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Episode: #749: Michael Lewis and Martine Rothblatt

Author: Tim Ferriss: Bestselling Author, Human Guinea Pig
Duration: 02:18:19

Episode Shownotes

This episode is a two-for-one, and that’s because the podcast recently hit its 10-year anniversary and passed one billion downloads. To celebrate, I’ve curated some of the best of the best—some of my favorites—from more than 700 episodes over the last decade. I could not be more excited. The episode

features segments from episode #427 "Michael Lewis — Inside the Mind of the Iconic Writer" and episode #487 "Dr. Martine Rothblatt — A Masterclass on Asking Better Questions and Peering Into the Future."Please enjoy!Sponsors:Shopify global commerce platform, providing tools to start, grow, market, and manage a retail business: https://shopify.com/tim (one-dollar-per-month trial period)AG1 all-in-one nutritional supplement: https://drinkag1.com/tim (1-year supply of Vitamin D [and 5 free AG1 travel packs] with your first subscription purchase.)Eight Sleep’s Pod 4 Ultra sleeping solution for dynamic cooling and heating: https://eightsleep.com/tim (save $350 on the Pod 4 Ultra)Timestamps:[00:00] Start[04:13] Notes about this supercombo format.[05:16] Enter Michael Lewis.[05:54] Why Michael quit his well-paid job to become a full-time author.[12:58] Liar’s Poker is a cautionary tale, not a how-to book.[15:16] On ambition and the metrics of success.[18:31] Maximizing self-satisfaction, optimizing the writing process, and learning to sing.[20:51] The value of having an impolite editor on your side.[23:52] On the merits of productive laziness.[28:13] How Michael determines if a project should proceed.[29:51] Michael's billboard.[32:45] Enter Martine Rothblatt.[33:14] Martine's appreciation for Alan Watts' book on human identity.[35:34] Martine's thoughts on AI-human coexistence in the movie Her.[36:31] BINA48 and realistic human simulations in media.[39:53] Martine's role models and inspirations.[41:20] When Martine started a biotech company to save her daughter's life.[52:44] Glaxo Wellcome's misconceptions about Martine's successful drug.[56:17] Martine's interest in satellite communication systems.[1:00:33] Promoting scientific literacy and curiosity.[1:05:20] Questioning authority and Martine's transgender journey.[1:10:28] Martine's non-binary gender identity.[1:12:34] Key decisions in Martine's transition.[1:13:28] The need for genetic information protection laws.[1:16:00] South American population and organ transplant research.[1:21:42] Vagus nerve manipulation for various therapies.[1:31:25] Martine's Alzheimer's cognitive enabler patent.[1:38:17] The Rothblatt family's "love nights" tradition.[1:43:54] The possibility of machines experiencing love.[1:49:20] Ethical considerations for future technology.[1:52:44] Current practices future generations might view as barbaric.[1:57:42] United Therapeutics' zero-carbon-footprint headquarters.[2:00:32] Refurbishing unusable lungs to save lives.[2:04:45] United Therapeutics' focus on long-term COVID-19 effects.[2:07:26] Martine's billboard.[2:08:27] Advice for finding positivity in life.[2:11:48] Parting thoughts.*For show notes and past guests on The Tim Ferriss Show, please visit tim.blog/podcast.For deals from sponsors of The Tim Ferriss Show, please visit tim.blog/podcast-sponsorsSign up for Tim’s email newsletter (5-Bullet Friday) at tim.blog/friday.For transcripts of episodes, go to tim.blog/transcripts.Discover Tim’s books: tim.blog/books.Follow Tim:Twitter: twitter.com/tferriss Instagram: instagram.com/timferrissYouTube: youtube.com/timferrissFacebook: facebook.com/timferriss LinkedIn: linkedin.com/in/timferrissPast guests on The Tim Ferriss Show include Jerry Seinfeld, Hugh Jackman, Dr. Jane Goodall, LeBron James, Kevin Hart, Doris Kearns Goodwin, Jamie Foxx, Matthew McConaughey, Esther Perel, Elizabeth Gilbert, Terry Crews, Sia, Yuval Noah Harari, Malcolm Gladwell, Madeleine Albright, Cheryl Strayed, Jim Collins, Mary Karr, Maria Popova, Sam Harris, Michael Phelps, Bob Iger, Edward Norton, Arnold Schwarzenegger, Neil Strauss, Ken Burns, Maria Sharapova, Marc Andreessen, Neil Gaiman, Neil de Grasse Tyson, Jocko Willink, Daniel Ek, Kelly Slater, Dr. Peter Attia, Seth Godin, Howard Marks, Dr. Brené Brown, Eric Schmidt, Michael Lewis, Joe Gebbia, Michael Pollan, Dr. Jordan Peterson, Vince Vaughn, Brian Koppelman, Ramit Sethi, Dax Shepard, Tony Robbins, Jim Dethmer, Dan Harris, Ray Dalio, Naval Ravikant, Vitalik Buterin, Elizabeth Lesser, Amanda Palmer, Katie Haun, Sir Richard Branson, Chuck Palahniuk, Arianna Huffington, Reid Hoffman, Bill Burr, Whitney Cummings, Rick Rubin, Dr. Vivek Murthy, Darren Aronofsky, Margaret Atwood, Mark Zuckerberg, Peter Thiel, Dr. Gabor Maté, Anne Lamott, Sarah Silverman, Dr. Andrew Huberman, and many more.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Full Transcript

00:00:00 Speaker_03
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00:01:35 Speaker_03
They currently ship to the United States, Canada, the United Kingdom, Europe, and Australia. This episode is brought to you by Shopify, one of my absolute favorite companies, and they make some of my favorite products.

00:01:50 Speaker_03
Shopify is the commerce platform revolutionizing millions of businesses worldwide, and I've known the team since 2008 or 2009. But prior to that, I wish I had personally had Shopify in the early 2000s when I was running my own e-commerce business.

00:02:04 Speaker_03
I tell that story in the 4-Hour Workweek, but the tools then were absolutely atrocious, and I could only dream of a platform like Shopify.

00:02:12 Speaker_03
In fact, it was you guys, my dear readers, who introduced me to Shopify when I polled all of you about best e-commerce platforms around 2009, and they've only become better and better since.

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00:03:22 Speaker_03
Shopify.com slash Tim. Go to Shopify.com slash Tim to take your business to the next level today. One more time, all lowercase, Shopify.com slash Tim. At this altitude, I can run flat out for a half mile before my hands start shaking.

00:03:39 Speaker_01
Can I ask you a personal question?

00:03:41 Speaker_00
Now is the appropriate time.

00:03:42 Speaker_01
What if I did the opposite? I'm a cybernetic organism living this year over a metal endoskeleton.

00:03:57 Speaker_03
Hello, boys and girls, ladies and germs, this is Tim Ferriss.

00:04:00 Speaker_03
Welcome to another episode of the Tim Ferriss Show, where it is my job to sit down with world class performers from every field imaginable to tease out the habits, routines, favorite books, and so on that you can apply and test in your own lives.

00:04:13 Speaker_03
This episode is a two for one, and that's because the podcast recently hit its 10th year anniversary, which is insane to think about, and passed 1 billion downloads.

00:04:23 Speaker_03
To celebrate, I've curated some of the best of the best, some of my favorites from more than 700 episodes over the last decade. I could not be more excited to give you these super combo episodes.

00:04:35 Speaker_03
And internally, we've been calling these the super combo episodes, because my goal is to encourage you to, yes, enjoy the household names, the super famous folks, but to also introduce you to lesser known people I consider stars.

00:04:49 Speaker_03
These are people who have transformed my life and I feel like they can do the same for many of you. Perhaps they got lost in a busy news cycle, perhaps you missed an episode.

00:04:58 Speaker_03
Just trust me on this one, we went to great pains to put these pairings together. And for the bios of all guests, you can find that and more at tim.blog slash combo. And now without further ado, please enjoy and thank you for listening.

00:05:16 Speaker_01
First up, Michael Lewis, the number one New York Times best-selling author of more than 15 books, including Moneyball, The Blind Side, and The Big Short, which were made into major motion pictures, and his latest, Going Infinite, which delves into the rise and fall of FTX and its founder, Sam Bankman Freed.

00:05:41 Speaker_01
a topic Michael also explores in depth in his critically acclaimed podcast, Against the Rules. You can learn more about Michael at michaellewiswrites.com.

00:05:54 Speaker_03
I'm looking at a paragraph from brainpickings.org, which is run by Maria Popova, who I'm very fond of, and there's a piece on your writing process.

00:06:06 Speaker_03
She may have been quoting a different source, but I just want to read something quickly, and then we can discuss. These are your words.

00:06:12 Speaker_03
Before I wrote my first book in 1989, the sum total of my earnings as a writer over four years of freelancing was about $3,000.

00:06:18 Speaker_03
So it did appear to be financial suicide when I quit my job at Salomon Brothers, where I'd been working for a couple of years and where I'd just gotten a bonus of $225,000, which they'd promised they'd double the following year to take a $40,000 book advance for a book that took a year and a half to write.

00:06:34 Speaker_03
Was that a hard decision, or was it something you'd just been biding your time for?

00:06:40 Speaker_02
You put it very well. It was something I'd been biding my time for. When I went into Salomon Brothers, I knew that this was a temp gig. I'd be there for a few years. And I was there more out of curiosity about how this world worked.

00:06:55 Speaker_02
than I was to advance a career. In fact, aside from the money, which I liked, I didn't think really much about the career at Sullivan Brothers because I knew I could only hang on, my interest would only last for so long.

00:07:08 Speaker_02
And I was intensely interested in it as I was learning about it. But when I kind of figured it all out and got a sense of how it all worked and there weren't any more questions I had that needed to be answered, I really started to get bored.

00:07:19 Speaker_02
But the whole time I was there, I was writing. I got myself in trouble because I naturally tend to write kind of about what's around me. And so I started to write things about this great boom that was happening on Wall Street.

00:07:33 Speaker_02
It was really the beginning of what we still live with, this notion of 22 or 23 year olds rolling on and making a fortune. The sums of money being made on Wall Street and the share of the economy it occupied was expanding rapidly.

00:07:46 Speaker_02
And no one quite understood why. So there was a natural market for me to sort of try to explain it. And I mentioned the Wall Street Journal asked me to write op-eds for them. I wrote an op-ed arguing that investment bankers were overpaid.

00:08:00 Speaker_02
And in the bottom of the op-ed, it said Michael Lewis is an associate with Salomon Brothers in London.

00:08:05 Speaker_00
Oh, God.

00:08:06 Speaker_02
Well, but, you know, I tell you, I must have, like, a blind streak, right? Because my reaction was, wow, great piece. You know, when they sent me the galleys or whatever it was, I was like, this is fabulous.

00:08:18 Speaker_02
And I didn't even think, what are the people at Salomon Brothers gonna think? Except maybe they're gonna be thinking it's so cool that I wrote an article in the Wall Street Journal.

00:08:25 Speaker_02
I got to work the next day, and there's a fellow who ran all of Salomon Brothers International. Delightful guy. He was the guy who had hired me in the first place. And he was ashen-faced sitting at my desk with this little newspaper on his lap.

00:08:40 Speaker_02
And he said, Michael, I mean, it was really not in anger. It was more in sadness. He said, Michael, you have no idea of the damage you've done. And I was kind of like, what do you mean?

00:08:49 Speaker_02
He said, this thing is being picked up all over the United States, and we've had a crisis meeting overnight of the Salomon Brothers board. What to do about it?

00:08:59 Speaker_02
They couldn't or wouldn't have fired me because I had just flukily started to generate a whole lot of money for them. Like a whole lot of money. I was essentially a salesperson and I had at that point the second...

00:09:11 Speaker_02
biggest money-generating account in the entire firm, and the person would speak only to me, even though I'd only been there a year and a half. It was basically the most sophisticated hedge fund sort of manager in Europe.

00:09:25 Speaker_02
And so they didn't want to fire me because they didn't want to lose him. He said to me, my boss, said, what are we going to do about this? And I said, I don't really want to do anything about this. And he said, well, we need you to stop writing.

