How effective these technologies will be or how controversial the hubbub they will produce remains to be seen, but anti-aging doctors figure that if we can hold on for ten to fifteen more years, then we’re looking at a life span of 120 years. And all those later years won’t be spent in a wheelchair and a nursing home. Thanks to the wonders of hormones, what’s on the table here is a geriatric second childhood. Unless, of course, Congress decides that anti-aging medicine is a serious threat to the seniors’ golf tour — and then, well, all bets are off.
The Final Frontier
THE POLITICS OF STEM CELLS
Of all the stories in this book, this one is the most historical. It is about the breakthrough known as stem cells, the promise of which is considerable. But that’s not the real reason I included it in the collection. Instead, I’ve chosen this story because of how well it elucidates an important point — how incredibly difficult innovation really is.
History is often a tale of victory. We remember the winners, forget the losers, and rarely think about how messy the battleground became along the way. Technological history is no different. Everyone knows Thomas Edison invented the lightbulb — few remember that it took him over 1,000 tries to get it right.
This story, then, is a view from the trenches. It’s about the science of stem cells, for certain, but it’s also about how politics, culture, and religion impact that science. It’s about deception and morality and deception in the name of morality. And, of course, it’s about money. In short, since the central theme of this book is the transformation of science fiction into fact, this story is a look at all the nonscientific forces that can turn such transformation into blood sport.
One final note: While stem cell technology has advanced considerably since this story was written, all of the issues presented here are still with us. This fight is far from over.
1.
Irv Weissman’s home is about twenty minutes from Stanford University, hidden from the road by a tall stand of trees. Inside, the rooms are spacious, and the living room more so. The ceiling is high and broad-beamed; the furniture Western chic: chairs hewn from tree branches, tables built from tree trunks. Spread out in front of the fireplace is a bearskin rug. This bear has seen better days. Weissman is talking about those days and, more specifically, about how they came to an end.
“We ate him,” he says. “Rare. We were a little nervous about it, because most wild bears have trichinosis, but what the hell.”
Weissman doesn’t look the bear-eating sort. He’s of middle height, middle weight, mildly balding, with fine clothes, a jovial aspect, and a long, wispy beard. He looks like a Russian poet or an aged food critic. But, beneath this exterior, he’s just a boy from Montana. Which is to say he comes from a culture of bear eaters.
Boys from Montana are raised by that big-sky country as much as they are by their parents. Weissman now works at Stanford, but still owns property in Montana. He goes back as often as he can, though with his schedule, that’s not often enough.
Many of the reasons Weissman does not get back to Montana can be found on his resume. At Stanford, he’s a much-lauded professor of cancer biology and pathology. In 2002 alone, he won the American Cancer Institute’s distinguished scientist award; the Van Bekkum Stem Cell Award; and was selected to the National Academy of Science’s Institute of Medicine. For the years prior to 2002 his resume lists more of the same, and this list goes on for three pages — in ten-point font.
On that resume, the only nonscientific pursuits listed are Weissman’s positions as external director of Montana Trout Unlimited and external director of the Montana Land Reliance. In 1994, he was voted Montana Conservationist of the Year. If you ask him about his passion for the state he will say: “People from Montana are open and friendly, and anyone who lives there is only two generations from the land.”
Irv, himself, is two generations from the land. His grandfather arrived at Ellis Island in the early portion of the last century, didn’t much like what he saw, so decided to walk across the country. He stopped walking in Montana. You could make the case that his grandfather was among the first Jewish homesteaders in Montana and not run into much argument, except that homesteading proved too much for his grandfather. Technically, Irv’s grandfather was a charter member in one of the smallest self-help groups in history: failed Jewish homesteaders of Montana.
After homesteading, his grandfather tried his hand at mining, rag picking, scrap selling, and fur trapping. He eventually opened a hide shop that became a hardware store that became five hardware stores. The first store was in Great Falls, Montana, where Irv was born.
Irv’s own father was tough as well, locally known as the “man of steel, man of iron.” When Irv was in the second grade, he opened the paper to find a story about a man who stabbed his father with a knife. Wounded, his father still beat the man silly. This toughness seems to run in the family. The only fear Irv admits to is spiders.
Irv’s father went into the family business. The hardware stores were called Weissman and Sons, but they have since closed down because, well, the sons had other ideas. When Irv was ten years old, he read Paul de Kruif’s book Microbe Hunters about the trailblazing work of Louis Pasteur and Paul Ehrlich and other early bacteriologists. For an entire generation of scientists this book proved seminal. Irv was no different.
Inspired by Microbe Hunters and still in high school, Weissman got a job at a local lab doing transplantation research. He published two papers, both on cancer and transplantation, before turning eighteen. He smiles at the thought of them, mainly because these are the same subjects he still puzzles over today, so many, many years later.
After high school, Weissman entered Dartmouth College, but found he didn’t fit in with the East Coast Jews or the East Coast non-Jews and soon transferred to Montana State University in Bozeman, where he could study premed without having to worry about, as he explains, “how a Jew from Montana was supposed to behave on the East Coast.”
