How Tech Will (and Won’t) Replace Your Doctor | TED Intersections

It is really hard to kind of get It is really hard to kind of get credible information out there that's credible information out there that's credible information out there that's also compelling when you're competing in also compelling when you're competing in also compelling when you're competing in in a world where where there's so much in a world where where there's so much in a world where where there's so much it's so easy to generate content that is it's so easy to generate content that is it's so easy to generate content that is compelling that is not accurate. compelling that is not accurate. compelling that is not accurate. >> Yeah. I mean there's so many ways to be >> Yeah. I mean there's so many ways to be >> Yeah. I mean there's so many ways to be wrong and there's only a few ways to be wrong and there's only a few ways to be wrong and there's only a few ways to be right and and so you know just if you do right and and so you know just if you do right and and so you know just if you do the math it's like if you say something the math it's like if you say something the math it's like if you say something it it's probably going to be wrong. Um it it's probably going to be wrong. Um it it's probably going to be wrong. Um unless you take a lot of steps to figure unless you take a lot of steps to figure unless you take a lot of steps to figure out if it's actually true uh true or out if it's actually true uh true or out if it's actually true uh true or not. All All >> [music] >> right. You want me to go first? >> right. You want me to go first? >> Let's do it. >> Let's do it. >> Let's do it. >> All right. Let's get into it. What is a >> All right. Let's get into it. What is a >> All right. Let's get into it. What is a health metric you wish people would health metric you wish people would health metric you wish people would focus on more? focus on more? focus on more? >> Is it too cheeky to say no metric? Um, >> Is it too cheeky to say no metric? Um, >> Is it too cheeky to say no metric? Um, so I think that we are inundated with so I think that we are inundated with so I think that we are inundated with health metrics. Some of that is to the health metrics. Some of that is to the health metrics. Some of that is to the good. I'm a doctor. A lot of what I'm good. I'm a doctor. A lot of what I'm good. I'm a doctor. A lot of what I'm focused on is metrics and quantification focused on is metrics and quantification focused on is metrics and quantification and how do we get people's cholesterol and how do we get people's cholesterol and how do we get people's cholesterol level to the right um uh number. But um level to the right um uh number. But um level to the right um uh number. But um I think we're also losing the ability to I think we're also losing the ability to I think we're also losing the ability to feel our bodies to understand feel our bodies to understand feel our bodies to understand subjectively what it means to be in good subjectively what it means to be in good subjectively what it means to be in good health and do I have energy today? Am I health and do I have energy today? Am I health and do I have energy today? Am I feeling unsettled? Um what does it mean feeling unsettled? Um what does it mean feeling unsettled? Um what does it mean to thrive? And so I think that instead to thrive? And so I think that instead to thrive? And so I think that instead of layering on more metrics which have a of layering on more metrics which have a of layering on more metrics which have a place, um the most important metric is place, um the most important metric is place, um the most important metric is really this qualitative sense of do I really this qualitative sense of do I really this qualitative sense of do I feel healthy today?

feel healthy today? feel healthy today? >> Yeah, I love that. Uh I couldn't agree >> Yeah, I love that. Uh I couldn't agree >> Yeah, I love that. Uh I couldn't agree more. We try to like quantify things, more. We try to like quantify things, more. We try to like quantify things, put a number on it, and that makes put a number on it, and that makes put a number on it, and that makes decisions easier, right? Um but the decisions easier, right? Um but the decisions easier, right? Um but the reality is that like everybody's biology reality is that like everybody's biology reality is that like everybody's biology is so different and so those numbers are is so different and so those numbers are is so different and so those numbers are sort of like um indicative, but I agree sort of like um indicative, but I agree sort of like um indicative, but I agree with you that there's a lot of behaviors with you that there's a lot of behaviors with you that there's a lot of behaviors and things that I think that probably and things that I think that probably and things that I think that probably make a lot of sense like um for people make a lot of sense like um for people make a lot of sense like um for people to spend more time on. for myself as a to spend more time on. for myself as a to spend more time on. for myself as a microbiologist like you know my answer microbiologist like you know my answer microbiologist like you know my answer to this is always the microbiome right to this is always the microbiome right to this is always the microbiome right but like even there there's not like a but like even there there's not like a but like even there there's not like a number or a metric that you can track number or a metric that you can track number or a metric that you can track you go out and you get your microbiome you go out and you get your microbiome you go out and you get your microbiome sequenced you get that information back sequenced you get that information back sequenced you get that information back like what do you do with that like we like what do you do with that like we like what do you do with that like we don't have like a good answer for what don't have like a good answer for what don't have like a good answer for what to do next even though we know it's so to do next even though we know it's so to do next even though we know it's so important and so central to our health important and so central to our health important and so central to our health and so honestly the answer I give is and so honestly the answer I give is and so honestly the answer I give is like just eat more fiber like you're like just eat more fiber like you're like just eat more fiber like you're almost assuredly not getting enough almost assuredly not getting enough almost assuredly not getting enough fiber 95% of Americans don't get enough fiber 95% of Americans don't get enough fiber 95% of Americans don't get enough fiber fiber fiber >> totally and for some people it can be >> totally and for some people it can be >> totally and for some people it can be motivating to have a number So if motivating to have a number So if motivating to have a number So if someone says walk 10,000 steps, maybe someone says walk 10,000 steps, maybe someone says walk 10,000 steps, maybe that takes someone and gives them a real that takes someone and gives them a real that takes someone and gives them a real tangible goal to walk towards. But I tangible goal to walk towards. But I tangible goal to walk towards. But I also think there's a problem when people also think there's a problem when people also think there's a problem when people have to look at their sleep tracker to have to look at their sleep tracker to have to look at their sleep tracker to figure out whether they feel well figure out whether they feel well figure out whether they feel well rested. You shouldn't have to like wake rested. You shouldn't have to like wake rested. You shouldn't have to like wake up like a how did I sleep last night?

up like a how did I sleep last night? up like a how did I sleep last night? Like that should be something that Like that should be something that Like that should be something that people can get from kind of being in people can get from kind of being in people can get from kind of being in touch with their own bodies. And so I touch with their own bodies. And so I touch with their own bodies. And so I think this uh push towards think this uh push towards think this uh push towards quantification needs to be paired with a quantification needs to be paired with a quantification needs to be paired with a vocabulary around how do I think I'm vocabulary around how do I think I'm vocabulary around how do I think I'm feeling today and what does it mean to feeling today and what does it mean to feeling today and what does it mean to live a good life? I love that point. live a good life? I love that point. live a good life? I love that point. It's like, it's so true. My whole life It's like, it's so true. My whole life It's like, it's so true. My whole life evaluated my sleep based on how I feel evaluated my sleep based on how I feel evaluated my sleep based on how I feel and now it's like, "Oh, I feel like a and now it's like, "Oh, I feel like a and now it's like, "Oh, I feel like a good sleep." And I look at my my health good sleep." And I look at my my health good sleep." And I look at my my health tracker and I'm like, "Oh, wait, was it tracker and I'm like, "Oh, wait, was it tracker and I'm like, "Oh, wait, was it not? Do I do I feel tired?" Like, I'm not? Do I do I feel tired?" Like, I'm not? Do I do I feel tired?" Like, I'm trying to like like convince myself, you trying to like like convince myself, you trying to like like convince myself, you know? So, that is a really interesting know? So, that is a really interesting know? So, that is a really interesting point. Yeah. point. Yeah. point. Yeah. >> Yeah. What is something that seems >> Yeah. What is something that seems >> Yeah. What is something that seems radical in healthcare now that will seem radical in healthcare now that will seem radical in healthcare now that will seem ordinary 20 years from now? ordinary 20 years from now? ordinary 20 years from now? >> I love this question. I think honestly >> I love this question. I think honestly >> I love this question. I think honestly it's genetic engineering. recently uh uh it's genetic engineering. recently uh uh it's genetic engineering. recently uh uh we the a person with cickle cell anemia we the a person with cickle cell anemia we the a person with cickle cell anemia we we cured that we I didn't I wasn't we we cured that we I didn't I wasn't we we cured that we I didn't I wasn't part of it but you know the the the part of it but you know the the the part of it but you know the the the medical community uh cured that uh by medical community uh cured that uh by medical community uh cured that uh by using genetic engineering and I think using genetic engineering and I think using genetic engineering and I think that is an amazing uh accomplishment and that is an amazing uh accomplishment and that is an amazing uh accomplishment and and an an amazing innovation amazing and an an amazing innovation amazing and an an amazing innovation amazing improvement I think that people get a improvement I think that people get a improvement I think that people get a little worried um about when they hear little worried um about when they hear little worried um about when they hear like oh we're going to genetically like oh we're going to genetically like oh we're going to genetically engineer so what does that make us not engineer so what does that make us not engineer so what does that make us not human anymore because we're changing our human anymore because we're changing our human anymore because we're changing our genes the reality is that our genes are genes the reality is that our genes are genes the reality is that our genes are changing all the time and we're changing changing all the time and we're changing changing all the time and we're changing them all the time right mutations are them all the time right mutations are them all the time right mutations are normal the things we're breathing in the normal the things we're breathing in the normal the things we're breathing in the things we're eating, those are all things we're eating, those are all things we're eating, those are all causing changes in our DNA. That happens causing changes in our DNA. That happens causing changes in our DNA. That happens all the time. And then from that, we get all the time. And then from that, we get all the time. And then from that, we get diseases. And and so this idea that now diseases. And and so this idea that now diseases. And and so this idea that now we understand better what some of those we understand better what some of those we understand better what some of those mutations and what they mean. And the mutations and what they mean. And the mutations and what they mean. And the fact that we could go in and correct fact that we could go in and correct fact that we could go in and correct them, I think is a positive progression them, I think is a positive progression them, I think is a positive progression that we have for human health, right?

