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Robert Langer: Edison of Medicine | Lex Fridman Podcast #105


small model | large model

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The following is a conversation with Bob Langer, professor at MIT and one of the most
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cited researchers in history, specializing in biotechnology fields of drug delivery systems
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and tissue engineering. He has bridged theory and practice by being a key member and driving
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force in launching many successful biotech companies out of MIT. This conversation was
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recorded before the outbreak of the coronavirus pandemic. His research and companies are at
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the forefront of developing treatment for COVID 19, including a promising vaccine candidate.
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You can watch it on basically any device. Once again, sign up at masterclass.com slash lex
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to get a discount and to support this podcast. And now here's my conversation with Bob Langer.
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You have a bit of a love for magic. Do you see a connection between magic and science?
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I do. I think magic can surprise you. And, you know, and I think science can surprise you. And
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there's something magical about, about science. I mean, making discoveries and things like that.
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Yeah. So on the magic side, is there some kind of engineering scientific process to the tricks
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themselves? Do you see, because there's a duality to it? One is you're the, you're, you're sort of
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the person inside and knows how the whole thing works, how the universe of the magic trick works.
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And then from the outside observer, which is kind of the role of the scientists,
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you, the people that observe the magic trick don't know at least initially anything that's
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going on. Do you see that kind of duality? Well, I think the duality that I see is fascination.
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You know, I think of it, you know, when I watch magic myself, I'm always fascinated by it. Sometimes
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it's a puzzle to think how it's done, but just the sheer fact that something that you never thought
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could happen does happen. And I think about that in science too. You know, sometimes you,
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something that you might dream about and helping to discover maybe you do in some way or form.
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What is the most amazing magic trick you've ever seen?
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Well, there's one I like, which is called the invisible pack. And the way it works is you have
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this pack and you hold it up. Well, first you say to somebody, this is invisible. And this deck,
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and you say, well, shuffle it, they shuffle it, but, you know, they sort of make believe.
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And then you say, okay, I'd like you to pick a card, any card, and show it to me. And you show
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it to me. And I look at it. And let's say it's the three of hearts. I said, well, put it back
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in the deck. But what I'd like you to do is turn it upside down from every other card in the deck.
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So they, they do that imaginary. And I said, do you want to shuffle it again? And they shuffle it.
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And I said, well, so there's still one card upside down from every other card in the deck. I said,
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what is that? And they said, well, three hearts. So it just so happens in my back pocket, I have
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this deck. It's, you know, it's a real deck. I show it to you. And I just open it up. And there's
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just one card upside down. And it's the three of hearts.
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And, and you can do this trick. I can. If I don't, I would have probably brought it.
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All right. Well, beautiful. Let's get into the, into the science. As of today, you have over 295,000
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citation and the H index of 269. You're one of the most cited people in history and the most
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cited engineer in history. And yet nothing great, I think, is ever achieved without failure. So
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the interesting part, what rejected papers, ideas, efforts in your life were most painful
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or had the biggest impact on your life? Well, it's interesting. I mean, I've had plenty of rejection
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too. You know, I, but I suppose one way I think about this is that when I first started, and this
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certainly had an impact both ways, you know, I first started, we made two big discoveries,
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and they were kind of interrelated. I mean, one was I was trying to isolate with my postdoctoral
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advisor, Judah Folkman, substances that could stop blood vessels from growing and nobody'd
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done that before. And so that was part A. Let's say a part B is we had to develop a way to study
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that. And what was critical to study that was to have a way to slowly release those substances
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for, you know, more than a day, you know, maybe months. And that had never been done before either.
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So we published the first one we sent to Nature, the journal, and they rejected it. And then we
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sent it, we revised it, we sent it to Science and they accepted it. And the other, the opposite
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happened. We sent it to Science and they rejected it, and then we sent it to Nature and they accepted
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it. But I have to tell you, when we got the rejections, it was really upsetting. I thought,
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you know, I did some really good work and Dr. Folkman thought we'd done some really good work and,
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and, but it, it was very depressing to, you know, get rejected like that.
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If you can linger on just the feeling or the thought process when you get the rejection,
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especially early on in your career, what, I mean, you don't know. Now people know you as,
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as, as a brilliant scientist. But at the time, I'm sure you're full of self doubt.
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And did you believe that maybe this idea is actually quite terrible, that it could have been
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done much better? Or is it underlying confidence? What was the feelings? Well, you feel depressed,
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you feel depressed. And I felt the same way when I got grants rejected, which I did a lot in the
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beginning. I guess part of me, you know, you have multiple emotions. One is being sad and being upset
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and also being maybe a little bit angry because you didn't feel the reviewers didn't get it.
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But then as I thought about it more, I thought, well, maybe I just didn't explain it well enough.
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And, you know, that you go through stages. So you say, well, okay, I'll explain it better next
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time. And certainly you get reviews. And when you get the reviews, you see what they either didn't
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like or didn't understand. And then you try to incorporate that into your next versions.
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You've given advice to students to do something big, do something that really can change the world
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rather than something incremental. How did you yourself seek out such ideas? Is there a process?
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Is there sort of a rigorous process? Or is it more spontaneous?
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It's more spontaneous. I mean, part of its exposure to things, part of it's seeing other people.
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Like I mentioned, Dr. Folkman, he was my postdoctoral advisor. He was very good at that.
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You could sort of see that he had big ideas. And I certainly met a lot of people who didn't.
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And I think you could spot an idea that might have potential when you see it,
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you know, because it could have very broad implications,
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where's a lot of people might just keep doing derivative stuff. But it's not something that
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I've ever done systematically, I don't think. So in the space of ideas, how many are just,
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when you see them, it's just magic. It's something that you see that could be impactful if you dig
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deeper. Yeah, it's sort of hard to say because there's multiple levels of ideas. One type of
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thing is like a new, you know, creation, like that you could engineer tissues for the first time
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or make tissues from scratch from the first time. But another thing is really just deeply
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understanding something. And that's important too. So, and that may lead to other things.
