By: Perrin B. Fourmy, Associate at Bell Nunnally & Martin LLP
Photo by Chevalie R.
“Dr. Thompson, it’s all over.”
A man with a badge and a walkie talkie was explaining to the lab coats and suits that they could come back inside. It was just another false alarm. Dr. Thompson had gotten used to these, but sometimes work had to be scrapped and started again because of the delays. These interruptions were even more troublesome for researchers, but in recent months, his specific responsibilities had shifted more towards management. He enjoyed his work less since leaving the lab, but that was the price he paid for success. One of the prices, at least.
The facilities staff sent an email a few weeks ago about problems with the fire suppression system and mentioned that there would be fire alarms going off every now and again until the problem was fixed. You’d think a multi-billion-dollar corporation could get this right, but it seemed like they just couldn’t figure out the problem. Except for the inconvenience, Dr. Thompson thought, at least these alarms were probably harmless.
As Dr. Thompson started walking back inside, he realized he skipped breakfast because he was in a rush to get to work and review the results of the new tissue developments. He was on the verge of missing lunch too. It was almost one in the afternoon; he needed to get something in his stomach. It wasn’t uncommon for him to lose track of time when he was working. Thankfully he had his wife, Jeannie, to take care of him. She made sure he never went too long without eating, and on more than one occasion found him sleeping at his desk and helped him into bed. Once, he woke up with half a purple face, when he accidentally knocked over a vial of gram stain after falling asleep at his desk. He spent the next week walking around looking like a Batman villain.
Even though he was the Director of Surgical and Pharmacological Development, Walter Thompson never really grew into the position. Deep down, he felt like a simple researcher, even after years overseeing the department. Lately, he had been tooling around in a jacket and tie more often than a lab coat. As he became more involved in the business side of things and less in the day-to-day experimentation and research, he had to look presentable at meetings and the occasional chat with investors or the media. Contemplative and diligent—he rarely rushed into things. He was the kind of man who never seemed to get too emotional, which wasn’t always Jeannie’s favorite quality. Sometimes he would sit for hours trying to figure out a problem when he knew there was something gnawing at him in the background, but in the end, he usually figured it out. At a certain point, he had begun to be respected precisely because of this patience and deliberation, although as a younger man people had seen it as reluctance to act. Either way, those things never really bothered him. He just went about his life.
Dr. Thompson began studying regenerative medicine at the University of Pittsburgh, writing his dissertation on a relatively new technique for growing organs in labs. It involved using biomaterials—basically polymers that worked well in the human body–to form a scaffold or framework of an organ, then “seeding” it with a combination of fast growing cell lines and autologous cells taken from individuals in need of organ transplants. Then, the cells would replicate, and in only a few weeks, there was an organ grown from scratch that matched the donor’s cells. At least that was his initial theory. He never had the chance to test it on a large scale until he entered the private sector. It was difficult to manage the procedure with anything much more complicated than simple blood vessels and bladders because things like kidneys and the pancreas involved as many as twenty different cell types in complex formations.
He eventually moved back to the South to be closer to his family, taking a job with Altruex. Altruex had spent a huge amount of money luring some of the world’s preeminent surgeons, researchers, and scientists. About fifteen years ago, Altruex, Targion, and Asari—all major players in the medical technology industry—started an intellectual arms race of sorts to patent technologies relating to tissue and organ regeneration, and Dr. Thompson was the beneficiary of that. Dr. Thompson’s work at Altruex initially focused on artificial organs, the same as his work at the University of Pittsburgh’s Center for Regenerative Medicine. He tried stem cells taken from umbilical cord blood to use in seeding the scaffolding, but on such a large scale, there was just too much protest. The next step was to switch to autologous cells taken from the host and then use those to grow new organs. But they could never get past the problem of organs with multiple complex systems and cell lines.