In 1960, he left Montana again, this time for Stanford Medical School, where, one way or another, he has stayed for the duration. At Stanford, Weissman’s early research focused on how the cells of the immune system fight cancer. He spent much of his time studying the relationship between blood cells, cancer, and radiation. Because of data that emerged after the explosion of the atomic bombs over Hiroshima and Nagasaki, scientists knew that exposing the human body to radiation wiped out both blood cells and cancer cells. They also knew that after irradiating the body (chemotherapy), you could perform a bone marrow transplant, replacing cancer-riddled marrow with marrow from a healthy, cancer-free donor, and the result was always the same: something in that cancer-free bone marrow would begin producing all sorts of healthy new cells.
It was quite a puzzle.
“We knew there must exist a very rare cell inside the bone marrow that gave rise to all types of cells,” explains Weissman. “But it was only a theory. No one had ever isolated that cell. Still, I started wondering if it was possible to tease it apart from all the others.”
His effort to do just that began in the late 1960s. For decades, Weissman sorted cells in his lab — essentially pouring mouse blood through a long series of high-tech strainers. With each pass, a different kind of cell was removed. Out came the T cells, out came the B cells, the red blood cells, the white blood cells, and so on and so on until there was only one kind of cell left. Finally, in 1988, Weissman managed to do something that no one else had ever done, something that most people didn’t even think was possible: He isolated a cell that gave rise to all varieties of blood cells, a precursor cell capable of radical transformation, or, technically, a hemotopietic stem cell. As a result of this discovery, Irv also became one of the first people on the planet to realize the astounding promise of these cells.
This has made him a very controversial man.
2.
If you’ve been living down in a cave or deep in a desert, perhaps you haven’t heard about stem cells but, otherwi
se, news of Irv’s discovery and its pluripotent ramifications have been hard to miss. Stem cells are our rawest materials, the original parts warehouse from which developing embryos build all the other cells that eventually form the body. Unlike specialized cells, which can only become one thing — a liver, say, or a nose — stem cells can turn into any other kind of cell. From a morphological perspective, they are the ultimate multi-tool. Medically, they’re a marvel.
When Weissman started working with mouse stem cells, he realized, nearly from the beginning, that he was on to something that could potentially save millions of lives. “I knew that if I could ever do this in humans,” he says, “I would be able to use chemotherapy to wipe out cancer cells and then transplant in new stem cells that would be completely disease-free.”
Cancer wasn’t the only thing on his mind. Weissman also knew that a great number of terrible diseases — Alzheimer’s, diabetes, Parkinson’s, many others — are caused by misbehaving cells. Thus, by replacing those misbehaving cells with healthy stem cells, it seemed possible that we could cure these diseases. In America, 1.3 million people have cancer; 4 million have Alzheimer’s; 1.5 million have Parkinson’s; 17 million have diabetes. This doesn’t include those in need of a new kidney or bladder or spinal cord — which stem cells can also be used to grow. That’s a lot of lives to save.
What Weissman didn’t get, especially at first, was that his own government would politicize these cells, essentially deciding that saving those millions of lives was a bad idea. What he didn’t understand then, but has come to understand since, is that without his rugged Montana perseverance, he might never get the chance to save those lives.
It’s a kerfuffle, all right.
As R. Alta Charo, professor of law and medical ethics at the University of Wisconsin, Madison and member of President Bill Clinton’s Bioethical Council, says: “The stem cell debate is a debate about everything but what it’s about.” Which is to say, the stem cell debate is not, actually, about stem cells.
So what is this debate really about? Plenty. It’s about President George W. Bush trying to win a second-term election after not actually winning the first. It’s about the son (Bush Jr.) not making the same mistakes as the father (Bush Sr.) and losing the support of evangelical Christians. Then there’s the right to life and a woman’s right to choose and whether the Supreme Court should deny the former to uphold the latter or vice versa. And that’s just the front end of this list. There’s also the values of the American people, the morals of the religious right, the economic potential of the biotech industry, the tension between church and state, the question of state’s rights, and a host of other nitpickery in between. In short, in the colorful history of Science versus Politics, stem cells have become the biggest knock-down, drag-out, hell-spat since Chuck Darwin told us we came from apes.
3.
If you want to drill down into this spat, then the first thing you need to understand are the five ways scientists currently obtain stem cells. The principal method is cloning or somatic cell nuclear transfer, wherein the DNA-containing nucleus of a somatic cell — that is, an adult, already specialized cell — is transferred into an enucleated egg cell, sort of like sucking all the filling out of a jelly donut and squirting it into the hollowed out core of a chocolate éclair.
Sort of, but not quite.
Once inside its new home, the somatic nucleus reprograms the egg cell, which begins to divide and birth new cells, and all of them now carry the DNA of the original somatic cell — which is how, for example, researchers cloned Dolly the Sheep. Where somatic cell nuclear transfer gets tricky is that this same process can be used to clone humans (an issue we’ll return to later).
