1 00:00:00,320 --> 00:00:03,840 Speaker 1: Since you're a subscriber to this Bloomberg podcast, we thought 2 00:00:03,840 --> 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 00:00:12,760 --> 00:00:17,640 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 00:00:22,520 --> 00:00:29,640 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 00:00:32,479 --> 00:00:35,480 Speaker 2: living in Miami, Damian j Well. 9 00:00:35,520 --> 00:00:38,040 Speaker 3: I play all types of music, but yes, my passion 10 00:00:38,159 --> 00:00:42,600 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 00:00:50,159 --> 00:00:52,320 Speaker 2: His passion started when he was twelve years old. 14 00:00:52,960 --> 00:00:55,440 Speaker 3: I saw a picture in a magazine that changed my life. 15 00:00:55,440 --> 00:00:57,280 Speaker 3: When I was young. It was a picture of a 16 00:00:57,320 --> 00:01:00,640 Speaker 3: young man who was holding every single would win because 17 00:01:00,640 --> 00:01:02,840 Speaker 3: he could play him all, and so I wanted to 18 00:01:02,840 --> 00:01:03,600 Speaker 3: be like that kid. 19 00:01:04,080 --> 00:01:07,600 Speaker 2: Damien started with the obo, then the flute, the alto, sacks, 20 00:01:07,640 --> 00:01:09,679 Speaker 2: the clarinet, and even the bassoon. 21 00:01:10,600 --> 00:01:13,600 Speaker 3: I also play guitar. I also play piano, and I 22 00:01:13,640 --> 00:01:17,720 Speaker 3: also play various percussion instruments, mainly Latin percussion stuff because 23 00:01:17,800 --> 00:01:20,520 Speaker 3: it's part of my project to perform Latin jazz. 24 00:01:23,319 --> 00:01:25,679 Speaker 2: But on a day that should have been a musical celebration, 25 00:01:26,480 --> 00:01:31,959 Speaker 2: Damien's life took a terrible turn. Hi. I'm Jordan Gospore, 26 00:01:32,520 --> 00:01:35,480 Speaker 2: a member of the University of Southern California's Center for 27 00:01:35,520 --> 00:01:40,480 Speaker 2: Health Journalism. This is Targeting the Toughest Diseases a podcast 28 00:01:40,520 --> 00:01:45,759 Speaker 2: produced by Bloomberg Media Studios and Vertex Pharmaceuticals. In this series, 29 00:01:46,160 --> 00:01:49,640 Speaker 2: we look at some of humanity's most challenging diseases and 30 00:01:49,720 --> 00:01:55,240 Speaker 2: how Vertex, a Boston based biotech company, is using innovative tools, methods, 31 00:01:55,520 --> 00:01:58,639 Speaker 2: and a unique philosophy to search for treatments and cheers. 32 00:02:03,200 --> 00:02:07,240 Speaker 2: Today we're looking at a cute pain. You might think 33 00:02:07,520 --> 00:02:10,040 Speaker 2: pain is just a sign that something else is wrong 34 00:02:10,040 --> 00:02:13,200 Speaker 2: in your body, but Vertex is looking at pain as 35 00:02:13,240 --> 00:02:17,520 Speaker 2: its own unique condition. They're researching it as a disease. 36 00:02:21,440 --> 00:02:26,240 Speaker 3: It's December twenty twenty two. I just finished about a 37 00:02:26,360 --> 00:02:30,000 Speaker 3: month of rehearsals with the Symphony, a very specific symphony 38 00:02:31,200 --> 00:02:37,600 Speaker 3: made up of nonprofit organizations sponsoring young musicians and professional 39 00:02:37,680 --> 00:02:41,400 Speaker 3: musicians here that play classical music that is of unheard 40 00:02:41,480 --> 00:02:42,919 Speaker 3: of composers of color. 