“It's A Bargain” Thrift Shop - Orthopaedic Hospital

things are common problems that we’re trying
to solve as a team.
motion: The opening of a new multimillion-dollar
research building suggests the importance
of new tools and technology. But the key to
research here focuses on people.
Dr. Adams: Yes. We have a lot of whiz-bang
technology available to us. But, to tell you the
truth, it’s how you apply that technology. The
conceptual part of science always tries to keep
up with the technical side, so there’s always a
technique that’s looking for a purpose.
It’s our job to partner with the engineers,
for instance, to make their efforts practical.
They could be developing ideas with funding
from NASA or the Department of Defense. But
we get our funding from the National Institute
of Health, which wants us to concentrate on a
human disease and fix it.
Breakthroughs will be possible because we
have discovered the human genome. Now the
idea is to find out what the human phenome
is — how these genes collaborate with one
another to cause a certain phenotype, or certain
outcome that’s visible in the workings.
The phenotype we just talked about is this
low-bone-mass phenotype. There probably are
10 different genes that collaborate to cause
either high or low bone mass. To discover
the circuitry and how genes interact with one
another is extremely challenging.
By comparison, some diseases are linked to
a single gene. Certain kinds of breast cancer are
caused by mutations in the human oncogene or
by the BRCA1 gene. Everything else is normal.
motion: As the vice chair for research, your job
seems a little like conducting an orchestra.
Dr. Adams: My job is to bring together the clinical
scientists, the orthopaedic surgeons and the
basic scientists. Until now, each of them never
really understood what each other said and
never really got along with one another because
what they do is completely different.
At Cedars, I ran a general clinical research
center. I’m a molecular biologist by training
so I always had a basic research program and
research
sought clinical grants to do that research. But
because I’m a clinician and because Cedars is
a hospital-based community, I morphed into
what the institution needed me to be: somebody
who would make it easy for scientists to do
their clinical research.
So, I understand what the orthopaedic surgeons
go through because I’m a clinician. I
understand what the basic scientists need to
know and what they do because I’m a basic scientist.
I’m a gap-filler here, a shuttle that goes
back and forth. The idea is to bring these groups
of scientists from different disciplines together
and sit in a room and talk with one another.
As you can imagine, there has to be some
translation in the language. The doctors are
really smart when they come here, but they’re
targeted to doing surgery. Then we have the
other really smart people — the scientists who
want to develop cures for human disease.
The orthopaedic surgeon says, “That’s crazy.
You can’t cure this disease.” The basic scientist
says, “Well, you know, I think we can.” And I’m
in the middle to say, “Well, you might be able
to make it a lot better to begin with and maybe,
maybe, you might get close to a cure.”
It’s rather like the story of AIDS. When
AIDS first hit, the clinicians took care of very
sick people. Then a lot of scientists got interested
because it was a major problem. Most
basic scientists want to work on science that
is relevant to humans. Even if they’re working
with flies or zebra fish, they want their work to
be applicable to the human cause. What it took
for that field to mature was a group of people
making the connections between the scientists
and the clinicians.
Now AIDS is a disease that you can live
with. During the course of this coming together,
we discovered so much about immunology
and infectious disease that we never would have
learned before.
I’m in the enviable position to realize
a long-standing dream, to create multidisciplinary
teams of scientists and clinicians to
develop innovative means of regenerating bone
and joint tissue in adults and children. I’m
excited about our potential.
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