1 00:00:00,520 --> 00:00:03,720 Speaker 1: Since you're a subscriber to this Bloomberg podcast, we thought 2 00:00:03,720 --> 00:00:07,320 Speaker 1: you'd be interested in a sponsored podcast called Targeting the 3 00:00:07,360 --> 00:00:12,400 Speaker 1: Toughest Diseases, produced by Vertex Pharmaceuticals and Bloomberg Media Studios. 4 00:00:13,039 --> 00:00:17,599 Speaker 1: It explores the innovative tools, methods, and unique philosophy Vertex 5 00:00:17,640 --> 00:00:21,159 Speaker 1: Pharmaceuticals is using to search for treatments for some of 6 00:00:21,280 --> 00:00:30,200 Speaker 1: humanity's most challenging diseases. Here's a recent episode. 7 00:00:28,600 --> 00:00:31,680 Speaker 2: That's Damian Sanchez or if you are a jazz fan 8 00:00:31,800 --> 00:00:34,800 Speaker 2: living in Miami, Damian j Well. 9 00:00:34,840 --> 00:00:37,320 Speaker 3: I play all types of music, but yes, my passion 10 00:00:37,440 --> 00:00:41,920 Speaker 3: lies in the jazz genre. The history of jazz inspires 11 00:00:41,920 --> 00:00:45,400 Speaker 3: me to create. I get very passionate about talking about 12 00:00:45,400 --> 00:00:48,280 Speaker 3: the history of jazz from its very beginnings until today. 13 00:00:49,479 --> 00:00:51,640 Speaker 2: His passion started when he was twelve years old. 14 00:00:52,280 --> 00:00:54,760 Speaker 3: I saw a picture in a magazine that changed my life. 15 00:00:54,760 --> 00:00:56,600 Speaker 3: When I was young. It was a picture of a 16 00:00:56,640 --> 00:01:00,440 Speaker 3: young man who was holding every single woodwind could play 17 00:01:00,480 --> 00:01:02,880 Speaker 3: them all, and so I wanted to be like that kid. 18 00:01:03,360 --> 00:01:06,919 Speaker 2: Damien started with the obo, then the flute, the alto, sacks, 19 00:01:06,959 --> 00:01:09,000 Speaker 2: the clarinet, and even the bassoon. 20 00:01:09,920 --> 00:01:12,880 Speaker 3: I also play guitar. I also play piano, and I 21 00:01:12,920 --> 00:01:17,040 Speaker 3: also play various percussion instruments, mainly Latin percussion stuff because 22 00:01:17,080 --> 00:01:19,840 Speaker 3: it's part of my project to perform Latin jazz. 23 00:01:22,640 --> 00:01:24,959 Speaker 2: But on a day that should have been a musical celebration, 24 00:01:25,800 --> 00:01:27,640 Speaker 2: Damien's life took a terrible turn. 25 00:01:29,640 --> 00:01:29,959 Speaker 3: Hi. 26 00:01:30,200 --> 00:01:33,559 Speaker 2: I'm Jordan Gospore, a member of the University of Southern 27 00:01:33,600 --> 00:01:38,000 Speaker 2: California Center for Health Journalism. This is Targeting the Toughest 28 00:01:38,000 --> 00:01:43,080 Speaker 2: Diseases a podcast produced by Bloomberg Media Studios and Vertex Pharmaceuticals. 29 00:01:44,319 --> 00:01:47,199 Speaker 2: In this series, we look at some of humanity's most 30 00:01:47,360 --> 00:01:51,800 Speaker 2: challenging diseases and how Vertex, a Boston based biotech company, 31 00:01:52,280 --> 00:01:56,440 Speaker 2: is using innovative tools, methods, and a unique philosophy to 32 00:01:56,480 --> 00:02:03,960 Speaker 2: search for treatments and cheers. Today we're looking at a 33 00:02:03,960 --> 00:02:08,200 Speaker 2: cute pain. You might think pain is just a sign 34 00:02:08,280 --> 00:02:11,359 Speaker 2: that something else is wrong in your body, but Vertex 35 00:02:11,440 --> 00:02:15,160 Speaker 2: is looking at pain as its own unique condition. They're 36 00:02:15,200 --> 00:02:16,840 Speaker 2: researching it as a disease. 