WEBVTT - Targeting Pain (Sponsored Content)

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<v Speaker 1>Since you're a subscriber to this Bloomberg podcast, we thought

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<v Speaker 1>you'd be interested in a six episode sponsored podcast called

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<v Speaker 1>Targeting the Toughest Diseases produced by Vertex Pharmaceuticals and Bloomberg

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<v Speaker 1>Media Studios. It explores the innovative tools, methods, and unique

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<v Speaker 1>philosophy Vertex Pharmaceuticals is using to search for treatments for

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<v Speaker 1>some of humanity's most challenging diseases. Here's a recent episode.

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<v Speaker 2>That's Damian Sanchez, or if you are a jazz fan

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<v Speaker 2>living in Miami, Damian j Well.

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<v Speaker 3>I play all types of music, but yes, my passion

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<v Speaker 3>lies in the jazz genre. The history of jazz inspires

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<v Speaker 3>me to create. I get very passionate about talking about

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<v Speaker 3>the history of jazz from its very beginnings until today.

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<v Speaker 2>His passion started when he was twelve years old.

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<v Speaker 3>I saw a picture in a magazine that changed my life.

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<v Speaker 3>When I was young. It was a picture of a

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<v Speaker 3>young man who was holding every single would win because

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<v Speaker 3>he could play him all, and so I wanted to

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<v Speaker 3>be like that kid.

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<v Speaker 2>Damien started with the obo, then the flute, the alto, sacks,

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<v Speaker 2>the clarinet, and even the bassoon.

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<v Speaker 3>I also play guitar. I also play piano, and I

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<v Speaker 3>also play various percussion instruments, mainly Latin percussion stuff because

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<v Speaker 3>it's part of my project to perform Latin jazz.

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<v Speaker 2>But on a day that should have been a musical celebration,

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<v Speaker 2>Damien's life took a terrible turn. Hi. I'm Jordan Gospore,

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<v Speaker 2>a member of the University of Southern California's Center for

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<v Speaker 2>Health Journalism. This is Targeting the Toughest Diseases a podcast

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<v Speaker 2>produced by Bloomberg Media Studios and Vertex Pharmaceuticals. In this series,

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<v Speaker 2>we look at some of humanity's most challenging diseases and

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<v Speaker 2>how Vertex, a Boston based biotech company, is using innovative tools, methods,

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<v Speaker 2>and a unique philosophy to search for treatments and cheers.

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<v Speaker 2>Today we're looking at a cute pain. You might think

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<v Speaker 2>pain is just a sign that something else is wrong

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<v Speaker 2>in your body, but Vertex is looking at pain as

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<v Speaker 2>its own unique condition. They're researching it as a disease.

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<v Speaker 3>It's December twenty twenty two. I just finished about a

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<v Speaker 3>month of rehearsals with the Symphony, a very specific symphony

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<v Speaker 3>made up of nonprofit organizations sponsoring young musicians and professional

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<v Speaker 3>musicians here that play classical music that is of unheard

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<v Speaker 3>of composers of color.

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<v Speaker 2>This was the day of the inaugural performance.

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<v Speaker 3>I wake up early that day. It was a Saturday.

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<v Speaker 3>We're performing at the Broward set of the Performing Arts,

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<v Speaker 3>this wonderful hall in Fort Lauderdale, Florida. I live in Miami,

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<v Speaker 3>so I grabbed my scooter.

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<v Speaker 2>See, Damien doesn't like driving. He's not a guy that

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<v Speaker 2>likes sitting still, and South Florida's traffic can be bad,

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<v Speaker 2>so instead of a car, he uses an electric kickscooter

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<v Speaker 2>and public transit. Getting to Fort Lauderdale means riding his

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<v Speaker 2>scooter to the train station, taking the train up the coast,

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<v Speaker 2>and then using the scooter again to get to the venue.

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<v Speaker 3>I have my English horrant and my obow and my

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<v Speaker 3>music and my backpack on my backstrapped on. I had

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<v Speaker 3>my helmet.

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<v Speaker 2>He's also wearing a brand new tuxedo.

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<v Speaker 3>And I remember looking to the left and looking to

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<v Speaker 3>the right and saying, ha ha ah, traffic sucks.

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<v Speaker 2>Damien was in the bike lane going down a steep

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<v Speaker 2>hill when a driver apparently attempting to get out of

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<v Speaker 2>the gridlock suddenly churned into the bike lane.

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<v Speaker 3>I hit the front of her car with my scooter,

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<v Speaker 3>which I do not let go of, which actually ends

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<v Speaker 3>up flipping me over the front of her car. I

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<v Speaker 3>fly into the air and I land on my ribs,

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<v Speaker 3>which get cracked, and my foot, my right foot get

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<v Speaker 3>caught up in the accident, and my tibia and my

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<v Speaker 3>fibua both are shattered in many many places, and my

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<v Speaker 3>leg is completely discombobulated, disjointed to the side.

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<v Speaker 2>Damien didn't lose consciousness. In fact, he tried to stand.

