Massachusetts Making Push to Offset Trump’s Research Cuts

Summary

---

Bloomberg Businessweek — "Massachusetts Making Push to Offset Trump’s Research Cuts"

Date: November 15, 2025
Hosts: Carol Massar & Tim Stenovec
Location: Boston Children’s Hospital
Notable Guests: Greg Ryan (Bloomberg), Dr. Joan LaRovere, Dr. Alyssa Baird, Dr. Ellen Grant, Dr. Martha Murray (Boston Children’s Hospital medical staff)

---

Episode Overview

This episode centers on Massachusetts’ ambitious proposal to counteract federal research funding cuts—especially in the life sciences—under the Trump administration. Broadcasting from Boston Children’s Hospital, the hosts profile the local, national, and economic impacts of these funding shifts. Meanwhile, they feature in-depth conversations with leading clinicians and researchers on innovation in pediatric medicine, advances in AI and neuroscience, challenges in pediatric oncology, and groundbreaking orthopedic surgery.

---

Key Discussion Points & Insights

1. Massachusetts' Push to Offset Federal Research Cuts

[02:01–09:48]

Context & Current Status

• Governor Maura Healy’s Proposal: $400 million in state funds to offset federal cuts, split equally between public and private research institutions (e.g., Harvard, MIT, Boston Children’s).
• Legislative Limbo: Lawmakers on Beacon Hill have yet to approve the funding, citing competing state priorities.
  • Greg Ryan: “It’s still in limbo… Lawmakers are skeptical. They say the state has a lot of need right now.” (03:22)
• Signaling Effect: The proposal aims not only to backfill funding but to communicate Massachusetts’ commitment to science and innovation.
  • “It sends a signal to scientists to, you know, stay here and do their research here.” — Greg Ryan (04:01)
• Scope: The funding would only partly patch lost NIH and federal dollars but is critical for maintaining Massachusetts’ leadership in biotech.
  • “It wouldn’t really even come close.” — Greg Ryan (04:01)

Broader Impacts

• Economic Ripple Effect: Research funding supports local economies, jobs, and the resilience of Boston’s “eds and meds” sector.
• Brain Drain Threat: Executives warn that instability makes U.S. scientists vulnerable to recruitment from China and Europe.
  • “Countries like China… they’re actively recruiting researchers.” — Greg Ryan (06:04)
• Public-Private Partnerships: Healy’s plan includes leveraging philanthropic/private dollars along with state funds.

Next Steps

• Awaiting Legislative Decision: The coming months will determine if the state legislature acts on the proposal after initial hearings.
  • “The next few months will be key… lawmaker will decide whether this will pass.” — Greg Ryan (07:02)

---

2. Massachusetts’ Millionaires Tax — Funding and Migration

[07:18–09:02]

• The ‘Millionaires Tax’: 4% surtax on income over $1 million (in effect since 2023).
• Revenue Impact: Has brought in $5.7 billion in two years, surpassing estimates by $3 billion. Funds have been used for free school meals, public transit, closing budget gaps.
• Migration Fears (Unproven): Despite warnings, data is inconclusive about out-migration of the wealthy.
  • “It didn’t make people flee the state.” — Tim Stenovec (07:31)
  • “People might still have kids in high school and they’re going to wait till their kids are out of school to move.” — Greg Ryan (08:46)

---

3. Economic Sentiment in Boston

[09:02–09:48]

• Mood: Slight pessimism amid strong institutional fundamentals.
  • “People are a little pessimistic… The state was dead last in job growth for private job growth over the past year.” — Greg Ryan (09:24)

---

On the Ground: Inside Boston Children’s Hospital

4. Environment & Mission

[12:16–14:43]

• World Leading Research & Care: Boston Children’s is the largest pediatric research enterprise and leading pediatric NIH funding recipient.

The Role of Dedicated Spaces

• Hale Roof Garden: A healing space for families and staff, reflecting a holistic approach to pediatric care.
  • “We need spaces like this for families to be able to step away and really, you know, think and decompress.” — Dr. Joan LaRovere (13:51)

---

5. Linking Clinical Care and Scientific Research

[15:28–17:02]

• Integrated Approach: Innovation and research are “in the DNA” of Boston Children’s, drawing staff who are passionate about changing outcomes.

AI & Big Data in Pediatric Medicine

[17:02–19:01]

• History of AI Use: Hospital teams have worked with leading AI companies and developed dedicated AI tools (e.g., BostonGPT for secure, internal AI use).
  • “AI has been a very important part of Boston Children’s Hospital for a long time.” — Dr. Joan LaRovere (17:33)
• Potential: Unlocking insights into rare and genetic diseases, predictive modeling, and personalized medicine.

Children’s Health Decisions & Lifelong Impact

• Early Interventions: Decisions made in infancy—such as cardiac surgeries—shape long-term health.
  • “Decisions that we are making early in life have long term impact.” — Dr. Joan LaRovere (19:36)

---

6. Challenges & Aspirations in R&D

[20:42–21:27]

• Support & Partnerships: Continued philanthropic and institutional engagement is vital to future breakthroughs.
  • “We have a great team, but we’re always needing, you know, support and engagement.” — Dr. Joan LaRovere (21:05)

---

7. Pediatric Neuro-oncology: Brain Tumors in Kids

Guest: Dr. Alyssa Baird
[22:12–28:43]

• Scope: Treats brain tumors from infancy through young adulthood.
• Unique Challenges: Pediatric brain cancers differ from adult cancers. Developmental implications drive the need for tailored therapies and long-term, multidisciplinary support.
  • “Historically… we have had to extrapolate data and treatments from the adult world, and it just doesn’t work.” — Dr. Alyssa Baird (24:27)
• Funding Gaps: Heavy reliance on philanthropy due to lower government and industry funding.
  • “We definitely rely on philanthropy hugely to make advancements in the field.” — Dr. Alyssa Baird (25:05)
• Advances: Genetics and molecular research are transforming individualized diagnosis and treatments.
• Future Screening: Moving closer to genetic screening for predispositions in certain pediatric brain tumors.
  • “I think we may get to that point where screening is better for all tumors, but we’re very close for certain types.” — Dr. Alyssa Baird (27:08)
• Family-Centered Care: Multidisciplinary collaboration is essential for the best outcomes.

---

8. Next-Generation Brain Imaging & Neuroscience

Guest: Dr. Ellen Grant
[31:35–42:23]

• Imaging for Early Detection: Research focuses on fetal and neonatal brain imaging. The earlier development can be characterized, the earlier interventions can begin.
  • “Everything begins in utero… So the more we can understand the early development, the more we to understand how we make sure children are on the right trajectory.” — Dr. Ellen Grant (32:27)
• Customized Tools: Industry often ignores pediatric hardware needs, so Boston Children’s builds its own devices and develops new analytic techniques.
  • “Industry’s not interested in fetuses, infants, and young children… We have to develop the devices to fit the size of the infant.” — Dr. Ellen Grant (34:26)
• Startup Culture: Integration of business thinking is required for translating research tools to clinical use.
  • “If we stay in the research realm, then it’s sometimes really hard to go that last mile and get something into clinical practice.” — Dr. Ellen Grant (35:51)
• AI for Personalized Care: Machine learning enables individualized predictions; chatbots being designed for parent information and support—with safeguards to avoid “AI hallucinations.”
  • “We can start to build models that predict not just group outcomes, but we want to get to individual outcomes because that’s what parents care about.” — Dr. Ellen Grant (36:09)

---

9. Orthopedics Innovation: Rethinking the ACL

Guest: Dr. Martha Murray
[43:10–54:03]

• ACL Injuries in Youth: Data suggests girls and boys may face similar risks when exposure is equal—challenging previous assumptions.
  • “When they corrected for unit of exposure… the injury rates look very similar.” — Dr. Martha Murray (44:45)
• Material Science Meets Surgery: Murray’s unique background led to the development of the BEAR method (Bridge-Enhanced ACL Repair)—the first new ACL repair technique in 50 years.
  • “I spent… in the medical school library just reading everything I could about why didn’t the ACL heal.” (45:31)
• How BEAR Works: Uses a sponge scaffold plus sutures and blood to rejoin torn ACL ends, facilitating healing rather than replacement.
• FDA Process: Partnership-oriented, thorough, and ultimately enabling patient safety and efficacy.
  • “It felt like it was a team effort… the FDA was an amazing partner.” — Dr. Martha Murray (49:17)
• Preventive Advice: Strength training, cross-training, and managing overuse are key practices for young athletes.
  • “So some things we can do to help them is help them work on strengthening… and cross training.” — Dr. Martha Murray (51:26)
• Anticipating the Future: Development underway for an injectable, office-based solution for rotator cuff injuries.