that we have for human health, right? that we have for human health, right? Like you imagine somebody born uh with Like you imagine somebody born uh with Like you imagine somebody born uh with Huntington disease and you know by the Huntington disease and you know by the Huntington disease and you know by the age of 10 they might know that they are age of 10 they might know that they are age of 10 they might know that they are going to die of this like terrible going to die of this like terrible going to die of this like terrible genetic disease that you could just genetic disease that you could just genetic disease that you could just alter back to the normal alil and have alter back to the normal alil and have alter back to the normal alil and have them live a long healthy life. And so I them live a long healthy life. And so I them live a long healthy life. And so I think I think now this feels very very think I think now this feels very very think I think now this feels very very radical and very crazy and not say that radical and very crazy and not say that radical and very crazy and not say that you know I think people think of like you know I think people think of like you know I think people think of like designer babies. there's a lot of designer babies. there's a lot of designer babies. there's a lot of distance between nothing and that distance between nothing and that distance between nothing and that endpoint, right? There's all these endpoint, right? There's all these endpoint, right? There's all these things we can do like for kind of like things we can do like for kind of like things we can do like for kind of like simple improvements of health um that I simple improvements of health um that I simple improvements of health um that I think um will seem I don't know if it's think um will seem I don't know if it's think um will seem I don't know if it's 20 years but will seem I think normal at 20 years but will seem I think normal at 20 years but will seem I think normal at some point. some point. some point. >> I [clears throat] love that and I think >> I [clears throat] love that and I think >> I [clears throat] love that and I think crisper related genetic technologies crisper related genetic technologies crisper related genetic technologies they are the future and they're going to they are the future and they're going to they are the future and they're going to have a um totally transformative impact have a um totally transformative impact have a um totally transformative impact and they're already having and they're already having and they're already having transformative impact as you're saying transformative impact as you're saying transformative impact as you're saying on certain diseases. another really on certain diseases. another really on certain diseases. another really powerful technology which is of course powerful technology which is of course powerful technology which is of course artificial intelligence and I think a artificial intelligence and I think a artificial intelligence and I think a lot about the delivery of healthcare and lot about the delivery of healthcare and lot about the delivery of healthcare and um how in 20 years I think a lot of the um how in 20 years I think a lot of the um how in 20 years I think a lot of the routine types of care that we get today routine types of care that we get today routine types of care that we get today will be delivered mostly by machines. So will be delivered mostly by machines. So will be delivered mostly by machines. So if you have an UTI, if you sprained your if you have an UTI, if you sprained your if you have an UTI, if you sprained your ankle and needed you know uh x-ray um ankle and needed you know uh x-ray um ankle and needed you know uh x-ray um certain other types of things that are certain other types of things that are certain other types of things that are preventative and routine care I think a preventative and routine care I think a preventative and routine care I think a lot of that is going to happen just with lot of that is going to happen just with lot of that is going to happen just with computers and algorithms. I still think computers and algorithms. I still think computers and algorithms. I still think a lot of the more complicated human a lot of the more complicated human a lot of the more complicated human difficult decisions that we have to make difficult decisions that we have to make difficult decisions that we have to make there's going to be a central role for there's going to be a central role for there's going to be a central role for doctors and nurses and other types of doctors and nurses and other types of doctors and nurses and other types of clinicians who are augmented with AI.

clinicians who are augmented with AI. clinicians who are augmented with AI. But I do think that there will be kind But I do think that there will be kind But I do think that there will be kind of two streams in in the way that we get of two streams in in the way that we get of two streams in in the way that we get care. One is this kind of more care. One is this kind of more care. One is this kind of more transactional stream. I mean not transactional stream. I mean not transactional stream. I mean not everyone wants um you know the human everyone wants um you know the human everyone wants um you know the human touch when they're just picking up their touch when they're just picking up their touch when they're just picking up their like uh you know cypro for their UTI. like uh you know cypro for their UTI. like uh you know cypro for their UTI. It's fine if that's transactional. But It's fine if that's transactional. But It's fine if that's transactional. But um if you're diagnosed with cancer or um if you're diagnosed with cancer or um if you're diagnosed with cancer or your parent has advanced heart failure your parent has advanced heart failure your parent has advanced heart failure or dementia um and there's a lot of or dementia um and there's a lot of or dementia um and there's a lot of uncertainty and a lot of integration uncertainty and a lot of integration uncertainty and a lot of integration that's needed of a person's values and that's needed of a person's values and that's needed of a person's values and preferences with the science and the preferences with the science and the preferences with the science and the evidence that's where I think um humans evidence that's where I think um humans evidence that's where I think um humans will still play a really central role uh will still play a really central role uh will still play a really central role uh not just in 20 years but in 50 years. not just in 20 years but in 50 years. not just in 20 years but in 50 years. >> Yeah. I think that last point really >> Yeah. I think that last point really >> Yeah. I think that last point really sparks a thought for me which is that sparks a thought for me which is that sparks a thought for me which is that like a part of the care is the human like a part of the care is the human like a part of the care is the human interaction and like you mentioned like interaction and like you mentioned like interaction and like you mentioned like sort of like palative care or like sort of like palative care or like sort of like palative care or like dementia or things like that right where dementia or things like that right where dementia or things like that right where there the interacting with this trusted there the interacting with this trusted there the interacting with this trusted person right who's like looking you in person right who's like looking you in person right who's like looking you in the eye and taking care of you is a the eye and taking care of you is a the eye and taking care of you is a really important part that you you really important part that you you really important part that you you basically can't replicate right but I basically can't replicate right but I basically can't replicate right but I recently read a study where they showed recently read a study where they showed recently read a study where they showed that depending on the branch of medicine that depending on the branch of medicine that depending on the branch of medicine and the and and the situation there were and the and and the situation there were and the and and the situation there were times when literally AI alone was better times when literally AI alone was better times when literally AI alone was better than AI plus a human or a human alone.