00:09:37 Speaker_02
And I said, I'm not going to stop writing. It's what I love to do. And he had the bright idea. He said, could you write under a different name? And I said, no problem. I can do that. And he said, what name are you going to use?

00:09:48 Speaker_02
Actually, it just popped into my head. I'll use my mother's maiden name. So I wrote under the name Diana Bleeker for maybe the next nine months or a year. Maybe not quite that long, but I wrote half a dozen pieces. They got better and better.

00:10:01 Speaker_02
I was getting better and better because I had better and better editing. So Michael Kinsley, who was then editing The New Republic, had walked into my life. And he was teach giving me writing lessons, basically, in the way he edited the pieces.

00:10:14 Speaker_02
But the pieces Diana Bleeker was writing, I mean, I really felt off the leash because nobody could trace it back to me. I was almost describing the trading floor around me in pieces. And people were circulating. It was really great.

00:10:27 Speaker_02
I was sitting in London at my desk doing my business, and I would watch people Xeroxing articles I'd written in the New Republic under Diana Bleeker and pass them out on the trading floor.

00:10:37 Speaker_02
And so I had a sense that, like, God, people are hungry for this. People are laughing, people are... It was just working.

00:10:43 Speaker_02
Now, the money part of it, what happened was, I came home one night to my house in London, picked up a phone call, and it was a man named Ned Chase, who happens to be Chevy Chase's dad, who was a senior editor at Simon & Schuster.

00:10:59 Speaker_02
And he said, I figured out who Diana Bleeker was, and I got your number. I never found out how he did that. We think you should write a book. And at that point, I thought, I'm out.

00:11:09 Speaker_02
If someone will publish a book by me, I'm not hanging around the Wall Street firm any longer. I did hang around an extra three months to get my bonus. But the minute I saw the money hit the bank account and I knew they couldn't take it back, I left.

00:11:21 Speaker_02
And not because I disliked them. It was just I loved a lot of the guys there. Mostly, it was almost all guys. I really liked my bosses, generally. I just was bored with the work, and I had this other thing I loved to do.

00:11:34 Speaker_02
You know, I had two conversations in which people tried to say, oh, don't do that. Don't walk away from a sure fortune to go take a flyer on writing a book. One was my bosses who took me into a room, and this tells you just how innocent an age it was.

00:11:51 Speaker_02
I mean, these days you'd be in a room with lawyers, right? And you'd be told you signed this non-disclosure agreement and you're writing anything about anything. They didn't care about it. They were worried about my sanity.

00:12:01 Speaker_02
They were actually worried about my career. They couldn't believe that I was gonna walk away from this really cushy situation and go and do that other thing. So they were trying to help me. And I just said, you know, I got this feeling I gotta do this.

00:12:16 Speaker_02
My father said, you know, you really could just wait. You really could just collect some millions of dollars and then write your books. But the problem was, I was, what, 27 at the time?

00:12:29 Speaker_02
I looked ahead of me, and I looked at people who were 35 or 37, and they seemed ancient, and they seemed completely stuck. Like, they made so much money, and their lives had adapted to the making of money. They depended on the making of money.

00:12:44 Speaker_02
I just thought, there's no way I'd spend a lot of time here and still even want to do this. I'd be trapped, and I don't want to do that. So, I ignored all that advice and just went and did it, and it worked out, you know? That was Liar's Poker.

00:12:58 Speaker_03
And Liar's Poker, at least I've read, was intended to be a cautionary tale of sorts. It's not how everybody took it. I mean, it's a very exciting book.

00:13:07 Speaker_02
The thing is, it's like a funny book. It was a funny story.

00:13:10 Speaker_03
It's a very, very funny book.

00:13:11 Speaker_02
And it's also an incredible story because you're seeing this transformation of this industry and the effect on all these young people. But I had only one kind of moralistic thought in mind when I wrote it.

00:13:25 Speaker_02
Because I really just thought my models that I had in my head when I wrote it, were Education of Henry Adams and Rousseau's Confessions. The model was just tell the world what happened exactly as you remember it, and that's enough.

00:13:40 Speaker_02
You don't need to layer on an interpretation of what happened. What happens, good enough.

00:13:45 Speaker_02
And the extent I wanted kind of to push the reader in any direction, it was just really young readers, like people in college, that I hoped would read it and would say, Yeah, I now know what this is. Yeah, there's money there.

00:14:01 Speaker_02
But a lot of it's kind of silly. And I have these other things I want to do with my life, and I'm going to go do them.

00:14:07 Speaker_02
So I'm not going to be seduced by Goldman Sachs or have Goldman Sachs prey on my anxiety about my future when I'm walking out of my college. I'm going to go do what I'm meant to do.

00:14:17 Speaker_02
And I felt that way because I had watched classmates at Princeton just naturally drift into the arms of the investment banks because they really couldn't, they felt they couldn't resist the money and they were anxious about not being successes.

00:14:29 Speaker_02
Then what happens is the book comes out and the book makes it seem, because it was, as business goes, incredibly colorful and entertaining and lucrative.

00:14:40 Speaker_02
And I had dozens of letters a day from young readers saying, dear Mr. Lewis, I really loved your how-to book about Wall Street, about how to make money on Wall Street.

00:14:52 Speaker_02
And I'm hoping that there's some tips in there that you didn't put in there that you could let me know so I have an edge. It just fueled the desire of young people to want to do it more. And I didn't see that coming.

00:15:04 Speaker_02
And that's something, I don't know, anybody who writes books, I think, learns that you write a book, but the reader reads a book. And the reader may read a book that's entirely different from what you thought you wrote.

00:15:14 Speaker_02
And you can't really do that much about it.

00:15:16 Speaker_03
How do you think about, if you do, ambition? And this may not be a good question, but it seems like, from what I've read, the overt ambition that people wear on their shirt sleeves in certainly many parts of Wall Street, you find

00:15:32 Speaker_03
off-putting or maybe in bad taste, but you certainly don't shy away from ambitious projects, right? How do you personally think about ambitious? And I don't want to put words in your mouth either.

00:15:43 Speaker_02
No, no, it's an interesting way to frame the question. How do I think about ambition?

00:15:48 Speaker_02
Well, I could tell you I thought it was so comical that I was going to be in this ambitious money-making world that the week before I went to Salomon Brothers, I went into Paul Stewart, this men's store, because I saw it through their window.

00:16:03 Speaker_02
I saw they had red suspenders with little gold dollar signs on them. And I thought, this is like a way to make fun of the whole thing. And nobody thought it was funny. Nobody thought it was like, you can't wear that shit around here.

00:16:15 Speaker_02
You can't wear that shit until you are a big enough deal to wear that shit. I've always been enormously ambitious in a way. I've always wanted my life to be great. Like, really great. I'm competitive. Like, very competitive. And I love competitive sports.

00:16:30 Speaker_02
I love winning. I don't particularly like losing. I guess, number one, I don't accept money as an accurate measure or any kind of real measure of whether you're winning or losing. So money doesn't have that hold on me. Fame, a bit more.

00:16:50 Speaker_02
I mean, I would say a lust for attention and fame is probably closer to a vice of mine than a lust for money and fortune. But even that, I find I get tired of, and it just doesn't interest me that much.

00:17:05 Speaker_02
I don't think I'm a maximizer in that I try to get a lot of a thing. It's more, if I'm trying to maximize anything, it's a feeling. And it's a feeling that that was a kick-ass book. I can look at something and just say, that is a great piece of work.

00:17:20 Speaker_02
That feeling is what I'm kind of always gunning for, and it's a pretty private feeling. And I think over time, I mean, you must have found this too, that the response that I have to external validation has become muted and numbed.

00:17:37 Speaker_02
And when I got a glowing review for Liar's Poker, and it went to the top of the New York Times bestseller list, it was like dancing all over my kitchen. I mean, I was just happy as a clam. I couldn't believe that it was like I just won the Super Bowl.

00:17:51 Speaker_02
And now, I don't read the reviews. I sometimes forget whether a book is on the New York Times bestseller list or not. I'm not paying as much attention to it. It doesn't gratify me in the same way.

00:18:05 Speaker_02
The gratification I get from looking at something that I think I've done that's really good is at least as great as it was back then. I think I'm tapping into that.

00:18:13 Speaker_02
I think I'm tapping into like the pleasure I got when I was just all by myself in a room laughing at my own jokes. It's sort of like maximizing self-satisfaction.

00:18:23 Speaker_02
Which is maybe not the most attractive trait that my ambition is to maximize my self-satisfaction. Maybe that's my ambition.

00:18:32 Speaker_03
let's jump into the process associated with the maximizing the self-satisfaction. You mentioned laughing at your own jokes.

00:18:40 Speaker_03
I have read that you sometimes write late at night, say midnight, you put on a headset and play the same soundtrack of, say, 20 songs over and over again. Is that something that you still do?

00:18:52 Speaker_02
Yes. In fact, I did it yesterday. Kids screwed up my natural writing My natural rhythm would be to kind of start about four in the afternoon and write till three in the morning and sleep until noon, but you can't do that with kids.

00:19:07 Speaker_02
So I now, I'm not as likely to be found late at night at my desk, though it happens sometimes. But whenever I'm writing, I have... headphones on, and I have a soundtrack I write to. And the soundtrack changes. It changes book to book.

00:19:24 Speaker_02
And it's got to the point where both my wife and my kids will recommend songs for the soundtrack for whatever the next project is, and I'll build a soundtrack intentionally. And the music is, you know, it's all over the map.

00:19:36 Speaker_02
It tends to be very up, but it tends to be music that I just stop hearing. And I noticed something really funny just the last couple of weeks, because

00:19:47 Speaker_02
I'm working on something now, the second season of my podcast, where I have a different relation to music.

00:19:54 Speaker_02
The podcast is about coaching, and the last episode, which I have still not written, it's the only episode I haven't written, is me getting coached in something I'm incredibly uncomfortable doing, and it's singing.

00:20:05 Speaker_02
I've been doing voice lessons an hour every day for the last three months. And there's a song I sing, and I'm not going to tell you which one it is, that I'm going to have to sing, that I've been practicing, that happens to be on my soundtrack.

00:20:19 Speaker_02
And now I realize I have to remove it because it kicks my brain into a different space. All of a sudden I hear it and it's like Pavlovian. I've got to belt out the tune, I've got to worry about hitting a high note, and it screws up my writing.

00:20:31 Speaker_02
I've just been hitting skip because I've been reluctant to change that, but I'm just gonna have to remove it. So it puts me, the music puts me in, the purpose of it is to shut out the possibility of interruption.

00:20:42 Speaker_02
I can't hear knocks on the door, phones, people dropping packages on the front porch, anything. I'm just in my own space. And I kind of cease to hear the sound. You mentioned Michael, was it Kinsley?

00:20:54 Speaker_03
Is that right? The editor? They're the New Republic. What made him a good editor or what did you learn from him? Can you remember anything that he helped tighten or improve?

00:21:04 Speaker_02
So Michael Kinsley had a gift for creating writers. There are dozens of people who were young writers then who he had profound influence on and careers that he just launched. And it's an odd assortment. And I was one of those people.

00:21:22 Speaker_02
I think what happens with writers who come up in a conventional way, like through creative writing programs or by writing for their circle of friends, is they get treated too politely. Their work gets treated too politely. So they don't hear

00:21:38 Speaker_02
a really withering critique of their work. And Michael Kinsley could not help himself. He delivered the most withering critiques of your work. The kind of throat-clearing, phony first paragraph, which was totally unnecessary.

00:21:52 Speaker_02
It would come back and it'd be just a big X through it. Why'd you even write that? Start here. It would be, I can't remember. I had learned a word that was just a completely obscure word. And I even remember the word, but I don't know how to pronounce it.

00:22:06 Speaker_02
It's Chthonian. It starts C-H. I think it means of the underworld. And I remember working it into the piece, and like a big circle around it saying, you fucking phony. What did you do? Go into the thesaurus? It was just like making merciless fun of me.

