From Basketball to Biology – and Beyond
Sitting Down With… Annabelle Manolo-Morgan, Professor in Cell and Developmental Biology and Visiting Scientist at Vanderbilt University, New Orleans, Louisiana, USA, and Founder of Masaya Medical
How did you get into cannabis?
First and foremost, I’m a molecular and cell biologist. I spent over 10 years at Vanderbilt University working in neuroscience and cardio-oncology before I moved into the clinical trial space. Cannabis never crossed my mind until my son (and third child), Macario, was born with epilepsy. It was so severe that he had 40 percent of his brain removed at five weeks old and was put on every medication going. As a scientist, I trust protocols – but I could see that those medications weren’t enough. My son wasn’t developing. I started questioning whether they were healing his brain or just covering a bigger problem. I’d never had to deal with patients before, so I’d never questioned the functional side of medicine. I started looking at peer-reviewed research on epilepsy and cannabinoids came up again and again. Now, I know cannabis. My husband is a reggae artist who, believe it or not, has never smoked a day in his life – but it means I’ve been around cannabis as a culture. I’d just never seen it as a medicine.
I decided to formulate my own medicine for Macario – a CBD base that had a high absorption rate. I asked my colleagues at the time to test it for stability without telling them what it was. They told me it was safe. I took my son off all of his medications and started giving him this formula. Within two months, he came to life. He laughed for the first time a week later. Imagine being six months old and never having laughed. Two months after that, he was crawling. Because he’s missing almost the entire left side of his brain, he’s supposed to be paralyzed on the right side of his body – but there he was crawling left, right, left, right, just like my other kids. At 14 months, he was walking.
At that point, I could have walked away with my healthy son and continued to work in my lab – but I felt that I needed to give other families the same opportunity we’d had. That’s when I decided to give my life to cannabis.
Could you tell us more about the study you’re working on now?
I knew I could never stand in front of the NHS or FDA and tell my story or any of the million others and expect them to approve a drug. They are nonbelievers. What they want is data – so I said, “Let’s give it to them.” I came up with the concept of a fibromyalgia and chronic pain study that fast-tracks traditional timelines by running phase trials in parallel – in vitro, in vivo, pilot in human, safety, and efficacy all at once. The human pilot study, which looks at three CBD tincture formulas, will start in the UK in coordination with an internationally recognized clinical research group based at the University of Manchester; parallel molecular and pharmacokinetic studies will be conducted in the US. I met with Flora Medical by chance and told them about what we were hoping to do and that nobody would fund our study. They understood our goals and decided to get involved – and I’m so grateful for their support.
Two reasons: one, there are still no true markers for it, and two, the symptoms are seen in a lot of other conditions – pain, inflammation, anxiety, depression. It allows us to take a wide-angle view, but funnel in when we need to. We don’t want to limit the study – we want to learn as we go along – but, ultimately, we want to know the true synergistic benefit of isolated CBD and be able to define it not only in patients, but in the lab – literally cells in a dish. Usually, the FDA or NHS need to see this data before you even approach a patient, so we’re having to convince them that cannabis is so safe that what would typically take 20 years can be done in five. We’re just waiting to have our proposal accepted by the NHS ethics committee.
Do you imagine there will be pushback to doing trials this way?
It’s going to be a fight. That’s why it was so important to get the right people involved – people who normally wouldn’t even look at cannabis. But the way we do science needs to change. What happened with my son made me realize that I spent seven years in a penthouse lab at the top floor of the cancer center and I never knew the name of one treating physician or oncologist. There’s a disconnect between science and medicine – and cannabis is a great platform to bridge that gap.
Why did you originally pursue a career in academia?
I’ve always had a hierarchical understanding of life. I know that if you want to make change, especially as a woman of color, you have to get to the top of the ladder to create the credibility that allows you to have these conversations without judgment. It doesn’t matter who the other person is, because we went through the same schooling and can stand toe-to-toe. I did what I had to do to get a seat at the table.
What are your long-term goals?
Not to sound like a superhero, but I want to change the face of medicine – specifically, the protocol-based approach we have today. I would love to see translational medicine used in practice, with people from different scientific backgrounds working together to evaluate patients in a number of different ways to provide the best possible personalized care.
What did you want to be growing up?
