00:00:02.600 --> 00:00:05.350
(waves crashing)

00:00:19.774 --> 00:00:23.112
(car horn blares)

00:00:23.112 --> 00:00:24.750
(motorcyle engine rumbling)

00:00:24.750 --> 00:00:27.275
- [Dr Reddy] Kayte, your
operation would take anywhere

00:00:27.275 --> 00:00:28.108
between 10 to 12 hours.

00:00:28.108 --> 00:00:29.940
It could be longer, depending on

00:00:29.940 --> 00:00:32.122
how difficult the initial
hepatectomy is going to be.

00:00:32.122 --> 00:00:33.600
- [Kayte] Okay.

00:00:33.600 --> 00:00:34.860
- There's a risk of death.

00:00:34.860 --> 00:00:37.322
This is not something
that has been done before.

00:00:37.322 --> 00:00:38.603
Hopefully it should be okay.

00:00:42.870 --> 00:00:44.280
We're going to first
have a good look inside

00:00:44.280 --> 00:00:47.043
and make sure that there's
no other cancer elsewhere.

00:00:47.043 --> 00:00:48.709
Then we will proceed with the transplant.

00:00:48.709 --> 00:00:51.292
(mellow music)

00:00:59.729 --> 00:01:00.911
- [Jake] Quit fucking with it.

00:01:00.911 --> 00:01:03.651
- Baby, it's come unstuck
and it's pulled out.

00:01:03.651 --> 00:01:04.823
I'm trying to push it back in.

00:01:05.820 --> 00:01:08.182
I would like some more tape.

00:01:08.182 --> 00:01:11.942
I don't know why they don't
have plastic tape in this place.

00:01:11.942 --> 00:01:15.359
(mellow music continues)

00:01:29.084 --> 00:01:30.695
- [Cecilia] Jesus loves you.

00:01:30.695 --> 00:01:34.112
(mellow music continues)

00:01:40.577 --> 00:01:43.050
- [Dr. Slavin] Many surgeons
think this is against nature,

00:01:43.050 --> 00:01:43.950
but they're wrong.

00:01:45.395 --> 00:01:46.852
- [Nurse] So you're going off to sleep.

00:01:46.852 --> 00:01:48.240
Okay, sweet dreams. We'll look after you.

00:01:48.240 --> 00:01:51.073
(machine beeping)

00:02:06.888 --> 00:02:10.085
(waves crashing)

00:02:10.085 --> 00:02:13.002
(jet ski rumbling)

00:02:15.002 --> 00:02:17.585
(upbeat music)

00:02:25.242 --> 00:02:28.463
(phone buzzes)

00:02:28.463 --> 00:02:30.046
- Happy 4th to you.

00:02:38.502 --> 00:02:40.710
- You still have time to
purchase a raffle ticket

00:02:40.710 --> 00:02:42.630
for a young lady who has liver cancer

00:02:42.630 --> 00:02:44.220
who works for Bay County.

00:02:44.220 --> 00:02:45.697
Her name is Kayte Hollingsworth.

00:02:45.697 --> 00:02:48.826
$10 tickets and it's a 1980 Rolls Royce.

00:02:48.826 --> 00:02:51.060
And if you don't buy
a ticket, that's okay,

00:02:51.060 --> 00:02:53.843
at least say a prayer for this
young lady and her family.

00:02:54.930 --> 00:02:55.863
We're in the south, you know,

00:02:55.863 --> 00:02:58.773
in the south, you gotta do a
little bit of gospel music.

00:03:00.180 --> 00:03:03.030
Jimmy Talley's here from the
Panama City Fire Department.

00:03:07.829 --> 00:03:09.047
- Hi.

00:03:09.047 --> 00:03:10.100
- [Kayte] Hi. (indistinct).

00:03:13.290 --> 00:03:15.131
If you look at me, I'm healthy.

00:03:15.131 --> 00:03:17.400
It's only if you have a CT scanner

00:03:17.400 --> 00:03:18.903
that you know I have cancer.

00:03:22.410 --> 00:03:25.650
Four years ago, I had just
terrible stomach pain.

00:03:25.650 --> 00:03:27.810
I knew something was very wrong

00:03:27.810 --> 00:03:30.510
and I went to the emergency room.

00:03:30.510 --> 00:03:32.610
While I was there, everything got better

00:03:32.610 --> 00:03:35.940
and I actually considered
leaving the emergency room

00:03:35.940 --> 00:03:38.640
because it felt better
and I didn't wanna go back

00:03:38.640 --> 00:03:40.890
and find out that it was something silly.

00:03:40.890 --> 00:03:45.890
So I told my friend that had
taken me that I wanted to leave

00:03:45.990 --> 00:03:47.850
and she convinced me to stay.

00:03:47.850 --> 00:03:50.580
She said, "You know,
this is the second time

00:03:50.580 --> 00:03:52.625
that you've had really bad
stomach pain in the last week."

00:03:52.625 --> 00:03:55.740
They did an ultrasound
and the doctor came in

00:03:55.740 --> 00:03:58.680
and he's like, "You have a liver tumor,"

00:03:58.680 --> 00:03:59.793
and up to that point, the thought

00:03:59.793 --> 00:04:02.373
of cancer had not even entered my mind.

00:04:05.100 --> 00:04:07.830
A couple of weeks later I found out

00:04:07.830 --> 00:04:11.460
that I had fibrolamellar
hepatocellular carcinoma.,

00:04:11.460 --> 00:04:13.950
something I had never heard of before.

00:04:13.950 --> 00:04:15.480
The first thing I did when I got home

00:04:15.480 --> 00:04:17.700
from the hospital was google fibrolamellar

00:04:17.700 --> 00:04:19.290
to find out what it was.

00:04:19.290 --> 00:04:22.590
- [Presenter] Fibrolamellar
hepatocellular carcinoma.

00:04:22.590 --> 00:04:24.030
- [Presenter 2] A rare cancer of the liver

00:04:24.030 --> 00:04:27.630
that only affects 200
patients worldwide each year.

00:04:27.630 --> 00:04:29.877
- [Presenter 3] 1 in 5
million in the population

00:04:29.877 --> 00:04:32.730
at large, usually kids and young adults.

00:04:32.730 --> 00:04:35.279
Currently there is no direct cure.

00:04:35.279 --> 00:04:39.540
- [Kayte] And the first result
that I had was a case study

00:04:39.540 --> 00:04:43.350
from Japan of a young man who
went to the emergency room.

00:04:43.350 --> 00:04:45.150
They find out they had fibrolamellar.

00:04:45.150 --> 00:04:46.953
Within a couple of days he was dead.

00:04:48.900 --> 00:04:52.860
And I literally went
and I stuck out my lip

00:04:52.860 --> 00:04:55.234
and I looked down and I cried

00:04:55.234 --> 00:04:59.837
like a little child that
has lost their candy bar

00:04:59.837 --> 00:05:03.543
and I just bawled.

00:05:16.359 --> 00:05:19.920
- When Kayte was first
diagnosed, we were about 5 months

00:05:19.920 --> 00:05:21.450
out from being married.

00:05:21.450 --> 00:05:23.793
We've been together for several years,

00:05:24.990 --> 00:05:27.743
but we were not yet married.

00:05:27.743 --> 00:05:30.410
(mellow music)

00:05:54.600 --> 00:05:58.449
Dealing with it, it's been
hard, you know, from day one.

00:05:58.449 --> 00:06:01.830
There's no textbook on her disease.

00:06:01.830 --> 00:06:04.440
So the first chemo she was on,

00:06:04.440 --> 00:06:07.860
it was the easier one
we've had to deal with.

00:06:07.860 --> 00:06:10.320
More recently, the chemos she's been on

00:06:10.320 --> 00:06:11.733
have been more difficult.

00:06:14.010 --> 00:06:15.540
- We've tried everything.

00:06:15.540 --> 00:06:18.030
You know I've done chemo,
I've done surgeries,

00:06:18.030 --> 00:06:19.560
I've done radiation

00:06:19.560 --> 00:06:22.849
and just progressively
got worse and worse.

00:06:22.849 --> 00:06:24.930
And I asked my doctors

00:06:24.930 --> 00:06:27.930
and they said, "I'm sorry,
but we don't have anything

00:06:27.930 --> 00:06:30.600
that is going to cure you."

00:06:30.600 --> 00:06:33.667
They had basically sent me home
to die. I was 23 years old.

00:06:38.662 --> 00:06:41.376
- [Announcer] Kayte
Hollingsworth has to go to India

00:06:41.376 --> 00:06:42.393
in order to get the treatment.

00:06:42.393 --> 00:06:44.940
- Kayte, God bless you.

00:06:44.940 --> 00:06:46.110
- [Announcer] I know I'm
ready for the fireworks.

00:06:46.110 --> 00:06:47.248
Who's ready for the fireworks?

00:06:47.248 --> 00:06:49.527
(audience cheering and clapping)

00:06:49.527 --> 00:06:53.755
- [Kayte] For a while I was
really in a sad mindset,

00:06:53.755 --> 00:06:56.790
(fireworks crackling)

00:06:56.790 --> 00:07:00.655
but right before Thanksgiving
last year, all that changed.

00:07:00.655 --> 00:07:05.655
(audience cheering)
(fireworks crackling)

00:07:10.890 --> 00:07:12.960
- [Cecilia] It's amazing
how it all happened.

00:07:12.960 --> 00:07:14.460
You know somebody who knows somebody

00:07:14.460 --> 00:07:16.260
who knows somebody is basically

00:07:16.260 --> 00:07:19.683
how this came to be in Kayte's life.

00:07:20.790 --> 00:07:22.560
- Hi, my name is Kayte Hollingsworth.

00:07:22.560 --> 00:07:25.410
I live here in Panama City,
Florida with my husband Jake

00:07:25.410 --> 00:07:26.970
and our two dogs and a cat.

00:07:26.970 --> 00:07:29.100
I can only find a few
people on the internet

00:07:29.100 --> 00:07:32.193
who are still fighting, who
are still alive to fight.

00:07:33.930 --> 00:07:35.310
And then I was added

00:07:35.310 --> 00:07:37.780
to the Facebook
fibrolamellar support group

00:07:39.240 --> 00:07:41.140
and that's how I met this friend, Tal.

00:07:42.660 --> 00:07:45.330
- [Tal] When I was first
told that I was terminal,

00:07:45.330 --> 00:07:47.520
I felt like I was being
kind of put out to pasture.

00:07:47.520 --> 00:07:49.140
I was being put in this box

00:07:49.140 --> 00:07:53.460
and they're gonna very humanely, you know,

00:07:53.460 --> 00:07:58.460
make me feel comfortable as my life ends.

00:07:59.760 --> 00:08:02.580
When people who know me and have any sense

00:08:02.580 --> 00:08:05.010
of what I've been through have someone

00:08:05.010 --> 00:08:07.650
in their lives, they get
sick, they often will call me

00:08:07.650 --> 00:08:10.260
and I'll tell him to talk to Howard.

00:08:10.260 --> 00:08:12.983
I wouldn't be alive today if
it wasn't for Howard Simons.

00:08:26.386 --> 00:08:27.219
(phone ringing)

00:08:27.219 --> 00:08:29.433
- Good morning, this is Howard Simons.

00:08:30.320 --> 00:08:31.290
(phone ringing)

00:08:31.290 --> 00:08:32.123
Good morning.

00:08:32.123 --> 00:08:34.410
Hello. What is the symptom?

00:08:34.410 --> 00:08:35.943
So what's your symptom?

00:08:38.400 --> 00:08:40.263
But let me look it up online, okay?

00:08:43.650 --> 00:08:46.620
Hello sir? Right, so you just pull it out

00:08:46.620 --> 00:08:49.529
and then you put it
straight into the new one.

00:08:49.529 --> 00:08:52.503
Does it work in broil? Or it
doesn't work in bake or broil?

00:08:56.700 --> 00:09:00.510
Oh, okay, it doesn't light
up or anything? Okay.

00:09:00.510 --> 00:09:03.660
Hello, this is Howard Simons
from appliancetimers.com.

00:09:03.660 --> 00:09:05.670
I'm just returning your call.

00:09:05.670 --> 00:09:08.310
As a human being, I have
a general policy of trying

00:09:08.310 --> 00:09:11.456
to help people who call me.

00:09:11.456 --> 00:09:12.990
And so they could call me up,

00:09:12.990 --> 00:09:15.930
it doesn't matter what it is, right?

00:09:15.930 --> 00:09:17.610
Just a minute, please.

00:09:17.610 --> 00:09:18.900
Most of my life,

00:09:18.900 --> 00:09:22.200
I never had any particular
interest in medicine.

00:09:22.200 --> 00:09:25.380
In the medical world, I'm a nobody,

00:09:25.380 --> 00:09:27.123
completely uncredentialed person.

00:09:27.983 --> 00:09:31.470
I have an appliance timers
rebuilding business in Toronto.

00:09:31.470 --> 00:09:32.760
Do you have a separate touch pad

00:09:32.760 --> 00:09:34.503
or is it integral to the board?

00:09:38.550 --> 00:09:41.240
Originally when I started
doing it, it was because 10

00:09:41.240 --> 00:09:44.250
or 11 years ago, a friend
of mine was diagnosed

00:09:44.250 --> 00:09:46.353
with acute myelogenous leukemia.

00:09:48.750 --> 00:09:53.070
Basically my friend was dying,
so I started doing research.

00:09:53.070 --> 00:09:55.083
I always have enjoyed problem solving,

00:09:55.083 --> 00:09:58.440
so it was just sort of a
thought, well, let me see

00:09:58.440 --> 00:09:59.760
if I can help him out.

00:09:59.760 --> 00:10:04.622
Now this coincided with the
ease of research provided

00:10:04.622 --> 00:10:06.398
by the internet

00:10:06.398 --> 00:10:08.970
so this allowed me to
read journal articles

00:10:08.970 --> 00:10:10.020
and things online.

00:10:10.020 --> 00:10:12.813
Of course, in the past this
would've been impossible.

00:10:13.710 --> 00:10:17.220
My friend had a particular
mutation in his leukemia

00:10:17.220 --> 00:10:20.595
and, you know, I had
noticed there was a drug

00:10:20.595 --> 00:10:23.306
which got approved for kidney cancer.

00:10:23.306 --> 00:10:26.070
And so I thought, oh well
now that it's approved

00:10:26.070 --> 00:10:29.190
for kidney cancer, it could be
used off label for leukemia.

00:10:29.190 --> 00:10:31.080
So I contacted my friend's wife

00:10:31.080 --> 00:10:33.360
to suggest that she ask the doctor

00:10:33.360 --> 00:10:35.007
and then he said, "Yeah,
it looks like a good idea.

00:10:35.007 --> 00:10:36.900
You should try it."

00:10:36.900 --> 00:10:39.041
At that point, I realized
that it's obviously not

00:10:39.041 --> 00:10:42.120
that difficult to come
up with decent ideas

00:10:42.120 --> 00:10:44.790
that these guys haven't thought of, right?

00:10:44.790 --> 00:10:47.808
So I figured, well this is something

00:10:47.808 --> 00:10:48.641
that, you know, maybe I
could achieve something

00:10:48.641 --> 00:10:50.729
in this area.

00:10:50.729 --> 00:10:53.396
(phone ringing)

00:10:55.235 --> 00:10:56.460
Good morning.

00:10:56.460 --> 00:10:58.320
- [Tal] A lot of people
might wonder how you come

00:10:58.320 --> 00:11:01.680
to trust the advice of this outsider.

00:11:01.680 --> 00:11:04.740
You know, he's not a
doctor, he is not a PhD.

00:11:04.740 --> 00:11:06.436
- [Howard] Have you tried
to get the wiring diagram?

00:11:06.436 --> 00:11:08.910
- [Tal] But, you know,
when he tells you something

00:11:08.910 --> 00:11:10.830
and you're not quite
sure, he'll just tell you,

00:11:10.830 --> 00:11:12.750
well, if you want to look at it yourself,

00:11:12.750 --> 00:11:13.920
this is where I got it from

00:11:13.920 --> 00:11:16.620
and these are articles in peer
reviewed medical journals,

00:11:16.620 --> 00:11:18.750
which I think the doctors
are supposed to read.

00:11:18.750 --> 00:11:19.920
And I don't know, sometimes maybe

00:11:19.920 --> 00:11:20.753
they don't have enough time,

00:11:20.753 --> 00:11:24.180
but I don't know where Howard
finds the time, but he does.

