The Imaginations of Unreasonable Men

The Imaginations of Unreasonable Men by Bill Shore Page B

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twelve.
    Dressed casually, Roepe had the lean body of the competitive triathlete that he is. His head was shaved and he sported a two-day growth of beard. He resembled a less menacing version of the actor John Malkovich. He wore a yellow LiveStrong band on his left wrist, and he had used a pen to write a scribbled note to himself on his palm.
    When I’d e-mailed Dr. Roepe to request an interview, he had consented but said, “I don’t see what this has to do with your work and I’m puzzled about what you think I can tell you of interest.” I gathered he was a man who didn’t like to waste time.
    He certainly didn’t waste any during his formal education. His career seems to have followed a meticulously plotted path. He was especially purposeful about pursuing multidisciplinary studies across physics, chemistry, and biology. But serendipity also played a critical role.
    I asked if there was any science background in his family:
    No, my father was a small town lawyer and judge. But my grandfather was a glass blower. He came here from Scotland. And at the beginning of World War II he realized that the army was going to need syringes and in those days
they were all made of glass. So he started making them. That grew into a pretty big glassware products company that supplied a few of the large pharmaceuticals. I remember going to the factory with him and being fascinated by all of the equipment, the glass tubes and beakers and coils. That’s when I knew I was going to be a chemist.
    After getting his degree in chemistry at Boston University, and then a Ph.D., he did a post-doc at the University of California at Los Angeles and ended up working on tumor drug resistance. He was offered a position at Sloan Kettering in New York, where he worked from 1990 to 1997. He had a corner office with two large windows. By chance it looked out onto the pediatric pavilion where children with leukemia waited for their chemo. “I mean that’s what I saw every day. It was right in front of me. All the time. My view was of those kids. That kind of reprioritizes your life. I decided that I wanted my work to be about children, and from there it wasn’t far to deciding that it should be children with the diseases that everyone else ignores.”
    At the heart of the difficulty in combating malaria, as I learned from Roepe, remains a still unknown and perhaps unknowable mystery of nature. This is where Roepe has trained his sights. “Quinine was the traditional drug used to treat malaria, and then came the much less expensive chloroquine, which the Germans created during World War II. But we still don’t know exactly how chloroquine works,” he told me. “We thought [the parasite] would never
be drug resistant, and in fact it wasn’t after six months. Instead it took thirty to forty years.” Chloroquine’s initial advantage over quinine was that it was vastly cheaper, but eventually the parasite evolved to become resistant to both.
    The malaria parasite thrives by literally eating the hemoglobin in the red blood cell. What’s left as a result of the metabolic process is heme, a toxic substance. To prevent itself from being poisoned by the heme, the parasite is able to crystallize it and sequester it harmlessly off to the side. Malaria drugs interfere with the parasite’s ability to do this, but no one knows exactly how. “We try lots of different possibilities until we find a drug to which the disease is sensitive,” Roepe explained. “When we find one that works, we go on to solve another problem. We don’t spend a lot of time trying to understand why it works.”
    Just as Roepe was entering the field, a consensus was developing that a certain gene in the parasite was the cause of resistance. Experiments to investigate this multi-drug-resistant (MDR) gene took about ten years. Funding was insufficient, and, according to Roepe, “no one was interested . . . except the NIH, the military, and the Brits.” It was Roepe’s experiments

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