than AI plus a human or a human alone. than AI plus a human or a human alone. Um and and then of course there were Um and and then of course there were Um and and then of course there were areas where you know one of those other areas where you know one of those other areas where you know one of those other two cases was the best. And so I think two cases was the best. And so I think two cases was the best. And so I think that will always be a dynamic um that will always be a dynamic um that will always be a dynamic um situation but ultimately AI is a tool situation but ultimately AI is a tool situation but ultimately AI is a tool and with all tools that kind of humanity and with all tools that kind of humanity and with all tools that kind of humanity has leveraged it just allows us to kind has leveraged it just allows us to kind has leveraged it just allows us to kind of level up what we can do next and and of level up what we can do next and and of level up what we can do next and and so we will never become like uh so we will never become like uh so we will never become like uh obsolete. I think that's what people obsolete. I think that's what people obsolete. I think that's what people worry about. It's just like we we'll worry about. It's just like we we'll worry about. It's just like we we'll focus our attention on the things that focus our attention on the things that focus our attention on the things that matter. All right. You ready for the matter. All right. You ready for the matter. All right. You ready for the next one? next one? next one? >> Yeah. Let's do it. >> Yeah. Let's do it. >> Yeah. Let's do it. >> All right. >> All right. >> All right. >> What do you think should be fair game in >> What do you think should be fair game in >> What do you think should be fair game in biology or medicine that people right biology or medicine that people right biology or medicine that people right now are reluctant about? I think a lot now are reluctant about? I think a lot now are reluctant about? I think a lot about um about um about um how poorly we do in detecting and how poorly we do in detecting and how poorly we do in detecting and treating cancer at an early stage and I treating cancer at an early stage and I treating cancer at an early stage and I think there's a tremendous appetite um think there's a tremendous appetite um think there's a tremendous appetite um from the public to go beyond the types from the public to go beyond the types from the public to go beyond the types of screening that we have today. Look, of screening that we have today. Look, of screening that we have today. Look, there are some people who don't get the there are some people who don't get the there are some people who don't get the colonoscopies and mimographies and colonoscopies and mimographies and colonoscopies and mimographies and papsmears and all those things that we papsmears and all those things that we papsmears and all those things that we have that are very effective at picking have that are very effective at picking have that are very effective at picking up cancer at an early stage. But um but up cancer at an early stage. But um but up cancer at an early stage. But um but there's a lot of people who say look there's a lot of people who say look there's a lot of people who say look that's three or five or even eight that's three or five or even eight that's three or five or even eight cancers that we can pick up but there cancers that we can pick up but there cancers that we can pick up but there are hundreds of types of cancers that are hundreds of types of cancers that are hundreds of types of cancers that people are at risk for and how do we people are at risk for and how do we people are at risk for and how do we detect those at an earlier stage and so detect those at an earlier stage and so detect those at an earlier stage and so there's a real movement. I mean you there's a real movement. I mean you there's a real movement. I mean you think about things like liquid biopsies think about things like liquid biopsies think about things like liquid biopsies where people are um uh taking blood and where people are um uh taking blood and where people are um uh taking blood and trying to see early signs of trying to see early signs of trying to see early signs of malignancies that are circulating in the malignancies that are circulating in the malignancies that are circulating in the bloodstream or even things like full bloodstream or even things like full bloodstream or even things like full body MRIs which I think right now don't body MRIs which I think right now don't body MRIs which I think right now don't have the evidence to recommend to the have the evidence to recommend to the have the evidence to recommend to the general population. The average person general population. The average person general population. The average person should not be going out and getting you should not be going out and getting you should not be going out and getting you know annual MRIs.

know annual MRIs. know annual MRIs. But I think in the future, you know, as But I think in the future, you know, as But I think in the future, you know, as technology improves, as these tests get technology improves, as these tests get technology improves, as these tests get better at picking up um, you know, the better at picking up um, you know, the better at picking up um, you know, the true positives from the false positives, true positives from the false positives, true positives from the false positives, as our imaging improves, I could see a as our imaging improves, I could see a as our imaging improves, I could see a future in which we have a radically future in which we have a radically future in which we have a radically different cancer detection paradigm different cancer detection paradigm different cancer detection paradigm where actually we're able to catch these where actually we're able to catch these where actually we're able to catch these cancers um much earlier and intervene in cancers um much earlier and intervene in cancers um much earlier and intervene in a stage that people can go on to live a stage that people can go on to live a stage that people can go on to live basically a normal life expectancy. What basically a normal life expectancy. What basically a normal life expectancy. What resonates with me in that is this idea resonates with me in that is this idea resonates with me in that is this idea of like of of like of of like of uh more proactivity, right? Like being uh more proactivity, right? Like being uh more proactivity, right? Like being ahead of things rather than being ahead of things rather than being ahead of things rather than being reactive. Um and diagnostics and our reactive. Um and diagnostics and our reactive. Um and diagnostics and our ability uh to leverage new technology ability uh to leverage new technology ability uh to leverage new technology that you know used to be too expensive that you know used to be too expensive that you know used to be too expensive or too impractical that that more and or too impractical that that more and or too impractical that that more and more can be kind of become lowhanging more can be kind of become lowhanging more can be kind of become lowhanging fruit can be things you can do on a fruit can be things you can do on a fruit can be things you can do on a regular routine basis. When I think regular routine basis. When I think regular routine basis. When I think about what people are reluctant about, about what people are reluctant about, about what people are reluctant about, it's it's interesting to me like that in it's it's interesting to me like that in it's it's interesting to me like that in much of our lives, we embrace technology much of our lives, we embrace technology much of our lives, we embrace technology as a way of advancing um a field and and as a way of advancing um a field and and as a way of advancing um a field and and bettering our lives in some way. When we bettering our lives in some way. When we bettering our lives in some way. When we get into a car, we want the most get into a car, we want the most get into a car, we want the most technologically advanced car. When we technologically advanced car. When we technologically advanced car. When we buy a cell phone, we want the most buy a cell phone, we want the most buy a cell phone, we want the most technologically advanced cell phone, technologically advanced cell phone, technologically advanced cell phone, right? That technology, that advancement right? That technology, that advancement right? That technology, that advancement is good. And I think that the narrative is good. And I think that the narrative is good. And I think that the narrative sort of flips a little bit when you look sort of flips a little bit when you look sort of flips a little bit when you look at like the food system and you look at at like the food system and you look at at like the food system and you look at like the health system. Sometimes people like the health system. Sometimes people like the health system. Sometimes people are are sort of reluctant or wary around are are sort of reluctant or wary around are are sort of reluctant or wary around like biotechnology entering the food like biotechnology entering the food like biotechnology entering the food system. But the reality of that is is system. But the reality of that is is system. But the reality of that is is that we can we can make deliberate that we can we can make deliberate that we can we can make deliberate decisions about our food and we can decisions about our food and we can decisions about our food and we can engineer our food to be better.

engineer our food to be better. engineer our food to be better. >> Say a little bit more about that. I mean >> Say a little bit more about that. I mean >> Say a little bit more about that. I mean about using biotechnology to improve the about using biotechnology to improve the about using biotechnology to improve the food supply. When they think about food supply. When they think about food supply. When they think about technology entering the food space, they technology entering the food space, they technology entering the food space, they think about ultrarocessed food. think about ultrarocessed food. think about ultrarocessed food. >> That's such a a great call out. You're >> That's such a a great call out. You're >> That's such a a great call out. You're right that like a lot of what the re right that like a lot of what the re right that like a lot of what the re part of the reason why there is a lot of part of the reason why there is a lot of part of the reason why there is a lot of mistrust of technology is that the mistrust of technology is that the mistrust of technology is that the technology that is in our food system is technology that is in our food system is technology that is in our food system is not always to our benefit. And so I not always to our benefit. And so I not always to our benefit. And so I agree that that engineering or that bi agree that that engineering or that bi agree that that engineering or that bi technology should be being applied in technology should be being applied in technology should be being applied in ways that can actually benefit the end ways that can actually benefit the end ways that can actually benefit the end user's health rather than benefit um you user's health rather than benefit um you user's health rather than benefit um you know like make you more addicted to the know like make you more addicted to the know like make you more addicted to the to the product which is a lot of times to the product which is a lot of times to the product which is a lot of times the case. And so as an example, um you the case. And so as an example, um you the case. And so as an example, um you know, we've done a lot of a lot of know, we've done a lot of a lot of know, we've done a lot of a lot of inefficient genetic engineering over the inefficient genetic engineering over the inefficient genetic engineering over the last several hundred years of like of a last several hundred years of like of a last several hundred years of like of a lot of the common crops we eat today, lot of the common crops we eat today, lot of the common crops we eat today, right? Like tomatoes and things, right? right? Like tomatoes and things, right? right? Like tomatoes and things, right? We do a lot of crossbreeding of them. Um We do a lot of crossbreeding of them. Um We do a lot of crossbreeding of them. Um and and to get this tomato that's like and and to get this tomato that's like and and to get this tomato that's like bright and red and looks wonderful and bright and red and looks wonderful and bright and red and looks wonderful and looks great on the shelf and and then we looks great on the shelf and and then we looks great on the shelf and and then we eat it and it tastes like water and eat it and it tastes like water and eat it and it tastes like water and people are like, "Oh, like this is this people are like, "Oh, like this is this people are like, "Oh, like this is this is terrible, right?" And um the reality is terrible, right?" And um the reality is terrible, right?" And um the reality is that like through crossbreeding we is that like through crossbreeding we is that like through crossbreeding we actually bred out things that provide a actually bred out things that provide a actually bred out things that provide a lot of the micronutrients that tomatoes lot of the micronutrients that tomatoes lot of the micronutrients that tomatoes traditionally have like these traditionally have like these traditionally have like these phyitochemicals and things in an attempt phyitochemicals and things in an attempt phyitochemicals and things in an attempt to make it look red and nice um to make it look red and nice um to make it look red and nice um accidentally through an inefficient form accidentally through an inefficient form accidentally through an inefficient form of genetic engineering through of genetic engineering through of genetic engineering through crossbreeding. We also silence genes crossbreeding. We also silence genes crossbreeding. We also silence genes that allow the fruit to keep creating that allow the fruit to keep creating that allow the fruit to keep creating sugars and polyphenols once once it's sugars and polyphenols once once it's sugars and polyphenols once once it's been picked off the vine. You can been picked off the vine. You can been picked off the vine. You can imagine you could use genetic imagine you could use genetic imagine you could use genetic engineering to go back and just turn engineering to go back and just turn engineering to go back and just turn that gene back on, right? And then now that gene back on, right? And then now that gene back on, right? And then now you have a tomato that looks beautiful you have a tomato that looks beautiful you have a tomato that looks beautiful and it's delicious and people buy it and and it's delicious and people buy it and and it's delicious and people buy it and then now they're eating more fruits and then now they're eating more fruits and then now they're eating more fruits and vegetables which is important, right?

