Popular Mechanics (South Africa)
Divided we fall
I MAGINE CANCER RESEARCHERS as thousands of ships attempting to cross the Pacific, all with skills and tools that they have perfected in their home countries. Some have expert navigators. Others build the most watertight ships. If someone could combine the skills of the entire group, they could build a supership the likes of which has never been seen. Instead, they seem to communicate mostly by throwing paper aeroplanes at each other.
“All you could do with governmentfunded academic research, in the age of paper, was share information in person, so you had these huge cancer meetings once a year where everybody holds their research until they get there,” says Greg Simon, the executive director of former vice president Joseph Biden’s Cancer Moonshot, an initiative launched by the Obama administration in 2016. “We haven’t changed it since.”
The system of medical journals, subscriptions to which can cost thousands, are hardly the only baked-in obstacle to progress in cancer research. Clinical trials are still designed the same way they were 50 years ago. Funding, applied for and received in crazed round-robins of grantwriting, tends to reward low-risk experiments. There’s secrecy and competition and slowness and inherent bureaucracy. The system wasn’t created to be inefficient, but now that it is, it is intractably so.
Just this week, Simon has flown all over the country trying to bring bullheaded institutions with impossibly huge data troves into a single kumbaya circle of progress. This morning, he gave a speech at the 28th Annual Cancer Progress Conference. Now he is entertaining a journalist at a sushi lunch in the lobby of a Manhattan hotel. By rights, he should be asleep at the table with his face on a plate. Instead, he orders plain fish, no rice, in a disarming Southern accent. (Simon is from Arkansas.)
When Simon was 28, he played drums in a rock band called the Great Zambini Brothers Band. Then he decided to do something with his life, “quit the band, waited tables, went to law school, got a job, and hated it”. he says. A friend found him work in Washington and by 41, Simon was working in the White House as an aide to then vice president Al Gore. Then he co-founded a Washington think tank called Fastercures. Then he worked as senior vice president for patient engagement at Pfizer. If anyone on Earth knows how to get from here to there, Simon is the guy.
Since he left the White House (again) in January, Simon and his team have begun developing, out of a Wework space, a spin-off of the Cancer Moonshot they’re calling the Biden Cancer Initiative. It will be its own separate nonprofit, apart from government or charity. Its goal: fix policy and make connections so that those with the expertise to cure cancer have a clear path to the finish line.
To achieve such a feat, Simon will work against a scientific version of the tragedy of the commons; an economic theory in which each person, acting in his own best interest, screws up the whole for everyone else. Convincing people and institutions to act against their own best interest will be much like governing, which is to say, slow and impossible. Yet it’s hard not to believe in Biden, a man who helped run the most powerful country in the world at the same time he lost his own son to brain cancer.
“We won’t be funding research. The world doesn’t need another foundation with money,” says Simon. “What it needs is someone like Biden, who’s willing to knock heads together… ” He pauses. “Or cajole heads together, to make the changes that everyone has an excuse not to do: I wanna make money, I want tenure, I wanna get published, I want this, I want that.”
The fragmentation in medical research – the lone ships out on the ocean – doesn’t exist as much in other sciences, says Simon, because scientists in other disciplines have no choice but to share equipment: telescopes or seismology sensors or space shuttles. Industries that have managed to work together have sent humans to the moon. “We don’t even know how much progress we could make in our cancer enterprise because we’ve never had it up and running at a level that would be optimal,” he says.
Simon himself had cancer. Three years ago. It was CLL. “I found it through a physical,” he says. “I never had any of the raging symptoms, like bleeding. During the chemo I didn’t notice it at all. Zero side effects. I thought I’d lose my hair so I grew a beard. But I didn’t.”
INTERLUDE
“You are writing. Are you writer?” asks the flight attendant on Delta Flight 3866 from Laguardia to Memphis in a thick Eastern European accent. It’s a late flight – post-work – and many of the passengers are asleep. My reading light is one of just three that are illuminated.
“I had cancer,” she says. “Breast cancer. I still have no boobs. After my surgery, they put in a balloon that they inflate step by step. After a few weeks I say to the doctor, ‘I am still as flat as pancake!’ And he says, ‘Ah, there must be a hole.’ ”
The flight is turbulent, so the flight attendant perches on the arm of the seat in front of me. “I go home after surgery and I have a chill, so I take my medication – they give
you such powerful medication – and I sleep. Thank God my friend came over and said I had to take a shower, because I took off the bandages and it was as red as this!” She points to the crimson bit of her Delta pin.
The flight attendant, diagnosed with stage 3a breast cancer, had developed a blood infection, and had to go to the hospital for intravenous antibiotics. After that, she had eight rounds of chemotherapy and 33 of radiation.
“There was so much pain, but I had to walk through the pain. I made myself,” she says. “I wrote ‘I love you’ on my mirror in lipstick. When you’re single and you have cancer and you look at yourself, you need to read that. What else is there to do?”