41 00:02:43,880 --> 00:02:46,120 Speaker 2: This was the day of the inaugural performance. 42 00:02:47,040 --> 00:02:48,960 Speaker 3: I wake up early that day. It was a Saturday. 43 00:02:48,960 --> 00:02:51,400 Speaker 3: We're performing at the Broward set of the Performing Arts, 44 00:02:51,440 --> 00:02:55,079 Speaker 3: this wonderful hall in Fort Lauderdale, Florida. I live in Miami, 45 00:02:55,240 --> 00:02:56,960 Speaker 3: so I grabbed my scooter. 46 00:02:58,600 --> 00:03:02,080 Speaker 2: See, Damien doesn't like driving. He's not a guy that 47 00:03:02,240 --> 00:03:06,040 Speaker 2: likes sitting still, and South Florida's traffic can be bad, 48 00:03:07,040 --> 00:03:10,600 Speaker 2: so instead of a car, he uses an electric kickscooter 49 00:03:10,680 --> 00:03:14,960 Speaker 2: and public transit. Getting to Fort Lauderdale means riding his 50 00:03:15,040 --> 00:03:18,200 Speaker 2: scooter to the train station, taking the train up the coast, 51 00:03:18,600 --> 00:03:21,280 Speaker 2: and then using the scooter again to get to the venue. 52 00:03:21,960 --> 00:03:24,880 Speaker 3: I have my English horrant and my obow and my 53 00:03:25,000 --> 00:03:27,359 Speaker 3: music and my backpack on my backstrapped on. I had 54 00:03:27,360 --> 00:03:27,880 Speaker 3: my helmet. 55 00:03:28,760 --> 00:03:30,959 Speaker 2: He's also wearing a brand new tuxedo. 56 00:03:32,440 --> 00:03:34,800 Speaker 3: And I remember looking to the left and looking to 57 00:03:34,840 --> 00:03:39,000 Speaker 3: the right and saying, ha ha ah, traffic sucks. 58 00:03:41,360 --> 00:03:44,120 Speaker 2: Damien was in the bike lane going down a steep 59 00:03:44,200 --> 00:03:47,560 Speaker 2: hill when a driver apparently attempting to get out of 60 00:03:47,560 --> 00:03:52,480 Speaker 2: the gridlock suddenly churned into the bike lane. 61 00:03:54,320 --> 00:03:56,440 Speaker 3: I hit the front of her car with my scooter, 62 00:03:57,000 --> 00:03:59,840 Speaker 3: which I do not let go of, which actually ends 63 00:03:59,920 --> 00:04:02,680 Speaker 3: up flipping me over the front of her car. I 64 00:04:02,760 --> 00:04:04,920 Speaker 3: fly into the air and I land on my ribs, 65 00:04:04,960 --> 00:04:08,040 Speaker 3: which get cracked, and my foot, my right foot get 66 00:04:08,160 --> 00:04:12,840 Speaker 3: caught up in the accident, and my tibia and my 67 00:04:12,960 --> 00:04:16,680 Speaker 3: fibua both are shattered in many many places, and my 68 00:04:16,839 --> 00:04:22,679 Speaker 3: leg is completely discombobulated, disjointed to the side. 69 00:04:23,640 --> 00:04:27,880 Speaker 2: Damien didn't lose consciousness. In fact, he tried to stand. 70 00:04:27,680 --> 00:04:31,080 Speaker 3: Up, and as soon as I put one ounce of 71 00:04:31,200 --> 00:04:35,360 Speaker 3: pressure on that right foot, then the pain started coming in, 72 00:04:36,120 --> 00:04:38,400 Speaker 3: very very strong. As you can imagine, I have all 73 00:04:38,440 --> 00:04:41,440 Speaker 3: these broken bones in my right leg, and I'm trying 74 00:04:41,440 --> 00:04:43,640 Speaker 3: to walk on it and walk it off like nothing 75 00:04:43,680 --> 00:04:44,320 Speaker 3: ever happened. 76 00:04:44,560 --> 00:04:49,000 Speaker 2: A crowd gathered and someone called for an ambulance. Within minutes, 77 00:04:49,120 --> 00:04:51,560 Speaker 2: he was in the emergency room of a nearby hospital. 