Fall 2014

The People’s Science

How a stem cell researcher put his own worldview under the microscope

By Jonathan Garlick

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Illustration: Lasse Skarbövik

The magic of stem cells takes my breath away. After years of watching them divide on plastic dishes, I am still amazed that we can coax them into life, still fascinated to see how closely their behavior in the lab mimics the way they function in our bodies. My job is simply to give them the environment they need to thrive and then get out of their way. If other scientists and I can do that just right, someday we’ll be able to transplant these cells into patients, where they will restore damaged and diseased tissues far more competently than we can now.

Little did I know, when first nurturing these cells, that they would take me on a remarkable journey—one that would move me beyond the walls of the lab, help me find my voice in the public conversation about science and lead me to guide students to discover how deeply science affects their lives.

What makes stem cells so promising for treating human diseases is that they are “pluripotent,” which means they can respond to chemical signals and become nearly any type of cell in the body. If we can figure out how to use them as a biological repair kit, the sky will be the limit for treating disease. Among the array of possibilities my lab has entertained are better ways to beat back gum disease, thereby saving teeth, and finding more reliable options to heal chronic skin wounds in people with diabetes, thereby saving limbs. Other researchers have developed stem cell treatments ranging from commonly used bone marrow transplantation to new ways to generate bone for spinal fusion.

I was not always occupied with the political issues driving the stem cell debate. But all the while, storm clouds loomed. The Dickey-Wicker Amendment, passed by Congress in 1996, made it illegal to use federal funds to support research “in which human embryos are created, destroyed, discarded or knowingly subjected to risk of injury or death.” So in 1998, when the stem cells I would work with were first derived from human embryos, they were almost immediately a topic of intense debate, as the process of isolating the stem cells destroyed the embryos. I soon realized the fate of any research that depended on embryonic stem cells was bound to be governed by the political winds.

The Bush administration dealt with the constraints of the Dickey-Wicker Amendment by restricting the use of human embryonic stem cells to those created before 2001. That meant only a very small number of useful embryonic stem cells would be available to researchers. In August 2010, when the Obama administration tried to roll out National Institutes of Health–approved guidelines to facilitate the use of human embryonic stem cells, District Court Judge Royce Lamberth ruled these guidelines to be unconstitutional. This effectively put a stop to all federal funding for embryonic stem cell research.

My goal became to make the public conversation about the roleof science in society more open.

Suddenly a very public controversy became very personal. Overnight, my NIH research funding was frozen, and I scrambled to figure out a new direction for my work. With the future of human embryonic stem cell research in limbo, I shifted my focus to what are known as induced pluripotent stem cells—made by pushing adult skin cells back to something close to an embryonic state. While this technology, developed in 2007, is a key part of the world’s research armamentarium, human embryonic stem cells are still the gold standard, and it is very likely that both types of pluripotent cells will be needed to realize stem cells’ incredible potential for human therapies. I could, however, no longer afford to think about what was optimal. I had to move forward using the resources that were still available to me. The exciting possibilities that my team had envisioned for human embryonic stem cell research had to remain unexplored.

New Perspectives

Mine was not the only lab that needed to redefine its agenda. Judge Lamberth’s decision threw the stem cell research community into turmoil as hundreds of scientists faced the same funding shutdown. Fortunately, the ruling was reversed one year later, but it will still take years to recover from the funding freeze. And there is nothing to stop a new president from possibly blocking human embryonic stem cell research again. Like many other stem cell researchers, I have had to acknowledge that the uncertainty surrounding human embryonic stem cell research will persist and that research with these cells remains vulnerable.

My perspective has changed profoundly in other ways as well. Clearly, I was forced to understand the importance of the simmering political, ethical and legal issues that had always surrounded stem cell research. I’d felt blindsided by a legal ruling. But a deeper transformation took hold as I began to rethink my ideas about the human embryo and its place in the national conversation. As I grappled with the questions that human embryonic stem cells have raised for many people, I opened up to a new way of seeing both science and its impact on all citizens.

My conversations with James Sherley, an outstanding stem cell scientist who was the plaintiff in the 2010 case that stopped federal funding for my embryonic stem cell research, were especially compelling. Perhaps I did need to consider his view that human embryos were “vulnerable” and in need of protection from destruction. While I did not agree with Sherley on all points, I grew to respect his beliefs and actions.

Thus my passionate interest in human stem cell therapies shifted toward an even greater interest in doing whatever I could to help the public engage in an open-minded discussion about the impact of science in their lives. I wanted to help people become more literate about science and more aware of its significant impact on their lives. I worked closely with a member of the House of Representatives to understand the intricacies of stem cell policy and was frequently called upon to share my views with the media on issues at the intersection of science and society.

Through it all, I maintained my determination to keep an open mind about all sides of the stem cell debate. I realized that a dogmatic approach—staking claims to one particular viewpoint—had to be left behind.

‘Aha’ Moments

More and more, I wanted to bring thorny science-based social issues into the classroom. I realized how important it was for students to grapple with all points of view about how science-based issues dramatically affect our lives. Stem cell research is just one such issue. Climate change, end-of-life decisions, reproductive choices and a host of others can be no less confounding. Addressing any of them in a serious way requires science literacy, a foundational knowledge and understanding of scientific concepts and processes. This also requires the tools to interpret the reporting of science, including skepticism, critical thinking and the ability to recognize and deal with the many gray areas—the unexplored spaces between the “facts” postulated by traditional scientific inquiry.

