When Elenoe “Crew” Smith first learned about sickle cell disease, it was part of a seventh-grade genetics lesson on passing traits — alongside the height and color of Mendel’s pea plants — from one generation to the next.
But the lesson hit home around the dinner table that night when Smith, telling her parents about what she had learned, was told that she might be a carrier of sickle cell — not presenting with the disease itself, but able to pass it on to the next generation.
“I had just gone from learning how devastating this disease was to, ‘Wait, you have the potential to have a child with this disease. It is in our family. It’s something that you should think about,’” Smith said.
That realization has served as a north star for Smith on a journey that has taken her from growing up on St. Thomas in the U.S. Virgin Islands, to Princeton, to Yale and eventually to Boston.
Now, Smith, 40, works as a director at Vertex Pharmaceuticals, looking to develop new treatments for the disease.
“My mission has always been to help people living with sickle cell disease,” Smith said. “That has always been my guide.”
It’s an exciting time, she said, to be working on treating the disease, especially somewhere like Vertex, one of two biotech companies to have gene therapies for the disease approved for use in the United States. Those treatments, the first gene therapies approved in the United States, were green-lit in December.
Smith’s work is not currently related to gene editing therapies, though she did her postdoctoral research on a team whose work led to Vertex’s approved CRISPR treatment.
Instead, she is looking at the challenge from a “small molecules” perspective, looking to develop a pill that could be sold at a drug store, to treat the disease.
If successful, a pill could close gaps, especially in parts of the world that don’t have access to the medical infrastructure to do the bone marrow transplants required for the existing gene therapies, said David Altshuler, chief scientific officer at Vertex.
It would also provide an alternative to the lengthy treatment times, limited number of treatment centers and hefty price tags required for the CRISPR therapies.
The process of developing that kind of pill requires addressing previously unfilled gaps in the medication-creation process — work that means “inventing a new kind of medicine,” Altshuler said.
Smith’s work in the field marks a track record of commitment to the goal of bringing therapies to treat the disease to more people, said Dr. Stuart Orkin, a researcher at Boston Children’s Hospital who leads the lab where Smith did her postdoctoral research.
The recent developments in the field have brought new attention to the work and disease.
“The publicity on this brings it out into the open in a way that hopefully will inspire more companies to do work,” she said. “It’s sort of whoever gets there first — hopefully it’s us — to have a therapy accessible to everyone who’s living with sickle cell disease, but the more people who are in the game, the more chances that we’ll be able to bring a transformative medicine to people living with this disease.”
Orkin called the recent approval of the gene therapies a moment of reflection.
“To me, it’s really a validation of the science that’s behind all the therapy and the science that may tell us eventually how to bring therapy to many more people,” he said.
Research, like what Smith is leading, is especially impactful, when it comes from women of color said Bonnie Bertolaet, executive director of Science Club for Girls, a Cambridge-based STEM-education nonprofit with a focus on bringing more girls — especially girls of color — into science, technology, engineering and math fields.
“When a woman of color speaks about a condition that affects communities of color, and they can see themselves in this narrative, I think it’s that much more powerful,” said Bertolaet, whose organization recognized Smith this year with one of the group’s annual Catalyst Awards.
During remarks at the May 2 award ceremony, Smith described meeting the father of a 16-year-old living with sickle cell disease, and the comfort her presence brought in doing work around a disease that largely impacts a community that has long had limited trust of medical research.
“He was relieved to see me, a Black mother, participating in the research that might bring a new future for his son,” Smith said. “Representation matters.”
As a Black woman scientist, Smith doesn’t come across many faces like hers.
According to a 2023 diversity report from the Massachusetts Biotechnology Council, workers of color — a designation that, for that report, included Black, Latinx and Indigenous individuals — made up 14% of the life sciences workforce of the group’s member companies who were surveyed, a figure that remained largely unchanged from the groups previous DEI report in 2021. That’s compared to nearly a third of the state’s workforce overall.
The same report found that women of color made up 8%.