78 00:04:52,560 --> 00:04:54,920 Speaker 2: The pain in his leg was unbearable. 79 00:04:58,120 --> 00:05:00,359 Speaker 3: This one guy says, we're gonna give you more, and 80 00:05:00,360 --> 00:05:03,320 Speaker 3: we're gonna manipulate that leg until they're ready to operate, 81 00:05:03,400 --> 00:05:06,320 Speaker 3: because it needs to be manipulated. I said, I've never 82 00:05:06,360 --> 00:05:09,359 Speaker 3: had any drugs. I don't take drugs. They said, well, 83 00:05:09,400 --> 00:05:12,839 Speaker 3: you're gonna want it. I said, okay, and they gave 84 00:05:12,839 --> 00:05:14,880 Speaker 3: it to me through my ivy and I felt like 85 00:05:14,920 --> 00:05:17,920 Speaker 3: I was really drunk. And then he grabbed my foot 86 00:05:17,960 --> 00:05:24,880 Speaker 3: and put it back in place. I ready didn't feel inebriated. 87 00:05:24,880 --> 00:05:27,960 Speaker 3: I was laughing. I was joking, you know. I was 88 00:05:28,000 --> 00:05:31,480 Speaker 3: being very bubbly, which I usually am anyways, but I 89 00:05:31,520 --> 00:05:32,440 Speaker 3: was kind of scared. 90 00:05:34,720 --> 00:05:37,680 Speaker 2: After a few hours, the drugs were off and the 91 00:05:37,720 --> 00:05:41,000 Speaker 2: pain returned. It was time for a second dose. 92 00:05:41,839 --> 00:05:45,360 Speaker 3: I wasn't gonna take anything. I didn't want to get hooked. 93 00:05:46,279 --> 00:05:50,240 Speaker 3: My family has a lineage of substance and alcohol abuse. 94 00:05:51,000 --> 00:05:53,960 Speaker 3: My brother fights it, and my uncles fought it, and 95 00:05:54,000 --> 00:05:55,920 Speaker 3: I've always had that trauma in my brain. 96 00:05:56,640 --> 00:06:00,719 Speaker 2: It's a horrible decision many patients face, choosing between pain 97 00:06:01,080 --> 00:06:04,720 Speaker 2: and the risk of addiction. The doctors tried their best 98 00:06:04,760 --> 00:06:05,520 Speaker 2: to persuade him. 99 00:06:05,880 --> 00:06:08,000 Speaker 3: They were all about it. They were all about it. 100 00:06:09,040 --> 00:06:10,840 Speaker 3: Now you sure, are you sure? You don't want to 101 00:06:10,880 --> 00:06:13,840 Speaker 3: think nothing? What are you gonna do? I'm just gonna 102 00:06:13,839 --> 00:06:14,839 Speaker 3: deal with it. 103 00:06:16,400 --> 00:06:19,080 Speaker 2: And that's what many patients do when faced with acute pain. 104 00:06:19,600 --> 00:06:21,080 Speaker 2: They just deal with it. 105 00:06:22,160 --> 00:06:26,320 Speaker 3: I never took any pain medication, no matter how bad 106 00:06:26,360 --> 00:06:28,800 Speaker 3: it hurt. But yeah, the first three months were held. 107 00:06:28,839 --> 00:06:33,120 Speaker 2: Man, pain isn't entirely a bad thing. It's actually an 108 00:06:33,160 --> 00:06:36,400 Speaker 2: important warning system. It's our body's way of telling us 109 00:06:36,560 --> 00:06:37,440 Speaker 2: something is wrong. 110 00:06:38,560 --> 00:06:40,880 Speaker 4: Typically, you expect a broken limb to hurt a lot 111 00:06:41,000 --> 00:06:44,320 Speaker 4: when you injure it gradually get better. It'll be a 112 00:06:44,480 --> 00:06:47,880 Speaker 4: key for a few weeks, but as it heals after 113 00:06:47,960 --> 00:06:50,560 Speaker 4: three months, you would not expect someone to still have 114 00:06:50,600 --> 00:06:52,040 Speaker 4: pain from that broken limb. 115 00:06:53,000 --> 00:06:55,520 Speaker 2: Doctor Norman Buckley is the director of the Michael G. 116 00:06:55,680 --> 00:06:58,640 Speaker 2: Degrout National Pain Center in Hamilton, Canada. 