In short
The episode argues that acute pain can be its own disease, not just a symptom, and explains Vertex Pharmaceuticals’ research strategy to treat pain by targeting the biological transmission of pain signals rather than relying mainly on opioids.
Guest backgrounds
Damien Sanchez, a Miami-based multi-instrumentalist (jazz; oboe, English horn, flute, sax, clarinet, guitar, piano, Latin percussion) who suffered a scooter crash in Fort Lauderdale in Dec 2022, shattering ribs and his tibia/fibula. Dr. Norman Buckley directs the Michael G. DeGroote National Pain Centre (Canada). Dr. David Altschuler is Vertex’s Chief Scientific Officer. Dr. Paul Negalescu leads Vertex’s pain research.
Key claims
Pain can persist beyond expected healing; opioid risks include addiction; Vertex aims to “cut off” pain signals before they reach the brain by targeting pain-signal proteins identified via human genetics.
Notable examples
Damien’s refusal of pain meds due to family addiction history; historical pain meds (opium, ether/chloroform, morphine/heroin, NSAIDs, opioids); the “wire/bucket brigade” analogy for pain-signal transmission along sensory nerves.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VOIntroduction to Targeting the Toughest Diseases
0:30 to 1:17
An overview of a new podcast focusing on innovative disease treatments.
“Support for the show comes from public.com.”
Introduction to Targeting the Toughest Diseases
2:14 to 3:02
An overview of a new podcast focusing on innovative disease treatments.
“Policies provided by Hartford Fire Insurance Company and its property and casualty affiliates, Hartford, Connecticut.”
Damien Sanchez's Journey and Accident
3:02 to 4:52
A jazz musician shares his experience leading up to a traumatic accident.
“It explores the innovative tools, methods, and unique philosophy Vertex Pharmaceuticals is using to search for treatments for some of humanity's most challenging diseases.”
The Impact of Pain After an Injury
4:52 to 7:30
Damien discusses the unbearable pain following his accident and his choices.
“You might think pain is just a sign that something else is wrong in your body.”
Understanding Pain as a Medical Condition
7:30 to 10:46
Experts discuss the complexities of pain and its treatment options.
“A crowd gathered and someone called for an ambulance.”
Vertex's Innovative Approach to Pain
10:46 to 14:00
Vertex Pharmaceuticals discusses their research on pain as a disease.
“There's a long history of research to build on, there's new technology available, or Vertex thinks they can develop it, there's a large unmet need and Vertex thinks it may be possible to make an impact.”
Understanding Pain Signal Transmission
14:00 to 15:39
Learn how pain signals are transmitted through the body and the research aimed at interrupting this process.
“It's transmitting a signal that says, I've got pain in one part of my body to the other part of your body.”
Introduction to Targeting the Toughest Diseases
15:39 to 15:51
Discover the podcast series focused on tackling challenging diseases.
“a podcast from Bloomberg Media Studios and Vertex Pharmaceuticals.”
Transcript
Automatic transcript. May contain errors.0:00The thing about AI for business, it may not automatically fit the way your business works.
0:05Damian Sanchez:At IBM, we've seen this firsthand. But by embedding AI across HR, IT, and procurement processes,
0:13Dr. Paul Negulescu:we've reduced costs by millions, slash repetitive tasks, and freed thousands of hours for strategic work. Now we're helping companies get smarter by putting AI where it actually pays off, deep in the work that moves the business. Let's create smarter business, IBM. Support for the show comes from public.com. If you're actively involved in your portfolio, you probably catch yourself repeating the same actions. Buying the dip, manually sweeping idle cash, putting on a hedge. On public, you can now create AI agents that handle all these tasks on your behalf. Just describe what you want to do in plain English.
0:48Dr. Paul Negulescu:Like, if the VIX hits 25, buy a put option on the S &P 500. Or, if my cash balance goes above$20 ,000, move the excess into my direct index. You approve the workflow and your agent handles the rest. Monitoring the market, watching for your conditions, and executing your strategies exactly as defined. An investing platform driven by your intent, not just your clicks. You can also get full read and write access to your account via the public API. Go to public.com slash market and fund your account in five minutes or less. That's public.com slash market. Paid for by public investing. Brokered services by Open to the Public Investing, Inc., member FINRA and SIPC.