vegetables which is important, right? vegetables which is important, right? And also is has more nutrients, more of And also is has more nutrients, more of And also is has more nutrients, more of the things that we know are good for us. the things that we know are good for us. the things that we know are good for us. The reality is that it's a the The reality is that it's a the The reality is that it's a the technology is a technology. It's a tool technology is a technology. It's a tool technology is a technology. It's a tool and what we apply it to do I think is and what we apply it to do I think is and what we apply it to do I think is what's important. And so um there is a what's important. And so um there is a what's important. And so um there is a lot of kind of like this push and pull lot of kind of like this push and pull lot of kind of like this push and pull against that. But I do think that one of against that. But I do think that one of against that. But I do think that one of the greatest things we can do for human the greatest things we can do for human the greatest things we can do for human health is be more deliberate about about health is be more deliberate about about health is be more deliberate about about how we're uh you know evolving our food how we're uh you know evolving our food how we're uh you know evolving our food system. system. system. >> It's so funny. I've gotten so used to >> It's so funny. I've gotten so used to >> It's so funny. I've gotten so used to beautiful looking, tasteless fruit and beautiful looking, tasteless fruit and beautiful looking, tasteless fruit and vegetables. You know, the other day I vegetables. You know, the other day I vegetables. You know, the other day I was eating a tomato and it was so juicy. was eating a tomato and it was so juicy. was eating a tomato and it was so juicy. I told my wife like, "Why is there so I told my wife like, "Why is there so I told my wife like, "Why is there so much juice in this tomato?" She's like, much juice in this tomato?" She's like, much juice in this tomato?" She's like, "That's what tomatoes are supposed to be "That's what tomatoes are supposed to be "That's what tomatoes are supposed to be like, not these like cardboard, you like, not these like cardboard, you like, not these like cardboard, you know, imprints that you've been eating." know, imprints that you've been eating." know, imprints that you've been eating." And so, uh, you know, what you say like And so, uh, you know, what you say like And so, uh, you know, what you say like resonates so strongly. resonates so strongly. resonates so strongly. >> Move on. >> Move on. >> Move on. >> Let's do it. >> Let's do it. >> Let's do it. >> What do people get wrong about the work >> What do people get wrong about the work >> What do people get wrong about the work you do? you do? you do? >> Uh, you know, I'm I'm a microbiologist >> Uh, you know, I'm I'm a microbiologist >> Uh, you know, I'm I'm a microbiologist and I, you know, we genetically engineer and I, you know, we genetically engineer and I, you know, we genetically engineer uh probiotic bacteria. Uh and the goal uh probiotic bacteria. Uh and the goal uh probiotic bacteria. Uh and the goal is for for that to make that for is for for that to make that for is for for that to make that for products for people to to purchase. And products for people to to purchase. And products for people to to purchase. And I think that the the thing that I think that the the thing that I think that the the thing that everybody assumes that that is wrong is everybody assumes that that is wrong is everybody assumes that that is wrong is that consumers uh won't do not want uh that consumers uh won't do not want uh that consumers uh won't do not want uh genetic engineering. They don't want genetic engineering. They don't want genetic engineering. They don't want GMOs. Uh and and the reality is that um GMOs. Uh and and the reality is that um GMOs. Uh and and the reality is that um they don't want the GMOs that they've they don't want the GMOs that they've they don't want the GMOs that they've currently been given. Um right because currently been given. Um right because currently been given. Um right because there is no benefit to them. Right?

there is no benefit to them. Right? there is no benefit to them. Right? You're asking the people who are You're asking the people who are You're asking the people who are benefiting are different than the people benefiting are different than the people benefiting are different than the people who are taking on the risk. Right? So if who are taking on the risk. Right? So if who are taking on the risk. Right? So if you walk into the grocery store and you you walk into the grocery store and you you walk into the grocery store and you have a choice between non- GMO corn and have a choice between non- GMO corn and have a choice between non- GMO corn and GMO corn, there is no benefit to you to GMO corn, there is no benefit to you to GMO corn, there is no benefit to you to buy the GMO corn, right? The benefit was buy the GMO corn, right? The benefit was buy the GMO corn, right? The benefit was for the seed producer or the farmer, for the seed producer or the farmer, for the seed producer or the farmer, right? And so you you say, "Well, I I right? And so you you say, "Well, I I right? And so you you say, "Well, I I don't know much about GMOs, but I've don't know much about GMOs, but I've don't know much about GMOs, but I've heard that they have some risk or some heard that they have some risk or some heard that they have some risk or some some problem or or they might be bad. So some problem or or they might be bad. So some problem or or they might be bad. So of course, I'm going to buy the non GMO of course, I'm going to buy the non GMO of course, I'm going to buy the non GMO because that's there's all risk and no because that's there's all risk and no because that's there's all risk and no reward, right?" Um and and so the the reward, right?" Um and and so the the reward, right?" Um and and so the the logical fallacy that happens from that logical fallacy that happens from that logical fallacy that happens from that is that then people assume that because is that then people assume that because is that then people assume that because they made that the consumers made that they made that the consumers made that they made that the consumers made that decision that they will reject all GMOs decision that they will reject all GMOs decision that they will reject all GMOs no matter what they do, no matter what no matter what they do, no matter what no matter what they do, no matter what they are. The reality is that people they are. The reality is that people they are. The reality is that people choose things based on risk and benefit choose things based on risk and benefit choose things based on risk and benefit all the time, right? And so we get into all the time, right? And so we get into all the time, right? And so we get into our cars every day and it's an our cars every day and it's an our cars every day and it's an incredibly risky behavior, right? Like incredibly risky behavior, right? Like incredibly risky behavior, right? Like one of the most likely ways for you to one of the most likely ways for you to one of the most likely ways for you to get injured or die is driving a car, but get injured or die is driving a car, but get injured or die is driving a car, but we do it because we say, "Well, that we do it because we say, "Well, that we do it because we say, "Well, that risk is worth the benefit, right?" And risk is worth the benefit, right?" And risk is worth the benefit, right?" And and so of course I'm going to I'm going and so of course I'm going to I'm going and so of course I'm going to I'm going to I'm going to make that choice. and to I'm going to make that choice. and to I'm going to make that choice. and most people do. Um, and I think the same most people do. Um, and I think the same most people do. Um, and I think the same is true with genetic engineering and is true with genetic engineering and is true with genetic engineering and GMOs is that if you use genetic GMOs is that if you use genetic GMOs is that if you use genetic engineering responsibly and build engineering responsibly and build engineering responsibly and build something that creates a benefit for the something that creates a benefit for the something that creates a benefit for the end user, then that's a much different end user, then that's a much different end user, then that's a much different kind of calculus, right? They say, okay, kind of calculus, right? They say, okay, kind of calculus, right? They say, okay, well, I don't know, maybe there's some well, I don't know, maybe there's some well, I don't know, maybe there's some risk with the GMO. I'm not sure. I'm not risk with the GMO. I'm not sure. I'm not risk with the GMO. I'm not sure. I'm not educated on this, but I know that I want educated on this, but I know that I want educated on this, but I know that I want this benefit and so I'm willing to kind this benefit and so I'm willing to kind this benefit and so I'm willing to kind of do that. And obviously, as somebody of do that. And obviously, as somebody of do that. And obviously, as somebody who uses genetic engineering, I believe who uses genetic engineering, I believe who uses genetic engineering, I believe we can make products that don't create we can make products that don't create we can make products that don't create risk. Um and and I think that is risk. Um and and I think that is risk. Um and and I think that is incumbent upon the technologists and and incumbent upon the technologists and and incumbent upon the technologists and and and the inventors uh to to use the and the inventors uh to to use the and the inventors uh to to use the technology responsibly. But ultimately technology responsibly. But ultimately technology responsibly. But ultimately at the end of the day, what people get at the end of the day, what people get at the end of the day, what people get wrong is this assumption that like we wrong is this assumption that like we wrong is this assumption that like we will always throw the baby out with the will always throw the baby out with the will always throw the baby out with the bath water. And that's just not true, bath water. And that's just not true, bath water. And that's just not true, right? Like you make products that

