Bedside to bench translation

The central questions that fuel my research did not emerge in the lab.  They come from the patients I have had the privilege of caring for over the past two and a half decades as an academic physician scientist.  One of the greatest sources of inspiration came from a 24-year-old woman with advanced addiction complicated by untreated HIV infection living in a tent encampment on Lower Wacker Drive directly under Chicago’s famous Magnificent Mile. Just steps from the campus of Northwestern Memorial Hospital where I met her.  The day after a positive pregnancy test, she walked into our HIV clinic seeking antiretroviral treatment for the first time almost a year after she learned she was infected.
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Over the next 3 months I was involved in her care as a consulting psychiatrist to her obstetric team, I watched in her motivations reorganize entirely.  She reduced her drug use dramatically and spoke about the life she was carrying in the same way any expectant mother would.  "My baby is going have a better life," she told me and delivered a healthy baby girl at 36 weeks - free from HIV - whom she named after me.

That experience made one question impossible to ignore:  what changed in this mother's brain during pregnancy that made it possible to change her behavior?  How can we make that last after delivery?  And what does this teach us about how addiction can be interrupted in all individuals?
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I am an academic physician scientist and founder of Sisternet.  I have spent my career asking the questions that tend to get left behind. Rather than stufying why drugs are so powerful, I am interested in the conditions that allow other things to compete.  Rather than understanding why people relapse, I want to understand the neurobiology that protects against it.  

I view pregnancy as nature's most powerful yet under-studied example of temporary recovery from addiction that can teach us about how  processes that perpetuate addiction can be powerfully interrupted.  I believe that the reward hierarchy in the brain is reorganized biologically in ways that can reveal new ways to treat addiction outside of pregnancy.  These ideas represent the intersection of addiction neuroscience, reproductive biology, and social science — asking what drives that shift, and whether it can be harnessed.

The dominant narrative in addiction science has long held that drug use hijacks the brain — permanently, catastrophically, hopelessly. I believe that framing is scientifically incomplete and quietly cruel. Rodent studies show that rats with extensive drug exposure will choose the company of another rat over cocaine, given a genuine alternative. Pregnancy shows that human motivational systems can reorganize dramatically under the right biological conditions. The tragedy is not that recovery is impossible. The tragedy is that we dismantle the conditions that make it possible — stable housing, social support, continuity of care — precisely when they matter most. At Sisternet, our work is guided by curiosity, integrity, and a deep belief that understanding the biology of change is also an act of justice.

Sisternet exists because these questions are too urgent and too interconnected for any one investigator to carry alone. We are building a laboratory culture rooted in deep trust, shared investment, and genuine collaboration across disciplines. We believe that breakthroughs emerge not from isolated brilliance, but from the right conditions. This same principle that governs our science governs our community.

Women like the one from Lower Wacker Drive have shown us what is possible. We owe them the science to understand it, and the treatments to sustain it.  

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