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Hello, boys andgirls, ladies andgerms.
This is TimFerris. Welcome to another episode of the Tim Ferris show where it is my job to sit down with world class performers from every field imaginable to tease out thehabits,routines, favoritebooks, and so on that you can apply and test in your ownlives.
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In his critically acclaimed podcast against therules, you can learn more about Michael atmichaulewisrights.com.
I'm looking at a paragraph frombrainpickings.org, which is run by MariaPopova, who I'm very fondof.
And there's a piece on your writingprocess.
She may have been quoting a differentsource, but I just want to read something quickly and then we can discuss these are yourwords.
Before I wrote my first book in1989, the sum total of my earnings is right over four years of freelancing wasabout $3,000.
So it did appear to be financial suicide when I quit my job at SolomonBrothers.
Red been working for a couple of years and where I just got in a bonusof $225,000, which they'd promised they'd double the following year to take a $40,000 book advance for a book that took a year and a half towrite.
Was that a hard decision or was it something you'd just been biting your timefor?
You put it verywell. It was something I'd been biting my timefor.
When I went into SolomonBrothers, I knew thatit, this was a tempgig, I'd be there for a fewyears.
And I was there more out of curiosity about how this world worked than I was to advance acareer.
Infact, aside from themoney, which Iliked, I didn't think really much about the career at Solomon Brothers because I knew I could only hangout.
My interest would only last for solong.
And I was intensely interested in it as I was learning aboutit.
But when I kind of figured it all out and got a sense of how it all worked and there weren't any more questions I had that needed to beanswered, I really started to getbored.
But the whole time I wasthere, I waswriting.
I got myself in trouble because I'd actually tend to write kind of about what's aroundme.
And so I started to write things about this great boom that was happening on WallStreet.
It was really the beginning of what we still livewith.
This notion of 22 or 23 year olds rolling on and making afortune.
The sums of money being made on Wall Street and the share of the economy that occupied was expandingrapidly.
And no one quite understoodwhy.
So there was a natural market for me to sort of try to explainit.
And I mentioned the Wall Street Journal asked me to write op-eds forthem.
I wrote an op-ed arguing that investment bankers wereoverpaid.
And in the bottom of theop-ed, it said Michael Lewis is an associate with Solomon Brothers inLondon.
Sogood. But I tellyou, I must have a blindstreak,right?
Because my reactionwas,wow, greatpiece.
When they sent me the galleys or whatever itwas, this isfabulous.
And I didn't even think what are the people at Solomon Brothers going tothink.
Except maybe they're going to be thinking so cool that I wrote an article on the Wall StreetJournal.
I got to work the nextday.
And there's a fellow who ran all of Solomon BrothersInternational, delightfulguy.
He was the guy who'd hired me in the firstplace.
And he was ash and face sitting at my desk with this little newspaper on hislap.
And hesaid,Michael, Imean, it was really not ananger.
And it was more insadness.
Hesaid,Michael, you have no idea of the damage you'vedone.
And I was kind oflike, what do youmean?
Hesaid, this thing is being picked up all over the UnitedStates.
And we've had a crisis meeting overnight of the Solomon Brothersboard, what to do aboutit.
They couldn't have wouldn't have fired me because I had just flukely started to generate a whole lot of money forthem, like a whole lot ofmoney.
I was essentially asalesperson.
And I had at that point the second biggest money generating account in the entirefirm.
And the person would speak only tome.
Even though I'd only been there a year and ahalf, it was basically the most sophisticated hedge fund sort of manager inEurope.
And so they didn't want to fire me because they didn't want to losehim.
He said tome, my bosssaid, what are we going to do aboutthis?
And Isaid, I don't really want to do anything aboutthis.
And hesaid,well, we need you to stopwriting.
And Isaid, I'm not going to stopwriting.
It's what I love todo. And he had the brightidea.
Hesaid, could you write under a differentname?
And Isaid, noproblem. I can dothat.
And hesaid, what name are you going touse?
Actually, just popped into myhead.
I'll use my mother's maidenname.
So I wrote under the name Diana Bleeker for maybe the next nine months or ayear.
I may be not quite thatlong.
But I wrote half a dozenpieces.
They got better andbetter.
I was getting better and better because I had better and betterediting.
So MichaelKinzley, who was then editing the newrepublic, had walked into mylife.
And he was teaching giving me writinglessons,basically, in the way he edited thepieces.
But the pieces Diana Bleeker waswriting.
Imean, I really felt off the leash because nobody could trace it back tome.
I was almost describing the trading floor around me inpieces.
And people werecirculating.
It was reallygreat. I was sitting in London at my desk doing mybusiness.
And I would watch people zero-oxingarticles.
I'd written in the new republic under Diana Bleeker and passed them out on the tradingfloor.
And so I had a sensethat,like,God, people are hungry forthis.
People arelaughing. Peoplewere, it was justworking.
Now, the money part ofit, what happenedwas, I came home one night to my house inLondon, picked up a phonecall.
And it was a man named NedChase, who happens to be Chevy Chase'sdad, who was a senior editor atSimon &Schuster.
And hesaid, I figured out who Diana Bleekerwas.
And I got yournumber. And I never found out how he didthat.
We think you should write abook.
And at thatpoint, Ithought, I'mout.
If someone will publish a book byme, I'm not hanging around the Wall Street firm anylonger.
I did hang around an extra three months to get mybonus.
But the minute I saw the money hit the bankaccount, and I knew they couldn't take itback, Ileft.
And not because I just likedthem.
It wasjust, I loved a lot of the guysthere.
Mostly, it was almost allguys.
I really liked mybosses,generally.
I just was bored with thework.
And I had this other thing I loved todo.
I had two conversations in which people tried tosay,oh, don't dothat.
Don't walk away from a sure fortune to go take a flyer on writing abook.
One was mybosses, who took me into aroom.
And this tells you just how innocent and age itwas.
Imean, these days you'd be in a room withlawyers,right?
And you'd betold, you signed this nine disclosureagreement, and you're writing anything aboutanything.
They didn't care aboutit.
They were worried about mysanity.
They were actually worried about mycareer.
They couldn't believe that I was going to walk away from this really cushy situation and go and do that otherthing.
So they were trying to helpme.
And I justsaid, youknow, I got thisfeeling, I got to dothis.
My fathersaid, youknow, you really could justwait.
You really could just collect some millions of dollars and then write yourbooks.
But the problemwas, I waswhat, 27 at thetime?
I looked ahead of me and I looked at people who were 35 or 37 and they seemed ancient and they seemed completelystuck.
Like they made so much money and their lives had adapted to the making ofmoney.
They depended on the making ofmoney.
I justthought, there's no way I'd spend a lot of time here and still even want to dothis.
I'd be trapped and I don't want to dothat.
So I ignored all that advice and just went and did it and it workedout, youknow, it waslike, that was Lyre'spoker.
And Lyre'spoker, at least I'veread, was intended to be cautionary tale ofsorts.
It's not how everybody tookit.
Imean, it's a very excitingbook.
The thingis, it's like a funnybook.
It was a funnystory. It's avery, very funnybook.
And it's also an incredible story because you're seeing this transformation of this industry and the effect on all these youngpeople.
But I had only one kind of moralistic thought in mind when I wroteit.
I really justthought, my models that I had in my head when I wrote it were education of Henry Adams and Rousseau'sconfessions.
The model was just tell the world whathappened, exactly as you remember it and that'senough.
You don't need to layer on an interpretation of whathappened.
What happens goodenough?
And the extent I wanted kind of to push the reader in anydirection, it was just really young readers like people in college that I hoped would read it and wouldsay,yeah, I now know what thisis.
Yeah, there's moneythere, but a lot of it's kind of silly and I have these other things I want to do with my life and I'm going to go dothem.
So I'm not going to be seduced by Goldman Sachs or have Goldman Sachs prey on my anxiety about my future when I'm walking out of mycollege.
I'm going to go do what I'm meant todo.
And I felt that way because I had watched classmates at Princeton just naturally drift into the arms of the investment banks because they reallycouldn't, they felt they couldn't resist the money and they were anxious about not beingsuccesses.
Then what happens is the book comes out and the book makes it seem because it was as business goes incredibly colorful and entertaining and lucrative and I had dozens of letters a day from young readerssaying, dearMr.
Lewis, I really loved your how to book about Wall Street about how to make money on Wall Street and I'm hoping that there's some tips in there that you didn't put in there that you could let me know so I have anedge.
It just fueled the desire of young people to want to do it more and I didn't see thatcoming.
And that'ssomething, I don'tknow.
Anybody writes books I think learns that you write a book but the reader reads a book and the reader may read a book that's entirely different from what you thought you wrote and you can't really do that much aboutit.
How do you think about if you do ambition and this may not be a good question but it seems like from what I've read the over ambition that kind of people wear on their shirts leaves in certainly many parts of Wall Street you find off-putting or maybe in bad taste but you certainly don't shy away from ambitiousprojects,right?
How do you personally think about ambitious and I don't wanna put words in your moutheither?
No,no, it's an interesting way to frame thequestion.
How do I think aboutambition?
Well, I could tell you I thought it was so comical that I was going to be in this ambitious money-making world that the week before I went to SolomonBrothers, I went into PaulStewart, this men's store because I saw it through theirwindow.
I saw they had red suspenders with a little gold dollar signs on them and Ithought, this is like a way to make fun of the whole thing and nobody thought it wasfunny.
Nobody thought it was like you can't wear that shit around here until you can't wear that shit until you are a big enough deal to wear thatshit.
I've always been enormously ambitious in away.
I've always wanted my life to begreat, like reallygreat.
I'mcompetitive, like very competitive and I love competitivesports.
I lovewinning. I don't particularly likelosing.
I guess numberone, I don't accept money as an accurate measure or any kind of real measure of whether you're winning orlosing.
So money doesn'thold, there's not that hold onme.
Fame a bitmore, I would say a lust for attention and fame is probably closer to a vice of mind than a lust for money andfortune.
But eventhat, I find I get tired of and it doesn't interest me thatmuch.
I don't think I'm a maximizer in that I try to get a lot of athing.
It's more if I'm trying to maximizeanything, it's a feeling and it's a feeling that that was a kickassbook.
I look at something and just say that is a great piece ofwork.
That feeling is what I'm kind of always gunning for and it's a pretty privatefeeling.
And I think overtime, Imean, you must have found thistoo, that the response that I have to external validation has become muted andnumbed.
And when I got a glowing review for Liars Poker and it went to the top of the New York Times bestsellerlist, it was like dancing all over mykitchen.
Imean, I was just happy as aclam.
I couldn't believe that it was like I just won the SuperBowl.
And now I don't read thereviews.
I keep some of forget whether a book is on the New York Times bestseller list ornot.
I'm not paying as much attention toit.
It doesn't gratify me in the sameway.
But the gratification I get from looking at something that I think I've done that's really good is at least as great as it was backthen.
I think I'm tapping intothat.
I think I'm tapping into the pleasure I got when I was just all by myself in a room laughing at my ownjokes.
It's sort of like maximizingself-satisfaction, which is maybe not the most attractive trait that my ambition is to maximize myself-satisfaction.
Maybe that's myambition.
Let's jump into the process associated with the maximizing theself-satisfaction.
You mentioned laughing at your ownjokes.
I have read that you sometimes write late atnight, saymidnight, you put on a headset and play the same soundtrackof,say, 20 songs over and overagain.
