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“We Are Electric” by Sally Adee: Medgadget Interviews the Author

June 12th, 2023 Scott Jung Education, etc., Exclusive

The human body has a deep connection with electricity. The transmission of electrical impulses is responsible for the movement of our limbs, the functioning of our organs, and the formation and recall of memories. The signatures of the various electrical signals emanating from our body can be telltale signs of our health, and a jolt of electricity can literally bring us back from the brink of death.

But while these things have long been known about the electricity constantly coursing through our bodies, what has more recently been discovered is the role that “bioelectricity” plays in the formation of our bodies. It turns out that each type of cell that we’re composed of has a unique bioelectric signature, a voltage signal that is used to communicate with other cells and cause stem cells to mature into specialized ones. For example, it was recently discovered that as we develop in the womb, bioelectricity is responsible for guiding the growing fetus into the normal human form with two arms, two legs, two eyes, etc., and hence, an in utero disruption of these electrical signals can lead to birth defects.

A greater understanding of the role of bioelectricity in our cells could have massive impacts in medicine, affecting the way we approach tissue engineering and regenerative medicine. And if the interrupting of bioelectric signals can stop cells from propagating, disrupting the voltage signals of cancer cells could keep them from metastasizing.

The electrical dimensions and properties of our cells, the tissues they collaborate to form, and the electrical forces that are involved in every aspect of life can be called our “electrome,” which is the subject that Sally Adee, a London-based freelance science and technology writer, shares all about in her recently published book, We Are Electric. The book covers over 200 years of research, from Luigi Galvani’s experiments on frog legs in the late 1700’s to the popularity of “electroceuticals” in the last decade. But despite the long history of research, therapeutic electricity has also had its fair share of quackery and shams, which Adee asserts has negatively impacted the pace of research in this field, as well as its acceptance in education.

Sally was kind enough to tell us more about the making of We Are Electric and what she thinks might be on the horizon for the human electrome.

Scott Jung, Medgadget: Can you share a little bit about your background and how you ended up writing about the body’s electric code?

Sally Adee: I started my journalism career at the engineering magazine called IEEE Spectrum, where I wrote about the hardware and software necessary to create neural interfaces, for example for integrating prosthetics into the nervous system. This was my first encounter with these ideas about reading and writing over the brain’s endogenous electrical signals.

A lot of people had been trying to decipher and manipulate this “neural code”. I spent a lot of time trying to understand how the endogenous electricity in our brains works, and how you can interface with it using electronic devices. So when I met the bioelectricity researcher Michael Levin and he proposed that the nervous system is only one of several bioelectric signaling mechanisms in the body, I fell down a deep rabbit hole. I began to read academic papers I had never heard of, about electrical signalling in development and wound healing – not in niche publications but places like Nature. But electricity wasn’t part of an accepted framework of how the body works. But why? Then I started reading the history of missteps in applying electricity in biology. Honestly from there the book just about wrote itself.

Medgadget: We Are Electric explored lots of different applications of electricity in medicine. Some were perceived as quackery, some failed due to politics, and many just couldn’t be studied in enough humans to validate the claims. What do you think are some of the most promising applications of bioelectricity right now?

Adee: Right now, the most promising near-term applications are in neuroscience contexts. So for example, Grégoire Courtine and Jocelyne Bloch are working on a neural bypass that takes the intent signals from the brain and routes them past a spinal injury to actuate the remaining neurons in the spine. This is extraordinary stuff. 

There are so many other ways electrical stimulation is being used to adjust disease and disorder in the nervous system. And that’s largely because electrical signalling is understood as an uncontroversial mechanism in neuroscience. And so people have spent money and time and other resources to investigate how to manipulate and understand these electrical signals, to great gain.

We haven’t had that gut of resources thrown at other ways electrical signalling works in biology. So for example its function in wound healing, or in development, or even perhaps in cancer. 

For wound healing that is starting to change. A $16 million DARPA project has bioelectricity as part of the suite of mechanisms that it wants to use to accelerate the healing of catastrophic wounds. There are now increasingly more projects around exploiting the endogenous electric fields that are generated by the body to heal wounds. In an echo of the beginnings of neurotechnology, these new projects are initially focused on helping patients for whom the new technological intervention is a last resort, like people who have non healing ulcers. If these devices work, money will follow, and from there all the rest. Ad hopefully people will start to see the big picture and start throwing money at some very fundamental basic science around the electrome.

Medgadget: What do you think are some of the biggest hurdles to a wider adoption of bioelectricity?

Adee: I think it’s a problem of narrative – science is subject to fashion just as much as any other human endeavour. And the narrative right now is that genes are the stars of cellular development, of cancer. If you understand the genetics you understand it all. But there’s another player, the electrical properties of the cells.

