Sound and Fury
The report drew immediate and intense attention. Discussion groups sprang up on the Internet; within weeks, thousands of patients from the United States and elsewhere had got in touch with Huang. First to report the story in print was Jerome Groopman, at the New Yorker, in a profile of Christopher Reeve published on November 10, 2003; he described a range of animal experiments that Reeve was following, including Young’s and especially Ramón-Cueto’s, and gave five paragraphs to the promise of Huang’s work and some of its problems.
In February 2004, in Vancouver, British Columbia, a consortium called the International Campaign for Cures of Spinal Cord Injury Paralysis held a two-day international workshop on clinical trials. Several speakers presented preliminary results of treatments involving drugs. Three spoke of clinical trials involving olfactory ensheathing glial cells, surgically implanted. Mackay-Sim, from Brisbane, described an initial human trial testing the safety of his procedure. He used ensheathing cells from each patient’s own mucosa, purified and grown for six weeks in culture, then injected at 40 small sites in and around the patient’s spinal lesions. Four patients got transplants; four got placebos. His assessments before and afterwards were elaborate and blind, the best in the business so far. Results were not yet in. Lima, from Lisbon, reported that he had treated seven patients by taking portions of their own olfactory mucosae, containing many sorts of cells, and transplanting these directly into spinal-cord lesions. Improvements were minimal, and one patient got worse. Lima used no placebos, and assessments were not blinded.
Huang reported his work – announcing that he had now given fetal-olfactory-ensheathing-cell transplants to more than 300 patients, including a number of Americans and other Westerners. Some patients, Huang said, showed improvements two or three days after the operation, although all experimental evidence said that nerves could not regrow that fast. He had tried no placebos; his assessments were unblinded and were thought rudimentary. He reported no adverse consequences, although with so many cases that was implausible. Follow-up was minimal and never conducted more than a few months after the procedure. The ethical risks were obvious and considerable.
James Guest and Eva Widerstrom-Noga, both physicians working with the Miami Project to Cure Paralysis, attended the Vancouver meeting. They came home with grave reservations; nonetheless, Bunge and her colleagues decided they needed to know more. They invited Huang to come to Miami.
Media attention built. On April 13, the Detroit Free Press ran a story about the Rehabilitation Institute of Michigan, located on the campus of the Detroit Medical Center. The previous fall, the institute had announced it would screen patients for possible operations in China or Portugal. After that, two patients had gone abroad, Robert Smith to Beijing and Erica Nader to Lisbon. While in the United States, Huang had visited the Rehabilitation Institute. Now with a waiting list approaching a hundred, the institute said that in August it would open an outpatient center where applicants would be evaluated and patients returning from China or Portugal would be monitored. The institute was already following up with Smith and Nader, and the newspaper’s account of their progress, though cushioned with language like “steady progress” and “long road to recovery,” was glowing.
That same day, public broadcasting stations aired an hour-long program called “Miracle Cell,” part of the starry-eyed series Innovation. Though it didn’t mention Huang, the program presented Lima’s work in Lisbon, enthusiastically overstating the progress his patients had made, and gave Raisman in London a platform from which to announce his plans for clinical trials. “Miracle Cell” repeatedly confused fetal olfactory ensheathing glial cells with stem cells.
Huang lectured at the Miami Project on May 5, 2004. Guest arranged to visit him for 10 days in July, accompanied by Tie Qian, a physician specializing in physical medicine and rehabilitation with the Miami Veterans Affairs Medical Center who is Chinese and speaks the language.
The second week in June, Tim Johnson, a reporter for the Knight Ridder News Service, filed an article from Beijing about Huang, his hospital, and his claims. It was picked up by a number of papers in the chain, including the Lexington, KY, Herald-Leader and the Miami Herald. On July 30, the Scientist, a weekly magazine of science news and features, carried an article about Huang. The Asian edition of Time ran a similar story from Beijing in its August 16 issue.
On August 27, the Chicago Tribune ran an article by Michael Lev that began, “A Chinese neurosurgeon has been besieged by desperate Americans willing to pay $25,000 for an implant of cells from aborted fetuses, a controversial and scientifically unproven procedure.” The piece was more thorough than most in voicing the uncertainties and reservations about Huang’s claims. Yet febrile publicity and desperate hope were by that time driving the public response. In Lev’s article Huang claimed that he had performed 450 transplants, while the waiting list for his procedure had grown to more than a thousand, including a hundred Americans.