00:22:24 Speaker_02
My byline, at the very beginning, I thought it sounded good for it to be Michael M. Lewis. My middle name is Monroe. I thought a middle initial kind of fancied it up. He put a big circle around it and said, don't do that.

00:22:37 Speaker_02
You know, don't be one of those people. You're not Michael M. Lewis. You're Michael Lewis. He was all the preposterous things that you naturally tend to do when you're putting

00:22:46 Speaker_02
you know, words on paper, he identified all of them as vices and stopped you from them. And so, in addition, he was unbelievably gifted at seeing what a good story was.

00:22:58 Speaker_02
You started to learn what was interesting and what wasn't just talking to him, just by how he responded to what you said. It was a kind of feedback. that everybody should get, but that most people are too tender and sensitive to deliver.

00:23:13 Speaker_02
It's a funny thing. I think that this happens in speech, too. I think that there's lots of inefficiency in human conversation, that people do all kinds of things they really shouldn't do, and that other people make fun of them for doing.

00:23:26 Speaker_02
People are endlessly telling stories about what some other person said, making fun of them. And it shouldn't be that way. We should be very efficient conversationalists because we do it all the time, but we aren't because we don't get feedback.

00:23:36 Speaker_02
Because people are too polite. And I think people are too polite with other people's writing. And what Michael Kinsley, his great gift in addition to being a kind of genius, was he just couldn't be polite. He was just so blunt.

00:23:47 Speaker_02
I'm Michael Lewis on my books instead of Michael M. Lewis because of Michael Kinsley.

00:23:52 Speaker_03
I have a question for you about, maybe this isn't the right word, but productive laziness.

00:23:57 Speaker_03
I was looking at an article that talked about a speaking gig from 2017, Qualtrics, you might know where this is going, but the quote that stuck out to me was, attributed to you, people waste years of their lives not being willing to waste hours of their lives.

00:24:13 Speaker_03
And I don't know if that prompts any memories, but is that something you can elaborate on?

00:24:17 Speaker_02
Sure, that wasn't a quote from me, it was a quote from one of my characters, Amos Tversky. He's one of the main characters in The Undoing Project. And it resonated with me. What he meant was that people don't back away from their work.

00:24:33 Speaker_02
And especially the need to always seem busy or be busy stops people from finding things that are really worth doing and sifting the ones that are worth doing from the ones that aren't worth doing.

00:24:43 Speaker_02
So it resonates with me because I am not a person who always has to be doing something. And in fact, my natural state... is probably inert, that I can really just lay around and screw off and procrastinate with the best of them.

00:25:01 Speaker_02
And it's partly because of how I grew up. I mean, I grew up in New Orleans, and there was not a whole lot of value attached to either ambition or career achievement.

00:25:10 Speaker_02
You were who you were because of how you were and who your family was and what neighborhood you grew up in and where you went to school. You were always so well-defined by your environment that trying to change it

00:25:22 Speaker_02
by doing stuff, didn't seem to make a whole lot of sense.

00:25:26 Speaker_02
And my father used to tell me, and it was, and I believed this until I was about 20, on our family coat of arms, there was a motto in Latin, and the motto was, do as little as possible, and that unwillingly, for it is better to receive a slight reprimand than to perform an arduous task.

00:25:45 Speaker_02
And he would just say that like, just keep that in mind, we live by these words. And so that's my kind of where I was coming from just generally. And I found this thing that didn't feel like work. So it didn't feel like an attempt at achievement.

00:26:01 Speaker_02
Not that achievement was bad, it's just that's not why I was doing it. But having said that, you know, I do find that being able to back away and get yourself, myself, in a state of mind in which I can say, it's okay if I never write anything else.

00:26:16 Speaker_02
It's okay if I never write another book. It's okay if I don't do anything for six months. And I can afford that now, and that's nice to be able – it's a luxury to be able to afford it.

00:26:25 Speaker_02
But I think a lot of people who can afford it don't actually take advantage of the luxury, because I think that doing that, putting yourself in a state of mind where, all right, I've got to make an argument about why I need to write another book, because I don't have to.

00:26:39 Speaker_02
changes your relationship to potential stories and potential material. It requires the material to rise to the level of interest where you feel obliged to engage with it.

00:26:50 Speaker_02
So you're not doing it just because you gotta write another book, you're doing it because, how can I not write this? And it serves my own sloth and indolence, serves as a kind of filter.

00:27:03 Speaker_02
And the filter is, no, I don't have to do that, so I'm not going to do that. I don't particularly want to do that, so I'm just not going to do that.

00:27:10 Speaker_02
And even if you tell me that, oh, it's got big bestseller written all over it, I'm not interested because it keeps me off that path. I think it's been very useful because it does two things at once.

00:27:21 Speaker_02
One is it raises the level of the bar that the material has to jump over to get to me. So the material is going to have to be really good if I'm going to engage with it. And two,

00:27:33 Speaker_02
It stops me from doing the same thing over and over again just to be successful. It enables me to, almost encourages me to move around and do surprising things.

00:27:44 Speaker_02
And I think readers and audiences really appreciate and will engage with the writer who's willing to take risks.

00:27:53 Speaker_02
that yeah, they like some of their writers to just keep doing the same things over and over again, but they'll follow you if you take a brave risk. Since I'm not doing it, I'm not trying to create the next sure-fire bestseller.

00:28:07 Speaker_02
I'm led to other and sometimes unlikely material. So the books end up being about a lot of different things.

00:28:14 Speaker_03
What are some of the questions or thresholds that indicate the material has risen above the necessary hurdles?

00:28:23 Speaker_03
I found one question, I don't know if this is you or not, so feel free to confirm or deny, but would I be sad if this story didn't get told?

00:28:33 Speaker_02
Yeah, that's funny. That is one. It's a really good question because there's not a clear-cut rule that I follow except feeling. And there are a couple of feelings that I associate with the desire to write a book.

00:28:48 Speaker_02
One is a feeling that if I don't do it, it won't properly get done because I have some privileged access to the story.

00:28:58 Speaker_02
And there are lots of different ways you can have privileged access to the story, but the sense that, yeah, this book really should be written, and someone needs to do it, and that someone is clearly me.

00:29:07 Speaker_02
The second and related feeling is I have an obligation to the material. It isn't... the material has an obligation to me as a writer. It's I have an obligation to this material. And once I have that feeling, I have a motive. I have a motive.

00:29:21 Speaker_02
And whether I'm fooling myself or not, it's a motive that's a deeper and more inspiring motive than, oh, I got to make a living, or, oh, I got to get a book on the bestseller list, or, oh, I got to have something to tell my friends when they ask me, what are you doing?

00:29:35 Speaker_02
It's the highest motive. It's I have an obligation. I have a duty. And I've had that feeling with every book I've written. How it gets to that point, I mean, they take their different paths to that point.

00:29:47 Speaker_02
But it obviously is some feeling in myself that this is an important story.

00:29:51 Speaker_03
If you could put a message, a quote, a question, anything at all on a billboard, metaphorically speaking, that would reach billions of people,

00:30:03 Speaker_03
Does anything come to mind, non-commercial, that you might put on a billboard, a saying, a mantra, something you remind yourself of, anything at all?

00:30:12 Speaker_02
It's gonna sound trite, whatever I say. And let me just say that I live in the world's capital of bumper stickers. At Berkeley, California... There are more bumper stickers per automobile than anywhere else in the world. It's been scientifically proven.

00:30:27 Speaker_02
You can walk down the street, and it's mostly political stuff, but it's just like people getting their point across in bumper stickers.

00:30:33 Speaker_02
And I have never had a bumper sticker on my car because it's not one thing I've ever wanted to say over and over forever. I'm not a bumper sticker or quote guy. However, if you say I got to put it up on a billboard, I would take

00:30:48 Speaker_02
the mantra of my high school baseball coach, one of the greatest men I've ever known, who is actually the subject of one of the podcast episodes. And he would just say it routinely, and it just kind of became part of you.

00:31:00 Speaker_02
He would say, don't be good, be great. And he'd say it to you as he handed you the ball to go out to pitch a game. He'd say it to you when you were working out. And you just, having that in mind,

00:31:11 Speaker_02
It's the kind of thing I try to keep in mind when I'm working on something. Good is not okay. If you're gonna do it, be great. Push yourself. And it's hard. And, you know, don't just stop when it's good enough. That's what I would stick on a billboard.

00:31:28 Speaker_02
It's one of those things that's in the billboard of my mind. Don't be good, be great. I love it. That's Billy Fitzgerald?

00:31:36 Speaker_03
Billy Fitzgerald. Just a quick thanks to one of our sponsors and we'll be right back to the show. I usually drink it in the mornings and frequently take their travel packs with me on the road. So what is AG1?

00:32:05 Speaker_03
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00:32:37 Speaker_03
Last time, drinkag1.com slash Tim. Check it out.

00:32:46 Speaker_01
And now, Dr. Martine Rothblatt, an American lawyer, author, and entrepreneur, and the chairperson and CEO of United Therapeutics, a biotechnology company she founded in 1996 to save the life of one of her daughters.

00:33:04 Speaker_01
You can learn more about Dr. Rothblatt and the work of United Therapeutics at unither.com.

00:33:14 Speaker_03
Martine or Dr. Rothblatt, both, welcome to the show. Thank you for making the time. Thanks so much, Tim. Just martines, fine.

00:33:22 Speaker_03
All right, and this interview, as my listeners might imagine, was challenging in the best way to prepare for because there are a million and one directions that we can go with just this bio alone, which is of course a snapshot, a distillation of much more that you have done.

00:33:40 Speaker_03
And I thought we could start in perhaps an unlikely place, and that is Alan Watts. I have read that you are a fan of Alan Watts, and specifically the book, subtitled On the Taboo Against Knowing Who You Really Are.

00:33:55 Speaker_03
Could you please explain, if that is true, why that is the case?

00:34:01 Speaker_00
Yes, thanks, Tim. Alan Watts has a really unique ability to see the dialectic aspect of everything in nature. By that, I mean that there's a kind of a yin-yang aspect to everything in nature.

00:34:16 Speaker_00
And he points out that, for example, you can't have a crest of a wave without the bottom of a wave. And it has helped me whenever I see things in life that seem negative to be able to look at it in another way and see the positive in it.

00:34:34 Speaker_03
When were you first introduced to his work? How did that come about?

00:34:40 Speaker_00
I was first introduced to it through the literature of this philosophy called transhumanism, sort of the idea that people can transcend some biological human limitations.

00:34:52 Speaker_00
A friend of mine, Frank Sazanowski, who is the head of the National Organization on Rare Diseases, pointed me in the direction of some Jesuits.

00:35:03 Speaker_00
He himself is both a Jesuit and an FDA lawyer, but he pointed me in the direction of some Jesuits, such as Teilhard de Chardin from France and other individuals here in the US. And then from those Jesuits, they referred to Alan Watts.

00:35:20 Speaker_00
I'm not sure if he was actually a Jesuit, but he undertook some religious training, both in China, I think, and in the US. He was a radio announcer for many years in San Francisco, I think during the 70s or 80s.

00:35:34 Speaker_00
I don't know if you remember, Tim, the film of a few years ago, Her, in which like a computer... I do. Yep. So I was watching that movie, which kind of is...

00:35:45 Speaker_00
interesting to me because it epitomized or it visualized the concept of computers becoming sentient. And in the middle of that movie, there's a scene in which Alan Watts appears. And I stood up in the movie theater and I said, oh my God, Alan Watts.

00:36:04 Speaker_03
Did you ultimately find the presentation in that movie to be compelling as it relates to sort of sentient intelligence?

00:36:12 Speaker_00
I did. I thought it was an accurate depiction of a likely way that sentience would begin to arise in our society, basically by being very, very useful to people, cleaning up their inboxes, stuff like that.

00:36:26 Speaker_03
This may be a good place, and we're gonna be all over the place in non-linear fashion. Bina48, who or what is Bina48, if I'm pronouncing that correctly?