---

Notable Quotes

• “This sends a signal… Massachusetts backs these efforts. It sends a signal to scientists to, you know, stay here and do their research here.” — Greg Ryan (04:01)
• “We need spaces like this for families to be able to step away and really… decompress.” — Dr. Joan LaRovere (13:51)
• “AI has been a very important part of Boston Children’s Hospital for a long time.” — Dr. Joan LaRovere (17:33)
• “Historically… we have had to extrapolate data and treatments from the adult world, and it just doesn’t work.” — Dr. Alyssa Baird (24:27)
• “If we stay in the research realm, then it’s sometimes really hard to go that last mile and get something into clinical practice.” — Dr. Ellen Grant (35:51)
• “When they corrected for unit of exposure… the injury rates look very similar.” — Dr. Martha Murray (44:45)
• “I really want to figure out this ACL thing.” — Dr. Martha Murray (45:31)

---

Highlighted Timestamps for Major Segments

• Massachusetts research funding proposal context: [02:01–07:02]
• Millionaires tax and economic impacts: [07:18–09:02]
• Boston Children’s overview & healing spaces: [12:16–14:43]
• Innovation in AI and research integration: [17:02–19:01]
• Pediatric oncology and brain tumors: [22:12–28:43]
• Fetal/neonatal imaging and AI for pediatrics: [31:35–42:23]
• Orthopedic innovation and BEAR procedure: [43:10–54:03]

---

Tone & Style

The episode is marked by urgency and optimism—hosts and guests candidly discuss funding challenges, scientific ambition, and the daily realities facing top-tier medical practitioners. The tone is informed, collaborative, and driven by a shared sense of purpose, with technical explanations delivered in accessible, human-focused language.

---

For Listeners New to the Episode:

This podcast episode deftly weaves immediate policy questions—can Massachusetts sustain its place as a science powerhouse?—with inspiring conversations about how innovation in medicine is happening on the ground, often at the intersection of public policy, philanthropy, business, and relentless medical curiosity.

Transcript

[Carol Massar]

Bloomberg businessweek is brought to you by Evolving Money, a podcast that explores how cryptocurrency is the next logical evolution of the financial system. Follow the podcast, which is sponsored by Coinbase. Wherever you get your audio programs in.

[Lenovo Advertiser]

The heat of battle, your squad relies on you. Don't let them down. Unlock elite gaming [e-mail] Dominate every match with next level speed, seamless streaming and performance that won't quit. Push your gameplay beyond performance with Intel Core Ultra processors for the next era of gaming. Upgrade to smooth high quality streaming with Intel WI Fi and maximize game performance with enhanced overclocking. Win the tech search power [e-mail] Lenovo.

[Carol Massar]

Lenovo.

[Greg Ryan]

This is Matt Rogers and Bowen Yang from Las Culturistas with Matt Rogers and Bowen Yang.

[Ed Helms]

JBL Tour Pro 3 earbuds are for.

[Carol Massar]

Those who don't conform to the standard.

[Greg Ryan]

Yeah, I mean, if you want to get into some touchscreen technology, how about the smart charging case Clear sound? These are not standard things. You're only going to get them with.

[Ed Helms]

The JBL Tour Pro 3B.

[Greg Ryan]

And I love the sound of JBL and goes these earbuds are packed with innovation because you can't stand out by following others.

[Ed Helms]

Touchscreen Smart charging case for one touch.

[Greg Ryan]

Control, instant EQ customization, True adaptive noise canceling and the one of a kind audio transmitter which can plug and play with everything from game consoles to in flight entertainment. What more could you want first doesn't follow. Grab a [e-mail].

[Carol Massar]

Bloomberg Audio Studios podcasts.

[Ed Helms]

Radio News this is Bloomberg Business Week Daily, reporting from the magazine that helps global leaders stay ahead with insight on the people, companies and trends shaping today's complex economy. Plus global business, finance and tech news as it happens. The Bloomberg Business Week Daily Podcast with Carol Massar and Tim Stenovec on Bloomberg Radio.

[Carol Massar]

We're here at Boston Children's. We're going to come back to some conversations in just a moment, but we also want to touch on a story that's so relatable to many of the institutions here in Boston. And really, I feel like around the country anything that's focused on health care, medicine and biotech.

[Tim Stenovec]

Tim yeah, business leaders, investors and academics have cheered Massachusetts governor Maura Healey's efforts to counter the Trump administration's research funding cuts with state money. So much so that a meeting earlier in the fall on the initiative required overflow seating, with more on the goal and where it sits right now and whether this could actually be applied to other states too. We are in Boston Right now. And we have joined by, we're joined by Greg Ryan. He's Bloomberg News Boston money and power reporter. He joins us on site here at Boston Children's. So you wrote about this last month, the hope here that state funding could offset some of the federal funding. Where does it stand right now?

[Greg Ryan]

It's still in limbo. So the governor proposed this over the summer. She proposed $400 million to backfill some of the Trump cuts. But lawmaker on Beacon Hill here in Boston have been skeptical. They say there's, the state has a lot of need right now. Yes, this is hugely important, the scientific research funding. But, you know, with cuts with snap, there was a hearing on the bill that took place in the middle of the shutdown. They said there's a lot of need and they're not sure how much money they should be devoting to this right now.

[Dr. Ellen Grant]

Well, that's interesting.

[Carol Massar]

All right, so take a step back. Tell us what Governor Healy, what her proposal is.

[Greg Ryan]

Sure. So she wants to take $400 million in state funding, apply half of it to public universities and public institutions to help them with their scientific research funding. You know, help them with the cuts they've experienced because of what's happened in D.C. and then the other half of the money goes to private institutions, so places like Harvard, Boston University, mit, as well as hospitals like Boston Children's.

[Tim Stenovec]

So where in terms of, of, of like offsetting the cuts, would that cover 100% of what has been cut?

[Greg Ryan]

It would not. No. It wouldn't really even come close. You know, hundreds of millions this year of loan just in NIH funding cuts. But the part of the, the purpose here and something the governor says a lot is this sends a signal. This says sends, she puts it, Massachusetts backs these efforts. It sends a signal to scientists to, you know, stay here and do their research here.

[Tim Stenovec]

Well, that's what I wanted to talk about. And you know, we think a lot about funding in the context of, okay, well, if it's going to research, that research will then ultimately potentially provide some sort of cure or treatment or something. You know, it's an investment in the future. But, but it's, it's bigger than that. I think it has to do with a local economy. It has to do with a, you know, we're sitting in Boston right now. I mean, this is an area of the country that's known for having biotech research. So some of it goes into the private sector. Then ultimately that money is used to pay people for the research. That money is then spent in the local economy. So there are knock on effects. There are repercussions of this pullback. Absolutely.

[Greg Ryan]

I mean, EDS and meds, as it's known around here, hospitals and universities are a huge part of the economy. When other parts of the country are in recession, it doesn't make our economy recession proof, but it really makes it resilient. And it has over the years. But those sectors are experiencing threats, really unprecedented threats right now based on the funding environment. So that money, yes, it goes to life save, potentially life saving research, but it also, you know, keeps jobs in the state and it has other economic activity, as you mentioned.

[Carol Massar]

Well, the other thing that everybody's so fearful of is.