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So sometimes you could think of a new technology or I thought of a new technology. But other times
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things came from just the process of trying to discover things. So it's never, and you don't
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necessarily know, like people talk about a ha moments, but I don't know if I've, I mean,
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I certainly feel like I've had some ideas that I really like. But it's taken me a long time to go
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from the thought process of starting it to all of a sudden knowing that it might work.
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So if you take drug delivery, for example, is the notion, is the initial notion kind of a very
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general one that we should be able to do something like this? And then you start to ask the questions
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of, well, how would you do it? And then digging and digging and digging? I think that's right.
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I think it depends. I mean, there are many different examples. The example I gave about
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delivering large molecules, which we used to study, these blood vessel inhibitors, I mean,
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there we had to invent something that would do that. But other times it's different. Sometimes
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it's really understanding what goes on in terms of understanding the mechanisms. And so it's not
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a single thing. And there are many different parts to it. Over the years, we've invented
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different, or discovered different principles for aerosols, for delivering genetic therapy
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agents, all kinds of things. So let's explore some of the key ideas you've touched on in your life.
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Let's start with the basics. So first, let me ask, how complicated is the biology and
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chemistry of the human body from the perspective of trying to affect some parts of it in a positive
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way? So that you know, for me, especially coming from the field of computer science and computer
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engineering robotics, it seems that the human body is exceptionally complicated. And how the
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heck you can figure out anything is amazing. Well, I agree with you. I think it's super complicated.
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I mean, we're still just scratching the surface in many ways. But I feel like we have made progress
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in different ways. And some of it's by really understanding things like we were just talking
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about. Other times, you know, you might, or somebody might, we or others might invent
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technologies that might be helpful on exploring that. And I think over many years,
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we've understood things better and better, but we still have such a long ways to go.
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Are there, I mean, if you just look, are there things that, are there knobs that are reliably
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controllable about the human body? So if you start to think about controlling various aspects of,
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when we talk about drug delivery a little bit, but controlling various aspects chemically
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of the human body, is there a solid understanding across the populations of humans that are solid,
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reliable knobs that could be controlled? I think that's hard to do. But on the other hand, whenever
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we make a new drug or medical device, to a certain extent, we're doing that, you know, in a small way,
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what you just said. But I don't know that there, that there are great knobs. I mean,
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and we're learning about those knobs all the time. But if there's a biological pathway or
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something that you can affect or understand, I mean, then that might be such a knob.
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So what is pharmaceutical drug? How do you do it? How do you discover a specific one?
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How do you test it? How do you understand it? How do you ship it?
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Yeah. Well, I'll give you an example, which goes back to what I said before. So when I was doing
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my postdoctoral work with Judah Folkman, we wanted to come up with drugs that would stop
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blood vessels from growing or alternatively make them grow. And actually, people didn't even believe
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that, that those things could happen. But
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Can we pause on that for a second? Sure.
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What is a blood vessel? What does it mean for a blood vessel to grow and shrink? And why is that
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important? Sure. So a blood vessel is could be an artery or vein or a capillary. And it,
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it, you know, provides oxygen, it provides nutrients, gets rid of waste. So, you know,
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to different parts of your body, if you so, so the blood vessels end up being very, very important.
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And, you know, if you have cancer, blood vessels grow into the tumor. And that's part of what
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enables the tumor to get bigger. And that's also part of what enables the tumor to metastasize,
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and which means spread throughout the body and ultimately kill somebody. So that was part of
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what we were trying to do. We tried what we wanted to see if we could find substances that could
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stop that from happening. So first, I mean, there are many steps. First, we had to develop a bio assay
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study blood vessel growth. Again, there wasn't one. That's where we needed the polymer systems
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because the blood vessels grew slowly, took months. So after we had the polymer system,
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and we had the bio assay, then I isolated many different molecules initially from cartilage.
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And almost all of them didn't work. But we were fortunate, we found one, it wasn't purified,
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but we found one that did work. And that paper, that was this paper I mentioned in science in 1976,
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those were really the isolation of some of the very first angiogenesis blood vessel inhibitors.
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There's a lot of words there. So first of all, polymer molecules, big, big molecules. So what
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are polymers? What's bio assay? What is the process of trying to isolate this whole thing,
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simplify it to where you can control and experiment with it? Polymers are like plastics or rubber.
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What were some of the other questions? Sorry, so a polymer is some plastics and rubber, and that
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means something that has structure and that could be useful for what? Well, in this case,
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it would be something that could be useful for delivering a molecule for a long time. So it
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could slowly diffuse out of that at a controlled rate to where you wanted it to go. So then you
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would find the ideas that there would be particular blood vessels that you can target, say they're
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connected somehow to a tumor, that you could target and over a long period of time to be able to
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place the polymer there and it'd be delivering a certain kind of chemical. That's correct. I think
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what you said is good. So that it would deliver the molecule or the chemical that would stop the
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blood vessels from growing over a long enough time so that it really could happen. So that was
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sort of what we call the bio assay is the way that we would study that. So sorry, so what is the
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bio assay? Which part is the bio assay? All of it. In other words, the bio assay is the way you study
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blood vessel growth. The blood vessel growth and you can control that somehow with,
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is there an understanding what kind of chemicals could control the growth of a blood vessel? Sure.
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Well, now there is. But then when I started, there wasn't. And that gets to your original
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question. So you go through various steps. We did the first steps. We showed that such molecules
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existed and then we developed techniques for studying them. And we even isolated fractions,
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you know, groups of substances that would do it. But what would happen over the next,
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we did that in 1976, we published that, what would happen over the next 28 years
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is other people would follow in our footsteps. I mean, we tried to do some stuff too. But ultimately,
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to make a new drug takes billions of dollars. So what happened was there were different
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growth factors that people would isolate, sometimes using the techniques that we developed.
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And then they would figure out using some of those techniques ways to stop those growth
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factors and ways to stop the blood vessels from growing. That, like I say, took 28 years,
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it took billions of dollars and worked by many companies like Genotech. But in 2004, 28 years
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after we started, the first one of those, Avastin, got approved by the FDA. And that's become, you
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know, one of the top biotech selling drugs in history. And it's been approved for all kinds of
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cancers and actually for many eye diseases too, where you have abnormal blood vessel growth.