1:31Dr. Paul Negulescu:Advisory services by Public Advisors, LLC, SEC Registered Advisor. Complete disclosures available at public.com slash disclosures. When you're running a business, the best days are the ones where priorities stay on track. For midsize and large companies, risk can affect multiple parts of the organization at once, from property and liability to cyber and regulatory challenges. At that level, managing risk becomes an ongoing discipline. At the Hartford, the focus is on helping businesses manage risk before it turns into something more disruptive. And when losses do happen, that work is paired with insurance coverage shaped by years of underwriting, risk engineering, and claims experience.
2:10Dr. Paul Negulescu:Learn more at thehartford.com slash risk mitigation. Policies provided by Hartford Fire Insurance Company and its property and casualty affiliates, Hartford, Connecticut.
2:26Dr. Paul Negulescu:it.
2:49Dr. Paul Negulescu:Since you're a subscriber to this Bloomberg podcast, we thought you'd be interested in a sponsored podcast called Targeting the Toughest Diseases, produced by Vertex Pharmaceuticals and Bloomberg Media Studios. It explores the innovative tools, methods, and unique philosophy Vertex Pharmaceuticals is using to search for treatments for some of humanity's most challenging diseases. Here's a recent episode.
3:18Damian Sanchez:That's Damien Sanchez, or if you are a jazz fan living in Miami, Damien J.
3:24Dr. Paul Negulescu:Well, I play all types of music, but yes, my passion lies in the jazz genre. The history of jazz inspires me to create. I get very passionate about talking about the history of jazz from its very beginnings until today.
3:38Damian Sanchez:His passion started when he was 12 years
3:41Dr. Paul Negulescu:old. I saw a picture in a magazine that changed my life when I was that young. It was a picture of a young man who was holding every single woodwind because he could play them all. And so I wanted to be like that kid.
3:53Damian Sanchez:Damien started with the oboe, then the flute, the alto sax, the clarinet, and even the bassoon.
3:59Dr. Paul Negulescu:I also play guitar. I also play piano. And I also play various percussion instruments, mainly Latin percussion stuff, because it's part of my project to perform Latin jazz.
4:12Damian Sanchez:But on a day that should have been a musical celebration, Damien's life took a terrible turn. Hi, I'm Jordan Gospore, a member of the University of Southern California's Center for Health Journalism. This is Targeting the Toughest Diseases, a podcast produced by Bloomberg Media Studios and Vertex Pharmaceuticals. In this series, we look at some of humanity's most challenging diseases and how Vertex, a Boston-based biotech company, is using innovative tools, methods, and a unique philosophy to search for treatments and cures.
4:52Damian Sanchez:Today, we're looking at acute pain. You might think pain is just a sign that something else is wrong in your body. But Vertex is looking at pain as its own unique condition. They're researching it as a disease.
5:10Dr. Paul Negulescu:It's December 2022. I just finished about a month of rehearsals with the symphony, a very specific symphony made up of non-profit organizations sponsoring young musicians and professional musicians here that play classical music that is of unheard of composers of color.
5:32Damian Sanchez:This was the day of the inaugural performance.
5:35Dr. Paul Negulescu:I wake up early that day. It was a Saturday. We're performing at the Broward Center of the Performing Arts, this wonderful hall in Fort Lauderdale, Florida. I live in Miami, so I grabbed my scooter.
5:47Damian Sanchez:See, Damien doesn't like driving. He's not a guy that likes sitting still. And South Florida's traffic can be bad. So instead of a car, he uses an electric kick scooter and public transit. Getting to Fort Lauderdale means riding his scooter to the train station, taking the train up the coast, and then using the scooter again to get to the venue.
6:10Dr. Paul Negulescu:I have my English horn and my oboe and my music and my backpack on my back strapped on. I had my helmet.
6:17Damian Sanchez:He's also wearing a brand new tuxedo.
6:21Dr. Paul Negulescu:And I remember looking to the left and looking to the right and saying, ha, ha, ha, ha, traffic sucks.
6:30Damian Sanchez:Damien was in the bike lane, going down a steep hill, when a driver, apparently attempting to get out of the gridlock, suddenly churned into the bike lane.
6:43Dr. Paul Negulescu:I hit the front of her car with my scooter, which I do not let go of, which actually ends up flipping me over the front of her car. I fly into the air and I land on my ribs, which get cracked, and my right foot gets caught up in the accident, and my tibia and my fibula both are shattered in many, many places, and my leg is completely discombobulated, disjointed to the side.
7:12Damian Sanchez:Damien didn't lose consciousness. In fact, he tried to stand up.
