> 0:00:38.080 I play all types of music, but yes, my passion 0:00:38.159 --> 0:00:42.640 lies in the jazz genre. The history of jazz inspires 0:00:42.640 --> 0:00:46.120 me to create. I get very passionate about talking about 0:00:46.120 --> 0:00:49.000 the history of jazz from its very beginnings until today. 0:00:50.200 --> 0:00:52.360 His passion started when he was twelve years old. 0:00:53.000 --> 0:00:55.440 I saw a picture in a magazine that changed my life. 0:00:55.480 --> 0:00:57.320 When I was young. It was a picture of a 0:00:57.360 --> 0:01:00.680 young man who was holding every single would win because 0:01:00.680 --> 0:01:02.840 he could play them all, and so I wanted to 0:01:02.880 --> 0:01:03.640 be like that kid. 0:01:04.080 --> 0:01:07.639 Damien started with the obo, then the flute, the alto, sacks, 0:01:07.680 --> 0:01:09.720 the clarinet, and even the bassoon. 0:01:10.640 --> 0:01:13.600 I also play guitar. I also play piano, and I 0:01:13.640 --> 0:01:17.760 also play various percussion instruments, mainly Latin percussion stuff because 0:01:17.800 --> 0:01:20.560 it's part of my project to perform Latin jazz. 0:01:23.360 --> 0:01:25.679 But on a day that should have been a musical celebration, 0:01:26.520 --> 0:01:28.360 Damien's life took a terrible turn. 0:01:30.360 --> 0:01:30.679 Hi. 0:01:30.920 --> 0:01:34.279 I'm Jordan Gospore, a member of the University of Southern 0:01:34.319 --> 0:01:38.720 California's Center for Health Journalism. This is Targeting the Toughest 0:01:38.720 --> 0:01:43.800 Diseases a podcast produced by Bloomberg Media Studios and Vertex Pharmaceuticals. 0:01:45.040 --> 0:01:47.920 In this series, we look at some of humanity's most 0:01:48.080 --> 0:01:52.520 challenging diseases and how Vertex, a Boston based biotech company, 0:01:53.000 --> 0:01:57.160 is using innovative tools, methods, and a unique philosophy to 0:01:57.200 --> 0:02:04.680 search for treatments and cures. Today, we're looking at a 0:02:04.680 --> 0:02:08.919 cute pain. You might think pain is just a sign 0:02:09.000 --> 0:02:12.040 that something else is wrong in your body, but Vertex 0:02:12.160 --> 0:02:15.880 is looking at pain as its own unique condition. They're 0:02:15.919 --> 0:02:17.560 researching it as a disease. 0:02:21.480 --> 0:02:26.280 It's December twenty twenty two. I just finished about a 0:02:26.400 --> 0:02:30.000 month of rehearsals with a symphony, a very specific symphony 0:02:31.240 --> 0:02:37.600 made up of nonprofit organizations sponsoring young musicians and professional 0:02:37.680 --> 0:02:41.440 musicians here that play classical music that is of unheard 0:02:41.480 --> 0:02:42.919 of composers of color. 0:02:43.919 --> 0:02:46.160 This was the day of the inaugural performance. 0:02:47.080 --> 0:02:48.960 I wake up early that day. It was a Saturday. 0:02:49.000 --> 0:02:51.440 We're performing at the Broward Set of the Performing Arts, 0:02:51.480 --> 0:02:55.120 this wonderful hall in Fort Lauderdale, Florida. I live in Miami, 0:02:55.240 --> 0:02:57.000 so I grab my scooter. 0:02:58.639 --> 0:03:02.080 See, Damien doesn't like driving. He's not a guy that 0:03:02.240 --> 0:03:06.079 likes sitting still, and South Florida's traffic can be bad, 0:03:07.080 --> 0:03:10.600 so instead of a car, he uses an electric kickscooter 0:03:10.720 --> 0:03:15.000 and public transit. Getting to Fort Lauderdale means riding his 0:03:15.080 --> 0:03:18.240 scooter to the train station, taking the train up the coast, 0:03:18.600 --> 0:03:21.120 and then using the scooter again to get to the venue. 0:03:22.000 --> 0:03:24.880 I have my English horrant and my olbow and my 0:03:25.000 --> 0:03:27.359 music and my backpack on my backstrapped on. I had 0:03:27.360 --> 0:03:27.880 my helmet. 0:03:28.800 --> 0:03:31.000 He's also wearing a brand new tuxedo. 0:03:32.480 --> 0:03:34.840 And I remember looking to the left and looking to 0:03:34.840 --> 0:03:39.040 the right and saying, ha ha ah, traffic sucks. 