Promise and Protocol

Gordie Howe’s stroke treatments and A. Alfred Taubman’s legacy to U-M are putting stem cell research’s game-changing potential into the spotlight

The names A. Alfred Taubman and Gordie Howe are iconic in different ways around Detroit, but rarely used in the same sentence. But now it is most appropriate — and somewhat ironic — when it comes to discussions about stem cell research.

Howe, the 87-year-old hockey legend of the Red Wings, recently survived a near-death experience (not the first of his life, by the way) after a stroke.

Taubman, the shopping mall builder, art dealer, and philanthropist, died of a heart attack April 17 at age 91. But he left a medical legacy that intertwines — in coincidence and contradiction — with the fate of Howe.

Their stem cell involvement personifies a new frontier of medical research. The cells are tiny specks of human tissue injected into sick people in attempts to cure illnesses like Lou Gehrig’s disease, stroke, and Alzheimer’s — and soon, perhaps, other maladies.

But the two men, and the doctors who speak for them now, represent radically different approaches on the stem cell question.

Howe, suffering from dementia, had a stroke last October. With help from his four children, he took an extreme route to recovery — to Tijuana, Mexico, for stem cell treatment not yet permitted in the United States.

His recovery from his stroke was swift and remarkable, family members say, and allowed him to travel for a celebration of his life in February to his hometown of Saskatoon, Saskatchewan, in Canada.

Scheduled for a second visit to Tijuana for another treatment in June, Howe was to spend the rest of the month with his son, Dr. Murray Howe, who works in Toledo. Dr. Howe planned to take his dad to visit old friends in Michigan as summer began.

“We had no [other] option,” Dr. Howe says, and believes that without the Tijuana treatment, “he’d be dead now.” The radiologist spoke after coming on shift in the X-ray reading department at Toledo Hospital at 4:30 p.m. on a recent Monday.

At about 5-foot-6 and 140 pounds, he is smaller than his 6-foot, 220-pound father but resembles him facially, especially in profile. He wore a scrub suit that exposed muscular arms and a fit physique from the sort of genes that run in the family.

“I probably diagnose four or five patients a night with a stroke,” Dr. Howe says. “For those patients, the end result is pretty abysmal. Their outcomes are poor. Their quality of life is dramatically changed.”

Gordie’s first near-death experience came 65 years ago, when he suffered a head injury in a playoff game that forced doctors to drill a hole in his skull to relieve the pressure of fluid on his brain. Compared to that, the injection of millions of stem cells into his spine was simple.

In the near future, based on what he saw from his father, Dr. Howe hopes others can recover in the same way.

“Diagnose the stroke here,” Dr. Howe says of the hospital, “and have the emergency room infuse this patient with stem cells that evening and reverse or alleviate the damage to the point where they could walk out of that hospital the next day with very little residual deficit.”

The Tijuana treatment would cost most patients $30,000, but his father is getting his for free because, Dr. Howe says, the providers admire him.

Since Gordie’s recovery, Dr. Howe said he and his siblings have invested in the company, Stemedica, based in San Diego. According to a recent USA Today report, the company is staffed by several Russian and Ukrainian scientists. The Soviet Union was Canada’s top world hockey rival in the 1970s — the last decade of Howe’s long career.

Taubman donated at least $142 million to the University of Michigan — $100 million of that went to the A. Alfred Taubman Medical Research Institute, which hosts the Consortium for Stem Cell Therapies. Dr. Eva Feldman, director of the institute, was a close friend of his and is actively involved in researching the potential of this nascent science.

Taubman became interested in a cure for ALS after it killed his friend, former New York Sen. Jacob Javits. ALS is amyotrophic lateral sclerosis, a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. A victim can lose the use of arms and legs and gradually wither away.

“Alfred said, ‘Jake, is there anything I can do?’ ” Dr. Feldman says. Javits replied: “Alfred, if there’s ever an opportunity to do something for this horrific disease, please do it.”

But Dr. Feldman, with money from Taubman and other sources, is playing it by the book — the American book — abiding by the strict protocols of the Food and Drug Administration. Her staff methodically tests animals and has completed two FDA-approved clinical trials with humans.

Like their geographic locations west of Detroit and south of Detroit, Dr. Feldman and Dr. Howe find themselves on different points of the stem cell compass. Dr. Feldman’s researchers are making progress with ALS in humans and have recently reported some promising results treating Alzheimer’s disease in mice. She hopes they soon will move on to larger animals and, perhaps, to humans.

Like Dr. Howe, she is optimistic, if more guardedly so in her words and emotional tone of voice.

“I think the potential of stem cell therapeutics remains unknown, but it’s vast and it’s great and it’s probably beyond our imagination,” Dr. Feldman says. “Ten years from now, I think the whole medical climate will be totally different.”

She says stem cell therapeutics along with study of genetics will blend together until “there will be cures for diseases that we now think incurable. There will be changes in our ability to diagnose and treat that currently we can’t even fathom.”

Dr. Feldman spoke in the lobby of a Michigan campus building before a symposium of ALS patients in clinical trial. They greeted her as they filed in, some in wheelchairs, others walking with help.

Asked about Gordie Howe’s experience, Dr. Feldman chooses her words with care.

“Am I glad that Gordie Howe is better?” she says. “Whooo! How can I not be? I’m a Michigander. My two boys played hockey and had his poster on their bedroom wall. But do I understand it? No, I don’t.”

Told that Howe is returning for another round of injections, Dr. Feldman says: “It scares me, but you know, if he’s benefiting from it, that makes me very, very happy.”

Her worry, she says, is that word of Howe’s recovery might encourage more “medical tourism” to places that aren’t subject to the rigorous controls of the FDA in the U.S. In some cases, she says, “people are given a product that will have no therapeutic effect and they are charged a great deal of money.

“One of the heart-breaking things I’ve seen as an ALS physician are individuals who use all of their resources, sell precious property, and go to India or China to get a therapy that is not efficacious at all,” Dr. Feldman says. “I really encourage individuals not to do that.”

Dr. Howe nods his head when told of Dr. Feldman’s doubts. “I completely see where the skeptics are coming from,” he says. “All those studies need to be done. All kinds of things need to be answered before this is completely mainstream.”

Like Dr. Feldman, Dr. Howe has a U-M connection — he went to medical school there. He visited Ann Arbor recently for a meeting with radiology residents and considered dropping in, unannounced, on Dr. Feldman to introduce himself.

“But I ran out of time,” he says. “I would really love to meet her.”

No doubt they would discuss what Dr. Howe calls his father’s “twilight” time and how it might be extended by what he calls “the most powerful and promising technology in the history of mankind.”