Speaker 1: Since you're a subscriber to this Bloomberg podcast, we thought
Speaker 1: you'd be interested in a sponsored podcast called Targeting the
Speaker 1: Toughest Diseases, produced by Vertex Pharmaceuticals and Bloomberg Media Studios.
Speaker 1: It explores the innovative tools, methods, and unique philosophy Vertex
Speaker 1: Pharmaceuticals is using to search for treatments for some of
Speaker 1: humanity's most challenging diseases. Here's a recent episode.
Speaker 2: That's Damian Sanchez or if you are a jazz fan
Speaker 2: living in Miami, Damian j Well.
Speaker 3: I play all types of music, but yes, my passion
Speaker 3: lies in the jazz genre. The history of jazz inspires
Speaker 3: me to create. I get very passionate about talking about
Speaker 3: the history of jazz from its very beginnings until today.
Speaker 2: His passion started when he was twelve years old.
Speaker 3: I saw a picture in a magazine that changed my life.
Speaker 3: When I was young. It was a picture of a
Speaker 3: young man who was holding every single woodwind could play
Speaker 3: them all, and so I wanted to be like that kid.
Speaker 2: Damien started with the obo, then the flute, the alto, sacks,
Speaker 2: the clarinet, and even the bassoon.
Speaker 3: I also play guitar. I also play piano, and I
Speaker 3: also play various percussion instruments, mainly Latin percussion stuff because
Speaker 3: it's part of my project to perform Latin jazz.
Speaker 2: But on a day that should have been a musical celebration,
Speaker 2: Damien's life took a terrible turn.
Speaker 3: Hi.
Speaker 2: I'm Jordan Gospore, a member of the University of Southern
Speaker 2: California Center for Health Journalism. This is Targeting the Toughest
Speaker 2: Diseases a podcast produced by Bloomberg Media Studios and Vertex Pharmaceuticals.
Speaker 2: In this series, we look at some of humanity's most
Speaker 2: challenging diseases and how Vertex, a Boston based biotech company,
Speaker 2: is using innovative tools, methods, and a unique philosophy to
Speaker 2: search for treatments and cheers. Today we're looking at a
Speaker 2: cute pain. You might think pain is just a sign
Speaker 2: that something else is wrong in your body, but Vertex
Speaker 2: is looking at pain as its own unique condition. They're
Speaker 2: researching it as a disease.
Speaker 3: It's December twenty twenty two. I just finished about a
Speaker 3: month of rehearsals with a symphony, A very specific symphony
Speaker 3: made up of nonprofit organizations sponsoring young musicians and professional
Speaker 3: musicians here that play classical music that is of unheard
Speaker 3: of composers of color.
Speaker 2: This was the day of the inaugural performance.
Speaker 3: I wake up early that day. It was a Saturday.
Speaker 3: We're performing at the Broward Set of the Performing Arts,
Speaker 3: this wonderful hall in Fort Lauderdale, Florida. I live in Miami,
Speaker 3: so I grab my scooter.
Speaker 2: See, Damien doesn't like driving. He's not a guy that
Speaker 2: likes sitting still, and South Florida's traffic can be bad,
Speaker 2: so instead of a car, he uses an electric kickscooter
Speaker 2: and public transit. Getting to Fort Lauderdale means riding his
Speaker 2: scooter to the train station, taking the train up the coast,
Speaker 2: and then using the scooter again to get to the venue.
Speaker 3: I have my English hornant and my obow and my
Speaker 3: music and my backpack on my backstrapped on. I had
Speaker 3: my helmet.
Speaker 2: He's also wearing a brand new tuxedo.
Speaker 3: And I remember looking to the left and looking to
Speaker 3: the right and saying, ha ha ah, traffic sucks.
Speaker 2: Damien was in the bike lane going down a steep
Speaker 2: hill when a driver apparently attempting to get out of
Speaker 2: the gridlock, suddenly turned into the bike lane.
Speaker 3: I hit the front of her car with my scooter,
Speaker 3: which I do not let go of, which actually ends
Speaker 3: up flipping over the front of her car. I fly
Speaker 3: into the air and I land on my ribs, which
Speaker 3: get cracked, and my foot, my right foot get caught
Speaker 3: up in the accident, and my tibia and my fibuya
Speaker 3: both are shattered in many many places, and my leg
Speaker 3: is completely discombobulated, disjointed to the side.
Speaker 2: Damien didn't lose consciousness. In fact, he tried to stand up.