right? Like you make products that right? Like you make products that people want, you do it responsibly, you people want, you do it responsibly, you people want, you do it responsibly, you do it transparently, you align with do it transparently, you align with do it transparently, you align with their values, you give them a benefit their values, you give them a benefit their values, you give them a benefit that they couldn't get any other way, that they couldn't get any other way, that they couldn't get any other way, and you tie that to the technology. And and you tie that to the technology. And and you tie that to the technology. And and and we've seen, you know, 15 million and and we've seen, you know, 15 million and and we've seen, you know, 15 million times that people have chosen chosen times that people have chosen chosen times that people have chosen chosen that technology. that technology. that technology. >> Yeah, that idea of, you know, risk and >> Yeah, that idea of, you know, risk and >> Yeah, that idea of, you know, risk and benefit resonates a lot. And I think it benefit resonates a lot. And I think it benefit resonates a lot. And I think it ties into, you know, my role. Um, you ties into, you know, my role. Um, you ties into, you know, my role. Um, you know, I work as a doctor and as a know, I work as a doctor and as a know, I work as a doctor and as a writer. And as a doctor, I think people writer. And as a doctor, I think people writer. And as a doctor, I think people often have the sense that you are, um, often have the sense that you are, um, often have the sense that you are, um, taking this huge body of scientific taking this huge body of scientific taking this huge body of scientific knowledge and just applying it to the knowledge and just applying it to the knowledge and just applying it to the person in front of you and coming up person in front of you and coming up person in front of you and coming up with a diagnosis and a treatment. And with a diagnosis and a treatment. And with a diagnosis and a treatment. And that's great when it happens. Um but that's great when it happens. Um but that's great when it happens. Um but more often what happens is you're more often what happens is you're more often what happens is you're operating in a type of gray zone where operating in a type of gray zone where operating in a type of gray zone where there isn't a perfect clinical trial and there isn't a perfect clinical trial and there isn't a perfect clinical trial and there isn't um you know uh the exact there isn't um you know uh the exact there isn't um you know uh the exact answer that you want and you're trying answer that you want and you're trying answer that you want and you're trying to walk people through the uncertainty to walk people through the uncertainty to walk people through the uncertainty and you're trying to and you're trying to and you're trying to >> weigh the risks and the benefits and the >> weigh the risks and the benefits and the >> weigh the risks and the benefits and the trade-offs and come up with a solution trade-offs and come up with a solution trade-offs and come up with a solution for someone that works for them. And so for someone that works for them. And so for someone that works for them. And so um so I think there's this uh kind of um so I think there's this uh kind of um so I think there's this uh kind of popular narrative of a doctor as uh popular narrative of a doctor as uh popular narrative of a doctor as uh having the right answer and giving it having the right answer and giving it having the right answer and giving it out and then things get better um or out and then things get better um or out and then things get better um or they don't. Um but a lot of what you're they don't. Um but a lot of what you're they don't. Um but a lot of what you're doing is actually managing um this whole doing is actually managing um this whole doing is actually managing um this whole big morass of gray area where you're big morass of gray area where you're big morass of gray area where you're you're trying to figure out what's you're trying to figure out what's you're trying to figure out what's important to someone and what types of important to someone and what types of important to someone and what types of risks are worth taking for some type of risks are worth taking for some type of risks are worth taking for some type of benefit. And then I think on the on the benefit. And then I think on the on the benefit. And then I think on the on the writing side um you know a lot of what writing side um you know a lot of what writing side um you know a lot of what I'm writing about is uh complicated I'm writing about is uh complicated I'm writing about is uh complicated scientific issues sometimes kind of scientific issues sometimes kind of scientific issues sometimes kind of controversial issues as well and controversial issues as well and controversial issues as well and particularly in the modern media particularly in the modern media particularly in the modern media environment I think people feel like

environment I think people feel like environment I think people feel like you're trying to persuade or convince you're trying to persuade or convince you're trying to persuade or convince people or express a particular point of people or express a particular point of people or express a particular point of view and again sometimes I am trying to view and again sometimes I am trying to view and again sometimes I am trying to u you know project a particular point of u you know project a particular point of u you know project a particular point of view but more often than not I'm just view but more often than not I'm just view but more often than not I'm just trying to figure out what the heck's trying to figure out what the heck's trying to figure out what the heck's going on you know the world is so going on you know the world is so going on you know the world is so complicated things are moving so fast complicated things are moving so fast complicated things are moving so fast that I think there's a lot of value in that I think there's a lot of value in that I think there's a lot of value in just trying to understand reality and just trying to understand reality and just trying to understand reality and put it out there clearly and make let put it out there clearly and make let put it out there clearly and make let people make their own um decisions and people make their own um decisions and people make their own um decisions and draw their own conclusions about um what draw their own conclusions about um what draw their own conclusions about um what is happening and so more often than not is happening and so more often than not is happening and so more often than not it's an exercise in trying to see things it's an exercise in trying to see things it's an exercise in trying to see things as clearly as I can and um put them into as clearly as I can and um put them into as clearly as I can and um put them into writing so that people can um take from writing so that people can um take from writing so that people can um take from that set of facts what they will and and that set of facts what they will and and that set of facts what they will and and so I think um you know not everything is so I think um you know not everything is so I think um you know not everything is uh is kind of expression of a particular uh is kind of expression of a particular uh is kind of expression of a particular agenda or point of view. A lot of it is agenda or point of view. A lot of it is agenda or point of view. A lot of it is just here's the facts as clear as I can just here's the facts as clear as I can just here's the facts as clear as I can see them. As a scientist that resonates see them. As a scientist that resonates see them. As a scientist that resonates immensely, right? I think similarly immensely, right? I think similarly immensely, right? I think similarly people people assume that there's like people people assume that there's like people people assume that there's like an answer, right? And especially when it an answer, right? And especially when it an answer, right? And especially when it comes to something as complicated as comes to something as complicated as comes to something as complicated as biology and human biology, right? Like biology and human biology, right? Like biology and human biology, right? Like as sure as you encounter as a doctor all as sure as you encounter as a doctor all as sure as you encounter as a doctor all the time that there's a vast swath of of the time that there's a vast swath of of the time that there's a vast swath of of realities and everything is in a great realities and everything is in a great realities and everything is in a great there's very few things that are black there's very few things that are black there's very few things that are black and white, right? because your and white, right? because your and white, right? because your individual biology is going to affect individual biology is going to affect individual biology is going to affect your outcome in a lot of ways. And it's your outcome in a lot of ways. And it's your outcome in a lot of ways. And it's the same with science. It's like in the same with science. It's like in the same with science. It's like in these conditions, in this situation, these conditions, in this situation, these conditions, in this situation, right? Um but there's so few black and right? Um but there's so few black and right? Um but there's so few black and whites, everything is in the middle. And whites, everything is in the middle. And whites, everything is in the middle. And I think that people want the answer and I think that people want the answer and I think that people want the answer and you're like, well, this is this is the you're like, well, this is this is the you're like, well, this is this is the heavily caveed answer based on how we heavily caveed answer based on how we heavily caveed answer based on how we set up the experiment, right? And and set up the experiment, right? And and set up the experiment, right? And and that's not interesting or exciting. And

