Investigating Addiction & Preventing Polio #285

Dr. Elissa Chesler:

I discovered that as a scientist, I'd have greater impact in the lab than in the clinic. But it's always been with me that everything I'm doing in the lab has as much, much broader reach to the whole world around that patient and around the society that's involved in their condition and how it's treated.

Ann Lee Hussey:

You know, in some of the really remote regions that we've, we've go to, we've actually brought health care to them for the first time ever. So children would die. You know, I was in Mali once and this really hit home to me. They don't even name their children until the child is at least a year old because they just want to make sure that the child.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to Love Maine radio show number 285, investigating addiction and Preventing Polio, airing for the first time on Sunday, March 5, 2017. We humans have been plagued by disease, both infectious and environmental since we began life on this planet. Today we discuss two very different diseases with individuals who are working to mitigate them. Scientists Dr. Alyssa Chesler and Dr. Vivek Kumar are studying addiction at the Jackson Laboratory in Bar Harbor. Ann Lee Hussey, herself a polio survivor, has traveled the world immunizing people against polio and other vaccine preventable diseases. Thank you for joining us.

Dr. Lisa Belisle:

Today it is my great pleasure to have with me Dr. Alyssa Chesler, who is an associate professor at the Jackson Laboratory in Bar harbor and director of the lab's center for Systems Neurogenetics of Addiction. She studies disease complexity and behavioral science with an emphasis on the genetic and genomic analysis of alcohol and substance use disorders. Also, I have with me Dr. Vivek Kumar, who is an assistant professor at the Jackson Laboratory and who studies the genetics of addiction. Thanks so much for coming in today.

Dr. Vivek Kumar:

You're welcome.

Ann Lee Hussey:

Thank you.

Dr. Lisa Belisle:

I know it was kind of a long travel down here from the Jackson Lab to Portland. So it's a big deal that we have you here, and not only for that reason, but also because the NIH gave you a large grant back in the summer. $11.7 million, I believe.

Dr. Elissa Chesler:

Yeah, that was our center for Systems Neurogenetics of Addiction. That gives us a lot of opportunity to bring investigators in to use new research resources and tools and approaches at the Jackson Lab to study addiction related behaviors across lots of different areas of addiction.

Dr. Lisa Belisle:

And for you, it's also been important to have conversations out in the general public about. About addiction. And I know, Dr. Kumar, that you actually gave a TED talk on the subject.

Dr. Vivek Kumar:

Yeah, I did.

Dr. Lisa Belisle:

Tell me a little bit about that. And why. Why is it important for you to be doing this with those of us in the general community?

Dr. Vivek Kumar:

Yeah. So my advocacy started because I read an op ed piece that was published in the Bangor Daily News of a woman named Colleen Singer, and she died less than 40 miles from where I live, mainly because she did not get the care and the treatment that she needed. And it really was a failing at a societal level, at a medical level to provide the property treatment. And I felt I was doing fundamental research in basic biology of addiction. But obviously there is a huge gap in terms of what we know scientifically and what is implemented at the policy level, at the state level and at the society level. I made it a mission to go out and talk about this disease, to fill this void, this gap. So I talk about addiction as a chronic disease Addiction should be treated in a long term basis, much like diabetes, hypertension. And I talk about the ideology of addiction, the treatment of addiction and the changing of mindset from a moral failure to one that is a more of a chronic disease that anyone could be vulnerable to and anyone could have, just like diabetes or hypertension.

Dr. Lisa Belisle:

It's my understanding that the Jackson Laboratory is really trying to do this in many areas to cross that bridge between fundamental bench science and public health and clinical work. Is this something you've been interested in for a long time as well, Dr. Chesler?

Dr. Elissa Chesler:

Absolutely. I think in a lot of ways as researchers, we try to solve the real problems underlying the disease, the mechanisms, the discovery of new treatments, new cures, using the genome to find those treatments. But at the end of the day, there's so much more infrastructure around disease, delivering health care and also understanding disease. So yeah, for me it's been, you know, in my education, I was originally actually an MD, PhD student. I discovered that as a scientist I'd have greater impact in the lab than in the clinic. But it's always been with me that everything I'm doing in the lab has this much broader reach to the whole world around that patient and around the society that's involved in their condition and how it's treated.

Dr. Vivek Kumar:

And I think all of us, all scientists, need to get out of the lab and convey what they're doing to the public. They get a huge, they get a huge amount of money from the National Institute of Health to do fundamental research. But if we don't kind of convey what we're doing back to society and we don't get involved in debates that are going on in our community, then science, it hurts science overall. We end up with people that don't believe in global warming. We end up with people that doubt something as fundamental as evolution. And it affects our kids and it affects the next generation. So we've got to, as scientists, we've got to get out there. No matter what we work on, we've got to get out there and talk about what we're working on and how it affects society.

