"It's not about cure. It's about quality of life." PART II

First of all I would like to thank Mr. McBride, executive director of Spinal Cord Injury British Columbia (SCI BC) for his thoughtful and speedy response to my email regarding his organisation's commitment to a cure for SCI.

The concern was raised after one of their posters explaining many of the challenges of paralysis used the slogan, "It's not about cure. It's about quality of life." sparked some controversy.

Of course we didn't get a response saying that SCI BC would now focus solely on cure, and that was never expected. SCI BC plays an important role in the SCI community by improving accessibility to housing, jobs, and the community as a whole and as a divergent membership organisation reflects the opinions of many who may or may not be cure oriented.

What we wanted to make sure was that they were; one, not anti cure; two, not flobbing cure off as some unrealistic goal; and three, they were going to continue putting a message out to the community which could easily be misconstrued as lowering the importance of cure. I think we got a Good response on all three points.

Are they anti-cure? No. In Mr. McBride's own words, "we did not intend to diminish the long-term priority of someday finding a cure for SCI. As a cellular neurobiologist who spent many years researching neuroprotection and neural repair after SCI, I am a strong believer in ongoing investment into the discovery science that is necessary for future treatment options and in the subsequent translational research that will be necessary to move those discoveries into clinical practice."

Do they think cure is unnecessary? No.
"We absolutely acknowledge that having access to a cure would increase the potential for people with SCI to achieve the quality of life they desire by reducing the barriers and challenges they face."

How about the continued use of this slogan. Again, I'm happy with the response. "Elaborating on the statement in question, we will be changing it so that is not as readily interpreted as negating cure as a priority. It was never our intention to imply this."

There are some areas where I think a more cure positive approach could be taken. I think like many SCI community organisations they understand our community's desire for cure but also don't want to spread false hope or have priest fail to concentrate on the here and now while they wait for cure. I personally do not think that the gulf between quality of life now so we can get to cure in the future needs to be so vast. I think the two are complimentary.

Since SCI BC is looking to change their slogan, Maybe we could give some of our own ideas which also reflects their organisations goals to achieve both quality of life and cure.

Have a suggestion, please leave it in the comment box below or send an email to StemCells.and.AtomBombs@gmail.com.

PS. As always, I'm having a lot of pain which makes it difficult to get motivated to write, but as always, when I do write and get some movement on a project, I feel a while lot better. I'll have to remember this.

Response from Mr. McBride

Hello Denis,
Thank you for taking the time to connect with me about the poster in question. We here at SCI BC are aware of the reaction it has generated – both positive and negative. In fact, it probably wins the prize for the highest volume of engagement we have had from any post. I am happy to clarify our position on the issue of cure, and although I am aware that my response will be published on your blog, I will nevertheless be frank and honest in my reply.

I will also confirm that I am very aware of your blog and the global movement you have so successfully created. I have watched with particular interest your communications with the Rick Hansen Foundation and Institute over the recent past. The voice of one can be strong but the voice of many can be a powerful thing.

With specific respect to the poster we posted recently, I will admit that we were somewhat hesitant about the phrase in question - "It's not about a cure. It's about quality of life." Let me interject now that we did not intend to diminish the long-term priority of someday finding a cure for SCI. As a cellular neurobiologist who spent many years researching neuroprotection and neural repair after SCI, I am a strong believer in ongoing investment into the discovery science that is necessary for future treatment options and in the subsequent translational research that will be necessary to move those discoveries into clinical practice. However, having been involved with SCI research for over 22 years, I am aware of the (frustratingly) slow pace of discovery and it is why I am passionate about resetting the balance of investment in both the types of research that are being conducted and between research and the invaluable community services that will allow people with SCI to maximize their potential and quality of life today.

Getting back to the poster, it was actually created for a very specific audience at a non-disability-related event we were featured at. We created the poster to highlight many of the everyday challenges faced by people with SCI, which you affirm in your email and of which the general public is mostly ignorant. We used the wording about cure to help differentiate what SCI BC does from other SCI-related organizations with which we share a backyard. Which is to say, we stated it that way not to diminish the importance of finding a cure, but rather to highlight that there is a lot to be done today that can have an immediate positive impact and what SCI BC does to try and foster that.

We were concerned the wording we chose about the cure might be misinterpreted but we put it out there to see what kind of response it might yield. This wasn’t meant as a deliberate provocation. We just thought we would test it and see what the response was before we changed the wording, which we will be doing soon.