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Matthew. So in general, one of the key ways you can alleviate,
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so what's the hope in terms of tumors associated with cancerous tumors?
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What can you help by being able to control the growth of vessels?
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So if you cut off the blood supply, you cut off the, it's kind of like a war almost, right?
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You, if you have, if the nutrition is going to the tumor and you can cut it off, I mean,
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you starve the tumor and it becomes very small, it may disappear or it's going to be much more
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amenable to other therapies because it is tiny, you know, like, you know, chemotherapy or immunotherapy
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is going to have a much easier time against a small tumor than a big one.
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Is that an obvious idea? I mean, it seems like a very clever strategy in this war
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against cancer. Well, you know, in retrospect, it's an obvious idea, but when Dr. Folkman,
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my boss first proposed it, it wasn't, a lot of people didn't thought he was pretty crazy.
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And so, in what sense, if you could sort of linger on it, when you're thinking about these
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ideas at the time, where you're feeling you're out in the dark, so how much mystery is there
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about the whole thing? How much just blind experimentation, if you can put yourself in
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that mindset from years ago? Yeah, well, there was, I mean, for me, actually, it wasn't just the idea,
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it was that I didn't know a lot of biology or biochemistry, so I certainly felt I was in the
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dark. But I kept trying and I kept trying to learn and I kept plugging, but I mean, a lot of it was
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being in the dark. So the human body is complicated, right? We established this. Quantum mechanics
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in physics is a theory that works incredibly well, but we don't really necessarily understand the
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underlying nature of it. So are drugs the same in that you can, you're ultimately trying to show
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that the thing works to do something that you try to do, but you don't necessarily understand
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the fundamental mechanisms by which it's doing it? It really varies. I think sometimes people do
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know them, because they've figured out pathways and ways to interfere with them. Other times,
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it is shooting in the dark, it really has varied. And sometimes people make serendipitous discoveries
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and they don't even realize what they did. So what is the discovery process for a drug?
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You said a bunch of people are trying to work with this. Is it a kind of mix of serendipitous
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discovery and art? Or is there a systematic science to trying different chemical reactions and how
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they affect whatever you're trying to do, like shrink blood vessels? Yeah, I don't think there's
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a single way to go about something in terms of characterizing the entire drug discovery process.
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If I look at the blood vessel one, yeah, there the first step was to have the kinds of theories
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that Dr. Folkman had. The second step was to have the techniques where you could study blood
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vessel growth for the first time and at least quantitate or semiquantitate it. The third step
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was to find substances that would stop blood vessels from growing. The fourth step was to
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maybe purify those substances. There are many other steps too. I mean, before you have an
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effective drug, you have to show that it's safe. You have to show that it's effective and you start
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with animals. You ultimately go to patients and there are multiple kinds of clinical trials you
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have to do. If you step back, is it amazing to you that we descendants of great apes are able
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to create drugs, chemicals that are able to improve some aspects of our bodies? Or is it
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quite natural that we were able to discover these kinds of things?
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Well, at a high level, it is amazing. I mean, evolution is amazing. The way I look at your
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question, the fact that we have evolved the way we've done, I mean, it's pretty remarkable.
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So let's talk about drug delivery. What are the difficult problems in drug delivery? What is
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00:22:43.920
drug delivery from starting from your early seminal work in a field to today?
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00:22:50.480
Well, drug delivery is getting a drug to go where you want it, at the level you want it,
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00:22:57.840
in a safe way. Some of the big challenges, I mean, there are a lot. I mean, I'd say one is,
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00:23:03.520
could you target the right cell? Like we talked about cancers or some way to deliver a drug just
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00:23:09.600
to a cancer cell and no other cell. Another challenge is to get drugs across different
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00:23:15.120
barriers. Like could you ever give insulin orally or give it passively, transdermally?
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00:23:21.200
Can you get drugs across the blood brain barrier? I mean, there are lots of big challenges. Can
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00:23:26.320
you make smart drug delivery systems that might respond to physiologic signals in the body?
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00:23:32.240
Oh, interesting. So smart, they have some kind of sense, a chemical sensor or is there something
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00:23:38.960
more than a chemical sensor that's able to respond to something in the body?
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00:23:42.240
Could be either one. I mean, one example might be if you were diabetic, if you had more,
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00:23:51.280
got more glucose, could you get more insulin? But that's just an example.
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00:23:56.960
Is there some way to control the actual mechanism of delivery in response to what the body is doing?
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00:24:02.240
Yes, there is. I mean, one of the things that we've done is encapsulate what are called beta
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00:24:07.120
cells. Those are insulin producing cells in a way that they're safe and protected. And then what'll
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00:24:13.440
happen is glucose will go in and cells will make insulin. And so that's an example.
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00:24:22.880
So from an AI robotics perspective, how close are these drug delivery systems to
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00:24:29.840
something like a robot? Or is it totally wrong to think about them as intelligent agents?
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00:24:34.720
And how much room is there to add that kind of intelligence into these delivery systems,
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00:24:40.480
perhaps in the future? Yeah, I think it depends on the particular delivery system.
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00:24:45.120
Of course, one of the things people are concerned about is cost. And if you add a lot of bells
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00:24:48.960
and whistles to something, it'll cost more. But I mean, we, for example, have made what I'll call
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00:24:54.560
intelligent microchips where you can send a signal and release drug in response to that signal.
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00:25:01.120
And I think systems like that microchip someday have the potential to do what you and I were just
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00:25:06.240
talking about, that there could be a signal like glucose and it could have some instruction to say
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00:25:11.440
when there's more glucose, deliver more insulin. So do you think it's possible that there could be
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00:25:17.120
robotic type systems roaming our bodies sort of long term and be able to deliver certain kinds
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00:25:22.000
of drugs in the future? Do you see that kind of future? Someday. I don't think we're very close
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00:25:28.400
to it yet. But someday, you know, that that's nanotechnology. And that would mean even miniaturizing
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00:25:33.600
some of the things that I just discussed. And we're certainly not at that point yet. But someday,
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00:25:38.320
I expect we will be. So some of it is just the shrinking of the technology. That's a part of it.
