Breath from Salt: A Deadly Genetic Disease, a New Era in Science, and the Patients and Families Who Changed Medicine Forever

by Bijal P. Trivedi

Overview

Recommended by Bill Gates and included in GatesNotes

"Elaborating on the science as well as the business behind the fight against cystic fibrosis, Trivedi captures the emotions of the families, doctors, and scientists involved in the clinical trials and their 'weeping with joy' as new drugs are approved, and shows how cystic fibrosis, once a 'death sentence,' became, for many, a manageable condition. This is a rewarding and challenging work."

—Publishers Weekly


Cystic fibrosis was once a mysterious disease that killed infants and children. Now it could be the key to healing millions with genetic diseases of every type—from Alzheimer's and Parkinson's to diabetes and sickle cell anemia.

In 1974, Joey O'Donnell was born with strange symptoms. His insatiable appetite, incessant vomiting, and a relentless cough—which shook his tiny, fragile body and made it difficult to draw breath—confounded doctors and caused his parents agonizing, sleepless nights. After six sickly months, his salty skin provided the critical clue: he was one of thousands of Americans with cystic fibrosis, an inherited lung disorder that would most likely kill him before his first birthday.

The gene and mutation responsible for CF were found in 1989—discoveries that promised to lead to a cure for kids like Joey. But treatments unexpectedly failed and CF was deemed incurable. It was only after the Cystic Fibrosis Foundation, a grassroots organization founded by parents, formed an unprecedented partnership with a fledgling biotech company that transformative leaps in drug development were harnessed to produce groundbreaking new treatments: pills that could fix the crippled protein at the root of this deadly disease.

From science writer Bijal P. Trivedi, Breath from Salt chronicles the riveting saga of cystic fibrosis, from its ancient origins to its identification in the dank autopsy room of a hospital basement, and from the CF gene's celebrated status as one of the first human disease genes ever discovered to the groundbreaking targeted genetic therapies that now promise to cure it.

Told from the perspectives of the patients, families, physicians, scientists, and philanthropists fighting on the front lines, Breath from Salt is a remarkable story of unlikely scientific and medical firsts, of setbacks and successes, and of people who refused to give up hope—and a fascinating peek into the future of genetics and medicine.

Product Details

ISBN-13:	9781948836371
Publisher:	BenBella Books, Inc.
Publication date:	09/08/2020
Pages:	576
Sales rank:	308,597
Product dimensions:	6.10(w) x 9.10(h) x 1.80(d)

About the Author

Bijal P. Trivedi is an award-winning freelance writer specializing in medicine and health. Her work has taken her from the hidden vaults of New York's Metropolitan Museum of Art to the Serengeti Plains to Moscow's Star City, where she blasted off with space tourism entrepreneurs on the "Vomit Comet" for astronaut training. Her work has appeared in Discover, Scientific American, New Scientist, Wired, The Economist, National Geographic, Science, Self, Nature, among others. Her feature "The Wipeout Gene" was anthologized in The Best American Science and Nature Writing: 2012. Trivedi is the former editor of the NIH Director's Blog, which shares compelling, cutting edge biomedical research with the general public. Trivedi also worked as a writer and editor for the National Geographic News Service, a wire service she helped launch in partnership with the New York Times Syndicate.

Table of Contents

Contents

Introduction

Part I
Chapter 1: Hello, Joey 1974
Chapter 2: The Treatment Plan 1974
Chapter 3: Case 44: Babies Hospital, New York City 1935
Chapter 4: A New Disease 1936–1937
Chapter 5: An Equal Opportunity Disease 1938–1942
Chapter 6: Christmas Homecoming 1974–1977
Chapter 7: The Sweat Test 1943–1960
Chapter 8: A Tribe of Desperate Parents 1950–1955
Chapter 9: Lessons from Polio 1955–1960
Chapter 10: The Registry 1960–1966
Chapter 11: The Therapist 1977
Chapter 12: A Disease in Search of Ideas 1964–1980
Chapter 13: The Hitman Cometh 1979–1982
Chapter 14: Salt and Water 1970–1981
Chapter 15: Salty Boy 1981–1983
Chapter 16: Birth of an Advocate 1984
Chapter 17: Out of Many, One 1978–1984

Part 2
Chapter 18: The Gene Hunters 1980–1984
Chapter 19: Lucky Number Seven 1984–1985
Chapter 20: Kate 1986
Chapter 21: To Screen or Not to Screen Newborns 1985
Chapter 22: Michigan 1985
Chapter 23: Joey’s Long Goodbye 1986
Chapter 24: Mad Pursuit 1987
Chapter 25: The Gene 1989
Chapter 26: Runny, Like Water 1989–1994
Chapter 27: Venture Philanthropy—A New Way to Fund Drug Development 1977–1999
Chapter 28: The Gene Is the Medicine 1989–1991
Chapter 29: Transforming the Lungs 1992–2003
Chapter 30: First-in-Human Trials 1992–1993
Chapter 31: The Beall Curve 1996

