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Speaker 3: We're here at Boston Children, so we're going to come
Speaker 3: back to some conversations in just a moment, but we
Speaker 3: also want to touch on a story that's so relatable
Speaker 3: to many of the institutions here in Boston and really
Speaker 3: I feel like around the country anything that's focused on healthcare,
Speaker 3: medicine and biotech.
Speaker 4: Team business leaders, investors and academics of cheered Massachusetts Governor
Speaker 4: Mara Healey's efforts to counter the Trump Administration's research funding
Speaker 4: cuts with state money, so much so that a meeting
Speaker 4: earlier in the fall on the initiative required overflow seating
Speaker 4: with more on the goal and where it sits right
Speaker 4: now and whether this could actually be applied to other
Speaker 4: states too. We are in Boston right now and we
Speaker 4: have joined We're joined by Greg Ryan, he's Bloomberg News
Speaker 4: Boston Money and Power reporter. He joins us on site
Speaker 4: here at Boston Children's So you wrote about this last month.
Speaker 4: The hope here that state funding could offset some of
Speaker 4: the federal funding. Where does it stand right now?
Speaker 5: It's still in limbo. So the governor proposed this over
Speaker 5: the summer. She proposed four hundred million dollars to backfill
Speaker 5: some of the Trump cuts. But lawmakers on Beacon Hill
Speaker 5: here in Boston have been skeptical. They say, there's the
Speaker 5: state has a lot of need right now. Yes, this
Speaker 5: is usually important, the scientific research funding, but you know
Speaker 5: it cuts with snap. There was a hearing on the
Speaker 5: bill that took place in the middle of the shutdown.
Speaker 5: They said there's a lot of need and they're not
Speaker 5: sure how much money they should be devoting to this
Speaker 5: right now.
Speaker 3: Well that's interesting, all right, So take a step back.
Speaker 3: Tell us what Governor Hewley, what her proposal is.
Speaker 5: Sure, So she's she wants to take four d million
Speaker 5: dollars in state funding, apply half of it to public
Speaker 5: universities and public institutions to help them with their scientific
Speaker 5: research funding, you know, help them with the cuts that
Speaker 5: they've experienced because of what's happened in DC. And then
Speaker 5: the other half of the money goes to private institutions,
Speaker 5: so places like Harvard, Boston University, MIT, as well as
Speaker 5: hospitals like Boston Children's.
Speaker 4: So where in terms of of like offsetting the cuts,
Speaker 4: would that cover one of what has been cut?
Speaker 5: It would not know, it wouldn't wouldn't really even come close.
Speaker 5: You know, hundreds of millions this year of loan just
Speaker 5: in nah funding cuts. But the part of the the
Speaker 5: purpose here and something the governor says a lot is
Speaker 5: this sends a signal, this says sends she puts in.
Speaker 5: Massachusetts backs these efforts. It sends a signals to scientists
Speaker 5: just you know, stay here and do their research here.
Speaker 4: Well, that's what I wanted to talk about. And then
Speaker 4: you know, we think a lot about funding and the
Speaker 4: context of Okay, well, if it's going to research, that
Speaker 4: research will then ultimately potentially provide some sort of cure
Speaker 4: or treatment or something. You know, it's an investment in
Speaker 4: the future. But it's bigger than that. I think it
Speaker 4: has to do with a local economy. It has to
Speaker 4: do with a you know, if we're sitting in Boston
Speaker 4: right now, I mean this is an area of the
Speaker 4: country that's known for having biotech research, so some of
Speaker 4: it goes into the private sector. Then ultimately that money
Speaker 4: is used to pay people for the research. That money
Speaker 4: is then spent in the local economy. So they are
Speaker 4: knock on effects. They are repercussions of this pullback absolutely.
Speaker 5: I mean eds and meds is it's known around here.
Speaker 5: Hospitals and universities are a huge part of the economy
Speaker 5: when other parts of the country are in recession. It
Speaker 5: doesn't make our economy recession proof, but it really makes
Speaker 5: it resilient, and it has over the years. But those
Speaker 5: sectors are experiencing threats, really unprecedented threats right now based
Speaker 5: on the funding environment. So that money, yes, it goes
Speaker 5: to life save potentially life saving research, but it also
Speaker 5: you know, it keeps jobs in the state, and it
Speaker 5: has other economic activity as you mentioned.
Speaker 3: Well, the other thing that everybody's so fearful of is, right,
Speaker 3: a brain drain essentially, right, So people are like, okay,
Speaker 3: well the funding isn't here. That's such a big part
Speaker 3: of the medical community. I mean, you know doctors, I've
Speaker 3: got doctors in the family. Like it's just that's a
Speaker 3: big part of what they do, and if the funding
Speaker 3: isn't here and the R and D isn't here, they
Speaker 3: may go elsewhere. I mean, this has been a concern
Speaker 3: about even you know, scientists and you know medical officials
Speaker 3: and so and so forth, even leaving the United States,
Speaker 3: right in terms of the money not being here.
Speaker 5: Yeah, I've talked to hospital executives in Massachusetts and they
Speaker 5: say countries like China, institutions and Europe, they're actively recruiting
Speaker 5: researchers because they know they face a lot of uncertainty
Speaker 5: here and they think they have a persuasive case to
Speaker 5: bring them over.
Speaker 3: Greg, I want to go back to what Governor Healy
Speaker 3: has wanted to do because what's interesting is, and you know,
Speaker 3: this is certainly part of the Bloomberg world for decades,
Speaker 3: this idea of public private partnerships. It was not only
Speaker 3: just public money, right, it was also involving private money
Speaker 3: to help in her mission.
Speaker 4: That's right.
Speaker 5: So the legislation was set up a fund that would
Speaker 5: bring in private philanthropic dollars to supplement the public dollars
Speaker 5: and the idea of being there's a lot of energy
Speaker 5: around supporting these institutions during this time, and so having
Speaker 5: a central funnel to bring in all that money and
Speaker 5: put it where it needs to go.
Speaker 3: So what's the next step? What are we waiting? We
Speaker 3: talked about this meeting where it was like no seats,
Speaker 3: everybody was there. So where does it go or what's next?
Speaker 4: So it's up to the legislature.
Speaker 5: They had their initial hearing on the bill a few
Speaker 5: weeks ago, so the next few months will be key.
Speaker 5: I'm sure they'll be There'll be more hearings and I
Speaker 5: think ultimately sometime next year, while makers will decide whether
Speaker 5: this will pass and how much money they wanted to
Speaker 5: vote to this effort.
Speaker 4: Hey, well we have you. There's something else we want
Speaker 4: to talk about, and it actually is related to what's
Speaker 4: going on when it comes to funding. It's the Millionaire's
Speaker 4: tax and.
Speaker 3: Knew you were going to go there. It's a story
Speaker 3: we were obsessed with when it came across the bloem.
Speaker 4: Well it was actually we spoke yesterday with Vanessa Williamson,
Speaker 4: who's a senior fellow and Government Studies at the Brookings Institutions.
Speaker 4: She got this new book out that's about taxes, and
Speaker 4: she mentioned the story and we knew it because we
Speaker 4: had talked about your story on air a few weeks ago.
Speaker 4: There's a tax of the ultra wealthy that Zorroon Mamdani,
Speaker 4: the Democratic mayor elect of New York likes. It's kind
Speaker 4: of being tested here, and the test here revealed that
Speaker 4: it didn't make people flee the state.