00:11:24.180 --> 00:11:25.617
- I enjoy doing it

00:11:25.617 --> 00:11:28.530
and I think of it as my job,
even though it's, you know,

00:11:28.530 --> 00:11:31.170
I don't get paid or anything,
but it's just what I do.

00:11:31.170 --> 00:11:36.153
You know, what I do for
a not living, right?

00:11:39.570 --> 00:11:40.620
- [Tal] And guess what?

00:11:40.620 --> 00:11:42.903
I'm not the only time
that he saved somebody.

00:11:46.922 --> 00:11:47.755
- [Stephanie] You know,
when you're diagnosed

00:11:47.755 --> 00:11:50.190
with stage four pancreatic cancer

00:11:50.190 --> 00:11:52.260
and you have to tell your
children that you're not going

00:11:52.260 --> 00:11:53.260
to live this summer,

00:11:54.750 --> 00:11:57.900
you will do everything
possible to survive.

00:11:57.900 --> 00:11:59.940
- [Howard] Stephanie, she heard about me

00:11:59.940 --> 00:12:02.160
through a mutual friend.

00:12:02.160 --> 00:12:05.703
- I phoned Howard, he
gets the basic information

00:12:05.703 --> 00:12:07.800
and he calls me back in 20 minutes

00:12:07.800 --> 00:12:12.180
and he says, "I've just
spoken to a surgeon in London

00:12:12.180 --> 00:12:14.680
and I've just spoken to
Kjell Oberg in Sweden

00:12:15.645 --> 00:12:18.447
and they're interested
and they want your files."

00:12:19.800 --> 00:12:24.183
And I remember thinking, oh
my god, this guy's a nut.

00:12:25.230 --> 00:12:29.286
So I said to Howard, "Howard,
if you don't mind me asking,

00:12:29.286 --> 00:12:31.617
why are these doctors talking to you?"

00:12:33.360 --> 00:12:36.870
And he said, "I have
their cell phone number

00:12:36.870 --> 00:12:39.057
and I call them and they take my call."

00:12:41.970 --> 00:12:45.570
- The thing is that doctors
are highly specialized.

00:12:45.570 --> 00:12:48.600
If you're professional, then
you have a particular job

00:12:48.600 --> 00:12:49.650
and you have to do that

00:12:49.650 --> 00:12:50.790
but that doesn't matter to me

00:12:50.790 --> 00:12:53.043
because I do whatever I want, right?

00:12:54.180 --> 00:12:56.520
If you wanna cure
cancer, you have to think

00:12:56.520 --> 00:12:58.620
of all the characteristics of cancer,

00:12:58.620 --> 00:13:01.380
all of the way cancer
can avoid getting killed

00:13:01.380 --> 00:13:04.920
and then you have to think of
the biological characteristics

00:13:04.920 --> 00:13:08.160
of the cancer and then
look for the solutions.

00:13:08.160 --> 00:13:11.253
You have to think about
everything all the time.

00:13:12.240 --> 00:13:15.960
The prognosis is utterly
dismal for this patient.

00:13:15.960 --> 00:13:19.230
No one can argue that
there's any decent idea

00:13:19.230 --> 00:13:22.500
for treating such a person, right?

00:13:22.500 --> 00:13:24.660
In the case of Kayte,

00:13:24.660 --> 00:13:27.570
because she has a liver full of cancer,

00:13:27.570 --> 00:13:30.360
she really should have
a completely new liver.

00:13:30.360 --> 00:13:33.030
Unfortunately, surgeons are not allowed

00:13:33.030 --> 00:13:35.733
to give a liver transplant
in this case, right?

00:13:37.200 --> 00:13:39.030
- [Dr Fuchs] The real
problem with transplantation

00:13:39.030 --> 00:13:42.540
for fibrolamellar is that
there are cancer cells lurking

00:13:42.540 --> 00:13:44.290
in the body outside of the liver

00:13:45.300 --> 00:13:47.853
and that's not gonna be
fixed with the transplant.

00:13:49.740 --> 00:13:52.890
Right now in medical centers,
the standard treatment

00:13:52.890 --> 00:13:54.930
after a liver transplantation is

00:13:54.930 --> 00:13:57.990
that something has to be done
to prevent organ rejection

00:13:57.990 --> 00:14:00.480
because the immune
system does not recognize

00:14:00.480 --> 00:14:02.640
and then wants to attack the liver.

00:14:02.640 --> 00:14:04.140
So, these patients are

00:14:04.140 --> 00:14:07.830
on lifelong immunosuppressive
drugs to prevent rejection.

00:14:07.830 --> 00:14:09.630
The fundamental problem is that

00:14:09.630 --> 00:14:12.390
if the patient is on
lifelong immunosuppression,

00:14:12.390 --> 00:14:15.120
the drugs will suppress the
ability of the immune system

00:14:15.120 --> 00:14:17.910
to fight any cancer outside the liver

00:14:17.910 --> 00:14:20.673
and the risk of the cancer
coming back is high.

00:14:22.110 --> 00:14:24.030
- Hi, my name is Kayte Hollingsworth.

00:14:24.030 --> 00:14:25.980
I live here in Panama City, Florida

00:14:25.980 --> 00:14:28.710
with my husband Jake and
our two dogs and a cat.

00:14:28.710 --> 00:14:31.470
- There's certain things that
bother me more than anything,

00:14:31.470 --> 00:14:34.020
one of which is people

00:14:34.020 --> 00:14:36.870
who believe that things are
true because of authority.

00:14:36.870 --> 00:14:39.330
- Right now, doctors don't have a cure.

00:14:39.330 --> 00:14:42.060
So what we do is we'll try one chemo

00:14:42.060 --> 00:14:44.997
and once that chemo stops
working, we'll go on to the next.

00:14:44.997 --> 00:14:46.533
The problem is eventually we know

00:14:46.533 --> 00:14:49.470
that all the chemos will stop working.

00:14:49.470 --> 00:14:51.450
- [Howard] There's a
very conservative culture

00:14:51.450 --> 00:14:56.013
that's endemic in this whole
process with Kayte, you know.

00:14:57.960 --> 00:15:00.144
- It's terrifying to feel so alone

00:15:00.144 --> 00:15:03.090
and feel like you have this
rare freak of nature cancer

00:15:03.090 --> 00:15:05.020
that no one knows anything about,

00:15:05.020 --> 00:15:06.743
the doctors don't know anything about.

00:15:07.920 --> 00:15:11.460
And so last year, one of the
hospitals gave me a bottle

00:15:11.460 --> 00:15:15.030
of 240 Percocet that the
doctor had sent me home

00:15:15.030 --> 00:15:15.863
to die with.

00:15:17.604 --> 00:15:19.890
At that point I made the decision,

00:15:19.890 --> 00:15:22.473
the doctors are not in
control, I'm in control.

00:15:28.590 --> 00:15:30.140
- [Howard] Oh, hi, how are you?

00:15:31.020 --> 00:15:31.853
- [Kayte] When he answered his phone.

00:15:31.853 --> 00:15:33.660
I've never met anyone like him.

00:15:33.660 --> 00:15:34.885
- [Howard] You induce tolerance

00:15:34.885 --> 00:15:36.240
with the bone marrow transplant.

00:15:36.240 --> 00:15:38.700
Because of that, the cancer
doesn't have the chance

00:15:38.700 --> 00:15:41.850
to metastasize anywhere else, right?

00:15:41.850 --> 00:15:44.280
- [Kayte] The amazing thing
is Howard can explain it to me

00:15:44.280 --> 00:15:45.488
to the point where I actually understand

00:15:45.488 --> 00:15:47.550
what he's talking about.

00:15:47.550 --> 00:15:50.703
That sort of makes the scary
things not quite seem so scary.

00:15:51.660 --> 00:15:54.630
- But this approach
could be highly effective

00:15:54.630 --> 00:15:58.410
with anti-tumor effect from
the bone marrow transplant.

00:15:58.410 --> 00:16:02.543
My idea for Kayte, something
that was never done before

00:16:02.543 --> 00:16:06.130
is essentially a liver
transplant from a living donor

00:16:07.409 --> 00:16:11.370
combined with a bone marrow
transplant from that same donor,

00:16:11.370 --> 00:16:13.980
which is like moving the
immune system from one person

00:16:13.980 --> 00:16:15.720
to another person

00:16:15.720 --> 00:16:19.353
and therefore the patient
becomes tolerant to the organ.

00:16:21.146 --> 00:16:24.090
And that is critical for two reasons.

00:16:24.090 --> 00:16:26.160
First of all, tolerance to the liver

00:16:26.160 --> 00:16:27.930
gets rid of the permanent need

00:16:27.930 --> 00:16:29.793
for immunosuppressive drugs.

00:16:30.900 --> 00:16:33.930
And the second thing is that bone marrow

00:16:33.930 --> 00:16:36.750
from a different person
provides a new immune system,

00:16:36.750 --> 00:16:40.380
which then also has the
capacity to kill cancer cells

00:16:40.380 --> 00:16:41.670
that might be outside of the organ

00:16:41.670 --> 00:16:42.970
that you're transplanting,

00:16:44.460 --> 00:16:46.500
which would protect against relapse

00:16:46.500 --> 00:16:49.533
and essentially completely
cure the person,

00:16:51.270 --> 00:16:53.430
and not only for fibrolamellar,

00:16:53.430 --> 00:16:57.213
theoretically all kinds of
other types of cancer, right?

00:16:58.050 --> 00:17:01.588
Now, if we can prove this
procedure to be effective,

00:17:01.588 --> 00:17:04.860
this approach could actually, you know,

00:17:04.860 --> 00:17:08.973
cure a very substantial number of people.

00:17:13.107 --> 00:17:16.650
- [Kayte] And so like my mind
is blown, I'm taking notes

00:17:16.650 --> 00:17:19.159
but I just had that sensation of like,

00:17:19.159 --> 00:17:21.273
This is it, this is what
I've been waiting for.

00:17:22.680 --> 00:17:24.090
- [Jake] They talked for hours.

00:17:24.090 --> 00:17:26.847
You know, I just asked her
like, "Who was that guy?"

00:17:27.897 --> 00:17:30.900
And she just said, "It's
one of Tal's friends."

00:17:30.900 --> 00:17:33.319
And I was like, "Is he a
doctor?" And she said "No."

00:17:33.319 --> 00:17:35.115
I said, "Well, he sounded
like he knew more than any

00:17:35.115 --> 00:17:37.170
of your doctors you've had."

00:17:37.170 --> 00:17:38.217
She said, "He did."

00:17:42.363 --> 00:17:45.113
(ducks quacking)

00:17:50.249 --> 00:17:52.749
(dog yelping)

00:18:00.055 --> 00:18:01.910
- [Robert] For my little girl,

00:18:01.910 --> 00:18:04.133
there's been such a
paradigm block about a cure.

00:18:05.130 --> 00:18:06.933
The tried and true methods don't work.

00:18:08.280 --> 00:18:09.753
The irony of the situation is

00:18:09.753 --> 00:18:14.753
that someone whose medical
background came from his desire

00:18:14.847 --> 00:18:17.260
to learn about the immune system

00:18:18.270 --> 00:18:19.680
and listening to Howard,

00:18:19.680 --> 00:18:23.160
I swear I thought he wrote
all the medical journals.

00:18:23.160 --> 00:18:27.963
Sometimes somebody with an idea
can change the whole world.

00:18:30.090 --> 00:18:31.680
- Most of the people I help are, you know,

00:18:31.680 --> 00:18:33.390
like stage four cancer patients

00:18:33.390 --> 00:18:35.590
who have been told
there's nothing for them.

00:18:36.657 --> 00:18:40.380
In such a case, you know, you have

00:18:40.380 --> 00:18:42.723
to do something that's unproven.

00:18:43.740 --> 00:18:46.161
But because of the very
restrictive authority

00:18:46.161 --> 00:18:49.863
of the idea of something
called evidence-based medicine,

00:18:51.030 --> 00:18:53.580
it is extremely difficult to get people

00:18:53.580 --> 00:18:55.950
to do something that's unproven.

00:18:55.950 --> 00:18:58.290
But I believe in medicine-based evidence,

00:18:58.290 --> 00:18:59.763
not evidence-based medicine.

00:19:03.030 --> 00:19:04.560
- Honestly, one of the biggest things

00:19:04.560 --> 00:19:06.390
to make this happen is Howard

00:19:06.390 --> 00:19:09.556
and his philosophy about
calling people he's never met.

00:19:09.556 --> 00:19:11.160
(bicycle bell rings)

00:19:11.160 --> 00:19:14.280
He has the guts to call
the world's top doctors

00:19:14.280 --> 00:19:16.383
as if he's a, you know, peer to peer.

00:19:18.210 --> 00:19:19.380
- I don't see any reason

00:19:19.380 --> 00:19:21.660
why an intelligent person wouldn't want

00:19:21.660 --> 00:19:23.193
to discuss a good idea.

00:19:24.060 --> 00:19:25.770
What I did was I got on the phone

00:19:25.770 --> 00:19:28.470
and got two of the best
doctors in the world to do it.

00:19:31.251 --> 00:19:33.690
The first time I spoke to
Slavin, he was the head

00:19:33.690 --> 00:19:36.763
of bone marrow transplantation
at Hadassah at the time.

00:19:36.763 --> 00:19:37.800
I didn't have his phone number

00:19:37.800 --> 00:19:40.140
so I found Hadassah's phone number.

00:19:40.140 --> 00:19:43.350
I phoned up their switchboard
and I asked to speak to him

00:19:43.350 --> 00:19:45.682
and they put me through to his cell phone.

00:19:45.682 --> 00:19:47.280
(phone buzzing)

00:19:47.280 --> 00:19:48.675
Dr. Slavin is perhaps the

00:19:48.675 --> 00:19:52.530
most creative bone marrow
transplant doctor in the world.

00:19:52.530 --> 00:19:54.451
I said, "Hello, Dr. Slavin, I have an idea

00:19:54.451 --> 00:19:56.683
that I want to discuss with you."

00:19:56.683 --> 00:19:58.110
Didn't even tell him my name.

00:19:58.110 --> 00:20:00.494
I was a random human being.

00:20:00.494 --> 00:20:01.710
- [Dr Slavin] Howard is very smart.

00:20:01.710 --> 00:20:04.590
He's read all my papers
and he knows them by heart.

00:20:04.590 --> 00:20:07.327
- And then I said, "You
know, the liver cancer ...

00:20:07.327 --> 00:20:08.190
Wouldn't it be a good idea

00:20:08.190 --> 00:20:10.200
to transplant the liver
and induce tolerance

00:20:10.200 --> 00:20:12.605
with the bone marrow transplant
from the same donor?"

00:20:12.605 --> 00:20:14.880
He said, "Absolutely, it should
be done with all organs."

00:20:14.880 --> 00:20:19.077
And we had this whole
tolerance induction festivity.

00:20:21.840 --> 00:20:22.860
Now I should mention

00:20:22.860 --> 00:20:26.250
that people had been writing
about inducing tolerance

00:20:26.250 --> 00:20:29.490
with bone marrow for a
long time, mostly Slavin.

00:20:29.490 --> 00:20:32.580
So in that respect, what I
came up with wasn't original.

00:20:32.580 --> 00:20:35.640
The only thing that was truly
original about my idea was

00:20:35.640 --> 00:20:38.340
using it as a treatment for liver cancer.

00:20:38.340 --> 00:20:39.173
Good bye.

00:20:40.050 --> 00:20:43.320
And actually this was before
I knew anything about Kayte.

00:20:43.320 --> 00:20:46.912
It was strictly just playing
with ideas in my mind.

00:20:46.912 --> 00:20:49.740
Then several years later when I heard

00:20:49.740 --> 00:20:51.510
from Tal about her condition,

00:20:51.510 --> 00:20:54.510
I thought that it sounded
like she might be a candidate.

00:20:54.510 --> 00:20:56.910
So this was just serendipitous anyway.

00:20:56.910 --> 00:20:59.110
It wasn't like I was
out looking for people.

00:21:00.780 --> 00:21:04.260
When I phoned Slavin, he
couldn't care less who I was.

00:21:04.260 --> 00:21:08.520
He heard an idea and he liked
it. But that's very rare.

00:21:08.520 --> 00:21:10.744
He's probably the only person
I've ever met like that

00:21:10.744 --> 00:21:12.213
to that extent.