Is that something that you stilldo?
Yes, infact, I did ityesterday.
Kids screwed up my natural writingrhythm.
My natural rhythm would be to start about four in the afternoon and write till three in the morning and sleep untilnoon, but you can't do that withkids.
Inow, I'm not as likely to be found late at night at mydesk, though it happenssometimes.
But whenever I'mwriting, I have headphones on and I have a soundtrack I writeto.
And the soundtrackchanges.
It changes book tobook.
And it's got to the point where both my wife and my kids will recommend songs for the soundtrack for whatever the next projectis.
And I'll build a soundtrackintentionally.
And the musicis, it's all over themap.
It tends to be veryup, but it tends to be music that I just stophearing.
And I notice something reallyfunny, just the last couple ofweeks.
Because I'm working on somethingnow, the second season of mypodcast, where I have a different relation tomusic.
The podcast is about coaching and the lastepisode, which I have still notwritten.
It's the only episode I haven'twritten, is me getting coached in something I'm incredibly uncomfortabledoing.
And it'ssinging. I've been doing voice lessons an hour every day for the last threemonths.
And there's a song Ising, and I'm not gonna tell you which one itis, that I'm gonna have tosing, that I've beenpracticing, that happens to be on mysoundtrack.
And now I realize I have to remove it because it kicks my brain into a differentspace.
All of a sudden I hearit, and it's likePavlovian.
I've got to belt out thetune.
I've got to worry about hitting a highnote, and it screws up mywriting.
And so I've just been hitting skip because I've been reluctant to changeit, but I have to just gonna have to removeit.
So the music puts me in the purpose of it is to shut out the possibility ofinterruption.
I can't hear knocks on thedoor,phones, people dropping packages on the frontporch,anything.
I'm just in my ownspace.
And I kind of cease to hear thesound.
You mentionedMichael, was itKinsley?
Is thatright? Theeditor?
They're the newrepublic.
What made him a goodeditor, or what did you learn fromhim?
Can you remember anything that he helped tighten orimprove?
So Michael Kinsley had a gift for creatingwriters.
There are dozens of people who were young writersthen, who he had profound influenceon, and careers that he justlaunched.
And it's an oddassortment.
And I was one of thosepeople.
I think what happens with writers who come up in a conventionalway, like through creative writing programs or by writing for their circle offriends, is they get treated toopolitely.
Their work gets treated toopolitely.
So they don't hear a really withering critique of theirwork.
And Michael Kinsley could not helphimself.
He delivered the most withering critiques of yourwork.
They kind of throat clearing phony firstparagraph, which was totallyunnecessary.
It would comeback, it'd be just a big axthroat.
Why'd you even writethat?
Starthere. It wouldbe, I canremember, I had learned a word that was just a completely obscureword.
And I even remember theword, but I don't know how to pronounceit.
It'sCthonian, it startsCH.
I think it means of theunderworld.
And I remember working it into thepiece, and like a big circle aroundit,saying, you fuckingphony.
What'd youdo? What'd youdo?
Go into theThessaurous.
It was just like making merciless fun ofme.
Mybyline, at the verybeginning, I thought it soundedgood.
It was for it to be MichaelM.
Lewis. My middle name isMonroe.
I thought a middle initial kind of fancied itup.
He put a big circle around it andsaid, don't dothat.
Don't be one of thosepeople.
You're not MichaelM.Lewis.
You're MichaelLewis. He was all the preposterous things that you naturally tend to do when you're putting words onpaper.
He identified all of them as vices and stopped you fromthem.
And so inaddition, he was unbelievably gifted at seeing what a good storywas.
You just started to learn what was interesting and what wasn't just talking tohim, just by how he responded to what yousaid.
It was a kind of feedback that everybody shouldget, but that most people are too tender and sensitive todeliver.
It's a funnything. I think that this happens in speechtoo.
I think that there's lots of inefficiency in human conversation that people do all kinds of things they really shouldn't do and that other people make fun of them fordoing.
People are endlessly telling stories about what some other personsaid, making fun ofthem.
And it shouldn't be thatway.
We should be very efficient conversationalist because we do it all thetime, but we aren't because we don't getfeedback.
Because people are toopolite.
And I think people are too polite with other people'swriting.
And what MichaelKinzley, his great gift in addition to be a kind ofgenius, was he just couldn't bepolite.
He was just soblunt. I'm Michael Lewis on my books instead of MichaelM.
Lewis because of MichaelKinzley.
I have a question for youabout, maybe this isn't the rightword, but productivelaziness.
I was looking at an article that talked about a speaking gig from 2017 inQualtrics.
You might know where this isgoing, but the quote that stuck out to mewas, it attributed toyou, people waste years of their lives and not being willing to waste hours of theirlives.
And I don't know if that prompts anymemories, but is that something you can elaborateon?
Sure, that wasn't a quote fromme.
It was a quote from one of mycharacters, AmosTversky, he's one of the main characters in the UndoingProject.
And it resonated withme.
What he meant was that the people don't back away from theirwork.
And especially the need to always seem busy or be busy stops people from finding things that are really worth doing and sifting the ones that are worth doing from the ones that aren't worthdoing.
So it resonates with me because I am not a person who always has to be doingsomething.
And infact, my natural state is probably inert that I can really just lay around and screw off and procrastinate with the best ofthem.
And it's partly because I grewup, Imean, I grew up in New Orleans and there was not a whole lot of value attached to either ambition or careerachievement.
You were who you were because of how you were and who your family was and what neighborhood you grew upin, where you went toschool.
You were always so well defined by your environment that trying to change it by doing stuff didn't seem to make a whole lot ofsense.
And my father used to tell me and itwas, and I believe this until I was about20, on our family coat ofarms, there was a motto in Latin and the motto was do as little as possible and that unwillingly for it is better to receive a slight reprimand than to perform an arduoustask.
And he would just say thatlike, just keep that in mind we live by thesewords.
And so that's my kind of where I was coming from just generally and I found this thing that didn't feel likework.
So it didn't feel like an attempt atachievement, nothing achievement was bad just that's not why I was doingit.
But having saidthat, youknow, I do find that being able to back away and get yourself myself in a state of mind in which I cansay, it's okay if I never write anythingelse.
It's okay if I never write anotherbook.
It's okay if I don't do anything for sixmonths.
And I can afford that now and that's nice tobe, it's a luxury to be able to affordit.
But I think a lot of people who can afford it don't actually take advantage of the luxury because I think that doingthat, putting yourself in a state of mindwhere, allright, I've got to make an argument about why I need to write another book because I don't haveto, changes your relationship to potential stories and potentialmaterial.
It requires the material to rise to the level of interest where you feel obliged to engage withit.
So you're not doing it just because you got to write it anotherbook, you're doing it because how can I not writethis?
And it serves my own sloth andindolence, serves as a kind offilter.
And the filteris,no, I don't have to dothat.
So I'm not gonna dothat.
I don't particularly wanna dothat.
So I just not gonna dothat.
And even if you tell methat,oh, it's got big best seller written all overit, I'm not interested because it keeps me off thatpath.
I think it's been very useful because it does two things atonce.
Oneis, it raises the level of the bar that the material has to jump over to get tome.
So the material's gonna have to be really good if I'm gonna engage withit.
Andtwo, it stops me from doing the same thing over and over again just to besuccessful.
It enables me to almost encourages me to move around and do surprisingthings.
And I think readers and audiences really appreciate and will engage with the writer who's willing to takerisks.
Thatyeah, they like theirwriter, some are their writers to just keep doing the same things over and overagain.
But they'll follow you if you take a braverisk.
Since I'm not doingit, I'm not trying to create the next sure fired bestseller.
I'm led to other and sometimes unlikelymaterial.
So the book's end up being about a lot of differentthings.
What are some of the questions or thresholds that indicate the material has risen above the necessaryhurdles?
I found onequestion, I don't know if this is you ornot, so feel free to confirm ordeny.
But would I be sad if this story didn't gettold?
Yeah, that'sfunny, that isone.
It's a really good question because there's not a clear cut rule that Ifollow, exceptfeeling.
And there are a couple of feelings that I associate with the desire to write abook.
One is a feeling that if I don't doit, it won't properly get done because I have some privileged access to thestory.
And there are lots of different ways you can have privileged access to thestory.
But the sensethat,yeah, this book really should be written and someone needs to do it and that someone is clearlyme.
The second and related feelingis, I have an obligation to thematerial.
It isn't the material has an obligation to me as awriter.
It's I have an obligation to thismaterial.
And once I have thatfeeling, I have amotive.
I have a motive and whether I'm fooling myself ornot, it's a motive that's a deeper and more inspiring motivethan,oh, I gotta make a livingor,oh, I gotta get a book on the best seller listor,oh, I gotta have something to tell my friends when they askme, what are youdoing?
It's the highestmotive.
It's I have anobligation.
I have aduty. And I've had that feeling with every book I'vewritten, how it gets to thatpoint.
Imean, they take their different paths to thatpoint.
But it obviouslyis, it's some feeling in myself that this is an importantstory.
If you could put amessage, aquote, aquestion, anything at all on a billboard metaphorically speaking that would reach billions ofpeople, does anything come tomind, non-commercial that you might put on abillboard, saying amantra, something you remind yourselfof, anything atall?
It's gonna soundtrite, whatever Isay.
And let mejust, let me just saythat, I live in the world's capital of bumperstickers.
It'sBerkeley,California.
There are more bumper stickers per automobile than anywhere else in theworld.
It's been scientificallyproven.
You can walk down thestreet, and it's mostly politicalstuff, but it's just like people getting their point across in bumperstickers.
And I have never had a bumper sticker on my car because it's not one thing I've ever wanted to say over and overforever.
I'm not a bumper sticker or quoteguy.
However, if you say I gotta put it up on abillboard, I would take the mantra of my high school baseballcoach, one of the greatest men I've everknown, who is actually the subject of one of the podcastepisodes.
And he would just say itroutinely, and he just kind of became part ofyou.
He wouldsay, don't begood, begreat.
And he'd say toyou, is he handed you theball, they got to pitch agame, he'd say toyou, when you were workingout, and youjust, having thatmind, it's the kind of thing I try to keep in mind when I'm working onsomething.
Good is notokay. If you're gonna doit, begreat.
Pushyourself. And it'shard.
And don't just stop when it's goodenough.
That's what I would stick on abillboard.
It's one of those things that's in the billboard of mymind.
Don't begood, begreat.
I loveit. That's BillyFitzgerald.
BillyFitzgerald. Just a quick thanks to one of our sponsors and we'll be right back to theshow.
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Lasttime, drinkag1.com slashTim.
Check itout. Andnow,Dr.
MartinRothblatt, an Americanlawyer,author, andentrepreneur, and the chairperson and CEO of UnitedTherapeutics, a biotechnology company she founded in 1996 to save the life of one of herdaughters.
You can learn more aboutDr.
Rothblatt and the work of United Therapeutics atunithtr.com.
Martin orDr.Rothblatt, both welcome to theshow.
Thank you for making thetime.
Thanks somuch,Tim. Just Martin'sfine.
Allright. And thisinterview, as my listeners mightimagine, was challenging in the best way to prepare for her because there are a million and one directions that we can go with just this bioalone, whichis, ofcourse, asnapshot, a distillation of much more that you havedone.
And I thought we could start in perhaps an unlikelyplace.