The female Michael Jordan – and I still do deep down. I never wanted to be a doctor or scientist, I just wanted to play basketball. I grew up in a small farm town in Saskatchewan – one of the coldest places in Canada. It can get down to -50 °C, so it’s no coincidence I chose a sport where I could play indoors. We didn’t have YouTube or the Internet back then, but we did have TV. One of the first games I watched gave me a “never give up” mentality. It was an NBA final. Michael Jordan was so sick his teammates were literally carrying him but, somehow, he played on and they ended up winning the championship. I didn’t just love the sport – I loved the drive and competitiveness I saw in those players. I told my mom and dad, “I’m going to play basketball.” My parents, traditional Filipinos, said I should be a nurse or a doctor. I got an academic scholarship to Toronto to play ball, but majored in biology to keep them happy. It was there I was scouted and came to the United States. I was playing collegiate basketball in New Orleans when Hurricane Katrina hit. It was devastating. President Bush gave a list of alternative universities that flood refugees could attend. I ended up at a school in eastern Kentucky, took a double major in biology and chemistry, and never picked up a basketball again.
My fiancée at the time, Roydell Williams, was drafted into the National Football League and suddenly my life became about him. I became a celebrity housewife, sitting at home all day. I found out I was pregnant with my first child – my only daughter – and realized that it isn’t what you tell your kids that matters; it’s what they see. What would I be teaching her? To marry rich and then not do anything? So I decided to go to medical school. I enrolled at Georgetown University, determined to become a medical doctor. I had another baby and then Roydell and I divorced. We’re great friends now, but it was a very difficult time in my life. I went from living the high life to being in school with no money and two kids under two. But I was determined to get my degree. One day, my dad called and told me he had terminal cancer and three months to live. I told him to send me his scans, his bloodwork – everything. I really believed I could find something that would save him. I sent my mentor his scans and she called me into her office and said, “Annabelle, go home now.” I refused to let it go. I looked up anything that could potentially reverse the cancer. Juices. Native herbs. Cannabis. Blackberries. We went back to the doctor after a month and his cancer was halfway gone. That was 10 years ago. My dad is still alive today.
When I went back to school, they were all waiting to say, “I’m so sorry about your father.” Instead, they said, “Wow, what a miracle!” But that’s where it stopped. Nobody was interested in how it happened or what we did. It wasn’t part of the protocol, so it must have been a miracle. And that’s why the doctors in America couldn’t help my dad any better than the doctors in Canada – because protocols told them that only approved medicines could be used. That moment made me rethink medical school. Was I going to be a puppet who just told my patients what I’d been taught instead of caring for them in a personalized way? I told my mentor how I felt and she said, “What about being a naturopathic doctor?” So that’s what I did.
Why is there so little data on cannabis?
We’re a young industry (though we act like we’re not) and the culture of cannabis moves incredibly fast. Although it’s great that we’re getting more widespread acceptance, we’re still inhibited by our regulatory abilities. It’s hard for scientists to get funded for cannabinoid research without a final product in mind, because what’s the return on basic science? And that’s why I’m so appreciative of Flora – because they understand that our work is bigger than cannabis. Our pharmaceutical world needs to change.
Is anyone to blame?
It’s not down to any one group. A lot of MDs don’t know how to do scientific studies – but a lot of my colleagues in academia are not moving the needle either. The only way to bridge the gap is by having one foot in one world and one foot in another. I want to see science become part of everyday medicine so people can heal in a more natural way – we deserve that.
Why don’t we take this approach already?
Money drives the way things are. I have been involved in studies where funding stops at the molecular level, which makes no sense – that’s the meat that would go on to create a medicine that could then be used in a clinical trial. Our current system is so tightly controlled that scientists do the work, only for it to be either shelved or published in a paper – and that’s it. Departments are put into boxes (driven by the people willing to fund them) and the gaps between them are never bridged. A lot of people don’t know much outside their own box. Once you start teaching them that each box can attach to others, we can be much more productive.
Why is there such a disconnect between specialties?
It’s difficult for scientists to speak translationally about what we do – it’s a whole different language. We need to get better at communication because, if we can’t get doctors to understand what we’re talking about, how are they going to explain it to their patients? Education must be at the forefront of our work because, ultimately, knowledge is power.
How can we bridge the gap between basic science and medicine more generally?
