Science didn't understand my kids' rare disease until I decided to study it | Sharon Terry

74,510 views ・ 2017-07-18

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00:12
The best Christmas my children ever had
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was also the worst Christmas my husband and I ever had.
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Elizabeth, age seven,
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and her brother, Ian, age five,
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couldn't imagine why they were getting everything they wanted for Christmas.
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The reason Santa was so generous
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was because of something my husband Pat and I knew
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and the kids couldn't comprehend.
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Something that we had just learned, and it terrified us.
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This was 1994
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and the story actually starts a few years earlier.
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For a couple of years I had noticed a rash on the sides of Elizabeth's neck
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that looked like prickly heat.
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For those same years, my father and brother both died of cancer,
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and I was probably overanxious about illness.
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The doctors assured us there was nothing wrong
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and I shouldn't worry,
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but I wasn't so sure.
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And so without a referral, and paying out-of-pocket,
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I took Elizabeth to a dermatologist.
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She was probably just allergic to something,
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but why did it appear just on the sides of her neck, this rash?
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So it's two days before Christmas,
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1994,
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and the dermatologist takes a quick look at her neck and says,
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"She has pseudoxanthoma elasticum."
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And then he shuts off the lights and looks in her eyes.
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It turns out, by chance,
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this dermatologist also trained in ophthalmology.
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Our lucky day.
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I am sick to my stomach.
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"Oma?"
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Oma's like melanoma, lymphoma --
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cancer.
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"Why are you looking in her eyes for a skin rash?"
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I scream and make no sound.
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So there it is.
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Elizabeth has pseudoxanthoma elasticum,
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PXE for short.
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Questions mix with fear
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and erupt like bile in my throat.
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Why are you looking in her eyes?
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What do you know about this? How do you know for sure?
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What is the prognosis?
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My training in pastoral counseling did not prepare me for this.
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Dr. Bercovitch tells us everything he knows about PXE.
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It's a rare genetic disorder,
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it's systemic,
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it's a slowly progressing, premature aging disease.
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It causes loose wrinkly skin in the flexor areas.
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It causes legal blindness,
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like macular degeneration,
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and a host of cardiovascular problems.
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Little is known about this disease,
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and some people die in their 30s,
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say some of the reports at the time.
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He then just glances at our son and says,
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"He has it, too."
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We want to flee back to the land of normal.
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Two days after Christmas,
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researchers come from a university in Boston,
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and they take blood from us and our children
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for a research project focused on finding the gene.
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A few days later,
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researchers come from a medical center in New York
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and say they want blood, too.
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"These are children.
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They're five and seven years old.
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Don't make them face the needle twice.
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Go and get your share from the other researchers."
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They laugh, incredulous.
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"Share?"
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It is then that we learn that there is little sharing in biomedical research.
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This moment, more than any other,
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lit a fire beneath my husband Pat and me.
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Pat and I went to a medical school library
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and we copied every article we could find on PXE.
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We didn't understand a thing.
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We bought medical dictionaries and scientific textbooks
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and read everything we could get our hands on.
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And though we still didn't understand,
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we could see patterns,
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and it became quickly apparent within a month
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that there was no systematic effort to understand PXE.
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In addition,
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the lack of sharing that we experienced was pervasive.
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Researchers competed with each other
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because the ecosystem was designed to reward competition
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rather than to alleviate suffering.
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We realized that we would have to do work on this condition ourselves
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to find solutions for ourselves and others like us.
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But we faced two major barriers.
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The first one:
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Pat and I have no science background.
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At the time, he's the manager of a construction company,
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and I'm a former college chaplain stay-at-home mom --
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hardly the backgrounds to take the research world by storm.
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The second barrier:
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researchers don't share.
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People told us you can't herd cats.
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Well, yes you can if you move their food.
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(Laughter)
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(Applause)
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DNA and clinical data is the food.
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So we would collect blood and medical histories,
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and require that all scientists using these resources
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would share results with each other and with the people who donated.
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Well before the internet was in common use,
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Pat and I established PXE International,
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a nonprofit dedicated to initiating research and conducting it on PXE
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and also supporting individuals with the disease.
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Using traditional media,
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we garnered around 100-150 people around the world
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who we asked,
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would you give us your blood, your tissue, your medical histories,
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your medical records?
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And we brought all of that together.
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We quickly learned that this shared resource was not going to be enough.
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And so we decided we had to do hardcore bench science --
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hardcore research.
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So we borrowed bench space at a lab at Harvard.
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A wonderful neighbor came a couple times a week
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and sat with the kids from 8pm to 2am
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while Pat and I extracted DNA,
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ran and scored gels
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and searched for the gene.
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Generous postdocs tutored us as we went along.
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Within a few years, we found the gene.
