Comment

The best scientists and the cutting edge physicians and surgeons are artists. It has been said that :

“The artist must create a spark before he can make a fire and before art is born, the artist must be ready to be consumed by the fire of his own creation.” Auguste Rodin

“In some spiritual traditions, salamanders represent the soul which is purified by fire but cannot be destroyed. This metaphor arises from a piece of ancient folklore that asserts: “If a salamander is thrown into the fire, it will emerge unharmed. “ The tradition has its origins in the habits of the salamandra salamandra. A forest native, the salamandra salamandra tends to hide in fallen leaves, rotting limbs and tree trunks. In earlier times, when human beings gathered fuel for their fires and added these materials to the hearth, quite often salamanders would emerge, seeming to arise from the heart of the flames. There are many different types of salamanders and one of these is the Fire Salamander. This may be where the origins of “the phoenix from the ashes” comes from. This is where the name Phoenix Therapeutics comes from.

You cannot move forward and grow without taking a risk and some of the poems which follow are about risk and renewal. As a recently qualified scientist this is appreciated, as the years pass it goes away to be replaced by a mechanical approach based on minimal error. We grow old because telomere length shortens, because the number of our stem cells decline and because we lose the capacity to take risk.

The poems therefore are not about rage or loss of life, as in the lines from Dylan Thomas : “Rage, rage against the dying of the light”. It is about a different sort of death and about renewal, because as Albert Schweitzer said : “The tragedy of life is what dies inside a man while he still lives.”

And so these poems are for me about stem cells and renewal. They are about what gets me out of bed in the morning.

A Fish out of Water

It starts very slowly, something very small
It emerges from somewhere not known at all
a belief in something dreamed, an aching in the heart
a desire to do something right, a desire to be a part

Of something outside yourself, more sensed than seen
maybe off-the-wall a bit, but not a smoke screen
So you move forward slowly, you take an unexpected chance
it makes you feel vulnerable as you slowly advance

It is the other side of the coin, a different sort of dream
where the most beautiful things cannot be seen
tasted or touched but felt, deep in the heart
where your armour and ego will not play a part

And you must be robust to control your own fear
With intensity diffused and the moment very near
What happens in that moment is something quite new
And the lasting effect is a re-defined you

Evolution

Life is tidal, life is a dance
With ebb-and-flow
as we wait for our chanceTo move through time
to become and to growTo do a little more than just go with the flow.


Compelled to move forward, with no special planFrom microbe through mammal
to modern manTo where each can star in their
own separate dream
With sex a shared part of some hidden theme


Can we learn from the past? Can we take what we know
And influence the strength
of the ebb-and-flow
Can we take what is random,
can we take what is chance
Can we write our own music and dance our own dance?


Can we wake up our spore cells create our own niche
Where we re-grow like a salamander
or a teleost fish
Can we heal broken hearts,
help the blind see
Can we make ourselves whole again set ourselves free

Darwinian Medicine

It just seemed to happen, always beyond our control
The starvation and predation, the trauma and gore….
Infections were few because our numbers were small
But whatever we did seemed not to matter at all

The stage had been set, the script was written
And it took us nine months to replace the young, smitten
not by disease or wars waging within,
But by the restrictions that made us most likely to win

Our brain was large but took nine months to grow
And this meant that maturity would be late, would be slow
So we learned to adapt, to create a safe niche

In the caves where warmth and shelter were found
We learned to make weapons and fence areas around
To grow plants and train dogs, breed cattle and sheep
A haven for growth, a safe place to sleep

A safe place for us but our enemies too
For the soft-wired microbes that grew as we grew
They mutated quickly and we were their host
A survival battle that we all but lost

But we rallied our hormones our genes and our cells
And through complex cell circuits we tried to stay well
and use feedbacks and loops to continually keep pace
And hold on to survival in nature’s arms-race

The price of survival was our disciplined expression
Of hard wired genes wrapped more for suppression
of mutations and inserts, which cause cancers to grow
But it came at a price which we are beginning to know

The cells which re-generate, grow and renew
Are an increasing risk factor and so became few
We reduced cell plasticity and that is the cost
And we live with the trade-off of what we have lost

Our structured expression our crystallized genes
Can unwind and transform and this it seems …..
Happens with injury when tissue oxygen is low,
accumulates damage and causes cancers to grow

Can organs rebuild without risk of cancer?
Will fish and salamanders give us the answer?
Could the answers lie in our own evolution
Because drugs and silver bullets are a temporary solution

The Mechanical Biologist

The genes and their code opened the door
To machines that would sequence, map and explore
The function of genes which defined all our traits
Although our sequence differed little from pigs and primates

But we looked at the enzymes that chopped up the array,
changed the beads in the strand that was DNA
We learned to take it apart, then stitch and anneal -
We could engineer genes, we felt quite unreal

The computers crunched numbers and soon we could tell
That control lay with us and not with the cell
These answers were long known to crabs, fish and bees
But we thought we were clever and better than these

