If you talk only of defeat, expect to lose. If you promise great victories without any basis in fact, expect to be proven wrong. If, however, you put in the work each day to change the world, you may just succeed.
Now if you will allow a moment on my soapbox I want to talk ALS.
For decades the fight against ALS languished. Doctors managed a patients death. ALS organizations carved up the community into my patients (read: donors) and yours. Pharma saw ALS as too risky. And the world knew little of our fight. /2
This instilled a language of defeatism into the fight. Doctors told patients at the 1st appointment there was nothing they could do. We expected drug trials would fail and we settled for leaders who pushed us to leave our estates to their org so we could help future patients. /3
That began to change scientifically in 2011 with genetic discoveries, but the language of our fight remained the same: patients were unheard, doctors defeated, progress ephemeral and public support absent. The narrative we bought into: progress will come in 20 years. /4
That narrative was bullshit. The last 2 years showed that.
Let’s start with treatments. Two treatments are coming before FDA soon, numerous trials are coming online in 2021, and the therapy pipeline is diverse and full and growing every day. /5
Let’s turn to the doctors. They pushed for the creation of a 53 center platform trial, they have discovered dozens of new genes, proteins and biomarkers linked to ALS and the best have begun using EAPs and therapies to fight the disease rather than manage our death. /6
Let’s turn to the patients. They have found their voice—real or synthetic—and pushed every part of the system to be built for and with patient input, to be focused on those alive today and to see us as subject matter experts to be heard, respected and valued in this fight. /7
Let’s turn to pharma. Next year alone they are looking to bring small molecule, ASO, AAV, and immunotherapy treatments to trial. They are seeking out patient input, making OLEs standard, expanding eligibility criteria for trials and placing larger bets in ALS. /8
Let’s turn to the public. A 200 member federal ALS caucus and NIH have helped increase research spending by tens of millions. The caucus introduced 2 critical bills, ACT and PPA, to fix flaws in our system that prevent patients from accessing promising therapies now. /9
The caucus will hopefully deliver SSDI reform after Thanksgiving and will continue to lead the fight to make real 21st century solutions to seemingly intractable problems.
There are those who will criticize this thread pointing out that patients are still denied therapies; /10
Pointing out that there still is no cure, that Congress has not passed critical reforms and that 17 people die every day in the US alone from ALS, including @PQuinnfortheWin today.
They are right—the fight rages on. What they miss though is that for the first time ever: /11
The outcome of the fight against ALS is not preordained. For the first time ever this is not a fight about 20 years from now but about today. About therapies that could impact my fight today, pathways to access today and breakthroughs today. /12
It is because patients, caregivers, advocates, doctors, researchers and yes pharma, pushed ahead, demanded better, and caused good trouble.
Now there are those that defend the old system, old vocabulary and tell us to sit down and shut up. /13
To them I say: don’t tell me what I can’t do nor what hope I can hold in my heart; instead join me in doing the work and changing the world. #EndALS /end
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The last 2 days I’ve watched this video a dozen times, each time thinking about waking up on Nov 4th.
This cycle led to a thread and ask: please share this thread with any undecided voter or D thinking about not voting. It may not sway them, but our future is worth the shot. /1
Let me step back for a minute. In 2008, I met my wife working on the Obama/Biden campaign. I was 28, living on fast food and the sense that I was bending the arc of history.
At 30 we were both working in the White House.
At 33 we moved to Chicago, leaving politics behind. /2
She ran education non-profits. Me, a federal prosecutor focused on cases involving the city’s most violent gangs.
By 37 we had 2 beautiful little girls. I could not have asked for more.
Then, out of the blue, I was diagnosed with ALS and given 6 months to live. /3
Seven years ago today I married @sabrevaya on the Aegean Sea surrounded by the most amazing family and friends. We danced by the water until 3 am, alive in every sense of the word. This is us that day. That perfect, amazing day. /2
The four years that followed were amazing. We built a life in Chicago. Landed our dream jobs and had two beautiful daughters. Sandra pushed me in every way to enjoy life, just see below. I could not have written a better mid-30s if I tried. /3
I could not sleep last night so I stared into the darkness trying to process the last few days. I am a former prosecutor and community organizer. I believe that laws are intended to protect those without power and to constrain those who abuse it.
We have witnessed raw, naked power unleashed against human beings asking to be safe in their daily routines—something I take for granted. We have seen a system militarized and bad actors seeking to foment chaos while those who have seen so much death bravely demand it stop.
Around 3 am I began reading Dr. King’s Letter from Birmingham Jail. I got stuck on this quote: “There comes a time when the cup of endurance runs over and men are no longer willing to be plunged into an abyss of injustice where they experience the bleakness of corroding despair.”
Every headline this morning mentioned possible treatments for COVID. Yet when you read the actual story it quickly pivoted into a binary, "he said-he said" morass.
As someone who has lived the fight for treatments, let me drop some knowledge that I wish was included instead👇
Let me start with a disclaimer: I'm not a doctor. Instead, I'm an ALS patient and advocate who has lived with and fought to update the drug access and discovery system every day since being diagnosed with this 100% terminal disease 2.5 years ago. So I write from that experience.
The drug discovery system in this country is not a binary process where a drug gets approved with a snap of the fingers: instead it is typically a multi-year process with a handful of off-ramps along the way.
Woke up this am to find the sun shining brilliantly. I sipped my coffee and smiled because I get to see another day.
I also thought about how the fight against terminal disease brings out the same feelings as the fight against Corona: anxiety, anger, doubt, distrust, frustration
So, for what it’s worth a few learnings:
1. Lack of information gives false theories power. Focus on finding trusted sources and share them to empower others.
2. Anger at what has not been done is natural—channel it into ways to help you and others cope with this stressful time
3. Find brave groups that are rising to fill the void and support them on social and financially.
4. Take extra care for your friends and family in crisis, we are are brothers and sisters keeper.
5. Thank those on the front lines—all of them—every day.
A few minutes ago I was wandering around a hotel lobby with my cane looking for a bathroom. A woman in her sixties got up from her table in the restaurant and walked over to me. As she approached, she said,
“Sorry, sometimes I’m a over helper. Are you looking for an accessible bathroom?”
I said I was and she gave me directions to one right off the elevator. I thanked her and began to walk to the elevator.
A second later I felt a tap on my shoulder. It was the same woman.
She had gotten back up from her table and said, “Wait one second, I want to check with the front desk to make sure the bathroom is open.”
She sprinted over to the front desk and after a minute came back flashing a thumbs up.