There are Grand Rounds or luncheons where doctors come and listen to our work as scientists and we figure out how we can collaborate. For instance, I’m interested in cardiac myocytes – the cells of the heart. To understand them, I need to figure out what my patient population is seeing most, which is hypoxia. So, I need to find doctors in my community who are dealing with patients with hypoxia so we can share data and figure out a solution together.
When you’re serving a large population, it makes sense to keep things systematic and consistent. But I think that, as a result, we’ve lost the ability to perform the best possible medicine by compartmentalizing information. If science labs don’t communicate with insurance, how will they know what research to fund for their patients? It’s good to see key universities like Vanderbilt implementing translational biology programs – but it shouldn’t be optional.
Is it a question of bringing in more disruptive thinkers or just waiting for times to change?
Both. If you’re stiff, you need to loosen up. If you’re creative, you need respect that these systems are in place for a reason. It takes work from both sides, but that’s how things change – with baby steps.
How did you find shifting from basic science to cannabis?
In basic science, you create hypotheses based on existing work. In cannabis, you create hypotheses based on hints and clues (because so little information is available), which is incredibly exciting. I believe our work will take cannabis to the next level and help us better understand the plant as a whole. It will allow us to sit in front of legislators and prove that cannabis really is no different than any other compound. We know it’s great; we know it’s safe; we just need the data to prove it.
Have you found any difference between working in British and North American environments?
I assumed the British setting would be much more conservative, but the scientists I work with, despite being incredibly old-school, are incredibly open to merging different aspects of science. Molecular studies, in vivo, clinical trials – it’s all fluid. In North America, we’re limited by the systems we work within. We talk about cellular studies and how they can impact humans but, because we exist within these rigid boxes, it seems quite far-fetched. In Britain, people are much more translationally minded.
How do you stay motivated?
I’m very strong-willed. I’ve been through a lot at 38 years old, but I’ve prevailed, and so I feel it is my duty to be an example to other women – to other moms, scientists, and leaders. I make no excuses. I think that comes from my basketball days when I was very young and very hungry. I learnt that, if I worked hard with good intent, things would come around in the end – maybe not necessarily in the way I wanted, but one way or another.
You touched on the difficulties of being a single mother working in these spaces. What needs to change to encourage more diversity in industry and academia?
For real change to happen, there has to be movement from both sides. We need to open our doors to people who might not have the perfect resume. And, as a candidate, you have to develop the right mentality to sit at that table. You’ve got to stand up to the challenge. Getting the role is one thing, but being able to sustain it – to be powerful and to understand that you’re representing a whole flock of young women – is another. In my mind, women are natural leaders, so I love to see the confidence of the women who are taking those roles. But those doors have to be opened first. And, once they are, we need to step through them with power.
What do you consider your biggest personal and professional achievements?
My biggest personal achievement was the decision to take my son off his medications and introduce cannabis into his life. Professionally, it was deciding not just to become a CBD scientist, but to create a bigger platform for cannabis that takes it to people who wouldn’t usually look twice at it. Ultimately, my biggest successes are the decisions I’ve made; sometimes, just making a choice is the hardest thing to do, especially when the odds are against you. My decisions are what has allowed me to be where I am today.
Outside work, what makes you happy?
Nothing makes me happier than seeing my family happy.
Who is your biggest inspiration?
My mom. She grew up poor, the second-oldest of 10 kids. When her father died, she felt responsible for helping my grandmother raise them, so she would perform in singing competitions every week to put food on the table. One day, someone came up to her and said, “We’re about to tour Europe for three years and we don’t have a lead singer; do you want to come with us?” She ended up touring the world and eventually moved to Canada, where she met my dad. I watched her work her tail off, never complaining and never giving up. I am who I am today because of her.
Describe your perfect non-working day.
I love hiking so I take my kids up a mountain. There’s no cellphone service up there – no calls, no email, no social media. Just peace. We also spend a ton of time in the kitchen. Or the beach. Any combination of those things is a perfect day for me.
Any advice to your younger self?
Never forget who you are and where your intentions lie. You lose sight of that sometimes. Always have a goal in mind. Work out what you want to achieve. Does this decision – whatever it might be – contribute to your long-term vision or will it distract you? If something happens that makes you shift or stop, you’ve got to take it in stride. I feel like many people get bogged down in stress and worry when things don't go our way instead of just saying, “I’ve got this.” You’re not in control of your destiny; all you can do is be conscious on the journey.