00:21:16.950 --> 00:21:18.780
- [Dr Slavin] If I keep
doing what everybody's doing,

00:21:18.780 --> 00:21:20.520
if I know ahead of time, it'll fail,

00:21:20.520 --> 00:21:21.970
there will never be progress.

00:21:25.230 --> 00:21:27.990
I went to college to study medicine

00:21:27.990 --> 00:21:30.573
and I always dream about curing cancer.

00:21:31.740 --> 00:21:33.780
Oncology at that time was based

00:21:33.780 --> 00:21:36.090
on the concept, the more, the better,

00:21:36.090 --> 00:21:39.210
more radiation, the better,
more chemotherapy, the better.

00:21:39.210 --> 00:21:44.040
And I thought if that cured
patients, fine, but it doesn't.

00:21:44.040 --> 00:21:45.630
So I thought instead of trying

00:21:45.630 --> 00:21:48.240
to do more dangerous hazardous procedures,

00:21:48.240 --> 00:21:50.043
I'd rather do smarter procedures.

00:21:50.940 --> 00:21:53.520
So all my life I come up with ideas

00:21:53.520 --> 00:21:55.470
that are outside the box.

00:21:55.470 --> 00:21:59.010
Unfortunately, in general,
doctors are very resistant

00:21:59.010 --> 00:22:00.240
to new ideas.

00:22:00.240 --> 00:22:02.430
They just like to do what
somebody else is doing,

00:22:02.430 --> 00:22:04.121
what the textbook says.

00:22:04.121 --> 00:22:05.550
It is surprising.

00:22:05.550 --> 00:22:06.600
I mean, you go for example

00:22:06.600 --> 00:22:09.521
to American Society of Clinical Oncology.

00:22:09.521 --> 00:22:11.880
The auditoriums are full like ants

00:22:11.880 --> 00:22:15.690
and you ask yourself,
what is new? Very little.

00:22:15.690 --> 00:22:18.720
They ask you to prove before
you do the first patient.

00:22:18.720 --> 00:22:22.260
But you must do it in
order to see that it works.

00:22:22.260 --> 00:22:25.072
So many years later, cancer remains one

00:22:25.072 --> 00:22:28.380
of the leading causes of death worldwide.

00:22:28.380 --> 00:22:30.303
For me, this is war.

00:22:32.157 --> 00:22:35.340
- [Dr Fuchs] Dr. Slavin,
he's one of the true pioneers

00:22:35.340 --> 00:22:37.200
in bone marrow transplants.

00:22:37.200 --> 00:22:40.530
He's published a lot of important papers.

00:22:40.530 --> 00:22:42.600
But the thing is, is that now he does sort

00:22:42.600 --> 00:22:44.430
of tailored therapies for patients

00:22:44.430 --> 00:22:46.854
and people that are in
traditional medicine sort of say

00:22:46.854 --> 00:22:48.720
"He's off the reservation now,"

00:22:48.720 --> 00:22:51.060
you know; "He's a quack
now," or something like that.

00:22:51.060 --> 00:22:52.560
I don't think so.

00:22:52.560 --> 00:22:55.470
If somebody with a bright idea comes up

00:22:55.470 --> 00:22:57.390
with a treatment that could work

00:22:57.390 --> 00:22:59.190
and I think that's not unreasonable.

00:23:02.280 --> 00:23:05.130
- So as you can see,
it's a complex program.

00:23:05.130 --> 00:23:07.710
If the patient accepts bone marrow cells

00:23:07.710 --> 00:23:11.100
from the donor, he becomes
tolerant of the liver.

00:23:11.100 --> 00:23:14.760
The other element which is
maybe even more interesting is

00:23:14.760 --> 00:23:16.440
to use somebody else's immune system

00:23:16.440 --> 00:23:17.643
to fight against cancer.

00:23:19.290 --> 00:23:23.160
- [Tal] The second part of
this plan was actually one

00:23:23.160 --> 00:23:25.230
of the things that Howard arranged for me.

00:23:25.230 --> 00:23:27.660
In my case, there was no liver transplant

00:23:27.660 --> 00:23:30.553
'cause they were able to
remove all the tumors from it.

00:23:30.553 --> 00:23:34.529
But I still probably had
cancer outside the liver.

00:23:34.529 --> 00:23:38.160
So I was given donor immune
cells from my brother

00:23:38.160 --> 00:23:40.233
by Professor Slavin in Tel Aviv,

00:23:41.280 --> 00:23:44.130
basically getting my
brother's immune system

00:23:44.130 --> 00:23:48.123
and my immune system to cooperate
for a time to kill cancer.

00:23:49.050 --> 00:23:51.950
- [Slavin] This is like
biological warfare against cancer.

00:23:53.040 --> 00:23:57.989
- For Kayte, we need someone
who's DNA at least half matched

00:23:57.989 --> 00:24:02.160
because the closer the match
is, the more likely you are

00:24:02.160 --> 00:24:05.343
to be able to induce tolerance.

00:24:12.405 --> 00:24:14.988
(upbeat guitar music)

00:24:27.600 --> 00:24:30.510
- One of the worst things
about this surgery is

00:24:30.510 --> 00:24:34.143
we need a living donor and it
has to be one of my brothers.

00:24:43.020 --> 00:24:43.950
- [Robert] Y'all are going
to be a little bit more

00:24:43.950 --> 00:24:46.680
than brothers and sisters after this.

00:24:46.680 --> 00:24:48.918
- That's why I'm so stressed out.

00:24:48.918 --> 00:24:52.710
I've spent hours and hours
googling medical journals

00:24:52.710 --> 00:24:55.230
and I had to do a lot
of looking inside myself

00:24:55.230 --> 00:24:59.070
and asking myself, can I ask
my brothers to risk their life?

00:24:59.070 --> 00:25:03.970
Press it, it records.
See if I can fix this.

00:25:03.970 --> 00:25:06.268
Took a while to get up here
and I stepped on a thorn

00:25:06.268 --> 00:25:08.008
and it hurt. A lot.

00:25:10.808 --> 00:25:12.658
Getting a bit dark, but I don't care.

00:25:13.620 --> 00:25:15.729
Do you know what I dreamed last night?

00:25:15.729 --> 00:25:17.010
I always wanted to be something.

00:25:17.010 --> 00:25:18.410
I always said I wanted be "they".

00:25:18.410 --> 00:25:19.581
He would always say, "Oh they do this."

00:25:19.581 --> 00:25:22.707
You know, "They're in
control," like "They do that."

00:25:22.707 --> 00:25:25.457
And I always like, "Who is
they?" like "I wanna be they."

00:25:26.790 --> 00:25:29.610
When I was in college, I took psychology

00:25:29.610 --> 00:25:33.780
because I wanted to be like
a behavioral therapist.

00:25:33.780 --> 00:25:35.250
I was planning on going to graduate school

00:25:35.250 --> 00:25:36.790
and possibly get my PhD

00:25:37.830 --> 00:25:40.200
and I wanted to get
married and have babies.

00:25:40.200 --> 00:25:41.283
I wanted everything.

00:25:42.312 --> 00:25:44.412
It's gonna be cool.
Watch! Really! Seriously!

00:25:46.586 --> 00:25:47.807
- [Robert] I see you, Kayte.

00:25:48.750 --> 00:25:50.880
Since she was a small child,

00:25:50.880 --> 00:25:54.213
she has been very independent
and very strong-willed.

00:25:55.110 --> 00:25:58.263
- [Mom] She was the child that
always looked for a solution.

00:25:59.251 --> 00:26:03.237
- And she always said,
"I'll do it myself."

00:26:05.550 --> 00:26:08.682
Even one time, she was
about maybe two years old,

00:26:08.682 --> 00:26:10.980
she stepped off the
dock, went in the water

00:26:10.980 --> 00:26:13.320
and all you could see were
the little eyes shining.

00:26:13.320 --> 00:26:15.120
She was probably that far under water.

00:26:15.120 --> 00:26:17.460
I jumped in, got her out

00:26:17.460 --> 00:26:21.150
and by George, she was
upset because I helped her.

00:26:21.150 --> 00:26:23.217
She looked at me straight in the eye

00:26:23.217 --> 00:26:25.977
and said, "Dada, you're
going to pay for this."

00:26:27.630 --> 00:26:30.813
- Growing up my sister was
really not afraid of anything.

00:26:32.070 --> 00:26:34.627
I think that's just her
base of her personality.

00:26:34.627 --> 00:26:36.197
Hi, Kayte.

00:26:37.350 --> 00:26:40.083
She's always found ways
to do things for herself,

00:26:41.310 --> 00:26:44.523
but if I found out I was
a match for the surgery,

00:26:45.390 --> 00:26:48.466
I'll jump up on the
kitchen table, do it now.

00:26:48.466 --> 00:26:50.160
- [Joseph] She's my big sister.

00:26:50.160 --> 00:26:52.740
She's the strongest person I've ever met.

00:26:52.740 --> 00:26:54.390
She took care of me.

00:26:54.390 --> 00:26:55.740
She's done that our entire life.

00:26:55.740 --> 00:26:57.440
She would fight any battle for me.

00:27:01.206 --> 00:27:05.010
- I had a dream last week
where I was a fly on the wall

00:27:05.010 --> 00:27:07.021
and my little brother was on a blind date

00:27:07.021 --> 00:27:10.530
and the girl asked him
if he had any siblings

00:27:10.530 --> 00:27:12.197
and he said, "I have a brother

00:27:12.197 --> 00:27:15.117
and I had a sister but she died."

00:27:16.380 --> 00:27:19.140
And then I woke up

00:27:19.140 --> 00:27:22.323
and still, anytime I
think about that dream,

00:27:25.014 --> 00:27:26.280
it makes me wanna hold on

00:27:26.280 --> 00:27:29.010
and make sure I do
everything I can to stay here

00:27:29.010 --> 00:27:33.990
because I saw a look of pain in his face,

00:27:33.990 --> 00:27:36.769
that I never, never want to see.

00:27:36.769 --> 00:27:39.436
(ominous music)

00:28:00.374 --> 00:28:03.420
- [Dr Rela] Yeah go on,
tell me about the patient.

00:28:03.420 --> 00:28:04.980
Tell me from the beginning.

00:28:04.980 --> 00:28:08.250
I was very excited when
Professor Slavin contacted me

00:28:08.250 --> 00:28:09.524
and said I have a patient.

00:28:09.524 --> 00:28:10.530
- [Dr Slavin] Okay.

00:28:10.530 --> 00:28:12.960
I met Rela before in England.

00:28:12.960 --> 00:28:15.810
At that time, we talked
about tolerance induction.

00:28:15.810 --> 00:28:18.810
- We both wanted to do
something for many years.

00:28:18.810 --> 00:28:21.905
And finally with this patient,
everything came together.

00:28:21.905 --> 00:28:22.738
Well done.

00:28:22.738 --> 00:28:23.571
- Bye-bye.

00:28:26.700 --> 00:28:29.100
- There are many different
people in our profession.

00:28:29.100 --> 00:28:31.477
Some just do it as a job

00:28:31.477 --> 00:28:35.520
and there are some who
are constantly pushing.

00:28:35.520 --> 00:28:37.170
For whatever reason, I've always wanted

00:28:37.170 --> 00:28:39.333
to make a difference in the world.

00:28:42.051 --> 00:28:44.790
- [Announcer 2] Dr. Rela
has found a place of honor

00:28:44.790 --> 00:28:46.650
in the Guinness Book of World Records,

00:28:46.650 --> 00:28:50.640
having performed a transplant
on a five day old baby.

00:28:50.640 --> 00:28:54.060
- I came to the UK in 1985

00:28:54.060 --> 00:28:57.300
and at that time, I was
very frustrated with India.

00:28:57.300 --> 00:28:59.070
I didn't think I was progressing enough

00:28:59.070 --> 00:29:02.430
and I never thought I
would return back to India

00:29:02.430 --> 00:29:04.672
- [Announcer 2] Global
hospitals in India, pioneers

00:29:04.672 --> 00:29:07.230
in the field of organ transplant.

00:29:07.230 --> 00:29:10.650
The mission is spearheaded
by Professor Mohamed Rela.

00:29:10.650 --> 00:29:12.090
Dr. Rela in effect

00:29:12.090 --> 00:29:15.210
initiated the living donor
liver transplant program

00:29:15.210 --> 00:29:17.580
at King's College, London.

00:29:17.580 --> 00:29:21.870
- But in 2009, I started
a transplant program there

00:29:21.870 --> 00:29:24.240
because now there's a huge opportunity

00:29:24.240 --> 00:29:26.190
to be very innovative in India

00:29:26.190 --> 00:29:29.313
and the quality of work
we do is excellent there.

00:29:30.450 --> 00:29:35.160
The decision to do this
with Kayte was not so easy.

00:29:35.160 --> 00:29:38.090
Normally because of her
advanced malignancy,

00:29:38.090 --> 00:29:42.270
Kayte would not have qualified
to have a liver transplant

00:29:42.270 --> 00:29:44.670
because with immunosuppression, the risk

00:29:44.670 --> 00:29:46.830
of recurrence is high.

00:29:46.830 --> 00:29:48.510
If we were not going

00:29:48.510 --> 00:29:52.035
to try transplanting
without immunosuppression,

00:29:52.035 --> 00:29:56.220
I would've never accepted
her for transplantation.

00:29:56.220 --> 00:29:57.840
And I wouldn't have agreed to it

00:29:57.840 --> 00:30:00.453
if Professor Slavin was
not directly involved.

00:30:01.320 --> 00:30:04.020
We put it through our
hospital ethics committee.

00:30:04.020 --> 00:30:08.160
They really agreed to
what we wanted to do.

00:30:08.160 --> 00:30:10.251
And I have to say the institution

00:30:10.251 --> 00:30:12.820
in India is extremely supportive of me

00:30:13.834 --> 00:30:16.428
and they wouldn't think
that I would do something

00:30:16.428 --> 00:30:19.683
that unethical that
they would worry about.

00:30:21.330 --> 00:30:25.785
- We are actually quite lucky
Dr. Rela is willing to do it.

00:30:25.785 --> 00:30:27.717
In the medical world, this procedure is

00:30:27.717 --> 00:30:30.990
what's called a heroic measure.

00:30:30.990 --> 00:30:34.801
And in medicine, heroic
measures are frowned upon.

00:30:34.801 --> 00:30:36.750
It's very hard to understand

00:30:36.750 --> 00:30:38.831
because heroism generally is considered

00:30:38.831 --> 00:30:40.500
to be a positive thing.

00:30:40.500 --> 00:30:44.610
But I've heard many doctors
say, "Oh, we can't do that.

00:30:44.610 --> 00:30:46.210
That would be a heroic measure."

00:30:48.360 --> 00:30:52.620
Interestingly, Slavin seems
to prefer heroic measures.

00:30:52.620 --> 00:30:54.954
He absolutely doesn't care
about what anyone thinks.

00:30:54.954 --> 00:30:57.243
If he likes an idea, he does it.

00:30:59.310 --> 00:31:04.050
- The vast majority of doctors
would not take this risk

00:31:04.050 --> 00:31:05.550
'cause you can never guarantee

00:31:05.550 --> 00:31:08.373
that this isn't gonna blow
up in everybody's face.

00:31:10.590 --> 00:31:12.360
- [Dr Real] If it should go wrong,

00:31:12.360 --> 00:31:14.973
some would see me as a maverick really,

00:31:16.245 --> 00:31:19.503
somebody who would do anything.

00:31:20.520 --> 00:31:21.933
That risk is there.

00:31:23.100 --> 00:31:24.660
But if you're not prepared

00:31:24.660 --> 00:31:27.513
to face failures, you can't innovate.

00:31:30.960 --> 00:31:34.470
In the early days, liver
transplantation itself was really

00:31:34.470 --> 00:31:37.563
hugely innovative and
dangerous thing to do.

00:31:38.907 --> 00:31:43.760
It was Dr. Thomas Starzl who
did it in Denver in the 1960s.

00:31:44.700 --> 00:31:47.310
- [Dr Starzl] The starting
point was what can I do

00:31:47.310 --> 00:31:49.052
that will benefit society

00:31:49.052 --> 00:31:52.113
and have some kind of real meaning?

00:31:55.290 --> 00:31:58.290
- Unfortunately, during
the first liver transplant,

00:31:58.290 --> 00:32:00.190
the patient bled to death on the table.

00:32:01.350 --> 00:32:03.720
- And many people thought we should stop.

00:32:03.720 --> 00:32:04.743
I didn't agree.

00:32:05.670 --> 00:32:07.593
- That is an act of courage, I think.