117 00:06:59,080 --> 00:07:03,320 Speaker 4: There certainly are or settings where people continue to report pain. 118 00:07:03,720 --> 00:07:07,040 Speaker 4: Then you have to consider what's the reason for. 119 00:07:06,960 --> 00:07:09,960 Speaker 2: That, he says. Doctors have used medicine to manage pain 120 00:07:10,120 --> 00:07:14,800 Speaker 2: for centuries. Opium in the sixteen hundreds, ether and chloroform 121 00:07:14,840 --> 00:07:18,320 Speaker 2: in the eighteen hundreds, then morphine and even heroin in 122 00:07:18,400 --> 00:07:23,480 Speaker 2: the nineteen hundreds. More recently, insets have been used. Those 123 00:07:23,480 --> 00:07:28,720 Speaker 2: are nonsterodal anti inflammatory drugs and of course opioids, which 124 00:07:28,800 --> 00:07:32,720 Speaker 2: can be effective but bring tolerability concerns and carry the 125 00:07:32,800 --> 00:07:37,240 Speaker 2: risk of addiction. Innovation and pain management has been slow, 126 00:07:37,800 --> 00:07:41,840 Speaker 2: in part because pain is both common and complex. It 127 00:07:41,880 --> 00:07:47,720 Speaker 2: affects individual people differently. Those differences might be influenced by gender, genetics, 128 00:07:47,960 --> 00:07:54,040 Speaker 2: and age, as well as other factors. Pain represents exactly 129 00:07:54,080 --> 00:07:57,520 Speaker 2: the kind of medical problem Vertex likes to target. There's 130 00:07:57,520 --> 00:08:00,440 Speaker 2: a long history of research to build on, there's new 131 00:08:00,480 --> 00:08:04,680 Speaker 2: technology available or Vertex thinks they can develop it. There's 132 00:08:04,720 --> 00:08:08,000 Speaker 2: a large unmet need, and Vertex thinks it may be 133 00:08:08,080 --> 00:08:09,920 Speaker 2: possible to make an impact. 134 00:08:10,200 --> 00:08:13,880 Speaker 1: We've picked a set of diseases, cystic fibrosis, type one, diabetes, 135 00:08:14,480 --> 00:08:17,040 Speaker 1: sickle cell disease, also pain. 136 00:08:18,000 --> 00:08:21,680 Speaker 2: That's doctor David Altschuler. He's the chief scientific officer at 137 00:08:21,720 --> 00:08:25,600 Speaker 2: Vertex Pharmaceuticals. What he's really on is a quest for 138 00:08:25,680 --> 00:08:29,640 Speaker 2: something innovative. He's in search of new ways to think 139 00:08:29,680 --> 00:08:31,120 Speaker 2: about old problems. 140 00:08:31,720 --> 00:08:34,160 Speaker 1: The real question in our mind is can we succeed, 141 00:08:34,440 --> 00:08:35,560 Speaker 1: can we make a difference? 142 00:08:37,080 --> 00:08:38,800 Speaker 5: Pain itself can be a disease. 143 00:08:39,480 --> 00:08:44,119 Speaker 2: That's doctor Paul Negelescu. He's leading Vertex's research in this area. 144 00:08:44,240 --> 00:08:47,679 Speaker 5: So while pain is a symptom of diseases, many diseases, 145 00:08:47,880 --> 00:08:50,360 Speaker 5: it can also be a disease in and of itself. 146 00:08:51,120 --> 00:08:53,640 Speaker 2: Vertex has been working on that puzzle for decades. 