37 00:02:20,760 --> 00:02:25,560 Speaker 3: It's December twenty twenty two. I just finished about a 38 00:02:25,680 --> 00:02:29,280 Speaker 3: month of rehearsals with a symphony, A very specific symphony 39 00:02:30,520 --> 00:02:36,880 Speaker 3: made up of nonprofit organizations sponsoring young musicians and professional 40 00:02:36,960 --> 00:02:40,720 Speaker 3: musicians here that play classical music that is of unheard 41 00:02:40,760 --> 00:02:42,239 Speaker 3: of composers of color. 42 00:02:43,200 --> 00:02:45,440 Speaker 2: This was the day of the inaugural performance. 43 00:02:46,360 --> 00:02:48,240 Speaker 3: I wake up early that day. It was a Saturday. 44 00:02:48,280 --> 00:02:50,720 Speaker 3: We're performing at the Broward Set of the Performing Arts, 45 00:02:50,760 --> 00:02:54,400 Speaker 3: this wonderful hall in Fort Lauderdale, Florida. I live in Miami, 46 00:02:54,520 --> 00:02:56,280 Speaker 3: so I grab my scooter. 47 00:02:57,919 --> 00:03:01,360 Speaker 2: See, Damien doesn't like driving. He's not a guy that 48 00:03:01,520 --> 00:03:05,359 Speaker 2: likes sitting still, and South Florida's traffic can be bad, 49 00:03:06,360 --> 00:03:09,880 Speaker 2: so instead of a car, he uses an electric kickscooter 50 00:03:10,000 --> 00:03:14,280 Speaker 2: and public transit. Getting to Fort Lauderdale means riding his 51 00:03:14,360 --> 00:03:17,520 Speaker 2: scooter to the train station, taking the train up the coast, 52 00:03:17,880 --> 00:03:20,400 Speaker 2: and then using the scooter again to get to the venue. 53 00:03:21,280 --> 00:03:24,160 Speaker 3: I have my English hornant and my obow and my 54 00:03:24,280 --> 00:03:26,639 Speaker 3: music and my backpack on my backstrapped on. I had 55 00:03:26,639 --> 00:03:27,160 Speaker 3: my helmet. 56 00:03:28,080 --> 00:03:30,280 Speaker 2: He's also wearing a brand new tuxedo. 57 00:03:31,760 --> 00:03:34,120 Speaker 3: And I remember looking to the left and looking to 58 00:03:34,120 --> 00:03:38,320 Speaker 3: the right and saying, ha ha ah, traffic sucks. 59 00:03:40,680 --> 00:03:43,440 Speaker 2: Damien was in the bike lane going down a steep 60 00:03:43,520 --> 00:03:46,880 Speaker 2: hill when a driver apparently attempting to get out of 61 00:03:46,880 --> 00:03:51,200 Speaker 2: the gridlock, suddenly turned into the bike lane. 62 00:03:53,600 --> 00:03:55,760 Speaker 3: I hit the front of her car with my scooter, 63 00:03:56,320 --> 00:03:59,240 Speaker 3: which I do not let go of, which actually ends 64 00:03:59,320 --> 00:04:02,280 Speaker 3: up flipping over the front of her car. I fly 65 00:04:02,360 --> 00:04:04,480 Speaker 3: into the air and I land on my ribs, which 66 00:04:04,520 --> 00:04:07,720 Speaker 3: get cracked, and my foot, my right foot get caught 67 00:04:07,800 --> 00:04:12,680 Speaker 3: up in the accident, and my tibia and my fibuya 68 00:04:12,840 --> 00:04:16,360 Speaker 3: both are shattered in many many places, and my leg 69 00:04:16,480 --> 00:04:21,520 Speaker 3: is completely discombobulated, disjointed to the side. 70 00:04:22,960 --> 00:04:27,320 Speaker 2: Damien didn't lose consciousness. In fact, he tried to stand up. 71 00:04:27,880 --> 00:04:30,960 Speaker 3: And as soon as I put one ounce of pressure 72 00:04:31,120 --> 00:04:34,640 Speaker 3: on that right foot, then the pain started coming in, 73 00:04:35,440 --> 00:04:37,720 Speaker 3: very very strong. As you can imagine, I have all 74 00:04:37,720 --> 00:04:40,719 Speaker 3: these broken bones in my right leg, and I'm trying 75 00:04:40,760 --> 00:04:42,960 Speaker 3: to walk on it and walk it off like nothing 76 00:04:42,960 --> 00:04:43,600 Speaker 3: ever happened. 