The Smartest People in Philadelphia

The Smartest People in Philadelphia

Medicine

Carl June

The Cancer Slayer 
Without the Vietnam War, Carl June never would have cured cancer.

June, 59, only joined the Navy because he didn’t want to get drafted. They put him through med school, then gave him a lab at Bethesda Naval Hospital. He wanted to study cancer, but that was only being done at the National Cancer Institutes. So he picked AIDS instead, trying to regenerate the T-cells that HIV kills off. Sure enough, he found a way to grow immune systems in the lab.

In 1999, Penn hired him away from the Navy. And he decided to try using what he’d learned about T-cells to turn them into “serial killers” for cancer. He would employ a disabled form of the AIDS virus that had been genetically reprogrammed with bits of DNA—from humans, mice, cows, even a woodchuck virus—to infect T-cells and stimulate them to create an antibody-like protein that would bind to a protein found on cancerous B-cells and kill them. In 2010, after years of safety trials, June harvested T-cells from patients with terminal leukemia, exposed those cells to the altered AIDS virus, and froze them. Chemotherapy then destroyed patients’ remaining T-cells, and they were re-infused with the frozen ones.

Then June waited. The patients got sick—really, really sick, with fevers of up to 105 degrees.

What June didn’t realize—what nobody realized—was that the sickness was part of the cure. The transplanted T-cells were proliferating in the patients, multiplying 10,000-fold, overwhelming the cancerous B-cells and wiping them out. Completely. As in: Cancer, cured. What’s more, the altered T-cells remain in the patients, ready to pounce should the cancer recur. “It worked much better,” June says understatedly, “than we thought it would.”

What makes this such a radical breakthrough is how simple it should now be to reprogram T-cells to attack brain cancer, or lung cancer—or ovarian cancer, which killed June’s first wife in 2001. “You don’t have to go back to ground zero for each different cancer,” he says. “It’s cut-and-paste. It’s a game-changer.” Which is why drug giant Novartis is building him a $20 million research center at Penn. So if June’s gene therapy cures your loved one’s cancer someday, you can thank the Vietnam War.

Jeffrey Brenner

The Health-Care Revolutionary
Brenner—physician and founder of Camden Coalition of Healthcare Providers—has worked for 10 years to get better care for the underserved in his city. His group’s focus on primary-care reform, home visits and “health coaches” for the chronically ill has drastically lowered medical costs in Camden.

• On the goal: “To fix health care in Camden. To make Camden the first city in the country to bend the cost curve and improve quality at the whole-city level.”
• On the scope of this thing: “This isn’t a problem of fixing poverty. This is a problem of stopping making excuses for an expensive, poorly run health system. And hey, everyone: It’s not just Camden—you’re all getting disorganized care.”
• On methods: “We’re deep in primary offices, helping them rethink how they deliver care. Things like building electronic registries of all patients, so if Mr. Jones hasn’t been back to deal with his diabetes in six months, you know about it. It triggers reminders, so you’re managing the population of patients. And group visits: Instead of a doctor running from room to room in 10-m­inute increments, you can bring 15 diabetics together in one room and spend an hour and a half with them.”
• On the model: “I don’t think there’s the Camden model; I think there’s the Camden philosophy. We have values, a mission, and try to focus on active problem-solving. I don’t want the message to be that it’s a one-size-fits-all thing. Data-based, local problem-solving is what people need to do.”

Zeke Emanuel

The Health-Care Revolutionary
Emanuel—oncologist, renowned bioethicist, Penn professor, son of a pediatrician, brother of Chicago mayor Rahm—has worked for the National Institutes of Health, written prolifically on health care in this country (among other topics), and helped craft Obama’s health-care reform act.

• On patient expectations: “We train doctors to rule out everything that could possibly be wrong. We have every piece of technology that can scan your body 27 times. It becomes a little self-defeating. Who sets patient expectations? Who’s advertising on Route 1 in New Jersey, telling you that you must have the robot doing your prostate surgery? Patients get their guidance from the health-care system.”
• On what really needs to happen: “We’re all going to have to hold hands and give up a little. We’ll have electronic health records that will follow us, and doctors who have good quality metrics.”
• On the elephant in the room: “Ten percent of the population uses about two-thirds of the health-care dollars: patients with chronic illness. Preventing the di­abetic from getting an infection that turns into gangrene that requires an am­putation—that’s going to be the key. Keeping them from becoming ‘frequent fliers.’”
• On the relentless finger-pointing: “When I ask, ‘Who’s at fault for the American health-care system?,’ I hear: Drug companies. Insurance companies. Trial lawyers. Demanding patients. There’s plenty of blame to go around. We need to be more open to creative solutions. ”

Paul Offit

The Vaccine Inventor 
If you’ve had a kid since 2006, you should really thank Offit. The infectious-disease doc at CHOP co-created a vaccine called Rota-Teq that safeguards kids against rotavirus—a very common diarrheal di­sease that each year kills more than half a m­illion children under five worldwide. The good doctor went on to draw fire from anti-vaccine groups for his 2008 book Autism’s False Prophets: Bad Science, Risky Medicine and the Search for a Cure—but, undaunted, is working on a new book about “the sense and nonsense of alternative medicine.”

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