that's not interesting or exciting. And that's not interesting or exciting. And so you sort of get these black and so you sort of get these black and so you sort of get these black and whites and then people extrapolate that whites and then people extrapolate that whites and then people extrapolate that well beyond kind of like your own well beyond kind of like your own well beyond kind of like your own narrative. And you know, I I think it's narrative. And you know, I I think it's narrative. And you know, I I think it's very similar uh uh you as a scientist, very similar uh uh you as a scientist, very similar uh uh you as a scientist, you are a writer as well. That's the you are a writer as well. That's the you are a writer as well. That's the challenge is that um I feel in a way challenge is that um I feel in a way challenge is that um I feel in a way science and medicine is sometimes at a science and medicine is sometimes at a science and medicine is sometimes at a rhetorical disadvantage. Yes. How the rhetorical disadvantage. Yes. How the rhetorical disadvantage. Yes. How the evidence that we have um is applicable evidence that we have um is applicable evidence that we have um is applicable in this case but not in that case and we in this case but not in that case and we in this case but not in that case and we don't want to draw broad conclusions. On don't want to draw broad conclusions. On don't want to draw broad conclusions. On the other side you have a set of people the other side you have a set of people the other side you have a set of people who don't care about any of who don't care about any of who don't care about any of some kernel of truth and just run with some kernel of truth and just run with some kernel of truth and just run with it. So the advantage I think we have is it. So the advantage I think we have is it. So the advantage I think we have is that often the facts are on our side and that often the facts are on our side and that often the facts are on our side and facts tend to ultimately prove out to to facts tend to ultimately prove out to to facts tend to ultimately prove out to to do well in the long run. But it's a do well in the long run. But it's a do well in the long run. But it's a tremendously difficult communication tremendously difficult communication tremendously difficult communication challenge because scientists what challenge because scientists what challenge because scientists what they're often doing is just laying out they're often doing is just laying out they're often doing is just laying out the studies and the facts as they can the studies and the facts as they can the studies and the facts as they can see it with all the relevant caveats and see it with all the relevant caveats and see it with all the relevant caveats and that's not not always the case uh for that's not not always the case uh for that's not not always the case uh for influencers on social media let's say influencers on social media let's say influencers on social media let's say >> right no absolutely I I think that um >> right no absolutely I I think that um >> right no absolutely I I think that um you're exactly right we hold ourselves you're exactly right we hold ourselves you're exactly right we hold ourselves to a different standard right of like to a different standard right of like to a different standard right of like saying what's accurate which is usually saying what's accurate which is usually saying what's accurate which is usually less provocative less interesting and so less provocative less interesting and so less provocative less interesting and so right you take like the sliver of like right you take like the sliver of like right you take like the sliver of like well in these situations this happened well in these situations this happened well in these situations this happened and then and then you kind of have a and then and then you kind of have a and then and then you kind of have a bunch of people make it more interesting bunch of people make it more interesting bunch of people make it more interesting by like making it a hard truth and then by like making it a hard truth and then by like making it a hard truth and then you go way, you know, pendulum swings, you go way, you know, pendulum swings, you go way, you know, pendulum swings, right? And then, oh, turns out that, you right? And then, oh, turns out that, you right? And then, oh, turns out that, you know, this isn't just some magical cure know, this isn't just some magical cure know, this isn't just some magical cure all for everything and then the pendulum all for everything and then the pendulum all for everything and then the pendulum swings all the way back to like, oh, you swings all the way back to like, oh, you swings all the way back to like, oh, you know, so it is really hard to kind of know, so it is really hard to kind of know, so it is really hard to kind of get credible information out there get credible information out there get credible information out there that's also compelling when you're that's also compelling when you're that's also compelling when you're competing in in a world where where competing in in a world where where competing in in a world where where there's so much it's so easy to generate there's so much it's so easy to generate there's so much it's so easy to generate content that is compelling that is not

content that is compelling that is not content that is compelling that is not accurate. accurate. accurate. >> Yeah. I mean, there's so many ways to be >> Yeah. I mean, there's so many ways to be >> Yeah. I mean, there's so many ways to be wrong and there's only a few ways to be wrong and there's only a few ways to be wrong and there's only a few ways to be right. And and so, you know, just if you right. And and so, you know, just if you right. And and so, you know, just if you do the math, it's like if you say do the math, it's like if you say do the math, it's like if you say something, it it's probably going to be something, it it's probably going to be something, it it's probably going to be wrong unless you're take a lot of steps wrong unless you're take a lot of steps wrong unless you're take a lot of steps to figure out if it's actually true uh to figure out if it's actually true uh to figure out if it's actually true uh true or not. true or not. true or not. >> If science can change how our minds and >> If science can change how our minds and >> If science can change how our minds and bodies work, what should stay off bodies work, what should stay off bodies work, what should stay off limits? limits? limits? >> That's a very good question. I think uh >> That's a very good question. I think uh >> That's a very good question. I think uh we were talking about gene editing we were talking about gene editing we were talking about gene editing before and the tremendous promise of before and the tremendous promise of before and the tremendous promise of gene editing for so many people, gene editing for so many people, gene editing for so many people, everything from cickle cell disease to everything from cickle cell disease to everything from cickle cell disease to cardiovascular disease and and beyond. cardiovascular disease and and beyond. cardiovascular disease and and beyond. And um one thing that all those And um one thing that all those And um one thing that all those therapies currently have in common is therapies currently have in common is therapies currently have in common is that they edit sematic cells. Um right that they edit sematic cells. Um right that they edit sematic cells. Um right cells that are skin cells or brain cells cells that are skin cells or brain cells cells that are skin cells or brain cells or organ cells. Basically every cell in or organ cells. Basically every cell in or organ cells. Basically every cell in your body that's not a reproductive your body that's not a reproductive your body that's not a reproductive cell. I think um some people have talked cell. I think um some people have talked cell. I think um some people have talked about editing germline cells and those about editing germline cells and those about editing germline cells and those are cells that go on of course to um are cells that go on of course to um are cells that go on of course to um pass on traits to the next generation pass on traits to the next generation pass on traits to the next generation and potentially propagate throughout the and potentially propagate throughout the and potentially propagate throughout the the species. And I think that most the species. And I think that most the species. And I think that most geneticists and ethicists believe geneticists and ethicists believe geneticists and ethicists believe strongly that we should not be doing.

strongly that we should not be doing. strongly that we should not be doing. And currently I think um we're not doing And currently I think um we're not doing And currently I think um we're not doing that in in humans. And I think that that in in humans. And I think that that in in humans. And I think that should remain an area where we're very should remain an area where we're very should remain an area where we're very cautious about because you don't know cautious about because you don't know cautious about because you don't know the unintended consequences when you put the unintended consequences when you put the unintended consequences when you put out um some new genetic technology that out um some new genetic technology that out um some new genetic technology that makes its way into the next generation makes its way into the next generation makes its way into the next generation and those next generations have not and those next generations have not and those next generations have not consented to have their you know genes consented to have their you know genes consented to have their you know genes changed in XYZ way. And I think changed in XYZ way. And I think changed in XYZ way. And I think relatedly we should be kind of cautious relatedly we should be kind of cautious relatedly we should be kind of cautious about the idea that there are quick about the idea that there are quick about the idea that there are quick fixes genetic or otherwise to problems fixes genetic or otherwise to problems fixes genetic or otherwise to problems of the human condition. And so if you of the human condition. And so if you of the human condition. And so if you think about um you know a lot of people think about um you know a lot of people think about um you know a lot of people let's say are having struggling with let's say are having struggling with let's say are having struggling with anxiety can we find a set of genes and anxiety can we find a set of genes and anxiety can we find a set of genes and edit them to reduce anxiety in the um in edit them to reduce anxiety in the um in edit them to reduce anxiety in the um in the population. I mean that might sound the population. I mean that might sound the population. I mean that might sound like a good thing. On the other hand, like a good thing. On the other hand, like a good thing. On the other hand, you know, anxiety and worry and you know, anxiety and worry and you know, anxiety and worry and preoccupation and fidiousness, these are preoccupation and fidiousness, these are preoccupation and fidiousness, these are all reasons that you might study for an all reasons that you might study for an all reasons that you might study for an exam instead of going out and partying exam instead of going out and partying exam instead of going out and partying the night before um something that is the night before um something that is the night before um something that is really important to you. Uh or ego. You really important to you. Uh or ego. You really important to you. Uh or ego. You know, we have problems with narcissism. know, we have problems with narcissism. know, we have problems with narcissism. Um maybe we want to tone down people's Um maybe we want to tone down people's Um maybe we want to tone down people's ego, which in some cases is probably ego, which in some cases is probably ego, which in some cases is probably good. Uh in other cases might mean that good. Uh in other cases might mean that good. Uh in other cases might mean that um people aren't as striving as they um people aren't as striving as they um people aren't as striving as they were before. They're not as innovative.