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We patented it so that it would be freely available.
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We created a diagnostic test.
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We put together a research consortium.
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We held research meetings and opened a center of excellence.
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We found more than 4,000 people around the world who had PXE,
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and held patient meetings
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and did clinical trials and studies.
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Through all this,
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we lived with fear.
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Fear of the disease breathing down our neck
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while the clock ticked.
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Fear of researchers,
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so well credentialed and positioned in a world made for them.
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Fear that we were making the wrong choices.
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Fear that the naysayers were right
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and the cats would simply find a new food.
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But greater than all these fears was our drive to make a difference
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for our kids and for all those we had met along the way.
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And very quickly,
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we also realized what we were doing for one disease,
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we should do for all diseases.
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We joined with, and I eventually led,
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Genetic Alliance --
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a network of health advocacy,
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patient advocacy,
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research and health organizations.
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We built scalable and extensible resources,
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like biobanks and registries and directories of support
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for all diseases.
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And as I learned about all those diseases and all those disease communities,
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I realized that there were two secrets in health care
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that were impacting me greatly.
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The first:
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there are no ready answers for people like my kids
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or all the people I was working with,
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whether common or rare conditions.
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And the second secret:
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the answers lie in all of us together,
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donating our data,
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our biological samples
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and ultimately ourselves.
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There is a small groundswell of individuals
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who are working to change this.
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Citizen scientists, activists, hacks
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who are using crowdsourcing, do-it-yourself science
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are changing the game.
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Even President Obama and Vice President Biden
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are evangelists for the idea
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that people should be partners in research.
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This is a founding principle of our organization.
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Sure, it's really hard
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to discover and develop interventions and therapies.
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The science is hard,
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the regulatory regime is difficult.
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There are a lot of stakeholders with lots of interests
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and misaligned incentives like publishing, promotion and tenure.
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I don't fault scientists for following this path,
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but I challenge them and us to do this differently.
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To recognize that people are at the center.
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Genetic Alliance has experimented
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in what it will take to transform these crusty systems.
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Our goal is to work without boundaries.
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That sounds abstract, but for us it's quite practical.
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When we're frustrated that entities won't share data --
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data that comes from people who gave their energy, their time, their blood
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and even their tears --
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we need to stop and ask,
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"How is it true that we could share, but we aren't?"
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We're part of this system, too.
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How do we make it so that people can share ideas freely?
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So that people can take risks and move closer to one another?
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This leads to a dissolving of us versus them,
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not only for organizations but also for individuals.
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If I'm going to ask organizations or individuals
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to strive for these standards,
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then I too need to explore my own being and my practices.
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If I'm going to ask clinicians and researchers and administrators
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to take risks,
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then I, Sharon, need to take risks as well.
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I need to face my personal fears.
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My fear of not having enough impact.
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My fear of not leading well.
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My fear of not being enough.
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Just before they entered their teens, our kids stopped us in our tracks
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and said, "You have to stop worrying about making a difference,
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making an impact,
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and instead, like us, learn to live with disease
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rather than fight it."
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I have to ask,
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where does all my fear come from?
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The kids' declaration shines a spotlight on that fear.
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It arises from a bedrock of love.
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I love Elizabeth and Ian.
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I love people with PXE.
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I love people with any disease.
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I love people.
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Some of my colleagues have discovered that it is not death we fear,
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it is the enormity of our loving.
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This expansive love opens me to great pain
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as I face loss.
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As I discover my fear,
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I discover that I
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and all those around me
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have boundless capacity for love.
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And I also discover
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as I move into this fear,
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that I can learn many new things
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and find paths
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to things like practical solutions
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as well as the core of healing and health.
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I don't fear fear the way I used to.
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In fact lately, with enormous support from all my fellow journeyers,
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I notice that it's not a warning the way it used to be.
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I notice that instead,
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it's an invitation to go forward
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because in it lies love and the path to greater love.
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If I turn with gentle curiosity toward that fear,
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I find enormous wealth within myself and others
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and the ability to step into challenges that I never thought I could.
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My kids are ahead of me on that path still.
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At ages 29 and 27,
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they declare they are happy and healthy
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despite having manifestations of PXE in their skin and eyes and arteries.
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And so I invite you, us, we,
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to turn toward our fear;
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to embrace the things that scare us
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and find the love at the center.
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We'll not only find ourselves there
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but we'll also be able to step into the shoes of those we fear
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and those who fear us.
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If we breathe into that fear
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and are vulnerable with the systems and people who challenge us,
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our power as changemakers grows exponentially.
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And when we realize
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that working on our inner life is working on our outer life
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and outer work is inner work,
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we get down to what is real
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and shit gets done.
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(Laughter)
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There is no limit to what we can accomplish together.
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Thank you.
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(Applause)
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