Dr. Elissa Chesler:

I also think in the area of addiction in particular, unlike any other disease, we tend to treat most diseases with drugs and medical interventions. But with addiction, there's a lot that comes to the individual from understanding the process of becoming addicted to for the family, for understanding the experience of an addiction. And so any education that we can do about what the disease really entails might actually have an immediate therapeutic benefit. So when we can understand the differences among different Mice, even in terms of their tendency to ingest alcohol or self administer a drug, we're saying that biology is playing a role in whether or not someone's likely to start using a substance, to compulsively use that substance, and to have difficulty stopping using that substance. And so when we can see that in mice, it helps us actually have, at least for me, a lot more compassion for people with the condition, a lot more understanding of, you know, this isn't something that a person has decided necessarily to do. I mean, there's some decision making process going on, but there's a tendency to make those decisions and a tendency for those processes to become hardwired in certain individuals. And understanding that biology, understanding how that change takes place, from experimenting with drugs to using them compulsively, I think can help people understand when they're starting to have trouble with the drug use and need to start thinking about or seeking help.

Dr. Lisa Belisle:

When you decide to go into science, it's pretty early on that you start developing interests in a field. So for each of you, I'm sure there was a turning point where you decided, I think addiction is what I would like to work on. Can you describe that for me?

Dr. Vivek Kumar:

Yeah, absolutely. So I come from the field of addiction, from a very molecular area. So my training was really molecular biology. My PhD was studying how genes turn on and genes turn off. And when I was looking for postdoctoral fellowship, I was trying to decide, you know, what field I should kind of go into. And then it turns out that behavior, we actually know very little about the molecular basis and the genetic basis of complex behavior. And it felt it was a black box. And there's a lot of discoveries that could be made. So I kind of picked as what are the big problems for the next 20, 30 years? And this, in my opinion, is one of them. Tom Enzo, who used to be the head of nimh, National Institute of Mental Health, has this great slide where he looks at the past 50 years and mortality from different diseases. If you look at cancer mortality, it's decreased significantly over 50 years. But if you look at mortality due to mental illnesses such as suicide, it's pretty much completely flat. And so there's just a huge amount of work that needs to be done. We need to understand the molecular, the genetic basis of these complex disorders. And that's the reason I got into the field.

Dr. Elissa Chesler:

Have you ever seen a duck have a messy landing on the water with a lot of splashing and everything? So I went into college. I wasn't exactly sure what I wanted to do. And I started taking my science courses and I took a biological psychology course. And it fundamentally changed the direction that I was pursuing. I think I wanted to do journalism, actually. And between that and this course I took in probability and statistics, I learned a lot about how we know things, how we come to know things, but also what a scientific discovery is, how we contribute to science, and how the brain supports behavior, how the brain can be changed in response to experience, but also that there is this biology underlying all behavior. And that truly fascinated me. And then I went on to pursue an MD, PhD. I was really inspired by Oliver Sacks and reading Awakenings. I really wanted to go in the clinic and do some research and fix people and not necessarily fix them, but I was inspired by the crosstalk between the clinic and the lab. And I ultimately, one thing leads to another in a career path, I think. And I just became so amazed by the tremendous opportunity to apply computation to biology. And especially in the area of behavior, where we have often trouble. We all know what blood pressure is, we can all measure blood pressure, but how do we measure behavior or addiction or depression, a much more complicated problem. And so I was inspired by the ability to use computation to understand those things and certain new techniques in genetics that would allow us to do that in a really impressive way. Between those two things and pursuing one opportunity after another, I really got involved in the issues around behavioral complexity. And then, you know, I've come to know a lot of people who suffer from alcoholism and addiction. And when I realize the synergies between what I can do in my lab and what's going on in their lives and the relationships among what we're learning and what they've experienced, it's all kind of come together for me. So I've just sort of landed in this area. And I'm really pleased that I am, because I think it is work that has real meaning and is really important to me.

Dr. Lisa Belisle:

Dr. Kumar, what are you on a day to day basis, what are you actually doing with addiction? And from what I understand, mice, and that's what Jackson Lab is known for.

Dr. Vivek Kumar:

Yeah. So your audience may wonder, how do you study something as complex as addiction in mice? But it turns out mice are a wonderful model to. To model complex diseases. Their brain structure is very similar to humans. Obviously it's much smaller, but all the relevant regions are there. All the relevant cell types are there. Genetically, we're very similar. We share most of our genes with mice and we can put mice and we can have very complex behavioral paradigms with mice. Something that we can't really do in humans. We can control their environment from before birth till the end of the experiment. So my lab really uses a classical, what's known as forward genetic approaches. And so forward genetics essentially means you take something that's completely normal and you try and break it. So we take a normal mouse, and we use mutagens to create random mutations. And then we ask, well, what are the genes that are mutated that lead to apnea, normal behavior? We can use something like cocaine response, which is a locomotive of mice run around just like humans, get hyperactive when they're given a psychoactive drug. So we use this approach. This is very like going back to the 1950s and 60s with Seymour Benzer, which is the idea that you take something normal, you break it, and then you find what's broken. And that gives you a clue as to how that system actually is functioning.