147 00:08:54,640 --> 00:08:57,320 Speaker 5: There are tens of millions of people in the US 148 00:08:57,440 --> 00:09:01,959 Speaker 5: that get pain Experience Says every year, either acute or 149 00:09:02,040 --> 00:09:02,760 Speaker 5: chronic pain. 150 00:09:03,280 --> 00:09:06,120 Speaker 2: One thing that really interested me is why does it 151 00:09:06,240 --> 00:09:10,320 Speaker 2: seem like some people are more sensitive to pain than others. 152 00:09:10,720 --> 00:09:15,480 Speaker 5: It's a very subjective thing pain, and it's actually we 153 00:09:15,520 --> 00:09:19,960 Speaker 5: don't understand what makes different people sensitive or not to pain. 154 00:09:20,840 --> 00:09:23,720 Speaker 5: I would say though, that there are outliers. I mean, 155 00:09:23,760 --> 00:09:26,079 Speaker 5: there are definitely some people that are way off the 156 00:09:26,200 --> 00:09:29,440 Speaker 5: charts in terms of their ability to detect pain or not. 157 00:09:29,880 --> 00:09:32,480 Speaker 2: Would you be able to break down for me a 158 00:09:32,480 --> 00:09:34,839 Speaker 2: little bit further into what exactly is pain? 159 00:09:35,480 --> 00:09:39,760 Speaker 5: It's a really good question. So pain is an unpleasant sensation. 160 00:09:40,320 --> 00:09:43,520 Speaker 5: It's something that you experience, and so therefore it is 161 00:09:43,559 --> 00:09:47,640 Speaker 5: something that has been processed by your brain and depending 162 00:09:47,679 --> 00:09:52,680 Speaker 5: on your state of mind, literally that affects your ability 163 00:09:52,720 --> 00:09:57,400 Speaker 5: to sense pain. So it's a complicated process by which 164 00:09:57,840 --> 00:10:01,960 Speaker 5: we perceive pain. Now the way that we're trying to 165 00:10:02,000 --> 00:10:04,360 Speaker 5: approach it, which is to kind of take it out 166 00:10:04,400 --> 00:10:08,280 Speaker 5: of the brain part, because we know it starts in 167 00:10:08,320 --> 00:10:11,240 Speaker 5: the periphery. In most cases, it's due to an injury 168 00:10:11,679 --> 00:10:15,880 Speaker 5: or a surgery or damage to a nerve that's outside 169 00:10:15,880 --> 00:10:18,880 Speaker 5: the brain, so that part of the body is sending 170 00:10:18,960 --> 00:10:22,520 Speaker 5: signals to the brain. It hurts, it hurts, and then 171 00:10:22,559 --> 00:10:25,280 Speaker 5: you're processing those signals, and depending on whether you're awake, 172 00:10:25,360 --> 00:10:29,480 Speaker 5: a sleep distracted, you feel different levels of pain. Our 173 00:10:29,520 --> 00:10:31,240 Speaker 5: goal is to try to cut it off so it 174 00:10:31,280 --> 00:10:35,040 Speaker 5: never really gets to the brain. Opioids work at the 175 00:10:35,160 --> 00:10:38,959 Speaker 5: level of the central nervous system. They actually suppress the 176 00:10:39,000 --> 00:10:41,680 Speaker 5: inputs that are coming into the brain, and so we're 177 00:10:41,679 --> 00:10:44,640 Speaker 5: trying to work from the outside of the brain to 178 00:10:44,840 --> 00:10:46,839 Speaker 5: reduce the pain signals into it. 179 00:10:47,800 --> 00:10:51,880 Speaker 2: That's the unique aspect of Vertex's approach to research, innovative 180 00:10:51,920 --> 00:10:55,319 Speaker 2: approaches based on the underlying mechanism of the disease. 