[Ed Helms]

Right.

[Carol Massar]

A brain drain, essentially.

[Dr. Martha Murray]

Right.

[Carol Massar]

So people are like, okay, well the funding isn't here. That's such a big part of the medical community. I mean, you know, doctors, I've got doctors in the family, like, it's just that's a big part of what they do. And if the funding isn't here and the R and D isn't here, they may go elsewhere. I mean, this has been a concern about even, you know, scientists and, you know, medical officials and so on and so forth. Even leaving the United States. Right. In terms of the money not being here.

[Greg Ryan]

Yeah. I've talked to hospital executives in Massachusetts and they say countries like China, institutions in Europe, they're actively recruiting researchers because they know they face a lot of uncertainty here and they think they have a persuasive case to bring them over.

[Carol Massar]

Greg, I want to go back to what Governor Healy has wanted to do, because what's interesting is, and you know, this certainly a part of the Bloomberg world for decades, this idea of public private partnerships, it was not only just public money.

[Dr. Martha Murray]

Right.

[Carol Massar]

It was also involving private money to help in this. In her mission.

[Greg Ryan]

That's right. So the legislation would set up a fund that would bring in private philanthropic dollars to supplement the public dollars. And the idea being there's a lot of energy around supporting these institutions during this time. And so having a central funnel to bring in all that money and put it where it needs to go.

[Carol Massar]

So what's the next step? What are we waiting? We talked about this meeting where it was like no seats. Everybody was there. So where does it go or what's next?

[Greg Ryan]

So it's up to the legislature. They had their initial hearing on the bill a few weeks ago. So the next few months will be key. I'm sure there'll be more hearings and I think ultimately sometime next year, lawmakers will decide whether this will pass. And how much money they want to devote to this effort.

[Tim Stenovec]

Hey, while we have you, there's something else we want to talk about and it actually is related to what's going on when it comes to funding. It's the millionaires tax.

[Carol Massar]

I knew you were going to go there. It's a story we were obsessed with when it when it came across the Bloomberg.

[Tim Stenovec]

Actually, we spoke yesterday with Vanessa Williamson, who's a senior fellow in governance studies at the Brookings Institution. She got this new book out that's about taxes and she mentioned this story and we knew it because we had talked about your story on air a few weeks ago. There's a, there's attacks of the ultra wealthy that Zoran Mamdani, the Democratic mayor elect of New York, likes. It's kind of being tested here and the test here revealed that it didn't make people flee the state. What are the details so far?

[Greg Ryan]

I should say so. The this millionaires tax, it's a 4% surtax on income over a million dollars. It went into effect in 2023. And in the past two years it's brought in $5.7 billion, which is $3 billion more than than lawmakers had budgeted for. So that's paid for everything from free meals at schools for kids to its the budget gap at the mbta, the local transit authority. It's come in quite handy during this time. But, you know, I've spoken to executives and business leaders who warn, yes, it's bringing in a lot of revenue now, but they still believe, you know, the longer this tax is in place, the more people are going to move away. And you know, again, it was just.

[Tim Stenovec]

Simply or maybe it doesn't attract people to the state or people are thinking about moving that too.

[Greg Ryan]

But having just gone into effect a few years ago, you know, people might still have kids in high school and they're going to wait till their kids are out of school to move. So the data isn't in yet to see how it's affecting migration in and out of Massachusetts. But in terms of revenue, it's been a success story so far.

[Carol Massar]

I got to say, I feel like people go where the jobs are ultimately and kind of deal with everything else. And if it's a good economy, a strong economy, there's great jobs, they're going to go there. Just got about a minute or so or just 45 seconds before we go. Greg, how would you describe, you know, we are constantly trying to figure out the economic outlook. How is it feeling in Boston? What's the mood? What's the sentiment?

[Greg Ryan]

You know, things are a little people are a little pessimistic right now, to be honest with you. The Massachusetts Taxpayers foundation just came out with a report that the state was dead last in job growth for private job growth over the past year. At the same time, you know, we have Harvard, we have mit, we have institutions like this. The fundamentals are great, but you know, the economy is struggling a bit at the moment.

[Carol Massar]

All right, interesting to know. Med and ed.

[Greg Ryan]

Meds and ads.

[Carol Massar]

Meds and ads. I'm going to remember that. So glad we could catch up with you. Thanks for joining us here too. At Boston Children's Bloomberg News, Boston money and power reporter Greg Ryan.

[Tim Stenovec]

Stay with us. More from Bloomberg businessweek Daily coming up after this.

[Carol Massar]

Bloomberg businessweek is brought to you by Evolving Money, a podcast that explores how cryptocurrency is the next logical evolution of the financial system. The program investigates how traditional finance firms are integrating crypto into their operations now that Washington has begun to pass much needed regulations. Follow the podcast, which is sponsored by Coinbase. Wherever you get your audio programs in.

[Lenovo Advertiser]

The heat of battle, your squad relies on you. Don't let them down. Unlock elite gaming [e-mail] Dominate every match with next level speed, seamless streaming and performance that won't quit. Push your game play beyond performance with Intel Core Ultra processors for the next era of gaming. Upgrade to smooth high quality streaming with Intel Wi Fi 6e and maximize game performance with enhanced overclocking. Win the tech search power [e-mail] lenovo.

[Carol Massar]

Lenovo.

[Ed Helms]

Hey everyone, Ed Helms here and.

[Greg Ryan]

Hi, I'm Kal Penn and we're the.

[Ed Helms]

Hosts of Irsay The Audible and iHeart Audiobook Club. This week on the podcast, I am sitting down with Jenny Garth, host of the iHeart podcast. I choose me to discuss the new Audible adaptation of the timeless Jane Austen classic Pride and Prejudice. This is not a trick question. There's no wrong answer. What role would I play?

[Carol Massar]

You know what? I can see you as Mr. Darcy.

[Dr. Martha Murray]

You got a little Colin Firth.

[Ed Helms]

Okay, that's really sweet. I appreciate that. But are you sure I'm not the dad? I'm not Mr. Bennett here. Listen to Earsay the Audible and iHeart Audiobook Club on the iHeartradio app or wherever you get your podcasts. You're listening to the Bloomberg Business Week Daily Podcast. Catch us live weekday afternoons from 2 to 5pm Eastern. Listen on Apple CarPlay and Android Auto with the Bloomberg Business app or watch us live on yout.

[Carol Massar]

And I've got to say, one of the most rewarding aspects of what we do here at Bloomberg Business Week Daily is when we get to actually come out of the office and go to different places, step out of the studio, dive into another world. We are so entrenched when it comes to Wall Street, Main Street, Washington, money and markets, how it exchanges with everything. But it's also a great reminder that there's just so much going on around the world that certainly affects people across the country, across the world. And also there's always an investment or money play into it. Let's kick off our coverage. We are at Boston Children's. It is the world's largest pediatric research enterprise. It is the leading recipient of pediatric research funding from the National Institutes of Health. It is a primary pediatric teaching hospital for Harvard Medical School, treats more children with rare diseases and complex conditions than any other hospital. Delighted to kick off our coverage here on this Friday with Dr. Joan LaRvere. She is senior vice president, interim chief medical officer at Boston Children. She's also co founder and of the NGO the Virtue foundation, which when we talked to her last time, we reminded you all that it's delivering healthcare in over 25 countries. So global. Dr. Lo Rivera, it's so nice to have you here. Last time you came to our home. Now we came to your home. Thank you. Thank you so much for having us.

[Dr. Joan LaRovere]

We're so happy to have you here with us.

[Carol Massar]

It's really delighted and, you know, we are delighted to be here. Like, we walk in and you feel something. And anybody who's had a kid in a hospital or visited a young one, it's tough. And I'm sitting in this space. Tell us where we are, because I know when kids have to deal with things, it's tough. And it sounds like this is a place that just makes it maybe a little easier.