Dr. Lisa Belisle:

I was interested when I was reading about the grant that your laboratory received, to hear that you were hoping to go beyond just treatment of addiction and really were hoping to get to a place of possibly preventing addiction. And I think, Dr. Chesler, maybe they were quoting you, and you were saying there were certain traits that. That we look for that go along with addiction. And if you can identify those traits earlier on in maybe a person or a family, maybe something can be done before the person gets to the place where they need treatment.

Dr. Elissa Chesler:

I think it may be possible. But we also have to keep in mind that people have understood that this is a disease that runs in families, and they've understood that for a long time. Most people do not need a genetic test to know, for example, that alcoholism has been in their family for five or six generations. So wither genetics. I think the, you know, for us, if we can understand, predict, characterize traits like impulsivity, traits like sensation seeking, you know, those people that really want to go out and take risks and do interesting things. Those are really good questions. Qualities, you know, but at the same time, they may lead to some vulnerabilities. And so, you know, the question is, does that help us when it comes time to think about prescribing drugs for pain or looking at understanding more broadly a pattern of behaviors, how we might intervene in. In schools or generally in the development. And yet we want to be careful because these are natural traits. These are normal variation among people. And it's only when stress, environment, drugs, and biology come together that this abnormal process kind of starts rolling. And so the question is, how do we predict it? How do we use that information without Actually derailing someone's creativity and opportunity and potential. But really to help people understand themselves better so that maybe the insight may come that, oh, wait, I should probably avoid this, or, oh, this is getting out of hand. And the earlier that happens, the more reverse is the changes of addiction are.

Dr. Vivek Kumar:

So there are four traits that are known to be predictors in teenagers, predictors of later issues with substance use disorders. This includes anxiety, as Alyssa mentioned, impulsivity, sensation seeking, and depression. So if, you know, you have a teenager or I have a 12 year old, so with any of these issues, it would be in their interest to kind of help them deal with something like anxiety. You help, you help them manage their feelings. You get them, you know, proper coping skills really early on. And we know that if they're given the proper coping mechanisms early, then that leads to reductions downstream and the need to take alcohol or take illicit substances. And it's really critical when a person starts using drugs. So the brain is developing till about 25. In our society, we make most alcohol. Nicotine is legal at 18, alcohol is legal at 21. Marijuana will soon be legal. And these are incredibly powerful neuromodulators that are going to perturb a developing system at a really critical point. So if a person starts drinking before the age of 15, their risks of alcohol abuse goes up almost fourfold if they were to just start drinking past the age of 21. So it's really critical when the developing nervous system gets a drug. And it's really important to kind of discover and keep an eye out for these predictors of later addictive behaviors and substance use disorder issues.

Dr. Lisa Belisle:

Are you able to do anything with behavior modification in mice?

Dr. Elissa Chesler:

You know, those are, that's an interesting question. And there are some studies that can be done and some that have been done to try to manipulate behavior in a manner that includes increases or decreases substance use. But in general, I think that's especially for the kinds of techniques that we're using where we do larger scale genetic studies. I think it's an area that's open for a lot of exploration right now. And now that we have over the past 10 years, I'd say really made significant advances in our ability to do studies of highly complex behaviors. Now is the time to ask those more complicated questions. We have the resources and we have the computational tools to actually ask those questions. Well, now,

Dr. Lisa Belisle:

what are some of the exciting things that you've learned that you've been surprised by?

Dr. Vivek Kumar:

Actually, I'm surprised every. And this is the reason I'm a Scientist is because I go into lab with this idea that I could discover something new that no one else has discovered. It rarely happens, but it does happen. So in one of the papers we published as part of my postdoctoral work, and the work we're continuing at the Jackson laboratory, We looked at two inbred strains of mice. And these mice were exactly identical in 1951. But sometime between 1961 and 1974, they picked up a mutation that causes a very different response to cocaine. So we identified this one nucleotide out of 2.5, 2.8 billion nucleotides. And that led to discovery of a gene and a pathway that people had not linked previously to addiction. And it turns out that this protein and this pathway regulates structure, actually the structure of brain cells in a very critical circuit in the brain called the mesolimbic reward circuitry. This circuitry is critical in regulating addiction. It's actually critical in regulating motivation. And when this circuitry is perturbed, it can lead to all sorts of problems, including addiction. So it turns out that this gene, which we cloned using cocaine response, now they've other people who study nicotine response or study alcohol response, or study food binging, have shown that the same mutation causes differences in all these different phenotypes, which may seem really odd, but remember, this reward circuitry Is regulating a lot of different behaviors. And food reward, sex reward, these are natural rewards that this circuitry actually evolved to kind of control. So it makes perfect sense that it's not only regulating drugs of abuse, but it's also regulating natural rewards. So that was very surprising. We made a discovery with one drug, and it turns out to have phenotypes in many other domains.