The wheels went round, the circuits they flowed
They simply confirmed what everyone knowed
The magic machines and odd devilish device
Made statistically certain our learnéd advice

But something was wrong it was soon very clear
And we had to make some results just disappear
So just like Alice of storybook lore
They went down a trapdoor much used on the floor

We examined intron sequences, once completely ignored,
And found secrets of genes which had not been explored
We learned how epigenes could control what came out
And now we knew everything, we had figured it out

We would make silver bullets and hit the bulls-eye
And tell all our clients they would no longer die
We would focus production and sell overseas
Become rich treating symptoms and live life at ease

This is just the beginning, the start of a trend
Being prescribed by genomics and some of their friends
From susceptibility testing to your own medication
To make you dependent from cradle unto cremation

We will drive a fast car, not ride a slow horse
And manipulate life for better or worse
We will broaden our markets with things automatic
We will be trendy and modern and monochromatic

Star Maps

With embryal stem cells the promise is nice
But the starting potential comes at a price
With a schitzoid cell type the outcome’s unknown
And control is a myth once the seeds are sown

Programmed to pursue life their own special way
Their genetic road map may lead them astray
With no inkling of society in complex multi-cells
On injection embryal entities don’t behave very well

Like expansion in cancers, an example we know,
These anarchic cells choose their own way to grow
Completely selfish not part of the whole
Like microbes these beings are beyond our control

These blastocyst cells are not meant for repair
And random injection leads to patient despair
These cells should be quarantined, kept in a dish
In vitro culture is their only safe niche

In the dish they can help with disease and etiology
identify toxins, explain developmental biology
Help discover diagnostics and ID new bugs
Lay the groundwork for delivery of new genes and drugs

But it’s all very easy to extend forward movement
To start large trials and show statistical improvement
With marginal difference for each patient perhaps
But with IP potential for the guys with the maps

Treatment with eggs is really bizarre
But much has been spent on even one star
The sad thing is these cells are often preferred
Over adult stem cells whose dream is deferred

It is all too tempting, with the stars and their hype
“Who gives a fig if we don’t get things right?”
It will be scientific, beyond logical reproach
With automated production and a reductionist approach

Stem Cells and Scaffolds

Doctors first used bone marrow transplants - to re-populate cells inside bone
The stem cells were matched and often donated by someone completely unknown
This sometimes led to rejection of cells,And other problems, of which we’re aware
But if the disease is genetic we must havea matched donor, which can be quite rare


But with physical injury and non-genetic disease our own stem cells are what we need
Dormant cells from our own stores are harvested, then implanted - just like a seed -
at the site of injury, where conditions are right To awaken these cells from their sleep
To regenerate tissues and blood vessels - To create tissues we wish to keep

This mimics what happens when enzymes react to injury and create a fibrin gel,
The gel stops blood loss and traps platelets, and secretes growth factors as well as
paracrine hormones, and when these are released, they induce our stem cells
                                                                              to migrate, from stores to the injury site
                                  where they’re triggered to help build blood vessels,
                                                                                  repair tissues and set things to right


In organic disease the diseased tissue and cells are what our stem cells regrow,
And because the repair window is not open for long, and because our cell numbers are low
We transplant a nano-scaffold or sponge containing the stem cells we need,
                                                                      this localises action, limits what can go wrong;
It permits the stem cells to rebuild organs which survive after the sponges
                                                                                   and niche environment have gone


The procedure is simple, you harvest the cells from your fat tissue or some other store
First fractionate this into specific stem cells, then expand them so you have more
When added to a natural framework or sponge they help endogenous progenitors
                                                                      rebuild their own tissue type
The procedure mimics nature and is simple to do
                                                                        A self-healing process not hype

An African Solution

We each have a kit to do minor repairs and daily re-grow cells anew
But in chronic disease our capacity is limited to make whole organs renew
Starfish and salamanders do this far better,
                                     and re-grow organs and legs
And this they do with cells in the adult
                                      and not with fertilized eggs

Using them as a model perhaps we can learn what frogs and fishes do
And then we will do much more than now, and learn to structure rescue
of limbs that are damaged and organs very sick,
                                       and assist the body to heal
Degenerative diseases of body and brain
                      that make our worst fears become real

I believe the future should be crafted not willed by working together to keep our lives real
By moving from stepping stones to milestones - we can help each tissue to heal -
in real time, at the bedside or in a peri-operative setting,
                            in a rural community - in pervasive African heat
We can treat the person and not just the disease,
                             Talk to the locals, tune into their beat

“Local is lekker” and affordable too, it should not cost a fortune to use cells to renew
We could offer therapy in the grass-roots milieu, reach out to all and express Ubuntu
Treat weakened immunity and resistant infection -
                                   correlate treatment with social demand
Empower local communities to do much more,
                                       and plant hope in this ancient land


Forget the noise from the Hollow Men who travel life with no destination
Let us solve our problems and seek to create tissue regeneration
Then the mechanistic answers will fall into place
                                                      and not be purely didactic
In the fight for survival let’s build a life-saving bridge,
                                         A bridge between logic and magic.