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<v Speaker 3>Up, and as soon as I put one ounce of

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<v Speaker 3>pressure on that right foot, then the pain started coming in,

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<v Speaker 3>very very strong. As you can imagine, I have all

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<v Speaker 3>these broken bones in my right leg, and I'm trying

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<v Speaker 3>to walk on it and walk it off like nothing

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<v Speaker 3>ever happened.

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<v Speaker 2>A crowd gathered and someone called for an ambulance. Within minutes,

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<v Speaker 2>he was in the emergency room of a nearby hospital.

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<v Speaker 2>The pain in his leg was unbearable.

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<v Speaker 3>This one guy says, we're gonna give you more, and

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<v Speaker 3>we're gonna manipulate that leg until they're ready to operate,

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<v Speaker 3>because it needs to be manipulated. I said, I've never

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<v Speaker 3>had any drugs. I don't take drugs. They said, well,

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<v Speaker 3>you're gonna want it. I said, okay, and they gave

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<v Speaker 3>it to me through my ivy and I felt like

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<v Speaker 3>I was really drunk. And then he grabbed my foot

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<v Speaker 3>and put it back in place. I ready didn't feel inebriated.

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<v Speaker 3>I was laughing. I was joking, you know. I was

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<v Speaker 3>being very bubbly, which I usually am anyways, but I

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<v Speaker 3>was kind of scared.

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<v Speaker 2>After a few hours, the drugs were off and the

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<v Speaker 2>pain returned. It was time for a second dose.

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<v Speaker 3>I wasn't gonna take anything. I didn't want to get hooked.

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<v Speaker 3>My family has a lineage of substance and alcohol abuse.

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<v Speaker 3>My brother fights it, and my uncles fought it, and

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<v Speaker 3>I've always had that trauma in my brain.

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<v Speaker 2>It's a horrible decision many patients face, choosing between pain

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<v Speaker 2>and the risk of addiction. The doctors tried their best

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<v Speaker 2>to persuade him.

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<v Speaker 3>They were all about it. They were all about it.

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<v Speaker 3>Now you sure, are you sure? You don't want to

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<v Speaker 3>think nothing? What are you gonna do? I'm just gonna

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<v Speaker 3>deal with it.

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<v Speaker 2>And that's what many patients do when faced with acute pain.

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<v Speaker 2>They just deal with it.

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<v Speaker 3>I never took any pain medication, no matter how bad

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<v Speaker 3>it hurt. But yeah, the first three months were held.

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<v Speaker 2>Man, pain isn't entirely a bad thing. It's actually an

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<v Speaker 2>important warning system. It's our body's way of telling us

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<v Speaker 2>something is wrong.

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<v Speaker 4>Typically, you expect a broken limb to hurt a lot

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<v Speaker 4>when you injure it gradually get better. It'll be a

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<v Speaker 4>key for a few weeks, but as it heals after

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<v Speaker 4>three months, you would not expect someone to still have

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<v Speaker 4>pain from that broken limb.

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<v Speaker 2>Doctor Norman Buckley is the director of the Michael G.

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<v Speaker 2>Degrout National Pain Center in Hamilton, Canada.

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<v Speaker 4>There certainly are or settings where people continue to report pain.

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<v Speaker 4>Then you have to consider what's the reason for.

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<v Speaker 2>That, he says. Doctors have used medicine to manage pain

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<v Speaker 2>for centuries. Opium in the sixteen hundreds, ether and chloroform

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<v Speaker 2>in the eighteen hundreds, then morphine and even heroin in

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<v Speaker 2>the nineteen hundreds. More recently, insets have been used. Those

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<v Speaker 2>are nonsterodal anti inflammatory drugs and of course opioids, which

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<v Speaker 2>can be effective but bring tolerability concerns and carry the

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<v Speaker 2>risk of addiction. Innovation and pain management has been slow,

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<v Speaker 2>in part because pain is both common and complex. It

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<v Speaker 2>affects individual people differently. Those differences might be influenced by gender, genetics,

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<v Speaker 2>and age, as well as other factors. Pain represents exactly

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<v Speaker 2>the kind of medical problem Vertex likes to target. There's

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<v Speaker 2>a long history of research to build on, there's new

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<v Speaker 2>technology available or Vertex thinks they can develop it. There's

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<v Speaker 2>a large unmet need, and Vertex thinks it may be

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<v Speaker 2>possible to make an impact.

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<v Speaker 1>We've picked a set of diseases, cystic fibrosis, type one, diabetes,

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<v Speaker 1>sickle cell disease, also pain.

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<v Speaker 2>That's doctor David Altschuler. He's the chief scientific officer at

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<v Speaker 2>Vertex Pharmaceuticals. What he's really on is a quest for

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<v Speaker 2>something innovative. He's in search of new ways to think

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<v Speaker 2>about old problems.

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<v Speaker 1>The real question in our mind is can we succeed,

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<v Speaker 1>can we make a difference?

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<v Speaker 5>Pain itself can be a disease.