0:03:41.400 --> 0:03:44.160 Damien was in the bike lane going down a steep 0:03:44.240 --> 0:03:47.600 hill when a driver apparently attempting to get out of 0:03:47.600 --> 0:03:51.920 the gridlock suddenly turned into the bike lane. 0:03:54.320 --> 0:03:56.480 I hit the front of her car with my scooter, 0:03:57.040 --> 0:03:59.880 which I do not let go of, which actually ends 0:03:59.920 --> 0:04:02.680 up flipping me over the front of her car. I 0:04:02.800 --> 0:04:04.960 fly into the air and I land on my ribs, 0:04:05.000 --> 0:04:08.080 which get cracked, and my foot, my right foot get 0:04:08.200 --> 0:04:12.880 caught up in the accident, and my tibia and my 0:04:13.000 --> 0:04:16.719 fibria both are shattered in many many places, and my 0:04:16.839 --> 0:04:22.679 leg is completely discombobulated, disjointed to the side. 0:04:23.680 --> 0:04:27.880 Damien didn't lose consciousness. In fact, he tried to stand up. 0:04:28.600 --> 0:04:31.680 And as soon as I put one ounce of pressure 0:04:31.839 --> 0:04:35.400 on that right foot, then the pain started coming in, 0:04:36.160 --> 0:04:38.440 very very strong. As you can imagine. I have all 0:04:38.440 --> 0:04:41.400 these broken bones in my right leg, and I'm trying 0:04:41.480 --> 0:04:43.320 to walk on it and walk it off like and 0:04:43.360 --> 0:04:44.320 nothing ever happened. 0:04:44.560 --> 0:04:49.039 A crowd gathered and someone called for an ambulance. Within minutes, 0:04:49.120 --> 0:04:51.560 he was in the emergency room of a nearby hospital. 0:04:52.600 --> 0:04:54.919 The pain in his leg was unbearable. 0:04:58.160 --> 0:05:00.360 This one guy says, we're gonna give you more, and 0:05:00.400 --> 0:05:03.360 we're gonna manipulate that leg until they're ready to operate, 0:05:03.440 --> 0:05:06.360 because it needs to be manipulated. I said, I've never 0:05:06.400 --> 0:05:09.400 had any drugs. I don't take drugs. They said, well, 0:05:09.400 --> 0:05:12.840 you're gonna want it. I said okay, and they gave 0:05:12.880 --> 0:05:14.919 it to me through my ivy and I felt like 0:05:14.960 --> 0:05:17.960 I was really drunk. And then he grabbed my foot 0:05:18.000 --> 0:05:24.839 and put it back in place. I ready didn't feel inebriated. 0:05:24.920 --> 0:05:28.000 I was laughing. I was joking, you know. I was 0:05:28.040 --> 0:05:31.480 being very bubbly, which I usually am anyways, but I 0:05:31.560 --> 0:05:32.480 was kind of scared. 0:05:34.760 --> 0:05:37.720 After a few hours, the drugs were off and the 0:05:37.760 --> 0:05:41.000 pain returned. It was time for a second dose. 0:05:41.839 --> 0:05:45.400 I wasn't gonna take anything. I didn't want to get hooked. 0:05:46.320 --> 0:05:50.279 My family has a lineage of substance and alcohol abuse. 0:05:51.000 --> 0:05:54.000 My brother fights it, and my uncles fought it, and 0:05:54.040 --> 0:05:55.919 I've always had that trauma in my brain. 0:05:56.680 --> 0:06:00.760 It's a horrible decision many patients face, choosing between pain 0:06:01.080 --> 0:06:04.760 and the risk of addiction. The doctors tried their best 0:06:04.760 --> 0:06:05.520 to persuade him. 0:06:05.920 --> 0:06:08.000 They were all about it. They were all about it. 0:06:09.080 --> 0:06:10.880 Now you sure, are you sure? You don't want to 0:06:10.920 --> 0:06:13.599 think nothing? What are you going to do? I'm just 0:06:13.600 --> 0:06:14.360 gonna deal with it. 0:06:16.440 --> 0:06:19.120 And that's what many patients do when faced with acute pain. 0:06:19.640 --> 0:06:21.120 They just deal with it. 0:06:22.160 --> 0:06:26.360 I never took any pain medication, no matter how bad 0:06:26.400 --> 0:06:29.040 it hurt. But yeah, the first three months were hel Man. 0:06:30.320 --> 0:06:33.600 Pain isn't entirely a bad thing. It's actually an important 0:06:33.600 --> 0:06:36.960 warning system. It's our body's way of telling us something 0:06:37.040 --> 0:06:37.440 is wrong. 0:06:38.560 --> 0:06:40.960 Typically, you expect a broken limb to hurt a lot 0:06:41.000 --> 0:06:44.360 when you injure it gradually get better. It'll be a 0:06:44.480 --> 0:06:47.919 key for a few weeks, but as it heals after 0:06:47.960 --> 0:06:50.560 three months, you would not expect someone to still have 0:06:50.640 --> 0:06:52.080 pain from that broken limb. 0:06:53.000 --> 0:06:55.560 Doctor Norman Buckley is the director of the Michael G. 0:06:55.720 --> 0:06:58.679 Degrout National Pain Center in Hamilton, Canada. 