Dr. Elissa Chesler:

Well, we've been looking at genes that play a role in multiple related behaviors. And one of the things that we discovered through. We kind of sometimes think of it like dumpster diving. But we've taken lots of old studies in behavioral genetics, and we've compiled the results of those studies, Mostly lists of genes that people kind of were less interested in. And we put them in a database, and that allowed us to see where and from piles up what genes are most highly connected to different behaviors or groups of behaviors. And doing this dumpster diving, we pulled one out that was really exciting to us. It actually is a gene that is involved in both alcohol withdrawal, but also alcohol preference. And we've been able to show that there are genetic variants among mice that influence how this gene is expressed in response to alcohol. And it actually can help us predict alcohol Withdrawal, alcohol drinking. And, you know, gene regulatory mechanisms are really interesting in although humans and mice share many, many genes in common, almost all of them, the very specific nature of that regulation differs, and yet we can show that this system in general is conserved from humans to mice, and that we may potentially be able to explain at least a little bit of variation in human alcohol drinking and those individuals that may experience more alcohol withdrawal. So that's something that we're looking at now. But it's always amazing to me that, you know, we have so many, so many mechanisms of alcohol and drug response. You know, people want to think there's a gene for this and a gene for that, but we're really extracting millions of different mechanisms, if you will. Maybe not millions, but a large number and different individuals are going to have different combinations of those mechanisms at play in their particular situation. So we've got much to do to relate those to each individual and what they may need.

Dr. Lisa Belisle:

Do you feel that we have become a more addicted society in general?

Dr. Elissa Chesler:

Yeah, I think so. I mean, you know, a huge predictor of addiction addiction is stress. And in alcohol drinking as well, there's issues in the stress response, but there's also systematic issues in life stressors. And when we have so many people experiencing economic distress, feeling a loss of opportunity in their lives, and a certain frustration, I think drugs and alcohol become attractive. And it's, you know, initiating is one thing. Starting to use is one thing. Having these things available freely flowing in communities, whether it's prescribed or street drugs, that's just getting started, right? And then it's what are the things that facilitate continued use? And all of that is interacting with it. A person who may or may not be addiction prone. And you can kind of think of it like there's a little bit of a needle there, and we may be born with it, set in some position, but life stress may push it closer and drug exposure may push it closer. And so even if someone's really not that prone to addiction, but have all the other events occur, they can too be probably pushed into alcohol or drug addiction.

Dr. Vivek Kumar:

Yeah, addiction, like any chronic disease, is a result of genes, your genetics, with your environment. So our genetics are not going to change that much. That takes many generations, but our environment can change fairly rapidly. So all we have to do is look at the crack epidemic or the heroin epidemic, or even the opioid abuse epidemic in the state of Maine. There are correlations between economic disparity and addiction, and it makes perfect sense. When people feel hopeless, they seek alternatives to you know, to kind of ease that pain. And drugs are a very easy way to deal with that.

Dr. Lisa Belisle:

Dr. Kumar, one of the things that you talked about was binge eating, which I find very interesting, because obviously, as a family practice doctor, not only do I deal with addictions in nicotine addictions to alcohol, but we now have this obesity epidemic. And so I'm particularly interested in why you think that we might be predisposed to this now, this particular addiction, because I think there is a huge food addiction issue.

Dr. Vivek Kumar:

Yeah, so it comes back to the circuitry, which is this mesolimbic reward circuitry. This circuitry evolved over millions of years where we have to. So think of. Let me put it this way. So we have an animal lives in a nest, and it has to make a decision every morning. Am I going to go out there and explore? And I'm going to find the risk is I can get eaten by a predator. But if I go out there, I can find a new mate, I can find a new source of food. And this balance, this exploratory drive, is regulated by these mesolimbic reward circuitry, which is a survival circuitry. Now, when we eat, we feel good. Dopamine gets released. So it's not surprising that, again, in certain contexts, we overeat to get a certain amount of dopamine release. And it's affecting a very similar. It's acting through this same circuit. It has other components, obviously, but it's the same circuit that cocaine and heroin and other drugs of abuse hijack. So it comes back to the circuit and functioning of circuits in the brain.

Dr. Lisa Belisle:

So really, you could become technically addicted to anything that's going to give you pleasure by doing it. People can become addicted to, say, yoga or meditation or good things that could actually good for them.

Dr. Vivek Kumar:

Absolutely. And this is one of the treatments for addiction. You wean someone off of a negative lifestyle and you get them on to a positive lifestyle. So you can feed the reward circuit with exercise that releases endorphins and dopamine. Also, you can feed it with social interaction. Yeah. When I meet you and I meet other people, that feels good. So. And this has been, you know, in kids, for instance, who are struggling with anxiety and impulsivity and all these. These four traits I mentioned, one of the things that you coach them to do is actually how int interact. Well, how. And you get them on exercise, you get them into organized sports, and so you feed that circuit with a completely different set of activities.

