“I’m afraid not, but it’s worth a trip. I’d share a cab with you, but I’ve got a meeting at a hospital late this afternoon, so I won’t be coming straight from the hotel.” He reached into his coat pocket again and took out a business card, then scrawled on the back. “The driver’s bound to know where it is, but here’s the address, just in case.”
“And they’ll be open at seven?”
“Oh, for sure. I’ve been there plenty of times at seven.”
“Okay, sounds good,” I said. “I’ll let you get back to your brushfire. See you at the library at seven.”
He smiled broadly. “See you there. Looking forward to it.”
CHAPTER 24
Glen Faust’s talk was titled “synthetic tissue,” a phrase bound to draw a crowd — an interested and potentially nervous or hostile crowd — at a tissue-bank convention.
He began with a brief PowerPoint tour of OrthoMedica’s R&D complex in Bethesda. The facility was easily twice the size of UT’s biomedical engineering building. It bristled with medical-imaging equipment, robotic surgical tools, and computer-controlled machine lathes. I was impressed: OrthoMedica looked like a cross between a research university, a teaching hospital, an automotive assembly line, a NASA clean room, and a computer factory.
The subtitle of Faust’s presentation—“Rebuilding the Human Body”—gave him a launching pad to showcase the company’s many products: artificial hips, knees, shoulders, elbows, and orthopedic hardware, as well as a line of surgical tools, developed to allow surgeons to install OrthoMedica parts — and only OrthoMedica parts — with precision and ease. “Our next generation of products and procedures will be custom-fit to every patient,” Faust said. “We’re developing interfaces that can translate a patient’s CT scan into specifications for computer-controlled fabricating systems — lathes and molds and laser cutting systems — to create parts and assemblies in better, stronger alloys and ceramics and plastics. We’ll custom-build replacement parts — synthetic bones and artificial joints — accurate to within one ten-thousandth of an inch.” He capped off the brief sales pitch with a swift series of 3-D animations, showing diseased and damaged human joints and limbs undergoing robotic surgery, their flaws fixed with the new, improved products and procedures being pioneered, at that very moment, by OrthoMedica.
Moving on, he discussed synthetic scaffolds: fine meshes of carbon, collagen, and other fibers that provided frameworks for bone or cartilage to grow into. He showed micrographs and animations of nanomaterials — tiny rods and tubes only a few molecules in diameter — that could, in the not-too-distant future, be delivered to an injured bone or ligament with a syringe, whereupon they’d assemble themselves into a precisely shaped scaffold. They reminded me of tiny Tinkertoys, these nanomaterials around which a patient’s body would mend itself. “Rebuilding the body,” Faust reminded us.
Next came bone. “Chemically, bone is mostly calcium phosphate,” he said. “When we think about creating synthetic bones, one of the first materials that comes to mind is ceramic.” He lifted a white coffee mug from the podium — one of the mugs from the tables at the back of the room — and tossed it upward six inches. He watched it spin end over end, then caught the base in his palm, as if he’d flipped a flapjack in a skillet. “This mug’s made of aluminum oxide. Aluminum oxide’s cheap and easy to mass-produce. It can withstand heavy static loads”—he bent and set the mug on the floor, upside down, then placed one foot on it and stood—“such as the weight of the human body.” He retrieved the mug from the floor, flipping and catching it again. “But the human skeleton has to withstand more than just static loads.” He tossed the mug a third time, but this time he made no move to catch it. The mug tumbled end over end past his hand, past the end of the podium, then shattered on the marble floor below the stage. The sharp crash made me jump, even though I’d seen it coming, and I wasn’t the only one in the ballroom who did.
“This is ceramic, too,” he said, taking a gleaming white sphere from his hip pocket. The sphere measured about an inch and a half in diameter; he rotated it in his fingertips, and as he did, the PowerPoint screen displayed a three-foot image of the same glossy object, also rotating. A small portion of the sphere had been sliced off, creating a flat spot the size of a quarter, pierced by a hole the diameter of my little finger. “This is the femoral head — the ball — from our best hip replacement. It makes a great ball bearing, because it’s harder, smoother, and more corrosion-resistant than titanium or other metals.” He tossed it into the air a foot, then caught it. “Like the coffee cup, this is made of aluminum oxide.” He lofted it ten feet into the air and let it fall to the marble floor. Instead of shattering, it bounced several times, then rolled to a stop against the front of the stage. Faust retrieved it and tossed and caught it a third time — the man liked threes — then held it up again. “But the difference between the fifty-cent mug and the hundred-dollar femoral head is that the femoral head has microscopic fibers embedded in the ceramic. It’s reinforced, like concrete with steel rebar, on a much finer scale. So is human bone: The load-bearing, brittle minerals in bone are reinforced with collagen fibers. Bone’s better — lighter, stronger, and far more flexible — than reinforced concrete. And though it pains me to admit it, bone’s better than any synthetic substitute we’ve been able to engineer at OrthoMedica.” He smiled. “So far, that is. But I hope not for long.”
He ended the talk with a brief discussion of stem cells — the simple, undifferentiated cells in the early stages of the human embryo, from which every specialized cell, tissue, and organ in the body eventually develops. Stem-cell researchers were already conducting clinical trials in which stem cells were being used to patch damaged hearts and repair spinal-cord injuries, he noted. “This isn’t just pie in the sky,” he stressed. “In Spain in 2008, a tuberculosis patient with a damaged windpipe got a new one, grown from stem cells and airway cells. Stem cells created a true replacement part for her.” As he flashed up graphics showing how the windpipe had been created in the spinning chamber of a “bio-reactor” and then transplanted into the patient, I heard murmurs of amazement from the audience.
Faust stilled the murmurs with a rhetorical question. “So is this the beginning of the end for tissue banks? The dying days of allograft tissue transplants from deceased donors?” He shook his head decisively. “Not in our lifetimes anyway. Case in point: That windpipe created from the patient’s own stem cells? The stem cells needed a scaffold, and where did that scaffold come from? From the windpipe of a deceased donor. A cadaver. Everything but the collagen matrix of the cadaver windpipe was removed — dissolved and washed away — and the patient’s cells were cultured around that collagen matrix. So the stem-cell magic couldn’t have happened without cadaver tissue. That won’t always be the case; maybe someday cadaver tissue will no longer be necessary. Unlikely. But if that day ever dawns, it will bring with it a new era of medical miracles, and won’t that be a great day for humanity?” He paused to let us contemplate that. “Thank you for your time and attention.”
I stayed around to speak to him after the Q&A session. “Very interesting,” I said. “Impressive research and production facilities you’ve got. No wonder OrthoMedica’s doing so well.”
“We try.” He smiled.
“But you’re not on the verge of turning stem cells into replacement hands.”
“I wish,” he said. “You’re thinking about your friend? What’s his name? Dr. Garcia?”
I nodded, surprised he remembered.