181 00:10:56,600 --> 00:11:00,760 Speaker 5: The way we're approaching pain is by targeting the proteins 182 00:11:00,800 --> 00:11:03,600 Speaker 5: that have been identified through human genetics as playing a 183 00:11:03,679 --> 00:11:08,000 Speaker 5: key role in the transmission of pain signals in the 184 00:11:08,040 --> 00:11:11,800 Speaker 5: pain sensing neurons. If you think about the pain sensing 185 00:11:11,880 --> 00:11:16,360 Speaker 5: neuron as a wire, it's transmitting a signal that says 186 00:11:16,520 --> 00:11:18,840 Speaker 5: I've got pain in one part of my body to 187 00:11:18,960 --> 00:11:21,959 Speaker 5: the other part of your body, and for that signal 188 00:11:22,000 --> 00:11:25,680 Speaker 5: to get transmitted. It has to be conducted along that 189 00:11:25,800 --> 00:11:29,880 Speaker 5: wire to conduct that electrical signal through that sensory nerve. 190 00:11:30,320 --> 00:11:33,360 Speaker 5: It's kind of like a bucket brigade. One channel opens 191 00:11:33,360 --> 00:11:35,640 Speaker 5: at one end and it passes the electrical signal to 192 00:11:35,679 --> 00:11:38,520 Speaker 5: the next and that gets passed to the next one 193 00:11:39,000 --> 00:11:41,800 Speaker 5: and so on, and that's how the signal gets propagated. 194 00:11:42,000 --> 00:11:45,720 Speaker 5: And so you know, we're trying to interrupt that transmission. 195 00:11:46,200 --> 00:11:49,120 Speaker 2: The work is focused on researching the mechanism of how 196 00:11:49,160 --> 00:11:51,840 Speaker 2: a pain signal travels in the body, with the hope 197 00:11:51,840 --> 00:11:59,720 Speaker 2: of making a difference for patients. It's been two years 198 00:11:59,720 --> 00:12:03,559 Speaker 2: since Damien's accident, and other than walking with a slight limp, 199 00:12:04,000 --> 00:12:07,040 Speaker 2: he's moved on with his life. He doesn't dwell on 200 00:12:07,080 --> 00:12:10,880 Speaker 2: those pain filled months after his surgery. In fact, he 201 00:12:10,920 --> 00:12:13,200 Speaker 2: says he really doesn't remember most of it. 202 00:12:14,440 --> 00:12:17,720 Speaker 3: You tend to block out memories that you don't want, 203 00:12:18,360 --> 00:12:22,439 Speaker 3: you really do. They're painful, So I think that's why 204 00:12:22,480 --> 00:12:25,000 Speaker 3: I don't remember more about that time in the hospital. 205 00:12:25,520 --> 00:12:28,280 Speaker 2: What he does remember is that when the pain was 206 00:12:28,360 --> 00:12:30,960 Speaker 2: so bad it made it difficult to even stand up, 207 00:12:31,720 --> 00:12:33,079 Speaker 2: he never lost his passion. 208 00:12:33,400 --> 00:12:34,959 Speaker 3: I don't want to give up on music. I don't 209 00:12:34,960 --> 00:12:37,080 Speaker 3: want to give up on my music. As long as 210 00:12:37,120 --> 00:12:39,800 Speaker 3: I'm close to the music and keep playing music, I'm 211 00:12:39,880 --> 00:12:40,360 Speaker 3: very happy. 212 00:12:40,480 --> 00:12:41,920 Speaker 5: So that's what I want to know. 213 00:12:41,960 --> 00:12:42,839 Speaker 3: I want to be at peace. 214 00:12:50,160 --> 00:12:53,560 Speaker 2: This is Targeting the Toughest diseases. A podcast from Bloomberg 215 00:12:53,600 --> 00:12:57,600 Speaker 2: Media Studios and Vertex Pharmaceuticals. If you like what you hear, 216 00:12:58,000 --> 00:13:02,480 Speaker 2: subscribe and leave us a review. I'm Jordan Gospore. Thanks 217 00:13:02,480 --> 00:13:03,040 Speaker 2: for listening.