The solution ultimately came from the work of Dr. Emile Lazardo, a Swedish researcher who developed a technique for dealing with organ rejection by using pigs and other animals. Dr. Lazardo’s work broke the industry open when he discovered the real key was not in trying to design human body parts from scratch but rather was in solving the problem using animal organs as donors. Once the DNA in the donor animal was manipulated slightly, they were able to “grow” universal organs on a massive scale. It was practically the silver bullet in medical technology, and this resulted in a hundredfold growth in Altruex’s market capitalization in only a few years. Licensing and royalties alone were over ten figures a year. Dr. Thompson and Dr. Lazardo began to work closely together after that, each benefiting from the other’s work, and when Dr. Lazardo retired a few years ago, Dr. Thompson took his place in Altruex’s hierarchy.
Right now, though, Dr. Thompson knew getting something in his stomach was his first priority. Jeannie was constantly getting on him about not getting enough healthy food, exercise, and sleep. While he couldn’t do much about the last two, she had been packing him a nice lunch every day for months now to deal with the first one. “Since I finished looking over the results of the experiments this morning,” he thought, “I might as well go ahead and eat something and take a break.”
Dr. Thompson decided to just go back to his office. It was surprisingly comfortable and spacious, with a couch and a conference table in case he needed to have a meeting. The company installed brand new furniture in all top-level executive offices over the past few years after their economic windfall. It seemed like the idea was to make work as comfortable as possible so that the staff would spend more time away from home. Whether it worked for others, he didn’t know, but Dr. Thompson always considered his office his home away from home.
When it came to lunch, Walter was a huge fan of sandwiches. They seemed to be the perfect food. Portable, simple to make, you could do all sorts of different things by switching out the ingredients. Something as simple as a different type of mustard or the condiments on the bread could make all the difference. It wasn’t just the convenience—they were pretty much the only food he could eat while still working (he’d become an expert at snacking one handed while recording notes on his experiments back in college, never taking his eyes off the microscope) —the simplistic perfection of the ability to combine a handful of ingredients to create a meal greater than the sum of its parts. In a way, it reminded him of science, where pretty much everything was made up of only a handful of elements. Of course, he took his sandwich habit a bit far; at last count, he had eight different kinds of mustard in the fridge.
One of his favorite sandwiches was inspired by the King . . . Elvis Presley—peanut butter and banana (years with Jeannie meant Walter was too healthy to actually fry it up the same way as Elvis). His grandfather also introduced him to mayonnaise and banana sandwiches, although he ate those far less often because it was just a bunch of fat. Still, it reminded him of being a child, and that was comforting.
Unfortunately, his wife hadn’t made him one of those in months. Come to think of it, he hadn’t really seen bananas at all recently, and those he saw were obscenely expensive. “Didn’t they used to be cheap?” he wondered to himself. He thought he could remember just a few years ago bananas only being a few bucks a pound. But maybe it was like gas, and there was some war over the banana crop. Dr. Thompson usually had his head in one medical journal or another, so sometimes he missed the little things. Still, he never liked not knowing the answer to something, even if it was trivial. He’d have to look this up.
“Search…what happened to all the bananas?”
As he walked into his office, Dr. Thompson activated his computer’s search function through voice recognition commands.
“Project results to all screens.” In just a second, he was provided a multitude of different options, some text websites, and a few videos. The results were shown on the screen at his desk and also overlaid on the various screens throughout the room, including the mounted television screen on the wall and the inlaid conference table surface. The twenty-four-hour news channel he left on the television all the time was reduced to a news crawl across the bottom. Well, he had a few minutes while he ate his lunch, so why not watch a video?
“Select and play video…result six…Dateline: The Banana Apocalypse.”
At just under forty minutes, this would fit in nicely, and the foreboding title led him to believe it would be interesting, if nothing else. He searched around in the small fridge in his office for his lunch while the narrator started talking in the background. As he unwrapped it, he realized what it was—roasted turkey with Havarti dill and smoked Gouda on pumpernickel. He really did love Jeannie; she knew him so well.