Part 3
Chapter 32: The Joey Fund 1989–1999
Chapter 33: A Network for Developing Therapeutic Drugs 1997–1998
Chapter 34: Aurora 1998–1999
Chapter 35: The Gates Open 1987–2000
Chapter 36: A Tale of Four Families—CF in the New Millennium 1999
Chapter 37: The Takeover 2001
Chapter 38: Getting the Band Together 2001–2003
Chapter 39: Pay to Play 2002–2004
Chapter 40: Molecular Architects of Vertex West 2004–2005
Chapter 41: Rat to Man 2003–2004
Chapter 42: A Christmas Gift 2004–2005
Chapter 43: The Lucky Four 2005–2007
Chapter 44: The Doorman Launches the Era of Genetic Medicine 2007–2008
Chapter 45: Disruption Fall 2008
Chapter 46: Tasting like Average People 2010–2012
Chapter 47: Milestones to a Cure 2004–2015
Chapter 48: Tackling the Common Mutation 2004–2013
Chapter 49: What Mutation Are You? 2013–2014
Chapter 50: The Mother of All Deals 2014
Chapter 51: Very Personal Clinical Trials 2021–2017
Chapter 52: The Triple 2015–2017
Chapter 53: The Home Stretch 2018
Chapter 54: The Leftovers 2015–2020
Chapter 55: A New Generation 2017–2020

Epilogue 2019–2020

Acknowledgments
Timeline
Endnotes
About the Author

What People are Saying About This

From the Publisher

"I couldn't put the book down."

—Bill Gates

“Science writer Bijal Trivedi interrogates the complexities of treating any genetic disorder, with a masterful command of the details. In an era invested in the promise and, some argue, hype surrounding precision medicine, this is a success story and a reality check in one.”

—Nature

“As a reader who knew very little about CF, I was gripped by Trivedi’s curiosity and attention to detail.”

—Discover

“Elaborating on the science as well as the business behind the fight against cystic fibrosis, Trivedi captures the emotions of the families, doctors, and scientists involved in the clinical trials and their “weeping with joy” as new drugs are approved, and shows how cystic fibrosis, once a “death sentence,” became, for many, a manageable condition. This is a rewarding and challenging work.”

—Publishers Weekly

“A thorough and engrossing saga packed with information, Breath from Salt is really about the transformative power of hope. It arrives at just the right moment, when too many of us have forgotten what human faith, ingenuity, and relentless determination can accomplish.”

—Dan Fagin, author of the Pulitzer Prize–winning Toms River

“Beautifully written, Breath from Salt brings to life the amazing story of a passionate community that dared to dream, work together, and take extraordinary risks to bring life-saving treatments to those with cystic fibrosis. Timely and important, the breakthroughs described in this book are likely to accelerate cures for many other genetic diseases.”

—Dr. Preston W. Campbell, former president and CEO of the Cystic Fibrosis Foundation

Editorial Reviews

07/27/2020

Science journalist Trivedi debuts with a glowing account of how Boston businessman Joe O’Donnell, after losing a son to cystic fibrosis in 1986, raised hundreds of millions for the Cystic Fibrosis Foundation, which pioneered the use of “venture philanthropy” for drug discovery. Trivedi covers low points in O’Donnell’s story (early on, when still struggling to keep his son alive, O’Donnell had “a sick child gasping for breath, a mortgage, no job, no health insurance, and no backup plan”) as well as his triumphs, as he became a powerful businessman and worked with the Cystic Fibrosis Foundation to fund groundbreaking research. Most notably, this included a well-placed investment in Vertex Pharmaceuticals, which in 2012 pioneered the first of several treatments involving drugs matched to patients’ individual gene mutations. Elaborating on the science as well as the business behind the fight against cystic fibrosis, Trivedi captures the emotions of the families, doctors, and scientists involved in the clinical trials and their “weeping with joy” as new drugs are approved, and shows how cystic fibrosis, once a “death sentence,” became, for many, a manageable condition. This is a rewarding and challenging work. Agent: Ethan Bassoff, Ross Yoon. (Sept.)

Correction: This review has been updated to clarify Joe O'Donnell's role with the Cystic Fibrosis Foundation.

Publishers Weekly

"I couldn't put the book down."

—Bill Gates

“A thorough and engrossing saga packed with information, Breath from Salt is really about the transformative power of hope. It arrives at just the right moment, when too many of us have forgotten what human faith, ingenuity, and relentless determination can accomplish.” 

—Dan Fagin, author of the Pulitzer Prize–winning Toms River

“Beautifully written, Breath from Salt brings to life the amazing story of a passionate community that dared to dream, work together, and take extraordinary risks to bring life-saving treatments to those with cystic fibrosis. Timely and important, the breakthroughs described in this book are likely to accelerate cures for many other genetic diseases.”

—Dr. Preston W. Campbell, former president and CEO of the Cystic Fibrosis Foundation

From the Publisher

09/01/2020

Trivedi is a freelance writer specializing in health and medicine whose work has appeared in Discover and Scientific American, among others. This work is a well-researched, far-reaching story of how genetic discoveries about cystic fibrosis led the way for treatments. It is also a complicated account, as Trivedi has woven stories of children with cystic fibrosis and their families, doctors, and researchers studying the disease to tell of the quest to understand and treat cystic fibrosis. She also profiles philanthropists and national organizations fundraising for more scientific research. The characters, struggles, and roadblocks all come to life, as the author compassionately writes about children and their families, as well as the people dedicated to raising awareness of cystic fibrosis. Providing a nuanced picture of the complexities of negotiating the funding of research and drug development—e.g., a national disease organization trying to work with small research start-ups as well as big drug companies—Trivedi doesn't lose sight of the people who worked together to make treatments for some forms of cystic fibrosis possible. VERDICT An excellent choice for those interested in learning more about medical history, and the process of bringing awareness to chronic illness.—Margaret Henderson, Ramona, CA

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