[Dr. Joan LaRovere]

That's exactly what this place is designed for. We're in the Hale Roof garden on the 10th floor of the Hale Building. The cardiac ICU that I work in is two and three floors below us because we cover two floors, our cardiac ICU. And we need spaces like this for families to be able to step away and really, you know, think and decompress and for staff. You know, these are very challenging, complex patients that we're taking care of in this building. Our neonatal intensive care unit is here. Our cardiac ICU is here. We have operating rooms in this building. You know, there's a lot of the cath labs are here. So it's Wonderful that we can have these magical spaces where you can just feel that you're in a pediatric hospital and there's a place to relax and think.

[Carol Massar]

Can I just say, it's like you're sitting on a tree, like a tree bench. There's like, I don't know, is this a rainbow? It feels like above us. It's pretty cool.

[Tim Stenovec]

You know, Carol mentioned the energy that we feel when we walk into a space such as Boston Children's, and we're reminded that it's not just a teaching hospital, a research hospital. It's also a place that. That treats kids from really all over the world. I'm wondering how you prioritize where resources go, whether it goes to treating patients right now versus thinking about research, thinking about development, thinking about ways to actually help patients in the future versus working with them right now. How do you allocate those resources?

[Dr. Joan LaRovere]

Well, that has always been part of the DNA of Boston Children's Hospital. It's been our mission. We deliver the highest, best quality clinical care. Really, that is the foundation of it all. And you see that. You know the motto of where the world comes for answers. There's a lot of complex patients from the Boston area, Massachusetts, New England. Obviously, we provide primary services for all levels of care for children in this community. However, there are many from across the United States and across the world who really seek that type of care and come to us usually the most complex cases. And I think that's really where we thrive. And the other piece of our DNA is the science. We, as you talked in the beginning.

[Carol Massar]

That makes a difference, right? When there's science involved, I feel like it's practitioners. Yes, you're dealing with patients, but it's people who are like, I want to understand how this works.

[Dr. Joan LaRovere]

That's everybody here. Yeah, that's the doctors, that's the nurses, that's the social workers, that's the physical therapists, that's the respiratory therapists, it's the pharmacists. I just could keep going. So I think that's what draws people to work here and to stay here. Because that purpose that we're going to actually change things and we're going to be able to find newer ways of doing things. We're going to help more children survive but also thrive. And that takes a real concerted effort. And you need the science here with clinical.

[Carol Massar]

One of the things, I think when you joined Tim and I back in New York, and listen, everybody's talking about AI, and I know that, like. But I think we all are thinking about what it could do for medicine and R and D and innovation. And I guess what we're trying to understand too is what's the reality of what AI is used within the medical community or R and D specifically. Like, where is it today? And you as someone who understands this space so well, and I'm curious, the conversations you guys have, where do you think it could go?

[Dr. Joan LaRovere]

Well, AI has been a very important part of Boston Children's Hospital for a long time. This isn't something new. We have incredible research groups and an incredible innovation team here who have been really standing up AI initiatives for a very long time. We talked about some of the work I personally have done in terms of, you know, Virtue foundation and the Global Health AI mapping and being able to match resources.

[Carol Massar]

Need you work with firms that are like specifically in AI?

[Dr. Joan LaRovere]

Yes, with databricks and data robot cards. You're building those, those real platforms that people can use. But I think about, for example, when ChatGPT first came out, we had Boston GPT immediately. We were looking to get that behind our firewalls. How can we integrate that? How can we use that for real purpose and improving both the care that we get to patients, but how can we use AI to also discover new things? I think the levels of data that we have and I think you touched upon in the beginning in terms of rare diseases, genetic diseases, we are the epicenter of that. And we've already been extremely successful in bringing new therapies to market for children. But when I look at the infrastructure that we're building, and I think you've had Dr. Wendy Chung come and speak and she's heading up a lot of that work, I think her best days are ahead of us and AI is unlocking that type of potential.

[Tim Stenovec]

I like hearing that, the optimism about our best days being ahead of us. And I think about just even during your career, how much treatments have changed in a pretty short time. I'm curious about the connection between kids and adults and treating children. And of course, if kids are healthy, then they turn into healthy adults. But this is a children's hospital that does a lot of research, it does a lot of teaching. Also, are there learnings that can be taken from what works with kids and even applied to a larger population, as not just those kids grow up, but as adults also need treatment?

[Dr. Joan LaRovere]

I think there's two points that strike me there. One is the decisions that we are making early in life have long term impact. It's something I've thought about my entire career in the Cardiac space and in cardiac intensive care, the decisions to have surgery on day two or day four, the decisions to use this drug or that drug, all of those things are shaping your long term self. But it was very hard to be able to look at and analyze that type of data until you've opened up big data AI. So I think again, along the lines of our best days are ahead of us that we're going to be able to see so much more through that. And then you said the innovations now many patients that I took care of are adults. Right. We have this huge growing adult population that we provide care for. Science is that's discovered here. It's in a pediatric hospital, but it's bringing forth therapies that are actually treating adults. So I think it's incredible to see how this innovation engine drives so much.

[Carol Massar]

If you could change one thing. Just got about 30 seconds. If you could change one thing in terms of the work that you guys are doing and the R and D, that would maybe make it easier. What would it be?

[Dr. Joan LaRovere]

Make it easier.

[Carol Massar]

Okay, backward. If you could change one thing though, that would help you guys in what you're working on. It sounds like you don't need. It sounds like you've got a great team.

[Dr. Joan LaRovere]

We have a great team, but we're always needing, you know, support and engagement and we're just trying to drive the next, the next level and partnerships to move in that direction. We are the leading children's hospital, so we're doing well, but we're always trying to push the envelope of what we can do.

[Carol Massar]

Yeah, it's fascinating. You could feel it.

[Dr. Joan LaRovere]

I felt, you know, like walking in, you can, right? The purpose, it was busy.

[Carol Massar]

It was lots of families, lots of kids and yeah, everybody on a mission.

[Dr. Joan LaRovere]

It's a privilege to be part of that mission.

[Carol Massar]

Well, thank you so much.

[Dr. Joan LaRovere]

Thank you.

[Carol Massar]

Thank you for inviting us and good to get some more time with you. Dr. Joan Laraverre, she is Interim Chief Medical Officer at Boston Children's Hospital, Director of Innovation and Outcomes. So delighted to talk with you.

[Ed Helms]

This is the Bloomberg Business Week daily podcast. Listen live each weekday starting at 2pm Eastern on Apple CarPlay and Android Auto with the Bloomberg Business app. You can also listen live on Amazon Alexa from our flagship New York station. Just say Alexa play Bloomberg 11:30.

[Carol Massar]

We want to continue from Boston Children's and with us now is Dr. Alyssa Baird. She's Director of Neurosurgical Oncology and co director of the Brain Tumor center at Boston Children's Hospital. Joining us here, I keep Saying, welcome.

[Dr. Martha Murray]

Thank you.

[Carol Massar]

But I realize. Thank you for bringing us here. Great to have you here. Tell us about your world. Like, what is it that you're dealing with on a regular basis, on a daily basis.

[Dr. Alyssa Baird]

Well, thanks for having me. I take care of kids that have brain tumors, and it's all ages. All ages? Yeah, from infants to really young adults, but all through childhood. And work with a phenomenal team here requires a huge team to take care of these kids. They're very complex diseases, and we work on all aspects of them. So active treatment. We do a lot of scientific research, we run clinical trials. We really support these kids not only through their therapeutic journey, but through survivorship and surveillance afterwards. So it's a long journey for them, and we really try to support them at every.

[Tim Stenovec]

How are clinical trials involving children different than clinical trials involving other age populations?

[Dr. Alyssa Baird]

Well, cancer in children is very, very different. The diseases are different. The implications are different, especially with brain tumors.

[Carol Massar]

Why is that? Is it development because of where the brain is or what?