“. . . at one time the world’s most popular fruit, for the banana, in the near term, it’s all over. But the story begins some hundreds of years ago, when mankind first started trying to cultivate the little yellow fruit . . . ,” the announcer began. Walter learned over the next few minutes that, unlike most fruits and vegetables, bananas were actually relatively unnatural. Well, the ones we ate, anyway. There were hundreds of different varieties of bananas but only one that worked for mass cultivation and sales.
“After 15,000 years of cultivation, farmers made the banana too perfect. In the late 1800s, with advances in shipping and storage, the banana became wildly popular in the United States and throughout the world. One variety in particular, the Gros Michel or Big Mike, came to completely dominate the market. The Gros Michel was not found in nature, but, rather, farmers created it through large-scale hybridization. Even though there were hundreds of varieties of natural bananas, none combined flavor and durability, resistance from disease, and a lack of seeds to make them edible. Cultivators began grafting shoots from different plants together. The end result was perfect but had one major problem—with no seeds, the resulting bananas couldn’t reproduce on their own.”
“You learn something new every day,” Dr. Thompson thought. How had he not known about this? But that still didn’t explain the missing bananas.
In the middle of his thoughts, Walter was brought back to reality when he heard a noise and his door opened suddenly. “Dr. Thompson, do you have a minute?” said an average-looking, middle-aged man in an expensive business suit, knocking on the door while opening it up at the same time.
Dr. Thompson hated people who did that; why knock if you were coming in anyway? This must be someone from the Marketing Division—those guys with MBAs who felt that, if they could get in the door, they could sell you on something. But this time, the Marketing man had someone else in tow behind him. An older, gray-haired man, also in a very expensive suit but who was looking at the room like he was a child seeing something for the first time—clearly not someone who worked for Altruex. Most likely another potential investor; the company had been taking advantage of its increased stock price and was looking to spin off some of its divisions to become semi-independent companies, and that apparently required independent capital, even when Altruex seemed to have enough of its own.
“Dr. Thompson, I hate to bother you on your lunch break, but I’ve got Fletcher Stevens, who runs the Wight Capital Management hedge fund, with me. He came down here to take a look at our facilities and learn a little more about what we have been doing recently in the field of regenerative medicine and organ transplantation, and I couldn’t think of anyone better to explain it than you. Do you have just a minute or two?”
Well, he thought, this was a big part of his job as Director of Surgical and Pharmacological Development. In essence, he was the top scientist at the company. When they needed a concept explained to the business folks, he was the guy to talk to. They had trotted him out in front of a seemingly limitless number of cameras at press conferences in the last few years. Nothing screamed authentic know-it-all like a man in a lab coat, although his was currently hanging in the closet, waiting to be called into media service. Maybe they’d think differently if they saw the man with the half-purple face.
“Sure, I’d be happy to,” said Dr. Thompson, putting on his business smile. He was practiced at not revealing his annoyance at these things. Having a discussion with fellow scientists was one thing, but this was kind of like teaching third-grade math. Maybe this time would be different, he thought.
“Mute video,” he said, and the narrator’s voice disappeared even though the screens continued to play in the background. “Here at Altruex, we have been doing a lot of work lately in regenerative medicine and organ transplantation,” Dr. Thompson said as he directed his attention to the two men in his office.
“Regenerative medicine?” Mr. Fletcher asked Dr. Thompson, interrupting him while expressing the same quizzical look Dr. Thompson had seen dozens of times before.
“It’s basically when you have an organ or body part that gets damaged, we think of ways to replace it or fix it faster,” said Dr. Thompson. “This can be total replacement or finding ways to encourage your own cells to fix themselves. Regenerative medicine has come a long way in the past few years, and Altruex is at the forefront of the technology. The main area I work in involves organ transplantation. There is any number of reasons individuals might need organs. A few years ago, it was not uncommon to have 150,000 people at any one time waiting for organs, and ninety percent of those were for kidneys and hearts. In addition to those who had organ failure, there were also plenty of individuals born with congenital defects like a hole in their heart or a something called aplasia of the lungs where you’re missing internal lung tissue. So the need has been out there, in children and adults. But even before we were able to develop whole organs, we worked on other tissues as well, like ears, blood vessels, and even bone.”