Smith credits her place in STEM, in part, to a host of guides along the way, starting at home. Growing up, she watched her father, a civil engineer and marine biologist, and her mom, an accountant. As a child, science — and suggestions that she should end up as a doctor — came naturally to her.
Throughout her academic career, she found professors and advisors to mentor and guide her toward roles that would fit her well. While pursuing an undergraduate degree in molecular biology at Princeton, she was set on pursuing a career as a genetic counsellor until a professor told her she would be well suited to working in research.
That kind of mentorship is something she said the next generation of scientists of color should seek out.
“It’s about your teachers” Smith said. “There are people who are invested in your learning and becoming the best person that you can be. It’s finding an adult that will support you and encourage you and guide you through your learning experience.”
Now, she hopes to be a mentor and figure that can bring and keep a more diverse group of scientists in the field. She tries to make time for anyone who reaches out to talk about her work.
According to colleagues, she understands the responsibility of showing off the success she’s had.
“I think she values trying to make it clear to people that that there are opportunities for them and there are people who care and people who are willing to mentor them and support them,” Altshuler said.
Smith said that knowing being present in the role shows that it’s possible for Black women to be scientists is something that keeps her going even when the work is tough.
“When I feel like I don’t want to do this anymore, or it’s too hard, or I could do something else, I think there is an understanding for me that me being here is having an impact on other people,” Smith said. “When I tell people what I do, they’re absolutely amazed not just because of the science but just the fact that I have survived in this environment, and I have made it through, and I have found success.”
Her impact lands: It’s one of the reasons Smith received the Science Club for Girls Catalyst Award this year.
“She combines so many elements about her work with really talking the talk and walking the walk about highlighting pathways for more women, more women of color, more people in general, to get involved in science and research,” Bertolaet said.
Smith said, in no small part, being that guiding figure comes from just being present and making sure people know what she’s done so that they know they can do it too.
At Charles Street AME Church, in Roxbury — Smith and her family still make the 45-minute drive from Framingham weekly, to the church that she and her husband started attending when they lived in Cambridge — Smith helps teach choir. It’s a role she stumbled into when her children joined the group and the choir director requested help.
There, she has the kids call her “Dr. Crew” — the nickname stems from a nautically inclined family, where soon-to-be-born Smith was not “the baby”, but her sailing father’s future “crew.” She insists on including the courtesy title with her name not because she cares so much about highlighting her doctorate in cell biology at Yale, but to show her students another face of what a doctor can be.
“For many of them, the doctors that they see are doctors who are white,” Smith said. “I want them to be able to realize that Black people can be doctors, and it doesn’t necessarily have to be an MD, it could be a research doctor.”
Smith, too, has a knack for storytelling. Bertolaet said that skill is key in a field that often fails to communicate how exciting the work can be.
“We’ve let the narrative and the stereotypes about it being dry and uninteresting or not creative take over, and nothing could be further from the truth,” she said. “We all feel very passionate about the research, and I think Dr. Smith conveys this in a really holistic way all the while putting the science front and center.”
Smith said success in the field also comes from keeping with it even when things get tough.
In the midst of an especially challenging organic chemistry class — the end of her early-college dreams of becoming a chemistry teacher — she was ready to retreat home to the Virgin Islands, but her mother made her stay and finish the year. Then she took a molecular biology class and got bitten by the genetics bug and settled in.
“When I went to college, my first year, I nearly failed out of Princeton, but nobody would know that because I have my diploma and no one ever asks you what that grade was, but science is hard,” Smith said. “One of the things that I have learned is the race is not for the swift, it’s for the steady.”
But problem-solving comes naturally to Smith, who said she is a puzzler. In her free time that means jigsaw puzzles — she recalled a 1,000-piece image of a sunny Mediterranean island that she did around the holidays, when her three kids were in day care and she was off from work — but it’s a philosophy she brings to her work at Vertex too, and one of the reasons she said she fell in love with research in the first place.
“To me, it’s just a big puzzle and we’re in the middle of it,” Smith said. “We’re living it and we’re just trying to put it together. I think it goes well with my natural inclination to want to figure things out.”
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