Ravel in our cells

If our cells could make music, what music would it make? Or at least, what kind would it resemble? I guess it would depend on what kinds of cells they are and what they do. If so, then stem cells – those seeds that are innately programmed to grow into major organs – would be some kind of holy grail for masterpieces, some kind of a source, a basic foundation for a symphony of biological possibilities.

This kind of music in our stem cells is being played out in research prominence worldwide with scientists and doctors listening and carefully joining the symphony with their own instruments. Amid the ethical dilemmas surrounding stem cell research at large, a group led by Dr. Sam Bernal (locally associated with St. Luke’s and Medical City and abroad, with UCLA as professor of medicine, chief of Cancer Research Laboratory and attending physician at Cedars-Sinai Medical Center, among many other things) is doing this kind of work right here at home that would make someone like me, interested in the music of our biological lives, take time to understand. I also thought that those who are quick to judge before understanding what this particular stem cell work entails, are like tone-deaf newcomers trying to stop a symphony just because they could not hear it. The best way to understand music is to listen and be open to where it will take you. So I had a conversation with Dr. Bernal and listened to him tell me the music he makes with his work on stem cells. As he spoke, I also could hear the poetry and rhythm of Dr. Lewis Thomas  (1913-1993), the doctor and author of many landmark books like Lives of a Cell and Medusa and the Snail, that many have called as some kind of biology for poets.

If you are familiar with Ravel’s Bolero (if you are not, it will not hurt to find and listen to it), you know that it plays the same basic melody over and over again but it does so gradually, with each instrument joining at certain intervals. That is what cancer cells are. From what scientists have discovered about most cancer cells, they start out as normal cells, like any other instrument at the start of a symphony before the performance moves on and becomes more and more complex. Our cells naturally divide. If they did not, we would not have become the organisms that we are, with differentiated organs. We would have just been single-celled organisms playing our own music inside our soundproof membranes. Ravel in our cells is that inspirational biological impetus to move on by multiplying its own music with the same melody. However, every time cells divide, the chances of it gaining that uncontrolled drive to divide, increases and spreads everywhere, beyond its main halls. It almost seems like the more it makes of itself, the more it even wants to do so – like people upon tasting power. We have not completely understood why cells behave this way. Maybe the cellular equivalent of some other music, not in accord with Ravel’s piece, throws Ravel’s music off to spin uncontrollably like perhaps inserting rap music into it. But we work with what we know and stem cells so far seem to hold some basic notes to the great masterpiece.

Stem cells are like the foundational composition of a symphony BEFORE it plays – the music, the instruments, the players BEFORE the performance. Dr. Bernal’s own kind of music joins just right at this stage of the music of our cellular lives.

Stem cells, as Dr. Bernal reiterated, could be coaxed in the lab, to become new cells that make up the heart, lung, liver or whatever else. Stem cells do not have the "baggage" that mature cells have in terms of their immunity or their ability to fight certain diseases and abnormalities. Stem cells have much better chances of recognizing earlier patterns before the music played uncontrollably or simply got broken in parts. He named three ways by which he extracts the stem cells and these are: by leukapharesis which is done by getting stem cells from the blood with an intravenous needle although with this, you could only extract adult stem cells (not to be confused with "mature" cells which are NOT stem cells); by needle to the bone which goes deep into the bone marrow, yielding the kind of stem cells which are more capable of growing to become different organs; and last, by extracting the umbilical cord blood which Dr. Bernal said is the most "versatile" of all the three since it has not expressed all the mature proteins yet and more so, it does not have to be completely matched since it can be coaxed in the lab to agree with the recipient.

What Dr. Bernal’s group does NOT do is destroy embryos for stem cell research. They only extract one single cell from a fertilized egg and put back the fertilized egg where it is stored for whatever use it will have later on. Equally important to note is the fact that Dr. Bernal’s group does NOT promise eternal sweet music for your cells. Dr. Bernal recognizes that Ravel is written in your cells and uses the music he has learned so far from his own work with stem cells, to keep Ravel playing for as long as he could, as beautifully as he could. He, as well as any self-respecting scientist who could face the evidence yielded so far by studies, knows that science has not yet come up with a potion or a process that could enable humans to live forever or stay young forever. Anything that claims such is plain and simple quackery, and anyone who claims such is an automatic card-carrying member in some kind of what I call "eternity for dummies" groups.

In fact this is what some evolutionary scientists think – that cancer is really a byproduct of how we have evolved as Homo sapiens. In a January 2007 article by Carl Zimmerman in the Scientific American entitled "Evolved for Cancer," he neatly presented the findings from various experiments that cancer is sort of the accidental price we pay for having become the species that we are. I particularly took interest in the mice experiment he cited wherein scientists tried to manipulate a protein called p-16 known to mute tumors, and found that while it could indeed suppress tumors, it also prevented the birth of new cells which could help diseased organs like livers and kidneys renew themselves. No free lunch – you gain some, you lose some. It is really Yin and Yang, as Dr. Bernal articulated. The ancients knew about it but we are just now recognizing its signature in terms of its molecular structure. The key is to strike a balance so that you last as long as you could with the music of your life remaining intact as it fades. No eternal cures for cells gone haywire so far because stem cells, though at the cusp of cell birth, are pregnant with the very same codes to which your older "sick" cells have given in. From what the studies have yielded so far, they all have a tendency to eventually give in to unstoppable Ravel.

If I could hear Ravel’s Bolero reach a critical mass within me or in anyone who means to me, then I will be cued to a sense of the beginning of the end. I am sure it will start a parallel suite in another aspect of my life, but understanding the nature of my own cells on top of an expected kind of anguish over mortality, is oddly enough, liberating and even graceful. As Lewis Thomas who died of cancer, wrote in Lives of A Cell: "Death is not a sudden all at once affair; cells go down in sequence, one by one" like the lights after a musical performance in Carnegie Hall going out, lumen per lumen. It moves us to yearn and strive, even more to make our own performances, while we can, worth all those lights in the halls of our very own lives.

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