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00:25:44.880
That's one of the things. In general, what role do you see AI sort of there? There's a lot of work
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00:25:52.960
now with using data to make intelligent, create systems that make intelligent decisions. Do you
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00:25:59.360
see any of that data driven kind of computing systems having a role in any part of this into the
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00:26:10.080
delivery drugs, the design of drugs and any part of the chain? I do. I think that AI can be useful
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00:26:17.920
in a number of parts of the chain. I mean, one, I think if you get a large amount of information,
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00:26:23.600
you know, say you have some chemical data because you've done high throughput screens.
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00:26:28.880
And let's I'll just make this up. But let's say I have I'm trying to come up with a drug to treat
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00:26:34.640
disease X, whatever that disease is. And I have a test for that. And hopefully a fast test. And
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00:26:43.520
let's say I test 10,000 chemical substances and a couple of work. Most of them don't work. Some
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00:26:50.000
maybe work a little. But if I had it, if you with the right kind of artificial intelligence,
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00:26:54.800
maybe you could look at the chemical structures and look at what works and see if there's certain
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00:26:58.880
commonalities, look at what doesn't work and see what commonalities there are. And then maybe
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00:27:04.320
use that somehow to predict the next generation of things that you would test.
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00:27:07.600
As a tangent, what are your thoughts on our society's relationship with pharmaceutical drugs?
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00:27:14.800
Do we, and perhaps I apologize if this is a philosophical, broader question, but
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00:27:20.480
do we over rely on them? Do we improperly prescribe them? In what ways is the system working well?
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00:27:26.320
In what way can it improve? Well, I think, you know, pharmaceutical drugs are really important.
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00:27:33.600
I mean, the life expectancy and life quality of people over many, many years has increased
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00:27:40.000
tremendously. And I think that's a really good thing. I think one thing that would also be good
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00:27:44.640
is if we could extend that more and more to people in the developing world, which is something that
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00:27:49.040
our lab has been doing with the Gates Foundation are trying to do. So I think ways in which it
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00:27:55.680
could improve. I mean, if there was some way to reduce costs, you know, that that's certainly
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00:28:00.720
an issue people are concerned about. If there was some way to help people in poor countries,
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00:28:05.680
that would also be a good thing. And then, of course, we still need to make better drugs for
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00:28:11.200
so many diseases. I mean, cancer, diabetes, I mean, we, you know, there's heart disease and
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00:28:17.200
rare diseases. There are many, many situations where it'd be great if we could do better and help
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00:28:21.760
more people. Can we talk about another exciting, another exciting space, which is tissue engineering?
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00:28:29.360
What is tissue engineering or regenerative medicine? Yeah. So that tissue engineering or
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00:28:34.080
regenerative medicine have to do with building an organ or tissue from scratch. So, you know,
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00:28:39.680
someday maybe we can build a liver, you know, or make new cartilage and also would enable you to,
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00:28:47.840
you know, someday create organs on a chip, which people we and others are trying to do,
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00:28:52.400
which might lead to better drug testing and maybe less testing on animals or people.
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00:28:57.760
Organs and a chip. That sounds fascinating. So what are the various ways to generate tissue?
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00:29:06.000
And how do, so, you know, the one is, of course, from stem cells. Is there other methods? What
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00:29:12.240
are the different possible flavors here? Yeah. Well, I think, I mean, there's multiple components.
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00:29:17.280
One is having generally some type of scaffold. That's what Jay Vikanti and I started many,
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00:29:22.480
many years ago. And then on that scaffold, you might put different cell types, which could be a
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00:29:28.880
cartilage cell, a bone cell, could be a stem cell that might differentiate into different things,
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00:29:33.600
could be more than one cell. And the scaffold, sorry to interrupt, is kind of like a canvas
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00:29:38.480
that it's a structure that you can, on which the cells can grow? I think that's a good explanation
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00:29:44.160
what you just did. I'll have to use that. The canvas, that's good. Yeah. So I think that that's
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00:29:49.120
fair. You know, when the chip could be such a canvas, could be fibers that are made of plastics
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00:29:55.040
and that you'd put in the body someday. And when you say chip, do you mean electronic chip?
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00:29:59.600
Like, not necessarily, it could be though, but it doesn't have to be. It could just be a structure
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00:30:04.720
that's not, not in vivo, so to speak, that's, you know, that's outside the body.
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00:30:10.720
So is there, canvas is not a bad word.
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00:30:12.960
So is there a possibility to weave into the scan as a computational component?
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00:30:22.080
So if we talk about electronic chip, some, some ability to sense, control some aspect of this
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00:30:29.280
growth process for the tissue? I would say the answer to that is yes. I think right now people
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00:30:34.800
are working mostly on, on validating these kinds of chips for saying, well, it does work as a
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00:30:42.800
effectively or hopefully as just putting something in the body. But I think someday what you suggested,
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00:30:49.360
you certainly would be possible. So what kind of tissues can we engineer today?
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00:30:53.440
What, yeah. Yeah. Well, well, so skin's already been made and approved by the FDA.
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00:30:58.640
There are advanced clinical trials, like what are called phase three trials,
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00:31:03.040
that are at complete or near completion for making new blood vessels. One of my former
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00:31:09.040
students, Laura Nicholson, led a lot of that. So that's amazing. So human skin can be grown.
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00:31:16.080
That's already approved through the entire, the FDA process. So that means what,
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00:31:23.520
so the one that means you can grow that tissue and do various kinds of experiments in terms of,
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00:31:31.840
in terms of drugs and so on. But what is that, does that mean that some kind of healing and
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00:31:37.280
treatment of different conditions for human beings? Yes. I mean, they've been approved now for,
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00:31:43.440
I mean, different groups have made them, different companies and different professors,
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00:31:47.520
but they've been approved for burn victims and for patients with diabetic skin ulcers.
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00:31:53.040
That's amazing. Okay. So skin, what else? Well, at different stages, people are like skin,
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00:32:03.360
blood vessels. There's clinical trials going now for helping patients hear better, for patients
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00:32:10.320
that might be paralyzed, for patients that have different eye problems. I mean,
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00:32:16.320
and different groups have worked on just about everything, new liver, new kidneys. I mean,
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00:32:21.440
there've been all kinds of work done in this area, some of it's early, but there's certainly a
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00:32:26.560
lot of activity. What about neural tissue? Yeah. The nervous system and even the brain.