were before. They're not as innovative. were before. They're not as innovative. They're not trying to make a name for They're not trying to make a name for They're not trying to make a name for themselves. all things that have themselves. all things that have themselves. all things that have sometimes very positive downstream sometimes very positive downstream sometimes very positive downstream consequences. And so I think my answer consequences. And so I think my answer consequences. And so I think my answer would focus on editing um restrictions would focus on editing um restrictions would focus on editing um restrictions on editing germline cells that are then on editing germline cells that are then on editing germline cells that are then passed on to the next generation. passed on to the next generation. passed on to the next generation. >> Yeah, it's interesting. I'll push back. >> Yeah, it's interesting. I'll push back. >> Yeah, it's interesting. I'll push back. I'll take a a slightly a different I'll take a a slightly a different I'll take a a slightly a different approach to that, but I I hear where approach to that, but I I hear where approach to that, but I I hear where you're going with that. I think kind of you're going with that. I think kind of you're going with that. I think kind of what we were talking about in the last what we were talking about in the last what we were talking about in the last um uh question, the idea of I think it's um uh question, the idea of I think it's um uh question, the idea of I think it's very hard to draw black and white that very hard to draw black and white that very hard to draw black and white that everything when you zoom in enough has a everything when you zoom in enough has a everything when you zoom in enough has a little bit of gray in it, you know, and little bit of gray in it, you know, and little bit of gray in it, you know, and and so I think that this idea of like and so I think that this idea of like and so I think that this idea of like what you stay off limits, it's it's very what you stay off limits, it's it's very what you stay off limits, it's it's very hard to kind of draw a line now that hard to kind of draw a line now that hard to kind of draw a line now that that that you're sure will still make that that you're sure will still make that that you're sure will still make sense 20 years from now, right? And uh I sense 20 years from now, right? And uh I sense 20 years from now, right? And uh I think that there are things on the on think that there are things on the on think that there are things on the on the extreme ends that we could probably the extreme ends that we could probably the extreme ends that we could probably all agree on that are probably silly to all agree on that are probably silly to all agree on that are probably silly to even talk about, right? So, you know, even talk about, right? So, you know, even talk about, right? So, you know, not interesting answers. But like even not interesting answers. But like even not interesting answers. But like even like you said like you know germline like you said like you know germline like you said like you know germline mutations I not saying that I'm mutations I not saying that I'm mutations I not saying that I'm advocating that that we definitely advocating that that we definitely advocating that that we definitely should do that but I think with a should do that but I think with a should do that but I think with a germline mutation like I I think if you germline mutation like I I think if you germline mutation like I I think if you zoomed in enough you find the gray areas zoomed in enough you find the gray areas zoomed in enough you find the gray areas there too right like I mentioned earlier there too right like I mentioned earlier there too right like I mentioned earlier Huntington right like this idea that Huntington right like this idea that Huntington right like this idea that like what if we could we can move that like what if we could we can move that like what if we could we can move that right this is a mutation that that uh right this is a mutation that that uh right this is a mutation that that uh will shorten this person's life like will shorten this person's life like will shorten this person's life like totally in a very simple change could uh totally in a very simple change could uh totally in a very simple change could uh could could make that better and to your could could make that better and to your could could make that better and to your point like there's a lot of unknowns point like there's a lot of unknowns point like there's a lot of unknowns absolutely right that's true with any absolutely right that's true with any absolutely right that's true with any technology but ultimately all technology but ultimately all technology but ultimately all technologies come with unknowns and then technologies come with unknowns and then technologies come with unknowns and then as we work through them and we are as we work through them and we are as we work through them and we are comfortable with those unknowns and we comfortable with those unknowns and we comfortable with those unknowns and we make those trade-offs then at some point make those trade-offs then at some point make those trade-offs then at some point we sometimes decide that that that's we sometimes decide that that that's we sometimes decide that that that's okay and so I'm not saying for sure that okay and so I'm not saying for sure that okay and so I'm not saying for sure that that's what happen mutation I'm not I'm that's what happen mutation I'm not I'm that's what happen mutation I'm not I'm not not advocating passionately that we not not advocating passionately that we not not advocating passionately that we should be doing it but I think that my should be doing it but I think that my should be doing it but I think that my take on this question is it's hard to

take on this question is it's hard to take on this question is it's hard to say what should stay off limits I would say what should stay off limits I would say what should stay off limits I would advocate more what should be off limits advocate more what should be off limits advocate more what should be off limits is close-mindedness like I think at the is close-mindedness like I think at the is close-mindedness like I think at the end of the day and that's not like we end of the day and that's not like we end of the day and that's not like we should we should embrace all possible should we should embrace all possible should we should embrace all possible technological advantages I mean I mean technological advantages I mean I mean technological advantages I mean I mean in all directions we should be thinking in all directions we should be thinking in all directions we should be thinking about like as the inventors and as the about like as the inventors and as the about like as the inventors and as the technologists we should be thinking technologists we should be thinking technologists we should be thinking about what are the impacts we should we about what are the impacts we should we about what are the impacts we should we shouldn't just do something because we shouldn't just do something because we shouldn't just do something because we can, right? We should we should think can, right? We should we should think can, right? We should we should think about like what are the unknowns, what's about like what are the unknowns, what's about like what are the unknowns, what's the consent, what are the ethics of what the consent, what are the ethics of what the consent, what are the ethics of what we're doing and that's not always the we're doing and that's not always the we're doing and that's not always the case. And so that needs to happen. But case. And so that needs to happen. But case. And so that needs to happen. But on the other side, I think the public on the other side, I think the public on the other side, I think the public and the skeptics should also maintain an and the skeptics should also maintain an and the skeptics should also maintain an open mind about like about like while open mind about like about like while open mind about like about like while something may sound scary or dangerous, something may sound scary or dangerous, something may sound scary or dangerous, like when you think about like the cost like when you think about like the cost like when you think about like the cost of not doing it for somebody who is of not doing it for somebody who is of not doing it for somebody who is bearing a lot of risk because we can't bearing a lot of risk because we can't bearing a lot of risk because we can't apply the technology, right? Like we apply the technology, right? Like we apply the technology, right? Like we can't sit in our town in in New York and can't sit in our town in in New York and can't sit in our town in in New York and tell people in Florida like what they tell people in Florida like what they tell people in Florida like what they should be doing about their environment, should be doing about their environment, should be doing about their environment, right? ultimately like they're the right? ultimately like they're the right? ultimately like they're the people bearing the risk of those things. people bearing the risk of those things. people bearing the risk of those things. And I think I think uh it's similar with And I think I think uh it's similar with And I think I think uh it's similar with genetics, right? That at the end of the genetics, right? That at the end of the genetics, right? That at the end of the day, it's it sounds scary to us, but day, it's it sounds scary to us, but day, it's it sounds scary to us, but then what about the person living then what about the person living then what about the person living without disease? >> What is so special about the gut biome?

