Inevitable Collision by Tory Williams outlines the true story of how a promising young man, “TJ,” suffers a spinal cord injury in an automobile accident and goes on to become the first patient clinically treated with a cell therapy derived from human embryonic stem cells. Moreover, TJ becomes an advocate for stem cell research and works toward raising awareness and funds to further his cause.
The book is suited to readers at the high school, undergraduate, and graduate levels, for both science majors and nonmajors. As the text provides numerous layers of complexity (outlined below) without an in-depth discussion of the science, the instructor can choose to focus on one or several of the relevant topics broached. Some of the relevant discussion points include the following: What are stem cells? Where do stem cells come from? Are there different types of stem cells? Should stem cell research be funded? If so, what types of research merit funding? What are the ethical, legal, social, and political issues surrounding stem cell research? Are there economic benefits associated with stem cell research?
Human embryonic stem cells are of great interest because they can potentially form any cell type in the body – muscle, bone, nervous system cells, etc. But the tricky part is figuring out how to coax human embryonic stem cells to make the cell type of interest, without contamination with unwanted cell types. Of course, research and treatments with human embryonic stem cells can be controversial for moral and ethical reasons.
Regardless of whether or not one supports research with human embryonic stem cells, the book tells an important story regarding the impact of stem cells and stem cell research on developing clinical interventions to treat neurological injuries (and disease). The writer illustrates an important moment in medical history by cataloguing the events leading to the first clinical trial involving cells transplanted into humans that were produced from human embryonic stem cells. The reader gains insight into the difficult task of organizing and running a clinical trial and the unfathomable decisions patients face regarding whether they might have the opportunity or not to join the trial or, if given the option to join, whether they should join, not knowing whether the treatment will positively or negatively affect their health and future well-being.
The book has many layers of complexity, making it suitable for a wide range of audiences. As stated previously, the overarching theme is the story of TJ and his challenges and achievements as he adjusts to his spinal cord injury and subsequent new way of life. The book provides a behind-the-scenes look at the politics of funding research involving human embryonic stem cells and the business aspects of this emerging technology. There are high financial stakes surrounding stem cell research. For example, when the federal government refused to fund human embryonic stem cell research beyond existing cells lines (most or all of which were known to be inappropriate for clinical therapies), many states funded stem cell research through private investors (e.g., California, Connecticut, and Massachusetts). In turn, this financial infrastructure fueled the expansion of biotechnology companies and biotechnology jobs, resulting in an overall positive impact on the economic growth for the participating states. The book highlights novel mechanisms to support research, including through for-profit and nonprofit entities, via public or private funds, and by leveraging investments and creating unique collaborations (e.g., between the state of Alabama and researchers at the California Institute for Regenerative Medicine). The book provides a great example of how to accomplish your goals through the power of networking.
Intermingled with the main story line are the author's personal anecdotes, which I found to be distracting from the main message. The author is, additionally, overly patronizing of research scientists, making them out to be superheroes rather than the regular people with intriguing talents that they (we) really are (scientists put their pants on one leg at a time too). A somewhat misguided view is presented that only those involved with the author's research funding programs are truly committed researchers. This narrow view contributes to a major conflict between different funding agencies, research programs, and colleagues that, in the end, causes the severance of friendships and collaborative research efforts toward clinical therapies with stem cells. Indeed, the book illustrates how research is not always collaborative. Rather, research can create the perfect storm of jealousy and lead to the loss of money, friends, allies, and jobs.
In summary, this is a highly recommended book for a broad range of audiences. It tells many stories within the story, to educate the reader regarding the economic and health benefits of stem cell–based therapies, their application in regenerative medicine, and the social aspects of stem cell research. The book is sure to spark several fascinating discussions with varying viewpoints.