0:06:59.120 --> 0:07:03.360 There certainly are a settings where people continue to report pain. 0:07:03.760 --> 0:07:07.080 Then you have to consider what's the reason for that, 0:07:07.560 --> 0:07:07.960 he says. 0:07:08.040 --> 0:07:12.160 Doctors have used medicine to manage pain for centuries. Opium 0:07:12.200 --> 0:07:15.920 in the sixteen hundreds, ether and chloroform in the eighteen hundreds, 0:07:16.400 --> 0:07:20.720 then morphine and even heroin in the nineteen hundreds. More recently, 0:07:21.200 --> 0:07:26.400 insets have been used. Those are nonsterodal anti inflammatory drugs 0:07:27.040 --> 0:07:30.600 and of course opioids, which can be effective but bring 0:07:30.680 --> 0:07:35.280 tolerability concerns and carry the risk of addiction. Innovation and 0:07:35.360 --> 0:07:39.120 pain management has been slow, in part because pain is 0:07:39.120 --> 0:07:44.600 both common and complex. It affects individual people differently. Those 0:07:44.640 --> 0:07:49.200 differences might be influenced by gender, genetics, and age, as 0:07:49.200 --> 0:07:54.480 well as other factors. Pain represents exactly the kind of 0:07:54.560 --> 0:07:58.360 medical problem Vertex likes to target. There's a long history 0:07:58.360 --> 0:08:02.080 of research to build on, there's new technology available or 0:08:02.360 --> 0:08:05.800 Vertex thinks they can develop it. There's a large unmet 0:08:05.840 --> 0:08:08.880 need and Vertex thinks it may be possible to make 0:08:08.920 --> 0:08:09.920 an impact. 0:08:10.240 --> 0:08:13.920 We've picked a set of diseases, cystic fibrosis, type one, diabetes, 0:08:14.480 --> 0:08:17.080 sickle cell disease, also pain. 0:08:18.040 --> 0:08:21.680 That's doctor David Altschuler. He's the chief scientific officer at 0:08:21.760 --> 0:08:25.600 Vertex Pharmaceuticals. What he's really on is a quest for 0:08:25.720 --> 0:08:29.680 something innovative. He's in search of new ways to think 0:08:29.720 --> 0:08:31.160 about old problems. 0:08:31.760 --> 0:08:34.200 The real question in our mind is can we succeed? 0:08:34.480 --> 0:08:38.800 Can we make a difference? Pain itself can be a disease. 0:08:39.520 --> 0:08:44.160 That's doctor Paul Negelescu. He's leading Vertex's research in this area. 0:08:44.280 --> 0:08:47.679 So while pain is a symptom of diseases, many diseases, 0:08:47.880 --> 0:08:50.400 it can also be a disease in and of itself. 0:08:51.160 --> 0:08:53.680 Vertex has been working on that puzzle for decades. 0:08:54.640 --> 0:08:57.360 There are tens of millions of people in the US 0:08:57.440 --> 0:09:02.800 that get pain experience every year, either acute or chronic pain. 0:09:03.320 --> 0:09:06.160 One thing that really interested me is why does it 0:09:06.280 --> 0:09:10.320 seem like some people are more sensitive to pain than others. 0:09:10.760 --> 0:09:15.520 It's a very subjective thing pain, and it's actually we 0:09:15.559 --> 0:09:20.000 don't understand what makes different people sensitive or not to pain. 0:09:20.840 --> 0:09:23.479 I would say though, that there are outliers. 0:09:23.520 --> 0:09:25.760 I mean, there are definitely some people that are way 0:09:25.800 --> 0:09:28.880 off the charts in terms of their ability to detect 0:09:28.880 --> 0:09:29.520 pain or not. 0:09:29.920 --> 0:09:32.520 Would you be able to break down for me a 0:09:32.520 --> 0:09:34.840 little bit further into what exactly is pain? 0:09:35.520 --> 0:09:39.760 It's a really good question. So pain is an unpleasant sensation. 0:09:40.360 --> 0:09:43.560 It's something that you experience, and so therefore it is 0:09:43.600 --> 0:09:47.640 something that has been processed by your brain and depending 0:09:47.720 --> 0:09:52.679 on your state of mind, literally that affects your ability 0:09:52.720 --> 0:09:57.760 to sense pain. So it's a complicated process by which. 