00:32:08.850 --> 00:32:13.020
Now it's routine to do
liver transplantation.

00:32:13.020 --> 00:32:15.183
Failure is very much part of innovation.

00:32:24.071 --> 00:32:25.635
- I'm looking for the part

00:32:25.635 --> 00:32:29.322
that has the most crust
that I could find there.

00:32:29.322 --> 00:32:31.320
- It's not fancy but it's
Kayte's favorite dish.

00:32:31.320 --> 00:32:33.177
- Now, this could have looked better.

00:32:33.177 --> 00:32:34.053
You have to wait.

00:32:35.976 --> 00:32:37.832
- You guys said you could
eat all those potatoes

00:32:37.832 --> 00:32:39.316
no matter how many.
- Hey, I'm coming back.

00:32:39.316 --> 00:32:41.924
It's hard to get 'em to spin around.

00:32:41.924 --> 00:32:43.507
- Like a turntable.

00:32:45.823 --> 00:32:47.763
- [Jake] What happened?

00:32:47.763 --> 00:32:50.026
- [Kayte] Liza's in a coma.

00:32:50.026 --> 00:32:51.028
- Say what?

00:32:51.028 --> 00:32:53.252
- Liza's in a coma.

00:32:53.252 --> 00:32:54.548
- I'm sorry, baby.

00:32:54.548 --> 00:32:58.191
- And they don't think she's
going to come out of it.

00:32:58.191 --> 00:33:01.274
Her ammonia levels have been going up

00:33:02.367 --> 00:33:05.790
and she's been in the
hospital a bunch of times but,

00:33:05.790 --> 00:33:08.465
I don't know, I couldn't
finish reading it.

00:33:09.643 --> 00:33:12.965
I have a very good
friend with fibrolamellar

00:33:12.965 --> 00:33:14.823
that I just found out is in a coma.

00:33:16.890 --> 00:33:19.983
She's been such an inspiration
to me to keep me going.

00:33:20.820 --> 00:33:23.910
When she was first diagnosed,
they basically told her,

00:33:23.910 --> 00:33:25.980
she was like 23 at the time,

00:33:25.980 --> 00:33:27.270
they told her, "If you
have anything you wanna do

00:33:27.270 --> 00:33:28.650
in your life, you need
to do it in the next year

00:33:28.650 --> 00:33:30.573
'cause you're gonna die within a year."

00:33:31.564 --> 00:33:33.361
And she said to me, "I was really sad

00:33:33.361 --> 00:33:35.310
and depressed for a day."

00:33:35.310 --> 00:33:38.160
And then she said, "Wait
a minute, I'm the CEO

00:33:38.160 --> 00:33:40.323
of this cancer and you're fired."

00:33:43.500 --> 00:33:47.568
It's our choice as individuals
to decide how we are going

00:33:47.568 --> 00:33:52.568
to carry whatever burden we're given.

00:33:52.980 --> 00:33:56.400
You know, we can be weighed
down and let it defeat us

00:33:56.400 --> 00:34:00.393
or we can carry it and
let it make us stronger.

00:34:21.300 --> 00:34:23.220
- [Dr. Slavin] And it takes
usually 10 to 15 years

00:34:23.220 --> 00:34:25.143
to introduce a new idea into medicine.

00:34:27.395 --> 00:34:29.070
But in the case

00:34:29.070 --> 00:34:31.530
of organ transplantation
without immunosuppression,

00:34:31.530 --> 00:34:33.093
it has been more difficult.

00:34:34.470 --> 00:34:38.523
- The history of tolerance
goes back to 1943.

00:34:42.172 --> 00:34:44.670
There is a scientist named
Ray Owen in the United States

00:34:44.670 --> 00:34:48.630
who was called to a farm where
these cows were being born.

00:34:48.630 --> 00:34:50.735
- [Dr. Slavin] Owen was
the first one to understand

00:34:50.735 --> 00:34:52.790
the secret of tolerance
is mixing the blood

00:34:52.790 --> 00:34:55.380
of the donor and the recipient.

00:34:55.380 --> 00:34:56.850
- [Dr. Fuchs] These
cows were actually twins

00:34:56.850 --> 00:34:59.760
and they were clearly not identical.

00:34:59.760 --> 00:35:01.795
And he found that each cow had a mixture

00:35:01.795 --> 00:35:04.140
of each other's blood types.

00:35:04.140 --> 00:35:05.460
- [Dr. Slavin] And he reasoned

00:35:05.460 --> 00:35:07.110
that because they shared the same placenta

00:35:07.110 --> 00:35:10.023
there was a mixture of blood in utero.

00:35:10.980 --> 00:35:14.530
- [Dr. Fuchs] In the 1950s,
there were experiments in mice

00:35:16.440 --> 00:35:19.530
where they deliberately took fetal mice

00:35:19.530 --> 00:35:21.600
and they gave transfusions

00:35:21.600 --> 00:35:24.930
of blood cells from a
genetically distinct mouse.

00:35:24.930 --> 00:35:25.763
And they found

00:35:25.763 --> 00:35:28.356
that when the mice grew up,
you could place a skin graft

00:35:28.356 --> 00:35:29.910
from the same donor

00:35:29.910 --> 00:35:31.650
and that animal was tolerant.

00:35:31.650 --> 00:35:33.873
- The mouse has never lied to me.

00:35:34.740 --> 00:35:37.143
If a mouse tells me the story, this is it.

00:35:39.360 --> 00:35:42.990
- [Dr. Fuchs] Basically it took
30, 40 years of experiments

00:35:42.990 --> 00:35:44.382
to get to the conclusion

00:35:44.382 --> 00:35:47.580
that you could actually
induce this state of tolerance

00:35:47.580 --> 00:35:49.440
by inducing something called chimerism.

00:35:49.440 --> 00:35:51.106
The stable mixture

00:35:51.106 --> 00:35:54.450
of blood cells from two
different individuals.

00:35:54.450 --> 00:35:58.110
Chimerism, the word derives
from Greek mythology.

00:35:58.110 --> 00:36:00.284
A chimera was actually
three different animals

00:36:00.284 --> 00:36:01.743
blended into one.

00:36:02.610 --> 00:36:05.220
- Most doctors say it's against nature.

00:36:05.220 --> 00:36:09.090
And my answer to that is not
only it's not against nature,

00:36:09.090 --> 00:36:11.391
it's nature's most successful experiment.

00:36:11.391 --> 00:36:13.891
(baby crying)

00:36:14.880 --> 00:36:18.933
Because all of us are example
of successful chimerism.

00:36:21.720 --> 00:36:25.170
In utero, we should all be rejected.

00:36:25.170 --> 00:36:27.543
No one of us is matched with our mother.

00:36:28.560 --> 00:36:31.650
Why aren't we rejected in utero?

00:36:31.650 --> 00:36:35.943
It is because Mother Nature
knows and induces tolerance.

00:36:39.180 --> 00:36:42.570
Nobody understands exactly
why the fetus is not rejected.

00:36:42.570 --> 00:36:44.763
But one of the possibilities
is that we know

00:36:44.763 --> 00:36:48.180
that the fetus ejects
stem cells to the mother.

00:36:48.180 --> 00:36:51.630
Because if you find in
mother's blood, male cells,

00:36:51.630 --> 00:36:53.700
you know it's a male baby.

00:36:53.700 --> 00:36:56.220
So that is why when I was at Stanford

00:36:56.220 --> 00:36:59.220
we developed similar strategies
to inject blood cells

00:36:59.220 --> 00:37:00.870
to the patient from the donor,

00:37:00.870 --> 00:37:03.780
which we proved in mice works.

00:37:03.780 --> 00:37:07.263
And I have maybe 50 publications
on this topic alone.

00:37:08.280 --> 00:37:10.800
In the medical system,
it can be so difficult

00:37:10.800 --> 00:37:12.180
to introduce new protocol.

00:37:12.180 --> 00:37:13.920
You become an enemy of everybody.

00:37:13.920 --> 00:37:15.540
You know, they look at
you like you're coming

00:37:15.540 --> 00:37:16.380
to kill their mothers.

00:37:16.380 --> 00:37:18.390
You know, like an enemy.

00:37:18.390 --> 00:37:20.760
What the hell? I mean I'm
trying to cure cancer patient.

00:37:20.760 --> 00:37:23.253
Give me a chance, you
know, with a new idea.

00:37:25.622 --> 00:37:26.455
- [Howard] It is very hard

00:37:26.455 --> 00:37:29.730
because this procedure's
never been done before.

00:37:29.730 --> 00:37:32.730
And in the West, the
regulatory environment is such

00:37:32.730 --> 00:37:34.270
and the legal environment is such

00:37:34.270 --> 00:37:38.012
that you practically can never
get something like this done.

00:37:38.012 --> 00:37:41.385
But when you know that
you're gonna die, the idea

00:37:41.385 --> 00:37:46.385
that individual human beings
should not have the autonomy

00:37:48.270 --> 00:37:50.430
to do what they please
with their own lives,

00:37:50.430 --> 00:37:52.113
to me, it's ridiculous.

00:37:54.360 --> 00:37:59.190
- Keeping in mind that like I
am a member of the profession,

00:37:59.190 --> 00:38:00.750
there is a reason why you have

00:38:00.750 --> 00:38:02.670
to get these things done formally

00:38:02.670 --> 00:38:05.430
and in a way that's scientifically valid.

00:38:05.430 --> 00:38:08.070
You know, every jot and
tittle of the protocol has

00:38:08.070 --> 00:38:10.230
to undergo extensive review.

00:38:10.230 --> 00:38:11.970
But that's a good thing.

00:38:11.970 --> 00:38:14.250
You know, making sure that
patients get the right treatment

00:38:14.250 --> 00:38:17.070
and also minimizing the risk.

00:38:17.070 --> 00:38:19.110
Medicine is like an ocean liner.

00:38:19.110 --> 00:38:20.733
It just doesn't turn on a dime.

00:38:22.505 --> 00:38:25.397
- But the problem is someone
with a lot of disease

00:38:25.397 --> 00:38:28.983
in the liver like Kayte
doesn't have the time for that.

00:38:31.121 --> 00:38:33.871
(birds chirping)

00:38:34.837 --> 00:38:37.170
(dog barks)

00:38:43.371 --> 00:38:44.970
- I kind of just feel like every ounce

00:38:44.970 --> 00:38:48.077
of energy is just running out of me.

00:38:48.077 --> 00:38:51.497
I just feel like... tired.

00:38:51.497 --> 00:38:55.400
It took me like two hours
to get dressed this morning.

00:38:56.730 --> 00:39:01.083
- It's rough, you know,
not for me, but for her.

00:39:02.130 --> 00:39:06.153
I want her to be normal,
live a normal life again.

00:39:13.767 --> 00:39:16.287
- [Howard] I have to do it
because I can't not do it.

00:39:16.287 --> 00:39:17.820
- [Rochelle] And I agree.

00:39:17.820 --> 00:39:21.180
He and I are sort of
opposite ends of the spectrum

00:39:21.180 --> 00:39:22.013
in terms of-

00:39:22.013 --> 00:39:23.250
- [Howard] Everything.

00:39:23.250 --> 00:39:24.780
- Physical.

00:39:24.780 --> 00:39:26.790
No, but one thing we have similarity to,

00:39:26.790 --> 00:39:28.110
you know what it is?

00:39:28.110 --> 00:39:29.273
We don't dabble in things.

00:39:29.273 --> 00:39:30.797
- One half of the genome.

00:39:30.797 --> 00:39:32.190
We have a similarity there.

00:39:32.190 --> 00:39:35.492
- The thing is that we're
both very intense about

00:39:35.492 --> 00:39:38.250
when we do something, we do it full force.

00:39:38.250 --> 00:39:41.220
Neither one of us dabble in things.

00:39:41.220 --> 00:39:43.980
Howard has always marched
to his own drummer.

00:39:43.980 --> 00:39:44.813
That's right.

00:39:45.990 --> 00:39:48.720
- [Gerald] Even as a
little boy, I remember

00:39:48.720 --> 00:39:52.560
when he was interested
in nuclear reactors.

00:39:52.560 --> 00:39:55.980
He knew where the neutrons
and protons were going.

00:39:55.980 --> 00:39:57.430
He knew everything, you know.

00:39:59.370 --> 00:40:01.567
- At four years old he said to me,

00:40:01.567 --> 00:40:05.727
"Mom, I'm my own best entertainment unit."

00:40:07.800 --> 00:40:10.383
- [Tal] What's interesting
about Howard's brain is the fact

00:40:10.383 --> 00:40:12.723
that Howard is actually a rabbi.

00:40:13.680 --> 00:40:14.981
To become a rabbi, it means you need

00:40:14.981 --> 00:40:19.800
to be very well versed in the
Talmud, which is Jewish law.

00:40:19.800 --> 00:40:22.080
You need to examine things and see, oh,

00:40:22.080 --> 00:40:22.913
but if this were true,

00:40:22.913 --> 00:40:24.210
it would actually contradict this thing

00:40:24.210 --> 00:40:26.070
in this other book somewhere.

00:40:26.070 --> 00:40:28.893
And so it becomes like a gigantic puzzle.

00:40:31.110 --> 00:40:34.080
- [Howard] The practice of
studying Talmud is a very

00:40:34.080 --> 00:40:36.930
good exercise for questioning authority

00:40:36.930 --> 00:40:39.150
because all views are questioned

00:40:39.150 --> 00:40:42.390
to the greatest extent
possible when you study Talmud.

00:40:42.390 --> 00:40:44.937
- And so he's able to look at
this medical journal over here

00:40:44.937 --> 00:40:46.290
and that journal over there

00:40:46.290 --> 00:40:49.470
and synthesize all of
that information into,

00:40:49.470 --> 00:40:52.623
"That means you need to have
this treatment" kind of thing.

00:40:53.610 --> 00:40:56.250
- Life to me is thinking.

00:40:56.250 --> 00:40:58.560
Everything's a problem
that needs to be solved.

00:40:58.560 --> 00:41:03.000
I only get pleasure out of innovation.

00:41:03.000 --> 00:41:05.959
I do get a certain satisfaction
out of helping people,

00:41:05.959 --> 00:41:08.340
but it's not more pleasurable.

00:41:08.340 --> 00:41:12.783
The pleasure I get from
creativity is the very act itself.

00:41:13.830 --> 00:41:15.600
- Something.
- Yeah, this was kind of...

00:41:15.600 --> 00:41:16.800
- When you go through medical school,

00:41:16.800 --> 00:41:18.450
you're taught not to be creative.

00:41:18.450 --> 00:41:20.760
You're taught to do
everything by the textbooks

00:41:20.760 --> 00:41:21.930
because you can get in trouble

00:41:21.930 --> 00:41:24.420
with malpractice if you're creative.

00:41:24.420 --> 00:41:27.120
But you know, unfortunately,

00:41:27.120 --> 00:41:30.390
when the textbooks run outta
answers, you need people

00:41:30.390 --> 00:41:31.833
who can think creatively.

00:41:34.950 --> 00:41:38.490
- When my father was old and not well,

00:41:38.490 --> 00:41:42.540
Howard helped me decide
to not allow my father

00:41:42.540 --> 00:41:44.460
to go into palliative care,

00:41:44.460 --> 00:41:46.241
which was suggested by the doctors

00:41:46.241 --> 00:41:49.290
who said he'd be dead in a week.

00:41:49.290 --> 00:41:50.940
- I remember we had this meeting

00:41:50.940 --> 00:41:55.940
with various manifestations
of medical mediocrity there.

00:41:59.070 --> 00:42:01.230
The doctor said that he was dying,

00:42:01.230 --> 00:42:04.500
so what we should do is we
should cut his water supply off

00:42:04.500 --> 00:42:06.180
so that we could kill him quicker.

00:42:06.180 --> 00:42:09.930
- But the doctors couldn't find
any reason why he was dying.

00:42:09.930 --> 00:42:12.430
- My grandfather loved to
live and had no interest

00:42:13.320 --> 00:42:15.120
in being killed.

00:42:15.120 --> 00:42:16.729
So I said, well, the
fact that the doctor says

00:42:16.729 --> 00:42:19.969
that he's dying from
an undiagnosed disease,

00:42:19.969 --> 00:42:23.070
that's fundamentally an
unscientific opinion.

00:42:23.070 --> 00:42:27.030
So we told them to give
him a couple IVs of saline

00:42:27.030 --> 00:42:29.133
and then we took him home.