00:36:36 Speaker_00
Yep, you've got it perfectly. So Bina's the name of my partner, and we've been married for about 40 years, and when she was 48,

00:36:46 Speaker_00
we undertook a joint project to try to create a digital simulacra or a digital copy of her basic personality with a lot of her memories and thoughts. And we thought this would be a very nice project as a combination of science and art and

00:37:04 Speaker_00
To encourage young people get them more excited about computer science and women in particular girls in particular.

00:37:11 Speaker_00
So we contracted with a couple of companies who were experts in both the software engineering side and in the physical modeling of a face that moves exactly like a human face does you might imagine.

00:37:26 Speaker_00
There's this exhibit at Disney World, Disneyland, of Lincoln and whatnot, something like that, but more realistic. We built this project, and since that time, Bina48 has thrilled audiences all around the world.

00:37:40 Speaker_00
I'm sure she has inspired hundreds, if not thousands, of girls to go into computer science, and she continues to get better and better, more and more advanced software.

00:37:50 Speaker_03
I don't know if you have watched the series Black Mirror before, but I find some of their episodes to be very strong.

00:37:58 Speaker_03
And in one of them, a significant other is effectively resurrected by pulling data and patterns and therefore mannerisms and so on from effectively social media accounts. So pulling from the cloud and feeding into

00:38:17 Speaker_03
this simulacrum or model of someone who used to be or in this case still is. How far away do you think we are from being able to do something along those lines convincingly?

00:38:30 Speaker_00
Yes, Tim, so I am a fan of the Black Mirror series, and there are a few other somewhat similar series that are streaming now, upload and whatnot. So it's an idea that's catching on.

00:38:42 Speaker_00
And even at a very basic level, social medias, firms like Twitter, for example, and probably Facebook as well, offer an opportunity that after a person passes away, their account can remain active,

00:38:57 Speaker_00
And I believe in the case of Twitter, can even continue tweeting in the way that you once tweeted. So I think this general idea is it's a trend.

00:39:08 Speaker_00
It's only going to grow more and more prevalent as software does a better and better job of copying the human personality.

00:39:17 Speaker_00
sometime in this century for sure, and maybe in just two or three decades, I think that there will be a digital copy of a person.

00:39:27 Speaker_00
Another word is like a digital doppelganger of a person who will claim to be the original person, and they may make that claim before or after the person died.

00:39:39 Speaker_00
And then psychologists and lawyers and theologians and philosophers will have to grapple with, is this just like a really super fancy digital photo album, or is this actually some form of digital sentience?

00:39:53 Speaker_03
When you were growing up, who were your role models or inspirations?

00:40:01 Speaker_03
Was there anyone in particular who stood out to you when you were in high school or at the very beginning, let's just call it freshman year, of your undergrad as icons worth emulating or lesser known role models worth emulating?

00:40:16 Speaker_03
Did anyone really stick out for you?

00:40:18 Speaker_00
I think that in terms of authors, I was very influenced by Robert Heinlein, the science fiction author. CB.

00:40:25 Speaker_03
Sure. Yeah, Stranger in a Strange Land and so on.

00:40:28 Speaker_00
AO. Absolutely. It was so brilliant. And then a few years ago when his widow released the uncensored, unedited version of Stranger in a Strange Land, it's like three times larger and no holds barred. I just savored every page of that. CB.

00:40:45 Speaker_00
My favorite book of all of his is Time Enough for Love, in which he covers almost every topic under the sun. So Heinlein's characters were somewhat of role models for me, like Lazarus Long is a common character in some Heinlein books.

00:41:03 Speaker_00
In the public sphere, I was very much enamored with Robert Kennedy. His positive, progressive approach to the world was something that endeared me to him, so I looked up to him. Those are a couple of the role models that I had at that time.

00:41:21 Speaker_03
You seem to be good at many things, of course, just based on the bio alone. But What strikes me is how quickly you are able to develop expertise in new fields.

00:41:35 Speaker_03
I'd like to use this as an opportunity to bring up what was mentioned at the very beginning of your bio, and that is United Therapeutics, a biotechnology company. She started to save the life of one of her daughters.

00:41:49 Speaker_03
I'd love for you to provide some context for this and tell a bit of the story, just because people will want to hear it. And then the follow-up, just to plant the seed for it, is how you learned biology.

00:42:05 Speaker_03
Because my understanding is you didn't have much in terms of background in biology. That's a huge mouthful of a question, but if you could give us a bit of the background, that would be extremely helpful and we can use that as a jumping off point.

00:42:21 Speaker_00
Sure, so it's kind of funny that you can go all the way through undergraduate at a great place like UCLA and never be required to take a life science course, but that was the case. So the last biology class I had was in high school,

00:42:38 Speaker_00
And here, suddenly, I was faced with a situation as an adult while running SiriusXM that our youngest daughter is diagnosed with a fatal illness. She can't even walk up a couple of stairs to the front door, and there are no medicines approved for it.

00:42:59 Speaker_00
I finally got her to the best doctor one could find, the head of pediatric cardiology at Children's National Medical Center in the middle of Washington, D.C. And the doctor said, you know, this is an extremely rare disease. No one knows why it arises.

00:43:15 Speaker_00
All the patients die within two to three years. He had only seen two or three other kids with it, and they both died. And all you can do is hope for a lung transplant. So Tim, I was completely crushed. I just saw black. I didn't know what to do.

00:43:32 Speaker_00
And the only thing I could think of doing while she was in the intensive care ward night after night, and myself and Bina would tag team staying there with her, was once she fell asleep to go down into the library,

00:43:47 Speaker_00
and to just begin learning about what was this illness she had, which they told me was called pulmonary arterial hypertension, and why were there no treatments available for it? So I just began reading and reading and reading.

00:44:04 Speaker_00
Most of the time I read things, I didn't understand what they were talking about, because there were these long medical words and chemical words. that I never learned in law school, or we never had to deal with in electrical engineering.

00:44:18 Speaker_00
But of course, there were dictionaries, and I looked up the words in a dictionary. And they had college-level anatomy textbooks. So what I didn't know, I just kept going backwards in academia, I guess you would say, backwards in learning or pedagogy.

00:44:35 Speaker_00
until I would even get to like a high school level textbook that would explain something. And I said, okay, I get that. And I kept taking notes and just educated myself night after night until I learned everything I needed to know.

00:44:49 Speaker_03
How did you, and I know this is a story you've told before, but ultimately in searching for possible solutions, and as we were chatting about before recording,

00:45:02 Speaker_03
There's a lot of luck involved, and it doesn't mean that your path is replicable by any set of parents who are caught in a tragic situation similar to what you experienced.

00:45:13 Speaker_03
But nonetheless, you were able to ultimately track down, I suppose it's fair to say, a molecule, a drug of some type.

00:45:23 Speaker_03
Would you mind describing for listeners the process then of attempting to secure the ability to utilize in any fashion this drug or to license it? If you could describe that, I have a number of questions that will stem off of it.

00:45:39 Speaker_00
There are a gazillion articles published on every type of medical research you could imagine. I mean, it's just a bottomless well. There are literally hundreds of different types of medical journals.

00:45:55 Speaker_00
Each of those journals have, you know, every year thousands of articles published across them. So it's difficult to find the information that you need. But in law school, we learn a very useful skill.

00:46:09 Speaker_00
This skill goes by the name of shepherdizing, after this type of index that they have in law school called shepherds.

00:46:17 Speaker_00
So what shepherdizing involves is when a judge writes a decision, like the Supreme Court issues a decision, they drop a lot of footnotes. And of course, one thing lawyers love to do is, you know, make footnotes and references.

00:46:31 Speaker_00
And then what you're supposed to do as a good lawyer is to look up all of the footnotes and the references that that Supreme Court or lower court case referred to. And then the shepherdizing process is after you get all of those references,

00:46:47 Speaker_00
to then look up all of the references in those other articles. And ultimately, you get to a point of diminishing returns, where three, four, five levels down, the references are all circling back around on themselves.

00:47:03 Speaker_00
So I applied that shepherdizing process to these medical articles. And somewhat like doctors, whenever a researcher publishes an article, They make footnotes and citations to other people's research who they relied upon.

00:47:19 Speaker_00
So I would get all of those articles and read those, and then I would follow up on all of the references in those.

00:47:25 Speaker_00
Finally, I read about a molecule that a researcher at GlaxoWellcome had written, in which they described testing this molecule for congestive heart failure. And it failed in its test of congestive heart failure. It did not work.

00:47:42 Speaker_00
But in the article, they had charts of what the molecule did. And the one thing that the molecule did that grabbed my attention was that it reduced the pressure between the lung and the heart, which is called the pulmonary artery.

00:47:59 Speaker_00
It reduced the pulmonary artery pressure while leaving the pressures in all of the rest of the body perfectly fine. Well, that's exactly the problem with pulmonary arterial hypertension, the people who have this disease. I'll make a quick footnote.

00:48:18 Speaker_00
When my daughter was diagnosed, 2,000 people in the US had the disease.

00:48:23 Speaker_00
Because medicines have become so much better and because we've been able to, like you mentioned in the introduction, get all these approvals, there are now 50,000 people in America alone living with it.

00:48:34 Speaker_00
So it's likely that people listening to your podcast will know somebody or another who has pulmonary arterial hypertension.

00:48:43 Speaker_00
And I read this article and I said, wow, just when I need this tiny stretch of artery, just between the heart and the lungs, this molecule somehow talks to that tiny stretch of artery and leaves the whole rest of the body alone.

00:48:57 Speaker_00
That was the holy grail that I was looking for. So I looked at where the author of the article was from. He was from GlaxoWelcome in Research Triangle Park, North Carolina.

00:49:09 Speaker_00
And I made a beeline down to him and asked him if he could develop this molecule that he'd found for my daughter's disease.

00:49:18 Speaker_03
Was it an immediate handing over of the keys to the kingdom? A big all-caps yes?

00:49:25 Speaker_00
No, it was actually a big all-caps no.

00:49:28 Speaker_00
Unfortunately, the individual who had written the article had actually retired a few months earlier, and the person that I ended up meeting with, who is in charge of research and development, said that this was just one article.

00:49:43 Speaker_00
It was an incidental finding. In any event, this disease afflicted so few people, it was completely unrealistic to expect GlaxoWelcome to develop this molecule for my daughter and other people with that disease. And I asked him,

00:50:02 Speaker_00
Stings bob bell is now a venture capitalist and very successful gentleman i asked doctor bell i said what would it take for you to develop this medicine he said well it probably would take you couldn't do it we only develop medicines if they have more than a billion dollars a year and revenue potential.

00:50:21 Speaker_00
He said, but it's possible you could buy it from us if you had a real pharmaceutical company with real pharmaceutical expertise. I could then introduce you to the business development people at GlaxoWelcome.

00:50:35 Speaker_00
So over the course of the next several months, I created a brand new biotechnology company. I was able to have a Nobel Laureate. who was formerly associated with GlaxoWelcome, become head of a scientific advisory board.

00:50:50 Speaker_00
And I re-approached GlaxoWelcome and I said, I have all the things that you asked for. Can you sell me this drug and we'll develop it ourselves?

00:51:00 Speaker_00
Well, Tim, it turns out that everybody I asked said, well, you have to get somebody else in the company to agree. And that's how it is in a big bureaucracy.

00:51:09 Speaker_00
It turned out that we had to have 15 different executives sign the same piece of paper to agree to license this drug to me.

00:51:20 Speaker_00
Finally it happened and all they wanted really was twenty five thousand dollars and a promise of ten percent of any money that i would ever get from this molecule i think they agreed to that only because i kept bugging them i was in their face all the time.

00:51:35 Speaker_00
Also because I believe a serendipitous factor was that Dr. Bell's sister had contracted a form of pulmonary hypertension from the time I first met him toward the end of this process, and he became a product champion for me within GlaxoWelcome.

00:51:53 Speaker_00
I mean, that was just purest, you know, luck or serendipity, whatever you want to say. And then they really didn't think this molecule had any chance at all. And they were really just doing it to get rid of me, I think.

00:52:05 Speaker_00
But still, all 15 people had to sign it. After we successfully developed this molecule, we have over time paid more than a billion dollars just in royalties. to GlaxoWelcome because that molecule has saved thousands of people's lives.