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00:32:34.000
Well, there have been people out of working on that too. We've done a little bit with that,
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00:32:37.280
but there are people who've done a lot on neural stem cells. And I know Evan Snyder,
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00:32:41.680
who's been one of our collaborators on some of our spinal cord works done work like that.
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00:32:46.000
And there have been other people as well. Is there challenges for the,
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00:32:51.120
when it is part of the human body, is there challenges to getting the body to accept this
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00:32:55.840
new tissue that's being generated? How do you solve that kind of challenge?
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00:33:00.000
There can be problems with accepting it. I think maybe in particular, you might mean rejection
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00:33:06.000
by the body. So there are multiple ways that people are trying to deal with that. One way is,
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00:33:11.760
which was what we've done and with Dan Anderson, who was one of my former postdocs, and I mentioned
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00:33:16.400
this a little bit before for a pancreas, is encapsulating the cells. So immune cells or
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00:33:24.480
antibodies can't get in and attack them. So that's a way to protect them. Other strategies could be
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00:33:32.400
making the cells non immunogenic, which might be done by different, either techniques, which might
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00:33:37.360
mask them or using some gene editing approaches. So there are different ways that people are
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00:33:42.160
trying to do that. And of course, if you use the patient's own cells or cells from a close relative,
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00:33:48.080
that might be another way and increases the likelihood that they'll get accepted
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00:33:52.640
if you use the patient's own cells. Yes. And then finally, there's some suppressive drugs,
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00:33:57.600
which will suppress the immune response. That's right now what's done, say, for liver transplant.
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00:34:03.760
The fact that this whole thing works just fascinating, at least from my
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00:34:08.080
outside perspective, will we one day be able to regenerate any organ or part of the human body
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00:34:15.520
in your view? I mean, it's exciting to think about future possibilities of tissue engineering.
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00:34:20.400
Do you see some tissues more difficult than others? What are the possibilities here?
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00:34:26.960
Yeah. Well, of course, I'm an optimist. And I also feel a timeframe, if we're talking about someday,
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00:34:32.240
someday could be hundreds of years. But I think that yes, someday, I think we will be able to
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00:34:37.040
regenerate many things. And there are different strategies that one might use. One might use some
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00:34:43.680
cells themselves. One might use some molecules that might help regenerate the cells. And so I
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00:34:50.000
think there are different possibilities. What do you think that means for longevity?
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00:34:54.640
If we look maybe not someday, but 10, 20 years out, the possibilities that tissue
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00:35:01.200
engineering, the possibilities of the research that you're doing, does it have a significant impact
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00:35:06.720
on the longevity of human life? I don't know that we'll see a radical increase in longevity,
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00:35:12.720
but I think that in certain areas, we'll see people live better lives and maybe somewhat longer
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00:35:21.040
lives. What's the most beautiful scientific idea in bioengineering that you've come across
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00:35:28.080
in your years of research? I apologize for the romantic.
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00:35:33.360
No, that's an interesting question. I certainly think what's happening right now with CRISPR is
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00:35:38.560
a beautiful idea. That certainly wasn't my idea. But I think it's very interesting here
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00:35:45.840
what people have capitalized on is that there's a mechanism by which bacteria are able to destroy
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00:35:53.920
viruses. And understanding that leads to machinery to cut and paste genes and fix a cell.
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00:36:05.680
Do you see a promise for that kind of ability to copy and paste? Like we said,
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00:36:14.800
the human body is complicated. That seems exceptionally difficult to do.
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00:36:23.120
I think it is exceptionally difficult to do, but that doesn't mean that it won't be done. There's
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00:36:28.000
a lot of companies and people trying to do it. And I think in some areas it will be done. Some
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00:36:32.560
of the ways that you might lower the bar are not just taking, not necessarily doing it directly,
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00:36:40.800
but you could take a cell that might be useful, but you want to give it some cancer killing
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00:36:47.920
capabilities, something like what's called a CAR T cell. And that might be a different way of
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00:36:52.480
somehow making a CAR T cell and maybe making it better. So there might be sort of easier things
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00:36:58.320
than rather than just fixing the whole body. So the way a lot of things have moved with medicine
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00:37:04.000
over time is stepwise. So I can see things that might be easier to do than say fix a brain.
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00:37:11.760
That would be very hard to do, but maybe someday that'll happen too.
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00:37:16.240
So in terms of stepwise, that's an interesting notion. Do you see that if you look at medicine
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00:37:21.680
or bioengineering, do you see that there is these big leaps that happen every decade or so or
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00:37:31.360
some distant period? Or is it a lot of incremental work? Not, I don't mean to reduce
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00:37:38.240
its impact by saying it's incremental, but is there sort of phase shifts in the science,
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00:37:46.240
big, big leaps? I think there's both. Every so often a new technique or new technology comes out.
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00:37:54.160
I mean, genetic engineering was an example. I mentioned CRISPR. I think every so often things
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00:38:00.800
happen that make a big difference, but still to try to really make progress, make a new drug,
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00:38:08.320
make a new device, there's a lot of things. I don't know if I'd call them incremental,
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00:38:12.640
but there's a lot, a lot of work that needs to be done. Absolutely. So you have over,
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00:38:19.440
numbers could be off, but it's a big amount. You have over 1,100 current or pending patents
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00:38:25.200
that have been licensed, sublicensed to over 300 companies. What's your view?
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00:38:32.160
What in your view are the strengths and what are the drawbacks of the patenting process?