77 00:04:43,839 --> 00:04:48,320 Speaker 2: A crowd gathered and someone called for an ambulance. Within minutes, 78 00:04:48,400 --> 00:04:50,840 Speaker 2: he was in the emergency room of a nearby hospital. 79 00:04:51,880 --> 00:04:54,240 Speaker 2: The pain in his leg was unbearable. 80 00:04:57,440 --> 00:04:59,560 Speaker 3: This one guy says, we're gonna give you morphine and 81 00:04:59,600 --> 00:05:02,640 Speaker 3: we're gonna manipulate that leg until they're ready to operate, 82 00:05:02,720 --> 00:05:05,640 Speaker 3: because it needs to be manipulated. I said, I've never 83 00:05:05,680 --> 00:05:08,680 Speaker 3: had any drugs. I don't take drugs. They said, well, 84 00:05:08,680 --> 00:05:12,120 Speaker 3: you're gonna want it. I said okay, and they gave 85 00:05:12,160 --> 00:05:14,200 Speaker 3: it to me through my ivy and I felt like 86 00:05:14,240 --> 00:05:17,240 Speaker 3: I was really drunk. And then he grabbed my foot 87 00:05:17,279 --> 00:05:24,120 Speaker 3: and put it back in place. I ready didn't feel inebriated. 88 00:05:24,200 --> 00:05:27,279 Speaker 3: I was laughing. I was joking, you know. I was 89 00:05:27,320 --> 00:05:30,760 Speaker 3: being very bubbly, which I usually am anyways, but I 90 00:05:30,839 --> 00:05:31,760 Speaker 3: was kind of scared. 91 00:05:34,040 --> 00:05:37,000 Speaker 2: After a few hours, the drugs were off and the 92 00:05:37,040 --> 00:05:40,320 Speaker 2: pain returned. It was time for a second dose. 93 00:05:41,120 --> 00:05:44,680 Speaker 3: I wasn't gonna take anything. I didn't want to get hooked. 94 00:05:45,600 --> 00:05:49,560 Speaker 3: My family has a lineage of substance and alcohol abuse. 95 00:05:50,279 --> 00:05:53,279 Speaker 3: My brother fights it, and my uncles fought it, and 96 00:05:53,320 --> 00:05:55,200 Speaker 3: I've always had that trauma in my brain. 97 00:05:55,960 --> 00:05:59,960 Speaker 2: It's a horrible decision many patients face, choosing between pain 98 00:06:00,360 --> 00:06:04,039 Speaker 2: and the risk of addiction. The doctors tried their best 99 00:06:04,040 --> 00:06:04,800 Speaker 2: to persuade him. 100 00:06:05,200 --> 00:06:07,280 Speaker 3: They were all about it. They were all about it. 101 00:06:08,360 --> 00:06:10,159 Speaker 3: Now you sure, are you sure? You don't want to 102 00:06:10,200 --> 00:06:12,880 Speaker 3: think nothing? What are you going to do? I'm just 103 00:06:12,880 --> 00:06:13,640 Speaker 3: gonna deal with it. 104 00:06:15,720 --> 00:06:18,400 Speaker 2: And that's what many patients do when faced with acute pain. 105 00:06:18,920 --> 00:06:20,400 Speaker 2: They just deal with it. 106 00:06:21,480 --> 00:06:25,640 Speaker 3: I never took any pain medication no matter how bad 107 00:06:25,680 --> 00:06:28,320 Speaker 3: it hurt. But yeah, the first three months were hell Man. 108 00:06:29,600 --> 00:06:32,880 Speaker 2: Pain isn't entirely a bad thing. It's actually an important 109 00:06:32,880 --> 00:06:36,240 Speaker 2: warning system. It's our body's way of telling us something 110 00:06:36,320 --> 00:06:36,719 Speaker 2: is wrong. 