Speaker 5: What are the details so far, I should say, yes,
Speaker 5: So this millionaire's tax, it's a four percent star tax
Speaker 5: on income over a million dollars. It went into effect
Speaker 5: in twenty twenty three, and in the past two years
Speaker 5: it's brought in five point seven million dollars, which is
Speaker 5: three billion dollars more than whailemakers had budgeted for. So
Speaker 5: that's paid for everything from free meals at schools for
Speaker 5: kids to it's the budget gap at the NBTA, the
Speaker 5: local transit authority. It's coming quite handy during this time.
Speaker 5: But you know, I've spoken to executives and business leaders
Speaker 5: who warn, yes, it's bringing me in a lot of
Speaker 5: revenue now, but they still believe. You know, the longer
Speaker 5: this tax is in place, the more people are going
Speaker 5: to move away.
Speaker 4: And you know, again it was just important, Maye. It
Speaker 4: doesn't attract people to the state or people are.
Speaker 5: That movie that too, that too, but just having just
Speaker 5: gone into effect a few years ago. You know, people myself,
Speaker 5: kids in high school, they're going to wait till their
Speaker 5: kids are out of school to move. So the data
Speaker 5: isn't in yet to see how it's affecting migration in
Speaker 5: and out of Massachusetts. But in terms of revenue, it's
Speaker 5: been a success story so far.
Speaker 3: I got to say, I feel like people go where
Speaker 3: the jobs are ultimately and kind of deal with everything else.
Speaker 3: And if it's a good economy, is strong economy, there's
Speaker 3: great jobs, they're going to go there. Just got about
Speaker 3: a minute or so, or just forty five seconds before
Speaker 3: we go great. How would you describe you know, we
Speaker 3: are constantly trying to figure out the economic outlook. How
Speaker 3: is it feeling in Boston? What's the mood, what's the sentiment?
Speaker 5: You know, things are a little people are little pessimistic
Speaker 5: right now, to be honest with you, such as as
Speaker 5: Taxpayers Foundation just came out with a report that the
Speaker 5: state was dead last in job growth for private job
Speaker 5: grop over the past year. At the same time, you know,
Speaker 5: we have Harvard, we have MIT, we have institutions like
Speaker 5: this that the fundamentals are great but you know, the
Speaker 5: economy is struggling.
Speaker 4: A bit at the moment.
Speaker 3: All right, interesting to know, med and ed, meds and eds,
Speaker 3: meds and eds. I'm going to remember that. So glad
Speaker 3: we could catch up with you. Thanks for joining us
Speaker 3: here too at Boston Children's Bloomberg News, Boston Money and
Speaker 3: Power port of Greg Ryan.
Speaker 4: Stay with us. More from Bloomberg Business Week Daily coming
Speaker 4: up after this.
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Speaker 3: And I've got to say, one of the most rewarding
Speaker 3: aspects of what we do here at Bloomberg Business Week
Speaker 3: Daily is when we get to actually come out of
Speaker 3: the office and go to different places, step out of
Speaker 3: the studio, dive into another world. We are so entrenched
Speaker 3: when it comes to Wall Street, Main Street, Washington Money
Speaker 3: and markets, how it exchanges with everything, but it's also
Speaker 3: a great reminder that there's just so much going on
Speaker 3: around the world that certainly affects people across the country,
Speaker 3: across the world. And also there's always an investment or
Speaker 3: a money played into it. Let's kick off our coverage.
Speaker 3: We are at Boston Children's. It is the world's largest
Speaker 3: pediatric research enterprise. It is the leading recipient of pediatric
Speaker 3: research funding from the National Institutes of Health. It is
Speaker 3: a primary pediatric teaching hospital for Harvard Medical School. Treats
Speaker 3: more children with rare diseases and complex conditions than any
Speaker 3: other hospital. Delighted to kick off our coverage here on
Speaker 3: this Friday with doctor Joan La Rovair. She a senior
Speaker 3: vice president Interim Chief Medical Officer at Boston children She's
Speaker 3: also co founder and president of the NGO, the Virtue Foundation,
Speaker 3: which when we talked to her last time, we reminded
Speaker 3: you all that it's delivering healthcare and over twenty five countries,
Speaker 3: so global. Doctor Lea Rivera, it's so nice to have
Speaker 3: you here. Last time you came to our home. Now
Speaker 3: we came to your home. Thank you, Thank you so
Speaker 3: much for having us.
Speaker 6: We're so happy to have you here with us.
Speaker 3: It's really delighted, and you know, we are delighted to
Speaker 3: be here. Like we walk in and you feel something.
Speaker 3: And anybody who's had a kid in a hospital or
Speaker 3: visited a young one. It's tough, and I'm sitting in
Speaker 3: this space. Tell us where we are, because anyone kids
Speaker 3: have to deal with things. It's tough, and it sounds
Speaker 3: like this is a place that just makes it maybe
Speaker 3: a little easier.
Speaker 6: That's exactly what this place is designed for. We're in
Speaker 6: the hail roof garden on the tenth floor of the
Speaker 6: home building. The cardiac I See You that I work
Speaker 6: in is two and three floors below us, because we
Speaker 6: covered two floors our cardiac I See You. And we
Speaker 6: need spaces like this for families to be able to
Speaker 6: step away and really, you know, think and decompress, and
Speaker 6: for staff. You know, these are very challenging, complex patients
Speaker 6: that we're taken care of in this building. Our neonatal
Speaker 6: intensive care unit is here, or Cardiac I See You
Speaker 6: is here. We have operating rooms in this building. You know,
Speaker 6: there's a lot of the cap labs are here. So
Speaker 6: it's wonderful that we can have these magical spaces where
Speaker 6: you can just feel that you're in a pedi after
Speaker 6: hospital and there's a place to relax and think.
Speaker 3: Can I just say it's like you're sitting on a tree,
Speaker 3: like a tree bench there's like, I don't know, is
Speaker 3: this a rainbow. It feels like above us. It's pretty
Speaker 3: it's pretty cool, you know.
Speaker 4: Carol mentioned the energy that we feel when we walk
Speaker 4: into a space such as Boston Children's and we're reminded
Speaker 4: that it's not just a teaching hospital, a research hospital.
Speaker 4: It's also a place that treats kids from really all
Speaker 4: over the world. And I'm wondering how you prioritize where
Speaker 4: resources go, whether it goes to treating patients right now
Speaker 4: versus thinking about research, thinking about development, thinking about ways
Speaker 4: to actually help patients in the future, versus working with
Speaker 4: them right now. How do you allocate those resources?
Speaker 6: Well, that has always been part of the DNA of
Speaker 6: Boston Children's Hospital. It's been our mission. We deliver the highest,
Speaker 6: best quality clinical care. Really, that is the foundation of
Speaker 6: it all. And you see that, you know, the motto
Speaker 6: of where the world comes for answers. There's a lot
Speaker 6: of complex patients from the Boston area of Massachusetts, New England. Obviously,
Speaker 6: we provide primary services for all levels of care for
Speaker 6: children in this community. However, there are many from across
Speaker 6: the United States and across the world who really seek
Speaker 6: that type of care and come to us usually the
Speaker 6: most complex cases, and I think that's really where we thrive.