7:17Dr. Paul Negulescu:And as soon as I put one ounce of pressure on that right foot, then the pain started coming in. Very, very strong, as you can imagine. I have all these broken bones in my right leg, and I'm trying to walk on it and walk it off like nothing ever happened.
7:33Damian Sanchez:A crowd gathered and someone called for an ambulance. Within minutes, he was in the emergency room of a nearby hospital. The pain in his leg was unbearable.
7:47Dr. Paul Negulescu:This one guy says, we're going to give you morphine and we're going to manipulate that leg until they're ready to operate because it needs to be manipulated. I said, I've never had any drugs. I don't take drugs. They said, well, you're going to want it. And I said, OK. And they gave it to me through my IV, and I felt like I was really drunk. And then he grabbed my foot and he put it back in place. I really did feel inebriated. I was laughing. I was joking. You know, I was being very bubbly, which I usually am anyways. But I was kind of scared.
8:23Damian Sanchez:After a few hours, the drugs were off and the pain returned. It was time for a second dose.
8:30Dr. Paul Negulescu:I wasn't going to take anything. I didn't want to get hooked. My family has a lineage of substance and alcohol abuse. My brother fights it, and my uncles fought it, and I've always had that trauma in my brain.
8:45Damian Sanchez:It's a horrible decision many patients face, choosing between pain and the risk of addiction. The doctors tried their best to persuade him.
8:54Dr. Paul Negulescu:They were all about it. They were all about it. No, you sure? You sure you don't want to take nothing? What are you going to do? I'm just going to deal with it.
9:05Damian Sanchez:And that's what many patients do when faced with acute pain. They just deal with it.
9:11Dr. Paul Negulescu:I never took any pain medication, no matter how bad it hurt. But yeah, the first three months were hell, man.
9:19Damian Sanchez:Pain isn't entirely a bad thing. It's actually an important warning system. It's our body's way of telling us something is wrong.
9:27Dr. Paul Negulescu:Typically, you expect a broken limb to hurt a lot when you injure it. Gradually get better, it'll be achy for a few weeks. But as it heals, after three months, you would not expect someone to still have pain from that broken limb.
9:41Damian Sanchez:Dr. Norman Buckley is the director of the Michael G. DeGroote National Pain Centre in Hamilton, Canada.
9:48Dr. Paul Negulescu:There certainly are settings where people continue to report pain. Then you have to consider what's the reason for that.
9:56Damian Sanchez:He says doctors have used medicine to manage pain for centuries. Opium in the 1600s, ether and chloroform in the 1800s, then morphine and even heroin in the 1900s. More recently, NSAIDs have been used. Those are non-steroidal anti-inflammatory drugs. And of course opioids, which can be effective, but bring tolerability concerns and carry the risk of addiction. Innovation in pain management has been slow, in part because pain is both common and complex. It affects individual people differently. Those differences might be influenced by gender, genetics, and age, as well as other factors. Pain represents exactly the kind of medical problem Vertex likes to target.
Read the full transcript
10:46Damian Sanchez:There's a long history of research to build on, there's new technology available, or Vertex thinks they can develop it, there's a large unmet need and Vertex thinks it may be possible to make an impact.
10:59Dr. Paul Negulescu:We've picked a set of diseases, cystic fibrosis, type 1 diabetes, sickle cell disease, also pain.
11:06Damian Sanchez:That's Dr. David Altschuler. He's the chief scientific officer at Vertex Pharmaceuticals. What he's really on is a quest for something innovative. He's in search of new ways to think about old problems.
11:20Dr. Paul Negulescu:The real question in our mind is, can we succeed? Can we make a difference? Pain itself can be a disease.
11:28Damian Sanchez:That's Dr. Paul Negalescu. He's leading Vertex's research in this area.
11:33Dr. Paul Negulescu:So while pain is a symptom of diseases, many diseases, it can also be a disease in and of itself.
11:40Damian Sanchez:Vertex has been working on that puzzle for decades.
11:43Dr. Paul Negulescu:There are tens of millions of people in the U.S. that get pain experiences every year, either acute or chronic pain.
11:52Damian Sanchez:One thing that really interested me is, why does it seem like some people are more sensitive to pain than others?
11:59Dr. Paul Negulescu:It's a very subjective thing, pain. And it's actually, we don't understand what makes different people sensitive or not to pain. I would say, though, that there are outliers. I mean, there are definitely some people that are way off the charts in terms of their ability to detect pain or not.