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<v Speaker 2>That's doctor Paul Negelescu. He's leading Vertex's research in this area.

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<v Speaker 5>So while pain is a symptom of diseases, many diseases,

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<v Speaker 5>it can also be a disease in and of itself.

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<v Speaker 2>Vertex has been working on that puzzle for decades.

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<v Speaker 5>There are tens of millions of people in the US

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<v Speaker 5>that get pain Experience Says every year, either acute or

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<v Speaker 5>chronic pain.

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<v Speaker 2>One thing that really interested me is why does it

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<v Speaker 2>seem like some people are more sensitive to pain than others.

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<v Speaker 5>It's a very subjective thing pain, and it's actually we

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<v Speaker 5>don't understand what makes different people sensitive or not to pain.

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<v Speaker 5>I would say though, that there are outliers. I mean,

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<v Speaker 5>there are definitely some people that are way off the

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<v Speaker 5>charts in terms of their ability to detect pain or not.

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<v Speaker 2>Would you be able to break down for me a

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<v Speaker 2>little bit further into what exactly is pain?

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<v Speaker 5>It's a really good question. So pain is an unpleasant sensation.

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<v Speaker 5>It's something that you experience, and so therefore it is

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<v Speaker 5>something that has been processed by your brain and depending

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<v Speaker 5>on your state of mind, literally that affects your ability

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<v Speaker 5>to sense pain. So it's a complicated process by which

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<v Speaker 5>we perceive pain. Now the way that we're trying to

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<v Speaker 5>approach it, which is to kind of take it out

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<v Speaker 5>of the brain part, because we know it starts in

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<v Speaker 5>the periphery. In most cases, it's due to an injury

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<v Speaker 5>or a surgery or damage to a nerve that's outside

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<v Speaker 5>the brain, so that part of the body is sending

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<v Speaker 5>signals to the brain. It hurts, it hurts, and then

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<v Speaker 5>you're processing those signals, and depending on whether you're awake,

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<v Speaker 5>a sleep distracted, you feel different levels of pain. Our

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<v Speaker 5>goal is to try to cut it off so it

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<v Speaker 5>never really gets to the brain. Opioids work at the

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<v Speaker 5>level of the central nervous system. They actually suppress the

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<v Speaker 5>inputs that are coming into the brain, and so we're

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<v Speaker 5>trying to work from the outside of the brain to

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<v Speaker 5>reduce the pain signals into it.

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<v Speaker 2>That's the unique aspect of Vertex's approach to research, innovative

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<v Speaker 2>approaches based on the underlying mechanism of the disease.

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<v Speaker 5>The way we're approaching pain is by targeting the proteins

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<v Speaker 5>that have been identified through human genetics as playing a

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<v Speaker 5>key role in the transmission of pain signals in the

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<v Speaker 5>pain sensing neurons. If you think about the pain sensing

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<v Speaker 5>neuron as a wire, it's transmitting a signal that says

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<v Speaker 5>I've got pain in one part of my body to

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<v Speaker 5>the other part of your body, and for that signal

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<v Speaker 5>to get transmitted. It has to be conducted along that

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<v Speaker 5>wire to conduct that electrical signal through that sensory nerve.

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<v Speaker 5>It's kind of like a bucket brigade. One channel opens

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<v Speaker 5>at one end and it passes the electrical signal to

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<v Speaker 5>the next and that gets passed to the next one

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<v Speaker 5>and so on, and that's how the signal gets propagated.

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<v Speaker 5>And so you know, we're trying to interrupt that transmission.

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<v Speaker 2>The work is focused on researching the mechanism of how

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<v Speaker 2>a pain signal travels in the body, with the hope

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<v Speaker 2>of making a difference for patients. It's been two years

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<v Speaker 2>since Damien's accident, and other than walking with a slight limp,

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<v Speaker 2>he's moved on with his life. He doesn't dwell on

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<v Speaker 2>those pain filled months after his surgery. In fact, he

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<v Speaker 2>says he really doesn't remember most of it.

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<v Speaker 3>You tend to block out memories that you don't want,

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<v Speaker 3>you really do. They're painful, So I think that's why

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<v Speaker 3>I don't remember more about that time in the hospital.

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<v Speaker 2>What he does remember is that when the pain was

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<v Speaker 2>so bad it made it difficult to even stand up,

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<v Speaker 2>he never lost his passion.

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<v Speaker 3>I don't want to give up on music. I don't

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<v Speaker 3>want to give up on my music. As long as

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<v Speaker 3>I'm close to the music and keep playing music, I'm

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<v Speaker 3>very happy.

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<v Speaker 5>So that's what I want to know.

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<v Speaker 3>I want to be at peace.

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<v Speaker 2>This is Targeting the Toughest diseases. A podcast from Bloomberg

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<v Speaker 2>Media Studios and Vertex Pharmaceuticals. If you like what you hear,

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<v Speaker 2>subscribe and leave us a review. I'm Jordan Gospore. Thanks

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<v Speaker 2>for listening.