And that is AlanWatts. I have read that you are a fan of AlanWatts.
And specifically the book subtitle on the taboo against knowing who you reallyare.
Could you please explain if that is true why that is thecase?
Yes.Thanks,Tim. Alan Watts has a really unique ability to see the dialectic aspect of everything innature.
Bythat, I mean that there's a kind of a yin-yin aspect to everything innature.
And he points outthat, forexample, you can't have a crest of a wave without the bottom of awave.
And it has helped me whenever I see things in life that seem negative to be able to look at it in another way and see the positive init.
When were you first introduced to hiswork?
How did that comeabout?
I was first introduced to it through the literature of this philosophy calledtranshumanism, sort of the idea that people can transcend some biological humanlimitations.
A friend ofmine, FrankSazanowski, who is the head of the national organization on rarediseases, pointed me in the direction of someJesuits.
He himself is a both a Jesuit and an FDAlawyer.
But he pointed me in the direction of someJesuits, such as on Teardou Chardonn from France and other individuals here in theUS.
And then from thoseJesuits, they referred to AlanWatts.
I'm not sure if he was actually aJesuit, but he undertook some religious training both inChina, Ithink, and in theUS.
He was a radio announcer for many years in SanFrancisco, Ithink, during the 70s or80s.
I don't know if you rememberhim, the film of a few yearsago, her inwhich, like acomputer.
Yep. So I was watching thatmovie, which is interesting to me because it epitomized or visualized the concept of computers becomingsentient.
And in the middle of thatmovie, there's a scene in which Alan Wattsappears.
And I stood up in themovie, and Isaid, oh mygod, AlanWatts.
LAUGHTER LAUGHTER Did you ultimately find the presentation in that movie to be compelling as it relates to sort of sentientintelligence?
Idid. I thought it was an accurate depiction of a likely way that sentience would begin to arise in oursociety,basically, by beingvery, very useful to people cleaning up theirinboxes, stuff likethat.
This may be a goodplace, and we're going to be all over the place in non-linearfashion.
Bina48. Who or what is Bina 48 if I'm pronouncing thatcorrectly?
Yep. You've got itperfectly.
So Bina's the name of mypartner.
We've been married for about 40years.
And when she was48, we undertook a joint project to try to create a digitalsimulcr, or a digital copy of her basic personality with a lot of her memories andthoughts.
And we thought this would be a very nice project as a combination of science andart, and to encourage youngpeople, get them more excited about computerscience, and women inparticular, girls inparticular.
So we contracted with a couple of companies who were experts in both the software engineering side and in the physical modeling of a face that moves exactly like a human facedoes.
You might imagine there's this an exhibited Disneyworld, Disney land of Lincoln andwhatnot, something likethat, but morerealistic.
We built thisproject. And since thattime, Bina 48 has thrilled audiences all around theworld.
I'm sure she has inspired hundreds of not thousands of girls to go into computerscience.
And she continues to get better andbetter, more and more advancedsoftware.
I don't know if you have watched the series Black Mirrorbefore, but I find some of their episodes to be verystrong.
And in one ofthem, a significant other is effectively resurrected by pulling data andpatterns, andtherefore, mannerisms and soon, from effectively social mediaaccounts.
So pulling from the cloud and feeding into this similacrum or the model of someone who used tobe, or in thiscase, stillis, how far away do you think we are from being able to do something along those linesconvincingly?
Yes,Tim. So I am a fan of the Black Mirrorseries.
And there are a few other somewhat similar series that they're streamingnow, upload andwhatnot.
So it's an idea that's catchingon.
And even at a very basiclevel, social media firms likeTwitter, forexample, and probablyFacebook, aswell, offer an opportunity that after a person passesaway, their account can remainactive.
And I believe in the case of Twitter can even continue tweeting in the way that you oncetweeted.
So I think this general idea is it's atrend.
It's only going to grow more and more prevalent as software does a better and better job of copying the humanpersonality.
Sometime in thiscentury, forsure, and maybe in just like two or threedecades, I think that there will be a digital copy of aperson.
And another word is like a digital doppelganger of a person who will claim to be the originalperson.
And they may make that claimbefore, after the persondied.
And then psychologists and lawyers and theologians and philosophers will have to grapplewith, is this just like a really super fancy digital photoalbum?
Or is this actually some form of digitalsentence?
When you were growingup, who were your role models orinspirations?
Was there anyone in particular who stood out to you when you were in high school or at the verybeginning, let's just call it freshman year of your undergrad as icons worth emulating or lesser known role models worthemulating?
Did anyone really stick out foryou?
I think that in terms ofauthors, I was very influenced by RobertHeinlein, the science fictionauthor.
Sure.Yeah, stranger in a strangeland.
Andso,absolutely, it was sobrilliant.
And then a few yearsago, when his widow released theuncensored, unedited version of stranger in a strangeland, it's like three times larger and no-holedbar.
I just savored every page ofthat.
My favorite book of all of his is Time Enough forLove, in which he covers almost every topic under thesun.
So Heinlein's characters were somewhat of role models forme.
Like Lazarus Long is a common character in some Heinleinbooks.
In the publicsphere, I was very much enamored with RobertKennedy.
Hispositive, progressive approach to the world was something that endeared me tohim.
So I looked up tohim. Those are a couple of the role models that I had at thattime.
You seem to be good at manythings, ofcourse, just based on the bioalone.
But what strikes me is how quickly you were able to develop expertise in newfields.
I'd like to use this as an opportunity to bring up what was mentioned at the very beginning of yourbio.
And that is UnitedTherapeutic, a biotechnologycompany.
She started to save the life of one of herdaughters.
I'd love for you to provide some context for this and tell a bit of the story just because people will want to hearit.
And then the follow up just to plant the seed for it is how you learnedbiology, because my understanding is you didn't have much in terms of background inbiology.
That's a huge mouthful of aquestion.
But if you could give us a bit of thebackground, that would be extremelyhelpful.
And we can use that as a jumping offpoint.
Sure. So it's kind of funny that you can go all the way through undergraduates at a great place like UCLA and never be required to take a life sciencecourse.
But that was thecase. So the last biology class I had was in highschool.
And here suddenly I was faced with a situation as an adult while running seriousexam.
That our youngest daughter is diagnosed with a fatalillness.
She can't even walk up a couple of stairs to the frontdoor.
And there are no medicines approved forit.
I finally got her to the best doctor one couldfind.
The head of pediatric cardiology at Children's National Medical Center in the middle ofWashington,DC.
And the doctorsaid, this is an extremely raredisease.
No one knows why itarises.
All the patients die within two to threeyears.
He had only seen two or three other kids with it and they bothdied.
And all you can do is hope for a lungtransplant.
SoTim, I was completelycrushed.
I just sawblack. I didn't know what todo.
And the only thing I could think of doing while she was in the intensive care ward night after night and myself and Bina would tag team staying there withher, was once she fell asleep to go down into the library and to just begin learning about what was this illness shehad, which they told me was called pulmonary arterialhypertension.
And why were there no treatments available forit?
So I just began reading and reading andreading.
Most of the time I readthings, I didn't understand what they were talking about because there were these long medical words and chemical words that I never learned in law school or we never had to deal with an electricalengineering.
But ofcourse, there weredictionaries.
And I looked up the words in adictionary.
And they had college level anatomytextbooks.
So what I didn'tknow, I just kept going backwards inacademia, I guess you wouldsay, backwards in learning orpedagogy, until I would even get to like a high school level textbook that would explainsomething.
And Isaid,OK, I getthat.
And I kept taking notes and just educated myself night after night until I learned everything I needed toknow.
How didyou, and I know this is a story you've toldbefore, but ultimately in searching for possiblesolutions, and as we were chatting about beforerecording, there's a lot of luckinvolved.
And it doesn't mean that your path is replicable by any set of parents who are caught in a tragic situation similar to what youexperienced.
Butnonetheless, you were able to ultimately trackdown, I suppose it's fair tosay, amolecule, a drug of sometype.
Would you mind describing for listeners the process then of attempting to secure the ability to utilize in any fashion this drug or to licenseit?
If you could describethat, I have a number of questions that will stem off ofit.
There are a gazillion articles published on every type of medical research you couldimagine.
Imean, it's just a bottomlesswell.
There are literally hundreds of different types of medicaljournals.
Each of those journals have everyyear, thousands of articles published acrossthem.
So it's difficult to find the information that youneed.
But in lawschool, we learn a very usefulskill.
This skill goes by the name of shepherdizing after this type of index that they have in law school calledshepherds.
So what shepherdizing involves is when a judge writes a decision like the Supreme Court issues adecision, they drop a lot offootnotes.
And ofcourse, one thing lawyers love to do is make footnotes andreferences.
And then what you're supposed to do as a good lawyer is to look up all of the footnotes and the references that that Supreme Court or lower court case referredto.
And then the shepherdizing process is after you get all of those references to then look up all of the references in those otherarticles.
Andultimately, you get to a point of diminishing returns wherethree,four, five levelsdown, the references are all circling back around onthemselves.
So I applied that shepherdizing process to these medical articles and somewhat likedoctors, whenever a researcher publishes anarticle, they make footnotes and citations to other people's research who they reliedupon.
So I would get all of those articles and readthose.
And then I would follow up on all of the references inthose.
Finally, I read about a molecule that a researcher at Glaxo welcome had written in which they described testing this molecule for congestive heartfailure.
And it failed in its test of congestive heartfailure.
It did notwork. But in thearticle, they had charts of what the moleculedid.
And the one thing that the molecule did that grabbed my attention was that it reduced the pressure between the lung and theheart, which is called the pulmonaryartery.
It reduced the pulmonary artery pressure while leaving the pressures in all of the rest of the body perfectlyfine.
Well, that's exactly the problem with pulmonary arterialhypertension, the people who have thisdisease.
I'll make a quickfootnote.
That when my daughter was diagnosed 2,000 people in the US had the disease because medicines have become so much better and because we've been able tohave, like youmentioned, in theintroduction, get all theseapprovals.
There are now 50,000 people in America alone living withit.
So it's likely that people listening to your podcast will know somebody or another who has pulmonary arterialhypertension.
And I read this article and Isaid,wow, just when I need this tiny stretch of artery just between the heart and thelungs, this molecule somehow talks to that tiny stretch of artery and leaves the whole rest of the bodyalone.
That was the holy grail that I was lookingfor.
So I looked at where the author of the article wasfrom.
He was from Glaxo Welcome in Research TrianglePark, NorthCarolina.
And I made a beeline down to him and ask him if he could develop this molecule that he'd found from my daughter'sdisease.
Was it an immediate handing over the keys to thekingdom?
A big allcaps,yes.No, it was actually a big all capsnote.
Unfortunately, the individual who had written the article had actually retired a few monthsearlier.
And the person that I ended up meeting with who is in charge of research and development said that this was just onearticle.
It was a incidental finding in any event this disease afflicted so fewpeople.
It was completely unrealistic to expect Glaxo Welcome to develop this molecule for my daughter and other people with thatdisease.
And I askedhim, he's named BobBell.
He's now a venture capitalist and very successfulgentleman.
I askedDr.Bell, Isaid, what would it take for you to develop thismedicine?
Hesaid,well, it probably wouldtake, you couldn't doit.
We only developed medicines if they have more than a billion dollars a year in revenuepotential.
Hesaid, but it's possible you could buy it fromus.
