The Heart Surgeon
Making Heart Surgery Obsolete
Stem cell research has received some bad publicity because certain stem cells are harvested from human embryos. However, there are many other types of stem cells, and most of the research being done has nothing to do with human embryos and is thus not morally controversial.
Stem cells are very special cells, different from any other cells found in living organisms. Unlike all other cells in our body, which eventually stop reproducing themselves (causing aging and death), stem cells can theoretically divide without limit, to replace themselves and replenish other cells. Equally important to being potentially immortal, each new cell after a division has the potential to remain a stem cell or develop into a specialized cell such as a kidney cell, a brain cell, a retina cell, and so on.
Stem cells are classified based on their source (i.e., bone marrow, adult, embryonic, etc.) and all have the following three common characteristics, which qualify them as stem cells:
Stem cells are capable of self-renewal, meaning they can continue to divide and duplicate themselves for long periods of time without changing their inherent characteristics.
Stem cells are unspecialized, meaning that they have no tissue-specific or specialized function. They don't beat or pump blood, like heart cells. They don't conduct information, like brain cells. They don't carry oxygen, like blood cells.
Stem cells give rise to specialized cells in a process called differentiation, meaning they can become a heart cell, a brain cell, or a blood cell.
Scientists are fascinated by the capacity of a few stem cells in an embryo to develop into a human being. But they are equally fascinated by they way adult stem cells seem to fight injury, cancer, replace damaged tissues, and slow aging.
Theoretically, a few stem cells injected into a bad heart or failing kidney could summon the body to grow new heart tissue or new kidney tissue, restoring these damaged organs to normal. Or, even better, a few stem cells could tell an existing organ headed for failure to stop aging and remain strong.
An incredible amount of research is ongoing, involving scientists isolating stem cells from all parts of the human body while preserving their "stemness" and using them to repair injured organs like a failing heart. One of the world leaders in this research is Dr. Russ Reiss, a cardiothoracic surgeon at the University of Utah and Salt Lake City VA Hospital.
Dr. Reiss (Russ) was born in the suburbs of Philadelphia, the son of two successful pediatricians. At an early age Russ was acutely aware that disease could strike anyone, rich or poor, at anytime. The desire and compassion to help sick people was ingrained in him almost from birth.
A light bulb went on when Russ witnessed his first open-heart operation during his third year of medical school at Hahnemann University. He committed himself at that moment to becoming a heart surgeon, and spent the next ten years in residency to rise to the top of his profession. He also completed a three-year research fellowship in immunology and microbiology, where he became fascinated by stem cells. His thesis was an account of how certain adult stem cells taken from the bone marrow could somehow "magically" protect mammals from lethal radiation injury.
At the time, many heart surgeons scoffed at stem cell research. To most, heart surgery was solely about mechanics—when something failed in the heart, you went in and replaced it physically with either a mechanical device or a transplanted organ. Few surgeons were well versed in stem cell biology and understood the implications behind the power of stem cells to heal and protect organs from damage. Just one year after Russ completed his fellowship, researchers at Duke University discovered that stem cells injected into the heart could repair heart damage after a heart attack. Russ's thesis was suddenly validated.
In 1998, Russ was recruited to the University of Utah, the place that had pioneered and implanted the first artificial heart, to complete his training and start up a cardiac stem cell program. Today Russ works with a multidisciplinary, multi-institutional team of researchers who focus on all aspects of stem cell therapy for the heart.
Ironically, his goal is to advance stem cell research to the point where artificial hearts, and all types of open-heart surgery, become medically obsolete.
Russ and I ride the mountain bike trails around Utah and ride together several times a week. Russ has taught me how to appreciate my heart and lungs like a finely tuned race car, and how to modify my breathing and physical activity for optimum performance. When I am working too hard and complain I can't ride that day, Russ drags me from my office telling me "you are no good to others unless you can take care of yourself first.... Rest your body, rest your mind, rest your ego."
On many of our rides, Russ is distraught with concern for some of his patients, and he stops frequently to take their calls. He often laments how most of his patients, almost by definition of being a heart patient, have not taken care of their bodies enough to prepare them for what is about to be the most grueling marathon of their life—open-heart surgery.
His greatest regret is that many patients whose life is saved through surgery soon return to the overeating, smoking, drinking, or whatever bad antiwellness behavior caused them to have to meet Russ in the first place. As Russ often says, "there has to be a better way."
"Medications and procedures can be critically important in the management of chronic disease, but they need to be recognized only as adjuncts to one's personal wellness program."
—Russ Reiss, MD