Speaker 6: And the other piece of our DNA is the science
Speaker 6: we as you talked in the beginning.
Speaker 3: That makes a difference, right when there's science involved. I
Speaker 3: feel like it's practitionally, yes, you're dealing with patients, but
Speaker 3: it's people who are like, I want to understand how
Speaker 3: this works.
Speaker 6: That's everybody here. Yeah, that's the doctors, that's the nurses,
Speaker 6: that's the social workers, that's the physical therapists, that's the
Speaker 6: respiratory therapist, it's the pharmacist. I just could keep going.
Speaker 6: So I think that's what's what draws people to work
Speaker 6: here and to stay here, because that purpose that we're
Speaker 6: gonna actually change things and we're going to be able
Speaker 6: to find newer ways of doing things. We're going to
Speaker 6: help more children survive but also thrive, and that takes
Speaker 6: a real concerted effort, and you need the science here
Speaker 6: with the.
Speaker 3: Clinical One of the things I think when you joined
Speaker 3: Tim and I back in New York and listen, everybody's
Speaker 3: talking about AI and I know that, but I think
Speaker 3: we all are thinking about what it could do for
Speaker 3: medicine and R and D and innovation. And I guess
Speaker 3: what we're trying to understand too, is what's the reality
Speaker 3: of what AI is used within the medical community or
Speaker 3: R and D specifically, like where is it today? And you,
Speaker 3: as someone who understands this space so well, and I'm
Speaker 3: curious the conversations you guys have, where do you think
Speaker 3: it could go? Well?
Speaker 6: AI has been a very important part of Boston Children's
Speaker 6: Hospital for a long time. This isn't something new. We
Speaker 6: have incredible research groups and an incredible innovation team here
Speaker 6: who've been really standing up AI initiatives for a very
Speaker 6: long time. We talked about some of the work I
Speaker 6: personally have done in terms of you know, Virtue Foundation
Speaker 6: and the Global Health AI mapping and being able to
Speaker 6: match resource and need.
Speaker 3: You work with Yeah, firms that are like specifically in AI.
Speaker 6: Yes, with theater brigs and data robac I you were
Speaker 6: building those real platforms that people can use. But I
Speaker 6: think about for example, when Chat GPT first came out,
Speaker 6: we had Boston GPT immediately we were looking to get
Speaker 6: that behind our firewalls. How can we integrate that, How
Speaker 6: can we use that for real purpose and improve both
Speaker 6: the care that we get to patients, But how can
Speaker 6: we use AI to also discover new things. I think
Speaker 6: the levels of data that we have, and I think
Speaker 6: you talked upon in the beginning in terms of rare diseases,
Speaker 6: genetic diseases, we are the epicenter of that, and we've
Speaker 6: already been extremely successful in bringing new therapies to market
Speaker 6: for children. But when I look at the infrastructure that
Speaker 6: we're building, and I think you've had doctor Wendy Chung
Speaker 6: come and speak and she's heading up a lot.
Speaker 1: Of that work.
Speaker 6: I think her best days are ahead of us, and
Speaker 6: AI is unlocking that type of potential.
Speaker 4: I like hearing that the optimism about our best days
Speaker 4: being ahead of us. And I think about, just even
Speaker 4: during your career, how much treatments have changed and in
Speaker 4: a pretty short time. I'm curious about the connection between
Speaker 4: kids and adults and treating children. And of course, if
Speaker 4: kids are healthy, then they turn into healthy adults. But
Speaker 4: this is a children's hospital that does a lot of search,
Speaker 4: it does a lot of teaching. Also, are there learnings
Speaker 4: that can be taken from what works with kids and
Speaker 4: even applied to a larger population as not just those
Speaker 4: kids grow up, but as adults also need treatment.
Speaker 6: I think there's two points that strike me there. One
Speaker 6: is that the decisions they were making early in life
Speaker 6: have long term impact. It's something I've thought about my
Speaker 6: entire career in the cardiac space and cardiac intensive care.
Speaker 6: The decisions to have surgery on day two or day four,
Speaker 6: the decisions to use this drug or that drug, all
Speaker 6: of those things are shaping your long term self. But
Speaker 6: it was very hard to be able to look at
Speaker 6: and analyze that type of data until you've opened up
Speaker 6: big data AI. So I think again along the lines
Speaker 6: of our best days are ahead of us, that we're
Speaker 6: going to be able to see so much more through that.
Speaker 6: And then you said the innovations. Now many patients that
Speaker 6: I took care of are adults. We have this huge
Speaker 6: growing adult population that we provide care for. Science is
Speaker 6: that's discovered here. It's in a pediatric hospital, but it's
Speaker 6: bringing forth therapies they're actually treating adults. So I think
Speaker 6: it's it's incredible to see how this innovation engine drives
Speaker 6: so much.
Speaker 3: If you could change one thing, just got about thirty seconds.
Speaker 3: If you could change one thing in terms of the
Speaker 3: work that you guys are doing and the r and
Speaker 3: d that would maybe make it easier. What would it be.
Speaker 6: Make it easier?
Speaker 3: Okay, back word, if you could change one thing though,
Speaker 3: that would help you guys and what you're working on.
Speaker 3: It sounds like you don't need it. Sounds like you've
Speaker 3: got a great team, and we have.
Speaker 6: A great team, but we're always needing, you know, support
Speaker 6: and engagement and we're just trying to drive the next
Speaker 6: level and partnerships to move in that direction. We are
Speaker 6: the leading children's ass but also we're doing well, but
Speaker 6: we're always trying to push the envelope of what we
Speaker 6: can do.
Speaker 3: Yeah, it's fascinating. You could feel it. I felt, you know,
Speaker 3: like walking in.
Speaker 6: You can write the purpose.
Speaker 3: It was busy, it was lots of families, lots of kids,
Speaker 3: and yeah, everybody on a mission.
Speaker 6: It's a privilege to be part of that mission.
Speaker 3: Well, thank you so much, thank you, thank you for
Speaker 3: inviting us, and good to get some more time with you.
Speaker 3: Doctor Joan la Rovere. She is an interim Chief Medical
Speaker 3: Officer at Boston Children's Hospital, Director of Innovation and Outcomes.
Speaker 3: So delighted to talk with you.
Speaker 2: This is the Bloomberg Business Week Daily Podcast. Listen live
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Speaker 4: We want to.
Speaker 3: Continue from Boston Children's and with us now is doctor
Speaker 3: Lissa Baird. She's director of Neurosurgical Oncology and co director
Speaker 3: of the Brain Tumor Center at Boston Children's Hospital, joining
Speaker 3: us here. I keep saying welcome, thank you, but I
Speaker 3: realized thank you for bringing us here. Great to have
Speaker 3: you here. Tell us about your world, like what is
Speaker 3: it that you're dealing with on a regular basis, on
Speaker 3: a daily basis.
Speaker 1: Well, thanks for having me. I take care of kids
Speaker 1: that have branch tumers and it's all ages. All ages, yeah,
Speaker 1: from infants to really young adults, but all through childhood
Speaker 1: and work with a phenomenal team here requires a huge
Speaker 1: team to take care of these kids. They're very complex
Speaker 1: diseases and we work on all aspects of them, so
Speaker 1: active treatment. We do a lot of scientific research, we
Speaker 1: run clinical trials. We really support these kids not only
Speaker 1: through their therapeutic journal journey, but through survivorship and surveillance afterwards.