If you had a real pharmaceutical company with real pharmaceuticalexpertise, I could then introduce you to the business development people at GlaxoWelcome.
So over the course of the next severalmonths, I created a brand new biotechnologycompany.
I was able to have a Nobel Laureate who was formally associated with Glaxo Welcome become head of a scientific advisoryboard.
And I re-approach GlaxoWelcome.
And Isaid, I have all the things that you askedfor.
Can you sell me this drug and we'll develop itourselves?
Well,Tim, it turns out that everybody I askedsaid,well, you have to get somebody else in the company toagree.
And that's how it is in a bigbureaucracy.
It turned out that we had to have 15 different executives sign the same piece of paper to license this drug tome.
Finally, ithappened. And all they wanted reallywas $25,000.
And a promise of10% of any money that I would ever get from thismolecule.
I think they agreed to that only because I kept buggingthem.
I was in their face all thetime.
Also because I believe a serendipitous factor was thatDr.
Bell's sister had contracted a form of pulmonary hypertension from the time I first met him toward the end of thisprocess.
And he became a product champion for me withinGlaxoWelcom.
Imean, that was just pure luck or serendipity whatever you want tosay.
And then they really didn't think this molecule had any chance atall.
And they were really just doing it to get rid ofme, Ithink.
Butstill, all 15 people had to signit.
After we successfully developed thismolecule, we have over time paid more than $1 billion just in royalties toGlaxoWelcom.
Because that molecule has saved thousands of people'slives.
It has produced $1 billion a year inrevenue, year after year after year forus.
And BobBell, when I invited him to our 15thanniversary, and he came with his sister who was still alive and on ourmedicine.
And he said this was the absolute best transaction that GlaxoWelcom had everdone.
So inhindsight, what did theymiss?
What accidentally got deleted from the spreadsheet or what assumption or assumptions were incorrect that they missed this opportunity socompletely?
I think there were probably maybe three mainones, the firstone.
And I can say this from first had knowledge since I am now the head of a pharmaceuticalcompany.
The odds of any molecule actually working in the human body are less than 1 and100.
When the human body is socomplicated, it's like a massive set of very precisely keyedlocks.
And every molecule is like a randomkey.
And the chance that you would have a molecule that opened a lock that fixed some dysfunction in the body rather than causing some harm to the body is it's less than 1 and100.
So first ofall, they figured the chance of this thing working just in general was less than 1 and100.
Secondly, they thought tothemselves, even if it worked a littlebit, there's only 2,000 people in the whole country with thisdisease.
They didn't really think that if it worked reallywell, the number of people would keepaccumulating.
I see you're saying if you have these people who would have died otherwise notdying, then that treatment cohort is just going to grow andgrow.
So youmean?Exactly. I thought about it like I was getting subscribers at seriousXM.
People said tome,oh,Martin, you'll be lucky to have 100,000subscribers.
Isaid,well, if I keepthem, andagain, another 100,000 the nextyear, then I'll be up to200,000.
And then maybe400,800,000.
Now we have 30million. They didn't think in that subscribermindset.
That was a secondproblem.
The third problem is that they didn't really imagine that the healthcare system would pay something like $100,000 per year for thismedicine.
And at thetime, this was in the early to about 20 yearsago, early2000s, I think like the average price for an expensive medicine was perhaps $10,000 a year for a patient or $10,000 for a course oftreatment.
Because of advances in things like precision medicine and genetherapy, there aremany, many medicines now that cost over $100,000 ayear, mostly for rarediseases.
And the healthcare system pays for them because so few people have these diseases that even though the medicines areexpensive, it's a drop in the bucket compared to diseases like hypertension or commonillnesses,asthma, that afflict tens of millions ofpeople.
So the healthcare system doesn't really mind paying a lot of money if it's a raredisease.
And the people at Glaxowelcome, we're clueless aboutthis.
They were actually looking for the big billion dollarblockbusters, not for the rarediseases.
So those were their threeomissions.
They failed to be Alan Watsy and they failed to see that because something is bigunderneath, that means that there's something else that'ssmall.
And that was what Alan Watsy would alwayssay.
He says something is good only because something else isbad.
At the veryleast, Imean, it's a valuable thought exercise when you're looking at the assumptions that you'remaking.
And what an incrediblestory.
You mentionedserious, we haven't spent any time on serious justyet.
When did you first fall in love or become intoxicated or enchanted by satellite systems or electricalengineering, Isuppose, but you can take whichever one is more interesting totackle?
You're absolutely right that I fell in love and I was intoxicated by satellitecommunications.
It seemed to me kind of magical that we can put a machine way out in space and that the machine can do amazing things across the whole face of theplanet.
My first real moment of firstlove, if youwill, was that a remote NASA tracking station in the IndianOcean.
And I had left UCLA to travel around theworld, really hitchhike around theworld.
And I found myself in the Indian Ocean on the set of islands called theSeychelles.
And on theseislands, at the top of the mountain in the middle of the mainisland, there was a NASA trackingstation.
And I went up intoit. And I was probably a pretty grungy 19-year-old at that point intime.
But the engineers inside there were kind of like a person and patient withme.
And they explained to me how their satellite antennas were communicating with satellites in all different orbits around the Earth and even all the way out toJupiter.
And I askedthem, Isaid, would it be possible for somebody to put a satellite up there and have it broadcast information back to the entireEarth?
And theysaid, if you made a powerful enoughsatellite, then the receiving equipment on Earth is a tool that you could hold it in the palm of yourhand.
And I could have kissed theguy.
Imean, I justsaid,wow, that's the purpose of mylife.
And I made a B line back toUCLA.
I changed my major to communicationstudies.
I did an undergraduate thesis on direct broadcastsatellites.
I did a joint JDMBA degree where I published a multiple articles on satellitecommunications.
I worked at Hughes AircraftCompany, which was a big manufacturer of satellites back then and helped design a satellite to cover SouthAmerica.
And then ultimately went out on my own with my dreamgoal, which was seriousXM.
What did it feellike, if you canremember, to have that answer given to you or that directionrather, given toyou, thepurpose, given toyou?
Did it feel a certainway, that type of conviction or that type ofbelief?
What do yourecall?Yeah,Tim, it's the bestfeeling.
It's the bestfeeling. Andactually, I don't think it really has anything to do withage.
I felt like the same kind of feeling when I was driving one of the firstTeslas.
And I was looking at themanual, and I saw how much electrical power itoutput.
And there's a very simple correlation between horsepower and electrical power between kilowatts andhorsepower.
It's almost one toone, notexactly.
And I was already a helicopter pilot and helicopter engines are always quoted in terms of theirhorsepower.
So rightaway, Isaid,wow, this car has enough power to actually lift ahelicopter.
I had that same kindof, this is the purpose of mylife, is to make an electrichelicopter.
So you can get this kind of excitement at any point inlife.
I think probably the best way to describeit,Tim, would be like a lightning bolt to yoursoul.
I was asking about biologyearlier, but I would be very curious since you mentioned also that there wereno,well, the requirements as such an undergranted require you to take any additional biologyclasses.
If you were trying toteach, let's justsay, aclass, and you could pick theage, or it could be a set ofclasses, scientificliteracy, being able to have enough basic fluency to provide more surface area for those lightningbolts.
If that makes anysense,right?
When you're looking at a manual or having a conversation with an engineer or reading a scientificstudy, do you have any thoughts on how we could cultivate more scientific literacy if that's the right phrase touse?
Yeah, I think that's a great phrase touse.
I think what's necessary is that you have to relate science to people's everydaylives.
And one of the greatest people are doingthis, and to go back to the beginning of theinterview, when you askedme, who was the role model forme, I should have said Carl Sagan was like anamazing, amazing role model tome.
I watched the Cosmos series over and overagain.
And Carl Sagan was a genius at being able to take scientific concepts and relate them to people's everydaylife.
And if you remember for watching thoseseries, the iconic image of him taking a dandelion and blowingit, and describing that this is how a star spreads out its gas throughout thegalaxy, those type of step-by-stepinstructions, ladders to get from one place toanother, is the way I think to build scientificliteracy.
And I would ask my students to think about anything that's important in theirlife, whatever it mightbe.
And from whatever they said was important to theirlife, I would then begin wrapping that in layers and layers of basic scientific concepts that pertain to what was important tothem.
Are there any other science fiction authors perse, but science authors or elucidators of science who have written anything that would be appropriate for a layaudience, if someone islistening, and they see their blindspots, which I know by definition is kind ofimpossible, but if they recognize they don't have enough scientific fluency or as much as they wouldlike, but they want to try to cultivatethat, do you have any recommendations forthem?
There's a lot of books likethat.
One of my favorites is a book by a historian ofscience, named ThomasCuen.
He was one of the most famous historians ofscience, and his book is perennially inprint.
It's called the structure of scientificrevolutions.
In thisbook, he goes through about 10 different revolutions inscience, where everybody thought the world was oneway, and then kind of like a crazy person wouldsay,no, I think it's like a differentway, and gradually set about proving it's a different way and created a revolution inscience.
And he explains this in very lateterms.
He takes you through the science ofgravity, forexample, with IsaacNewton, science ofrelativity, withEinstein,electricity, withMaxwell, and soon, in a very step-by-stepfashion, to make the scienceaccessible.
And in theway, his main point in writing thisbook, is to teach people criticalthinking, to teach people to questionauthority.
Ultimately, all science is about is justsaying,why?
Why? Like everytwo,three, four-year-old kid knows how to dothat,right?
Why?Why?Why? And I think Thomas Cuen does a great job of that in hisbook.
I should also pointout, and please feel free to correct me if I'moversimplifying, but thewhy,why,why, is not just forfour-year-olds.
It's not just for scientists in lab codes or whatever people envision scientists tobe.
It's also extremely helpful in situations like those you found yourself in with BlacksowWelcome, and attempting tolicense, Imean, constantly pushing for explanation and clicking on those footnotes to go to thefootnotes, to go to thefootnotes, to ultimately get to some point of leverage where you can move thingsaround.
It seems like it's also not just an intensely interesting and academically rewarding approach tothought, but an immensely practical approach tolife.
At least that's how it seems from reading so many of yourstories.
Youknow, when you discoversomething, what's happening is that gazillions of neurons are lighting up in yourbrain, and it's lighting up the pleasure centerstoo.
So I really believe that there's nothing more exciting than having a realization aboutsomething, coming to an inspiration aboutsomething, which is why books in reading are somagical.
Another science fiction writer who I feel does such a great job of explaining concepts that can inspire people is OctaviaButler.
She wrote a lot ofbooks.
One ofthem, very wellknown, is parable of thesower, parable of thetalents.
And in thesebooks, she gives people an appreciation of questioningauthority.
So I'm not sure what it was that my parentsdid.
I don't really remember them specifically encouraging my questioning ofthem.
And infact, I do remember my father discouragingit.
Butnevertheless, what happened to me was I absorbed the Americanculture.
And the American culture is a culture of questioningauthority.
I recently heard one of the latest interviews with Tony Fauci when hewas, people were askinghim, why is it that Americans won't do these basic public health steps to stop thepandemic?
And hesaid, youknow, American culture does not like to be told what todo.
American culture is died in the wool questionauthority.
You'd be hard pressed to find another country where it would be more difficult to get people to follow a single rule for everybody than the UnitedStates.
So it's that American cultural ethic of questioning authority that I know is like deep in my mentalDNA.
So we were chatting just a few minutes ago aboutrealizations,inspiration.