0:09:57.880 --> 0:09:59.199 We perceive pain. 0:10:00.559 --> 0:10:03.000 Now the way that we're trying to approach it, which 0:10:03.200 --> 0:10:05.480 is to kind of take it out of the brain part, 0:10:06.160 --> 0:10:09.080 because we know it starts in the periphery. 0:10:09.240 --> 0:10:10.679 In most cases it's due to. 0:10:10.600 --> 0:10:14.560 An injury or a surgery or damage to a nerve 0:10:15.120 --> 0:10:18.320 that's outside the brain, so that part of the body 0:10:18.400 --> 0:10:22.080 is sending signals to the brain. It hurts, It hurts, 0:10:22.280 --> 0:10:24.920 and then you're processing those signals, and depending on whether 0:10:24.920 --> 0:10:27.560 you're awake a sleep distracted, you feel. 0:10:27.320 --> 0:10:28.319 Different levels of pain. 0:10:29.320 --> 0:10:31.120 Our goal is to try to cut it off so 0:10:31.160 --> 0:10:35.000 it never really gets to the brain. Opioids work at 0:10:35.000 --> 0:10:35.800 the level. 0:10:35.520 --> 0:10:36.840 Of the central nervous system. 0:10:36.880 --> 0:10:41.240 They actually suppress the inputs that are coming into the brain, 0:10:41.280 --> 0:10:43.920 and so we're trying to work from the outside of 0:10:43.960 --> 0:10:46.880 the brain to reduce the pain signals into it. 0:10:47.840 --> 0:10:51.920 That's the unique aspect of Vertex's approach to research, innovative 0:10:51.960 --> 0:10:55.360 approaches based on the underlying mechanism of the disease. 0:10:56.600 --> 0:11:00.240 The way we're approaching pain is by targeting the these 0:11:00.280 --> 0:11:03.480 proteins that have been identified through human genetics as playing 0:11:03.559 --> 0:11:07.880 a key role in the transmission of pain signals in 0:11:07.920 --> 0:11:11.440 the pain sensing neurons. If you think about the pain 0:11:11.480 --> 0:11:16.000 sensing neuron as a wire, it's transmitting a signal that 0:11:16.080 --> 0:11:18.520 says I've got pain in one part of my body 0:11:18.800 --> 0:11:21.440 to the other part of your body, and for that 0:11:21.600 --> 0:11:25.600 signal to get transmitted, it has to be conducted along 0:11:25.640 --> 0:11:29.920 that wire to conduct that electrical signal through that sensory nerve. 0:11:30.320 --> 0:11:33.400 It's kind of like a bucket brigade. One channel opens 0:11:33.400 --> 0:11:35.640 at one end and it passes the electrical signal to 0:11:35.720 --> 0:11:38.520 the next and that gets passed to the next one 0:11:39.000 --> 0:11:41.840 and so on, and that's how the signal gets propagated. 0:11:42.000 --> 0:11:45.760 And so you know, we're trying to interrupt that transmission. 0:11:46.200 --> 0:11:49.160 The work is focused on researching the mechanism of how 0:11:49.160 --> 0:11:51.839 a pain signal travels in the body, with the hope 0:11:51.880 --> 0:11:59.720 of making a difference for patients. It's been two years 0:11:59.720 --> 0:12:03.600 since Damien's accident, and other than walking with a slight limp, 0:12:04.000 --> 0:12:07.080 he's moved on with his life. He doesn't dwell on 0:12:07.120 --> 0:12:10.880 those pain filled months after his surgery. In fact, he 0:12:10.960 --> 0:12:13.200 says he really doesn't remember most of it. 0:12:14.480 --> 0:12:17.760 You tend to block out memories that you don't want, 0:12:18.400 --> 0:12:22.440 you really do. They're painful, So I think that's why 0:12:22.520 --> 0:12:25.040 I don't remember more about that time in the hospital. 0:12:25.559 --> 0:12:28.280 What he does remember is that when the pain was 0:12:28.400 --> 0:12:30.960 so bad it made it difficult to even stand up, 0:12:31.720 --> 0:12:33.120 he never lost his passion. 0:12:33.400 --> 0:12:35.000 I don't want to give up on music. I don't 0:12:35.000 --> 0:12:37.080 want to give up on my music. As long as 0:12:37.120 --> 0:12:39.800 I'm close to the music and keep playing music, I'm 0:12:39.880 --> 0:12:42.120 very happy. So that's what I want to know. I'm 0:12:42.120 --> 0:12:42.840 want to be at peace. 0:12:50.200 --> 0:12:53.560 This is Targeting the toughest diseases. A podcast from Bloomberg 0:12:53.600 --> 0:12:57.640 Media Studios and Vertex Pharmaceuticals. If you like what you hear, 0:12:58.040 --> 0:13:02.520 subscribe and leave us a review. I'm Jordan Gospore. Thanks 0:13:02.520 --> 0:13:03.079 for listening.