Speaker 1: So it's a long journey for them and we really
Speaker 1: try to support them at every stage.
Speaker 4: How are clinical trials involving children different than clinical trials
Speaker 4: involving other age populations.
Speaker 1: Well, cancer in children is very very different. The diseases
Speaker 1: are different, the implications are different, especially with brain tumors.
Speaker 3: Why is that? Is it development because of where the
Speaker 3: brain is or what?
Speaker 1: Partially? I mean we're dealing with patients that have developing brains.
Speaker 1: I mean there are very different implications for that. But
Speaker 1: also the diagnoses vary quite a bit. You know, the
Speaker 1: common diseases we see in childhood brain cancer are very
Speaker 1: very different than that in adult cancer, and they require
Speaker 1: different treatments and the support and you know, network needs
Speaker 1: to be different. We have to support these kids through
Speaker 1: developmental stages, through hormonal development, through cognitive development, emotional development.
Speaker 1: You know, the family needs are different, and you know,
Speaker 1: the diseases require very specific therapies. One thing historically that
Speaker 1: has happened is because pediatric cancer has not been as
Speaker 1: well supported. Historically, we have had to extrapolate data and
Speaker 1: treatments from the adult world and it just doesn't.
Speaker 3: Work, you know, I have a good friend and the
Speaker 3: same thing. Her son went through it and unfortunately it
Speaker 3: didn't work out well. But when she started doing research,
Speaker 3: she realized it's just no money, no funding. And they
Speaker 3: actually started a foundation to kind of but selling kids,
Speaker 3: selling cookies and like, just to try and drum up
Speaker 3: money and interest and attention. And we talk about it
Speaker 3: with women that R and D like you just don't
Speaker 3: see it as much and it's getting solely better, but
Speaker 3: with kids, why is it that it's lagged in terms
Speaker 3: of time and money and effort, not here obviously, but elsewhere.
Speaker 1: Yeah, I mean, we definitely rely on philanthropy hugely to
Speaker 1: make advancements in the field. But I think you know,
Speaker 1: historically the numbers are lower. The financial support from government
Speaker 1: has been different. It follows volume, as does industry. You know,
Speaker 1: there's a complex, you know, complex reasons for that. But yeah,
Speaker 1: there needs to be a shift and focus and more
Speaker 1: attention on specific pediatric treatments.
Speaker 4: We are talking a lot about treatments and it makes
Speaker 4: me wonder about if we understand what causes this stuff
Speaker 4: in the first place. And certainly treatments in recent years
Speaker 4: have gotten so much better. In gene therapy, has gotten better,
Speaker 4: but I'm wondering if we have an understanding in the
Speaker 4: medical community about why some kids get sick and why
Speaker 4: some don't.
Speaker 1: Yeah, there have been huge advancements in pediatric brain tumors.
Speaker 1: It's really one of the most exciting fields right now
Speaker 1: because of how many things have really moved forward in
Speaker 1: the field. And so we know so much more about
Speaker 1: the biology of these tumors and the genetic underpinnings to them,
Speaker 1: and can really drill down with each individual tumor to
Speaker 1: find out what the molecular change has been in the
Speaker 1: cells that is driving tumor growth. And that's really helped
Speaker 1: us understand them and opened up a whole new field
Speaker 1: of individual treatments. And so, you know, every tumor is different.
Speaker 1: In some tumors, we've discovered that there may be a
Speaker 1: cell of origin that the child is born with a
Speaker 1: lot of tumors. We don't understand why some kids are
Speaker 1: getting them and some don't. Some may have familial implications
Speaker 1: and some may have environmental We don't understand everything, but
Speaker 1: we're learning more and more every day, and we know
Speaker 1: so much more about the individual genetics of the tumor.
Speaker 4: Could we get to a point within our lifetimes where
Speaker 4: there is some sort of screening for kids when they're
Speaker 4: born or in their early days that helps identify what
Speaker 4: they could be susceptible too, and then we could allow
Speaker 4: for different different treatments ahead of that to prevent it
Speaker 4: actually from happening.
Speaker 1: Definitely, I think so. And it may not be for
Speaker 1: every tumor, but I think we're already getting close to
Speaker 1: that for certain diagnoses where we know specific things that
Speaker 1: you know, we can potentially screen for, and we're finding
Speaker 1: certain you know, germline mutation that are you know, familial hereditary.
Speaker 1: So yeah, I think we may get to that point
Speaker 1: where we're screening is better for all tumors, but we're
Speaker 1: very close for certain types of tumors.
Speaker 3: Is there differences in boys and girls when it comes
Speaker 3: to either tumors or what impacts.
Speaker 1: For some Yeah, for some diagnoses and some have you know,
Speaker 1: greater percentages with boys and some with girls. It really
Speaker 1: just depends on the diagnosis and many many it's equivalent.
Speaker 3: I am also curious about, like you guys seem to
Speaker 3: certainly take a family approach, and you have to when
Speaker 3: it's kids, Like what's involved when you've got specific therapies
Speaker 3: and it's not it's leading to the surgery or whatever
Speaker 3: the treatment is.
Speaker 1: In now, the treatment of these kids takes a village.
Speaker 1: We have a huge multidisciplinary team. I mean we have neurosurgeons, neurooncologists, neurologists,
Speaker 1: the neuropathologists, geneticists, neurediologists, and we also have you know,
Speaker 1: the rehabilitation experts with physical occupational therapy, the neuropsychologists and endochronologists.
Speaker 1: I mean, there are so many different expertise, you know,
Speaker 1: fields that are required to take care of these kids
Speaker 1: because brain tumors really affect every single aspect of their
Speaker 1: life and have the potential to affect every aspect of
Speaker 1: their physical and neurodevelopment. And so you know, we are
Speaker 1: really fortunate here to have so much expertise that we're
Speaker 1: able to really individualize the team needed for each specific child.
Speaker 3: Thank you so much. This is heavy stuff. Thank you
Speaker 3: so much. Really appreciate it. Doctor Lisabaert, director of Neurosurgical
Speaker 3: on College and co director of the Brain Tumor Center
Speaker 3: at Boston Children's Hospital. This is Bloomberg.
Speaker 4: Stay with us. More from Bloomberg Business Week Daily coming
Speaker 4: up after this.
Speaker 2: You're listening to the Bloomberg Business Weekdaily Podcast. Catch us
Speaker 2: live weekday afternoons from two to five pm Eastern. Listen
Speaker 2: on Apple CarPlay and Android Auto with the Bloomberg Business app,
Speaker 2: or watch us live on YouTube.
Speaker 4: Well, let's get back to our depth look and conversations
Speaker 4: about the work that's being done at Boston Children's Hospital.
Speaker 4: That's where Carol and I are this afternoon. We kick
Speaker 4: off this hour with doctor Ellen Grant. She's Director of
Speaker 4: Fetal Neonatal Neuroimaging and Developmental Science here at Boston Children's Hospital.
Speaker 4: Here she leads a seventy person neuroimaging and computational science
Speaker 4: center that's working to develop tools to better detect and
Speaker 4: understand brain physiology and development, all with the goal to
Speaker 4: improve cognitive, behavioral, and neurological outcomes, not just in fetuses,
Speaker 4: but in infants and toddlers and then of course ultimately
Speaker 4: as they get older. Doctor Grant joins us on site
Speaker 4: here at Boston Children's Hospital. Doctor Grant, welcome, How are
Speaker 4: you very good?