I'd like to ask if we flash backto,well, we could flash back to any point in time that youchoose,really.
How did you relate to or think about gender in your youth and you can choose what youthmeans?
And I guess I'm wondering if there were any flashes of realization or if you came sort of pre-installed with a certain orientation or way of thinking about it or feeling aboutit, whatever you could say to speak to your experience of gender when you wereyounger, I would love to hearit.
Sure. So it is related to this questioning ofauthority,Tim.
Around teenageyears, I hada, youknow, constant vision of myself not as amale, but as afemale.
And ofcourse, I said tomyself,WTF, why am I thinking likethis?
I can't imagine anybody else is thinking likethis, butnevertheless, the thoughts werereal.
And the feelings were real and the feelings werevisceral.
Could you describe thefeelings?
Because I think I'm certainly very interested in what form thattakes.
Is it a discomfort of sometype?
Is it alonging? How did it feel foryou?
So first I should say that I think the transgender feeling is different for every single transgenderperson.
And talk to them about myfeelings.
I don't want to give the impression that these are going to be the feelings of other transgendered people because as acommunity, whereas heterogeneous as anybodyelse.
So forme, it was really a matter of just visualizing myself in a femaleform.
And there was not any dislike of my maleform.
Again, it was kind of very Alan Watsian in that I saw myself as male only because the opposite of male wasfemale.
So I can also see myself asfemale.
And this was the way my mind wasworking.
And when I say I sawmyself, it was just kind of like a physiologicembodiment.
Obviously I knew like boys and girls and men and women's bodies weredifferent.
So I was stuck with this visualization of myself as a woman when I was very much trapped in a malebody.
It was the prevailing view that this was a completely unacceptable way tobe.
So the authority wasno, this is notpossible.
People are only male orfemale.
And never the twain shallmeet.
Soagain, this American Paul Revereish question authority mindset got mereading.
And I found once again that there was a vast literature ontransgenderism,transsexualism, Native American people who were too spirited communities in India and other parts of Asia that identified as neither male norfemale.
So even though this was never something I learned in junior high or high school or elementary school or really anywhere in American culture in say the1990s, I learned through books that humanity was not either strictly male or strictlyfemale.
And as I began to questionauthority, I began to say tomyself, why can't I also come out as not strictly male and not strictlyfemale?
When I think a lot of listeners hear the words male andfemale, they think of the physiological differences that you might put side by side looking at physicalcharacteristics.
When you say not totally male or female or not cleanly bifurcated into solely those twocategories, do you mean to say masculine and feminine traits or what we would often find labeled as such or do you mean somethingelse?
Imean, predominantly the masculine and feminine traits that you referto.
Now oftentimes those masculine and feminine traits are just a short hop skip in the jump from masculine and feminineapparel,right, depending on how peopledress.
They're a short hop skip in the jump from masculine and feminine hairstyles in anage, that was the time of prince and boy George andwhatnot.
And then you get to masculine and feminine manicures like why can't a guy paint hisnails?
And then you get to next questions of secondary and primary sexorgans.
And some people wishing to take hormones to alter their actual physiology and ultimately go through surgery to alter theirphysiology.
And I found that there was actually like a vast literature following again footnotes tofootnotes, references toreferences.
I waslike, oh mygod, it is possible to infect alter your physiology to match yourpsychology.
What appeared to be the most intelligent researchers in this area are opining that this is a safe and healthy thing to do for people who feel that they are kind of quote unquote trapped in the wrongbody.
From say zero to100%, how well do you feel you have your physiology matching your own psychology at themoment?
100%.100%. What were the biggest or the most importantdecisions, actions that youtook?
Did any surprise you to have a disproportionate effect on increasing thatpercentage?
No, but I think that every part of the transition process kind of fell inplace.
It was not something that happens on theday.
It's kind of you get to a point of diminishingreturns.
So over a period ofyears, I graduallytransitioned.
And I think even to thispoint, I'm still in a transitionprocess.
I kind of went from a pure male to amore, I would say notpure, but I wouldsay, knocking on the female door to a point today where I feel very comfortable identifying astransbinary, meaning that I embrace both masculine and feminine aspects of myselfcompletely.
Looking at theintroduction, which I read at the top of theshow, so tospeak, there is a line about leading efforts of the transgender community to establish their own health law standards and of the International Bar Association toprotect.
And this is the part I want to ask you to elaborate on autonomy rights and genetic information via an internationaltreaty.
What are autonomy rights and geneticinformation?
Sure. Soautonomy, it's just a fancy word for saying that people should be able to make up their ownmind.
That people should have thepower, theauthority, the freedom to decide what to do with their ownbody.
And geneticrights, ofcourse, refers to the humangenome, the DNA that we allhave.
Now, there is a tremendous diversity of human genomes outthere.
There are peoplewho, because of theirDNA, they are pretty much immune to some kind ofcancers.
Whereas otherpeople, because of theirDNA, it's very likely that they'll get those type ofcancers.
There are somepeople, because of theirDNA, they almost cannot feelpain.
They have an extremely high tolerance forpain.
There are otherpeople, because of theirDNA, that the slightest pinprick will send themscreaming.
So once on Craig Venter and Francis Collins led the effort to decode the human genome and about the year2000, all types of pharmaceutical companies and academic researchers began scouring the world to engage in what's called genetic mining or genomemining, meaning going to different populations of people around theworld, often that have been intermarried for quite awhile.
So their genomes are kind of concentrated and trying to learn something from those communities DNA that can then be translated into useful pharmaceuticals to help everybody else have some of the strengths or less of the weaknesses of those isolatedpopulations.
What I was concerned with is that if people extract the DNA from these remotecommunities, thatthey, infact, do so only with the consent of those communities or with the consent of the elected representatives of those communities so that they can have some fair financial return for their naturalendowment.
Isay, so it's similar in a sense topreventing,say, biopiracy from theAmazon, where you have these tribes who are not providing their own human geneticinformation, butare,say, acting as a wellspring of ethno-botany and providing source materials for creatingpharmaceuticals.
And you wouldwant, youknow, there to be some recompense to those groups translating that into yourown, sort of endogenous genetics would be where you're referringto.
That'sfascinating. Never even thought aboutthat.
Are there any examples you could give ofthese, sort of tightly knitclusters, maybe the clusters is too small word of people who are being studied for thisreason, or medicinalpurposes?
There are actuallymany, many dozens and there are quite a few companies who specialize in this type ofarea.
The population that comes top of mind tome,Tim, rightnow, because it's such a fascinating story and it relates to my own activities in organ manufacturing is a community of people living in Ecuador andPeru, veryclose-knit,intermarried, that are all a kind ofdwarfism.
And theseindividuals, they rarely grow taller than four feet tall and it was discovered overthe, just over the past15, 20years, that they are descendants of Jews from 2,000 years ago who were forced into a diaspora across the Mediterranean after the Roman occupation ofPalestine.
And in that ancienttime, these people were a very small stature but it was just part of the humandiversity.
They ended up as a group mostly ending up in Spain and then when the inquisition tookhold, their descendants who were still verysmall, they leftSpain, they went to the new world and because the inquisition still had some type of a hand in the larger population centers of what's now Peru andEcuador, they went out into the rural areas and there they lived for several hundredyears.
And it turns out that thispopulation, they have one gene that makes their body not receptive to growthhormone, all of usnaturally, we produce growth hormone and the cells of our bodies have a receptor for that growthhormone.
And when the growth hormone locks into thereceptor, we begingrowing.
This population of people in Peru andEcuador, they lack the growthhormone.
That gene fell off like 2000 years ago and they kept passing it on and on and not much growth hormonereceptor.
So they're perfectlyintelligent, they live normallives, they just don't grow verylarge.
So I found this population fascinating because in mycompany, UnitedTherapeutics, we're trying to create an unlimited supply of transplantableorgans.
And one of the ways we do this is by modifying the genome of the pig and it's kind of like a fluke ofnature,Tim, that the pig'sorgans, theirheart, theirkidneys, their lungs are very much the same size and functionality as humankidneys, hearts andlungs.
The only problem is that if you leave a pig on thezone, they'll actually grow extremelylarge.
And when these first transplants weredone, they had to euthanize the animal recipients of the transplants because the organs from the pig had grown toolarge.
So what we did is we took a page from this population of people in Peru andEcuador.
The Western medicine gives them a diseasename.
It's called Lerun'sdisease,L-A-R-O-N, after this Israeli scientist who discovered what was going onhere.
So wesaid,well, why don't we modify a growth hormone receptor knockout just like the Lerun's population has into thesepigs.
So when we transplant the kidneys of these pigs intopeople, the kidneys won't keep growing and growing as a normal pig can be many hundreds ofpounds.
Instead, the kidney will just stop growing at the same size as when we transplantedit.
And that's working out reallywell.
Let's talk more about organmanufacturing.
So what are some of the other precursors or requirements for having a sufficient supply of organs to meet whatever demands there are in the US or in the worldtoday?
The demands whether it's in the US or outside the US are huge and areway, way in excess of thesupply.
I would say that one of the greatest unmet medical needs today is an adequate supply of transplantableorgans.
It's a beautiful thing that before people like Tom Starsel questioned authority instead it was possible to do an organ transplant in our parents teenage years and adultyears, that would have just been like crazystuff.
Like you take an organ from a deadperson, you put it in a live person who has a bad organ and the person comes back tohealth.
That's about as crazy as itgets, but they didit.
Youknow, they didit. And now standing on theirshoulders, we have hundreds of thousands of people clamoring for theseorgans, yet each year there are only about 30,000 kidneys available fortransplant, only around 3000hearts, only around 2000lungs.
And so the gap between the need for these organs and the supply ishumongous.
Are youstill, or Isay, you know therapeutics currently trying to manipulate the vagusnerve?
Is that inprocess?Yes, that isn't inprocess.
And it's a fascinatingarea,Tim.
We are very fortunate to work with the father of bioelectronicmedicine,Dr.
KevinTracy. He's the chief medical officer at the Northwell Medical Complex up in the New Yorkarea.
And by theway, that remindsme, speaking of how can lay people get access to scientific knowledgeeasily, subscribe to ScientificAmerican.
I'm sorry to put an advertisement inhere.
ScientificAmerican. I find Scientific American in NationalGeographic, two oflike, youknow, the greatest ways for laypeople, which I do consider myself a layperson, to learn about all different types of signs that they might not know anythingabout.
So one day I got my Scientific American intomail, and on thecover, it was using electronics to curediseases.
Well, here Iam. Like my whole career has just been like electronicengineering, buildingsatellites.
Andnow, because of mydaughter, I'm like in this medicalfield.
So I'mlike, soexcited.
It was one of those lightning bolts to thesoul.
Now I have a chance to bring my mail and female sidetogether, to bring my satellite and my biology side together and mergethem.
So I got veryexcited. And I had a chance to meet and now work with and support the work ofDr.
Tracy. And he taught me of a very simplesentence,Tim, which I've subsequently found to be absolutely true in all the research I'veread.
It is that the nervous system touches every single cell on yourbody.
The nervous system touches every single cell in ourbody.
The largest nerve in thebody, there's one nerve that isway, way larger than all the rest ofthem.
It's the vagusnerve. It starts in ourmind.
It wraps around ourheart, ourlungs, ourgut.
It's an immensenerve. And by stimulating this vagusnerve, it's possible to have positive therapeutic effects in thebody.