00:52:22 Speaker_00
It has produced, you know, a billion dollars a year in revenue year after year after year for us.

00:52:29 Speaker_00
And Bob Bell, when I invited him to our 15th anniversary, and he came with his sister who was still alive and on our medicine, and he said this was the absolute best transaction that GlaxoWelcome had ever done.

00:52:44 Speaker_03
So in hindsight, what did they miss? What accidentally got deleted from the spreadsheet? Or what assumption or assumptions were incorrect that they missed this opportunity so completely?

00:52:58 Speaker_00
I think there were probably like maybe three main ones.

00:53:02 Speaker_00
The first one, and I can say this kind of from firsthand knowledge since I am now the head of a pharmaceutical company, the odds of any molecule actually working in the human body are less than one in a hundred.

00:53:15 Speaker_00
I mean, the human body is so complicated. It's like a massive set of very precisely keyed locks. And every molecule is like a random key.

00:53:28 Speaker_00
And the chance that you would have a molecule that opened a lock, that fixed some dysfunction in the body, rather than causing some harm to the body, it's less than one in a hundred.

00:53:39 Speaker_00
So first of all, they figured the chance of this thing working just in general, was less than one in a hundred. Secondly, they thought to themselves, even if it worked a little bit, there's only 2,000 people in the whole country with this disease.

00:53:54 Speaker_00
They didn't really think that if it worked really well, the number of people would keep accumulating.

00:53:59 Speaker_03
I see what you're saying. If you have these people who would have died otherwise not dying, then that treatment cohort is just going to grow and grow and grow. Is that what you mean?

00:54:09 Speaker_00
Exactly i thought about it like like i was getting subscribers at sirius xm you know people said to me oh martin you'll be lucky to have a hundred thousand subscribers i said well if i keep them, i get another hundred thousand the next year then i'll be up to two hundred thousand and then i will you know maybe four hundred eight hundred thousand now we have thirty million.

00:54:27 Speaker_00
they didn't think in that subscriber mindset. That was the second problem. The third problem is that they didn't really imagine that the healthcare system would pay something like $100,000 per year for this medicine.

00:54:44 Speaker_00
And at the time, this was in the early to about 20 years ago, early 2000s, I think like the average price for an expensive medicine was perhaps $10,000 a year for a patient or $10,000 for a course of treatment.

00:55:01 Speaker_00
Because of advances in things like precision medicine and gene therapy, there are many, many medicines now that cost over $100,000 a year, mostly for rare diseases, and the healthcare system pays for them because

00:55:16 Speaker_00
So few people have these diseases that even though the medicines are expensive, it's a drop in the bucket compared to diseases like hypertension or common illnesses, asthma, that afflict tens of millions of people.

00:55:32 Speaker_00
So the healthcare system doesn't really mind paying a lot of money if it's a rare disease. And the people at GlaxoWelcome were clueless about this. They were actually looking for the big billion-dollar blockbusters, not for the rare diseases.

00:55:46 Speaker_00
So those were their three omissions. They failed to be Alan Wattsian. They failed to see that because something is big underneath, that means that there's something else that's small. And that was what Alan Watts would always say.

00:55:59 Speaker_00
He says something is good only because something else is bad.

00:56:04 Speaker_03
At the very least, I mean, it's a valuable thought exercise when you're looking at the assumptions that you're making. And what an incredible story. You mentioned Sirius. We haven't spent any time on Sirius just yet.

00:56:17 Speaker_03
When did you first fall in love or become intoxicated or enchanted by satellite systems? Or electrical engineering, I suppose, but you can take whichever one is more interesting to tackle.

00:56:31 Speaker_00
You're absolutely right that I fell in love and I was intoxicated by satellite communications. It seemed to me kind of magical that we can put a machine way out in space and that machine can do amazing things across the whole face of the planet.

00:56:50 Speaker_00
My first real moment of first love, if you will, was at a remote NASA tracking station in the Indian Ocean.

00:56:59 Speaker_00
And I had left UCLA to travel around the world, really hitchhike around the world, and I found myself in the Indian Ocean on a set of islands called the Seychelles.

00:57:10 Speaker_00
And on these islands, at the top of the mountain, in the middle of the main island, there was a NASA tracking station. And I went up into it, and I was probably a pretty grungy, 19-year-old at that point in time.

00:57:25 Speaker_00
But the engineers inside there were kind and patient with me, and they explained to me how their satellite antennas were communicating with satellites in all different orbits around the Earth and even all the way out to Jupiter.

00:57:41 Speaker_00
And I asked them, I said, would it be possible for somebody to put a satellite up there and have it broadcast information back to the entire Earth.

00:57:51 Speaker_00
And they said if you made a powerful enough satellite, then the receiving equipment on Earth could be so small that you could hold it in the palm of your hand. And I could have kissed the guy. I just said, wow, that's the purpose of my life.

00:58:08 Speaker_00
And I made a beeline back to UCLA. I changed my major to communication studies. I did an undergraduate thesis on direct broadcast satellites. I did a joint JD-MBA degree where I published multiple articles on satellite communications.

00:58:25 Speaker_00
I worked at Hughes Aircraft Company, which was a big manufacturer of satellites back then, and helped design a satellite to cover South America, and then ultimately went out on my own with my dream goal, which was SiriusXM.

00:58:38 Speaker_03
What did it feel like, if you can remember, to have that answer given to you, or that direction rather, given to you, the purpose given to you? Did it feel a certain way, that type of conviction or that type of belief? What do you recall?

00:58:57 Speaker_00
Yeah, Tim, it's the best feeling. It's the best feeling. And actually, I don't think it really has anything to do with age.

00:59:03 Speaker_00
I felt like the same kind of feeling when I was driving one of the first Teslas, and I was looking at the manual, and I saw how much electrical power it output. And there's a very simple correlation between horsepower

00:59:19 Speaker_00
And electrical power between kilowatts and horsepower it's almost one to one not exactly and i was already a helicopter pilot and helicopter engines are always quoted in terms of their horsepower so right away i said wow.

00:59:35 Speaker_00
This car has enough power to actually lift a helicopter. I had that same kind of, this is the purpose of my life, is to make an electric helicopter. So you can get this kind of excitement at any point in life.

00:59:51 Speaker_00
I think probably the best way to describe a tin would be like a lightning bolt to your soul.

00:59:56 Speaker_03
I was asking about biology earlier, but I would be very curious, since you mentioned also that the requirements as such in undergrad require you to take any additional biology classes, if you were trying to teach, let's just say, a class, and you could pick the age or it could be a set of classes, scientific literacy.

01:00:17 Speaker_03
being able to have enough basic fluency to provide more surface area for those lightning bolts, if that makes any sense, right? When you're looking at a manual or having a conversation with an engineer or reading a scientific study.

01:00:32 Speaker_03
Do you have any thoughts on how we could cultivate more scientific literacy, if that's the right phrase to use?

01:00:41 Speaker_00
Yeah, I think that's a great phrase to use. I think what's necessary is that you have to relate science to people's everyday lives.

01:00:51 Speaker_00
And one of the greatest people at doing this, and to go back to the beginning of the interview when you asked me who was the role model for me, I should have said Carl Sagan was like an amazing, amazing role model to me.

01:01:06 Speaker_00
I watched the Cosmos series over and over again. And Carl Sagan was a genius at being able to take scientific concepts and relate them to people's everyday life.

01:01:20 Speaker_00
And if you remember from watching those series, the iconic image of him taking a dandelion, and blowing it, and describing that this is how a star spreads out its gas throughout the galaxy.

01:01:36 Speaker_00
Those type of step-by-step instructions, ladders to get from one place to another, is the way I think to build scientific literacy. And I would ask my students to think about anything that's important in their life, whatever it might be.

01:01:52 Speaker_00
And from whatever they said was important to their life, I would then begin wrapping that in kind of layers and layers of basic scientific concepts that pertain to what was important to them.

01:02:05 Speaker_03
Are there any, not science fiction authors per se, but science authors or elucidators of science who have written anything that would be appropriate for a lay audience?

01:02:16 Speaker_03
If someone is listening and they see their blind spots, which I know by definition is kind of impossible, but if they recognize they don't have enough scientific fluency or as much as they would like, but they want to try to cultivate that, do you have any recommendations for them?

01:02:32 Speaker_00
There's a lot of books like that. One of my favorites is a book by a historian of science named Thomas Kuhn. He was one of the most famous historians of science, and his book is perennially in print. It's called The Structure of Scientific Revolutions.

01:02:54 Speaker_00
In this book, he goes through about 10 different revolutions in science, where everybody thought the world was one way, and then kind of like a crazy person would say, no, I think it's like a different way.

01:03:10 Speaker_00
and gradually set about proving it's a different way and created a revolution in science. And he explains this in very lay terms.

01:03:20 Speaker_00
He takes you through the science of gravity, for example, with Isaac Newton, science of relativity with Einstein, electricity with Maxwell, and so on. in a very step-by-step fashion to make the science accessible.

01:03:38 Speaker_00
And in the way, his main point in writing this book is to teach people critical thinking, to teach people to question authority.

01:03:46 Speaker_00
Ultimately, all science is about is just saying why, why, like every two, three, four-year-old kid knows how to do that, right? Why, why, why? And I think Thomas Kuhn does a great job of that in his book.

01:04:00 Speaker_03
I should also point out, and please feel free to correct me if I'm oversimplifying, but the why, why, why is not just for four-year-olds. It's not just for scientists in lab coats or whatever people envision scientists to be.

01:04:16 Speaker_03
It's also extremely helpful in situations like those you found yourself in with

01:04:24 Speaker_03
GlaxoWelcome and attempting to license, constantly pushing for explanation and clicking on those footnotes to go to the footnotes to go to the footnotes to ultimately get to some point of leverage where you can move things around. It seems like

01:04:41 Speaker_03
It's also not just an intensely interesting and academically rewarding approach to thought, but an immensely practical approach to life. At least that's how it seems from reading so many of your stories.

01:04:55 Speaker_00
You know, when you discover something, what's happening is that gazillions of neurons are lighting up in your brain, and it's lighting up the pleasure centers, too.

01:05:07 Speaker_00
So I really believe that there's nothing more exciting than having a realization about something. coming to an inspiration about something, which is why books and reading are so magical.

01:05:20 Speaker_00
Another science fiction writer who I feel does such a great job of explaining concepts that can inspire people is Octavia Butler. She wrote a lot of books. One of them very well known is Parable of the Sower, Parable of the Talents.

01:05:36 Speaker_00
And in these books, she gives people an appreciation of questioning authority. So I'm not sure what it was that my parents did. I don't really remember them specifically encouraging my questioning of them.

01:05:50 Speaker_00
In fact, I do remember my father discouraging it. But nevertheless, what happened to me was I absorbed the American culture. And the American culture is a culture of questioning authority.

01:06:06 Speaker_00
I recently heard one of the latest interviews with Tony Fauci when people were asking him, why is it that Americans won't do these basic public health steps to stop the pandemic?

01:06:21 Speaker_00
And he said, you know, American culture does not like to be told what to do. American culture is dyed-in-the-wool question authority.

01:06:32 Speaker_00
You'd be hard-pressed to find another country where it would be more difficult to get people to follow a single rule for everybody than the United States. So it's that American cultural ethic of questioning authority that I know is deep in my

01:06:51 Speaker_00
mental DNA.

01:06:52 Speaker_03
So we were chatting just a few minutes ago about realizations, inspiration. I'd like to ask if we flashback to, well we could flashback to any point in time that you choose really, how did you relate to or think about gender in your youth?

01:07:10 Speaker_03
And you can choose what youth means. I guess I'm wondering if there were any flashes of realization or if you came sort of pre-installed with a certain orientation or way of thinking about it or feeling about it.

01:07:24 Speaker_03
Whatever you could say to speak to your experience of gender when you were younger, I would love to hear it.

01:07:29 Speaker_00
Sure. So it is related to this question of authority, Tim. Around teenage years, I had a constant vision of myself, not as a male, but as a female. And of course, I said to myself, WTF, why am I thinking like this?