00:42:30.990 --> 00:42:33.660
- [Rochelle] And Howard
came every day after work.

00:42:33.660 --> 00:42:35.970
He would cook, he would sing with my dad,

00:42:35.970 --> 00:42:37.710
he'd talk to my dad.

00:42:37.710 --> 00:42:39.480
- Within a couple weeks,
he was back to normal

00:42:39.480 --> 00:42:42.330
and he lived over a year after
that quite happily, right?

00:42:52.549 --> 00:42:54.115
- We had a great turnout.

00:42:54.115 --> 00:42:57.300
The girls will be selling
some more raffle tickets.

00:42:57.300 --> 00:42:58.950
Well that's our prime rib lunch.

00:42:58.950 --> 00:43:00.900
We're actually having a
fish fry this Thursday

00:43:00.900 --> 00:43:03.373
and then the prime rib
is the Friday after that.

00:43:03.373 --> 00:43:06.373
(people chattering)

00:43:08.392 --> 00:43:09.225
- [Kayte] I was a little afraid

00:43:09.225 --> 00:43:11.469
that people would think I
was crazy for going to India.

00:43:11.469 --> 00:43:12.720
- Come on, you guys.

00:43:14.040 --> 00:43:15.030
- My husband and I talked

00:43:15.030 --> 00:43:18.510
to some transplant surgeons
here about Howard's idea

00:43:18.510 --> 00:43:21.330
and although they did not
give me one single option,

00:43:21.330 --> 00:43:24.210
they still told me the
idea was completely crazy

00:43:24.210 --> 00:43:26.190
and then if I did it, I would die.

00:43:26.190 --> 00:43:29.550
And it was mainly because
it hasn't been done before.

00:43:29.550 --> 00:43:33.273
But everything at one point
had never been done before.

00:43:34.349 --> 00:43:36.333
At one point, the earth was flat.

00:43:41.250 --> 00:43:44.550
- I think that we would be
remiss if we understated the role

00:43:44.550 --> 00:43:47.103
that Kayte's courage plays in all of this.

00:43:48.210 --> 00:43:51.240
She's a very brave person.

00:43:51.240 --> 00:43:53.640
Healthy people might not understand.

00:43:53.640 --> 00:43:56.013
Healthy people would
think of her as desperate.

00:43:56.970 --> 00:43:58.530
In other words, why not try the treatment

00:43:58.530 --> 00:44:00.120
since you have no chance otherwise?

00:44:00.120 --> 00:44:03.930
But I know from experience,
most people who are terminal

00:44:03.930 --> 00:44:05.433
choose not to do it anyway.

00:44:06.627 --> 00:44:09.990
With Kayte, we're looking at an n of 1.

00:44:09.990 --> 00:44:10.950
We're looking at - right?

00:44:10.950 --> 00:44:12.600
We're looking at one human being.

00:44:13.857 --> 00:44:17.490
- With this type of
cancer, which is so rare

00:44:17.490 --> 00:44:18.960
that it's not really studied

00:44:18.960 --> 00:44:22.380
'cause it doesn't get
any kind of attention,

00:44:22.380 --> 00:44:24.783
Kayte feels like maybe
this will help everyone.

00:44:26.881 --> 00:44:27.714
- I face reality.

00:44:27.714 --> 00:44:30.750
I know that this might end badly

00:44:30.750 --> 00:44:33.240
and it might end badly immediately,

00:44:33.240 --> 00:44:34.980
but somebody has to be the first.

00:44:34.980 --> 00:44:38.487
Somebody has to be the first
one to say, "Hey, I'll try it."

00:44:44.375 --> 00:44:47.125
(car door slams)

00:44:49.132 --> 00:44:51.633
- [Hairdresser] Well,
gotta get that haircut.

00:44:51.633 --> 00:44:53.133
Really short.

00:44:55.092 --> 00:44:56.354
- I mean, I love it right now.

00:44:56.354 --> 00:44:59.263
It's really cute, but because
of what we're fixing to go do,

00:44:59.263 --> 00:45:02.350
it's just - it'll get to this point again.

00:45:02.350 --> 00:45:06.050
- Yeah, how long are you
gonna have to be over there?

00:45:06.050 --> 00:45:07.339
- I'm thinking at least three months

00:45:07.339 --> 00:45:08.558
but we really don't know how long.

00:45:08.558 --> 00:45:09.391
It just depends on

00:45:09.391 --> 00:45:12.388
how long my recovery is.
- How well everything goes.

00:45:12.388 --> 00:45:15.155
And this is an inch longer.

00:45:15.155 --> 00:45:16.590
We can start with that.

00:45:16.590 --> 00:45:18.600
- I will be in India tomorrow.

00:45:18.600 --> 00:45:20.423
- [Hairdresser] And then kind
of go shorter on your sides.

00:45:21.350 --> 00:45:26.350
- I know that I'm going
to be very anxious.

00:45:26.880 --> 00:45:30.033
I'm definitely gonna
take my anxiety pills.

00:45:31.539 --> 00:45:33.492
- All right, ready?
(clipper buzzing)

00:45:33.492 --> 00:45:34.325
- Ready.

00:45:37.079 --> 00:45:39.810
When I get nervous I just get jittery

00:45:39.810 --> 00:45:40.983
but I'm gonna be ready.

00:45:42.092 --> 00:45:44.610
And you have to go in
with your fighter spirit.

00:45:44.610 --> 00:45:46.378
You gotta go in with all your armor on.

00:45:46.378 --> 00:45:51.378
(clipper buzzing)
(mellow music)

00:46:01.950 --> 00:46:04.350
Cancer, I think kind of helps you learn

00:46:04.350 --> 00:46:07.680
what you are in control of and
what you aren't in control of

00:46:07.680 --> 00:46:09.518
and what you are in control of,

00:46:09.518 --> 00:46:11.290
you have to learn to own

00:46:12.660 --> 00:46:14.940
and fight and hold onto it

00:46:14.940 --> 00:46:16.940
because people will try to take it away.

00:46:18.270 --> 00:46:19.680
Not just doctors,

00:46:19.680 --> 00:46:22.710
but people who mean well,
like family and friends.

00:46:22.710 --> 00:46:25.620
They'll try to take away
some of your control.

00:46:25.620 --> 00:46:28.440
And I fight for it.

00:46:28.440 --> 00:46:32.843
Like no one lays out my
pills for me, I do that.

00:46:32.843 --> 00:46:36.570
I mean there are times when
I've had to rely on, you know,

00:46:36.570 --> 00:46:38.100
my mom's had to wipe my butt

00:46:38.100 --> 00:46:41.880
after I've gone to the
bathroom, you know, it happens.

00:46:41.880 --> 00:46:44.339
But when you can do things for yourself,

00:46:44.339 --> 00:46:47.050
you have to stay in control

00:46:50.223 --> 00:46:51.880
because, I mean

00:46:53.670 --> 00:46:57.450
otherwise, I think you
lose your sense of self

00:46:57.450 --> 00:46:59.940
and that is one of the
most important things

00:46:59.940 --> 00:47:01.980
that you have to hold onto.

00:47:01.980 --> 00:47:05.940
And that cancer teaches
you a lot about who you are

00:47:05.940 --> 00:47:07.140
and what you're made of.

00:47:09.221 --> 00:47:11.804
(dogs barking)

00:47:16.217 --> 00:47:19.020
- [Jacob] We have known for a little bit

00:47:19.020 --> 00:47:22.233
that I was the best match for the surgery.

00:47:24.240 --> 00:47:28.113
So what I'm gonna do is give my sister

00:47:29.568 --> 00:47:33.363
a portion of my liver,
whichever part that is.

00:47:34.980 --> 00:47:39.090
I'm not detailed or - I
don't know the details yet.

00:47:39.090 --> 00:47:41.340
I mean I really don't have
any information really.

00:47:41.340 --> 00:47:43.560
They're just gonna do
what they have to do.

00:47:43.560 --> 00:47:44.393
That's gonna be it.

00:47:44.393 --> 00:47:46.710
And I will accept whatever
consequences come along

00:47:46.710 --> 00:47:47.580
'cause I'm saving my sister

00:47:47.580 --> 00:47:50.673
with my liver and my bone marrow.

00:47:53.220 --> 00:47:55.083
To me, that's all I have to know.

00:47:57.390 --> 00:48:00.828
There's a risk, but death happens

00:48:00.828 --> 00:48:05.823
and if I can save Kayte's life
through death then so be it.

00:48:07.330 --> 00:48:09.980
But we're gonna give the
middle finger to death here.

00:48:12.066 --> 00:48:13.566
We're gonna do it.

00:48:20.790 --> 00:48:22.770
- [Howard] We are ready
to leave for India.

00:48:22.770 --> 00:48:25.442
Kayte and Jacob get there before me.

00:48:25.442 --> 00:48:28.025
(mellow music)

00:48:44.376 --> 00:48:46.680
- [Kayte] I've never
been to India, you know,

00:48:46.680 --> 00:48:48.483
and it is a world away.

00:48:51.816 --> 00:48:54.720
Of course, it's scary
'cause I love my life.

00:48:54.720 --> 00:48:56.987
I love everything about it.

00:48:58.914 --> 00:49:01.597
- Heavenly father, we come to you tonight.

00:49:01.597 --> 00:49:03.138
Thank you so much for all the things

00:49:03.138 --> 00:49:05.638
that are being done for Kayte.

00:49:06.797 --> 00:49:08.464
And for safe travel.

00:49:10.776 --> 00:49:12.231
In Jesus' name, amen.

00:49:12.231 --> 00:49:14.814
(mellow music)

00:49:58.413 --> 00:50:01.330
(engines rumbling)

00:50:06.810 --> 00:50:09.477
(bells chiming)

00:50:13.851 --> 00:50:16.434
(upbeat music)

00:50:18.780 --> 00:50:20.582
- We arrive in India

00:50:20.582 --> 00:50:22.230
and the only way I can
really describe it is

00:50:22.230 --> 00:50:24.198
there's just chaos.

00:50:24.198 --> 00:50:27.365
(car engine rumbling)

00:50:28.200 --> 00:50:29.927
And we were driving through
the streets in the middle

00:50:29.927 --> 00:50:32.250
of the night dodging cows, dogs

00:50:32.250 --> 00:50:34.884
and vegetable stands.

00:50:34.884 --> 00:50:37.860
(bike horn blares)

00:50:37.860 --> 00:50:39.599
- It was very scary.

00:50:39.599 --> 00:50:41.160
There was a driver going very fast

00:50:41.160 --> 00:50:43.443
on the opposite side
of the road or no road.

00:50:45.870 --> 00:50:47.040
- I'm watching my sister.

00:50:47.040 --> 00:50:48.664
I'm half awake.

00:50:48.664 --> 00:50:49.830
It's kind of like my
head is flopping around.

00:50:49.830 --> 00:50:51.540
It's like I'm thinking in my head.

00:50:51.540 --> 00:50:53.340
So you met a guy on Facebook.

00:50:53.340 --> 00:50:54.806
He told you about a Canadian guy

00:50:54.806 --> 00:50:56.421
who's a plumber

00:50:56.421 --> 00:51:01.421
who has interest in medical journals

00:51:03.120 --> 00:51:05.040
and now we are in the middle of India.

00:51:05.040 --> 00:51:08.373
It was just crazy.

00:51:51.240 --> 00:51:53.220
- [Cecilia] First, both
Jacob and Kayte had

00:51:53.220 --> 00:51:55.170
to go through all their physicals,

00:51:55.170 --> 00:51:58.053
their cardiologist, all their blood work,

00:52:07.828 --> 00:52:09.933
- [Kayte] I didn't know I
needed to pack my own tape.

00:52:12.152 --> 00:52:13.920
I'm getting that sinking feeling in my gut

00:52:13.920 --> 00:52:16.143
that this isn't right.

00:52:19.017 --> 00:52:22.100
(people chattering)

00:52:26.769 --> 00:52:28.260
- I told Jake, I don't
know much about women

00:52:28.260 --> 00:52:30.633
but one thing I know is
that they like chocolate.

00:52:30.633 --> 00:52:33.181
So I just bought chocolate without asking.

00:52:33.181 --> 00:52:36.360
I knew that she would like it.

00:52:36.360 --> 00:52:39.587
I brought all kinds of food
mostly for the patients' family

00:52:39.587 --> 00:52:41.793
'cause it's too much of a shock for them.

00:52:47.310 --> 00:52:49.750
My parents insisted on
taking me to the airport

00:52:51.038 --> 00:52:52.680
and my mother meant to embarrass me

00:52:52.680 --> 00:52:55.110
and go inside with me when I checked in.

00:52:55.110 --> 00:52:58.980
You know, I mean I'm only
50 years old, you know.

00:53:04.411 --> 00:53:05.791
Here we go.

00:53:05.791 --> 00:53:09.240
Okay, Jake food.

00:53:09.240 --> 00:53:10.840
I should separate the Jake food.

00:53:11.970 --> 00:53:13.410
That's Jake food.

00:53:13.410 --> 00:53:14.583
Melba toast is for me.

00:53:17.869 --> 00:53:20.036
And what is this in a bag?

00:53:21.846 --> 00:53:22.846
Grape juice.

00:53:26.427 --> 00:53:29.418
(indistinct)

00:53:29.418 --> 00:53:32.085
(mellow music)

00:53:48.570 --> 00:53:49.962
This is really exciting.

00:53:49.962 --> 00:53:51.792
I've never been to India before.

00:53:51.792 --> 00:53:54.933
- Have you met the patient?
- Pardon me?

00:53:54.933 --> 00:53:55.766
I've never met the patient.

00:53:55.766 --> 00:53:57.982
- Oh I see.
- I've never met her.

00:53:57.982 --> 00:53:59.403
She's never met me.

00:54:01.020 --> 00:54:04.180
What happened was I helped out a friend.

00:54:04.180 --> 00:54:07.410
I helped out someone
who had fibrolamellar.

00:54:09.017 --> 00:54:10.800
Hi Kayte, how are you?

00:54:10.800 --> 00:54:12.420
Oh, I got something for you.

00:54:12.420 --> 00:54:16.110
I stopped off in Belgium
so I got you chocolate.

00:54:16.110 --> 00:54:18.510
- Oh, thank you. That's so nice.

00:54:18.510 --> 00:54:20.089
- Hey, and then cookies too.

00:54:20.089 --> 00:54:23.216
- Delicious. I can't wait.
- I'm Cecilia, Kayte's mom.

00:54:23.216 --> 00:54:24.420
- Hi, pleased to meet you.
- Nice to meet you, Howard.

00:54:24.420 --> 00:54:26.587
- Hello.
- Hello. This is nice.

00:54:26.587 --> 00:54:29.608
I walked here this morning,
passed all the goats.

00:54:29.608 --> 00:54:30.813
- [Jacob] We heard.

00:54:32.460 --> 00:54:33.810
- It was nice.
- You're braver than us.

00:54:33.810 --> 00:54:35.640
- I brought you like
American cheese stuff.

00:54:35.640 --> 00:54:37.821
- That's fine.
- It's all right.

00:54:37.821 --> 00:54:39.177
I mean you can make a
grilled cheese out of it.

00:54:39.177 --> 00:54:40.620
And I brought you ketchup.

00:54:40.620 --> 00:54:42.370
Considering that ketchup
was stolen from the Indians

00:54:42.370 --> 00:54:44.745
to begin with.

00:54:44.745 --> 00:54:45.866
It was actually a chutney.

00:54:45.866 --> 00:54:46.863
- Okay.

00:54:46.863 --> 00:54:49.350
- [Howard] Yeah. How
are your bones feeling?

00:54:49.350 --> 00:54:50.760
- [Jacob] Warm and...
- Warm and sore?

00:54:50.760 --> 00:54:52.144
- Annoying.
- Yeah.

00:54:52.144 --> 00:54:54.420
- I'm aware of them.
- Yeah.

00:54:54.420 --> 00:54:55.710
Yeah, it's interesting.

00:54:55.710 --> 00:54:56.700
You can actually feel.

00:54:56.700 --> 00:54:58.650
Those are your blood cells multiplying.

00:54:58.650 --> 00:55:00.720
- Yeah, every bone I'm aware of.

00:55:00.720 --> 00:55:03.510
- They're just full of
marrow trying to get out.

00:55:03.510 --> 00:55:05.190
- The shot I got yesterday

00:55:05.190 --> 00:55:07.350
to prepare my bone marrow makes me aware

00:55:07.350 --> 00:55:09.510
of every bone in my body.