By a fluke ofnature, a positivefluke, the vagus nerve comes out to the skin in two and only two places around the left and rightears.
Youknow, there are like a couple of different ridges in yourearlobe, or yourear, I guess I would sayit.
And one of them called the symboconkey is the place where the vagus nerve comesout.
And if you electrically stimulate the symboconkey on either the left or the rightear, it's been provennow,again, in lots of published literature to have positive therapeutic effects on thebody.
What are some of those positive therapeuticeffects?
One which has been documented quite extensively is the ability to control Crohn's disease and irritable bowelsyndrome, which are two gastrointestinalproblems, as well as very highpriced, and I would say tinged with some potential side effect biologic medicines that are approved by the FDA to treat Crohn's disease and irritable bowelsyndrome.
Another illness that has been shown to mediate against is rheumatoidarthritis.
And the common factor here is that we have two types of nervoussystems.
We have a fight-or-flight nervoussystem, which is the sympathetic nervoussystem, and we have a rest and digest nervoussystem, which is called the parasympathetic nervoussystem.
When diseasesoccur, it's because one of those two nervoussystems, the sympatheticone, thefight-or-flight, takes more of a dominant position in the body and causes a state of inflammation or overactivation.
And by stimulating the vagusnerve, you can ramp up the power of the parasympathetic nervous system and calm down this kind of overstressed state that leads to an irritable bowel syndrome or to the inflammation ofarthritis.
This is in the course of doing all the reading for thisconversation.
One of those things that really woke me up and maybe pay attention for a bunch ofreasons.
One is relevance to my current life because I've been working with a doctor for about 10 weeks doing heart rate variabilitytraining.
And there are some researchers withclaims, I want to say out of Rutgers andelsewhere, that certain types of HRV training affect vagaltone.
And via affecting that vagal tone have a host of cascading therapeuticbenefits, whether or not that holds up to scrutiny ornot, I don'tknow, but thesecond, and I'm embarrassed to even give voice tothis.
So hopefully this won't just destroy any tiny shred of credibility that I might have as I mentionedit.
But I lived in China for a period of time incollege, went to universities there in Beijing as effectively an exchangestudent, but it was a one-wayexchange.
I don't think we had any students in return fromChina.
And the ears are very much utilized in the world ofacupuncture.
And I'm curious to know if you think that whether by trial and error orotherwise, it's possible that acupuncture stumbled upon the effects without knowing the mechanism of stimulating or affecting the ears to then in turn affect the vagusnerve.
I know it's quite astretch, but when I first read about this access via theears, that is one thing that jumped to mind because I always kind of poopood and if I'm beinghonest, ridiculed the idea of using the ears to access these deep innerpoints.
But here weare. So I don't know if you have anythoughts.
Kim,first, your credibility isimmense.
Sodon't... You would have to actually say something crazy to dent into what you said is the opposite of crazy what you said is extremely insightful andprescient.
So as convinced as I was that putting a satellite in geostationary orbit would enable people across the planet to receive radiosignals, as convinced as I was that we could have a molecule that would halt the progression of my daughter and other people'sdisease.
That's exactly how convinced I am that the acupuncturists of traditional Chinese medicine did in fact come upon the nerve patterns that are accessible from theearlobe.
And one of the first things thatDr.
Tracy showed to me was a very medically accurate from a Chinese traditional medicine practitioner map of the earlobe in terms of exactly where you putthem.
I'msorry, I don't know what the official name is of the pins or needles that they put in your earlobe and how they map to different parts of thebody.
And then he showed me on an anatomy map how that traces the lines of the vagusnerve.
That'swild.So,wow.Yeah, it is totallytrue.
And why really would it not betrue?
Imean, thousands of years of Chinesecivilization, they have had a chance to do so much trial anderror.
And they were a literate civilization for solong.
So, the results that trial and error could be passed on and passedon.
So, I do think it's entirely rational that they would have figured thisout.
And what I'm hoping for now and what I'm trying to support is there is an opportunity to what I call in my ownwords, crack the humanneurome.
So, what that means is that there are unique patterns of amplitudes and signal lengths and signal voltages that will activate some different part of the vagus nerve thanothers.
And each of these different voltages and wavelengths will correlate to a different part of the humanbody.
We don't know what thoseare.
Rightnow, we are just kindof, in the way I would say we're stumber than the acupuncturist because almost all of the work that the FDA has allowed to go forward on vagal nervestimulation, they all use the same pulse with the same pulsepower.
And itworks, so that'sgreat.
But I think it can work even better if we decoded the humanneurome.
And I believe in thefuture, people will be able to put on a pair of like beatheadsets.
And those beat headsets will have gelless, meaning like you don't need like the EKG kind ofgel, gel less electrodes will rest across your symboconkey and your traga and the different parts of your airlow.
And will provide you a stimulation that matches the particular ailment that youhave, eliminate the ailment without taking anypills, without paying any money toanybody.
This is an area I wanna keep digging in because it'srare.
Andwell, it's pretty much non-existent that I have the opportunity to speak with someone with so much electrical engineering background about the possible applications or implications of technology likethis.
I'd love to just throw out another group of devices to see if you have any opinions on them one or theother.
But potential applicationsof, let's just say TDCS orTMS, transgranular direct current stimulation or other means of stimulating thebrain, typically using some type of conducivegel, but not always in the case of a TMSpaddle.
Have you looked at these technologies or done any reading in the literature related tothem?
A littlebit, I'm aware of a friend of mine has a company that obtained an FDA approval for treating a particular form of brain cancer with this type oftechnology.
So there's this very solid scientific benefit that's beendocumented.
After many years of working through theFDA, I have a world of respect for the rigor that they put into any decision to approvesomething.
So when they approvedit, it meant that it was scientifically proven towork.
Something that is quite different fromthat, but at the same time related toit, is on the last day of2019, which was like the last day of thedecade, it turned out to be aweekday, I forget if it was a Tuesday orwhatever, but the US patent office only issues patents on one day of aweek.
And it was like the one day of a week that the issue was or is Tuesday orwhatever.
And it was a patent that I received for a device that I call a Alzheimer's cognitiveenabler.
And this device is worn over thecranium, as youmentioned, and it senses nerve impulses inside thebrain.
It is connected to a computer with a visual recognition and a speech comprehension system so that if a patient with Alzheimer's is not able to adequately communicate and appear to recognize the people who are coming into theirroom, the computer vision recognition system and sound recognition system will talk on behalf of the Alzheimer'spatients.
Sayhello,son, thank you for coming to seeme.
And it is actually being triggered by recognitions that are deep in the Alzheimer's patient's mind so that more people will come to visit thepatient, the patient's stress levels may belower.
So I believe this kind of bridging of electronics in the mind is really right around thecorner.
What inspired putting the work into that research and filing thatpatent?
I think part of it was seeing my mother-in-law suffer pretty badly from somewhere on the spectrum between dementia and Alzheimer's was never really completely clear where she was atthat.
And she would recognize us comingin, but she couldn'tcommunicate.
And it would have meant a lot to everybody if she would be able tocommunicate.
My own mother is more or less at that point right now aswell.
Secondly, the work on the BINA48 computer showed me that it was really possible for people to strike up meaningful relationships with the digital version ofBINA, the BINA48robot.
And so it was just like a very short step from instead of putting all of BINA's or even a good portion of her memories and her personality into thiscomputer, why not actually have the computer's interaction capability in put output capability triggered by something like a neuro-sky type of EEG braininterface.
And the last piece of it was given a Christmas present by a friend ofmine, which was one of these neuro-sky headsets that lets you kind of like play a game just with your thoughts by controlling your EEGsignals.
So that's a consumer product anybody canbuy.
And it reallyworks. Youknow, this conversation brings back a lot of memories for me because I have Alzheimer'sdisease.
It's very prevalent on both sides of my family and observed both sets of my grandparents deteriorate to the point where at least some of them couldn't recognize immediate familymembers.
And was recently rewatching segments of a documentary I saw called A LiveInside.
And the subtitle is A Story of Music andMemory.
And what struck me most about this documentary is that not that they could play music from someone's youth to them through headsets and watch them come alive in some really spectacularways, bothphysically, in terms of kinesiology movingaround, but alsopsychologically, the most impressive part to me is that they would play musicfor,say, handful ofminutes, five to 10 minutes from someone's youth and then turn off themusic.
And that person could have a perfectlycoherent, reasonably fast speedconversation, whereas prior to the administration of themusic, they were from theoutside,catatonic,basically.
And it makes me wonder what music isdoing.
I'm sure there are people who study this and probably have a better mechanisticexplanation.
And how it could be incorporated into therapies intended to counter dementia or advanced Alzheimer'sdisease, things of thistype.
Tim, yousee, just in thisconversation, we are in covering so many vast new oceans of opportunity for people to learn and studyabout.
Tome, music is the foundational human technology because the first thing that we ever could become aware of would be the beat of our mother's hearts while we were still inutero.
And thatbeat, that's arhythm,okay?
And after we'reborn, youknow, people may have better or worserhythm, but there's nobody that cannot detect the sound of a beat and move toit.
And then all the different types of melodies and chords that build uponrhythm, it's just fancier and fancier forms ofmusic.
So I believe that there's tremendous therapeutic properties tomusic.
It's just beenscratched.
They evenscratched. It's been kind of like blown onlike.
Pfft. And it's there for like all the thousands of young people today who have comeup, grown up with more music than ever before to begin to apply this great human cultural technology of music to the biggest mystery in the entireuniverse, which is the humanmind.
I wanna come back to the mind or moreaccurately, consciousness in amoment.
Butfirst, this will seem like a left turn and itis.
I was reading a piece in the Washington Post that covered quite a lot of yourlife.
And there was a segment on LoveNight.
I don't know if that's enough of aprompt, but can you tell us what Love Nightis?
So whenDina, my partner and I gotmarried, we each had one child from a previous marriage that each of us had custodyof.
And then we had two childrentogether.
And we were kind of trying to build a blended family that would feel like nobody was a stepmom or a stepdad that everybody was just like in onefamily.
And infact, we cross-adopted each other's kids from our previousmarriages.
So I was taking the kids to musicclasses.
All of the kids were in the Yamaha music program where they learned piano and violin instruments likethat.
And we would practicesongs.
And I was brought up Jewish where every Friday night was something that wasspecial.
It was the Sabbath and the family sat down together and had dinner and set a couple ofprayers.
So Bina and I tried tothink, how can we like merge all these thingstogether, the Jewishtradition, the need to create a blendedfamily, the music that we were all enjoying from watching the kids learn to play piano andviolin.
And we decided to every Friday night have a special familyceremony, which we would call LoveNight.
And we sang asong, which the melody was actually based on one of the kids songs that they had learned in the Yamaha musicprogram.
The words were very simple andaffirming.
And at LoveNight, the core of Love Night was that each person around the table would have an opportunity tosay, what Love meant to them during the pastweek, during the week from the previous Friday to thisFriday?
What does Love mean toyou?
And Bina and I as theadults, we would say something either sophisticated orsimple.
I loveBina. I loveMartin.
I love thekids. The kids started off justsaying, what Love means to me is like our dogs or ourcar.
Very basicthings. But as they grewolder, they came into more and more sophisticated definitions and expressions of love until after a couple of decades ofthis, all of us have heard thousands of different things that Love can mean to aperson.