[Dr. Alyssa Baird]

Partially. I mean, we're dealing with patients that have developing brains. I mean, there are very different implications for that. But also the diagnoses vary quite a bit. You know, the common diseases we see in childhood brain cancer are very, very different than that in adult cancer, and they require different treatments. And the support network needs to be different. We have to support these kids through developmental stages, through hormonal development, through cognitive development, emotional development. You know, the family needs are different, and, you know, the diseases require very specific therapies. One thing historically that has happened is because pediatric cancer has not been as well supported historically, we have had to extrapolate data and treatments from the adult world, and it just doesn't work.

[Carol Massar]

You know, I have a good friend and the same thing. Her son went through it and unfortunately didn't work out well. But when she started doing research, she realized there's just no money, no funding, and they actually started a foundation to kind of. But selling kids, selling cookies and like, just to try and drum up money and interest and attention. And we talk about it with women that R and D. Like, you just.

[Dr. Ellen Grant]

Don'T see it as much.

[Carol Massar]

And it's getting slowly better. But with kids, why is it that it's lagged in terms of time and money and effort? Not here, obviously, but elsewhere.

[Dr. Alyssa Baird]

Yeah, I mean, we definitely rely on philanthropy hugely to make advancements in the field. But I think, you know, historically the numbers are lower. The financial support from government has been different. It follows volume, as does industry. You know, there's a Complex, you know, complex reasons for that. But, yeah, there needs to be a shift in focus and more attention on specific pediatric treatments.

[Tim Stenovec]

We are talking a lot about treatments, and it makes me wonder about if we understand what causes this stuff in the first place. And certainly treatments in recent years have gotten so much better and gene therapy has gotten better. But I'm wondering if we have an understanding in the medical community about why some kids get sick and why some don't.

[Dr. Alyssa Baird]

Yeah, there have been huge advancements in pediatric brain tumors. It's really one of the most exciting fields right now because of how many things have really moved forward in the field. And so we know so much more about the biology of these tumors and the genetic underpinnings to them and can really drill down with each individual tumor to find out what the molecular change has been in the cells that is driving tumor growth. And that's really helped us understand them and opened up a whole new field of individual treatments. And so every tumor is different. In some tumors, we've discovered that there may be a cell of origin that the child is born with a lot of tumors. We don't understand why some kids are getting them and some don't. Some may have familial implications and some may have environmental. We don't understand everything, but we're learning more and more every day, and we know so much more about the individual genetics of the tumor.

[Tim Stenovec]

Could we get to a point within our lifetimes where there is some sort of screening for kids when they're born or in their early days that helps identify what they could be susceptible to? And then we could allow for different, I don't know, different treatments ahead of that to prevent it actually from happening?

[Dr. Alyssa Baird]

Definitely, I think so. And it may not be for every tumor, but I think we're already getting close to that for certain diagnoses where we know specific things that we, you know, we can potentially screen for. And we're. We're finding certain, you know, germline mutations that are, you know, familial hereditary. So, yeah, I think we may get to that point where screening is better for all tumors, but we're very close for certain types of tumors.

[Carol Massar]

Is there differences in, in boys and girls when it comes to either tumors or what impacts?

[Dr. Alyssa Baird]

For some, yeah, for some diagnoses and some have, you know, greater percentages with boys and some with girls. It really just depends on the diagnosis. And many, many, it's equivalent.

[Carol Massar]

I am also curious about, like, you guys seem to certainly take a family approach, and you have to, when it's kids like what's involved when you've got specific therapies and it's not, it's leading up to the surgery or whatever the treatment is.

[Dr. Alyssa Baird]

No, the treatment of these kids takes a village. We have a huge multidisciplinary team. We have neurosurgeons, neuro oncologists, neurologists, the neuropathologists, geneticists, neuroradiologists, and we also have the rehabilitation experts with physical occupational therapy, the neuropsychologists and endocrinologists. I mean, there are so many different expertise fields that are required to take care of these kids because brain tumors really affect every single aspect of their life and have the potential to affect every aspect of their physical and neurodevelopment. And so, you know, we are really fortunate here to have so much expertise that we're able to really individualize the team needed for each specific child.

[Carol Massar]

Thank you so much.

[Dr. Joan LaRovere]

This is heavy stuff.

[Carol Massar]

Thank you so much. Really appreciate it. Dr. Alyssa Baird, Director of Neurosurgical Oncology and co director of the Brain Tumor center at Boston Children's Hospital. This is Bloomberg.

[Tim Stenovec]

Stay with us. More from Bloomberg Business Week Daily. Coming up after this.

[Lenovo Advertiser]

In the heat of battle, your squad relies on you. Don't let them down. Unlock elite gaming [e-mail] Dominate every match with next level speed, seamless streaming and performance that won't quit. Push your gameplay beyond performance with Intel Core Ultra processors for the next era of gaming. Upgrade to smooth high quality streaming with Intel Wi Fi 6e and maximize game performance with enhanced overclocking. Win the tech search Power up at Lenovo.

[Ed Helms]

Hey, audiobook lovers. This week on the podcast I'm sitting down with musician, producer and walking encyclopedia Questlove. We're talking about Mark Ronson's memoir Night how to be a DJ in 90s New York City. All right, like we talked about before, Mark Ronson found sanctuary in the DJ booth. What's a tool or piece of equipment in the studio or on stage that gives you the most control? So I have two microphones on stage. We have the microphone that you hear as the audience.

[Tim Stenovec]

Then we have a second microphone in which we communicate with each other.

[Ed Helms]

I feel like that second microphone kind of saved all of our friendships.

[Tim Stenovec]

No band likes each other after 20 years or 25 years.

[Ed Helms]

The Beatles broke up in seven and.

[Tim Stenovec]

A half years and we're going on 35.

[Ed Helms]

Listen to Earsay, the Audible and iHeart Audiobook Club on the iHeartradio app or wherever you get your podcasts. This is Jacob Goldstein from what's yous Problem? Business software is expensive and when you buy software from lots of different companies, it's not only expensive, it gets confusing. Slow to use, hard to integrate. Odoo solves that because all Odoo software is connected on a single affordable platform. Save money without missing out on the features you need. Odoo has no hidden costs and no limit on features or data. Odoo has over 60 apps available for any needs your business might have, all at no additional charge. Everything from websites to sales to inventory to accounting, all linked and talking to each other. Check out [e-mail] that's O-O-O.com youm're listening to the Bloomberg Business Week Daily Podcast. Catch us live weekday afternoons from 2 to 5pm Eastern. Listen on Apple CarPlay and Android Auto with the Bloomberg Business app or watch us live on YouTube.

[Tim Stenovec]

Let's get back to our in depth look and conversations about the work that's being done at Boston Children's Hospital. That's where Carol and I are this afternoon. We kick off this hour with Dr. Ellen Grant. She's director of Fetal Neonatal neuroimaging and Developmental Science here at Boston Children's Hospital. Here she leads a 70 person neuroimaging and computational science center that's working to develop tools to better detect and understand brain physiology and development, all with the goal to improve cognitive, behavioral and neurological outcomes not just in fetuses, but but in infants and toddlers and then of course, ultimately as they get older. Dr. Grant joins us on site here at Boston Children's Hospital. Dr. Grant, welcome. How are you?

[Dr. Joan LaRovere]

Great.

[Dr. Martha Murray]

Good.

[Dr. Ellen Grant]

Thank you. Thanks so much for having me.

[Tim Stenovec]

Thanks for joining us. Brain Imaging in Children if we have a better understanding of the brain and fetal development and for babies and toddlers, what will that allow us to understand? What does it prevent? What does it treat?

[Dr. Ellen Grant]

Well, everything begins in utero pretty much. So your life is an arc from infancy or when you conceive through to adulthood. So the more we can understand the early development, the more we to understand how we make sure children are on the right trajectory. So the goal is to characterize brain development very early on. So we tell at the very earliest point when to start to deviate from a normal trajectory so we can get things back on track early as possible. And ideally, we want in future to be able to prevent diseases from happening, not just try to, you know, deal with them and try to correct them later on when the damage is partly done.

[Carol Massar]

So how early can we do it today and detect that there's something wrong? How early, realistically, do you think we can get it to?