00:55:09.510 --> 00:55:11.855
Even like the small bones
in my hands, I can feel them

00:55:11.855 --> 00:55:14.580
and they feel like they're
charcoal briquettes

00:55:14.580 --> 00:55:15.970
just cooking away

00:55:17.743 --> 00:55:19.884
- The stem cells like stick
to the inside of your bone

00:55:19.884 --> 00:55:23.790
and they don't do anything
unless they're needed.

00:55:23.790 --> 00:55:25.620
They'll just sit there forever.

00:55:25.620 --> 00:55:28.140
And what this does is it causes them to,

00:55:28.140 --> 00:55:30.840
it gets them off of the
bone and into the blood

00:55:30.840 --> 00:55:32.540
and it causes them to proliferate.

00:55:34.260 --> 00:55:36.030
- So it's easier to get to them.

00:55:36.030 --> 00:55:38.850
Then they need to do, run anti-rejection.

00:55:38.850 --> 00:55:40.170
- [Howard] Anti-rejection, right, exactly.

00:55:40.170 --> 00:55:41.820
Mixed chimerism. You're trying

00:55:41.820 --> 00:55:44.880
to create mutual tolerance, right?

00:55:44.880 --> 00:55:47.220
- [Kayte] Hearing Howard
talk about everything

00:55:47.220 --> 00:55:48.450
does make me feel better.

00:55:48.450 --> 00:55:51.420
Like he has such a depth of knowledge.

00:55:51.420 --> 00:55:53.884
- Bone marrow is comprised
of all kinds of cells.

00:55:53.884 --> 00:55:58.290
I am sanguine about blood
cells, if you'll excuse the pun.

00:55:58.290 --> 00:56:00.570
I didn't mean to, you know,

00:56:00.570 --> 00:56:02.370
sanguine comes from the word sanguis,

00:56:02.370 --> 00:56:04.260
which means blood but anyway.

00:56:04.260 --> 00:56:05.740
Some humor from me.

00:56:05.740 --> 00:56:06.990
- When I met Howard, he
felt like the big brother

00:56:06.990 --> 00:56:08.460
that I've never really had.

00:56:08.460 --> 00:56:11.472
I can understand a little
bit how his mind works.

00:56:11.472 --> 00:56:13.050
I can only imagine his head

00:56:13.050 --> 00:56:15.300
he's thinking about 50 different things.

00:56:15.300 --> 00:56:18.038
- Get them in the car.
- Yeah.

00:56:18.038 --> 00:56:20.490
They're just gonna go meet a doctor.

00:56:20.490 --> 00:56:23.463
The two most interesting
doctors get here tomorrow.

00:56:23.463 --> 00:56:26.296
(dramatic music)

00:56:31.950 --> 00:56:33.420
- [Dr. Rela] I've always wanted to be able

00:56:33.420 --> 00:56:36.690
to do transplantation without
immunosuppressive drugs.

00:56:36.690 --> 00:56:39.243
It will completely change
the world of transplantation.

00:56:39.243 --> 00:56:42.720
It's going to improve not
just liver transplants,

00:56:42.720 --> 00:56:44.376
It's all progress.

00:56:44.376 --> 00:56:46.560
There is something like a
hundred thousand transplants

00:56:46.560 --> 00:56:48.301
in the world each year.

00:56:48.301 --> 00:56:51.634
(plane engine rumbling)

00:56:55.620 --> 00:56:57.780
- If we are successful in this case,

00:56:57.780 --> 00:56:59.961
not only we cure this charming young lady

00:56:59.961 --> 00:57:01.706
who is otherwise doomed,

00:57:01.706 --> 00:57:04.500
but more than that, it'll be a message

00:57:04.500 --> 00:57:06.153
for so many other patients
all over the world

00:57:06.153 --> 00:57:08.303
that could be cured
with the same strategy.

00:57:20.460 --> 00:57:23.107
- [Kayte] Today, when I
finally met Howard, I was like,

00:57:23.107 --> 00:57:25.009
"Howard, you know, my family
just wants to thank you so much

00:57:25.009 --> 00:57:27.683
for doing all the work
that you've done for us."

00:57:27.683 --> 00:57:30.600
And he was just like, "That's
completely ridiculous.

00:57:30.600 --> 00:57:32.250
You don't have to say thank you."

00:57:34.230 --> 00:57:35.961
- There's a Hebrew expression.

00:57:35.961 --> 00:57:38.250
(indistinct)

00:57:38.250 --> 00:57:40.431
In a place where there
isn't a person, you have

00:57:40.431 --> 00:57:42.030
to be the person.

00:57:42.030 --> 00:57:43.440
That's the case.

00:57:43.440 --> 00:57:46.557
But I would like to add to Hillel,

00:57:46.557 --> 00:57:48.360
there isn't another person.

00:57:48.360 --> 00:57:50.040
Don't assume that there's another person

00:57:50.040 --> 00:57:51.040
because there isn't.

00:57:56.946 --> 00:57:58.259
- [Dr Rela] You see, I
think the ideal situation

00:57:58.259 --> 00:58:01.380
to do transplant without
immunosuppression is actually

00:58:01.380 --> 00:58:03.600
in this country because-

00:58:03.600 --> 00:58:04.440
- [Dr Slavin] Cost?

00:58:04.440 --> 00:58:05.550
- The cost is an issue

00:58:05.550 --> 00:58:10.330
and you can have a number of
children who need a transplant

00:58:10.330 --> 00:58:13.800
and who can, for the
transplant collect some money

00:58:13.800 --> 00:58:16.887
or we can get donations,
do the transplant.

00:58:16.887 --> 00:58:19.597
But if you commit them to
lifelong immunosuppression,

00:58:19.597 --> 00:58:22.470
they won't continue that and
they will lose the graft.

00:58:22.470 --> 00:58:24.780
Hi, I'm Mohamed Rela.

00:58:24.780 --> 00:58:25.863
- Ah, you never met.

00:58:25.863 --> 00:58:28.089
- How are you?
- Fine, thanks.

00:58:28.089 --> 00:58:30.203
- That's the big moment. I didn't know.

00:58:30.203 --> 00:58:31.412
I thought you already did meet.

00:58:31.412 --> 00:58:32.580
- I just came from (indistinct).

00:58:32.580 --> 00:58:33.683
- I see, okay.

00:58:34.620 --> 00:58:39.057
So this is the reason
why we are here, okay?

00:58:39.057 --> 00:58:40.447
The first question I asked him,

00:58:40.447 --> 00:58:43.167
"Are you sure you are
going to do a transplant?"

00:58:44.010 --> 00:58:47.610
Because if you find some
surprises, adhesions,

00:58:47.610 --> 00:58:50.910
god-knows-what, after
radiation and prior surgery.

00:58:50.910 --> 00:58:52.860
- She has a bad artery, doesn't she?

00:58:52.860 --> 00:58:54.030
- She has a bad artery

00:58:54.030 --> 00:58:55.766
but we have a donor today,
a cadaver donor today.

00:58:55.766 --> 00:58:58.440
- Yeah, that's why I
just wanted to make sure.

00:58:58.440 --> 00:59:00.573
Oh, just one specific point.

00:59:02.220 --> 00:59:04.230
If Kayte requires blood vessels,

00:59:04.230 --> 00:59:08.190
it's not good to use a
third party one, right?

00:59:08.190 --> 00:59:09.270
Because you're inducing,

00:59:09.270 --> 00:59:13.080
because you're only inducing
tolerance to the the donor.

00:59:13.080 --> 00:59:14.444
- I didn't think about that.

00:59:14.444 --> 00:59:17.313
- You see, that's why he
is here 'cause he is good.

00:59:19.320 --> 00:59:22.530
- [Dr. Rela] He seems to
know all the literature.

00:59:22.530 --> 00:59:24.722
- [Howard] Kayte's hepatic
artery is in bad shape

00:59:24.722 --> 00:59:28.170
because some genius in Alabama decided

00:59:28.170 --> 00:59:29.903
to irradiate her liver

00:59:29.903 --> 00:59:32.820
to, of course, kill the tumor

00:59:32.820 --> 00:59:34.653
but that damaged the hepatic artery.

00:59:35.850 --> 00:59:38.673
Now she requires grafts of blood vessels.

00:59:42.030 --> 00:59:44.073
- [Kayte] I had high dose radiation.

00:59:45.270 --> 00:59:47.040
A couple weeks later, I couldn't eat

00:59:47.040 --> 00:59:49.440
and I was waking up in the
middle of the night with pain.

00:59:49.440 --> 00:59:50.970
I couldn't sleep.

00:59:50.970 --> 00:59:52.020
And we went in for a CT

00:59:52.020 --> 00:59:54.714
and they mentioned like,
"Oh, well some of your liver,

00:59:54.714 --> 00:59:56.670
you know, it's basically like

00:59:56.670 --> 00:59:59.370
when you defrost hamburger
meat in the microwave,

00:59:59.370 --> 01:00:01.620
you know, some of it gets a little cooked

01:00:01.620 --> 01:00:03.393
but it's still good."

01:00:03.393 --> 01:00:06.480
- [Jacob] Basically,
barbecued her insides.

01:00:06.480 --> 01:00:08.180
- [Howard] They almost killed her.

01:00:09.930 --> 01:00:14.100
If my idea works, hopefully
we can start the revolution

01:00:14.100 --> 01:00:16.170
of curative oncology as opposed

01:00:16.170 --> 01:00:19.290
to the nihilistic form of oncology

01:00:19.290 --> 01:00:21.098
that we have today, you know.

01:00:21.098 --> 01:00:23.848
(waves crashing)

01:00:31.554 --> 01:00:34.971
(school kids chattering)

01:00:40.106 --> 01:00:41.439
- [Kayte] I need to pee.

01:00:48.299 --> 01:00:49.632
Or not.

01:00:50.738 --> 01:00:52.488
I'll just carry it.

01:00:56.031 --> 01:00:56.864
- [Dr Slavin] She is really wonderful

01:00:56.864 --> 01:00:59.383
but it's a complicated
case in terms of ...

01:00:59.383 --> 01:01:02.010
already had two surgeries and radiation

01:01:02.010 --> 01:01:04.140
and all those chemotherapies.

01:01:04.140 --> 01:01:07.020
This is a heavily beaten body already.

01:01:07.020 --> 01:01:07.853
- [Cecilia] Right.

01:01:07.853 --> 01:01:10.243
- So it's more prone to
infections, it's more prone

01:01:10.243 --> 01:01:13.259
to complications because
of the past history.

01:01:13.259 --> 01:01:15.480
Tomorrow's not going to be easy.

01:01:15.480 --> 01:01:18.090
Sometimes a straw can
break a camel, you know.

01:01:18.090 --> 01:01:19.509
There's a limit

01:01:19.509 --> 01:01:21.327
but we think it's doable

01:01:21.327 --> 01:01:23.190
and that's why we offer it.

01:01:23.190 --> 01:01:24.573
- You're very courageous.

01:01:25.862 --> 01:01:27.900
- I mean, somebody must be.
- Yes.

01:01:27.900 --> 01:01:29.800
- Otherwise there will be no progress.

01:01:37.208 --> 01:01:38.041
- [Jacob] I've been eating chicken breasts

01:01:38.041 --> 01:01:39.450
and broccoli, salt and pepper only.

01:01:39.450 --> 01:01:40.283
- [Cecilia] No flavor.

01:01:40.283 --> 01:01:42.510
- I had to run on the treadmill.

01:01:42.510 --> 01:01:44.430
Getting prepared for the surgery,

01:01:44.430 --> 01:01:45.263
they were like, "I don't know

01:01:45.263 --> 01:01:46.980
how we're gonna operate
on someone so big."

01:01:46.980 --> 01:01:51.157
I was like, "But I'm just
smallest I've been in years."

01:01:51.157 --> 01:01:53.024
I'm still a giant in India.

01:01:53.024 --> 01:01:55.857
(machine beeping)

01:01:58.290 --> 01:02:00.972
- [Howard] Right now, Jacob
is doing an apheresis,

01:02:00.972 --> 01:02:03.088
running his blood through a centrifuge

01:02:03.088 --> 01:02:06.555
to spin out the cells that
they need for tomorrow.

01:02:06.555 --> 01:02:08.331
Tomorrow at the operation,

01:02:08.331 --> 01:02:10.102
we should get get quite a bit out of him.

01:02:10.102 --> 01:02:11.255
- [Dr. Slavin] Hm?

01:02:11.255 --> 01:02:13.295
- [Howard] He should have a lot of marrow.

01:02:13.295 --> 01:02:15.167
- [Jacob] I'm kind of juicy.

01:02:15.167 --> 01:02:16.597
- [Dr. Slavin] He is a mensch.

01:02:16.597 --> 01:02:19.710
- Today, I found out my
vein is gonna be used

01:02:19.710 --> 01:02:21.630
as an artery for my sister

01:02:21.630 --> 01:02:25.023
and tomorrow, the doctors
will be cutting into my leg.

01:02:26.580 --> 01:02:29.400
It is scary but glad it's me

01:02:29.400 --> 01:02:31.950
because I'm the most expendable
to be able to send over here

01:02:31.950 --> 01:02:35.160
and wait for however many
months we're stuck here

01:02:35.160 --> 01:02:37.740
because I'm living at home.

01:02:37.740 --> 01:02:39.180
You know, I don't have family.

01:02:39.180 --> 01:02:40.930
I don't have anything...

01:02:40.930 --> 01:02:44.370
Well, maybe one remote possibility
but that's a weird story.

01:02:44.370 --> 01:02:45.370
I don't wanna - so.

01:02:46.326 --> 01:02:50.160
- So the name was chimerism.
- Yes.

01:02:50.160 --> 01:02:52.760
- [Dr. Slavin] Which means
it's a mixed animal made

01:02:52.760 --> 01:02:54.360
of the best part of each animal.

01:02:55.500 --> 01:02:57.750
- [Jacob] We're going
to be the same person.

01:03:00.613 --> 01:03:02.430
- [Howard] At this
point, my primary concern

01:03:02.430 --> 01:03:05.640
about the treatment is
because you need chimerism,

01:03:05.640 --> 01:03:07.840
which comes from the
bone marrow transplant,

01:03:08.790 --> 01:03:10.876
this procedure is going

01:03:10.876 --> 01:03:13.773
to be more dangerous than
a regular liver transplant.

01:03:15.750 --> 01:03:17.670
- [Dr Fuchs] With bone
marrow transplantation,

01:03:17.670 --> 01:03:19.800
the most feared complication is something

01:03:19.800 --> 01:03:21.828
called graft-versus-host disease.

01:03:21.828 --> 01:03:23.250
Big problem in

01:03:23.250 --> 01:03:26.610
which a donor's immune
system kills everything.

01:03:26.610 --> 01:03:29.733
Not just the cancer but the
normal tissues of the body.

01:03:32.130 --> 01:03:34.230
- I  made it very clear to Kayte.

01:03:34.230 --> 01:03:36.900
There are different ways
of doing this procedure.

01:03:36.900 --> 01:03:40.320
I originally wanted to do the
full bone marrow transplant

01:03:40.320 --> 01:03:44.730
but the hospital in Chennai
had no experience dealing

01:03:44.730 --> 01:03:46.650
with graft-versus-host disease.

01:03:46.650 --> 01:03:48.960
So she would've had to have
the bone marrow transplant

01:03:48.960 --> 01:03:50.670
somewhere other than India.

01:03:50.670 --> 01:03:52.045
And because of her condition,

01:03:52.045 --> 01:03:54.280
Kayte doesn't have time to do that.

01:03:56.120 --> 01:04:00.453
So what Slavin did was he chose
an interesting compromise.

01:04:01.860 --> 01:04:05.040
- [Dr Slavin] We don't need a
full bone marrow transplant.

01:04:05.040 --> 01:04:08.640
It's enough to do the bone
marrow mini transplant.

01:04:08.640 --> 01:04:12.039
In other words, we only need
to educate the bone marrow

01:04:12.039 --> 01:04:13.770
of the patient to accept the organ

01:04:13.770 --> 01:04:16.800
by transient circulation of donor cell.

01:04:16.800 --> 01:04:19.179
You don't even have to do it permanently.

01:04:19.179 --> 01:04:22.227
This is called mixed chimerism.

01:04:23.460 --> 01:04:27.360
- The only disadvantage is
you just have an immune system

01:04:27.360 --> 01:04:31.380
which has been conditioned to
some extent to be tolerant,

01:04:31.380 --> 01:04:32.850
but you don't have any guarantee.