There is now a very slowly growing awareness of how functionally important the electrical signals are that move all these bits around. If we could develop broad programmes to study what underpins all this electrical functionality – and how it impacts on gene expression, hormone release and mechanical changes, I think that everything else would take care of itself. Understanding is the first step, generating new insights, technologies and hypotheses, and these become virtuous cycles that create advances, as we have seen in neuroscience.

But it has to start with awareness that these things really exist and are not some quack’s fever dream.

Medgadget: You discuss the difficulty of bioelectricity being accepted by the academic community for various reasons: it’s cross-disciplinary, it’s been unfairly historically associated with quackery, and it’s still a relatively novel area of research. How do you envision that the incorporation of bioelectricity into undergraduate or graduate academic curriculum would ideally look like to you?

Adee: What an excellent question and one I have been struggling with since publication. 

It’s been posed by a lot of people who got in touch after reading my book. Some want to know how their kids can study this stuff in school. Others want to know what path could lead to formal graduate study in bioelectricity. 

“Oh that’s easy” I thought and forwarded it to the editors at the journal Bioelectricity. It was not, in fact, “easy”. Some researchers do think you could start with a standard neuroscience curriculum focused on electrophysiology, which would lead you neatly to ion channel physics. From there you’d explore ion channels in other cells, in development and healing, in oncology, and how it all interfaces with genetics.

However, others disagree that it should be taught formally at all. They like the self-determined, non top down pathways that have led today’s crop of bioelectricity researchers to find their way to the topic.

And they have a point – all this unstructured cross-pollination has certainly resulted in a vibrant research community. All these people with all their different priors that they’ve taken from the wide range of disciplines they come from, their shared knowledge and tools have yielded so many new insights and connections over the past 25 years or so. 

But as exciting as it all is, one researcher told me that bioelectricity research is today where astronomy was when Galileo first picked up a telescope. The next few years were just a cornucopia of low-hanging fruit. Here a moon, there a moon, everywhere a moonmoon! But eventually, does there come a point where you need to buckle down and formalize the discipline? I dunno, that almost seems like a question for Kuhn or Popper.

Medgadget: You concluded the book with a mention about some of the tools being developed to better understand the human electrome, but kept it brief due to space constraints. Can you share about a favorite tool that you weren’t able to cover in the book?

Adee: It’s got to be xenobots. They are robots (maybe?) made from live frog skin cells that have been removed from the bioelectric constraints of their former host environment. I only mentioned them in one particular context in the book, but these things are going to be so consequential for so much research and applied science. Away from the signals that determined their behaviour and identity, these cells were freed to figure out what they would do if they could take charge of their own destiny. As research subjects, these could tell us so much about the power of bioelectric signals in the body. 

Another is the battery being developed by MIT scientists that could power brain implants with electrons siphoned from the glucose in cerebro-spinal fluid. If we can figure out how to power devices in the body with totally biological power sources, now you have de-risked these implants substantially, and it’s another path to better, longer term data.

Medgadget: The “cast of characters” of We Are Electric included several animals: frogs, squids, salamanders, marine fucus, and even unfertilized rabbit eggs! What was one of your favorite examples of animal biomimicry or fascinating animal abilities that you came across in your research?

Adee: You’ll find a little frog sitting at the bottom of the title page of every American version of the book. My wonderful editor at Hachette, Mollie Wiesenfeld, was able to convince the publisher to commemorate these lovely little creatures for their sacrifices in the service of bioelectricity. While writing the book, I fell in love with these animals even more than I had been before (I already had a tattoo of a poison dart frog on my shoulder). Their involuntary contributions to bioelectricity research made me sad and queasy – they were drawn and quartered, they were cut to ribbons, they were chopped into body-horror batteries. In more than one instance, the areas around scientific centers that used them to investigate bioelectric functions ran out of frogs. 

This is why the research animal I’m most excited about in the world is the digital twin. I hope that we are not too far away from a future in which animal models can be increasingly replaced by high-fidelity digital replicas of people and systems, which would offer a more direct substrate for experimentation than these imperfect proxies that have suffered only so they could (often) lead us down the garden path.

We Are Electric is available now in bookstores everywhere, and online.

Scott Jung

Scott Jung (@scottjung) is a Silicon Valley-based medical and health technology reporter and advocate, with a focus on wearables, telemedicine, and health technology in emerging countries. He has represented Medgadget at CES and Digital Health Summit, TEDMED, Stanford Medicine X, and SXSW. Always on the lookout for innovative medical technology worldwide, Scott has been invited to visit Colombia, Poland, and many other countries around the world to share how medtech is enriching the lives of its people. Scott holds a B.S. degree in Biomedical Engineering from the University of Southern California and an M.S. degree in Medical Product Development Management from San José State University. Scott is always looking for the next big thing in medical technology and digital health. Interested in helping him transform lives? Get in touch with him at http://scottju.ng

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