Speaker 3: Thank you thanks so much for having me.
Speaker 4: Thanks for joining us. Brain imaging and children. If we
Speaker 4: have a better understanding of the brain and fetal development
Speaker 4: and for babies and toddlers. What will that allow us
Speaker 4: to understand, what does it prevent, what does it treat?
Speaker 7: Well, everything begins in uterul pretty much, so your life
Speaker 7: is an arc from infancy or one you're conceived through
Speaker 7: to adulthoods. So the more we can understand the early development,
Speaker 7: the more we can start to understand how we make
Speaker 7: sure children are on their trajectory. So the goal is
Speaker 7: to characterize brain development very early on, so we tell
Speaker 7: the very earliest point when to start to deviate from
Speaker 7: a normal trajectory, so we can get things back on
Speaker 7: track early as possible. And ideally we want in future
Speaker 7: to be able to prevent diseases from happening, not just
Speaker 7: try to you know, deal with them and try to
Speaker 7: correct them later on when the damage is partly done.
Speaker 3: So how early can we do it today and detect
Speaker 3: that there's something wrong? How early, realistically do you think
Speaker 3: we can get it to?
Speaker 7: Yeah, we start looking at fetuses at about eleven fifteen
Speaker 7: weeks something around there at the earliest, right closer to
Speaker 7: around eighteen weeks. We start to characterize brain development, you know,
Speaker 7: eighteen nineteen weeks or so, So it begins quite early
Speaker 7: when we start to see and look at early brain development.
Speaker 4: Well, you and your team did a study a few
Speaker 4: years ago that gave your results to argue for earlier
Speaker 4: MRI during pregnancy. Yeah, is that study enough to actually
Speaker 4: change the standard of care?
Speaker 3: Well, we do use.
Speaker 7: It early here at Boston Children, So when there's an indication,
Speaker 7: we do it as early as we can to better
Speaker 7: characterize the entire fetus. Because it's not just the brain,
Speaker 7: it's the body it's attached to too, So we want to
Speaker 7: understand not just the brain development, how that brain is
Speaker 7: developing the context of the other organ systems.
Speaker 3: So we can do because it doesn't necessarily run hand
Speaker 3: in hand, like, it can be very different, right or
Speaker 3: like in terms of what's going on with brain development
Speaker 3: versus the rest of the system, they can disconnect.
Speaker 7: No, they're intimately connected in life.
Speaker 3: So if there's one, yeah, so that's why we want
Speaker 3: to understand it.
Speaker 7: So the same For example, we deal with a lot
Speaker 7: of congenital heart disease here that has effects from brain development.
Speaker 7: We deal with congenital dive fromatic hernius that has effects
Speaker 7: on brain development. So everything is happening in the fetus,
Speaker 7: whether there's a brain or not. Is it has the
Speaker 7: potential to have subtle effects on brain development.
Speaker 3: Why do kids, I mean kids do need specialized tools
Speaker 3: for brain imaging to ask us about that one.
Speaker 7: Yeah, that's the whole reason that it came to Boston
Speaker 7: Children's is industries not interested in fetuses and pints and
Speaker 7: young children, so it's really hard to get devices that
Speaker 7: are built specifically for these age range.
Speaker 3: So that's why I brought a team of technical people.
Speaker 7: So they're engineers, physicists, computer scientists, data scientists that help
Speaker 7: to either develop the devices or come up with better
Speaker 7: ways to analyze the data that we get with an
Speaker 7: ion trying to understand pediactors ectric disorders. So for example,
Speaker 7: we want to monitor and we're developing optical devices for
Speaker 7: the nick you to monitor s freeble bloodflow. But the
Speaker 7: heart of a heart rate of a neonate is one
Speaker 7: hundred and fifty, so we have to sample at a
Speaker 7: much higher rate than you would in an adult to
Speaker 7: get the same information. So we have to build specifically
Speaker 7: devices to the physiology. And then I can think of
Speaker 7: ahead of a premature baby. It's very very small, so
Speaker 7: I can't take a probe that we use in adults
Speaker 7: and just put it on a pre term, so we
Speaker 7: have to develop the devices to fit the size of
Speaker 7: the infants.
Speaker 3: I want to just go And I feel like we
Speaker 3: touched on this earlier. I mean we are Bloomberg Business Week.
Speaker 3: We are Bloomberg and very entrenched in financial markets. And
Speaker 3: I feel like the more I've been doing this, money
Speaker 3: just follows everything. Money is why people do things or
Speaker 3: don't do things. Is that really it is just the
Speaker 3: market I hate to even make it that way. The
Speaker 3: market size and so you don't have medical equipment companies
Speaker 3: building the things because they just don't think the market
Speaker 3: size is big enough. That is a big problem. Yeah,
Speaker 3: and I.
Speaker 7: Think it's that's where we're trying to get into more
Speaker 7: of a business perspective. Like if we start to do
Speaker 7: a small startup that starts to answer those questions and
Speaker 7: a bigger company might buy it. But if we stay
Speaker 7: in the research realm, then it's sometimes really hard to
Speaker 7: go that last mile and get something into clinical practice.
Speaker 3: So how do you do that? How do you cross that?
Speaker 3: So what do you do?
Speaker 7: Yeah, this is what we're strategy strategizing on right now,
Speaker 7: is trying to figure out how we do those small
Speaker 7: startups get industry interested if and a lot of things
Speaker 7: we're doing right now. Actually, one of the projects we're
Speaker 7: working on is you know, AI strategies, right, and if
Speaker 7: we can get enough data on infants or fetuses and
Speaker 7: so on, we can start to build models that predict
Speaker 7: not just group outcomes, but we want to get to
Speaker 7: individual outcomes because that's what parents care about, right, So
Speaker 7: if we can figure out get those models together.
Speaker 3: So that's what we're working on now, is trying.
Speaker 7: To create these AI models that are specialized for pediatrics
Speaker 7: and hoping to do startups around that particular concept.
Speaker 3: I have to ask one more quesident. Are venture capitalists interested?
Speaker 7: I don't know because we haven't really talked about me
Speaker 7: that I've heard about, but I think they always want
Speaker 7: something that's almost ready.
Speaker 3: So we're hoping to go further along. Yeah, a little
Speaker 3: bit further along. Okay. Interesting?
Speaker 4: Can what we learn and what you understand through imaging
Speaker 4: about the brains development be applied to how adult brains
Speaker 4: are treated.
Speaker 7: Everything in adult life has its genesis in infants, right.
Speaker 4: So we learn we're all there once.
Speaker 7: Yeah, yeah, exactly, and some of the ways that adult
Speaker 7: brain response is more prominent in a pediatric brain, so
Speaker 7: in some disorders to go to pediatric models to see
Speaker 7: a physiologist. More prominent in neonates or infants, but also
Speaker 7: occurs in adults.
Speaker 4: You know, there was a in doing the research. In
Speaker 4: the prep for our interview with you, there is a
Speaker 4: picture of a physician or a therapist doing some what's
Speaker 4: I think is called therapeutic hypothermia too a brand new
Speaker 4: baby's head. Yes, and my understanding is that oxygen deprivation
Speaker 4: around birth is one of the leading reasons that you
Speaker 4: actually see babies come into the Nike You.
Speaker 3: Yes, that is one of the main reasons. Yes.
Speaker 4: And the therapy for this is as simple as.
Speaker 3: Yeah, you cool them down or down there.
Speaker 7: The normal yeah, at least abnormal thermic is when they
Speaker 7: have injuries. A response to that sort of the whole
Speaker 7: physiological response to an injury is to have a fever,
Speaker 7: and that is detrimental. So we want to keep them
Speaker 7: cool so that they don't set off these cascades of
Speaker 7: brain injury. And that's partly why we build this one device,
Speaker 7: because we want to be able to monitor through the
Speaker 7: nick you stay and optimize management. But it's interesting, we
Speaker 7: don't even know what the great blood pressure for a
Speaker 7: newborn is So this is why we wanted to have
Speaker 7: a probe that could measures rebel blood flow to the
Speaker 7: brain because there is no way to monitor whether there's
Speaker 7: enough brain or sit and getting to the brain with
Speaker 7: the tools that we have right now.
Speaker 3: I feel like we don't even talk about blood pressure
Speaker 3: when it comes to like infants, right, Yeah, we just don't.
Speaker 3: But you need to know. You did your residency and
Speaker 3: fellowship in the nineteen nineties. Curious how imaging has changed
Speaker 3: since then, and then where do you think how will
Speaker 3: it improve in the next I don't know, ten years.
Speaker 3: You know what's a smart benchmark?
Speaker 7: Yeah?
Speaker 5: Yeah, I know.
Speaker 7: When I was in training, NTMAR was just starting and
Speaker 7: it was very slow. So where we come now is
Speaker 7: the acceleration acquisition is just incredible. What used to take
Speaker 7: us an hour to do we can do in ten
Speaker 7: minutes now, So there was creed.
Speaker 3: The speed of acquisition is huge.
Speaker 7: Were also developing a lot of analysis that we can
Speaker 7: do after the images are acquired to give us more
Speaker 7: quantitative metrics, because the whole thing in medicine to get
Speaker 7: past the qualitative read of a radiologist, which is helpful,
Speaker 7: but we want to put more numbers on it, so
Speaker 7: we can have a more dynamic range on how we
Speaker 7: describe each child and this therefore we can get into
Speaker 7: better precision medicine and open prediction. So we're getting more
Speaker 7: to that quantitative aspect of imaging now, and not just
Speaker 7: brain but all body parts of course, and you know,
Speaker 7: down to feudel age.
Speaker 3: Is it for kids to every case is very personal
Speaker 3: and individual? Or are there trends and things that you
Speaker 3: can help and so that one case can help another.
Speaker 3: Is there a body of knowledge that gets built off
Speaker 3: of this?
Speaker 7: Yes, there's body that of knowledge gets built off of this.
Speaker 7: But this is where we come back to AI. I
Speaker 7: only can remember so much, you know, even though I've
Speaker 7: been in practice for a long time.
Speaker 3: Things follow up crap.
Speaker 7: So this is where I'm really excited about AI because
Speaker 7: I can, you know, minor databases to find where's an
Speaker 7: individual child just like that one I'm treated. Now, what
Speaker 7: did they respond to, what worked for them? And how
Speaker 7: are these two similar? So I can mind the databases
Speaker 7: to start to come up with individual outcome prediction, which
Speaker 7: is what we're doing right now.
Speaker 3: With databases.
Speaker 7: We've got some from some of the major trials for hypothermia,
Speaker 7: and so we can use this large database to start
Speaker 7: try to take individual outcomes. You can say, well, I
Speaker 7: have a newborn with this pH that had these, you know,
Speaker 7: and I'm a mother of this age, and put in
Speaker 7: features and they could give you from that database and
Speaker 7: outcome prediction. So working on that and also working on
Speaker 7: making data more available to parents, because I think a
Speaker 7: lot of parents are very frustrated with trying to read
Speaker 7: the literature, even if you're using chat, GPT or overly hards,
Speaker 7: it's really hard. And then you get group statistics and
Speaker 7: then where does my kid fit in between the twenty
Speaker 7: five to seventy five percent you know, good outcome or
Speaker 7: something like that. To get chatbots that can work with
Speaker 7: some of our databases, so people anybody can talk to,
Speaker 7: you know, a physician, so to speak, to give the
Speaker 7: answers that they want.
Speaker 4: That's that's pretty remarkable because you know, I just think
Speaker 4: about the tone of these chatbots and if there's a
Speaker 4: way that they can be you know, we talked about,
Speaker 4: we talked earlier this week about what a challenge it
Speaker 4: can be for people to actually interact with them in
Speaker 4: an quote unquote normal way. But is there a way
Speaker 4: for them to actually be empathetic and work with patients,
Speaker 4: work with parents and with families.
Speaker 3: If you give us we've got about forty second.
Speaker 7: Yeah, yeah, no, we're working on that, but I can't
Speaker 7: tell you all the secrets because we're.
Speaker 3: Going to hang. No, you go all over the bath.
Speaker 3: Can I ask you, when you guys do use AI
Speaker 3: in cha? Do you have hallucinations? Like do the AI hallucinations?
Speaker 5: Do you?
Speaker 3: Or how do you? Especially when you're dealing with medical permission.
Speaker 7: There's a lot of safeguards who put around that, so
Speaker 7: it's it's we have again. This is sort of more
Speaker 7: the secret sauce that I can't talk about yet, But
Speaker 7: there are ways to constrain chatbots to give you reasonable
Speaker 7: answers that are statistically sound. All right, so when you
Speaker 7: can when you come back, yes, it will okay, good stuff.
Speaker 3: So appreciate. Doctor Ellen Grant, director of Fetal Neonatal, Neuroimaging
Speaker 3: and Developmental Sciences here at Boston Children's Hospital, Thank you again.
Speaker 2: You are listening to the Bloomberg Business Weekdaily Podcast. Catch
Speaker 2: us live weekday afternoons from two to five pm Eastern
Speaker 2: Listen on Apple CarPlay and Android Auto with the Bloomberg
Speaker 2: Business App or watch us live on YouTube.
Speaker 4: We are live from Boston Children's Hospital, where we're speaking
Speaker 4: with some of the nations leading doctors on matters related
Speaker 4: to health, health policy, innovation, medical care, and everything that
Speaker 4: has to do with health. Carol, A fixture at my
Speaker 4: high school in college was torn acls volleyball, lacrosse, soccer,
Speaker 4: field hockey. A torn ACL, surgery to reconstruct it, then
Speaker 4: weeks on crutches, months of recovery, and oftentimes it was girls,
Speaker 4: not boys who tore their ACL, which.
Speaker 3: I find interesting. I guess I would have thought it
Speaker 3: was the other way around.
Speaker 4: Girls and women's women tear their acls at a higher
Speaker 4: rate than men and boys. This is doctor Martha Murray's world.
Speaker 4: She's orthopedic surgeon in chief for Boston Children's Hospital. She
Speaker 4: joins us here into Boston where we are at Boston
Speaker 4: Children's Hospital. Doctor Murray, welcome, how are you.
Speaker 6: I'm good? Thank you so much for having sta.
Speaker 4: So you've got this background in material science and engineering,
Speaker 4: it's not typical for a surgeon. We're going to talk
Speaker 4: about your innovation and ACL surgery in just a minute.