As mentioned above, we have been pleasantly surprised by the volume of response we have had to the poster. We welcome all forms of constructive feedback and think engagement of this kind is healthy. We often don’t hear about positive reactions to what we post, but we have had an overwhelmingly positive response to the poster. That said, we have also received a lot of negative responses to the cure statement, and we totally understand why. It is good to have it validated.

Elaborating on the statement in question, we will be changing it so that is not as readily interpreted as negating cure as a priority. It was never our intention to imply this. However, we think it is important to reflect the fact that people with SCI have broad ranges of priorities and that not all feel they need to be cured to have a quality of life – that one doesn’t need to be cured to be whole. We know this based on what so many of our members tell us and from some very interesting research that affirms it.

That said, we absolutely acknowledge that having access to a cure would increase the potential for people with SCI to achieve the quality of life they desire by reducing the barriers and challenges they face. However, as this may be a very long-term proposition, we need to respond to the those who are not engaging in their communities or working to maximize their potentials because they are waiting for a cure they believe will be around the corner.

Through our 57 years of service delivery and the reports we receive from the health practitioners we engage with, we know that too many people with SCI are not participating in rehab or community services because they think these things are unnecessary as a cure is what they really need to move forward and that it must be coming soon. Unfortunately, researchers and mainstream media alike have perpetuated the false hope of an imminent cure. Through my research background and the connections with the research community that I maintain, I think it is clear that there aren’t any sure-fire candidates for a cure coming anytime soon. One never knows, of course, but I think the probability is low. This is why I advocate for ongoing basic science to better understand the complexity of spinal cord injury and why I advocate for research into what might not be considered cure-based (such as rehab strategies, mitigating or preventing secondary complications, and assistive technologies, all of which can yield meaningful, near-term benefits for people with SCI). It is also why I advocate for greater investment in community services.

I know I may be opening myself up to a mix of feedback, but more on my perspectives on resetting the balances of research and community service can be found in my blog posts and in SCI BC’s The Spin magazine. Here are a couple of links to these entries:

·         Investing research vs Community: http://sci-bc.ca/sci-research/investing-research-vs-community/

·         Snotty Spine: A good investment? http://sci-bc.ca/news/snotty-spine-good-investment/

·         New research restores voluntary movement after complete SCI: http://sci-bc.ca/sci-research/new-research-restores-voluntary-movement-after-complete-sci/

·         The Spin Magazine: http://sci-bc.ca/stories/spin-magazine/

I know this is a rather verbose response, but I hope you and the Stem Cells and Atom Bombs community will appreciate that SCI BC does indeed think find a cure for SCI is a priority. I also hope that, as you mentioned in your email, it is recognized that there are many challenges faced by people with SCI that we need to address today and that SCI BC has a focus on many of them, and that it would be a great disservice to people with SCI if all of the money was diverted to efforts towards a cure. Too many would suffer unnecessarily and/or miss out on too much waiting for it to be realised.

We feel very strongly that we must reflect the views of our members who tell us that they know a cure may not be available in their lifetime and that they want us to promote and facilitate changes that will enhance their lives today, such as greater access to accessible housing, accessible transportation, funding to support all aspects of daily living, information on and access to accessible travel and recreation, reduced secondary health complications, and equal opportunities to participate in our communities. Through our Peer Support and Information Services, they appreciate knowing what is possible and how to try and achieve it.

With limited resources, time and expertise, we must achieve a balance between perusing the ultimate,  long-term goal of finding a cure for SCI with what is needed in the immediate and near-term to maximize ability and quality of life. This is not an easy equation and there will be endless debate about where that balance should lie. This, however, is healthy debate as it increases awareness and understanding that will benefit all participants in it.

Thank you again for taking the time to connect with me about the discussion we’ve generated through our poster. As we knew we would likely be doing when we posted it, we will be adjusting the wording of the contentious statement in the near future. I appreciate that what we change it to may not satisfy everyone, but I hope that you and those who follow and contribute to your blog know that SCI BC knows that finding a cure for SCI is a priority for almost everyone, but that where it fits on peoples priority list varies greatly.

I will be more than happy to continue the dialogue.

Sincerely,

chris
Chris McBride, PhD

Executive Director

Spinal Cord Injury BC 
780 SW Marine Drive, Vancouver, BC   V6P 5Y7  | www.sci-bc.ca | twitter: @sci_bc | Facebook:  SpinalCordInjuryBC | YouTube: