Demystifying Medicine One Month at a Time

Tag: Gene Goldwasser

RIP: DFS (1930-2014)

Don Steiner died last week. You probably haven’t heard of him, unless you’re steeped in the lore of the University of Chicago or involved in the world of diabetes research.

Steiner is being remembered for discovering proinsulin, the hormonal precursor to insulin. As part of his work, he made the realization that proinsulin was made in the beta cells of the pancreas as two molecules bound together by a short molecule which came to be known as “c-peptide.” It’s not a stretch to say that his work was key in transitioning the mass manufacture of insulin away from grinding up the pancreases of cows and pigs to being able to manufacture pharmaceutical-grade insulin using modern technology.

Steiner was a throwback to a more innocent time in the world of biomedical research. As his Times obit states

steiner

Joe Stafford/UChicago

Some of [Steiner’s] research could have been patented, but Dr. Steiner never considered doing that, said Dr. Arthur Rubenstein, a professor of medicine at and a former dean of the medical school at the University of Pennsylvania, who studied under Dr. Steiner and collaborated with him.

“There it was, one of the really, really great discoveries, and there was no patent,” Dr. Rubenstein said.

That decision was part of a pattern. “He shared everything with everybody,” Dr. Rubenstein said. Dr. Steiner, he said, gave his students ideas and time, made them first authors on scientific publications that would advance their careers, and even shared materials and data with competitors who did not always credit his contributions.

This would never happen today. Universities have become more sophisticated about intellectual property, entrepreneurialism, and—let’s be honest—profits.

The story about Steiner’s openness reminded me of his contemporary, Professor Gene Goldwasser. Goldwasser, also of the University of Chicago, spent two decades unraveling the secrets of the hormone EPO (erythropoietin). He, too, could have patented his discoveries, but he thought it too important to share his work to move the science forward. Some say had he patented his molecular discovery he (and the university he worked for) would have made hundreds of millions of dollars.

I was lucky enough to spend time with Goldwasser near the end of his life. He introduced me to Professor Steiner on a couple of occasions. They were great friends. The two of them were part of a golden age in bioscience at the University of Chicago, the place where in 1942 the first sustained atomic chain reaction took place under Enrico Fermi.

I know that Goldwasser felt that since taxpayers (i.e. the federal government) had supported his research career, there was no doubt his discoveries ‘belonged to all of us.’ I’ve no doubt that Steiner felt the same way.

The two of them shared not only a love for science, but were ‘fiends for culture,’ supporting the arts—they were lovers of music, drama, and studio art.

Their deaths not only are a huge loss in Chicago, but for the whole world.

The Giving Spirit

Inside Trader.

Inside Trader: Dr. Gilman

Mega-blogger/tweeter Kent Bottles wrote a great post entitled “The Battle for the Souls of American Doctors.”

In it, he juxtaposed two articles about doctors that appeared in the NY Times on the same day:

  1. A news story about once-esteemed UMichigan neurologist Sidney Gilman, who ‘sold out’ late in his career for money, stock, and lavish trappings. Gilman crossed the line into insider trading when he advised clients to dump stock in anticipation of an announcement of a trial drug’s ineffectiveness in slowing Alzheimer’s.
  2. An obituary of a real Dr. House, Dr. William House, who is credited as being the inventor of the cochlear implant, among other medical and surgical innovations.

I find both stories compelling, because they show men of achievement, fortitude, and vision.

Dr. Gilman’s story is of a man at the pinnacle of the profession being seduced by the temptations of money, fame, and influence. He seeks redemption by cooperating with authorities to avoid jail time, yet is disgraced in the eyes of his profession.

Hearing to the deaf.

Hearing to the deaf: Dr. House

Dr. House’s story is that of the dogged innovator, who continues on in spite of protests from naysayers:

…for 27 years, Dr. House had faced stern opposition while he was developing the [cochlear implant]. Doctors and scientists said it would not work, or not work very well, calling it a cruel hoax on people desperate to hear. Some said he was motivated by the prospect of financial gain. Some criticized him for experimenting on human subjects. Some advocates for the deaf said the device deprived its users of the dignity of their deafness without fully integrating them into the hearing world.

His invention allows the deaf to hear. How valuable an asset is that? How much would a patent for such a device bring? Licensing fees? Royalties?

Neither [his] institute nor Dr. House made any money on the implant. He never sought a patent on any of his inventions…because he did not want to restrict other researchers. A nephew…said his uncle had made the deal to license it to the 3M Company not for profit but simply to get it built by a reputable manufacturer.

Reflecting on his business decisions in his memoir, Dr. House acknowledged, “I might be a little richer today.”

Gene, we miss you.

Gene, we miss you.

Such humbleness is truly astounding. I am reminded of my friend the late Gene Goldwasser, discoverer of erythropoietin, the hormone that makes red blood cells. It’s now a cloned molecule, and biosynthesized in giant industrial vats to the tune of billions of dollars in annual drug sales for companies like Amgen and Johnson & Johnson.

Gene explained to me that he had no inclination to apply for a patent on EPO. For one thing, no one did that in the 1970s. For another, all of his research had been funded by Federal grant dollars–i.e. our tax dollars at work. “I could no sooner patent my research than stop paying taxes,” he explained.

As Bottles concludes at the end of his post, “A major challenge for 21st century American medicine is to cultivate the culture epitomized by Dr. House and avoid the mistakes of Dr. Gilman.”

I agree.

Remembering Gene

A tribute to a life well-lived.

Gene Goldwasser (1922-2010)

Gene Goldwasser died last week. [Obits here and here.]

He was 88, and he was my friend.

I wrote previously about a series of conversations I conducted with Gene and Rabbi A.J. Wolf a few years ago.

I met Gene one Spring day after calling to invite him to sit in on a class I was teaching to a small group of medical students about social issues in health care.

I’d read about him in a book called “The $800 Million Pill,” by Merrill Goozner. In the book, Goozner writes the story of Gene’s two decade hunt to isolate the hormone erythropoietin (EPO).

Part of the story relates how Gene tried to interest traditional big pharma companies in his discovery, only to be brushed aside. Instead, Gene wound up sharing his discovery with what became Amgen. The company went on to make a windfall from recombinant production of the hormone and licensing it as a drug for patients with anemia and kidney failure.

A molecular model of EPO. (photo from Wikipedia)

Gene never profited from his discovery, the way that scientists and inventors now clamor to patent everything in sight. He believed that his discovery should be shared with the public; after all, the government had funded his research career–he figured the taxpayers ought to get the benefit of his discovery.

Gene was old fashioned that way. He was also old fashioned in the way his interests outside of work were so protean. He was a fiend for culture, attending concerts and plays on an almost nightly basis until his health no longer permitted him to.

He told me of his great love for sailing, for travel, for reading. He even was a biographer, penning the story of his great mentor at the University of Chicago, Leon O. “Jake” Jacobson, M.D.

Gene fought prostate cancer for more than 20 years. He vastly outlived his life expectancy given the stage of the disease, and when it recurred this past summer he was grateful for the ‘second life’ he’d been given.

The cancer eventually caused his kidneys to fail, and rather than decide to start undergoing dialysis treatments, Gene and his wife Deone elected hospice and comfort care to cure. He spent his final days in their beautiful apartment, literally entertaining family and friends and saying his goodbyes.

After ten days at home, Gene drifted into a gentle coma, and died within two days, surrounded by his family.

He chose a good death.

Shortly before he died, Gene completed work on his own memoir. I can’t wait to read it.

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