MGR Series Highlights

October's Medicine Grand Rounds (MGRs) brought together voices from across disciplines to explore the evolving landscape of medicine - from emerging scientific frontiers to the moral, social, and human dimensions of care.

As the fall series continues, we invite you to revisit some of the month's key takeaways - moments of insight, dialogue, and inspiration - that remind us why the practice of medicine is as much about understanding people as it is about understanding science.

Photos courtesy of Alex Medina and Steve Fisch

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Nobel laureate Jennifer Doudna, PhD, co-inventor of CRISPR gene editing, spoke at Stanford's Department of Medicine Grand Rounds on the revolutionary path from basic bacterial biology to modern genetic medicine.

"We're at an incredibly exciting moment," Doudna said. "For the first time, breakthroughs in biology are colliding with technologies like AI - and at that intersection lies the possibility of genetic cures." From Bacteria to Breakthrough CRISPR's story began not in high-tech labs but in bacteria defending themselves against viruses. Working with microbiologist Jill Banfield, Doudna discovered that bacteria stored snippets of viral DNA as molecular mugshots. This finding revealed that RNA could do more than carry messages - it could guide proteins to cut specific pieces of DNA.

Collaborating with Emmanuelle Charpentier, Doudna transformed this bacterial defense into CRISPR-Cas9, a tool that can edit any gene by swapping its RNA "guide."

Genetic Medicine Comes to Life

In 2023, CRISPR reached the clinic with the first FDA-approved therapy for sickle cell disease. The patient, Victoria Gray, went from constant pain to living symptom-free for six years after receiving her own CRISPR-edited stem cells.

"Meeting her brought home what this technology can mean," Doudna said. "It's not just molecules in a lab. It's mothers being able to care for their kids again."

The Next Frontier

Doudna shared the story of "baby KJ," born with a rare metabolic disorder and treated in 2024 with a custom CRISPR therapy built in months - a glimpse of personalized, rapid-response medicine.

Still, challenges remain: delivery, access, and cost. Doudna urged continued innovation to make gene editing more equitable.

"CRISPR began as a curiosity in yogurt bacteria," she said. "Now, it's rewriting the future of medicine - and the story is only beginning."

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At this week's Medicine Grand Rounds, Stanford psychiatrist and bestselling author Anna Lembke, MD, known for Drug Dealer, MD and Dopamine Nation, delivered an illuminating talk on addiction and the modern brain's struggle to maintain balance in an age of abundance.

Drawing from more than 25 years in addiction medicine, Lembke framed her lecture around the concept of a "pleasure-pain balance," explaining how every pleasurable stimulus triggers a compensatory dip that drives craving and compulsion. Using vivid metaphors and accessible neuroscience, she described how chronic overstimulation-from substances to smartphones-reshapes the brain's reward circuitry, creating what she calls a "dopamine deficit state."

Lembke explored the "plenty paradox": as wealth and access rise, rates of depression, anxiety, and overdose have surged. Technology, she argued, has "drugified" daily life, making nearly everything-from food to media-more potent and harder to resist. Yet she also offered hope. Through intentional abstinence, mindfulness, movement, and what she calls "healthy doses of pain," individuals can restore equilibrium and rediscover joy in ordinary experiences.

She concluded with a reflection on shame and honesty in recovery, emphasizing that telling the truth-first to oneself, then to others-reawakens the brain's capacity for control and connection. "What goes up must come down," she reminded the audience. "To find balance, we must sometimes lean into discomfort."

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Harvard psychiatrist and medical anthropologist Arthur Kleinman, MD, came to Stanford's Medical Grand Rounds with a blunt thesis: care is reciprocity - and medicine is drifting away from it. "The true symbol of medicine isn't a single serpent on a staff," he said. "It's two serpents facing one another. Care is a relationship."