“With all of our efforts, it was pretty much a race to see which solution worked first, because there were a lot of different ways to tackle the problem. Most people thought it would be activating regular cells to make them stem cells, which allow any regular tissue to regenerate itself. There are enzymes you can inject into any cell type to cause them to reprogram themselves and become stem cells and cause the organ to regenerate itself. I originally worked on creating artificial organs, but the real breakthrough came about ten years ago—with pigs of all things.”
“Pigs? How exactly is that?” said Mr. Stevens.
“Well,” Dr. Thompson continued, “there are a lot of different animals that are similar enough to humans that we’ve thought about using their organs, and it’s been going on for almost a hundred years. There’s a name for transplanting organs from one species to another—it’s called xenotransplantation. For years, we used organs from baboons and pigs, but the problem with nonhuman organs is the same problem with organ donation from human cadavers—rejection. The human body realizes the organ isn’t one of its own, and the immune system starts to attack it. So a few years ago, we figured out how to remove and suppress those portions of the organ’s DNA that were responsible for rejection and how to basically grow pigs that had human compatible organs.”
“So you were trying to grow human organs in pig bodies?” said Mr. Fletcher, who looked almost repulsed by the idea.
Dr. Thompson smiled. This was the usual response. “Not exactly, more like pig organs where we had taken out all the pig qualities and just left behind the standard mammal qualities. You would be surprised how much all mammals have in common.”
“So did it work?” asked Mr. Fletcher again. He seemed only slightly more at ease with this explanation.
“Yeah, it did. The main problem we had is that there are a few viruses that pigs have which can be pretty problematic. One is called cytomegalovirus, or CMV, which is just a form of herpes that can result in continual infections. The other is called porcine endogenous retrovirus, or PERV. In essence, it is pieces of viruses that are part of a pig’s DNA but that don’t really cause much impact. Pigs carry any number of viruses, or bits of viruses, but over thousands of generations the pigs have developed immunity and operate basically as carriers. It’s the same in all mammals, including people. We carry bits and pieces of DNA around with us that may have been harmful at one time but just kind of float around now.”
“So you give someone a pig kidney, and they get pig herpes?” said Mr. Fletcher, laughing. “That doesn’t sound like a good thing. But I guess if my choices were to die from kidney failure or get herpes, I’d probably take the pig kidney.”
“Oh, no,” said Dr. Thompson, chuckling as well, “we solved that problem while we were dealing with the rejection issues. We can’t be the company that gave half the world herpes. I think our stock might take a hit. See, the human body only attacks certain things it doesn’t recognize. So when we figured out the things in the pig organs that were setting off the alarms, so to speak, we just removed that portion of the DNA. When we figured out how to do that, we did the same thing with the CMV and PERV genomes in the DNA. It was a very difficult process, but once we did it, we just cloned the pigs so that they would all have the same characteristics. We basically made pigs that had organs suitable for humans. We worked first with kidneys and hearts, and then we did the same with the other organs in the body. Eventually, we were able to get most of the major organs taken care of that way. Even though it cost a fortune, we got expedited approval from the FDA to work with patients who would have been dead in two to three months without it, which greatly sped up the trial process.”
“So you grow Frankenpigs in a lab somewhere and then harvest their organs?” said Mr. Fletcher, with a bit of a smile at his own joke, looking at both Dr. Thompson and his Marketing-man-slash-chaperone for approval.
“Something like that. As long as someone can survive the surgery itself, we have eliminated the issue of rejection almost entirely. There are hundreds of millions of people walking around the world now with genetically identical organs. It’s kind of amazing—we basically developed a universal donor organ.”
“Wait, hundreds of millions of people need organs?” said Mr. Fletcher, in that same half-confused, half-surprised way he had about him. “I thought you said there were only a few hundred thousand people on the transplant lists each year.”
“Oh, that was just in the United States,” said Dr. Thompson, adjusting himself in his chair and glancing briefly at his seemingly long-forgotten sandwich. He also saw that the video he was watching was still playing in the background, although the sound was muted. He’d explained this stuff multiple times before, and he really wanted to just sit and eat his sandwich and finish watching the video.
“And once we didn’t have the organ shortage problem,” he continued, “the transplant lists were opened to anyone, for any reason. Even the elderly, people with multiple system problems, drug addicts, they were all eligible. But the real key was cancer. We realized that, if we replaced cancerous organs immediately, the chance of cancer spreading throughout the body would be almost nonexistent. It was the ultimate preventative measure. So now, if there is any significant problem with an organ, we replace it before it can spread or lead to further damage.”
“Thanks so much, Dr. Thompson,” said the Marketing man, putting his arm on Mr. Fletcher and trying to hustle him out the door. Dr. Thompson still had no clue what the Marketing man’s name was. “Maybe these guys were cloned out of business school,” he thought.
“We’ve got to get Mr. Fletcher to a meeting with some of the board members before he heads out.”
“Yes, Dr. Thompson,” said Mr. Fletcher, extending his hand and positively beaming with an ear-to-ear grin, “this has been extremely eye opening. Thank you so much for taking the time to chat with me. What you guys are doing here is amazing, and I think I may be sitting down with Barry here later and talking investment.”
Dr. Thompson stood up and shook Mr. Fletcher’s hand, after making sure he didn’t have any sandwich crumbs, and then escorted “Barry” and Mr. Fletcher to the door. “Barry,” he thought, “so that’s his name? That figures.” He’d never met a Barry who was going to change the world, and based on his recent encounters, that was still true. But, as he glanced at Mr. Fletcher and “Barry” walking down the hall, he could rest satisfied knowing he’d pleased another potential investor and maybe massaged some money out of him to help with the upcoming expansion.
Dr. Thompson went back inside his office, thinking immediately of the rest of his sandwich. As he walked over to his desk, he said, “Unmute sound, back up video ten minutes.” Dr. Thompson was really curious about what happened to the Gros Michel. How did an entire species of banana just disappear?
As he continued his lunch, Dr. Thompson learned that the Gros Michel banana had succumbed to a disease called Panama disease, a deadly fungus. Apparently it infected the soil, and once that happened, there was nothing anyone could do. The real problem was that, because the bananas were hybrids that had been developed from multiple species, one of the side effects was that they ended up being asexual. As a result, the species was spread across the world for planting by cutting shoots off the trees. In essence, this meant every single Gros Michel was genetically identical. The lack of diversity meant they could not breed resistance to viruses and disease.
“. . . by 1960, the exporters of the Gros Michel were nearly bankrupt,” the anchor on the video said. “They needed a new banana variation, which led to the cultivation of the Cavendish.” A map of the world came up on the screen, showing a skull and crossbones over each region that had experienced Panama disease. Along with each symbol was the date the disease had struck. It looked like a wave washing over the world, with only a few countries left untouched.
“Most people recognized the Cavendish did not keep nearly as well as the Gros Michel, and it was far less flavorful, but the growers had a need, and they needed to meet that need. For a while, things seemed to be okay. But soon enough, it would be all over for the Cavendish as well . . .”
That seemed rather ominous, he thought, but before Dr. Thompson could hear the rest of the story, he heard a sharp knock on the door.
“Come in,” Dr. Thompson said to the door.
Dr. Smith, one of the Senior Directors of Surgical Research, burst in with a harried look on his face. Even before he said anything, Dr. Thompson could tell there was a problem. Like himself, Dr. Smith was usually very composed, and at the moment he was anything but.
“Dr. Thompson, there’s some sort of problem. We’re getting reports on it now, but there’s an issue in Beijing with a bunch of transplant patients. I just wanted to know that you’d be around for the next few hours while we get more information. I’ll let you know more as soon as I find out. Hopefully it’s nothing big, but I’ll be back later to let you know.”
