Priming the Personal Connections

After completing medical school at Duke, and getting married, Coles did his residency at Boston's Mass General, training in internal medicine and cardiology. He also managed to pick up a public health Master's from Harvard, and had two children. Then he got a call from Merck. "I had started thinking about working on population-based healthcare as a result of the public health degree, and got the notion that there were other ways to impact lives than just provide patient care," says Coles. "I thought about a career on Capital Hill as a healthcare policy staffer; Merck called out of the blue." As chair of the Minority Recruitment Committee at Mass General, Coles' activities had sparked the interest of Merck, specifically then-CEO Roy Vagelos. "Merck was very interested at the time in building a pipeline of minority scientists," says Coles. That interest turned into a three-year corporate grant to fund summer research internships at Mass General, and during that time, Coles received the aforementioned call: "Would you ever consider working for us?" Merck wanted to know. The offer came "at just the perfect time," says Coles, adding that Vagelos is "a big part of the reason that I'm in the industry."

"Roy had a really neat idea that physicians could be good business people, and had built a small team of physicians who had a business interest or direct marketing experience," recalls Cole. His first assignment at Merck was in the company's customer marketing group, where he got to learn the products, and work closer to the customer. Four years later, Bristol-Myers Squibb recruited Coles to help manage its partnership with Sanofi, and to launch Plavix and Avapro globally. "You only get to launch products very rarely in a marketer's life, so it was a dream come true," he says. As Coles' career blossomed at BMS—toward the end of what he refers to as his "middle decade" with Big Pharma—he began to contemplate the next 10 years, with an eye toward the biotech industry.

One day, Coles' son Andrew started complaining about pain in his left arm. The pediatricians couldn't find anything. "It wasn't until he woke up one morning and his sternum was actually protruding that we realized something was really seriously wrong," says Coles. During an evaluation, Andrew developed a variety of symptoms, including blood in the urine. That led to an evaluation of his kidneys, which uncovered "a huge mediastinal mass" in his chest. "One of the few rare emergencies in pediatrics is a compromising mediastinal mass, because of its proximity to the vital structures, including the trachea and other things, and [cardiac] arrest is not all that uncommon in these far-gone stages," says Coles. "Our physician said, 'Do not delay. I want you to go to Sloan-Kettering tomorrow morning and be there at 9 a.m. I've arranged for them to receive you.'"

At the time of diagnosis, Coles was interviewing at Vertex Pharmaceuticals, where he'd been recruited to head up the company's commercial operations. "To receive a phone call from my wife in the middle of business meetings is highly unusual, and I knew something was wrong, so I jumped on an airplane and headed home," says Coles. At Sloan-Kettering the next morning, it was determined that an emergency biopsy and surgery were needed. Andrew's pathology report came back with non-Hodgkin's lymphoma.

Most people can recall easily where they were on Sept. 11, 2001. Coles was at Sloan-Kettering in Manhattan, where his son was having a spinal tap and receiving chemotherapy. "One of the aides in the hospital walked in and told us that the buildings had been hit, literally as Andrew was coming out of anesthesia. And the fascination with what was happening, combined with Andrew's situation, was really surreal for us," says Coles.

After six cycles of chemotherapy, Andrew's cancer went into remission. "I took the job at Vertex, because I thought our life had suddenly been clarified, only to find out after I started at Vertex, six weeks later, that Andrew had relapsed, and we were told that he needed to have a bone marrow transplant. And I can tell you that I learned more about our industry through that episode than I had learned in the previous decade before that," says Coles. "The thing I recognized was the enormous value that we bring into the lives of people. Not just from a health point of view, but in easing the burden on their loved ones as well. When I went to give Andrew an injection of Neupogen, which he needed after his first cycle of chemotherapy, I recognized at the moment when I held that vial in my hand that this was really a life-giving opportunity for my son, potentially. I know it sounds dramatic, but it hit me in a way that had not occurred to me before."