The Soul of Care Drawing from his memoir The Soul of Care, Kleinman spoke as both scholar and caregiver. He described a decade caring for his wife, Joan, through Alzheimer's disease - a routine of bathing, feeding, dressing, and gentle presence. "It wasn't resilience," he said. "It was endurance. And there's joy in endurance." The point wasn't sentiment; it was clinical: relationships determine whether care is humane, coherent, and sustainable.

What We Don't Measure

Kleinman argued that modern systems prize institutional efficiency over quality of care. We track throughput and billing, but not time spent listening, clarity of communication, clinical judgment, or the healing power of the physical exam's "laying on of hands." He sees technology, including AI, as a potential ally only if it augments rather than replaces human presence (e.g., liberating clinicians from screens so they can face patients).

Training the Next Clinician

Students often enter medical school strong in empathy and curiosity and graduate weaker in both, he warned: a cultural failure, not a scientific one. He urged departments to place master clinicians at the bedside as primary teachers and to build habits and rituals of care into daily practice.

Kleinman closed with the charge he shared with his late colleague Paul Farmer: when confronted with suffering and equipped with tools to help, ACT. "Care," he said, "is the moral heart of medicine. It's time we treat it that way."

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This week's speaker, Miriam Mutebi, MD, is a breast surgical oncologist and clinical epidemiologist at Aga Khan University in Nairobi, Kenya. The first woman in Kenya to train as a breast surgeon, she is an international leader in global oncology and a driving force behind efforts to strengthen cancer care systems across sub-Saharan Africa.

"I like to say I'm in the hope business," she began. "Every aspect of global oncology must be underpinned by hope - because without it, we lose the will to confront inequity." In her talk, Mutebi presented both the scope of the challenge and the momentum for change. She noted that 70% of the world's cancer deaths occur in low- and middle- income countries, yet only 5% of global oncology resources reach these settings. She described how patients often navigate long diagnostic delays, fragmented health systems, and cultural stigma, particularly women who may lack decision-making power or financial independence to seek care.

Her approach focuses on developing women-centered, context-appropriate models of cancer care through workforce development, policy reform, and primary care training. She highlighted the need to integrate oncology into broader health systems and to move beyond external aid toward sustainable, locally led solutions. "True progress," she said, "means moving from dependency to partnership, where countries define and drive their own health priorities."

The lectureship commemorates Brooke Peterson Gabster, MD, who joined Stanford's residency program in 2018 with a commitment to improving health systems both locally and globally. Before her death from metastatic osteosarcoma in 2021, she worked to expand access to care for marginalized populations and envisioned a career bridging clinical medicine and policy.

Mutebi's address reflected that same vision - anchored in data, equity, and humanity. She closed with an African proverb that captured the spirit of the day: "When women rise, communities heal."

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At this week's Grand Rounds, Mark Skyler Scott, MD, offered a thrilling glimpse into what he calls "the future of medicine now": 3D bioprinting human organs. Trained in Medical Engineering at MIT, Scott's work spans the creation of neural and vascular tissue, organoids, and soft robotic systems designed to mimic the body's living structures. Now leading a lab at Stanford and collaborating with the Children's Heart Center, his team is developing techniques to print billions of heart cells with the long-term goal of engineering a functional human heart. Scott explained that while a printed heart for patients is still years away, rapid advances in stem cell biology, organoid self-assembly, and a new method known as embedded 3D printing are transforming organ engineering. By printing soft, cell-rich "mayonnaise-like" materials within a supportive gel, his group can now sculpt vascular networks that keep tissue alive-overcoming a roadblock that has limited the field for decades.

His team's innovations include large-scale bioreactors to grow stem-cell aggregates by the billions, multi-nozzle printers that can print 32 tissues simultaneously, and an "omni-printer" capable of approaching tissue from multiple directions, mimicking surgical precision. Their prototypes already include vascularized cardiac tissue that beats in unison and silicone heart valves that open and close under simulated flow.

While immense challenges remain - from immune responses to scaling and cell maturation - Scott's vision is clear: each experiment brings medicine one tangible step closer to building a living, beating human heart.

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