01:07:50 Speaker_00
I can't imagine anybody else's thinking like this. But nevertheless, the thoughts were real. And the feelings were real and the feelings were visceral.

01:07:59 Speaker_03
Could you describe the feelings? Because I think I'm certainly very interested in what form that takes. Is it a discomfort of some type? Is it a longing? How did it feel for you?

01:08:13 Speaker_00
So first I should say that I think the transgender feeling is different for every single transgender person.

01:08:21 Speaker_00
And talking about my feelings, I don't want to give the impression that these are going to be the feelings of other transgender people because as a community, were as heterogeneous as anybody else.

01:08:33 Speaker_00
So for me, it was really a matter of just visualizing myself in a female form. And there was not any dislike of my male form. Again, it was kind of very Alan Wattsian in that I saw myself as male only because the opposite of male was female.

01:08:55 Speaker_00
So I could also see myself as female. And this was the way my mind was working. And when I say I saw myself, it was just kind of like a physiologic embodiment. Obviously, I knew like boys and girls and men and women's bodies were different.

01:09:12 Speaker_00
So I was stuck with this visualization of myself as a woman. wherein I was very much trapped in a male body. It was the prevailing view that this was a completely unacceptable way to be. So the authority was, no, this is not possible.

01:09:30 Speaker_00
People are only male or female, and never the twain shall meet. So again, this American Paul Revere-ish question authority mindset got me reading.

01:09:44 Speaker_00
And I found, once again, that there was a vast literature on transgenderism, transsexualism, Native American people who were two-spirited, communities in India and other parts of Asia that identified as neither male nor female.

01:10:02 Speaker_00
So even though this was never something I learned in junior high or high school or elementary school or really anywhere in American culture in, say, the 1990s, I learned through books that humanity was not either strictly male or strictly female.

01:10:18 Speaker_00
And as I began to question authority, I began to say to myself, why can't I also come out as not strictly male and not strictly female?

01:10:28 Speaker_03
When I think a lot of listeners hear the words male and female, they think of the physiological differences that you might put side by side looking at physical characteristics.

01:10:40 Speaker_03
When you say not totally male or female or not cleanly bifurcated into solely those two categories, do you mean to say masculine and feminine traits are what we would often find labeled as such? Or do you mean something else?

01:10:56 Speaker_00
I mean, predominantly the masculine and feminine traits that you refer to. Now, oftentimes those masculine and feminine traits are just a short hop, skip, and a jump from masculine and feminine apparel.

01:11:11 Speaker_00
Depending on how people dress, they're a short hop, skip, and a jump from masculine and feminine hairstyles. in an age, you know, that was the time of Prince and Boy George and whatnot.

01:11:24 Speaker_00
And then you get to, you know, masculine and feminine manicures, like, why can't a guy paint his nails? And then you get to next questions of, you know, secondary and primary sex organs. And some people

01:11:40 Speaker_00
wishing to take hormones to alter their actual physiology and ultimately go through surgery to alter their physiology. And I found that there was actually like a vast literature following again, footnotes to footnotes, references to references.

01:11:57 Speaker_00
I was like, oh my God, it is possible to, in fact, alter your physiology to match your psychology.

01:12:07 Speaker_00
What appeared to be the most intelligent researchers in this area are opining that this is a safe and healthy thing to do for people who feel that they are kind of quote-unquote trapped in the wrong body.

01:12:23 Speaker_03
From, say, zero to 100%, how well do you feel you have your physiology matching your own psychology at the moment? 100%. What were the biggest or the most important decisions, actions that you took?

01:12:40 Speaker_03
Did any surprise you to have a disproportionate effect on increasing that percentage?

01:12:47 Speaker_00
Nope i think that you know every part of the transition process kind of fell in place it was not something that happens on the on the day it's kind of you get to a point of diminishing returns so over a period of years i gradually transitioned.

01:13:02 Speaker_00
And I think even to this point, I'm still in a transition process.

01:13:07 Speaker_00
I kind of went from a pure male to a more, I would say not pure, but I would say knocking on the female door, to a point today where I feel very comfortable identifying as trans-binary, meaning that I embrace both the masculine and feminine aspects of myself completely.

01:13:29 Speaker_03
Looking at the introduction, which I read at the top of the show, so to speak, there is a line about leading efforts of the transgender community to establish their own health law standards and of the International Bar Association to protect, and this is the part I want to ask you to elaborate on, autonomy rights and genetic information via an international treaty.

01:13:51 Speaker_03
What are autonomy rights and genetic information?

01:13:54 Speaker_00
Sure, so autonomy is just a fancy word for saying that people should be able to make up their own mind, that people should have the power, the authority, the freedom to decide what to do with their own body.

01:14:08 Speaker_00
And genetic rights, of course, refers to the human genome, the DNA that we all have. Now, there is a tremendous diversity of human genomes out there. There are people who, because of their DNA,

01:14:24 Speaker_00
They are pretty much immune to some kind of cancers, whereas other people, because of their DNA, it's very likely that they'll get those type of cancers. There are some people, because of their DNA, they almost cannot feel pain.

01:14:39 Speaker_00
They have an extremely high tolerance for pain. There are other people, because of their DNA, that the slightest pinprick will send them screaming.

01:14:48 Speaker_00
So once Craig Venter and Francis Collins led the effort to decode the human genome, and about the year 2000, all types of pharmaceutical companies and academic researchers began scouring the world to engage in what's called genetic mining, or genome mining.

01:15:09 Speaker_00
meaning going to different populations of people around the world, often that have been intermarried for quite a while, so their genomes are kind of concentrated, and trying to learn something from those communities' DNA

01:15:25 Speaker_00
that can then be translated into useful pharmaceuticals to help everybody else have some of the strengths or less of the weaknesses of those isolated populations. What I was concerned with is that if people extract the DNA

01:15:42 Speaker_00
from these remote communities that they in fact do so only with the consent of those communities or with the consent of the elected representatives of those communities so that they can have some fair financial return for their natural endowment.

01:16:01 Speaker_03
I say so it's similar in a sense to preventing say biopiracy from the Amazon where you have these tribes who are not providing their own human genetic information but are say acting as a wellspring of

01:16:16 Speaker_03
ethnobotany and providing source materials for creating pharmaceuticals. And you would want there to be some recompense to those groups. Translating that into your own sort of endogenous genetics would be what you're referring to. That's fascinating.

01:16:33 Speaker_03
Never even thought about that. Are there any examples you could give of these sort of tightly knit clusters, maybe the clusters is too small a word, of people who are being studied for this reason? For medicinal purposes?

01:16:46 Speaker_00
There are actually many, many dozens, and there are quite a few companies who specialize in this type of area.

01:16:52 Speaker_00
The population that comes top of mind to me, Tim, right now, because it's such a fascinating story and it relates to my own activities in organ manufacturing, is a community of people living in Ecuador and Peru, very close-knit, intermarried,

01:17:10 Speaker_00
that are all a kind of dwarfism. And these individuals, they rarely grow taller than four feet tall.

01:17:18 Speaker_00
And it was discovered just over the past 15, 20 years that they are descendants of Jews from 2,000 years ago who were forced into a diaspora across the Mediterranean after the Roman occupation of Palestine.

01:17:36 Speaker_00
And in that ancient time, these people were of very small stature, but it was just part of the human diversity. They ended up as a group, mostly ending up in Spain.

01:17:47 Speaker_00
And then when the Inquisition took hold, their descendants, who were still very small, they left Spain, they went to the New World.

01:17:56 Speaker_00
And because the Inquisition still had some type of a hand in the larger population centers of what's now Peru and Ecuador, they went out into the rural areas, and there they lived for several hundred years.

01:18:09 Speaker_00
And it turns out that this population, they have one gene, that makes their body not receptive to growth hormone. All of us, naturally, we produce growth hormone, and the cells of our bodies have a receptor for that growth hormone.

01:18:24 Speaker_00
And when the growth hormone locks into the receptor, we begin growing. This population of people in Peru and Ecuador, they lack the growth hormone. That gene fell off like 2,000 years ago, and they kept passing it on and on.

01:18:41 Speaker_00
Not much growth hormone receptor. So they're perfectly intelligent, they live normal lives, they just don't grow very large.

01:18:49 Speaker_00
So I found this population fascinating because in my company, United Therapeutics, we're trying to create an unlimited supply of transplantable organs. And one of the ways we do this is by modifying the genome of the pig.

01:19:04 Speaker_00
And it's kind of like a fluke of nature, Tim, that the pig's organs, their heart, their kidneys, their lungs, are very much the same size and functionality as human kidneys, hearts, and lungs.

01:19:16 Speaker_00
The only problem is that if you leave a pig on its own, they'll actually grow extremely large. And when these first transplants were done,

01:19:25 Speaker_00
they had to euthanize the animal recipients of the transplants because the organs from the pig had grown too large. So what we did is we took a page from this population of people in Peru and Ecuador. Western medicine gives them a disease name.

01:19:44 Speaker_00
It's called Laron's disease, L-A-R-O-N, after this Israeli scientist who discovered what was going on here.

01:19:52 Speaker_00
So we said, well, why don't we modify a growth hormone receptor knockout, just like the larynx population has, into these pigs, so when we transplant the kidneys of these pigs into people, the kidneys won't keep growing and growing as a normal pig can be many hundreds of pounds.

01:20:12 Speaker_00
Instead, the kidney will just stop growing at the same size as when we transplanted it, and that's working out really well. Let's talk more about organ manufacturing.

01:20:23 Speaker_03
What are some of the other precursors or requirements for having a sufficient supply of organs to meet whatever demands there are in the U.S. or in the world today?

01:20:38 Speaker_00
The demands, whether it's in the U.S. or outside the U.S., are huge and are way, way in excess of the supply. I would say that one of the greatest unmet medical needs today is an adequate supply of transplantable organs.

01:20:54 Speaker_00
It's a beautiful thing that, you know, before people like Tom Starzl questioned authority and said it was possible to do an organ transplant, in our parents' teenage years and adult years, that would have just been, like, crazy stuff.

01:21:09 Speaker_00
Like, you take an organ from a dead person, you put it in a alive person who has a bad organ, and the person comes back to health. That's about as crazy as it gets. But they did it. You know, they did it. And now, standing on their shoulders,

01:21:22 Speaker_00
We have hundreds of thousands of people clamoring for these organs, yet each year there are only about 30,000 kidneys available for transplant, only around 3,000 hearts, only around 2,000 lungs.

01:21:37 Speaker_00
And so the gap between the need for these organs and the supply is humongous.

01:21:42 Speaker_03
Are you still, or I should say United Therapeutics, currently trying to manipulate the vagus nerve? Is that in process?

01:21:51 Speaker_00
Yes, that is in process and it's a fascinating area, Tim. We are very fortunate to work with the father of bioelectronic medicine, Dr. Kevin Tracy. He's the chief medical officer at the Northwell Medical Complex up in the New York area.

01:22:10 Speaker_00
And by the way, that reminds me, speaking of how can lay people get access to scientific knowledge easily, subscribe to Scientific American. I'm sorry to put an advertisement in here.

01:22:22 Speaker_00
But I find Scientific American and National Geographic, two of the greatest ways for laypeople, which I do consider myself a layperson, to learn about all different types of science that they might not know anything about.

01:22:36 Speaker_00
So one day I got my Scientific American in the mail, and on the cover it was using electronics to cure diseases.

01:22:46 Speaker_00
Well, here I am, my whole career has just been electronic engineering, building satellites, and now, because of my daughter, I'm in this medical field, so I'm so excited. It was one of those lightning bolts to the soul.

01:22:59 Speaker_00
Now I have a chance to bring my male and female side together, to bring my satellite and my biology side together and merge them. So I got very excited and I had the chance to meet and now work with and support the work of Dr. Tracy.

01:23:14 Speaker_00
And he taught me a very simple sentence, Tim, which I've subsequently found to be absolutely true in all the research I've read. It is that the nervous system touches every single cell in your body.