Dr. Lisa Belisle:

Do you have any final thoughts for us, Dr. Chesler? Final thoughts well, how about some interim

Dr. Elissa Chesler:

at this stage? You know, I think we've really touched on the issues that there's a lot of interconnectivity between behaviors, normal behaviors, pleasurable experiences, and this very unfortunate condition of addiction. And unraveling that complexity and understanding how we can get people on a better path is very important. I think the other thing is just getting that care widely available in our communities. There are places in Maine where there may be one or no people really experienced and certified in this area. And just making sure that care is available and that preventive measures are available is so crucial right now. So we're going to learn a lot about the biology, but we've got to get it out to people.

Dr. Lisa Belisle:

What about you, Dr. Kumar?

Dr. Vivek Kumar:

Yeah, I think one of the main things we as addiction researchers need to get across about our work is that addiction is not a moral, personal failure. It really is a disease. It's a disease like diabetes, like hypertension. We need to treat it like that. It can be managed. We're not going to. When someone has substance use disorder or is an addict, we're not going to cure them. We can manage their illness. Part of that management is that they're going to relapse, just like someone with diabetes will eventually relapse and their blood sugar will go out of control. So it's very important to get that point across and, and not judge people who are suffering with addiction and who are dealing with addiction.

Dr. Lisa Belisle:

I've been speaking with Dr. Alyssa Chesler and Dr. Vivek Kumar from the Jackson Laboratory up in Bar Harbor, Mount Desert Island, I guess technically. I really appreciate the time that you are taking not only to be having this conversation with me, but also to be working on this because this is something that's important to all of us really in our not only in the state of Maine, but around the country. So thank you for the. Thank you for all of this.

Dr. Vivek Kumar:

Thank you, thank you for covering this important topic.

Dr. Lisa Belisle:

Ann Lee Hussey, a polio survivor who has made the eradication of polio and the alleviation of suffering by polio survivors her life's work. Over the past several years, she has participated in 28 Volunteer National Immunization Day trips overseas. She was recently honored as a White House Champion of Change for her humanitarianism and contributions to public service. Thanks so much for coming in today.

Ann Lee Hussey:

Thank you for having me.

Dr. Lisa Belisle:

So you and I met at the York Hospital benefit, I believe, in the fall.

Ann Lee Hussey:

Correct.

Dr. Lisa Belisle:

You're from the South Berwick area.

Ann Lee Hussey:

Correct.

Dr. Lisa Belisle:

You were born, I believe, at York Hospital.

Ann Lee Hussey:

I was, yes.

Dr. Lisa Belisle:

But you've been all over the world. You've had kind of an exciting life for someone that's. That's honestly, you know, a Mainer for

Ann Lee Hussey:

a little girl from Maine. Yes, exactly.

Dr. Lisa Belisle:

Yeah.

Ann Lee Hussey:

Yes.

Dr. Lisa Belisle:

Did you think that when you developed this disease that it would send you down a road like this?

Ann Lee Hussey:

Never. If you'd asked me that 20 years ago, I would have just looked at you funny, because, actually, growing up, you know, my polio, I never thought a whole lot about, and I just tried to be part of what was going on around me with my peers, but it was my exposure to Rotary. And when I learned about what they were doing with a program to eradicate polio, I thought to myself, why am I not involved in this?

Dr. Lisa Belisle:

So tell me about the polio itself. It's something that in the United States, most of us don't really think about that much because we're not faced with. With the actual disease. How old were you when you developed polio?

Ann Lee Hussey:

I was 17 months. I contracted polio three months after the very first polio vaccine by Dr. Salk was released.

Dr. Lisa Belisle:

And so obviously, you wouldn't have much of a memory of that.

Ann Lee Hussey:

I don't. I don't remember that experience, only stories that have been told to me by my mom and my siblings and cousins.

Dr. Lisa Belisle:

What types of stories have you been told about that? I would imagine for a mother or parents or grandparents, it must have been pretty scary for them to have essentially a toddler come down with this horrible disease.

Ann Lee Hussey:

Yeah, actually, I can't imagine how my mother would have reacted to that. I was the youngest of five and the only one that was affected. But I know that she knew what it was immediately, not only because they'd lived through that polio era, but because her brother had Contracted polio when he was 5. And so her younger brother. So she'd already seen that happen. So I think she was very scared. And I was initially paralyzed from the waist down. It was a while before she ever told me that. So I can't imagine how a mother must feel when the only thing that her little girl is moving is her head and arms. And please keep in mind there are others who have. Were far more affected than I. So I feel very lucky in the respect that I'm doing as well as I am today. But other stories that were told to me is my. My older sister told me about how my mom used to get up every three hours around the clock to massage my legs and move them to enable me to walk. So I owe her a lot. I owe my mom a tremendous amount. And other stories were my cousins that just came out a couple years ago, how they used to take me down to the local pond, which is down the road, and she would take my braces off and put me in the water. Little did she know how therapeutic that was.

Dr. Lisa Belisle:

So they were almost inadvertently doing things that now we actually offer as exactly. A legitimate means of healing.