12:19Damian Sanchez:Would you be able to break down for me a little bit further into what exactly is pain?
12:24Dr. Paul Negulescu:It's a really good question. So pain is an unpleasant sensation. It's something that you experience. And so therefore, it is something that has been processed by your brain. And depending on your state of mind, literally, that affects your ability to sense pain. So it's a complicated process by which we perceive pain. Now, the way that we're trying to approach it, which is to kind of take it out of the brain part, because we know it starts in the periphery. In most cases, it's due to an injury or surgery or damage to a nerve that's outside the brain. So that part of the body is sending signals to the brain.
13:09Dr. Paul Negulescu:It hurts. It hurts. And then you're processing those signals, and depending on whether you're awake, asleep, distracted, you feel different levels of pain. Our goal is to try to cut it off so it never really gets to the brain. Opioids work at the level of the central nervous system. They actually suppress the inputs that are coming into the brain. So we're trying to work from the outside of the brain to reduce the pain signals into it.
13:36Damian Sanchez:That's the unique aspect of Vertex's approach, to research innovative approaches based on the underlying mechanism of the disease.
13:45Dr. Paul Negulescu:The way we're approaching pain is by targeting these proteins that have been identified through human genetics as playing a key role in the transmission of pain signals in the pain-sensing neurons. If you think about the pain-sensing neuron as a wire, It's transmitting a signal that says, I've got pain in one part of my body to the other part of your body. And for that signal to get transmitted, it has to be conducted along that wire to conduct that electrical signal through that sensory nerve. It's kind of like a bucket brigade. One channel opens at one end and it passes the electrical signal to the next, and that gets passed to the next one, and so on.
14:29Dr. Paul Negulescu:And that's how the signal gets propagated. And so, you know, we're trying to interrupt that transmission.
14:35Damian Sanchez:The work is focused on researching the mechanism of how a pain signal travels in the body, with the hope of making a difference for patients.
14:47Damian Sanchez:It's been two years since Damien's accident. And other than walking with a slight limp, he's moved on with his life. He doesn't dwell on those pain-filled months after his surgery. In fact, he says he really doesn't remember most of it.
15:03Dr. Paul Negulescu:You tend to block out memories that you don't want. You really do. They're painful. So I think that's why I don't remember more about that time in the hospital.
15:14Damian Sanchez:What he does remember is that when the pain was so bad, it made it difficult to even stand up. He never lost his passion.
15:22Dr. Paul Negulescu:I don't want to give up on music. I don't want to give up on my music. as long as I'm close to the music and keep playing music, I'm very happy. So that's what I want. I want to be at peace.
15:38Damian Sanchez:This is Targeting the Toughest Diseases, a podcast from Bloomberg Media Studios and Vertex Pharmaceuticals. If you like what you hear, subscribe and leave us a review. I'm Jordan Gosporé. Thanks for listening.
16:00Damian Sanchez:Get the news you need in just 15 minutes.
16:03Dr. Paul Negulescu:Start your day with Bloomberg Daybreak, the podcast with a global view on the stories that matter. I'm Nathan Hager. And I'm Karen Moscow. Join us each morning for curated stories on current events, politics, business, and foreign relations. Plus one conversation on the day's biggest developments, all in just 15 minutes. Subscribe to Bloomberg Daybreak for a precise, thoughtful take on the stories that matter. Listen to Bloomberg Daybreak each morning on Apple, Spotify, or anywhere you listen.
From the publisher
Damian Sanchez, (Damian J to music fans) is a Miami-based jazz musician. A car accident landed him in the hospital with multiple fractures to his leg. Once there, he faced the difficult decision of whether or not to take the pain medication that was offered to him. With patients like Damian in mind, Dr. Paul Negulescu and the research team at Vertex are thinking differently about pain – they’re investigating potential non-opioid based treatment options that aim to target pain differently.
Produced by Bloomberg Media Studios and Vertex Pharmaceuticals.
Featured guests:
Damian Sanchez is a Miami based jazz musician. He is the founder of the Damian J Foundation.
Norm Buckley is the Scientific Director of the Michael G. DeGroote Institute for Pain Research and Care at McMaster University.
David Altshuler is the Executive Vice President, Global Research and Chief Scientific Officer at Vertex Pharmaceuticals.
Paul Negulescu is a renowned cystic fibrosis researcher and now the Senior Vice President leading the team researching pain at Vertex Pharmaceuticals.
Read more about Vertex's approach to targeting pain at VRTX.com
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