[Dr. Ellen Grant]

Yeah, we started looking at fetuses at about 11, 15 weeks, something around there. At the earliest, closer to around 18 weeks, we start to characterize brain development, you know, 18, 19 weeks or so. So it begins quite early when we start to see and look at early brain development.

[Tim Stenovec]

Well, you and your team did a study a few years ago that gave you results to argue for earlier MRI during pregnancy.

[Dr. Martha Murray]

Yeah.

[Tim Stenovec]

Is that study enough to actually change the standard of care?

[Dr. Ellen Grant]

Well, we, we do use it early here at Boston Children's. So when there's an indication, we do it as early as we can to better characterize the entire fetus. Because it's not just the brain, it's the body it's attached to too. So we want to understand not just the brain development, but how that brain is developing in the context of the other organ systems. So we can do that because it.

[Carol Massar]

Doesn'T necessarily run hand in hand. Like it can be very different.

[Dr. Joan LaRovere]

Right.

[Carol Massar]

In terms of what's going on with brain development versus the rest of the system. They can disconnect. No, they're.

[Dr. Ellen Grant]

They're intimately connected in life.

[Carol Massar]

So there's one.

[Dr. Ellen Grant]

Yeah, so that's why we want to understand. So say, for example, we deal with a lot of congenital heart disease here that has effects from brain development. We deal with congenital diaphragmatic hernias that have effects on brain development. So everything that's happening in the fetus, whether it is a brain or not, is. Has the potential to have subtle effects on brain development.

[Carol Massar]

Why do kids, I mean, kids do need specialized tools for brain imaging. Talk us about that.

[Dr. Ellen Grant]

Why? That's the whole reason that I came to Boston Children's is industry's not interested in fetuses, infants and young children. So it's really hard to get devices that are built specifically for these age range. So that's why I brought a team of technical people. So they're engineers, physicists, computer scientists, data scientists that help to either develop the devices or come up with better ways to analyze the data that we get with an eye on trying to understand pediatric disorders. So, for example, we want to monitor and we're developing optical devices for the NICU to monitor cerebral blood flow. But the heart rate of a neonate is 150. So we have to sample at a much higher rate than you would in an adult to get the same information. So we have to build specifically devices to the physiology. And then if you think of a head of a premature baby, it's very, very small. So I can't take a probe that we use in adults and just put it on a preterm. So we have to develop the devices to fit the size of the infant.

[Carol Massar]

I want to just go and I feel like we touched on this earlier. I mean, we are Bloomberg Business Week. We are Bloomberg and very entrenched in financial markets. And I feel like the more I've been doing this, money just follows everything. Money is why people do things or don't do things. Is that really it? Is it just the market? I hate to even make it that way. The market size. And so you don't have medical equipment companies building the things because they just don't think the market size is big enough.

[Dr. Ellen Grant]

That is a big problem. And I think that's where we're trying to get into more of a business perspective. Like if we do a small startup that starts to answer those questions and a bigger company might buy it, but if we stay in the research realm, then it's sometimes really hard to go that last mile and get something into clinical practice.

[Carol Massar]

So how do you do that? How do you cross that? So what do you do?

[Dr. Ellen Grant]

Yeah, this is what we're strategizing on right now, is trying to figure out how we do those small startups, get industry interested. And a lot of things we're doing right now, actually, one of the projects we're working on on is, you know, AI strategies. Right. And if we can get enough data on infants or fetuses and so on, we can start to build models that predict not just group outcomes, but we want to get to individual outcomes because that's what parents care about. Right. So if we can figure out, get those models together. So that's what we're working on now is trying to create these AI models that are specialized for pediatrics and hoping to do startups around that particular concept.

[Carol Massar]

I have to ask one more question. Are venture capitalists interested?

[Dr. Ellen Grant]

I don't know because we haven't really talked any that I've heard about. But I think they always want something that's almost ready.

[Carol Massar]

So we're hoping to further along.

[Dr. Ellen Grant]

Yeah, a little bit further along.

[Carol Massar]

Okay, interesting.

[Tim Stenovec]

Can what we learn and what you understand through imaging about the brain's development be applied to how adult brains are treated?

[Dr. Ellen Grant]

Everything in adult life has its genesis in infants, right? So we learn a lot.

[Tim Stenovec]

We were all there once.

[Dr. Ellen Grant]

Yeah, yeah, exactly. And some of the ways the adult brain response is Very more prominent in a pediatric brain. So in some disorders they go to pediatric models to see a physiology that's more prominent in neonates or infants, but also occurs in adults.

[Tim Stenovec]

You know, there was in doing the research, in the prep for our interview with you, there is a picture of a physician or a therapist doing some, what I think is called therapeutic hypothermia to brand new baby's head.

[Dr. Martha Murray]

Yeah.

[Tim Stenovec]

And my understanding is that oxygen deprivation around birth is one of the leading reasons that you actually see babies come into the nicu.

[Dr. Ellen Grant]

Yes, that was one of the main reasons. Yes.

[Tim Stenovec]

And the therapy for this is as.

[Dr. Ellen Grant]

Simple as, yeah, you cool them down or. Yeah, okay, at least it's abnormal thermic. Because when they have injuries, sort of the whole physiological response to an injury is to have a fever and that is detrimental. So we want to keep them cool so that they don't set off these cascades of brain injury. And that's partly why we built this one device, because we want to be able to monitor through the NICU stay and optimize management. But it's interesting, we don't even know what the right blood pressure for a newborn is. So this is why we wanted to have a probe that could measure cerebral blood flow to the brain. Because there is no way to monitor whether there's enough brain or oxygen getting to the brain with the tools that we have right now.

[Carol Massar]

I feel like we never even talk about blood pressure when it comes to like infants. Right? Yeah, we just don't. But you need to know.

[Dr. Martha Murray]

Yeah.

[Carol Massar]

You did your residency and fellowship in the 1990s. Curious how imaging has changed since then. And then where do you think? How will it improve in the next, I don't know, 10 years? I don't know. What's a smart benchmark?

[Dr. Ellen Grant]

Yeah, yeah. When I was in training, Mr. Was just starting and it was very slow. So where we've come now is the acceleration. Acquisition is just incredible. What used to take us an hour to do, we can do in 10 minutes now. So there was speed. The speed of acquisition is huge. We also developing a lot of analysis that we can do after the images are acquired to give us more quantitative metrics. Because the whole thing in medicine to get past the qualitative read of a radiologist, which is helpful, but we want to put more numbers on it so we can have a more dynamic range on how we describe each child. And therefore we can get into better precision medicine and output prediction. So we're getting more to that quantitative aspect of imaging now and not Just brain, but all body parts, of course. And you know, down to fetal age.

[Carol Massar]

Is it for kids too? Every case is very personal and individual, or are there trends and things that you can help so that one case can help another? Is there a body of knowledge that gets built off of this?

[Dr. Ellen Grant]

Yes, there's body of knowledge gets built off of this. But this is where we come back to AI. I only can remember so much, you know, even though I've been in practice for a long time, things fall out.

[Carol Massar]

Join the crowd.

[Dr. Ellen Grant]

So this is where I'm really excited about AI because I can, you know, mine our databases to find where's an individual child just like that one I'm treating now. What did they respond to, what worked for them and how are these two similar? So I combine the databases to start to come up with individual outcome prediction, which is what we're doing right now, with databases we got from some of the major trials for hypothermia. And so we can use this large database to try to take individual outcomes. You can say, well, I have a newborn with this ph that had these, you know, and I'm a mother of this age and put in features and they could give you that database and outcome prediction. So, working on that and also working on making data more available to parents because I think a lot of parents are very frustrated with trying to read the literature. Even if you're using ChatGPT or Open, it's really hard. And then you get group statistics and then where does my kid fit in between the 25 to 75%, you know, good outcome or something like that, to get chatbots that can work with some of our databases. So people, anybody can talk to, you know, a physician, so to speak, to give the answers that they want.