111 00:06:37,839 --> 00:06:40,240 Speaker 4: Typically, you expect a broken limb to hurt a lot 112 00:06:40,279 --> 00:06:43,640 Speaker 4: when you injure it gradually get better. It'll be a 113 00:06:43,760 --> 00:06:47,200 Speaker 4: key for a few weeks, but as it heals after 114 00:06:47,240 --> 00:06:49,840 Speaker 4: three months, you would not expect someone to still have 115 00:06:49,920 --> 00:06:51,360 Speaker 4: pain from that broken limb. 116 00:06:52,279 --> 00:06:54,839 Speaker 2: Doctor Norman Buckley is the director of the Michael G. 117 00:06:55,000 --> 00:06:57,960 Speaker 2: Degrout National Pain Center in Hamilton, Canada. 118 00:06:58,400 --> 00:07:02,640 Speaker 4: There certainly are settings where people continue to report pain. 119 00:07:03,040 --> 00:07:06,360 Speaker 4: Then you have to consider what's the reason for that, 120 00:07:06,839 --> 00:07:07,240 Speaker 4: he says. 121 00:07:07,320 --> 00:07:11,440 Speaker 2: Doctors have used medicine to manage pain for centuries. Opium 122 00:07:11,480 --> 00:07:15,200 Speaker 2: in the sixteen hundreds, ether and chloroform in the eighteen hundreds, 123 00:07:15,680 --> 00:07:20,040 Speaker 2: then morphine and even heroin in the nineteen hundreds. More recently, 124 00:07:20,520 --> 00:07:25,720 Speaker 2: insets have been used. Those are nonsterodal anti inflammatory drugs, 125 00:07:26,320 --> 00:07:29,880 Speaker 2: and of course opioids, which can be effective but bring 126 00:07:29,960 --> 00:07:34,560 Speaker 2: tolerability concerns and carry the risk of addiction. Innovation and 127 00:07:34,640 --> 00:07:38,400 Speaker 2: pain management has been slow, in part because pain is 128 00:07:38,400 --> 00:07:43,880 Speaker 2: both common and complex. It affects individual people differently. Those 129 00:07:43,920 --> 00:07:48,480 Speaker 2: differences might be influenced by gender, genetics, and age, as 130 00:07:48,480 --> 00:07:53,840 Speaker 2: well as other factors. Pain represents exactly the kind of 131 00:07:53,840 --> 00:07:57,640 Speaker 2: medical problem Vertex likes to target. There's a long history 132 00:07:57,640 --> 00:08:01,400 Speaker 2: of research to build on, there's new technology available or 133 00:08:01,640 --> 00:08:05,360 Speaker 2: Vertex thinks they can develop it. There's a large unmet need, 134 00:08:06,000 --> 00:08:09,200 Speaker 2: and Vertex thinks it may be possible to make an impact. 135 00:08:09,520 --> 00:08:13,200 Speaker 1: We've picked a set of diseases, cystic fibrosis, type one, diabetes, 136 00:08:13,760 --> 00:08:16,360 Speaker 1: sickle cell disease, also pain. 137 00:08:17,320 --> 00:08:20,960 Speaker 2: That's doctor David Altschuler. He's the chief scientific officer at 138 00:08:21,040 --> 00:08:24,880 Speaker 2: Vertex Pharmaceuticals. What he's really on is a quest for 139 00:08:25,000 --> 00:08:28,960 Speaker 2: something innovative. He's in search of new ways to think 140 00:08:28,960 --> 00:08:30,440 Speaker 2: about old problems. 141 00:08:31,040 --> 00:08:33,480 Speaker 1: The real question in our mind is can we succeed? 142 00:08:33,760 --> 00:08:34,840 Speaker 1: Can we make a difference? 143 00:08:36,400 --> 00:08:38,079 Speaker 5: Pain itself can be a disease. 144 00:08:38,800 --> 00:08:43,400 Speaker 2: That's doctor Paul Negelescu. He's leading Vertex's research in this area. 145 00:08:43,559 --> 00:08:47,000 Speaker 5: So while pain is a symptom of diseases, many diseases, 146 00:08:47,160 --> 00:08:49,680 Speaker 5: it can also be a disease in and of itself. 