Ann Lee Hussey:

Exactly. Yeah. Well, my mother was told by the doctor to do all she could. I mean, I still went for a rehabilitation center as a toddler, but there are many things that my mom had to do at home for me to get me to do that. One of those experiences that I really remember was my mom used to fill her purse with sand, and I would sit on the kitchen table and she would hang it off my foot and make me lift, do leg lifts. So, you know, whatever it takes.

Dr. Lisa Belisle:

Well, that's a creative approach. Yeah, that takes quite a woman to say, I don't mind having my purpose purse filled with sand.

Ann Lee Hussey:

My mom was a good woman and

Dr. Lisa Belisle:

the youngest of five, too.

Ann Lee Hussey:

I was youngest of five.

Dr. Lisa Belisle:

So it's not. Not enough that, you know, she's already got five children to take care of, and then on top of that, she gets to work with her youngest.

Ann Lee Hussey:

Right, right. And overall, my siblings, you know, I'm sure there was some jealousy with misunderstanding at that age of why I was receiving all that attention, but overall, they were very accommodating. And, you know, it was a time growing up in a small town when neighbors reached out, you know, they would bring meals over to my mom, and that helped tremendously.

Dr. Lisa Belisle:

So does it ever occur to you that it was maybe not the best luck that this vaccine was coming out and that you just happened to contract this prior to that happening?

Ann Lee Hussey:

You Know, I don't ever think about the fact that I may have had bad luck. I don't think that at all. In fact, I don't blame anybody. You know, it's a virus and it happened, and I was young enough to not know any different. So I grew up with the challenges that I had and learned how to face those and overcome what I could and deal with it again. I have to tell you that especially now after traveling around the world, I see so many other people that are so far more affected that, you know, I'm truly blessed. I didn't spend time in an iron lung, which would have been extremely scary. And I'm not in a wheelchair now. I don't know what will come down the road for me. But. So, no, I don't ever. I don't blame anybody. It's not woe is me. Never ever has it been woe is me.

Dr. Lisa Belisle:

So I'm not sure that everybody who's listening has enough experience with polio to know what actually happens when one contracts this disease. You've already mentioned a couple of things. Paralysis and the need to be in an iron lung. And that's because not only do your muscles of your legs, your limbs become paralyzed, but you can also not be able to breathe because there's a muscle called the diaphragm that needs to be able to move in order for you to actually bring lungs. Air in and out of your lungs.

Ann Lee Hussey:

Exactly.

Dr. Lisa Belisle:

But that's. I mean, this is. This is scary stuff that was going on, and people would. I think what I'm remembering hearing is that they would close down pools and swimming holes and people would quarantine their children in the middle of the summer. And, I mean, there was a fear

Ann Lee Hussey:

around, this huge fear, a huge fear. And, you know, especially in the city, because it's. It seemed to though it did, I mean, affect the country, too. But at the time that I contracted polio, there was one of the last large epidemics in the Boston area. And so many parents in the cities would pack up their children and move out to the country thinking they were going to escape the virus. Well, they may have, but it actually may have brought it to me. I mean, there's no proof of that, but there's that possibility. But they. I have friends who tell me how they were never able to see any of their friends during the summer. You know, at the end of school, they never saw them again until school started up again in the fall. And then they may not have seen all of them. Some of them may have Passed away from polio during the summer.

Dr. Lisa Belisle:

So I'm wondering how it makes you feel as someone who has survived this virus that is vaccine preventable to hear that some people may have misgivings about vaccines.

Ann Lee Hussey:

It bothers me tremendously, to the point of I get a little bit angry because I don't think that it's fair that a parent make that judgment for a child when there are so many facts out there telling us that the vaccine is safe and that the consequences of not taking the vaccine are huge. As you said, it's a totally preventable disease. And if you get polio, you always have polio and the effects are lifelong. So why would a parent take that risk is my question. Why would they do that? There's so much documentation out there that tells us that vaccines are good.

Dr. Lisa Belisle:

And I guess at least with polio, more people are confused. This is one that if they're going to choose amongst vaccines, that this is one that they are willing to have their children get.

Ann Lee Hussey:

Yes, yes, that's true. If they were to travel with me, though, overseas, they might think differently about refusing the measles or the whooping cough or others, because there's still large epidemics of that happening out there.

Dr. Lisa Belisle:

Well, tell me about that.

Ann Lee Hussey:

Well, when I go out to immunize, you know, on the polio campaigns, we visit villages and we're reaching all these children up to the age of five. And many times they will say, well, these children, there's a polio outbreak. I mean, a measles outbreak in this village. And I think back to myself, I don't see that so much. In the US we have in recent years. And those mothers will walk miles to come for measles vaccination for their child. Miles not only for the polio, but they will walk miles for the measles and all the other ones that the health workers offer.

Dr. Lisa Belisle:

What countries have you visited?

Ann Lee Hussey:

I've been to India many times, different parts of India. And I visited Nigeria multiple times. And in addition to that, I've been to Bangladesh and Egypt, Niger, Mali, Benin and Chad and Madagascar.

Dr. Lisa Belisle:

And what do you see when it comes to outbreaks of these diseases? How is the community able to actually respond?

