TMC Spotlight: Mauro Ferrari, Ph.D.

MAURO FERRARI, PH.D., president and CEO of Houston Methodist Research Institute, is known for his revolutionary treatment of cancer using nanotechnology. Ferrari spoke with Pulse about ‘disciplinary fracking,’ what soothes his soul, and why he identifies with the butler from Downton Abbey.

Q | You’re an avid marathon runner, which requires a lot of mental and physical discipline. How does that discipline translate to your research?

A | Running is a metaphor for cancer research in the sense that rule No. 1 is you don’t stop. No matter what happens, you keep on going. That’s what it takes. Now, to bring true innovation to the clinic, it’s a journey of many, many years. Incremental innovation can go a little bit faster, but, of course, incremental innovation hasn’t cured metastatic disease yet. To cure metastatic disease, you need to be able to think of things that are truly different—starting from scratch—and refuse to die and keep on going.

Cancer research is also kind of like a game of basketball, with a few differences. One, you are pretty much 30 points behind the whole time, which doesn’t mean you can’t win the game, but it means that if you don’t have the psychological mindframe that you’re not going to stop playing no matter what, then you know you’re never going to win. You can win, but not if you quit.

Second difference is a basketball game is 48 minutes. Each of the games I’m talking about is at least 20 years. Third big difference is you only get one game per life, so you have to use it wisely. That’s the way I think: Play the best you can and try to make good things happen.

Q | How many marathons have you run?

A | About 30, but I take my time. One reason why I think I like it so much is it’s easier than any day in the office. Also, I’m not very good at it. That’s the important part. I think it teaches you humility.

I like to run what they call ‘ultra-marathons’ up mountains. I’ve done marathons with a total elevation gain of 12,000 feet. It’s a mystical experience. The longest one I’ve done, the 100K (62 miles), took me about 16.5 hours.

Everybody is able to celebrate when they win. If it comes easy, boom, you do it again and you do it again. Learning comes from slogging through things you are having a hard time doing. I think that’s a good lesson.

Q | I understand your first wife, Marialuisa, passed away from cancer while you were a professor at the University of California, Berkeley. How did that personal tragedy shape your life and career?

A | To me, it’s a notion of philosophy of life, if you will. I don’t know what the meaning of life is. I don’t think anyone does. But I have this sneaky suspicion that it’s got something to do with turning one’s own pain and suffering into good things for others. If you’re able to do that, the meaning of life is within reach. That is kind of my notion that brings joy, that brings a sense of mission, that brings some settlement for all the restlessness of life. If you turn your own pain into good things for others, I think that’s a step in the right direction.

Q | How did you meet your wife Paola?

A | I knew Paola even before I knew Marialuisa. We are from the same small part of the same small town up in the mountains of Italy. We went to the same high school, though she’s a few years younger than I am. She had come to the U.S. independently to be a Fulbright Scholar at Columbia University, working at the United Nations.

The two of us—the three of us, including Marialuisa—come from very humble backgrounds. Nobody in our three families had ever been to college, so this was a major step in breaking away from tradition.

Q | How so?

A | We have steel mills in our town, and that was a traditional place of occupation for everybody. It was either that or the military. My family was military. I was the black sheep of the family; I went to college. I was really focused and got my Ph.D. from Berkeley. I get back to Italy and I’m thinking, ‘Man, I’ve gotten my break into big-time action!’ All those Nobel laureates at Berkeley. Back in my day, there were 17 Nobel laureates. I was watching all these great people and I was thinking great thoughts.

Before I married Marialuisa, I actually stopped going to college for six months so that I could make
money any which way I could, including tutoring high school kids. I was a tutoring machine. When I got back to Italy after Berkeley, my father said, ‘Well, now you’ve got your Ph.D., you can charge more when you tutor high school kids!’ You see the disconnect? It was all in good faith, but what the heck did they know about Cal Berkeley, universities, Nobel laureates and all that stuff? It’s entirely different.

Q | You started as a mathematical physicist and mechanical engineer, then moved into medicine. Tell me about that combination of disciplines.

A | At Berkeley, I was a mathematician who used to work on mathematical physics. My job was in the mathematical foundation of the theory of relativity and how it applies to the expansion of the universe. Then I got a Ph.D. in mechanical engineering, then taught and got a tenured faculty position in materials science, civil engineering and bioengineering. That was just at Berkeley. Then I moved over to Ohio State, where I was a full tenured professor of medicine. I started medical school at age 43 as a full professor of medicine. That was a lot of fun.

You know the words ‘interdisciplinary’ and ‘multidisciplinary?’ I don’t like either word. I like the word ‘superdisciplinary.’ You know when you get excited and the sparks start flying when you put two different things together? Now that I’ve moved to Texas, the way I think about what I try to do is ‘disciplinary fracking.’ I go deep, and I break barriers so the juices start flowing and everybody wins.

You can get little earthquakes, but in this case, it’s good earthquakes.

Q | How will a ‘super-disciplinary’ approach or ‘disciplinary fracking’ help us cure cancer?

A | The reason we haven’t been able to cure cancer is diversity. There is no such thing as one disease. There are hundreds of diseases. Every cancer is different, and you can only fight like with like. Unless you have a diversity of approaches that work together, you cannot beat the diversity of cancers. Nobody can do it solo.