01:23:28 Speaker_00
The nervous system touches every single cell in our body. The largest nerve in the body, there's one nerve that is way, way larger than all the rest of them. It's the vagus nerve. It starts in our mind, it wraps around our heart, our lungs, our gut.

01:23:46 Speaker_00
It's an immense nerve. And by stimulating this vagus nerve, it's possible to have positive therapeutic effects in the body.

01:23:56 Speaker_00
By a fluke of nature, a positive fluke, the vagus nerve comes out to the skin in two and only two places, around the left and right ears.

01:24:08 Speaker_00
You know, there are like a couple of different ridges in your earlobe, or your ear, I guess how you would say it, and one of them, called the simpaconchi, is the place where the vagus nerve comes out.

01:24:20 Speaker_00
And if you electrically stimulate the simpaconchi on either the left or the right ear, it's been proven now, again, in lots of published literature, to have positive therapeutic effects on the body.

01:24:33 Speaker_03
What are some of those positive therapeutic effects?

01:24:36 Speaker_00
One which has been documented quite extensively is the ability to control Crohn's disease and irritable bowel syndrome, which are two gastrointestinal problems, as well as very high priced, and I would say tinged with some potential side effect, biologic medicines that are approved by the FDA to treat Crohn's disease and irritable bowel syndrome.

01:25:03 Speaker_00
Another illness that has been shown to mediate against is rheumatoid arthritis. And the common factor here is that we have two types of nervous systems.

01:25:16 Speaker_00
We have a fight-or-flight nervous system, which is the sympathetic nervous system, and we have a rest and digest nervous system. which is called the parasympathetic nervous system.

01:25:28 Speaker_00
When diseases occur, it's because one of those two nervous systems, the sympathetic one, the fight or flight, takes more of a dominant position in the body and causes a state of inflammation or overactivation.

01:25:43 Speaker_00
And by stimulating the vagus nerve, you can ramp up the power of the parasympathetic nervous system and calm down this kind of overstressed state that leads to an irritable bowel syndrome or to the inflammation of arthritis.

01:26:00 Speaker_03
This is in the course of doing all the reading for this conversation, one of those things that really woke me up and made me pay attention for a bunch of reasons.

01:26:09 Speaker_03
One is relevance to my current life because I've been working with a doctor for about 10 weeks doing heart rate variability training.

01:26:18 Speaker_03
And there are some researchers with claims, I wanna say out of Rutgers and elsewhere, that certain types of HRV training affect vagal tone and via affecting that vagal tone have a host of cascading therapeutic benefits.

01:26:36 Speaker_03
Whether or not that holds up to scrutiny or not, I don't know. But the second, and I'm embarrassed to even give voice to this, so hopefully this won't just destroy any tiny shred of credibility that I might have as I

01:26:49 Speaker_03
mention it, but I lived in China for a period of time in college, went to two universities there in Beijing as effectively an exchange student, but it was a one-way exchange. I don't think we had any students in return from China.

01:27:04 Speaker_03
And the ears are very much utilized in the world of acupuncture.

01:27:10 Speaker_03
And I'm curious to know if you think that whether by trial and error or otherwise, it's possible that acupuncture stumbled upon the effects without knowing the mechanism of stimulating or affecting the ears to then in turn affect the vagus nerve.

01:27:34 Speaker_03
I know it's quite a stretch, but when I first

01:27:37 Speaker_03
read about this access via the ears, that is one thing that jumped to mind because I always kind of poo-pooed and, if I'm being honest, ridiculed the idea of using the ears to access these deep inner points, but here we are.

01:27:52 Speaker_03
So I don't know if you have any thoughts.

01:27:54 Speaker_00
Tim, first, your credibility is immense. You would have to actually say something crazy to Denton, or what you said is the opposite of crazy. What you said is extremely insightful and prescient.

01:28:07 Speaker_00
So, as convinced as I was that putting a satellite in geostationary orbit would enable people across the planet to receive radio signals, as convinced as I was that we could have a molecule that would halt the progression of my daughter and other people's disease, that's exactly how convinced I am.

01:28:29 Speaker_00
that the acupuncturists of traditional Chinese medicine did in fact come upon the nerve patterns that are accessible from the earlobe.

01:28:40 Speaker_00
And one of the first things that Dr. Tracy showed me was a very medically accurate, from a Chinese traditional medicine practitioner, map of the earlobe.

01:28:53 Speaker_00
in terms of exactly where you put, I'm sorry, I don't know what the official name is of the pins or needles that they put in your earlobe, and how they map to different parts of the body.

01:29:04 Speaker_00
And then he showed me on an anatomy map how that traces the lines of the vagus nerve. So, yeah, it is totally true. And why really would it not be true? I mean, thousands of years of Chinese civilization,

01:29:22 Speaker_00
they have had a chance to do so much trial and error. And they were a literate civilization for so long. So the results of that trial and error could be passed on and passed on.

01:29:34 Speaker_00
So I do think it's entirely rational that they would have figured this out. And what I'm hoping for now and what I'm trying to support is there is an opportunity to, what I call in my own words, crack the human neuron.

01:29:50 Speaker_00
So what that means is that there are unique pattern of amplitudes and signal lengths. and signal voltages that will activate some different part of the vagus nerve than others.

01:30:06 Speaker_00
And each of these different voltages and wavelengths will correlate to a different part of the human body. We don't know what those are. Right now we are just kind of, in a way I would say we're dumber than the acupuncturists,

01:30:21 Speaker_00
because almost all of the work that the FDA has allowed to go forward on vagal nerve stimulation, they all use the same pulse width, the same pulse power, and it works. So that's great.

01:30:34 Speaker_00
But I think it could work even better if we decoded the human neuron. And I believe in the future,

01:30:42 Speaker_00
people will be able to put on a pair of like beet headsets and those beet headsets will have gel-less, meaning like you don't need like the EKG kind of gel, gel-less electrodes, will rest across your simbiconche and your trachea and the different parts of your earlobe and will provide you a stimulation that matches the particular ailment that you have, eliminate the ailment without taking any pills, without paying any money to anybody.

01:31:08 Speaker_03
This is an area I want to keep digging in because it's rare, well it's pretty much non-existent, that I have the opportunity to speak with someone with so much electrical engineering background about the possible applications or implications of technology like this.

01:31:25 Speaker_03
I'd love to just throw out another group of devices to see if you have any opinions on them one way or the other.

01:31:35 Speaker_03
potential applications of, let's just say, TDCS or TMS, so transcranial direct current stimulation, or other means of stimulating the brain, typically using some type of conducive gel, but not always in the case of a TMS paddle.

01:31:55 Speaker_03
Have you looked at these technologies or done any reading in the literature related to them?

01:32:00 Speaker_00
A little bit. I'm aware of a friend of mine has a company that obtained an FDA approval for treating a particular form of brain cancer with this type of technology. So there's a very solid scientific benefit that's been documented.

01:32:15 Speaker_00
After many years of working through the FDA, I have a world of respect for the rigor that they put into any decision to approve something. So when they approved it, it meant that it was scientifically proven to work.

01:32:26 Speaker_00
Something that is quite different from that, but at the same time related to it, Tim, is on the last day of 2019, which was like the last day of the decade, it turned out to be a weekday. I forget if it was a Tuesday or whatever, but the U.S.

01:32:46 Speaker_00
Patent Office only issues patents on one day of a week. And it was like the one day of a week that they issue them on, whether it was Tuesday or whatever. And it was a patent that I received for a device that I call a Alzheimer's Cognitive Enabler.

01:33:03 Speaker_00
And this device is worn over the cranium, as you mentioned, and it senses nerve impulses inside the brain. It is connected to a computer with a visual recognition and a speech comprehension system.

01:33:20 Speaker_00
so that if a patient with Alzheimer's is not able to adequately communicate and appear to recognize the people who are coming into their room, the computer vision recognition system and sound recognition system will talk on behalf of the Alzheimer's patient, say, you know, hello, son, thank you for coming to see me.

01:33:44 Speaker_00
And it is actually being triggered by recognitions that are deep in the Alzheimer's patient's mind. so that more people will come to visit the patient, the patient's stress levels may be lower.

01:33:56 Speaker_00
So I believe this kind of bridging of electronics and the mind is really right around the corner.

01:34:03 Speaker_03
What inspired putting the work into that research and filing that patent?

01:34:10 Speaker_00
I think part of it was seeing my mother-in-law suffer pretty badly from somewhere on the spectrum between dementia and Alzheimer's, was never really completely clear where she was at that.

01:34:23 Speaker_00
And she would recognize us coming in, but she couldn't communicate. And it would have meant a lot to everybody if she would be able to communicate. My own mother is more or less at that point right now as well.

01:34:38 Speaker_00
Secondly, the work on the BINA48 computer showed me that it was really possible for people to strike up meaningful relationships with the digital version of BINA, the BINA48 robot.

01:34:53 Speaker_00
And so it was just like, you know, a very short step from instead of putting all of Bina's or even a good portion of her memories and her personality into this computer, why not actually have the computer's interaction capability, input-output capability,

01:35:11 Speaker_00
triggered by something like a NeuroSky type of EEG brain interface.

01:35:16 Speaker_00
And the last piece of it was I was given a Christmas present by a friend of mine, which was one of these NeuroSky headsets that lets you kind of like play a game just with your thoughts by controlling your EEG signals.

01:35:30 Speaker_00
So that's a consumer product anybody can buy, and it really works.

01:35:35 Speaker_03
This conversation brings back a lot of memories for me because I have Alzheimer's disease.

01:35:39 Speaker_03
It's very prevalent on both sides of my family and observed both sets of my grandparents deteriorate to the point where at least some of them couldn't recognize immediate family members.

01:35:51 Speaker_03
and was recently re-watching segments of a documentary I saw called Alive Inside, and the subtitle is A Story of Music and Memory.

01:36:01 Speaker_03
And what struck me most about this documentary is that not that they could play music from someone's youth to them through headsets and watch them come alive in some really spectacular ways, both

01:36:17 Speaker_03
physically, in terms of kinesiology moving around, but also psychologically.

01:36:22 Speaker_03
The most impressive part to me is that they would play music for, say, a handful of minutes, five to ten minutes from someone's youth, and then turn off the music, and that person could have a perfectly coherent, reasonably fast-speed conversation, whereas prior to the administration of the music, they were

01:36:42 Speaker_03
from the outside catatonic, basically.

01:36:45 Speaker_03
And it makes me wonder what music is doing, I'm sure there are people who study this and probably have a better mechanistic explanation, and how it could be incorporated into therapies intended to counter dementia or advanced Alzheimer's disease, things of this type.

01:37:03 Speaker_00
Tim, you see, just in this conversation, we are uncovering so many vast new oceans of opportunity for people to learn and study about.

01:37:12 Speaker_00
To me, music is the foundational human technology, because the first thing that we ever could become aware of would be the beat of our mother's hearts while we were still in utero. And that beat, that's a rhythm, okay? And after we're born,

01:37:32 Speaker_00
People may have better or worse rhythm, but there's nobody that cannot detect the sound of a beat and move to it. And then all the different types of melodies and chords that build upon rhythm, it's just fancier and fancier forms of music.

01:37:47 Speaker_00
So I believe that there's tremendous therapeutic properties to music. It's just been scratched, not even scratched, it's been kind of like blown on, like,

01:38:00 Speaker_00
And it's there for like all the thousands of young people today who have come up, grown up with more music than ever before to begin to apply this great human cultural technology of music to the biggest mystery in the entire universe, which is the human mind.

01:38:17 Speaker_03
I want to come back to the mind, or more accurately, consciousness in a moment. But first, this will seem like a left turn, and it is.

01:38:26 Speaker_03
I was reading a piece in the Washington Post that covered quite a lot of your life, and there was a segment on Love Night. I don't know if that's enough of a prompt, but can you tell us what Love Night is?

01:38:41 Speaker_00
So when Dina, my partner, and I got married, we each had one child from a previous marriage that each of us had custody of. And then we had two children together.