The second method is parthenogenesis, the Greek word for virgin birth, in which an unfertilized egg is tricked into cell division and then mined for stem cells. The third idea is hybridization, or using existing stem cell lines (meaning cell lines that researchers have already isolated) to create new cell lines via genetic manipulation. And while both of these notions are exciting, no one really knows if either will work. So, for now, both are off the radar.
In the remaining two methods, fetal stem cells are culled from aborted fetuses or embryonic stem cells are removed from unused embryos taken from in vitro fertilization clinics. And it is these final two methods that have put stem cells into the middle of America’s reproductive rights debate.
“Every year since Roe v. Wade, thousands of women have been having abortions,” explains Alta Charo. “That’s thirty years — an entire generation of women who have experienced the ability to choose. That’s a huge demographic imperative. The evangelical right is fighting against a culture of tolerance for embryonic destruction, and they’re losing that fight every time a woman knows she can make a choice.”
While opponents have been trying to oust Roe v. Wade for thirty years, one of the main reasons it’s held fast is the idea that a human embryo does not have the same rights as a human being. Thus, to overturn the decision, you need significant evidence showing that the American people have changed their minds and now feel that embryos are people too — an idea that is more than a little problematic.
For starters, while the Bush administration and the evangelical right are waging war against stem cells, neither has said a peep about fertility clinics. Yet, during the normal process of in vitro fertilization, embryos are destroyed by the boatload. Current techniques cull twenty or so embryos for every one that’s implanted. The remainder are frozen for short-term insurance (to make sure that implantation took), then eventually discarded. But it’s bad politics to piss off sterile parents and the billion-dollar industry they support, so both the Bush administration and the religious right have stayed mum on pregnancy, yet become exceptionally vocal about stem cells.
Then there’s that other problem — embryos really aren’t people too. “When I’m trying to explain this issue to a reporter or a congressman,” says Irv Weissman, “I run a little experiment. I’ll walk up to a stranger on the street and ask them to draw an embryo. Invariably, every time, without fail, they draw a fetus with a face. But a fetus with a face is not an embryo.”
An embryo is a scientific term used to describe the period of time from when a zygote is formed until the time it begins to have discernible organs — meaning that the word embryo was literally created to distinguish it from a fetus. It is nothing like the cartoons that people draw. There’s no face. Nothing even vaguely human. Under a microscope, it looks like a tightly wound ball of waxy string.
To come at this from the other direction, the current medical definition of death is the cessation of brain function. This means that the opposite of death — the beginning of life — must be the emergence of brain function. Scientists believe that the earliest signs of an active nervous system are the development of pain responses, which show up around the nineteenth week of pregnancy, or long after an embryo has become a fetus.
If you ignore these facts and still want to prove to the Supreme Court that both the scientific community and the American public have changed their minds about the status of the embryo, then you need precedents. The evidence would have to show that in related — but not abortion-specific — cases the embryo is now being afforded the same protections as both a fetus and an adult human.
To this end, President George W. Bush stacked a bevy of antichoice judges in the lower courts and appointed a pro-life attorney general in John Ashcroft. Then, in October 2002, the administration changed the section of the Health and Human Services charter that regulates research done on human subjects. The old charter granted legal protection to adults and fetuses. The new version protects embryos as well. Next, while women’s groups had been lobbying the government to provide health care for pregnant women, the Bush administration extended the reach of the State Children’s Health Insurance Program to cover both embryos and fetuses but, oddly, not pregnant women. Bush also lobbied for a ban on partial-birth abortions — which would criminalize a proced
ure now used primarily in extreme, life-threatening situations — and reinstated Ronald Reagan’s gag rule, barring federally funded family planners from discussing abortion or providing abortion services.
“The point of these things,” says Allison Herwitt, director of government relations for the National Abortion and Reproductive Rights Action League, “was to weave embryonic rights into law. These were not individual occurrences. They were a well-crafted strategy to end legal abortions. And one of the next steps in that strategy is to outlaw stem cell research — not because the research itself is in question, but because banning the way that research is conducted can help them to achieve their true goal.”
4.
Under a microscope, stem cells are even less impressive than embryos. They grow in tiny clusters — when magnified tenfold, individual cells are still smaller than pinheads — and look not unlike slimy, slightly metallic grapes. “It’s almost funny,” says Dr. Larry Goldstein, “that something this dull-looking could cause such a fuss.”
Goldstein, another scientist in the middle of the stem cell storm, is a handsome, plainspoken man in his late forties. As a professor of cellular and molecular medicine at the University of California, San Diego, Goldstein oversees twenty-three researchers and several thousand mice. His work involves trying to decode how proteins, lipids, and organelles move through the neurons and brain cells, which is information that could help us cure Alzheimer’s, Huntington’s and Lou Gehrig’s disease. But to get this information, he needs stem cells.
Currently, much of Goldstein’s work involves nonhuman-derived stem cells, which are not technically a point of contention. “But five years from now,” he says, “if I want to actually cure these diseases, I’ll need access to human embryonic stem cells, and I want to make sure they’re available.”
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