Ann Lee Hussey:

Well, fortunately, we've been doing the polio program now for 31 years. And along with the eradication of polio, we've actually brought a greater awareness to how vaccines can help these individuals and a greater awareness to mothers for the reasons to come to health clinics. So that's what we see now. We see parents willing to go to Medical doctors and nurses within their own countries to receive the help of their kids. That's a huge improvement over 30 years.

Dr. Lisa Belisle:

What was it like before

Ann Lee Hussey:

there were tribal doctors, there were, you know, not medically fact based doctors or there just wasn't any access to health care at all. You know, in some of the really remote regions that we've go to, we've actually brought health care to them for the first time ever. So children would die. You know, I was in Mali once and this really hit home to me. They don't even name their children until the child is at least a year old because they just want to make sure that the child's going to live.

Dr. Lisa Belisle:

I guess that's one of the things that I'm wondering is if you live in a country that is probably challenged by things like sanitation, access to good nutrition, access to medical care, then if you have an outbreak, then it's not as if you had an outbreak in a place like Portland or you have access to the Barbara Bush Children's Hospital and the Maine Centers for Disease Control. You're talking about. You're already starting from a very different place.

Ann Lee Hussey:

Exactly, exactly. And that's one of the reasons why the eradication of polio has taken so long. Because we are working with children who are malnourished and, and underserved in so many ways and undereducated and all of that. So when we go to give a vaccine to a child who's malnourished, their immune system doesn't necessarily respond as quickly as it would to a child here in Portland because they're not as healthy. Chronic diarrhea is one of the biggest killers of children overseas. The same reason because of the poor sanitation and water that's not clean.

Dr. Lisa Belisle:

Why has this been important to Rotary?

Ann Lee Hussey:

Well, it's very important to Rotary. We tested it in 1979. I say tested in quotes. When an individual, a Rotarian from the Philippines, asked if they could do a grant, have funds that would immunize the children in the Philippines. Because at the time that he was asking, the Philippines was reporting the largest number of polio cases in that Asia region. And we did that and the success was immediate. We decreased the rate immensely. And it wasn't long after that the Philippines was polio free. So when you see that kind of proof, number one, we're willing to try. Number two, the polio is only in humans, so there's no animal reservoir or anything, or it would be impossible to do. But more importantly, what the unique thing about Rotary is that we are an army of volunteers all around the globe. We're 1.2 million and growing strong. And it's that army of volunteers who can do advocacy, who can do hands on, who can get out into the streets and talk to the people in their own communities and make them understand the importance of what they're doing. And I think that is what made Rotary such a strong partner. When we finally did reach out to the world health agencies around the world, they knew that that's what Rotary brought, was that army of volunteers, the ability to fundraise and the ability to advocate. And that's what we do best.

Dr. Lisa Belisle:

In addition to doing this work, you also work with your husband, who's a veterinarian and you're a veterinary technician. And you've been working together. You've been married 34 years. You've had a practice for how many years now?

Ann Lee Hussey:

Since 84. So do the math.

Dr. Lisa Belisle:

So you're pretty busy and you have this whole other life.

Ann Lee Hussey:

I do have this whole other life. I have to admit that I don't work at the clinic anymore though. Rotary sort of became my life. And my husband, who's also a Rotarian, realized how important this was to me and said, it's okay, go do it. Go see where this takes you. And so as the first couple years went by and I became more and more involved, I worked less and less. And so now I don't. I mean, I know all the girls and I go down and I visit and all of that, but I don't have to be at the office because we have such excellent help to do it for me. And Rotary has become my life. Polio eradication in many ways has become my life. I have a passion to see the end of this for many reasons, mostly because of the children of the world. And no child should have to suffer no child again from a total preventable disease.

Dr. Lisa Belisle:

What was the turning point for you? At what point did you go from someone who had had polio to someone who wanted to eradicate polio?

Ann Lee Hussey:

Well, remember my uncle was a polio survivor, so he was sort of a mentor for me because I grew up watching how he dealt with things physically and emotionally. And then I learned about Rotaries program and I had the opportunity to take my very first trip in January of 2001 and I traveled to India. So I stepped way outside my comfort zone, leaving Little Maine and stepping out. And it was fun. It was amazing actually, to see the program, to see the logistics, to see what a tremendous amount of work they were doing in India. But the thing that caught me was when I visited a rehabilitation center. I've told this story many times. My apologies to the viewers who may have heard this, but they paraded out in front of us a group of school children because they wanted to show off how they were helping. And that's fine. So they all had assistive devices, various sorts. But there was one little girl that I will never forget. And when she walked past me, limping past me, she smiled at me. And I, of course, returned her smile. She was a beautiful little girl. But I looked down at her legs showing beneath her skirt, and there was that same thin right leg, that same heavy metal brace. And I was really overcome with memories of myself at her age. And I broke down. I basically broke down. And I cried. I cried so hard. And I say that I cried for her, but I cried for me. But I cried for all the waste that polio was bringing to so many, especially being there in India and seeing them on the streets. And I thought, I have to do more. You know, I could hear my uncle's voice in my ears saying, if you can just prevent one child, you'll have done your job. Well, I've prevented more than one child after all these years, but my job's not finished. And so I think it's that little girl. It's her smile, it's her perseverance, and it's my uncle's voice that keeps me going.