147 00:08:50,440 --> 00:08:52,960 Speaker 2: Vertex has been working on that puzzle for decades. 148 00:08:53,920 --> 00:08:56,640 Speaker 5: There are tens of millions of people in the US 149 00:08:56,760 --> 00:09:02,079 Speaker 5: that get pain experiences every year, either acute or chronic pain. 150 00:09:02,600 --> 00:09:05,439 Speaker 6: One thing that really interested me is why does it 151 00:09:05,559 --> 00:09:09,600 Speaker 6: seem like some people are more sensitive to pain than others. 152 00:09:10,040 --> 00:09:14,800 Speaker 5: It's a very subjective thing pain, and it's actually we 153 00:09:14,840 --> 00:09:19,280 Speaker 5: don't understand what makes different people sensitive or not to pain. 154 00:09:20,120 --> 00:09:23,040 Speaker 5: I would say though, that there are outliers. I mean, 155 00:09:23,080 --> 00:09:25,400 Speaker 5: there are definitely some people that are way off the 156 00:09:25,520 --> 00:09:28,760 Speaker 5: charts in terms of their ability to detect pain or not. 157 00:09:29,200 --> 00:09:31,800 Speaker 6: Would you be able to break down for me a 158 00:09:31,800 --> 00:09:34,120 Speaker 6: little bit further into what exactly is pain? 159 00:09:34,800 --> 00:09:39,040 Speaker 5: It's a really good question. So pain is an unpleasant sensation. 160 00:09:39,640 --> 00:09:42,840 Speaker 5: It's something that you experience, and so therefore it is 161 00:09:42,880 --> 00:09:46,960 Speaker 5: something that has been processed by your brain and depending 162 00:09:47,000 --> 00:09:51,959 Speaker 5: on your state of mind, literally that affects your ability 163 00:09:52,000 --> 00:09:56,720 Speaker 5: to sense pain. So it's a complicated process by which 164 00:09:57,160 --> 00:10:01,160 Speaker 5: we perceive pain. Now, now the way that we're trying 165 00:10:01,200 --> 00:10:03,280 Speaker 5: to approach it, which is to kind of take it 166 00:10:03,440 --> 00:10:06,960 Speaker 5: out of the brain part, because we know it starts 167 00:10:07,440 --> 00:10:10,040 Speaker 5: in the periphery. In most cases, it's due to an 168 00:10:10,040 --> 00:10:14,600 Speaker 5: injury or a surgery or damage to a nerve that's 169 00:10:14,679 --> 00:10:17,760 Speaker 5: outside the brain, so that part of the body is 170 00:10:17,800 --> 00:10:21,640 Speaker 5: sending signals to the brain. It hurts, it hurts, and 171 00:10:21,679 --> 00:10:24,600 Speaker 5: then you're processing those signals, and depending on whether you're awake, 172 00:10:24,640 --> 00:10:28,760 Speaker 5: a sleep distracted, you feel different levels of pain. Our 173 00:10:28,800 --> 00:10:30,560 Speaker 5: goal is to try to cut it off so it 174 00:10:30,559 --> 00:10:34,360 Speaker 5: never really gets to the brain. Opioids work at the 175 00:10:34,440 --> 00:10:38,280 Speaker 5: level of the central nervous system. They actually suppress the 176 00:10:38,280 --> 00:10:40,959 Speaker 5: inputs that are coming into the brain, and so we're 177 00:10:41,000 --> 00:10:43,960 Speaker 5: trying to work from the outside of the brain to 178 00:10:44,120 --> 00:10:46,160 Speaker 5: reduce the pain signals into it. 179 00:10:47,120 --> 00:10:51,199 Speaker 2: That's the unique aspect of Vertex's approach to research, innovative 180 00:10:51,240 --> 00:10:54,640 Speaker 2: approaches based on the underlying mechanism of the disease. 