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00:38:36.240
Well, I think for the most part there's strengths. I think that if you didn't have patents,
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00:38:42.960
especially in medicine, you'd never get the funding that it takes to make a new drug or a
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00:38:47.680
new device, which according to Tufts, to make a new drug costs over $2 billion right now,
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00:38:53.440
and nobody would even come close to giving you that money, any of that money, if it weren't for
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00:38:58.800
the patent system, because then anybody else could do it. That then leads to the negative,
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00:39:08.720
though. Sometimes somebody does have a very successful drug, and you certainly want to try
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00:39:14.560
to make it available to everybody. And so the patent system allows it, allowed it to happen in
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00:39:22.720
the first place, but maybe it'll impede it after a little bit or certainly to some people or to
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00:39:28.560
some companies once it is out there. What's on the point of the cost? What would you say is the
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00:39:37.120
most expensive part of the $2 billion of making a drug? Human clinical trials. That is by far the
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00:39:45.120
most expensive. In terms of money or pain or both? Well, money, but pain goes hard to know.
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00:39:51.680
I mean, but usually proving that something new is safe and effective in people is almost always
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00:40:00.080
the biggest expense. Could you linger on that for just a little longer and describe what it takes to
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00:40:05.680
prove for people that don't know in general what takes to prove that something is effective on
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00:40:12.480
humans? Well, you'd have to take a particular disease, but the process is you start out with
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00:40:21.280
usually you start out with cells, then you'd go to animal models. Usually you have to do a couple
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00:40:25.200
animal models. And of course, the animal models aren't perfect for humans. And then you have to
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00:40:30.000
do three sets of clinical trials at the minimum, a phase one trial to show that it's safe in small
link |
00:40:35.120
number of patients, a phase two trial to show that it's effective in a small number of patients,
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00:40:39.760
and a phase three trial to show that it's safe and effective in a large number of patients.
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00:40:44.480
And, you know, that could end up being hundreds or thousands of patients. And they have to be
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00:40:51.120
really carefully controlled studies. And, you know, you'd have to manufacture the drug. You'd
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00:40:55.840
have to, you know, really watch those patients. You have to be very concerned, you know, that
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00:41:02.160
it is going to be safe. And then you look at, see, does it treat the disease better than
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00:41:08.240
whatever the gold standard was before that, assuming there was one?
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00:41:12.800
That's a really interesting line. Show that it's safe first, and then that it's effective.
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00:41:18.080
First do no harm.
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00:41:19.360
First do no harm. That's right. So how, again, if you can linger it a little bit,
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00:41:26.240
how does the patenting process work?
link |
00:41:29.200
Yeah, well, you do a certain amount of research. Though that's not necessarily,
link |
00:41:34.400
has to be the case. But for us, usually it is. Usually we do a certain amount of research
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00:41:38.960
and make some findings. And, you know, we had a hypothesis, let's say we prove it,
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00:41:46.480
or we make some discovery, we invent some technique. And then we write something up,
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00:41:51.440
what's called a disclosure. We give it to MIT's Technology Transfer Office. They then give it
link |
00:41:56.800
to some patent attorneys, and they use that and plus talking to us and, you know, work on writing
link |
00:42:02.960
a patent. And then you go back and forth with the USPTO, that's the United States Patent and
link |
00:42:08.960
Trademark Office. And, you know, they may not allow it the first, second, or third time,
link |
00:42:14.400
but they will tell you why they don't. And you may adjust it, and maybe you'll eventually get it,
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00:42:19.920
and maybe you won't.
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00:42:21.360
So you've been part of launching 40 companies. Together worth, again, numbers could be outdated,
link |
00:42:28.400
but an estimated $23 billion. You've described your thoughts on a formula for startup success.
link |
00:42:36.880
So perhaps you can describe that formula, and in general describe what does it take to build a
link |
00:42:42.000
successful startup?
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00:42:44.160
Well, I'd break that down into a couple of categories. And I'm a scientist, and certainly
link |
00:42:48.560
from the science standpoint, I'll go over that. But I actually think that really the most important
link |
00:42:53.920
thing is probably the business people that I work with. And, you know, when I look back at the
link |
00:42:59.840
companies that have done well, it's been because we've had great business people. And when they
link |
00:43:04.400
haven't done as well, we have it as good business people. But from a science standpoint, I think
link |
00:43:09.200
about that we've made some kind of discovery that is almost what I'd call a platform, that you
link |
00:43:15.440
could use it for different things. And certainly the drug delivery system example that I gave
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00:43:20.800
earlier is a good example of that. You could use it for drug A, B, C, D, E, and so forth.
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00:43:27.040
And that I'd like to think that we've taken it far enough so that we've written at least one
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00:43:32.320
really good paper in a top journal, hopefully a number, that we've reduced it to practice in
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00:43:38.240
animal models, that we've filed patents, maybe had issued patents that have what I'll call very
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00:43:47.040
good and broad claims. That's sort of the key in a patent. And then in our case, a lot of times
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00:43:53.040
when we've done it, a lot of times it's somebody in the lab, like a postdoc or graduate student,
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00:43:59.280
that spent a big part of their life doing it and that they want to work at that company because
link |
00:44:03.760
they have this passion that they want to see something they did make a difference in people's
link |
00:44:07.600
lives. Maybe you can mention the business component. It's funny to hear great side to say that there's
link |
00:44:15.600
value to business folks. That's not always said. So what value, what business instinct is valuable
link |
00:44:25.120
to make a startup successful, a company successful? I think the business aspects are, you have to
link |
00:44:33.680
be a good judge of people so that you hire the right people. You have to be strategic so you
link |
00:44:39.840
figure out if you do have that platform that could be used for all these different things.
link |
00:44:43.440
And knowing that medical research is so expensive, what thing are you going to do first,
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00:44:48.800
second, third, fourth, and fifth? I think you need to have a good, what I'll call FDA regulatory
link |
00:44:55.120
clinical trial strategy. I think you have to be able to raise money credibly. So there are a lot
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00:45:02.080
of things. You have to be good with people, good manager of people. So the money and the people
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00:45:07.040
part I get, but the stuff before, in terms of deciding the ABCD, if you have a platform which
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00:45:14.240
drugs the first and take a testing, you see nevertheless, scientists as not being always
link |
00:45:20.560
too good at that process. Well, I think they're a part of the process, but I'd say there's probably,
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00:45:26.320
I'm going to just make this up, but maybe six or seven criteria that you want to use and that's
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00:45:32.000
not just science. I mean, the kinds of things that I would think about is the market big or small.