Speaker 4: But on the boys versus girls, men versus women. Why
Speaker 4: do ACL tears affect women more than men.
Speaker 8: Well, it's a really interesting question and it's been one
Speaker 8: of much debate for the last few decades, and there
Speaker 8: have been things like, well, it must be a hormone cycle,
Speaker 8: or it's the shape of women's hips and their valgus
Speaker 8: angles to their knees. But a really interesting study came
Speaker 8: out very recently from the Harvard School of Public Health
Speaker 8: as well as Harvard University with doctor Danielson and doctor Richardson,
Speaker 8: where they actually showed that the studies that say that
Speaker 8: women tear their acl more frequently than men were often
Speaker 8: based when the women's teams were smaller than the men's teams,
Speaker 8: and the way they calculated exposures was the number of
Speaker 8: practices or games you played in, not necessarily your playing time.
Speaker 8: So if you're a man who's on a hockey team
Speaker 8: versus a woman who's on a hockey team, the women's
Speaker 8: teams were smaller, so those women were playing more, so
Speaker 8: they were planting hockey.
Speaker 1: It's a bad example.
Speaker 8: Soccer would be better, but if the team is smaller,
Speaker 8: the women are going to be planting and pivoting and
Speaker 8: playing much more time per game or practice.
Speaker 3: So more stress, more stress, more use, more tears.
Speaker 4: So maybe it's not maybe women in all things equal,
Speaker 4: maybe women and men don't have a different rate of torn.
Speaker 8: Acl correct when when they corrected for unit of exposure.
Speaker 8: So kind of game time playing rather than just a game,
Speaker 8: the injury rates look very similar.
Speaker 4: Wow, that's totally different than what's I mean, do you
Speaker 4: is that? Do you is this the standard? Now? I
Speaker 4: mean do you think this is?
Speaker 8: It's relatively new work that's coming out, but it resonates
Speaker 8: with most of us who take care of women and
Speaker 8: men on their on their athletic teams.
Speaker 3: Yeah, I want to ask about your background material science
Speaker 3: and engineering. I know Tim said it not typical for
Speaker 3: a surgeon, but I think it's it's a really smart combination. Well,
Speaker 3: I have a doctor, a foot doctor, same thing engineering,
Speaker 3: and like he doesn't just dealing with my foot, he
Speaker 3: thinks about, Okay, what are you doing? What else is
Speaker 3: going on in your body? Tell me about that mix
Speaker 3: and why it's kind of unique and smart and ties
Speaker 3: things together.
Speaker 8: Well, for me, it was a it was actually a necessity.
Speaker 6: Right.
Speaker 8: So I was an engineering graduate student and a friend
Speaker 8: of mine came into a party one night and on
Speaker 8: as Tim was saying and who had torn his ACL?
Speaker 8: And I said, oh, are they going to go sew
Speaker 8: it back together? And he was a med student. He
Speaker 8: was like, you, stupid engineer, we can't sew it back together.
Speaker 8: You have to take it out and replace it with
Speaker 8: the graft of tenant that they're going to take from
Speaker 8: the back of my leg. And then it's all this rehab.
Speaker 8: And I thought that seems kind of excessive, right, Like
Speaker 8: that's a lot to have to go through. And so
Speaker 8: I spent the next six months or so in the
Speaker 8: medical school library just reading everything I could about why
Speaker 8: didn't the ACL heal? And I realized nobody really had
Speaker 8: figured out why it didn't. You know, they tried it
Speaker 8: sewing back together didn't work. So then went to grafts,
Speaker 8: and we've been doing graphs for fifty years and nobody
Speaker 8: really asked why doesn't it heal? And so for me
Speaker 8: then there was no biomedical engineering at that time, and
Speaker 8: so my choices were to continue on with my project,
Speaker 8: which was developing airplane wings that were invisible to you know,
Speaker 8: to radar, and I thought, well, that's a really cool project,
Speaker 8: but I really want to figure out this ACL thing.
Speaker 8: And my advisor was like, well, I guess you could
Speaker 8: go to medical school.
Speaker 4: This is a net like serious and then so okay, Well,
Speaker 4: the advisor obviously had an impact in her friend obviously
Speaker 4: had an impact. But fast forward, you know, thirty years
Speaker 4: plus and you have actually invented a new way to
Speaker 4: treat ACL tears, the bear method. You did figure out
Speaker 4: that there's a reason why acls don't heal like an
Speaker 4: MCL would actually heal.
Speaker 3: Why is that, Well, it's really interesting.
Speaker 8: So both the medial collateral ligament and the anti a
Speaker 8: cruciate ligament are ligaments. When you look at them under
Speaker 8: the microscope, they look very similar. But interestingly, when the
Speaker 8: MCL tears, you can go on to brace in it
Speaker 8: about six weeks, that ligament will heal fine in your
Speaker 8: back playing soccer. In contrast, the ACL, when it tears,
Speaker 8: even if we try to sew it back together, it
Speaker 8: doesn't heal. And so we wondered why, and so we
Speaker 8: did a series of studies where we looked and we
Speaker 8: compared the two tissues in their response to injury. And
Speaker 8: what we found was that actually the response to injury
Speaker 8: is very similar in the two ligaments. So the tissue
Speaker 8: and the cells and the tissue were doing exactly what
Speaker 8: they were supposed to do in both tissues, but the
Speaker 8: difference was in the MCL. When it tears, the ends
Speaker 8: bleed and that blood clots in forms what we call
Speaker 8: a hematoma between the two torn ends of the ligament.
Speaker 8: And then in contrast, in the ACL, because it lives
Speaker 8: in this fluid environment of the joint, the ends bleed,
Speaker 8: but instead of making a clot or hematoma between the
Speaker 8: torn ends of the ligament, the blood disperses through the
Speaker 8: fluid of the joint, and so the two ends never
Speaker 8: have that scaffolding, that biologic scaffolding to hold them back together.
Speaker 8: So once we discovered that, then it was a fairly
Speaker 8: logical step to say, is there some way we could
Speaker 8: immobilize the blood in between those two torn ligament ends
Speaker 8: and get that biologic signal where it needs to be
Speaker 8: to encourage healing of the ACL. And that's really what
Speaker 8: bridge enhanced ACL repair or BEAR is. So the magic
Speaker 8: is kind of the sponge that we've developed that can
Speaker 8: absorb the patient's blood. You can place that blood laden
Speaker 8: sponge in between the torn ends of the ACL, so
Speaker 8: the ACL back together. But now you have the biology
Speaker 8: plus the sutures and the repair and the ligament will heal.
Speaker 4: So is what is done in terms of numbers or
Speaker 4: percentage with the method that you pioneered, what you invented,
Speaker 4: versus actual reconstruction and using other ligaments.
Speaker 8: That's a great question. So this is still fairly new.
Speaker 8: So we got FDA approval for this product in twenty twenty,
Speaker 8: and so it's only been in practice for a few
Speaker 8: years now. There's studies coming out of Children's here, which
Speaker 8: is where we did the first studies, of course, but
Speaker 8: now other centers are coming along and doing follow on
Speaker 8: studies and those results are starting to come out, and
Speaker 8: it's very exciting to watch it grow.