181 00:10:55,880 --> 00:10:59,960 Speaker 5: The way we're approaching pain is by targeting these proteins 182 00:11:00,120 --> 00:11:02,880 Speaker 5: that have been identified through human genetics as playing a 183 00:11:02,960 --> 00:11:07,280 Speaker 5: key role in the transmission of pain signals in the 184 00:11:07,320 --> 00:11:11,120 Speaker 5: pain sensing neurons. If you think about the pain sensing 185 00:11:11,160 --> 00:11:15,680 Speaker 5: neuron as a wire, it's transmitting a signal that says 186 00:11:15,840 --> 00:11:18,160 Speaker 5: I've got pain in one part of my body to 187 00:11:18,280 --> 00:11:21,280 Speaker 5: the other part of your body, and for that signal 188 00:11:21,320 --> 00:11:25,400 Speaker 5: to get transmitted, it has to be conducted along that wire. 189 00:11:25,800 --> 00:11:29,800 Speaker 5: To conduct that electrical signal through that sensory nerve. It's 190 00:11:29,880 --> 00:11:32,800 Speaker 5: kind of like a bucket brigade. One channel opens at 191 00:11:32,800 --> 00:11:35,080 Speaker 5: one end and it passes the electrical signal to the 192 00:11:35,080 --> 00:11:38,760 Speaker 5: next and that gets passed to the next one and 193 00:11:38,800 --> 00:11:41,400 Speaker 5: so on, and that's how the signal gets propagated. And 194 00:11:41,480 --> 00:11:45,040 Speaker 5: so you know, we're trying to interrupt that transmission. 195 00:11:45,480 --> 00:11:48,440 Speaker 2: The work is focused on researching the mechanism of how 196 00:11:48,440 --> 00:11:51,080 Speaker 2: a pain signal travels in the body, with the hope 197 00:11:51,160 --> 00:11:59,000 Speaker 2: of making a difference for patients. It's been two years 198 00:11:59,040 --> 00:12:02,880 Speaker 2: since Damien's acts, and other than walking with a slight limp, 199 00:12:03,280 --> 00:12:06,360 Speaker 2: he's moved on with his life. He doesn't dwell on 200 00:12:06,400 --> 00:12:10,199 Speaker 2: those pain filled months after his surgery. In fact, he 201 00:12:10,240 --> 00:12:12,480 Speaker 2: says he really doesn't remember most of it. 202 00:12:13,760 --> 00:12:17,040 Speaker 3: You tend to block out memories that you don't want, 203 00:12:17,679 --> 00:12:21,720 Speaker 3: you really do. They're painful, So I think that's why 204 00:12:21,800 --> 00:12:24,319 Speaker 3: I don't remember more about that time in the hospital. 205 00:12:24,840 --> 00:12:27,560 Speaker 2: What he does remember is that when the pain was 206 00:12:27,679 --> 00:12:30,280 Speaker 2: so bad it made it difficult to even stand up, 207 00:12:31,040 --> 00:12:32,400 Speaker 2: he never lost his passion. 208 00:12:32,679 --> 00:12:34,280 Speaker 3: I don't want to give up on music. I don't 209 00:12:34,280 --> 00:12:36,400 Speaker 3: want to give up on my music. As long as 210 00:12:36,400 --> 00:12:39,080 Speaker 3: I'm close to the music and keep playing music, I'm 211 00:12:39,160 --> 00:12:40,760 Speaker 3: very happy. So that's what. 212 00:12:40,760 --> 00:12:41,240 Speaker 1: I want to know. 213 00:12:41,240 --> 00:12:42,160 Speaker 3: I want to be at peace. 214 00:12:49,480 --> 00:12:52,840 Speaker 2: This is Targeting the Toughest diseases. A podcast from Bloomberg 215 00:12:52,880 --> 00:12:56,920 Speaker 2: Media Studios and Vertex Pharmaceuticals. If you like what you hear, 216 00:12:57,320 --> 00:13:00,880 Speaker 2: subscribe and leave us a review. I'm Jordan gos forre 217 00:13:01,480 --> 00:13:02,320 Speaker 2: Thanks for listening.