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00:45:39.120
Are there good animal models for it so that you could test it and it wouldn't take 50 years?
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Are there clinical trials that could be set up, ones that have clear endpoints where you could
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make a judgment and another issue would be competition. Are there other ways that some
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companies out there are doing it? Another issue would be reimbursement. Can it get reimbursed?
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So a lot of things that you have manufacturing issues you'd want to consider. So I think there
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are really a lot of things that go into what you do first, second, third or fourth.
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So you lead one of the largest academic labs in the world with over $10 million in annual grants
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and over a hundred researchers, probably over a thousand since the lab's beginning.
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Researchers can be individualistic and eccentric. How do I put it nicely? There you go, eccentric.
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00:46:39.760
So what insights into research leadership can you give having to run such a successful lab
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with so much diverse talent? Well, I don't know that I'm any expert. I think that what you do,
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to me, I mean, I just want, I mean, it's going to sound very simplistic, but I just want people
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in the lab to be happy to be doing things that I hope will make the world a better place to
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be working on science that can make the world a better place. And I guess my feeling is if
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we're able to do that, it kind of runs itself. So how do you make a researcher happy in general?
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What I think when people feel, I mean, this is going to sound like, again, simplistic or maybe
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like motherhood and apple pie, but I think if people feel they're working on something really
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important that can affect many other people's lives and they're making some progress,
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they'll feel good about it and they'll feel good about themselves and they'll be happy.
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But through brainstorming and so on, what's your role and how difficult it is as a group
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in this collaboration to arrive at these big questions that might have impact?
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Well, the big questions come from many different ways. Sometimes it's trying to
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things that I might think of or somebody in the lab might think of, which could be a new
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technique or to understand something better. But gee, we've had people like Bill Gates and
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the Gates Foundation come to us and Juvenile Diabetes Foundation come to us and say,
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gee, could you help us on these things? And I mean, that's good too. It doesn't happen just one way.
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And I mean, you've kind of mentioned it, happiness, but is there something more,
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00:48:24.560
how do you inspire a researcher to do the best work of their life? So you mentioned passion
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and passion is a kind of fire. Do you see yourself having a role to keep that fire going to
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to build it up, to inspire the researchers through the pretty difficult process of
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going from idea to big question to big answer?
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I think so. I think I try to do that by talking to people, going over their ideas and their progress.
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I try to do it as an individual. Certainly when I talk about my own career, I had my setbacks as
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different times and people know that, that know me. And you just try to keep pushing and so forth.
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But yeah, I think I try to do that as the one who leads the lab.
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00:49:20.800
So you have this exceptionally successful lab and one of the great institutions in the world,
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MIT, and yet sort of, at least in my neck of the woods and computer science and artificial
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00:49:34.320
intelligence, a lot of the research is kind of a lot of the great researchers, not everyone,
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but some are kind of going to industry. A lot of the research is moving to industry.
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What do you think about the future of science in general? Is there drawbacks? Is there strength to
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the academic environment that you hope will persist? How does it need to change? What needs
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to stay the same? What are your just thoughts on this whole landscape of science and its future?
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Well, first, I think going to industry is good, but I think being in academia is good.
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I have lots of students who've done both and they've had great careers doing both.
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I think from an academic standpoint, the biggest concern probably that people feel today
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at a place like MIT or other research heavy institutions is going to be funding and particular
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00:50:30.800
funding that's not super directed so that you can do basic research. I think that's probably
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the number one thing, but it would be great if we as a society could come up with better ways
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to teach so that people all over could learn better. So I think there are a number of things
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that would be good to be able to do better. So again, you're very successful in terms of funding,
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but do you still feel the pressure of that, of having to seek funding? Does it affect the science
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or is it or can you simply focus on doing the best work of your life and the funding comes
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00:51:12.480
along with that? I'd say the last 10 or 15 years, we've done pretty well funding,
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but I always worry about it. You know, it's like you're still operating on more soft money than
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hard and so I always worry about it, but we've been fortunate that places have come to us like
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the Gates Foundation and others, Juvenile Diabetes Foundation, some companies and they're willing
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to give us funding and we've gotten government money as well. We have a number of NIH grants and
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I've always had that and that's important to me too. So I worry about it, but I just view
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that as a part of the process. Now, if you put yourself in the shoes of a philanthropist,
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like say I gave you $100 billion right now, but you couldn't spend it on your own research.
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So how hard is it to decide which labs to invest in, which ideas, which problems,
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00:52:14.640
which solutions? Because funding is so much such an important part of progression of science in
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00:52:23.040
today's society. So if you put yourself in the shoes of a philanthropist, how hard is that problem?
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How would you go about solving it? Sure. Well, I think what I do, the first thing
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is different philanthropists have different visions. And I think the first thing is to
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form a concrete vision of what you want. Some people, I mean, I'll just give you two examples
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of people that I know. David Koch was very interested in cancer research and part of that
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00:52:48.080
was that he had cancer and prostate cancer and a number of people do that along those lines.
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They've had somebody, they've either had cancer themselves or somebody they loved
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00:52:59.200
had cancer and they want to put money into cancer research. Bill Gates, on the other hand,
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I think when he had got his fortune, I mean, he thought about it and felt, well,
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how could he have the greatest impact? And he thought about helping people in the developing
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world and medicines and different things like that, like vaccines that might be really helpful
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for people in the developing world. And so I think first you start out with that vision.
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And once you start out with that vision, whatever vision it is, then I think you'd try to
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ask the question, who in the world does the best work if that was your goal? I mean,
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but you really, I think, have to have a defined vision. Vision first. Yeah, that comes and I
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think that's what people do. I mean, I have never seen anybody do it otherwise. I mean,
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and that, by the way, may not be the best thing overall. I mean, I think it's good
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that all those things happen. But what you really want to do, and I'll make a contrast in a second,
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in addition to funding important areas, like what both of those people did is to help young people.
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And that they may be at odds with each other because a farm or a lab like ours, which is
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a molder, might be very good at addressing some of those kinds of problems. But I'm not young.