And with that, Dr. Smith shut the door and quickly moved off down the hall. Dr. Thompson barely even had time to get out of his seat before Dr. Smith was gone. He was a little confused, but there was nothing else he could do now except wait. He couldn’t put out every fire. Dr. Thompson went back to his desk—maybe he could actually finish his lunch now. It really was delicious. Sometimes he took the little things for granted. He had to thank Jeannie when he got home later tonight.
“Unmute video,” he said. Based on the progress bar along the bottom, the documentary was apparently almost over.
“. . . even heavy spraying and wrapping the bunches in bags couldn’t protect the Cavendish forever. While scientists found a way to prevent the obvious enemy, Panama disease, they missed the real danger. The real weakness was not that their identical genetic makeup made them lack resistance to disease, it was actually popularity—something growers thought was a strength. The real problem was something which came to be called Banana Bunchy Top Virus, or BBTV.” The narrator spoke while the screen showed images of what this virus could do. The voice-over was explaining the leaves would yellow and wither, and the crop never grew properly again.
“The virus was extremely deadly. What the growers began to realize, far too late, was that there were two problems. The first was obvious—that, because all Cavendish bananas were genetically identical clones, if one crop could catch the disease, they all could. The other problem was the explosion in popularity of the fruit. The problem with the Gros Michel had developed over several years and allowed growers to figure out a solution. But in the last few years, well over 150 million tons a year of bananas were being produced, and to keep up with that, plantations were popping up everywhere. Because there were so many plantations in close proximity to each other, when one crop caught the virus, it took only a matter of weeks to infect the entire region.”
All of a sudden, something wasn’t sitting quite right with Dr. Thompson. He felt a thought rolling around in his head that he couldn’t quite place. It had been a long day, what with the false alarms, meeting that investor, and the vague warning from Dr. Smith. But he knew that when he had one of these thoughts, it would eat at him until he figured it out.
At that same moment, the news crawl across the bottom of the television started flashing.
“BREAKING NEWS!!! Beijing—massive viral outbreak occurring. Four dead in last twenty-four hours, thousands feared infected. Possibly H3N2 influenza.”
That’s when Dr. Thompson realized the problem. He didn’t even need Dr. Smith to tell him. They had worried so much about engineering the perfect organ that wouldn’t be rejected by the body and was free of viruses endemic to pig tissue that they forgot to deal with the inherent weaknesses that the lack of a diverse organ population would have. All of their studies were conducted in small populations, and when it finally did work, the need for organs was so great they rushed it out the door. And there were soon millions of people who now shared identical tissue structures. If a virus had infected one of them, then all those people were at risk because almost one in twenty people on the planet had some type of tissue from Altruex in his or her body.
His head was spinning. For years, he spent every bit of his intellect attempting to do something good for the world—to prolong life, to cure disease. Now, this wonderful tool might end up being the world’s biggest nightmare. By manipulating porcine DNA to remove deadly viruses, they had left gaps. They had spent so much time making it perfect on the inside and eliminating traces of internal disease that they had not thought enough about how interaction with the mutations of the outside world would impact things or about what would fill in those gaps. All he could think of was that nature had made that decision for them. And with every implanted organ and tissue being genetically identical, if one person became infected, it meant every person who had those tissues could become infected. They spent so much time trying to make sure the organs did not carry inherent disease that they forgot there was a world outside that already had it.
He thought back to the H1N1 outbreak during World War I, which infected almost a third of the world’s population and killed as many as a hundred million people in only two years. Is this how he would be remembered, for unleashing the next plague upon the world? Dr. Thompson sat, frozen, wondering if maybe there was some way this would turn out okay. But in the back of his mind, he knew what would happen. He knew this was just the beginning. He sat there processing everything as the narrator wound down the video.
“. . . what the agricultural experts had not anticipated was that the problem with the Gros Michel would be even worse with the Cavendish. When it happened, it was devastating. The proximity of one plantation to another. The ease of transport and movement. The disease could not be isolated. In the span of a few months, mass produced bananas could no longer be found. The virus spread like wildfire. The multibillion dollar industry was bankrupt.” Dr. Thompson was thinking it at the same time the narrator said it.
“It was all over.”