Medical is Magical and Magical is Art

Researchers Use HIV to Cure "Bubble Boy" Disease

This week, a number of articles seemed to question why Olympic organizers are still planning on handing out 150,000 condoms if they are making athletes follow other Covid protocols like dining alone and maintaining social distance. The phrase “mixed message” has been dropped just like it is every time a high school adopts a condom availability program. To assuage these doubters, Olympic organizers said this week: “The distribution of condoms is not for use at the athletes’ village, but to have athletes take them back to their home countries to raise awareness of HIV and AIDS issues.” But we all know that’s not true. As I explained earlier this year, athletes’ villages have historically been horny places—thousands of people in peak physical form gathered together in tight quarters for what are already destined to be the most exhilarating weeks of their lives. No one is surprised by the sex. Since 1988, Olympic organizers have handed out condoms to keep athletes safe. I understand that this year everyone is far more concerned with Covid-19 than HIV or gonorrhea, but getting rid of the condoms or pretending that they’re just souvenirs is not going to help. Young people in schools with condom availability programs do not have any more sex than their peers in schools without such programs. They are, however, more likely to use condoms when they do have sex. The same is likely true for athletes. Hopefully, they will be motivated by their own health (and performance) and follow social distancing rules to avoid Covid, but if they don’t there is no need to make it so they’re also at risk for HIV and gonorrhea. 

Jeff Toobin Returns

Jeffrey Toobin is back on CNN and I have to say I am neither surprised nor particularly upset. For those who had forgotten the week in which Jeff’s penis dominated the news, Toobin was caught on camera masturbating during a break in a Zoom meeting with colleagues from the New Yorker in October. He was fired from the magazine and put on indefinite leave by CNN.

Getting his on-air job back certainly confirms his status as the poster child for white male privilege, but I’m not sure he deserved to be banished forever. Unless CNN is covering up information to the contrary, it appears that he is less a sexual predator and more just an idiot who suffered a major technical snafu.

There’s nothing wrong with taking a masturbation break when you work from home. (Hell, this boss provides a room for her employees to take masturbation breaks in the office, granted she is a producer of feminist porn.) Having done so does not make him a bad person. Being entirely unaware of his privilege might.

Which brings me to the totally awkward exchange between Toobin and CNN anchor Alisyn Camerota in which she explains what happened as he smiles goofily and says the last seven months have been awful, he’s been going to therapy, trying to be a better person, and volunteering at a food bank (which he’s totally gonna keep doing as proof that he is, in fact, a better person). Oh, and he also worked on his book about the Oklahoma City bombing.

This is totally the wrong messaging for him. At one point he fumbled whether he’d turned his camera off or actually left the meeting (and that’s an important distinction). If I were his crisis PR person, I would have given him the following advice. 

Do:

·       Be crystal clear on the facts: “I thought I had left the meeting and was alone in my apartment.”

·       Take responsibility: “This was a terrible and embarrassing mistake, and I am truly sorry it happened. I want to apologize again to my colleagues, my family, and the people who have supported my career by reading my work and watching me here.”

·       Recognize your privilege: “I am humbled to be given a second chance, I realize that this is a reflection of the privilege I have in society and in my career and that a lot of people are not given this kind of opportunity. I want to thank CNN and viewers for that.”

Do not:

· Concede the moral high ground: Do not admit you are a bad person, this was an accident.

·  Try too hard to make yourself sound like a good person: Working in a foodbank is noble, but that is totally undermined as soon as you try to use it for PR purposes. It just makes you sound like a spoiled rich guy who needed something to put on his nice-guy resume and undermines the part about you not being a bad person in the first place.

· Mention your book: It sounds like a plug for something you want viewers to buy, it’s way too soon for that.

Alas, neither Toobin nor his CNN producers asked me for advice before they sent him back in front of the camera and started yet another week in which Jeff’s penis dominates our news cycle.

Researchers Use HIV to Cure “Bubble Boy” Disease (but Grey’s Anatomy Did It First)

In 1976, before Grease, Saturday Night Fever, and Scientology, John Travolta gave a riveting, over-the-top performance in the made-for-TV-movie The Boy in the Plastic Bubble. In a world before HIV and Covid-19, this Emmy-winning tour de force taught us all lessons about how important our immune systems really are.

Travolta played a teenager without an immune system who had been surviving by living in isolation—in a literal plastic bubble in his parents’ house—but ends up going to high school wearing what looks like a modified space suit. While the character was a work of fiction, he was based on two real life young men born with SCID—Severe Combined Immunodeficiency—a rare combination of genetic disorders caused by a gene mutation that leaves children unable to fight even simple infections. 

This disorder affects at least 1 in 50,000 to 100,000 newborns but can be difficult to diagnose, which is why there is now a CDC program to screen all infants at birth. Most babies who have it do not go on to live their lives in a sterile bubble, though with no treatment children with this condition rarely live past age two.

For years the standard treatment has been a bone marrow transplant in the first few months of life. Stem cells from a matched donor (ideally a healthy brother or sister) can help rebuild the infant’s immune system. Unfortunately, only about 25% of kids born with SCID find a perfect donor. Stem cell transplants can be done with other donors, but kids who receive this kind of transplant often have recurring immune problems later in life.  

In recent years, researchers have been looking at gene therapy as another treatment for SCID. The therapy involves collecting stem cells from a child’s bone marrow and then using a virus as a vector to insert a healthy copy of the missing gene into their cells. The cells are then put back into the child’s body after they have undergone chemotherapy similar to what they would need to prepare for a bone marrow transplant.

In a groundbreaking 2019 study, researchers at St. Jude’s used HIV as the vector, but it’s a version of the virus that has been engineered so that the active parts have been removed and recipients cannot become infected with HIV. That experimental treatment was a success. Dr. James Downing, the President and CEO of St. Jude’s, told CNN at the time: “This is the first time we’ve seen a total reconstitution of the immune system, which has provided the ability for these children to get out of isolation. So, we’re comfortable, I think, at this point stating that this is a cure. Only time will say [if this will be] a durable, lifelong cure.”

Last month, researchers at UCLA, the National Institutes for Health, and Great Ormand Streets Hospital in London published their findings of a similar gene therapy used on 50 kids with SCID and announced similar success. The therapy worked with all but two of the kids, both of whom were able to go back to the other treatments they were receiving. Dr. David Kohn, one of the lead researchers on the study, said in a statement: “All the patients are alive and well, and in more than 95% of them, the therapy appears to have corrected their underlying immune system problems.”

I’d like to point out that Dr. Miranda Bailey of Grey Sloan Memorial Hospital successfully used HIV to treat a boy in a bubble years before either of these studies were published. Of course, she had the advantage of being fictional and not having to get past peer review. Not to mention she did it without the parents’ consent and didn’t get in trouble.

Fake medicine is fun and so dramatic, but the real stuff is just as cool. As Paul Simon reminds us in the first track on Graceland: “Medicine is magical and magical is art. Think of the boy in the bubble and the baby with the baboon heart.”