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I train a lot of people who are young, but it's not the same as helping somebody use an assistant
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professor someplace. So I think what's I think been good about our thing, our society or things
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overall, or that there are people who come at it from different ways. And the combination,
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the confluence of the government funding, the certain foundations that that fund things and
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other foundations that you don't want to see disease treated, well, then they can go seek out
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people or they can put a request for proposals and see who does the best. I'd say both David Koch
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and Bill Gates did exactly that. They sought out people, both of them, or their foundations that
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they were involved in, sought out people like myself. But they also had requests for proposals.
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You mentioned young people and that reminds me of something you said in an interview of
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written somewhere that said some of your initial struggles in terms of finding
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a faculty position or so on that you didn't quite for people fit into a particular bucket,
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00:55:32.000
a particular right. Can you speak to that? How do you see limitations to the academic system that
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it does have such buckets? Is there how can we allow for people who are brilliant, but outside
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00:55:55.200
the disciplines of the previous decade? Yeah, well, I think that's a great question.
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I think the department has to have a vision, and some of them do. Every so often,
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there are institutes or labs that do that. I mean, at MIT, I think that's done sometimes. I know
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00:56:18.080
Mechanical Engineering Department just had a search and they hired Geo Traverso, who was a
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00:56:25.680
fellow with me, but he's actually a molecular biologist and a gastroenterologist, and he's
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one of the best in the world. But he's also done some great mechanical engineering and
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designing some new pills and things like that, and they picked him. Boy, I give them a lot of
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credit. I mean, that's vision to pick somebody, and I think they'll be the richer for. I think
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the Media Lab has certainly hired people like Ed Boyden and others who have done very different
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things, and so I think that that's part of the vision of the leadership who do things like that.
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Do you think one day, you've mentioned David Koch in cancer, do you think one day we'll cure
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cancer? Yeah, I mean, it goes one day. I don't know how long that day will come.
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Soon. Yeah, soon, no, but I think.
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So you think it is a grand challenge. It is a grand challenge. It's not just solvable within a
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few years. I don't think very many things are solvable in a few years. There's some good ideas
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that people are working on, but I mean, all cancers, that's pretty tough.
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If we do get the cure, what will the cure look like? Do you think which mechanisms,
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which disciplines will help us arrive at that cure from all the amazing work you've done
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00:57:42.480
that has touched on cancer? No, I think it'll be a combination of biology and engineering.
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I think it'll be biology to understand the right genetic mechanisms to solve this problem,
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and maybe the right immunological mechanisms and engineering in the sense of producing the
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molecules, developing the right delivery systems, targeting it, or whatever else needs to be done.
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00:58:05.520
Well, that's a beautiful vision for engineering. So on a lighter topic, I've read that you love
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00:58:11.200
chocolate and mentioned two places, Ben and Bill's Chocolate Emporium and the Chocolate Cookies,
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00:58:18.560
the Soho Globs from Rosie's Bag Curing Chestnut Hill. I went to their website and I was trying
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to finish a paper last night. There's a deadline today, and yet I was wasting way too much time
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at 3 a.m. instead of writing the paper, staring at the Rosie Baker's Cookies, which were just
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00:58:36.960
look incredible. Soho Globs is look incredible. But for me, oatmeal, white raisin cookies
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won my heart just from the pictures. Do you think one day we'll be able to engineer
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the perfect cookie with the help of chemistry and maybe a bit of data driven artificial
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intelligence or is cookies something that's more art than engineering? I think there's
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some of both. I think engineering will probably help someday. What about chocolate? Same thing,
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00:59:09.120
same thing. You'd have to go to see some of David Edwards stuff. He was one of my postdocs,
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and he's a professor at Harvard, but he also started Cafe Art Sciences, and there's a really
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cool restaurant around here. But he also has companies that do ways of looking at fragrances
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00:59:28.560
and trying to use engineering in new ways. That's just an example, but I expect someday that
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AI and engineering will play a role in almost everything.
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00:59:40.880
Including creating the perfect cookie? Yes.
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Well, I dream of that day as well. When you look back at your life, having accomplished an incredible
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amount of positive impact on the world through science and engineering, what are you most proud
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00:59:55.120
of? My students, I really feel when I look at that, we've probably had close to a thousand
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01:00:01.760
students go through the lab. They've done incredibly well. I think 18 are in the National
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01:00:08.560
Academy of Engineering, 16 in the National Academy of Medicine. They've been CEOs of companies,
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01:00:15.200
presidents of universities, and they've done, I think, eight are faculty at MIT, maybe about 12
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01:00:21.840
at Harvard. It really makes you feel good to think that the people, they're not my children,
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01:00:28.640
but they're close to my children in a way, and it makes you feel really good to see them have
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01:00:33.680
such great lives and them do so much good and be happy. Well, I think that's a perfect way to end
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01:00:39.440
it, Bob. Thank you so much for talking. My pleasure. It was an honor. Good questions. Thank you.
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01:00:45.200
Thanks for listening to this conversation with Bob Langer, and thank you to our sponsors,
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01:00:49.920
Cash App and Masterclass. Please consider supporting the podcast by
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01:00:54.800
downloading Cash App and using code Lex Podcast, and signing up at masterclass.com
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01:01:01.040
slash Lex. Click on the links, buy all the stuff. It's the best way to support this podcast and
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the journey I'm on in my research and startup. If you enjoy this thing, subscribe on YouTube,
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01:01:13.680
review it with 5,000 app of podcast, support it on Patreon, or connect with me on Twitter
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01:01:18.960
at Lex Freedman, spelled without the E, just F R I D M A N. And now let me leave you with some words
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01:01:26.720
from Bill Bryson in his book, A Short History of Nearly Everything. This book has a lesson,
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01:01:33.680
is that we're awfully lucky to be here. And by we, I mean every living thing. To attain any kind of
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01:01:40.880
life in this universe of ours appears to be quite an achievement. As humans, we're doubly lucky,
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01:01:46.400
of course. We enjoy not only the privilege of existence, but also the singular ability to
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01:01:52.240
appreciate it, and even in a multitude of ways to make it better. It is talent we have only barely
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01:01:59.520
begun to grasp. Thank you for listening and hope to see you next time.