I started with Tufts undergraduates. In the spring of 2012, I created a freshman seminar, Science and the Human Experience, that engaged an interdisciplinary teaching team—a stem cell scientist, a science policy expert, an occupational therapist, an anesthesiologist and pain expert, a veterinary radiologist, a science librarian, a dentist and a philosopher and bioethicist. We first developed our students’ foundational science literacy with a brief overview of scientific principles. But as quickly as possible, we moved on to the questions the bioethicist—Professor Mitchell Silver—posed: When does life begin? What defines personhood? Dan Carr, the anesthesiologist, asked questions about how we experience pain as a sociocultural phenomenon. Professor Sheldon Krimsky, the policy expert, posed questions on the ethical dimensions of human cloning. Other faculty asked what it means to grow old, what social factors determine human health and what determines our sexual well-being.

Our team wanted to humanize the sciences, to challenge the students both intellectually and personally, evoking passionately held views. It was all part of what we termed ensemble learning—an approach where students don’t merely talk about issues that are important to them, but also seriously consider and weigh the worth of opinions other than their own. Faculty modeled this conversation for their students, as each shared ways they find personal value and meaning in their professional lives. Class discussions became personal and poignant, as students entertained a spectrum of views related to diversity, inclusion and social justice.

Teaching the seminar has been a profoundly rewarding experience, not least because of the many “aha” moments that happen as students discuss the impact of science on their lives for the first time. An English major with a passion for lyric poetry was moved to take an active stand on reproductive choices after realizing that many states were attempting to legislate when “personhood” and “life” begin.  A student studying Arabic and international relations found new meaning in science by viewing men’s health issues through the lens of her Lebanese heritage. And a student with an interest in peace and justice studies, who had started class with strong opinions on abortion, realized that she hadn’t fully considered that the fetus, as well as the mother, might have rights. She told us that encountering students and speakers from the other side of the argument helped her to respect points of view that had at first seemed incomprehensible.

Silver upended many a student’s perspective as he helped them hash out whether traits such as self-awareness and the ability to feel pain are necessary and sufficient to say something is “human.” Students then pondered who, of those exhibiting traits of personhood, should be considered “valuable.” Students’ entire sense of self was on the line as they wrapped their heads around the concept of “epigenetics”—the idea that parents’ experiences and environment can alter the genes they transmit to future generations. I knew this was a powerful idea when I met one of the students in the gym and he told me, albeit jokingly, that he was working out for the health of his future children.

Students understood the importance of following science-related news. To engage their ability to advocate for what they believed in, they learned to write publishable op-eds on issues that compelled them—a task that required that they both articulate their feelings and marshal educated, persuasive arguments. They responded with pieces on topics like the stigma of antidepressants, the question of whether their “ADHD generation” can meet society’s demands and the need for an opt-out system for organ donation. One student called for sweeping changes in pediatric palliative care, reflecting on the inspiring life of his younger sister, who suffered from multiple birth defects and whose “quantity and quality of life were dramatically enhanced by palliative intervention.”

Early on, it became clear that as students filtered the complex issues of science through a personal lens and had intimate discussions with their peers, their perception of science as a dry discipline without any relevance to their own lives was transformed. They began to understand that scientific inquiry is a never-ending and necessary process. Science “used to feel so hard and fast, unchanging, solid,” a student wrote. “But now it feels like water, moving, changing to shape itself to new environments, slipping through cracks, impossible to know through and through.”

And as I taught the course, I myself learned about the value of bringing science to life for people. I continue pursuing the goals of my stem cell research every day, but the culture of my lab has changed. We welcome students of all ages, from middle school to college, for lab immersion experiences. I am even more enthusiastic about speaking to science journalists, and now weigh in on ethical dilemmas and such topics as the stem cell hamburger recently created by Dutch researchers. I’ve also been known to reach out to my audiences, young and old alike, explaining science in the form of rap and hip-hop, another of my passions.

Last term, James Sherley spoke to our students, challenging them to think about the value of a human embryonic life, and asking them where they would draw the line in protecting the most vulnerable in our society. The following week, Brooke Ellison, of the Stony Brook University Stem Cell Center, a brilliant advocate for stem cell research, spoke to the class. A student asked her what the conversation between her and Sherley would sound like. She responded that she would open the conversation by looking for common ground based on issues of compassion and caring for the sick—things we all agree on.

Students understood that while some beliefs can’t be changed, we nevertheless can find core beliefs that connect us. Our students get it! Now this is the conversation we all need to share.

Jonathan Garlick is a professor in, and director of, the division of cancer biology and tissue engineering at the School of Dental Medicine. He is also a professor in the department of developmental, molecular and chemical biology at the School of Medicine; the department of biomedical engineering in the School of Engineering; and the interdisciplinary studies program at the Sackler School of Graduate Biomedical Sciences. This story first appeared in the Summer 2014 issue of Tufts Magazine.

Listen to Jonathan Garlick teach three comedians about the science behind stem cells—and a rap about dentistry—on this podcast (bit.ly/1lYAfyv) from the WBUR public radio show “You’re the Expert.”

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