It’s important that we have depth in all of the disciplines, but it is equally important—perhaps even more important—that we understand how to connect them in a synergistic fashion. I’m a big believer in the notion that science is autobiography and that science is essentially self-confession. We can only do the science that our brain cells are wired to do.

My brain sees patterns, sees connections. I’ve been a professional mathematician, professional engineer, this and that. I wasn’t good at any. I’m a little bit better at putting things together and seeing ways in which things can get together and do things that are impressive, which is good for the job that I do.

Everything we do here is at the service of patients. A lot of times in the sciences, we do science for the sake of science. I don’t mean to criticize because that’s the right thing for a lot of people. That’s right for universities, but here, we are a hospital.

Every day, I get phone calls or emails or contacts from people who are desperate, who are dying. Someone with breast cancer, metastatic disease, their life expectancy on average 24 to 36 months. It’s them, it’s their husbands, their children who contact me and say, ‘We read about this thing in mice. Can you do it to my loved one or to me?’ Those are very difficult questions and we field each and every one of them personally.

Q | You have a framed printout with the words ‘Luke 12:48’ above your office doorway. What does that mean to you?

A | This is the passage from the Gospel of Luke where it talks about the fact that from people to whom much is given, much is expected. Look where we are: the No. 1 medical center in the world. If we don’t work on the big problems, who will? We can’t run away, shy away. It’s a responsibility. It’s an ethical responsibility.

Q | There’s also a handwritten note next to it. What’s the story behind that?

A | That’s the story of a young lady who actually came in from Italy. She was 16, seeking desperate, experimental treatment. She was taken care by another institution and by great people who did all the right things, but she was a desperate case with cancer of the brain. As part of her treatment and the evolution of her disease, at a certain point, she went into a coma. I had become very close to her and her family. They were from Italy, so I was kind of their reference.

Then in the summer, I was on a trip for a couple of weeks while she was in a coma. I came back and I wanted to see the family in the ICU. I thought there was a good likelihood that she would be dead, but she wasn’t. Not only that, but she had woken up from the coma. She couldn’t speak, but she could see.

I bought a little plush toy for her at the airport on the way in. I didn’t want to show up emptyhanded. She saw that, so she motioned her mother, who brought her the writing pad. She wrote the first line you were able to read: “Thank you.” It was “Thank you.”

The second line is in Italian and it said, “I missed you.” She died a few days later.

Marialuisa helped me get down in the depths of this and we walked through the depths while we were in pain together. Of course, tragedy was a big inspiration for me to say, “Look, pain is really bad,” but it’s a great source of energy that you can use for doing good things for others.

Unfortunately, in this line of business, if you’re the head of the research institute, everybody comes to you for new things and, if you take personal care as Luke tells you, we have the opportunity—the responsibility—then. There are many places you can see and feel and touch and share and be reminded that you got a job to do. That’s what this is all about.

Q | As the leader of the Houston Methodist Research Institution, I imagine you don’t have a lot of free time on your hands. What do you do in your free time?

A | I’m writing theater productions. I write and I perform. The next one I’m going to do is called, I’m
Not an Actor. My idea is I’m there in front of a lot of people and I talk to them like I’m talking to you. I’m telling true stories. When you’ve got 2,000 people in a room, it’s kind of hard to look everybody in the face, but that’s where the challenge is. I have been through a lot. This has been a very difficult, very rewarding life and I think it’s worth telling.

Q | Why do these performances? Is it for the benefit of the audience or for you?

A | I think it has to be both. There has to be some emotional fracking. In some ways, there is a restlessness inside me and it is soothed by talking about things and sharing. You get a feeling of community.

It’s all part of the mission concept of life. Whether you’re religious or not religious, it doesn’t make any difference. It’s all about service to others. It’s the only thing that I find to be soothing for the soul. Nothing else.

The only thing that brings any soothing—if you have a restless soul, at least—is when you get to do something for others and then think of another thing to do for others.

Q | At UC Berkeley, they have these blue placards in the parking lots given to Nobel laureates for reserved parking spaces.

A | I had a blue placard too.

Q | You did?

A | For the handicapped. While playing an intramural game, one of my students destroyed my right ankle, so I got the disabled person’s parking permit for six months. They would say, “You see, I got you a blue placard.” I wanted the other one!

Q | Do you feel like you might be getting the placard anytime soon?

A | I’ve met and I’ve worked with a lot of Nobel laureates, more than 50 at this time, in physics, in chemistry, in medicine. I have a lot of respect for everybody and these are great people that have received the Nobel prizes, but I’ve seen people get very sick when they start thinking about these sorts of things. I think it’s very unhealthy.

There’s only one thing to think about: The people who are waiting for the drug. The patients. If you start thinking about anything else, it’ll ruin your life. You get heartburn, ulcers. That is not something worth talking about, but sometimes people ask me the question—especially students—and I try to tell them, “Who cares?” If you start doing things for that, your life is going to be miserable whether you get it or not. If you build your life on the notion that you need to get an award, then you want some other award. It’s like one car, two cars, three cars, who cares? There’s only one thing: serve.

Q | You have a Downton Abbey tumbler on a shelf in your office. What’s the meaning behind it?

A | In Downton Abbey, there is one character I identify with very much. The gentleman’s name is Mr. Carson. He is the butler in this environment of great aristocracy and big castles, which is where we are at the Houston Methodist Research Institute. I know my job. I’m the butler. And I’m very happy to be the butler and a servant.