[Tim Stenovec]

That's, that's pretty remarkable because, you know, I just think about the, the tone of these chatbots and if there's a way that they can be, you know, we talked about, we talked earlier this week about what a challenge it can be for people to actually interact with them in a quote unquote normal way. But is there a way for, for them to actually be empathetic and, and work with patients, work with parents, work with families?

[Carol Massar]

Give us. We've got about 40 seconds.

[Dr. Ellen Grant]

Yeah, yeah, no, we're working on that. But I can't tell you all the secrets because we're hang. You can't wait?

[Carol Massar]

No, you go longer than that. Can I ask you something? Would you guys do use AI in chat pods? Do you have hallucinations? Like, do the AI hallucinations, do you or how do you, especially when you're dealing with medical information.

[Dr. Ellen Grant]

There's a lot of safeguards we put around that. So it's it, it's we have again, this is sort of more the secret sauce that I can't talk about yet, but there are ways to constrain chatbots to give you reasonable answers that are statistically sound.

[Dr. Martha Murray]

All right.

[Carol Massar]

So when you can, will you come back?

[Dr. Ellen Grant]

Yes, I will.

[Carol Massar]

Okay. Good stuff. So appreciate it. Dr. Ellen Grant, director of Fetal Neonatal Neuroimaging and Developmental Sciences here at Boston Children's Hospital. Thank you again.

[Ed Helms]

You're listening to the Bloomberg Business Week Daily Podcast. Catch us live weekday afternoons from 2 to 5pm Eastern. Listen on Apple CarPlay and Android Auto with the Bloomberg Business app or watch us live on YouTube.

[Tim Stenovec]

We are live from Boston Children's Hospital where we're speaking with some of the nation's leading doctors on matters related to health, health policy, innovation, medical care and everything that has to do with health. Carol, a fixture at my high school in college was torn acls, volleyball lacrosse, soccer, field hockey, a torn ACL surgery to reconstruct it, then weeks on crutches, months of recovery, and oftentimes it was girls, not boys, who tore their ACLs.

[Carol Massar]

Which I find interesting. I guess I would have thought it was the other way around.

[Tim Stenovec]

Girls and women tear their ACLs at a higher rate than men and boys. This is Dr. Martha Murray's world. She's orthopedic surgeon in chief for Boston Children's Hospital. She joins us here in Boston, where we are at Boston Children's Hospital. Dr. Murray, welcome. How are you?

[Dr. Martha Murray]

I'm good. Thank you so much for having me.

[Carol Massar]

Nice to have you.

[Tim Stenovec]

So you've got this background in material science and engineering. It's not typical for a surgeon. We're to going going to talk about your innovation in ACL surgery in just a minute. But on the boys versus girls, men versus women, why do ACL tears affect women more than men?

[Dr. Martha Murray]

Well, it's a really interesting question and it's been one of much debate for the last few decades. And there have been things like, well, it must be a hormone cycle or it's the shape of women's hips and their valgus angles to their knees. But a really interesting study came out very recently from the Harvard School of Public Health as well as Harvard University with Dr. Daniel Danielson and Dr. Richardson where they actually show that the studies that say that women tear their ACL more frequently than men were often based when the women's teams were smaller than the men's teams. And the way they calculated exposures was the number of practices or games you played in, not necessarily your playing time. So if you're a man who's on a hockey team versus a woman who's on a hockey team, the women's teams were smaller, so those women were playing more. So they were planting. Example, soccer would be better, but if the team is smaller, the women are going to be planting and pivoting and playing much more time per game or practice.

[Carol Massar]

So more stress, more use.

[Dr. Martha Murray]

More stress, more use, more terror.

[Tim Stenovec]

So maybe it's not. Maybe women and all things equal, maybe women and men don't have a different rate of torn ACLs.

[Dr. Martha Murray]

Correct. When. When they corrected for unit of exposure. So kind of game time playing rather than just a game. The injury rates look very similar.

[Tim Stenovec]

Wow, that's totally different than what I mean, is this the standard now? I mean, do you think this is.

[Dr. Martha Murray]

It's relatively new work that's coming out, but it resonates with most of us who take care of women and men on their athletic teams.

[Dr. Alyssa Baird]

Yeah.

[Carol Massar]

I want to ask about your background. Materials science and engineering. I know Tim said, not typical for a surgeon, but I think it's a really smart combination. Well, I have a doctor, a foot doctor, same thing, engineering. And like, he doesn't just deal with my foot. He thinks about, okay, what are you doing? What else is going on in your body? Tell me about that mix and why it's kind of unique and smart and ties things together.

[Dr. Martha Murray]

Well, for me, it was actually of necessity. Right. So I was an engineering graduate student, and a friend of mine came into a party one night on crutches, as Tim was saying, and who had torn his acl. And I said, oh, are they going to go sew it back together? And he was a med student. He was like, you stupid engineer. We can't sew it back together. You have to take it out and replace it with the graft of tenon that they're going to take from the back of my leg. And then it's all this rehab. And I thought, that seems kind of excessive. Right. Like, that's a lot to have to go through. And so I spent the next six months or so in the medical school library just reading everything I could about why didn't the ACL heal? And I realized nobody really had figured out why it didn't heal. They tried it, sewing back together, didn't work. So then went to grafts. And we've Been doing grafts for 50 years, and nobody really asked, why doesn't it heal? And so for me then, there was no biomedical engineering at that time. And so my choices were to continue on with my project, which. Which was developing airplane wings that were invisible to, you know, to radar. And I thought, well, that's a really cool project, but I really want to figure out this ACL thing. And my advisor was like, well, I guess you could go to medical school.

[Carol Massar]

This is a Netflix series in the making.

[Tim Stenovec]

Okay, well, the advisor obviously had an impact. Your friend obviously had an impact. But fast forward, you know, 30 years plus, and you have actually invented a new way to treat ACL tears. The bear method. You did figure out that. That there's a reason why ACLs don't heal like an MCL would actually heal. Why is that?

[Dr. Martha Murray]

Well, it's really interesting. So both the medial collateral ligament and the anterior cruciate ligament are ligaments. When you look at them under the microscope, they look very similar. But interestingly, when the MCL tears, you can go on a brace, and at about six weeks, that ligament will heal fine, and you're back playing soccer. In contrast, the acl, when it tears, even if we try to sew it back together, it doesn't heal. And so we wondered why. And so we did a series of studies where we looked and we compared the two tissues and their response to injury. And what we found was that actually the response to injury was very similar in the two ligaments. So the tissue and the cells in the tissue were doing exactly what they were supposed to do in both tissues. But the difference was in the mcl, when it tears, the ends bleed, and that blood clots and forms what we call a hematoma between the two torn ends of the ligament. And then, in contrast in the acl, because it lives in this fluid environment of the joint, the ends bleed. But instead of making a clot or hematoma between the torn ends of the ligament, the blood disperses through the fluid of the joint. And so the two ends never have that scaffolding, that biologic scaffolding to hold them back together. So once we discovered that, then it was a fairly logical step to say, is there some way we could immobilize the blood in between those two torn ligament ends and get that biologic signal where it needs to be to encourage healing of the acl? And that's really what bridge enhanced ACL repair, or bare, is. So the magic is kind of the sponge that we've developed that can absorb the patient's blood. You can place that blood laden sponge in between the torn ends of the acl, sew the ACL back together. But now you have the biology plus the sutures and the repair and the ligament will heal.

[Tim Stenovec]

So what is done in terms of numbers or percentage with the method that you pioneered, what you invented versus actual reconstruction and using other ligaments?

[Dr. Martha Murray]

That's a great question. So this is still fairly new. So we got FDA approval for this product in 2020 and so it's only been in practice for a few years now. There's studies coming out of Children's here, which is where we did the first studies of course. But now other centers are coming along and doing follow on studies and those results are starting to come out and it's very exciting to watch it grow.