01:04:32.850 --> 01:04:34.769
Therefore, if you have an event

01:04:34.769 --> 01:04:38.332
that wakes up the immune
system like an infection,

01:04:38.332 --> 01:04:40.803
then rejection could happen at any time.

01:04:48.870 --> 01:04:51.240
- [Dr Reddy] Kayte, there
are two complications

01:04:51.240 --> 01:04:53.760
after any liver transplant
that you that you need to know

01:04:53.760 --> 01:04:56.040
and these are quite serious complications

01:04:56.040 --> 01:04:58.090
and usually the patient will not survive.

01:04:59.160 --> 01:05:00.870
One is called hepatic artery thrombosis,

01:05:00.870 --> 01:05:04.953
which means the artery that
we join can get blocked off.

01:05:06.395 --> 01:05:09.523
The risk of that happening is only 1%.

01:05:09.523 --> 01:05:11.010
The second risk is called
primary nonfunction,

01:05:11.010 --> 01:05:11.880
which means the liver,

01:05:11.880 --> 01:05:13.950
that we transplanted
into you doesn't work.

01:05:13.950 --> 01:05:16.098
The risk is again about 1%, okay?

01:05:16.098 --> 01:05:19.783
- [Kayte] What was the name
of the first complication?

01:05:19.783 --> 01:05:21.414
- Hepatic artery thrombosis.

01:05:21.414 --> 01:05:24.062
- Hepatic artery thrombosis.

01:05:24.062 --> 01:05:26.179
- And that's the risk that is there.

01:05:26.179 --> 01:05:28.350
In your case, the previous
surgeries that you had

01:05:28.350 --> 01:05:31.103
and all that is going to make
things a bit more difficult.

01:05:31.977 --> 01:05:33.240
We are gonna first have a good look inside

01:05:33.240 --> 01:05:35.890
and make sure that there's
no other cancer elsewhere.

01:05:37.350 --> 01:05:39.250
Then we'll proceed with the operation.

01:05:40.440 --> 01:05:42.081
That's something that
Professor Rela will decide

01:05:42.081 --> 01:05:43.180
on the table.

01:05:47.280 --> 01:05:48.780
- [Dr Slavin] Tomorrow is a big challenge.

01:05:49.980 --> 01:05:51.767
As I think both Dr. Rela and I agree

01:05:51.767 --> 01:05:53.730
that the the only thing we don't want is

01:05:53.730 --> 01:05:55.470
to lose the first patient

01:05:55.470 --> 01:05:56.303
'cause it'll be very difficult
to get the second patient.

01:05:58.560 --> 01:06:00.330
In the beginning with anesthesia,

01:06:00.330 --> 01:06:02.490
I will take bone marrow
cells from the donor.

01:06:02.490 --> 01:06:05.172
We can put the patient
on the side. Can we?

01:06:05.172 --> 01:06:06.838
- [Dr Real] Yeah, you can.
- I don't need many holes.

01:06:06.838 --> 01:06:09.150
It's only one in the
skin, boom, and that's it.

01:06:09.150 --> 01:06:09.983
- Yeah.

01:06:09.983 --> 01:06:11.820
- And then you do the transplant

01:06:11.820 --> 01:06:13.530
and then we do bone marrow infusion

01:06:13.530 --> 01:06:14.700
because in case you're bleeding,

01:06:14.700 --> 01:06:15.990
I don't want to waste the cells.

01:06:15.990 --> 01:06:17.010
- Yep.

01:06:17.010 --> 01:06:18.240
One of the questions was

01:06:18.240 --> 01:06:20.700
will we start the recipient
first or the donor first,

01:06:20.700 --> 01:06:22.860
because the liver is a
large liver in the donor.

01:06:22.860 --> 01:06:26.064
That operation is going to take
five or six hours at least.

01:06:26.064 --> 01:06:29.190
And therefore if we do her operation first

01:06:29.190 --> 01:06:31.350
and then start the donor operation,

01:06:31.350 --> 01:06:33.420
she'll be anesthetized
for a very long time.

01:06:33.420 --> 01:06:35.550
That's probably not in
her interest really.

01:06:35.550 --> 01:06:38.078
So I think we should start with the donor

01:06:38.078 --> 01:06:39.570
and then the recipient.

01:06:39.570 --> 01:06:42.180
- What happens if you open the recipient

01:06:42.180 --> 01:06:44.137
and then you say, God forbidden,

01:06:44.137 --> 01:06:45.840
"I cannot do the transplant."

01:06:45.840 --> 01:06:48.409
- If we get into trouble,
there have been instances

01:06:48.409 --> 01:06:51.030
where the donor organ
has been divided into two

01:06:51.030 --> 01:06:52.780
and then left without being removed

01:06:53.730 --> 01:06:55.950
and the liver will actually recover.

01:06:55.950 --> 01:06:59.610
With Kayte, the question
is whether we go ahead,

01:06:59.610 --> 01:07:01.920
if there is extra-hepatic disease.

01:07:01.920 --> 01:07:04.890
Also, what is the amount
of damage from all

01:07:04.890 --> 01:07:07.102
of that previous radiation?

01:07:07.102 --> 01:07:10.770
I mean the radiology
actually doesn't show.

01:07:10.770 --> 01:07:12.780
We'll only know when the donor organ is

01:07:12.780 --> 01:07:14.381
actually nearly ready to come out.

01:07:14.381 --> 01:07:15.750
- Okay.

01:07:15.750 --> 01:07:16.936
- We won't know any other way.

01:07:16.936 --> 01:07:18.226
- So we have to pray.
- Yes.

01:07:18.226 --> 01:07:20.893
(mellow music)

01:07:44.323 --> 01:07:47.947
- I can tell everyone's tired
and ready for a conclusion,

01:07:49.860 --> 01:07:51.573
whatever conclusion it is.

01:07:52.589 --> 01:07:53.940
I mean, to me, I accept any conclusion

01:07:53.940 --> 01:07:56.280
'cause it's the next
step for the next people

01:07:56.280 --> 01:07:59.190
because there will be others who will try,

01:07:59.190 --> 01:08:02.880
even if it just needs
to show a little promise

01:08:02.880 --> 01:08:04.440
and that's good to me

01:08:04.440 --> 01:08:06.600
and for humanity, that's good enough.

01:08:06.600 --> 01:08:09.403
But I would really like
my sister to live. Yeah.

01:08:53.248 --> 01:08:55.998
(birds chirping)

01:09:01.110 --> 01:09:03.860
(waves crashing)

01:09:24.484 --> 01:09:29.484
(bell rings)
(people chattering)

01:09:57.144 --> 01:09:59.894
(fire crackling)

01:10:02.510 --> 01:10:04.010
- [Cecilia] Jesus loves you.

01:10:05.129 --> 01:10:09.629
- I thought I was holding
it together but I guess not.

01:10:15.286 --> 01:10:17.336
- [Jacob] I could use
another two hours of sleep.

01:10:18.872 --> 01:10:22.020
Yeah, just ready to get it done.

01:10:24.870 --> 01:10:28.669
- All right Howard, just
remember this was all your idea.

01:10:28.669 --> 01:10:31.252
Remember, it was all your idea.

01:10:34.778 --> 01:10:35.925
- Hey, have a good time.

01:10:35.925 --> 01:10:39.008
- Bye, All. Love you,
Momma. Love you, Jake.

01:10:58.789 --> 01:11:00.206
- [Dr Real] You okay there?

01:11:01.455 --> 01:11:02.788
- [Dr. Slavin] Okay.

01:11:09.711 --> 01:11:12.203
- You'll be going to sleep now, okay?

01:11:12.203 --> 01:11:13.422
- [Jacob] Okay.

01:11:13.422 --> 01:11:15.338
(machine beeping)

01:11:33.105 --> 01:11:34.350
- So, you're going off to
sleep, okay? Sweet dreams.

01:11:34.350 --> 01:11:35.435
We look after you.

01:11:35.435 --> 01:11:36.696
- [Kayte] Thank you.

01:11:36.696 --> 01:11:39.529
(machine beeping)

01:11:53.209 --> 01:11:55.876
(ominous music)

01:12:53.977 --> 01:12:55.584
(liquid trickling)

01:12:55.584 --> 01:12:59.936
- This is the bone marrow we
will inject after surgery.

01:12:59.936 --> 01:13:01.519
- Table down, please.

01:13:03.411 --> 01:13:06.003
- We are ready to start on the donor.

01:13:06.003 --> 01:13:08.836
(machine beeping)

01:13:47.777 --> 01:13:50.527
(hammer tapping)

01:13:54.010 --> 01:13:57.177
- We are ready to open up the recipient.

01:13:58.567 --> 01:14:00.600
Hopefully the problem is
totally within the liver

01:14:00.600 --> 01:14:01.884
and nowhere else.

01:14:01.884 --> 01:14:04.717
(machine beeping)

01:14:23.184 --> 01:14:26.101
- [Dr Rela] We have the
abdomen open for Kayte.

01:14:31.235 --> 01:14:32.393
And the peritoneal cavity
is absolutely clean.

01:14:32.393 --> 01:14:37.140
There is no disease, which
is what we were hoping for.

01:14:37.140 --> 01:14:39.240
She had a lot of radiotherapy

01:14:39.240 --> 01:14:41.223
and the damage is not that bad.

01:14:42.222 --> 01:14:44.298
I don't think that will be a problem.

01:14:44.298 --> 01:14:46.917
- [Dr. Slavin] Okay? No problem.

01:14:46.917 --> 01:14:50.408
- No problem.
- Good.

01:14:51.247 --> 01:14:53.670
- [Howard] Everything
is going quite smoothly.

01:14:53.670 --> 01:14:56.520
The surrounding tissue, it
looks like it's in good shape.

01:14:57.630 --> 01:15:00.603
They're now waiting for the
donor liver to be removed.

01:15:07.920 --> 01:15:10.260
This is my first time in surgery.

01:15:10.260 --> 01:15:11.730
There's a certain aesthetic appeal

01:15:11.730 --> 01:15:14.160
to the movement in the operating room.

01:15:14.160 --> 01:15:15.603
It's sort of like a dance.

01:15:18.270 --> 01:15:20.370
- [Dr. Rela] Let's excise
the liver for Kayte.

01:15:21.510 --> 01:15:24.420
- [Howard] The most
impressive thing about it was

01:15:24.420 --> 01:15:26.700
the nurses understood
the surgery well enough.

01:15:26.700 --> 01:15:30.697
Dr. Rela did not have to ask
for any instruments at all.

01:15:34.839 --> 01:15:38.006
- [Dr. Rela] Okay, the liver's coming out.

01:15:46.620 --> 01:15:50.070
- So this is where Kayte's
original artery stops

01:15:50.070 --> 01:15:52.043
and this was blocked off.

01:15:52.043 --> 01:15:53.010
So what we've done is we've cut it

01:15:53.010 --> 01:15:56.100
to the level where there's good flow

01:15:56.100 --> 01:15:58.380
and then we'll join a bit of vein,

01:15:58.380 --> 01:16:01.566
which we're taken from Jacob's leg.

01:16:01.566 --> 01:16:04.316
(dramatic music)

01:16:12.200 --> 01:16:17.200
The long tubular structure
we are seeing is the vein.

01:16:17.937 --> 01:16:20.354
- Now, we put the new liver in.

01:16:25.521 --> 01:16:28.104
And then we connect the artery.

01:16:40.560 --> 01:16:42.150
- [Howard] The level of precision

01:16:42.150 --> 01:16:47.150
and just the sewing skills
of Dr. Rela amaze me.

01:16:48.540 --> 01:16:50.970
He told me that it wasn't difficult

01:16:50.970 --> 01:16:53.730
because he's used to
doing pediatric grafts

01:16:53.730 --> 01:16:56.768
where the vessels are much smaller.

01:16:56.768 --> 01:16:58.744
- [Dr. Rela] I think that looks perfect.

01:16:58.744 --> 01:17:02.180
Look, the color is changing. Can you see?

01:17:02.180 --> 01:17:04.019
- [Dr. Slavin] There is blood
flowing through the liver.

01:17:04.019 --> 01:17:05.135
- [Dr. Rela] The color's getting better.

01:17:05.135 --> 01:17:07.504
- [Dr. Slavin] How will be the
liver function test tomorrow?

01:17:07.504 --> 01:17:09.540
- [Dr. Rela] Liver function
test should be perfect.

01:17:09.540 --> 01:17:11.290
Trust me, this is a nice operation.

01:17:13.576 --> 01:17:15.493
- [Dr. Slavin] I trust in you.

01:17:18.570 --> 01:17:20.897
- [Dr. Rela] Jacob's operation
actually was more difficult

01:17:20.897 --> 01:17:23.683
than I expected, because he's big.

01:17:23.683 --> 01:17:28.683
- Okay, 1, 2, 3.
(machine beeping)

01:17:34.107 --> 01:17:37.816
- This is bone marrow cells
that we aspirated this morning

01:17:37.816 --> 01:17:39.821
to induce tolerance.

01:17:39.821 --> 01:17:41.984
Now we make a chimera.

01:17:41.984 --> 01:17:44.651
(ominous music)

01:18:19.145 --> 01:18:21.645
- [Dr. Slavin] Shake it, shake it.

01:18:23.024 --> 01:18:24.261
One more syringe here

01:18:24.261 --> 01:18:26.752
and then the rest of it, intravenous.

01:18:26.752 --> 01:18:29.919
(surgeons chattering)

01:18:35.122 --> 01:18:39.205
If this goes well, then
another patient is ready.

01:18:42.187 --> 01:18:44.520
- [Dr Real] Let's speak to the family.

01:18:50.166 --> 01:18:52.403
Sit down, sit down.

01:18:52.403 --> 01:18:54.486
The operation's finished.

01:18:56.400 --> 01:18:59.706
It's gone very well.
Better than I expected.

01:18:59.706 --> 01:19:02.550
- [Jake] They said that
we could see the liver.

01:19:02.550 --> 01:19:03.383
- [Dr Rela] Yes, you can.

01:19:03.383 --> 01:19:06.510
We normally show the liver
to the patients' relatives.

01:19:06.510 --> 01:19:07.770
That's the tumor.

01:19:07.770 --> 01:19:09.320
We've taken some pieces off it.

01:19:10.290 --> 01:19:13.010
- Those are tumors, Jake?
- Mm-hmm.

01:19:13.010 --> 01:19:14.366
- [Cecilia] All those little ones?

01:19:14.366 --> 01:19:15.713
- [Dr. Rela] Yeah, these are tumors.

01:19:17.380 --> 01:19:19.072
- [Dr Slavin] I have
to say one more thing.

01:19:19.072 --> 01:19:20.226
You will never

01:19:20.226 --> 01:19:23.421
in the world could have a
better one than Mohamed.

01:19:23.421 --> 01:19:25.410
- We couldn't be happier to be here.

01:19:25.410 --> 01:19:27.300
Actually, like, you know,

01:19:27.300 --> 01:19:29.760
we were worried like you
have no idea to begin with,

01:19:29.760 --> 01:19:32.403
but like, we couldn't
be in a better place.

01:19:36.630 --> 01:19:39.570
- [Howard] This was, I think,
a pretty difficult surgery.

01:19:39.570 --> 01:19:41.520
But the first couple disastrous things

01:19:41.520 --> 01:19:43.270
that could happen haven't happened.

01:19:46.020 --> 01:19:48.240
Right now, the worst case scenario is

01:19:48.240 --> 01:19:50.631
that tolerance is not induced,

01:19:50.631 --> 01:19:54.810
in which case, Kayte would need
to be on immunosuppressants.

01:19:54.810 --> 01:19:58.943
And having a new liver, it
would be impossible to conceive

01:19:58.943 --> 01:20:01.493
because she would be worse
off than she was before.

01:20:03.560 --> 01:20:06.827
- I think the healing is going to go well.

01:20:06.827 --> 01:20:08.494
Then we can go home.

01:20:25.265 --> 01:20:27.380
- Is the video on?
- Yeah.

01:20:27.380 --> 01:20:31.320
- Yeah, this is the day
after Kayte's third surgery

01:20:31.320 --> 01:20:34.083
and she's looking so good.

01:20:34.980 --> 01:20:37.050
Recovery was going well,

01:20:37.050 --> 01:20:40.140
but after a few weeks the doctor came in

01:20:40.140 --> 01:20:42.477
and said, "We have to
take you to surgery."