Speaker 3: And as soon as I put one ounce of pressure
Speaker 3: on that right foot, then the pain started coming in,
Speaker 3: very very strong. As you can imagine, I have all
Speaker 3: these broken bones in my right leg, and I'm trying
Speaker 3: to walk on it and walk it off like nothing
Speaker 3: ever happened.
Speaker 2: A crowd gathered and someone called for an ambulance. Within minutes,
Speaker 2: he was in the emergency room of a nearby hospital.
Speaker 2: The pain in his leg was unbearable.
Speaker 3: This one guy says, we're gonna give you morphine and
Speaker 3: we're gonna manipulate that leg until they're ready to operate,
Speaker 3: because it needs to be manipulated. I said, I've never
Speaker 3: had any drugs. I don't take drugs. They said, well,
Speaker 3: you're gonna want it. I said okay, and they gave
Speaker 3: it to me through my ivy and I felt like
Speaker 3: I was really drunk. And then he grabbed my foot
Speaker 3: and put it back in place. I ready didn't feel inebriated.
Speaker 3: I was laughing. I was joking, you know. I was
Speaker 3: being very bubbly, which I usually am anyways, but I
Speaker 3: was kind of scared.
Speaker 2: After a few hours, the drugs were off and the
Speaker 2: pain returned. It was time for a second dose.
Speaker 3: I wasn't gonna take anything. I didn't want to get hooked.
Speaker 3: My family has a lineage of substance and alcohol abuse.
Speaker 3: My brother fights it, and my uncles fought it, and
Speaker 3: I've always had that trauma in my brain.
Speaker 2: It's a horrible decision many patients face, choosing between pain
Speaker 2: and the risk of addiction. The doctors tried their best
Speaker 2: to persuade him.
Speaker 3: They were all about it. They were all about it.
Speaker 3: Now you sure, are you sure? You don't want to
Speaker 3: think nothing? What are you going to do? I'm just
Speaker 3: gonna deal with it.
Speaker 2: And that's what many patients do when faced with acute pain.
Speaker 2: They just deal with it.
Speaker 3: I never took any pain medication no matter how bad
Speaker 3: it hurt. But yeah, the first three months were hell Man.
Speaker 2: Pain isn't entirely a bad thing. It's actually an important
Speaker 2: warning system. It's our body's way of telling us something
Speaker 2: is wrong.
Speaker 4: Typically, you expect a broken limb to hurt a lot
Speaker 4: when you injure it gradually get better. It'll be a
Speaker 4: key for a few weeks, but as it heals after
Speaker 4: three months, you would not expect someone to still have
Speaker 4: pain from that broken limb.
Speaker 2: Doctor Norman Buckley is the director of the Michael G.
Speaker 2: Degrout National Pain Center in Hamilton, Canada.
Speaker 4: There certainly are settings where people continue to report pain.
Speaker 4: Then you have to consider what's the reason for that,
Speaker 4: he says.
Speaker 2: Doctors have used medicine to manage pain for centuries. Opium
Speaker 2: in the sixteen hundreds, ether and chloroform in the eighteen hundreds,
Speaker 2: then morphine and even heroin in the nineteen hundreds. More recently,
Speaker 2: insets have been used. Those are nonsterodal anti inflammatory drugs,
Speaker 2: and of course opioids, which can be effective but bring
Speaker 2: tolerability concerns and carry the risk of addiction. Innovation and
Speaker 2: pain management has been slow, in part because pain is
Speaker 2: both common and complex. It affects individual people differently. Those
Speaker 2: differences might be influenced by gender, genetics, and age, as
Speaker 2: well as other factors. Pain represents exactly the kind of
Speaker 2: medical problem Vertex likes to target. There's a long history
Speaker 2: of research to build on, there's new technology available or
Speaker 2: Vertex thinks they can develop it. There's a large unmet need,
Speaker 2: and Vertex thinks it may be possible to make an impact.
Speaker 1: We've picked a set of diseases, cystic fibrosis, type one, diabetes,
Speaker 1: sickle cell disease, also pain.
Speaker 2: That's doctor David Altschuler. He's the chief scientific officer at
Speaker 2: Vertex Pharmaceuticals. What he's really on is a quest for
Speaker 2: something innovative. He's in search of new ways to think
Speaker 2: about old problems.
Speaker 1: The real question in our mind is can we succeed?
Speaker 1: Can we make a difference?
Speaker 5: Pain itself can be a disease.
Speaker 2: That's doctor Paul Negelescu. He's leading Vertex's research in this area.
Speaker 5: So while pain is a symptom of diseases, many diseases,
Speaker 5: it can also be a disease in and of itself.
Speaker 2: Vertex has been working on that puzzle for decades.
Speaker 5: There are tens of millions of people in the US
Speaker 5: that get pain experiences every year, either acute or chronic pain.
Speaker 6: One thing that really interested me is why does it
Speaker 6: seem like some people are more sensitive to pain than others.
Speaker 5: It's a very subjective thing pain, and it's actually we
Speaker 5: don't understand what makes different people sensitive or not to pain.
Speaker 5: I would say though, that there are outliers. I mean,
Speaker 5: there are definitely some people that are way off the
Speaker 5: charts in terms of their ability to detect pain or not.
Speaker 6: Would you be able to break down for me a
Speaker 6: little bit further into what exactly is pain?
Speaker 5: It's a really good question. So pain is an unpleasant sensation.
Speaker 5: It's something that you experience, and so therefore it is
Speaker 5: something that has been processed by your brain and depending
Speaker 5: on your state of mind, literally that affects your ability
Speaker 5: to sense pain. So it's a complicated process by which
Speaker 5: we perceive pain. Now, now the way that we're trying
Speaker 5: to approach it, which is to kind of take it
Speaker 5: out of the brain part, because we know it starts
Speaker 5: in the periphery. In most cases, it's due to an
Speaker 5: injury or a surgery or damage to a nerve that's
Speaker 5: outside the brain, so that part of the body is
Speaker 5: sending signals to the brain. It hurts, it hurts, and
Speaker 5: then you're processing those signals, and depending on whether you're awake,
Speaker 5: a sleep distracted, you feel different levels of pain. Our
Speaker 5: goal is to try to cut it off so it
Speaker 5: never really gets to the brain. Opioids work at the
Speaker 5: level of the central nervous system. They actually suppress the
Speaker 5: inputs that are coming into the brain, and so we're
Speaker 5: trying to work from the outside of the brain to
Speaker 5: reduce the pain signals into it.
Speaker 2: That's the unique aspect of Vertex's approach to research, innovative
Speaker 2: approaches based on the underlying mechanism of the disease.
Speaker 5: The way we're approaching pain is by targeting these proteins
Speaker 5: that have been identified through human genetics as playing a
Speaker 5: key role in the transmission of pain signals in the
Speaker 5: pain sensing neurons. If you think about the pain sensing
Speaker 5: neuron as a wire, it's transmitting a signal that says
Speaker 5: I've got pain in one part of my body to
Speaker 5: the other part of your body, and for that signal
Speaker 5: to get transmitted, it has to be conducted along that wire.
Speaker 5: To conduct that electrical signal through that sensory nerve. It's
Speaker 5: kind of like a bucket brigade. One channel opens at
Speaker 5: one end and it passes the electrical signal to the
Speaker 5: next and that gets passed to the next one and
Speaker 5: so on, and that's how the signal gets propagated. And
Speaker 5: so you know, we're trying to interrupt that transmission.
Speaker 2: The work is focused on researching the mechanism of how
Speaker 2: a pain signal travels in the body, with the hope
Speaker 2: of making a difference for patients. It's been two years
Speaker 2: since Damien's acts, and other than walking with a slight limp,
Speaker 2: he's moved on with his life. He doesn't dwell on
Speaker 2: those pain filled months after his surgery. In fact, he
Speaker 2: says he really doesn't remember most of it.
Speaker 3: You tend to block out memories that you don't want,
Speaker 3: you really do. They're painful, So I think that's why
Speaker 3: I don't remember more about that time in the hospital.
Speaker 2: What he does remember is that when the pain was
Speaker 2: so bad it made it difficult to even stand up,
Speaker 2: he never lost his passion.
Speaker 3: I don't want to give up on music. I don't
Speaker 3: want to give up on my music. As long as
Speaker 3: I'm close to the music and keep playing music, I'm
Speaker 3: very happy. So that's what.
Speaker 1: I want to know.
Speaker 3: I want to be at peace.
Speaker 2: This is Targeting the Toughest diseases. A podcast from Bloomberg
Speaker 2: Media Studios and Vertex Pharmaceuticals. If you like what you hear,
Speaker 2: subscribe and leave us a review. I'm Jordan gos forre
Speaker 2: Thanks for listening.