[Carol Massar]

I'm also curious. You mentioned like FDA approval, like the approval process, is it a smart one? Is it the right one in terms of making sure that what's being done and studied, the R and D, that it's safe when it's finally done on patients, or is it preventing things from maybe put into use sooner? I'm just curious where you guys weigh in. You're in it. You're in it every day.

[Dr. Martha Murray]

Yeah, I think it's a delicate balance. But I would say in our personal experience, the FDA was an amazing partner. So we were able to get into an early adoption program where they actually met with us and helped us and put together a panel of experts that would help us figure out how to make this the safest possible product and the most effective product. Before we went to patients and we found their advice incredibly valuable. Lot of conversation and back and forth and just having them, it felt like it was a team effort because we were in alignment. I mean, as a physician, I was going to be shaking the hands of these patients and my partners were and we wanted to make sure things were as safe as possible. So they helped us with that.

[Tim Stenovec]

Do we have data yet on long term impact or long term outcomes yet when it comes to the bare procedure?

[Dr. Martha Murray]

Yeah, our longest data that we have is at about six years. And it's only in the small number of patients in those first studies that we did. But the reason that we want to study it longer term is because as you may know, many of these patients will develop arthritis early in life. And as a pediatric orthopedic surgeon, I want to make sure we have a procedure that's going to last my patients for 60 or 70 years, not have the knee break down in 10 or 20 years. And so we're very interested in this arthritis question with Bayer. And in our pre clinical studies, we were able to see that arthritis was actually much less in the subjects that we treated with an ACL repair with the sponge versus a reconstruction. So we're interested in seeing if that same thing plays out in patients. And the early data suggests that it will. It is true. But again, that's very early data on small numbers of patients. So we're excited to see how that pans out.

[Carol Massar]

We're talking with Dr. Martha Murray. She's orthopedic surgeon in chief for Boston Children's Hospital. That's where we are, Tim and me, on this Friday. Preventive care. Like, so much of what we talk about often when we're doing interviews is preventive care. And I feel like the whole health community has been thinking about this for a long time. So what's the preventive care? So that as much as we don't want you unemployed, like, how do we, how do we think about taking better care if we're living longer? Like, how do we think about this?

[Dr. Martha Murray]

So there's a couple questions on that. So one is how do we help our teenagers reduce their risk of injury? And I think the main thing for that for our athletes when they're in.

[Carol Massar]

It, because we push kids when they're younger, I think a lot of parents really push kids.

[Dr. Martha Murray]

So some things we can do to help them is help them work on strengthening in addition to just play time. And another thing is cross training. So not playing the same sport all year round or playing the same sport every day, giving their body a chance to rest and heal between exposures to sport. It's as simple as that?

[Carol Massar]

I think.

[Dr. Martha Murray]

So, wow.

[Tim Stenovec]

Does ACL tear happen more in kids than adults or. And if. Yes, is it because kids are the ones who are playing sports and, you know, we're just sitting at computers?

[Dr. Martha Murray]

I think that's probably part of it. Again, it gets to this exposure question, how many times do you plant and change direction? And so the peak of ACL injrews is really the high school athlete because there's so many, everybody's playing a sport and so we see a lot of them there.

[Carol Massar]

I want to ask you about social media and all of us sitting on phones or sitting in front of screens. Like, I just, I keep thinking that we're gonna, one day, I don't know whether it's 50 years from now we're gonna have a neck that basically goes over there or maybe not because we're gonna have Glasses on. And that's how, like, how do you think about this digital world?

[Tim Stenovec]

You're laughing, but can you surgically remove my phone from my hand? That's what. That's what Carol wants.

[Carol Massar]

But I do think about what it's doing to us.

[Dr. Martha Murray]

Well, look at. I not just don't have the ACL fixed for you. I don't know if I can fix.

[Carol Massar]

The social media, but physically, like a. I'm just thinking, like, how kids are in their phones constantly and stuff, and, like, the shape. Do we need to be thinking about what this is doing kind of to our spine and different things.

[Dr. Martha Murray]

I think so. But I also think things come in cycles. Right? And we see now if you walk down the street, you see everybody's on their phone. I think we're gonna. Five years from now, we're gonna look back at that and say, why are we doing that? You know, maybe we'll start looking up at the sky more often.

[Carol Massar]

I hope so.

[Dr. Martha Murray]

Yeah, that's what I hope to.

[Tim Stenovec]

Yeah. I mean, gosh, that's like you're. You're opening up, you know, I know.

[Carol Massar]

I just. I look around on the subway and just. Everybody and I'm just think curvature and I don't know, whatever. What's the next thing you're working on or that you're excited about?

[Dr. Martha Murray]

I'm really excited about a product that we're working on for rotator cuff injuries. And it's a product that's injectable, so that potentially, it's great. Yeah. You could have ultrasound of your shoulder, see where the tear is, and then inject the product into the tear, maybe in an office visit. So that's what we're working on. But very early days on that.

[Tim Stenovec]

Again, a challenge with pediatric patients as well.

[Dr. Martha Murray]

No, this is more adults. But we were just. We thought if we could make this work for a ligament, maybe we could try it for. For the rotator cuff tendon. And the nice thing about the rotator cuff is it is accessible by ultrasound and injection. And it's a pretty easy model for us to study. If we can make that injectable work there, then there's lots of other places we could apply it. Meniscus. Other things.

[Tim Stenovec]

Did you ever figure out the invisible airplane wings?

[Carol Massar]

No, not too late.

[Dr. Martha Murray]

Social media. Invisible airplane wings, acl. You guys are killing it.

[Tim Stenovec]

Well, we are glad you ended up going into pediatric orthopedic surgery.

[Carol Massar]

Is there another career like you're gonna add on fine after this? You could do it.

[Dr. Joan LaRovere]

You could do it.

[Dr. Martha Murray]

I'll try.

[Carol Massar]

This was so much fun.

[Dr. Martha Murray]

Yeah, it was fun. Thank you guys very much.

[Carol Massar]

Dr. Martha Murray. She's orthopedic surgeon chief for Boston Children's Hospital.

[Ed Helms]

This is the Bloomberg Business Week Daily Podcast available on Apple, Spotify and anywhere else you get. Your podcasts listen live weekday afternoons from 2 to 5pm eastern on bloomberg.com the iHeartRadio app, TuneIn and the Bloomberg Business App. You can also watch us live Every weekday on YouTube and always on the Bloomberg terminal.

[Lenovo Advertiser]

In the heat of battle, your squad relies on you. Don't let them down. Unlock elite gaming [e-mail] dominate every match with next level speed, seamless streaming and performance that won't flip. Push your gameplay beyond performance with Intel Core Ultra processors for the next era of gaming. Upgrade to smooth high quality streaming with Intel Wi Fi 6e and maximize game performance with enhanced overclocking. Win the tech search power [e-mail] lenovo.

[Carol Massar]

Lenovo.

[Ed Helms]

ABC Wednesday, it's the CMA awards Live.

[Dr. Martha Murray]

That's what I'm talking about.

[Ed Helms]

With performances by Lainey Wilson, Kelsey Ballerini, Zach Top, Riley Green, Ella Langley, Kenny Chesney, Megan Maroney, Brandy Carlisle and the hottest collabs, Miranda Lambert and Chris Stapleton, Jabuzzi and Steven Wilson Jr. Big X the Plug featuring lip combs. It's country music's biggest night hosted by.

[Carol Massar]

Your girl, Lainey Wilson.

[Ed Helms]

The CMA Awards live Wednesday, 8, 7 Central on ABC and next day on Hulu. This podcast is brought to you by FedEx. The new power Moves hey, you know those people in your office who are always pulling old school corporate power moves? Like the guy who weaponizes eye contact. He's confident, he's engaged, he's often creepy. It's an old school power move, but this alpha dog laser gaze won't keep your supply chain moving across borders. The real power move? Having a smart platform that keeps up with the changing trade landscape. That's why smart businesses partner with FedEx and use the power of digital intelligence to navigate around supply chain issues before they happen. Set your sights on something that will actually improve your business. FedEx the new power Move.