01:20:43.590 --> 01:20:46.380
- [Dr Slavin] Postoperatively,
she was off immunosuppression

01:20:46.380 --> 01:20:49.920
for two weeks, but then she
did have a low grade rejection.

01:20:49.920 --> 01:20:51.480
Her enzymes were slightly up

01:20:51.480 --> 01:20:54.003
and we had to start her
back on immunosuppression.

01:20:56.340 --> 01:20:59.883
- This failing to induce
tolerance is not a disaster.

01:20:59.883 --> 01:21:01.949
She still has a new liver in her,

01:21:01.949 --> 01:21:04.980
which means we reset
the clock on the disease

01:21:04.980 --> 01:21:07.740
and so if she relapses,
she would start out

01:21:07.740 --> 01:21:09.390
with a clean liver.

01:21:09.390 --> 01:21:10.770
- Possibly, we may be able

01:21:10.770 --> 01:21:12.540
to withdraw immunosuppression
in the future

01:21:12.540 --> 01:21:14.253
and still have tolerance.

01:21:16.145 --> 01:21:20.880
However, around the third
week she had a problem

01:21:20.880 --> 01:21:24.090
with her hepatic artery,
hepatic artery thrombosis

01:21:24.090 --> 01:21:27.060
but we caught that very quickly.

01:21:27.060 --> 01:21:27.893
Scissors.

01:21:29.070 --> 01:21:32.790
We re-operated on her and
revascularized her artery

01:21:32.790 --> 01:21:36.060
and subsequently established a good flow.

01:21:36.060 --> 01:21:37.560
Yeah, that's good.

01:21:37.560 --> 01:21:40.800
Fortunately, Kayte's a very strong person.

01:21:40.800 --> 01:21:43.140
- [Caroline] It will be good.

01:21:43.140 --> 01:21:47.250
I was the one who was taking
care from the starting.

01:21:47.250 --> 01:21:49.380
Yeah, she's very courageous.

01:21:49.380 --> 01:21:52.020
Kayte won't tell about her pain, okay.

01:21:52.020 --> 01:21:54.810
Whenever we go inside, she just smiles.

01:21:54.810 --> 01:21:59.130
She just ask us whether we
had a breakfast or everything.

01:21:59.130 --> 01:22:01.030
She's a good girl. She won't complain.

01:22:02.310 --> 01:22:04.413
When she goes home, we'll miss her.

01:22:05.370 --> 01:22:08.558
- This is the day after
Kayte's third surgery.

01:22:08.558 --> 01:22:11.397
Jacob and I are leaving tonight to go home

01:22:11.397 --> 01:22:13.590
and she's looking so good.

01:22:13.590 --> 01:22:16.380
She's gonna be out here very soon

01:22:16.380 --> 01:22:17.820
and have some time to relax

01:22:17.820 --> 01:22:20.555
and get even better at the hotel

01:22:20.555 --> 01:22:24.963
and flying high to the
United States of America.

01:22:28.416 --> 01:22:29.253
I love India.

01:22:31.714 --> 01:22:34.416
Do you want to say anything?

01:22:34.416 --> 01:22:37.136
- I'm ready to go home.

01:22:37.136 --> 01:22:38.053
- For sure.

01:23:00.853 --> 01:23:04.103
(boat engine rumbling)

01:23:18.599 --> 01:23:20.040
- [Jake] I believe in God,

01:23:20.040 --> 01:23:24.280
but I just don't feel like

01:23:26.160 --> 01:23:27.063
he's very fair.

01:23:31.968 --> 01:23:34.718
(ominous music)

01:24:07.200 --> 01:24:09.300
- [Howard] Sunday morning, I got up

01:24:09.300 --> 01:24:10.430
at, you know, my regular like 4:00

01:24:10.430 --> 01:24:12.445
in the morning or whatever,

01:24:12.445 --> 01:24:14.343
and I saw an email from India.

01:24:15.205 --> 01:24:17.790
You know, my eyes were not adjusted yet,

01:24:17.790 --> 01:24:22.790
so I just saw words, like, I saw "Kayte"

01:24:23.040 --> 01:24:27.210
and then I saw words, which
were like a scary size,

01:24:27.210 --> 01:24:30.750
but it took a while before
my eyes could adjust enough

01:24:30.750 --> 01:24:32.490
to actually read it.

01:24:32.490 --> 01:24:34.953
Yeah, that's how I found out she died.

01:24:44.580 --> 01:24:47.213
- [Dr Rela] It is difficult
to think over all of it.

01:24:48.870 --> 01:24:52.966
I mean, I'm very saddened
by Kayte's death.

01:24:52.966 --> 01:24:54.603
It was very unexpected.

01:24:57.060 --> 01:25:00.060
She had a problem with her hepatic artery

01:25:00.060 --> 01:25:03.030
and I used a small part of hepatic artery.

01:25:03.030 --> 01:25:04.560
Perhaps that was a mistake

01:25:04.560 --> 01:25:08.610
because the artery was
probably not completely healthy

01:25:08.610 --> 01:25:09.783
and it thrombosed.

01:25:11.760 --> 01:25:14.493
That was what we called
an insult to the liver.

01:25:15.420 --> 01:25:18.270
What happened from that
insult was probably,

01:25:18.270 --> 01:25:20.202
she had some necrosis of some parts

01:25:20.202 --> 01:25:22.480
of the liver from that insult

01:25:23.550 --> 01:25:27.960
and from then on really, she
never became completely normal.

01:25:27.960 --> 01:25:31.440
Her liver function tests were
quite abnormal for a while,

01:25:31.440 --> 01:25:33.840
and she developed some septic episodes

01:25:33.840 --> 01:25:37.053
and finally she died of sepsis really.

01:25:38.910 --> 01:25:40.293
It's a failing really.

01:25:41.820 --> 01:25:44.025
It upsets me enormously.

01:25:44.025 --> 01:25:46.740
I don't know what else I can do.

01:25:50.670 --> 01:25:54.480
- [Slavin] Unfortunately, it
didn't end the way we wanted.

01:25:54.480 --> 01:25:58.443
Not because of Dr. Rela or
because the theory was wrong,

01:25:59.610 --> 01:26:03.333
but rather, because of the
fact that she was so sick.

01:26:04.890 --> 01:26:07.143
Maybe that contributed
to the complications.

01:26:08.340 --> 01:26:10.350
The bottom line is she's not with us.

01:26:10.350 --> 01:26:11.883
That's very sad, of course,

01:26:14.550 --> 01:26:17.070
- I do question whether
I should have done it

01:26:17.070 --> 01:26:18.213
in the first place.

01:26:35.220 --> 01:26:37.623
- Kayte's death was just crushing.

01:26:40.680 --> 01:26:43.020
As Kayte was being
wheeled into the surgery,

01:26:43.020 --> 01:26:45.777
she said, "Well, Howard,
you got me into this."

01:26:47.640 --> 01:26:49.680
In a way, I mean even the artery

01:26:49.680 --> 01:26:52.653
that thrombosed was my idea, right?

01:27:05.550 --> 01:27:08.813
Appliance Timers.
- (indistinct)

01:27:09.810 --> 01:27:13.320
- That SF number is the
number of spitfire controls,

01:27:13.320 --> 01:27:14.920
but I need the Frigidaire number

01:27:16.140 --> 01:27:17.303
and that starts, okay.

01:27:19.577 --> 01:27:21.540
Now, I work all the time

01:27:21.540 --> 01:27:24.630
so that I don't have
time to feel depressed.

01:27:24.630 --> 01:27:25.630
It's just, you know,

01:27:26.790 --> 01:27:29.280
it's just changed my life a lot, you know?

01:27:50.095 --> 01:27:53.095
(people chattering)

01:28:13.245 --> 01:28:14.413
- [Caroline] Ezee.

01:28:14.413 --> 01:28:17.413
(people chattering)

01:28:24.887 --> 01:28:26.137
Do you like it?

01:28:27.779 --> 01:28:32.613
- Surprise. Now that I am
living with my wife and son.

01:28:34.590 --> 01:28:37.050
The first time I remember
seeing Caroline in India,

01:28:37.050 --> 01:28:38.400
she like just kind of stood there

01:28:38.400 --> 01:28:40.680
and looked at us like
deer in the headlights

01:28:40.680 --> 01:28:43.560
'cause she, I guess, in
one moment resigned herself

01:28:43.560 --> 01:28:46.653
to being the giant American's nurse.

01:28:47.820 --> 01:28:50.130
- I never see a huge man like that,

01:28:50.130 --> 01:28:55.130
but I liked him.

01:28:55.215 --> 01:28:58.215
(people chattering)

01:29:04.050 --> 01:29:05.970
- I wouldn't qualify it as fate

01:29:05.970 --> 01:29:08.970
'cause to me that means
it's already written.

01:29:08.970 --> 01:29:09.803
When people ask me that

01:29:09.803 --> 01:29:13.503
and it's like, you don't believe
that that was God's plan.

01:29:14.670 --> 01:29:16.587
It's like your sister has
to get this terrible cancer

01:29:16.587 --> 01:29:17.940
and need to go to India

01:29:17.940 --> 01:29:20.223
and die just for you to meet your wife.

01:29:21.084 --> 01:29:24.723
No. If that is a plan,
that is a terrible plan.

01:29:35.160 --> 01:29:36.637
You wanna see it?
- Yeah.

01:29:42.703 --> 01:29:44.877
- It's big.
- It's big.

01:29:44.877 --> 01:29:46.340
- And I'm still pulling hairs out

01:29:46.340 --> 01:29:48.620
of the side from where they cut.

01:29:48.620 --> 01:29:53.400
Very unpleasant having
to dig those out with two

01:29:53.400 --> 01:29:56.403
to three needles and getting
multiple angles, yeah.

01:29:57.630 --> 01:29:59.672
If I got on the ground, I'm
probably not gonna get back up.

01:29:59.672 --> 01:30:00.870
(people chattering)

01:30:00.870 --> 01:30:03.300
I notice I get tired faster

01:30:03.300 --> 01:30:05.970
and I know I can't lift
as much as I used to.

01:30:05.970 --> 01:30:07.620
I'm as good as I can be.

01:30:07.620 --> 01:30:10.050
I guess, if you wanna put in percentages,

01:30:10.050 --> 01:30:13.743
I would say I'm like 75
of what I was before.

01:30:15.150 --> 01:30:17.070
I can't feel my left foot.

01:30:17.070 --> 01:30:21.153
I think they hit a nerve here
when they took that vein.

01:30:22.950 --> 01:30:25.680
It's like when I'm walking,
I'm really paying attention

01:30:25.680 --> 01:30:28.053
that the floor is actually under my foot.

01:30:29.430 --> 01:30:31.500
It's not the most fun thing in the world,

01:30:31.500 --> 01:30:33.603
but I'd do it again if I could.

01:30:35.820 --> 01:30:39.330
The most important thing is I
want Kayte to be remembered.

01:30:39.330 --> 01:30:42.338
She's no longer here, but
she's definitely not gone.

01:30:42.338 --> 01:30:45.005
(mellow music)

01:30:54.194 --> 01:30:57.003
- [Dr Fuchs] Well, I thought
he was a telemarketer.

01:30:57.003 --> 01:31:01.687
No, I'm just kidding.

01:31:01.687 --> 01:31:05.130
You know, I was pretty impressed

01:31:05.130 --> 01:31:06.430
with Howard's idea

01:31:07.680 --> 01:31:11.583
and in fact, we are going to
be doing it at Johns Hopkins.

01:31:13.440 --> 01:31:16.920
I have to say that in
a way, learning about

01:31:16.920 --> 01:31:19.983
Kayte Hollingsworth was
what made the trial happen.

01:31:20.940 --> 01:31:23.370
You know, here's a person
with an unwillingness

01:31:23.370 --> 01:31:25.590
to sort of accept dogma;

01:31:25.590 --> 01:31:28.952
who said, I'm not gonna
go out, you know, timidly

01:31:28.952 --> 01:31:32.883
and you don't oftentimes see that.

01:31:35.130 --> 01:31:38.310
- This new trial is the same
idea as what we did in India

01:31:38.310 --> 01:31:40.923
but it'll be done in a
slightly different way.

01:31:42.690 --> 01:31:44.580
Now that we're doing it in Hopkins,

01:31:44.580 --> 01:31:46.800
we're first doing the liver transplant

01:31:46.800 --> 01:31:48.356
and then we're gonna do immunosuppression

01:31:48.356 --> 01:31:51.930
and then when the liver is
deemed to be healthy enough

01:31:51.930 --> 01:31:54.480
and well enough regenerated,
we're actually going

01:31:54.480 --> 01:31:57.210
to use a full bone marrow transplant,

01:31:57.210 --> 01:31:59.400
which is full chimerism.

01:31:59.400 --> 01:32:00.900
And then by the time we're done,

01:32:00.900 --> 01:32:02.430
after a couple months hopefully

01:32:02.430 --> 01:32:04.459
there will be permanent tolerance

01:32:04.459 --> 01:32:06.600
and then we can remove immunosuppression

01:32:06.600 --> 01:32:09.093
and hopefully everyone
lives happily ever after.

01:32:16.143 --> 01:32:18.234
- [Dr Slavin] I'm proud of
the fact we did not give up.

01:32:18.234 --> 01:32:21.540
That is the credit to
Howard as well as Dr. Rela

01:32:21.540 --> 01:32:23.397
who was courageous enough
to try something new

01:32:23.397 --> 01:32:25.713
and I hope he will try to do it again.

01:32:27.107 --> 01:32:29.160
- [Dr Rela] I'm ready for it.

01:32:29.160 --> 01:32:31.199
If you're not prepared to face failures,

01:32:31.199 --> 01:32:33.243
you can never innovate.

01:32:34.377 --> 01:32:38.853
- For a long time, I was
depressed because Kayte died.

01:32:39.810 --> 01:32:43.020
I just have to remember that
she preferred it that way.

01:32:43.020 --> 01:32:46.140
That is she preferred to die trying

01:32:46.140 --> 01:32:48.843
to do something beneficial
for the whole world.

01:32:50.850 --> 01:32:54.270
If you invent a treatment to
treat a particular patient,

01:32:54.270 --> 01:32:56.400
that trial would be an n of 1,

01:32:56.400 --> 01:32:59.223
which means a number of
patients in the trial is one.

01:33:04.140 --> 01:33:08.820
- [Cecilia] She passed away a
week before her 27th birthday,

01:33:08.820 --> 01:33:12.723
but she has left a legacy behind her.

01:33:16.110 --> 01:33:20.433
I'm proud of her. Somebody
has to be first in everything.

01:33:21.510 --> 01:33:25.320
- She said, "Something has to
be done so I'm gonna do it."

01:33:25.320 --> 01:33:27.870
That's what Kayte always
said, "I'll do it myself."

01:33:28.740 --> 01:33:29.740
That's what she did.

01:33:33.090 --> 01:33:34.980
- [Tal] I think that
that's the kind of person

01:33:34.980 --> 01:33:36.630
when everyone else is
saying there's nothing

01:33:36.630 --> 01:33:40.140
that can be done, this one
person is not afraid to go

01:33:40.140 --> 01:33:41.875
and change the world.

01:33:41.875 --> 01:33:44.610
- [Howard] You know, the
thing is that many people,

01:33:44.610 --> 01:33:47.310
they have an idea that could
make a difference, right?

01:33:49.380 --> 01:33:51.510
- [Dr Fuchs] Good ideas
can come from anywhere.

01:33:51.510 --> 01:33:53.399
You can't have such an ego

01:33:53.399 --> 01:33:56.132
that you reject something out of hand

01:33:56.132 --> 01:33:59.460
because you never know where a
good idea is gonna come from.

01:33:59.460 --> 01:34:01.920
It could come from, you
know, basic biology.

01:34:01.920 --> 01:34:03.210
It could come from physics.

01:34:03.210 --> 01:34:04.380
It could come from some guy

01:34:04.380 --> 01:34:06.663
that's walking down the street, you know?

01:34:15.150 --> 01:34:17.650
(phone beeps)

01:34:20.040 --> 01:34:21.063
- Appliance Timers.

01:34:24.060 --> 01:34:25.270
What's your symptom?

01:34:27.800 --> 01:34:30.383
(mellow music)

01:35:03.177 --> 01:35:06.594
(mellow music continues)

01:35:31.668 --> 01:35:35.085
(mellow music continues)

01:35:59.778 --> 01:36:03.195
(mellow music continues)

01:36:29.838 --> 01:36:33.255
(mellow music continues)