Speaker 3: I'm also curious you mentioned but like FDA approval, like
Speaker 3: the approval process, is it a smart one? Is it
Speaker 3: the right one in terms of making sure that what's
Speaker 3: being done and studied, the R and D, that it's
Speaker 3: safe for when it's finally done on patients, or is
Speaker 3: it preventing things from maybe putting put into you sooner?
Speaker 3: Like I'm just curious where you guys weigh in. You're
Speaker 3: in it, You're in it every day. Yeah, I think
Speaker 3: it's a delicate balance. But I would say in our
Speaker 3: personal experience, the FDAY was an amazing partner. Okay, So
Speaker 3: we were able to get into an early adoption program
Speaker 3: where they actually met with us and helped us and
Speaker 3: put together a panel of experts that would help us
Speaker 3: figure out how to make this the safest possible product
Speaker 3: and the most effective product before we went to patients,
Speaker 3: and we found their advice incredibly valuable. There was a
Speaker 3: lot of conversation and back and forth and just having
Speaker 3: them it felt like it was a team effort because
Speaker 3: we were in alignment. I mean, as a physician, I
Speaker 3: was going to be shaking the hands of these patients
Speaker 3: that my partners were and we wanted to make sure
Speaker 3: things were as safe as possible, so they helped.
Speaker 6: Us with that.
Speaker 4: Do we have data yet on long term impact or
Speaker 4: long term outcomes yet when it comes to the bear procedure.
Speaker 8: Yeah, Our longest data that we have is at about
Speaker 8: six years, and it's only in the small number of
Speaker 8: patients in those first studies that we did. But the
Speaker 8: reason that we want to study at longer term is because,
Speaker 8: as you may know, many of these patients will develop
Speaker 8: arthritis early in life and as a pediatric orthopedic surgeon.
Speaker 8: I want to make sure we have a procedure that's
Speaker 8: going to last my patients for sixty or seventy years,
Speaker 8: not have the knee breakdown in ten or twenty years.
Speaker 8: And so we're very interested in this arthritis question with
Speaker 8: Bear and in our preclinical studies we were able to
Speaker 8: see that arthritis was actually much less in the subjects
Speaker 8: that we treated with an acl repair with the sponge
Speaker 8: versus a reconstruction. So we're interested in seeing if that
Speaker 8: same thing plays out in patients. Early day to suggest
Speaker 8: that it will it is true, but again that's very
Speaker 8: early data on small numbers of patients, so we're excited
Speaker 8: to see how that pans out.
Speaker 3: We're talking with doctor Martha Murray. She's orthopedic surgeon and
Speaker 3: she for Boston Children's Hospital. That's where we are Tim
Speaker 3: and me on this Friday. Preventive care, Like, so much
Speaker 3: of what we talk about often when we're doing interviews
Speaker 3: is preventive care. And I feel like the whole health
Speaker 3: community has been thinking about this for a long time.
Speaker 3: So what's the preventive care So that as much as
Speaker 3: we don't want you unemployed, like, how do we think
Speaker 3: about taking better care if we're living longer, Like, how
Speaker 3: do we think about this? So there's a couple questions
Speaker 3: on that. So one is how do we help.
Speaker 8: Our teenagers reduce their risk of injury? And I think
Speaker 8: the main thing for that for our athletes when they're.
Speaker 3: In it because we push kids when they're younger. I
Speaker 3: think a lot of parents really push kids.
Speaker 8: So some things we can do to help them is
Speaker 8: help them work on strengthening in addition to just playtime.
Speaker 8: And another thing is cross training, So not playing the
Speaker 8: same sport all year round or playing the same sport
Speaker 8: every day, giving their body a chance to rest and
Speaker 8: heal between exposures to sport.
Speaker 4: Does it's as simple as that, I think? So, Wow,
Speaker 4: does acl TAAR happen more in kids than adults? Or
Speaker 4: and if yes, is it because kids are the ones
Speaker 4: who are playing sports and you know we're just sitting
Speaker 4: at computers.
Speaker 8: I think that's probably part of it. Again, it gets
Speaker 8: to this exposure question. How many times do you plant
Speaker 8: and change direction? And so the peak of a c.
Speaker 8: Andrews is really the high school athlete because there's so
Speaker 8: many everybody's playing a sport and so we see a
Speaker 8: lot of them there.
Speaker 3: I want to ask you at social media and all
Speaker 3: of us sitting on phones, are sitting in front of screens,
Speaker 3: like I just I keep thinking that we're going to
Speaker 3: one day. I don't know whether it's fifty years from
Speaker 3: now we're going to have a neck that basically goes
Speaker 3: over there or maybe not because we're gonna have glasses on.
Speaker 3: And that's like, how do you think about this digital world?
Speaker 3: You're laughing?
Speaker 4: But can you surgically remove my phone from my hand?
Speaker 4: That's what That's what I want.
Speaker 3: But I do think about what it's doing to us. Well,
Speaker 3: look at it, not just on the fixed for you.
Speaker 8: I don't know if I can fix the social media.
Speaker 3: But physically, like I'm just thinking like how you know
Speaker 3: kids are in their phones constantly and stuff in like
Speaker 3: the shape, Like do we need to be thinking about
Speaker 3: what this is doing onto our spine and different things?
Speaker 3: I think so.
Speaker 8: But I also think things come in cycles, right, And
Speaker 8: we see now if you walk down the street, you
Speaker 8: see everybody's on their phone. I think we're going to
Speaker 8: five years from now, we're going to look at back
Speaker 8: at that and say why are we doing that? You know,
Speaker 8: maybe we'll start looking up at the sky more, I hope. So, yeah,
Speaker 8: that's what I hope too.
Speaker 4: Yeah, I mean, gosh, that's like your open air.
Speaker 3: I know. I just I look around on the subway
Speaker 3: and just everybody and I'm just thinking the curvature and
Speaker 3: I don't know, whatever, what's the next thing you're working
Speaker 3: on or that you're excited about.
Speaker 8: I'm really excited about a product that we're working on
Speaker 8: for rotator cuff injuries. And it's a product that's injectable,
Speaker 8: so that potentially it's great. Yeah, you can have ultrasound
Speaker 8: on your shoulder, see where the tear is, and then
Speaker 8: inject the product into the tear, maybe in an office visit.
Speaker 8: So that's what we're working on, but very early days
Speaker 8: on that.
Speaker 4: Again, a challenge with pediatric patients as well.
Speaker 8: No, this is more adults. But we were just we
Speaker 8: thought we could make this work for a ligament, maybe
Speaker 8: we could try it for the rotator cuff ten And and
Speaker 8: the nice thing about the rotator cuff is it is
Speaker 8: accessible by ultrasound and injection and it's a pretty easy
Speaker 8: model for us to study. If we can make that
Speaker 8: injectable work then and there's lots of other places we
Speaker 8: could apply a meniscus other things.
Speaker 4: Did you ever figure out the Invisible Airplane wings?
Speaker 6: No?
Speaker 8: Not too late, well, social media in Visible Airplane Wings
Speaker 8: ACL wrote that you guys are killing me.
Speaker 4: Oh we are glad you ended up going into pediatric
Speaker 4: orthopedic surgery?
Speaker 3: Is there another career like to add on after this?
Speaker 3: You could do it, You could do it. Welcome, This
Speaker 3: was so much fun. It was fun. Thank you guys
Speaker 3: very much, Doctor Martha Murray. She's orthopedic surgeon chief for
Speaker 3: Boston Children's Hospital.
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