Dr. Lisa Belisle:

You still deal with the after effects of polio? I do as an adult. Because once you get polio, if you're lucky enough to survive, it's always with

Ann Lee Hussey:

you, always with you. Every day of my life, it's there. And polio has a condition known as post polio syndrome that can affect survivors anywhere from 30 to 40 years after they have that acute paralysis. And you never know when that's going to hit. And what post polio syndrome is, is extreme fatigue. You can have extreme pain in both muscles and joints, and then your weakness starts to take over. And some people actually end up back in wheelchairs or in leg braces, riding scooters, you know, and here's a disease that they had overcome, that they had triumphed, that they persevered. And now it was coming back to haunt them. Not the disease, but the effects. So I wake up every morning and put my feet on the floor and say, I've still got it. You know, I may be a little weaker than yesterday. I may have to hold onto the railings. I may walk slower than all my friends, but I'm still here. That's how I look at life. I'm still here.

Dr. Lisa Belisle:

So you've obviously given so much time of yourself that you've been recognized

Ann Lee Hussey:

as

Dr. Lisa Belisle:

a White House champion of change. But you don't think of yourself in any way as being close to finished with this?

Ann Lee Hussey:

No, we're close. We are very close. But until we've reached that last child, until we come to zero cases, and then we pass three to four years without any more, then we'll be finished.

Dr. Lisa Belisle:

What is the current state of polio eradication?

Ann Lee Hussey:

We are at a very good spot right now. We are poised, actually, to possibly have the last case be finished this year in 2017. We never want to say for sure because, you know, that polio virus is a persistent little devil and hides out in areas that we're constantly watching. But we have the lowest number of cases being reported. Stop and think. When we started, there were a thousand cases being reported every single day, so over 350,000 a year globally. Last year, for 2016, there were only 37 cases globally. We've driven that virus and reduced the area where it's found now into just geographical regions within Pakistan, Afghanistan and Nigeria into small regions. We have the tools. We know how to eradicate polio. The challenges that remain are areas of conflict, areas of inaccessibility, rugged terrain as well as the conflict and funding. You know, we still need 1.8 billion through 2019 to finish this job, but we have very generous donors, and we think that that will happen, but we always need more donors. So anyone listening wants to help the children of the world and be a part of a very historic movement, go to npoleonow.org but really, we are poised. And, you know, Rotary doesn't do this alone. Rotary works with our partners, World Health Organization, Centers for Disease Control and unicef, and in recent times, the Bill and Melinda Gates Foundation. And we're all determined. All of the partners offer their own personal expertises to get us through this. And many thanks for Bill Gates and his contributions. They've been very, very generous. So, yeah, I think we're so close. We're so close. We used to put our fingers up and put this little space between them, but that space is getting smaller all the time.

Dr. Lisa Belisle:

Ann Lee, anything else that you think that people who are listening ought to know about polio and the work that you're doing?

Ann Lee Hussey:

Just, again, let me just say, you know, if you're willing to contribute, go to npoleo.org if you're willing to learn more about rotary, go to rotary.org A nice website is the globalpolioeradication.org website. It will tell you the history of where we've come from, what's happening real time today in these countries that are still endemic. And I have to add that in addition to the partners that I already mentioned, the governments of the world are huge part of this. And we couldn't finish this job. We couldn't have achieved what we have today without the government's support. And that includes the governments that were the endemic regions, as well as countries like our own in Canada and European that are giving funds to finish this job. So I want the people to know that this is the largest public private health initiative ever created. It's changing the world and we're making history. And if you want to be a part of it, come join us.

Dr. Lisa Belisle:

Well, if I wasn't convinced before, I am now. I appreciate your coming in and speaking with me and I really appreciate all the work that you're doing to spread the right information about immunizations and about eradicating polio. I've been speaking with Ann Lee Hussey, a polio survivor who has made the eradication of polio and the alleviation of suffering by polio survivors her life's work. Keep up the good work, Ann Lee.

Ann Lee Hussey:

Thank you. Thanks for having me.

Dr. Lisa Belisle:

You have been listening to Love Maine Radio show number 285, investigating addiction and preventing polio. Our guests have included Dr. Alyssa Chesler, Dr. Vivek Kumar and Ann Lee Hussey. For a preview of each week's show, sign up for our E. We love to hear from you, so please let us know what you think of Love Maine Radio. We welcome your suggestions for future shows. Also let our sponsors know that you have heard about them here. We are privileged that they enable us to bring Love Maine Radio to you each week. This is Dr. Lisa Belisle. I hope that you have enjoyed our Investigating Addiction and Preventing Polio show. Thank you for allowing me to be a part of your day. May you have a bountiful life.