>> What is so special about the gut biome? >> This is area of deep passion for me, of >> This is area of deep passion for me, of >> This is area of deep passion for me, of course. Uh and I think it's probably not course. Uh and I think it's probably not course. Uh and I think it's probably not news to anybody that it's the gut news to anybody that it's the gut news to anybody that it's the gut microbiome is incredibly impactful on microbiome is incredibly impactful on microbiome is incredibly impactful on human health. There are as many human health. There are as many human health. There are as many bacterial cells as human cells uh in our bacterial cells as human cells uh in our bacterial cells as human cells uh in our bodies. And while all of our human cells bodies. And while all of our human cells bodies. And while all of our human cells uh have the same DNA, um all these uh have the same DNA, um all these uh have the same DNA, um all these bacterial cells have different DNA and bacterial cells have different DNA and bacterial cells have different DNA and they're so they're performing tens of they're so they're performing tens of they're so they're performing tens of thousands more functions than our own thousands more functions than our own thousands more functions than our own our own cells are performing. Um we are our own cells are performing. Um we are our own cells are performing. Um we are really a walking ecosystem. And what's really a walking ecosystem. And what's really a walking ecosystem. And what's even more interesting is that um unlike even more interesting is that um unlike even more interesting is that um unlike our human cells, this bacterial our human cells, this bacterial our human cells, this bacterial community is constantly changing. It's community is constantly changing. It's community is constantly changing. It's very plastic and dynamic. And so uh it's very plastic and dynamic. And so uh it's very plastic and dynamic. And so uh it's not surprising that uh that it has this not surprising that uh that it has this not surprising that uh that it has this huge impact on every aspect of our huge impact on every aspect of our huge impact on every aspect of our health. People have probably heard a lot health. People have probably heard a lot health. People have probably heard a lot of kind of like the gut brain axis and of kind of like the gut brain axis and of kind of like the gut brain axis and this idea that like um our bacteria are this idea that like um our bacteria are this idea that like um our bacteria are kind of like communicating directly with kind of like communicating directly with kind of like communicating directly with our brain and that's true. I mean our brain and that's true. I mean our brain and that's true. I mean literally the chemical language that our literally the chemical language that our literally the chemical language that our brain uses to talk to it to between brain uses to talk to it to between brain uses to talk to it to between cells and neurotransmitters was taken cells and neurotransmitters was taken cells and neurotransmitters was taken from bacteria. Bacteria produce many of from bacteria. Bacteria produce many of from bacteria. Bacteria produce many of the neurotransmitters our brain do. And the neurotransmitters our brain do. And the neurotransmitters our brain do. And the challenge is that we don't right now the challenge is that we don't right now the challenge is that we don't right now understand much more than that than understand much more than that than understand much more than that than that. It's really impactful but it is that. It's really impactful but it is that. It's really impactful but it is such a complex system and and we're such a complex system and and we're such a complex system and and we're really just kind of scratching. It seems really just kind of scratching. It seems really just kind of scratching. It seems like the gut microbiome is incredibly like the gut microbiome is incredibly like the gut microbiome is incredibly diverse, but also a very delicate diverse, but also a very delicate diverse, but also a very delicate balance. You know, in my own work, I see balance. You know, in my own work, I see balance. You know, in my own work, I see if too much of the bad bacteria grow and if too much of the bad bacteria grow and if too much of the bad bacteria grow and you don't have enough of the good you don't have enough of the good you don't have enough of the good bacteria, you can have a devastating bacteria, you can have a devastating bacteria, you can have a devastating infection. If some of the bacteria that infection. If some of the bacteria that infection. If some of the bacteria that are in your gut, the millions and are in your gut, the millions and are in your gut, the millions and billions and trillions of them uh enter billions and trillions of them uh enter billions and trillions of them uh enter the bloodstream on the heart, that could the bloodstream on the heart, that could the bloodstream on the heart, that could be deadly. Um so there is this really

be deadly. Um so there is this really be deadly. Um so there is this really interesting balance and um uh that interesting balance and um uh that interesting balance and um uh that that's required uh inside the body in that's required uh inside the body in that's required uh inside the body in terms of the the microbiome. But it terms of the the microbiome. But it terms of the the microbiome. But it seems like we haven't quite gotten to seems like we haven't quite gotten to seems like we haven't quite gotten to the stage where we can intervene based the stage where we can intervene based the stage where we can intervene based on this knowledge. And so where do we on this knowledge. And so where do we on this knowledge. And so where do we need to go to get to that place? need to go to get to that place? need to go to get to that place? >> Yeah, I think it's a it's it's a very >> Yeah, I think it's a it's it's a very >> Yeah, I think it's a it's it's a very hard question to answer because even hard question to answer because even hard question to answer because even just like kind of pick out the good just like kind of pick out the good just like kind of pick out the good bacteria versus the bad, it's actually bacteria versus the bad, it's actually bacteria versus the bad, it's actually context dependent, right? Like um we context dependent, right? Like um we context dependent, right? Like um we often have heard about bacteria like often have heard about bacteria like often have heard about bacteria like E.coli. It's this like you know it's a E.coli. It's this like you know it's a E.coli. It's this like you know it's a food pathogen it makes you sick. You food pathogen it makes you sick. You food pathogen it makes you sick. You naturally have several strains of ecoli naturally have several strains of ecoli naturally have several strains of ecoli living in your gut and they're living in your gut and they're living in your gut and they're performing really important functions performing really important functions performing really important functions all the time but then there are other all the time but then there are other all the time but then there are other strains that aren't so good. So like strains that aren't so good. So like strains that aren't so good. So like it's the strain level but then it's also it's the strain level but then it's also it's the strain level but then it's also like the context the other bacteria like the context the other bacteria like the context the other bacteria around that are counterbalancing it that around that are counterbalancing it that around that are counterbalancing it that are really important. They create this are really important. They create this are really important. They create this whole complex network and interplay. And whole complex network and interplay. And whole complex network and interplay. And so first thing we do is just learn more so first thing we do is just learn more so first thing we do is just learn more and learn I think more population level and learn I think more population level and learn I think more population level and network level effects of like of of and network level effects of like of of and network level effects of like of of a highly dynamic and highly complex a highly dynamic and highly complex a highly dynamic and highly complex system more complex than anything else system more complex than anything else system more complex than anything else we've ever examined. Basically, the more we've ever examined. Basically, the more we've ever examined. Basically, the more different types of bacteria you have in different types of bacteria you have in different types of bacteria you have in your gut and the more evenly they're your gut and the more evenly they're your gut and the more evenly they're distributed, the more functions you have distributed, the more functions you have distributed, the more functions you have at your disposal. It's basically you're at your disposal. It's basically you're at your disposal. It's basically you're building out a bigger toolbox. And so, building out a bigger toolbox. And so, building out a bigger toolbox. And so, the way you support diversity is eating the way you support diversity is eating the way you support diversity is eating more fiber and not just the absolute more fiber and not just the absolute more fiber and not just the absolute amount of fiber. It's eating a diversity amount of fiber. It's eating a diversity amount of fiber. It's eating a diversity of different kinds of fiber. Different of different kinds of fiber. Different of different kinds of fiber. Different bacteria like different types of fiber.

bacteria like different types of fiber. bacteria like different types of fiber. So, eating lots of different plants So, eating lots of different plants So, eating lots of different plants every day, uh, getting from natural every day, uh, getting from natural every day, uh, getting from natural sources, right? It's not just like put a sources, right? It's not just like put a sources, right? It's not just like put a scoop of 20 grams of fiber in your in, scoop of 20 grams of fiber in your in, scoop of 20 grams of fiber in your in, you know, into your smoothie and like you know, into your smoothie and like you know, into your smoothie and like you're good to go. It's like really you're good to go. It's like really you're good to go. It's like really getting that that all those different getting that that all those different getting that that all those different types of branches and chains of fibers types of branches and chains of fibers types of branches and chains of fibers from all these different foods. Like for from all these different foods. Like for from all these different foods. Like for instance, I try to eat 20 different instance, I try to eat 20 different instance, I try to eat 20 different types of plant every day and and 30 types of plant every day and and 30 types of plant every day and and 30 different types of plant every week um different types of plant every week um different types of plant every week um as a way of supporting a diverse as a way of supporting a diverse as a way of supporting a diverse microbiome. You get a diverse microbiome microbiome. You get a diverse microbiome microbiome. You get a diverse microbiome and you do fiber fermentation in the gut and you do fiber fermentation in the gut and you do fiber fermentation in the gut creates short- chain fatty acids which creates short- chain fatty acids which creates short- chain fatty acids which we know are beneficial. So that's the we know are beneficial. So that's the we know are beneficial. So that's the lowhanging fruit. Beyond that, I think lowhanging fruit. Beyond that, I think lowhanging fruit. Beyond that, I think we just have a lot of work to do to we just have a lot of work to do to we just have a lot of work to do to figure it out. Well, figure it out. Well, figure it out. Well, >> this was great, Zach. Thanks for taking >> this was great, Zach. Thanks for taking >> this was great, Zach. Thanks for taking the time. I really enjoyed this the time. I really enjoyed this the time. I really enjoyed this conversation. conversation. conversation. >> Drew, this was super great. I appreciate >> Drew, this was super great. I appreciate >> Drew, this was super great. I appreciate it. Lots of thought provoking