Now, I'd like to fast forwardand,sorry, to be on a little riffhere, but I'm on a fast forward to the current COVIDpandemic.
Our kids are all adultsnow.
They've flown thecoop.
They have their ownkids.
Andsuddenly, we are in a situation where we can't all gather together in any one house for LoveNight.
You don't want totravel.
You don't want to like endangerpeople, so on and soforth.
So we decided to continue the Love Nighttradition, but onZoom, or to befair, GoogleMeet.
So every Fridaynight, from my son who's a captain in the army in Iraq to his wife who's on a basin El Paso to my other son with four grandchildren inFlorida, to my daughter in Brooklyn and her kid and herhusband.
And we all get together on Zoom plus friends of all ofours.
The kids were not embarrassed by LoveNight.
Infact, they wanted to share it with their friends and their friends weresaying,whoa, this iscrazy.
This isbeautiful. And so we get together every Fridaynight.
We sing our Love Nightsong.
And now there's about 20 ofus.
We go around virtually what Love meant to us during that previousweek.
And I would say Love Night is one of the most beautiful parts of mylife.
Oh, I am so glad that I asked thatquestion.
And LoveNight, could you give a few more examples of possible answers just to give people a flavor for how people might answer thisquestion?
BecauseI, forinstance, would love to try this with mygirlfriend, with some of ourfriends,family, etcetera.
But I would be nervous as the orchestrator that I might get that question and not have the ability to kick things offeffectively.
So everymorning, being a my partner goes outfor, takes our two dogs out for a walk with one of her best friends who lives a few housesaway.
And that best friend now joins our LoveNight.
And lastFriday, shesaid, what Love means to me is every morning going out for a walk with Ben and thedogs.
Lastweek, our youngestgrandson,Saturn,he's, youknow, was born in2010.
So he's 10 yearsold. Hesaid, what Love means to me isthis.
And he pulled a piece ofpaper.
Hesaid, I got a 95 on my mathtest.
And he was just so proud of himself and shared it withus.
So those are typical examplesof, Ithink, I last timesaid, what Love means to me is sitting down at the piano and playing different songs frommemory.
So to use this is askipping, I was going to say a skippingstone, but I think I'm beginning my metaphors mixedup.
Isay, launchpad, a lilypad, pick your choice toconsciousness.
Do you think that we will be ableto, as I've heard you put itonce, recapitulate or recreate consciousnesssynthetically?
And does that mean we'll have machines that canlove, forinstance, in the not too distantfuture?
What would it mean to have createdconsciousness?
Sure, I do believe it'spossible.
And a great book that I would recommend that goes into this subject in beautiful detail is called the Emotion Machine by MarvinMinsky.
And Marvin Minsky is often thought of as the father of artificialintelligence.
He was a professor at MIT for great manyyears.
So in the Emotion Machinebook, he really describes exactly how you would go about creating a computer and the type of software that it would take in order for the machine to feel what we feel when we say that we lovesomebody.
And I think it's likely to occur to him because it's hard for me to think of any aspect of life that cannot be replicated if one had sufficiently advancedtechnology.
One of my favorite sayings from another rolemodel, ArthurC.
Clarke, is that magic is indistinguishable from sufficiently advancedtechnology.
So I think just like we have been able to create an artificialhip, artificialknees, artificialhearts.
In my owncompany, we are building lungs andkidneys.
People are creating artificialnerves.
People like Elon Musk has formed a wholecompany,Neuralink, where he's working on downloading a whole humanbrain.
I have little doubt that humans will end up being able to replicate a humanmind.
Now, whether or not the rest of society accepts it as a human mind ornot, I think is going to be a long-pitchbattle.
And that's what is the subject of mybook, VirtuallyHuman, that whole book is talks about how and when will society accept digital consciousness as being as conscious as ahuman.
But even if that digital consciousness is not yet at humanlevel, what happens when it's atsay, primate level or at K9 level or even at a rodentlevel?
If you can get to any of theselevels, you could kind of see how it's the same old human effort of keep making incremental improvements that would eventually get you to the humanlevel, where I think that the individual alive today that has the best understanding of this topic is a guy at Google named RayKurzweil, he's a director of engineering atGoogle.
And what I love about Ray is he never tires of pointing out that this digital humanconsciousness, it'shuman.
Human consciousness is a humanphenomena.
So when we create a digital analog or doppelganger or asimulcra, whatever you want to callit, when we create aher, that her ishuman.
It's not us versusthem.
It'sone, it's we will have been able to move our mind into a digitalsubstrate, just like if our knees giveout, you move it to a mechanical substrate or if an organ givesout, you transplant it with anotherorgan.
Where wouldyou, if you had to kind of price his rightstyle, put a timeline onthis, when do you think we'll have rodent or canine level consciousness plusintelligence?
It's pretty hard to sayTim, because one thing I am not is I'm not asous-sayer, I'm not aprophet, I'm not avisionary, any of thosethings.
I'm just a humble technologist and all the projects I workon, they have five-year time horizons because I have difficulty really seeing beyond fiveyears.
So every technology I'm workingon, it's like I want to get this thing done and out to the public within fiveyears.
Also, I am totally a believer in this adage that futurists usually over-promise in the near term and under-promise in the longterm.
So what that would mean in this context is you will hear a lot of futuristssaying,oh, we'll have digital rats or digital dogs or digital people in10, 20 or 30years.
They have probably over-promised in the nearterm.
What they have under-promised in the long term is in not10,20, 30years, but in say80, 90 or 100years, there won't be just digitalrats, digital dogs and digitalpeople, but most people will bedigital.
Exciting and I suppose for somepeople, very terrifying at the sametime.
What are some of the most important ethical questions or considerations related to technology as we move into future decades in yourmind?
In mymind, the biggest problem with technology is that people only think about the rights to implement the technology and they don't think about the obligations they have as somebody creating atechnology.
And by what I mean by thatis, youknow, there was this great philosopher of the 20th century IsaacBerlin, the belief he wasGerman, and he had a real simplemessage.
His message was that for everyright, there is anobligation.
It'sagain, it's a very AlanWatzian, sorry to keep coming back to AlanWatz, but it's a very Alan Watzian point of view that a right only means something in the context of itsobligation.
So forexample, if I have a right to be aparent, which we think everybody has a right to be aparent, you only have that right to be a parent so long as you comply with your obligation to be at least not a horribleparent.
If you're a horribleparent, you will have your children taken away from you and you'll no longer in that sense be aparent.
So with regard totechnology, I think there is a point of view that anybody who can create a technology has a right to make thattechnology, but I dispute the ethics of thatperspective.
I think that every right to make a technology is coupled to an obligation to have the consent of anybody who would be adversely affected by thattechnology.
So forexample, my right to build an atomic power plant or a nuclear power plantsomeplace, I don't just have thatright.
That right is coupled to an obligation that I have to have the consent of all the surrounding communities of people who could be adversely affected by the implementation of thattechnology.
And it comes into this domain of in my ownfield, say the transplantation of genetically modified pig organs intopeople.
For me to have a right to do thattechnology, I have to have the consent of the larger community that that's a safe thing to do in a democratic country that consent is issued on behalf of the country by the government and in the field ofhealth, it's issued by theFDA.
So before the FDA permits us to transplant these genetically modified pig organs intopeople, they want us to demonstrate to them that there is norisk, not a smallrisk, but no risk of any kind of animal virus seeping into the human population as a result of these animaltransplants.
So insummary, I believe like an amazing field for thefuture, a field that will probably in the future have almost as many people with this career as our web designers today is the field of technoethics.
Everybody who wants to create a technology will need to wrap the technology in an ethical envelope ofconsent.
If we look at scienceover, while we could look at it over the last few thousandyears, but let's just say last a few hundredyears, you mentioned earlier that I think you were discussing the structure of scientificrevolutions, how thesebreakthroughs, these massive scientific leaps forward seem like complete madness at the time to the vastmajority.
And we don't have to go that far back to find say surgery without or with minimal use of anesthetics on newborns andinfants.
Imean, this is not the darkages.
This islike, youknow, less than a hundred yearsago.
You see some really appalling things that were taken as best practices or commonpractice.
And one of myfriends, who's an outstandingdoctor, likes to repeatthis, Isuppose, adage that you hear among gooddoctors, which is50% of what we know iswrong.
We just don't know which50%.
That seems to always betrue.
So if we flash forward 10 or 20years, and I know you're not a profitor asSusser, but I'mcurious, or it could be five years as atechnologist, what do you think are any of the things we're doing now or believe now that will be shown to be patently absurd or viewed as barbaric or crazy or naive in the nearfuture?
Probably a lot ofthings.
Yeah.Sinter, a lotof, youknow, what we look back in thepast, that seems to bebarbaric.
Building on top of your example of the torturous procedures put ontoneonates, people forget that the founder of the American MedicalAssociation, the first doctor who created the American MedicalAssociation, his name wasDr.
Gross. He lived inPhiladelphia, and he did not believe in a sepsis atall.
And so he would do all of his procedures right in his streetclothes, infecting everybody and countless women lost their lives because of having those type of quote-unquotedoctors, helping with the delivery of the children and ending up creating a septic condition in themothers.
And one of the most famous painters in Americanhistory, ThomasAikens, painted this picture of the Gross Clinic whereDr.
Gross was teaching all the young doctors how to do a procedure and you see dirt and his shoes and scuffeyhands.
Then he wasfollowed. The second president of the American Medical Association was aDr.
Agnew, who was the student ofGross.
And he had read about the research of Lister in England and became a believer that even though we can't see these thingsgerms, they'rereal.
And we need to practice strict septic procedures before we do anoperation.
A few yearslater, Thomas Aikens painted the AgnewClinic.
And you see that the doctors in white smocks and everybody is looking super sterile andclean.
So these type of revolutions can occur just like one generation to thenext.
It's not something that takes a longtime.
I thinkthat, youknow, looking at what's going on today in ourworld, I think the fact that we burn our own house will look to be absolutelybonkers.
Peoplesay,well, let me get thisright.
You've gotlike, youknow, a super thinatmosphere.
Imean, you guys saw that from space since the60s, atleast.
This atmosphere around your planet is superthin.
You have an undeniable record of measurements of carbon dioxide into the atmosphere going up year after year afteryear.
And you continue to just spew without limit greenhouse gases into thisatmosphere.
Despite the factthat, youknow, people are dying on theshorelines, dying ofdiseases, etcetera, etcetera.
I think they will think we are as stupid as somebody who would light a fire in the middle of their house to try to keep warm and not bother with the smoke that they were chokingon.
Yeah. Andthen, if I could add an addendum tothat, did you guys know that the Earth receives 10,000 times the amount of solar energy falls right on the Earth each day than it uses 10,000 times the amount ofenergy.
Itflows. And that's not to talk about the wind and that's not to talk about the waves and that's not to talk about the nuclearenergy.
I think the people in the future may think we were pretty stupid to be so scared of nuclearenergy, which has killed a few dozens of people that we went ahead andjust, youknow, stopped all the nuclear plants and began pouring ungodly amounts of greenhouse gases into the atmosphere that will kill millions ofpeople.
That will seem ludicrous tothem.
I think thisis, and I won't keep you too muchlonger, but I thinkthis, I would be remiss if I didn't ask you to comment on or describe your own engineering projects with carbon neutrality or zero emissions as an objective because this is not just idle hand waving foryou.
This is something that you've taken a keen engineering mindto.
And I think that was not mentioned in your bio even though it's yet another one of these examples of extreme curiosity andcapability.
Could you just describe what you've done in thatarena,please?
So this is another area that gives me immenseenjoyment.
Again, another kind of like lighting both to my soul is to try to createinfrastructure, buildings and cars and planes and things that have a zero carbonfootprint.
And I look at it as an intellectual challenge when I've read that peoplesaid,well, we cannot have a zero carbon footprint society until2050.
That's what the authoritiessay.
You know alreadyTim, I'm going to saywhy?
Whynot? Whynot? Whynot?
I'm going to question thatauthority.
So about three yearsago, we undertook to build a new headquarters for a company in SilverSpring, Maryland that would have a zero carbonfootprint.
Not in the bestclimate,Maryland.
It's got its good seasons and its badseasons.
Right in the middle of acity, SilverSpring, Maryland is a built up suburb ofWashington,DC.
And for the manufacture of medicines andstuff, which is a somewhat of an energy intensiveactivity.
So we built 150,000 square foot zero carbon footprintbuilding, which turned out to be the largest zero carbon footprint building in the entireworld.
And we inaugurated it a couple yearsago.
It turns out we produce more energy than we use each yearnow, two yearsrunning.
We did this by just thinking carefully about energy and how to manageit.
So forexample, we have underneath the building 50wells, each of which go down 500feet.
And they exchange heat from the building with the coolness of the earth in thesummer, bring the coolness backup.
And in thewinter, they exchange coolness of the building with the steady temperature of the earth in the winter to keep the buildingwarm.
The sides of the building are cladded with solarpanels.
The entire building has a brain that automatically opens the windows and closes the windows to allow naturalventilation.
It's a role model for many other buildings and lots of designers and engineers have come overthere.
Another example is in the delivery of ourorgans.
When we right now we refurbishorgans, lungs inparticular, that a decedent hasdonated, or the decedent's family has agreed to thedonation.
But when the transplant surgeons look at thatlung, they say it's too much full of fluid andmucus.
We can't useit, throw itaway.
So what United Therapeutics saysis, give us yourlonely,unwanted, unlovedlungs.
Fly them to SilverSpring,Maryland, we will refurbishthem.
We'll show through a high-speed digital network to the transplant surgeons all across the country that the organ is good as new through this digital network and bronchoscope and x-ray and all thatstuff.
And then we fly the lungs back out to them and we've saved over 150 lives thisway,Tim.
How do you refurbish alung?
Youfirst, you have to remove it from the dyingbody.
A dying body is a terrible place tobe.
So we remove it from thedecedent.
We cool itdown. So we kind of give ita, I won't say we freezeit, but we cool it down very lowtemperature.
We fly it to Maryland and we put it in a glassdome.
And in this glassdome, we havetubes.
We have a kind of artificial blood and airpumping.
So we've made a kind of isolated artificial body just for thatlung.
And we have expert technicians who workthese,sorry, I don't know the exact name of theequipment, but it sucks out the mucus and the operate on the lungs like it was aperson.
But it's just an isolated pair oflungs.
And the transplant doctors who could be in Texas orFlorida, wherever they tell us through the digital screen and thevoice, put the bronchoscope down the left side or down the right side to gofurther.
Giveme, they see this and they know what theywant.
So our technicians know how to dothis.
And within four hours in almost two-thirds of thetime, we were able to take what was anon-compliant, dead piece of tissue and turn it into a nicely breathinglung.
It's so beautiful to watchhim.
The lungs go in and out like a butterfly's wings going up anddown.
Infact, you could see a video of it on that Washington Post article you werementioning.
And then we cool the lungs back down and we fly it to the transplantsurgeon.
And100% of the time that they have accepted theselungs, they have had successful lung transplants with like I mentioned over 150 people walking out of thehospital.
But I mentioned this because this is a lot of flyingaround, flyinghere, flyingthere, helicopters going back andforth,planes.
And if I'm going to make an unlimited supply oforgans, and you remember all those numbers we talked about at the beginning of thecall, the hundreds of thousands of people who needs theseorgans, that is going to be a humongous carbonfootprint.
We could have said toourselves,well, we're doing such a goodthing, we're saving all theselives.
We could be permitted to foul our atmosphere because it's balanced by the good things we'redoing.
Butinstead, we like to ask ourselves like the challengingquestion, how can we do like the good thing and the right thing at the sametime?
How can we manufacture all these lungs and deliver them with a zero carbonfootprint?
And the solution came from the technology of electrichelicopters, which are powered by renewable energy that can fly these organs from one place to the other without adding any carbon footprint atall.
And I will be a little bit of a susayerhere.
I am absolutely convinced that in thisdecade, the2020s, we will be delivering manufactured organs by electrichelicopter.
Hmm, I loveit. Ihave, I will sayone, I made sheet and sneak in one or twomore, but aquestion.
I'm not talking withyou.
Likewise, this is justendlessly, endlesslyinteresting.
Somany, so many different pathways into thelabyrinth.
But I need to makesure, Isuppose, since my job is supposedlyinterviewer, that I can find my way backout.
I have read thathe, how long will show you theway?
How long will show you theway?
He does have a most seductive and hypnotic voice for those who haven'theard.
Irecommend, I have read that a favorite saying of yoursis,quote, identify the corridors of indifference and run like hell downthem.
Endquote. Can you please speak to that or explain what that means foryou?
Yes. So identify the corridors of indifference and run like hell downthem.
Means to try to finda, I'll put it in businessterms, a market area that isignored, a unmetneed.
But it doesn't really have to just apply tomedicine.
It can apply to any area oflife.
And the way I would phraseit,Tim, in justlike, youknow, a verynatural, almost folkloreishway, is that it's better to be a big fish in a smallpond, than a small fish in a bigpond.
In a business school back atUCLA, one person we studied a lot was the experience of general electric under JackWelch.
And he had anadage, which from a business sensewas, Ithink,very, verysmart.
Hesaid, if you can't be number one or number two in amarket, don't eventry.
Because you will have to spend an amount of money equal to the revenues of the number one or a number two in that market to become the number one or number two in themarket.
If you're not the number one or numbertwo, you will always struggle to beprofitable.
But if you are the number one or numbertwo, your profitability isassured.
So what that means translated to all of our activities is if there's anarea,like, forexample, a number of people havesaid, youknow, we should getinvolved.
We, when I saywe, my company nighttherapeutics, should get involved in creating a vaccine forCOVID.
And tome,well, youknow, it's not a corridor ofindifference.
There are dozens of companies working on a vaccine forCOVID.
So that's not what we would want todo.
It's very unlikely we'd ever be successful onthat.
Somebody elsesaid,well, how about thesepeople, the COVID longhaulers, the people who have survived from a very difficult course ofCOVID.
And they've got chronic lung problems that are bothering them months and likely years after theeffect.
Isaid,yes, that's a corridor ofindifference.
Nobody is thinking about the longhaulers.
The people who nowhave, youknow, chronic lung problems because of the havoc that COVID racked in theirlungs.
Let's develop some medicines for these chronic longhaulers.
Makes a lot ofsense. That makes a lot ofsense.
On arelated, maybe a related note in somerespects, this is a question that doesn't alwayswork.
So I'll take the blame if itdoesn't.
But if you had a billboard metaphorically speaking to get amessage, aquote, aword, animage, aquestion, anything out to billions ofpeople.
Let's just assume they all speak English for the sake ofargument.
What might you put on thatbillboard?
I think Apple computer and Steve Jobs got there before me thinkdifferent, thinkdifferent.
Why is thatimportant? Because thesolutions, youknow, Albert Einstein said you can't solve a problem on the same level that it wascreated.
You have to solve it on a differentlevel.
If we all think the exact sameway, we will never get out of the ruts that we'rein.
The only way to get out of the problems that we face is to thinkdifferently, to go down the corridor ofindifference, to questionauthority, to bediverse.
Thinking different is the pathway to solving problems that existtoday.
Looking back at everything we've talked about and looking at all of the copious pages of notes for prep in front ofme, it strikes me that you've forged many paths for yourself and helped others do the same by thinkingdifferent, but also thinking brightly coming back to Alan Watts yetagain, the Yin and the Yang and seeing thepositive, looking for the positive in differentcircumstances, differentsituations.
Do you have any advice or recommendations for people who struggle to dothat, who are maybe mired in a sense of hopelessness might be too strong aword, but those who tend to see the glass as half full and perhaps as a result of that tend to see half the spectrum of options orsolutions?
It's a really difficult question toanswer,Tim, because everybody's situation is so unique and sodifferent.
I do not doubt that formany, manypeople, it is just a badlife, whether it started that way or ended up theway, and it's almost impossible to see a wayout.
The perspective that I take is that I try to stay in touch with myancestors.
I think about the great-grandmothers who had to bear children in the worst of possiblecircumstances.
I think about all ofthe, like mypartner,Venus, great-grandmothers who were picking cotton as slaves and had to work allday, being bitten up bybugs, burning in thesun, feet deep inmud, and then bear a child at the lastmoment.
Whether it's like my great-grandparents from Eastern Europe or hers from the Africandiaspora, they had nothing to look forward to other than just the hope that they were going to have some children and that maybe those children might have a little bit of a better life than theydid.
If not theirchildren, their children'schildren.
So their only purpose inlife, their only hope inlife, their only joy inlife, was to make a generation and that maybe that generation would bebetter.
Now, here we are inAmerica, or really most any other country in theworld.
We're at a point now where like eight out of ten people have a smartphone with access to all the world's knowledge andinformation, with access to countless amounts of music and training throughYouTube.
There are many people in the world still in direcircumstances, but the vast majority of people are doing better than people have ever done before inhistory.
So I say to myself and I wouldask, youknow, somebody else looking through the world darkly rightnow, looking at the glass halffull, I wouldsay, how much worse it must have been in thepast.
What do I owe to my grandparents and great-grandparents and great-great-grandparents who suffered andtoyled, who barely managed to survive to produce anothergeneration?
What do I owe tothem? I owe to them to make the absolute most possible out of my life and that's what I'm going todo.
Hotdamn,Martian. I'm ready to get out there and get amongstit.
I have so enjoyed thisconversation.
There are 79 more hours we could do just in roundone.
I won't subject you to that and I'm so grateful that you were willing to make the time to have thisconversation.
Thank you somuch. My pleasure being withyou,Tim.
Tim, is there anything else you would like to say toJester, ask of those listening before we bring this to aclose?
Two of my best friends and people who I think are thesmartest, mostcreative, most happy-loving people Iknow.
Paul Mann and Diai Walek both said to me that your podcast is the best and Martina Tim Ferriss and Vizio on yourpodcast.
You have to go onit. So thankyou, Diai and thankyou,Paul.
Thanks to them also forme.
I have for manymonths, my whole team knowsthis.
I've been hoping to have youon.
I had high hopes coming intoit.
You exceeded all of those highhopes, which seems to be a pattern foryou.
I'm just very grateful and happy that we had a chance toconnect.
So thank youagain. For everyonelistening, you can find Martina on Instagram at TransBinary Twitter atSkyBuyom.
We will link to everything in the show notes that have mentioned in thisconversation, the books and everything you can imagine that we discussed will be available in the shownotes.
It'sTim. blog forward slash podcast and until nexttime, bekind, practice lovenight, thinkdifferent, think brightly and thanks for tuningin.
Heyguys, this is Timagain.
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