01:38:52 Speaker_00
And we were kind of trying to build a blended family that would feel like nobody was a stepmom or a stepdad, that everybody was just like in one family. And in fact, we cross-adopted each other's kids from our previous marriages.

01:39:11 Speaker_00
So I was taking the kids to music classes. All of the kids were in the Yamaha music program where they learn piano and violin, instruments like that. And we would practice songs.

01:39:24 Speaker_00
And I was brought up Jewish where every Friday night was something that was special. It was the Sabbath and the family sat down together and had dinner and said a couple of prayers.

01:39:38 Speaker_00
So Bina and I tried to think, how can we merge all these things together? The Jewish tradition, the need to create a blended family, the music that we were all enjoying from watching the kids learn to play piano and violin.

01:39:54 Speaker_00
And we decided to, every Friday night, have a special family ceremony, which we would call Love Night. And we sang a song, which the melody was actually based on one of the kids' songs that they had learned in the Yamaha Music Program.

01:40:11 Speaker_00
The words were very simple and affirming. And at Love Night, the core of Love Night was that each person around the table

01:40:23 Speaker_00
would have an opportunity to say what love meant to them during the past week, during the week from the previous Friday to this Friday. What does love mean to you? Bina and I, as the adults, we would say something

01:40:40 Speaker_00
either sophisticated or simple, like, I love Bina, I love Martine, I love the kids. The kids started off just saying, like, what love means to me is, like, our dogs or our cat, you know, very basic things.

01:40:54 Speaker_00
But as they grew older, they came into more and more sophisticated definitions and expressions of love until after a couple of decades of this, all of us have heard thousands of different things that love can mean to a person.

01:41:10 Speaker_00
Now I'd like to fast forward, and sorry to be in a little riff here, but I wanna fast forward to the current COVID pandemic.

01:41:18 Speaker_00
Our kids are all adults now, they've flown the coop, they have their own kids, and suddenly we are in a situation where we can't all gather together in any one house for love night.

01:41:30 Speaker_00
You don't want to travel, you don't want to endanger people, so on and so forth. So we decided to continue the Love Night tradition, but on Zoom, or to be fair, Google Meet. So every Friday night from my son, who's a captain in the army in Iraq,

01:41:50 Speaker_00
to his wife, who's on a base in El Paso, to my other son with four grandchildren in Florida, to my daughter in Brooklyn, and her kid, and her husband, and Bina and I, we all get together on Zoom, plus friends of all of ours.

01:42:05 Speaker_00
The kids were not embarrassed by Love Night. In fact, they wanted to share it with their friends, and their friends were saying like, whoa, this is crazy, this is beautiful. And so we get together every Friday night, we sing our Love Night song,

01:42:18 Speaker_00
And now there's about 20 of us. We go around virtually, what love meant to us during that previous week. And I would say Love Night is one of the most beautiful parts of my life.

01:42:28 Speaker_03
Ah, I'm so glad that I asked that question. And Love Night, could you give a few more examples of possible answers just to give people a flavor for how people might answer this question?

01:42:46 Speaker_03
Because I, for instance, would love to try this with my girlfriend, with with some of our friends, family, et cetera, but I would be nervous as the orchestrator that I might get that question and not have the ability to kick things off effectively.

01:43:01 Speaker_00
So every morning, Bina, my partner, goes out for, takes our two dogs out for a walk with one of her best friends who lives a few houses away. And that best friend now joins our love nights.

01:43:15 Speaker_00
And last Friday she said, what love means to me is every morning, going out for a walk with Bina and the dogs. Last week, our youngest grandson, Saturn, he was born in 2010, so he's 10 years old, he said, what love means to me is this.

01:43:34 Speaker_00
And he pulled a piece of paper, he said, I got a 95 on my math test. And he was just so proud of himself and shared it with us. So those are typical examples of, I think I last time said what love means to me

01:43:50 Speaker_00
is sitting down at the piano and playing different songs from memory.

01:43:55 Speaker_03
To use this as a skipping stone, but I think I'm getting my metaphors mixed up, a launch pad, a lily pad, pick your choice.

01:44:07 Speaker_03
To consciousness, do you think that we will be able to, as I've heard you put it once, recapitulate or recreate consciousness synthetically? And does that mean we'll have machines that can love, for instance, in the not-too-distant future?

01:44:26 Speaker_03
What would it mean to have created consciousness?

01:44:30 Speaker_00
Sure, I do believe it's possible. And a great book that I would recommend that goes into this subject in beautiful detail is called The Emotion Machine by Marvin Minsky. And Marvin Minsky is often thought of as the father of artificial intelligence.

01:44:48 Speaker_00
He was a professor at MIT for a great many years. So in The Emotion Machine book, he really describes exactly how you would go about

01:44:59 Speaker_00
creating a computer and the type of software that it would take in order for the machine to feel what we feel when we say that we love somebody.

01:45:11 Speaker_00
And I think it's likely to occur, Tim, because it's hard for me to think of any aspect of life that cannot be replicated if one had sufficiently advanced technology.

01:45:26 Speaker_00
One of my favorite sayings from another role model, Arthur C. Clarke, is that magic is indistinguishable from sufficiently advanced technology. So I think just like we have been able to create an artificial hip, artificial knees, artificial hearts.

01:45:47 Speaker_00
In my own company, we are building lungs and kidneys. People are creating artificial nerves. People like Elon Musk has formed a whole company, Neuralink, where he's working on downloading a whole human brain.

01:46:03 Speaker_00
I have little doubt that humans will end up being able to replicate a human mind. Now, whether or not the rest of society accepts it as a human mind or not, I think is going to be a long pitch battle.

01:46:18 Speaker_00
And that's what is the subject of my book, Virtually Human. That whole book talks about how and when will society accept digital consciousness as being as conscious as a human.

01:46:32 Speaker_00
But even if that digital consciousness is not yet at human level, what happens when it's at, say, primate level, or at canine level, or even at rodent level?

01:46:44 Speaker_00
If you can get to any of these levels, you could kind of see how it's the same old human effort of keep making incremental improvements

01:46:52 Speaker_00
that would eventually get you to the human level, where I think that the individual alive today that has the best understanding of this topic is a guy at Google named Ray Kurzweil. He's a director of engineering at Google.

01:47:07 Speaker_00
And what I love about Ray is he never tires of pointing out that this digital human consciousness It's human. Human consciousness is a human phenomena.

01:47:21 Speaker_00
So when we create a digital analog or doppelganger or simulcra, whatever you want to call it, when we create a her, that her is human. It's not us versus them.

01:47:34 Speaker_00
It's one, it's we will have been able to move our mind into a digital substrate, just like if our knees give out, you move it to a mechanical substrate, or if an organ gives out, you transplant it with another organ.

01:47:50 Speaker_03
Where would you, if you had to, kind of Price is Right style, put a timeline on this? When do you think we'll have rodent or canine level consciousness plus intelligence?

01:48:02 Speaker_00
Yeah, it's pretty hard to say, Tim, because one thing I am not is I'm not a soothsayer, I'm not a prophet, I'm not a visionary, any of those things.

01:48:11 Speaker_00
I'm just a humble technologist, and all the projects I work on, they have five-year time horizons because I have difficulty really seeing beyond five years.

01:48:22 Speaker_00
So every technology I'm working on, it's like I want to get this thing done and out to the public within five years. Also, I am totally a believer in this adage that futurists usually overpromise in the near term and underpromise in the long term.

01:48:42 Speaker_00
So what that would mean in this context is you will hear a lot of futurists saying, oh, we'll have digital rats or digital dogs or digital people in 10, 20, or 30 years. They have probably overpromised in the near term.

01:48:58 Speaker_00
What they have underpromised in the long term is in not 10, 20, 30 years, but in, say, 80, 90, or 100 years, there won't be just digital rats, digital dogs, and digital people, but most people will be digital.

01:49:16 Speaker_03
exciting and I suppose for some people very terrifying at the same time. What are some of the most important ethical questions or considerations related to technology as we move into future decades in your mind?

01:49:33 Speaker_00
In my mind, the biggest problem with technology is that people only think about the rights to implement the technology and they don't think about the obligations they have as somebody creating a technology.

01:49:50 Speaker_00
And what I mean by that is there was this great philosopher of the 20th century, Isaac Berlin, I believe he was German, and he had a real simple message. His message was that for every right,

01:50:05 Speaker_00
There's an obligation it's again it's a very i want to see him sorry to keep coming back to a lot but it's a very i want to see in point of view that i write only mean something in the context of its obligation.

01:50:19 Speaker_00
So for example if i have a right to be a parent. Which we think everybody has a right to be a parent. You only have that right to be a parent so long as you comply with your obligation to be at least not a horrible parent.

01:50:35 Speaker_00
If you're a horrible parent, you will have your children taken away from you, and you'll no longer, in that sense, be a parent.

01:50:41 Speaker_00
So with regard to technology, I think there is a point of view that anybody who can create a technology has a right to make that technology. But I dispute the ethics of that perspective.

01:50:54 Speaker_00
I think that every right to make a technology is coupled to an obligation. to have the consent of anybody who would be adversely affected by that technology.

01:51:07 Speaker_00
So for example, my right to build an atomic power plant or a nuclear power plant someplace, I don't just have that right, that right is coupled to an obligation that I have to have the consent of all the surrounding communities of people who could be adversely affected by the implementation of that technology.

01:51:29 Speaker_00
And it comes into this domain of, in my own field, say, the transplantation of genetically modified pig organs into people.

01:51:39 Speaker_00
For me to have a right to do that technology, I have to have the consent of the larger community that that's a safe thing to do. In a democratic country, that consent is

01:51:52 Speaker_00
issued on behalf of the country by the government, and in the field of health, it's issued by the FDA.

01:52:00 Speaker_00
So before the FDA permits us to transplant these genetically modified pig organs into people, they want us to demonstrate to them that there is no risk, not a small risk, but no risk of any kind of animal virus

01:52:15 Speaker_00
seeping into the human population as a result of these animal transplants.

01:52:20 Speaker_00
So in summary, I believe an amazing field for the future, a field that will probably in the future have almost as many people with this career as our web designers today, is the field of technoethics.

01:52:36 Speaker_00
Everybody who wants to create a technology will need to wrap that technology in an ethical envelope of consent.

01:52:44 Speaker_03
If we look at science over, well, we could look at it over the last few thousand years, but let's just say the last few hundred years, you mentioned earlier that, I think you were discussing the structure of scientific revolutions, how these breakthroughs, these massive scientific leaps forward seem like complete madness at the time to the vast majority.

01:53:08 Speaker_03
And we don't have to go that far back to find, say, surgery without or with minimal use of anesthetics on newborns and infants. I mean, this is not the Dark Ages. This is, you know, less than a hundred years ago.

01:53:21 Speaker_03
You see some really appalling things that were taken as best practices or common practice.

01:53:28 Speaker_03
And one of my friends, who's an outstanding doctor, likes to repeat this, I suppose, adage that you hear among good doctors, which is, 50% of what we know is wrong, we just don't know which 50%. And that seems to always be true.

01:53:44 Speaker_03
So if we flash forward 10 or 20 years, and I know you're not a prophet or a soothsayer, but I'm curious, or it could be five years as a technologist, what do you think

01:53:55 Speaker_03
Are any of the things we're doing now or believe now that will be shown to be patently absurd or viewed as barbaric or crazy or naive in the near future?

01:54:07 Speaker_00
probably a lot of things, since a lot of what we look back in the past at seems to be barbaric. Building on top of your example of the tortuous procedures put onto neonates, people forget that the founder of the American Medical Association,

01:54:28 Speaker_00
The first doctor who created the American Medical Association, his name was Dr. Gross. He lived in Philadelphia, and he did not believe in asepsis at all. And so he would do all of his procedures right in his street clothes.

01:54:47 Speaker_00
infecting everybody and countless women lost their lives because of having those type of quote-unquote doctors helping with the delivery of the children and ending up creating a septic condition in the mothers.

01:55:01 Speaker_00
And one of the most famous painters in American history, Thomas Eakins, painted this picture of the Gross Clinic, where Dr. Gross was teaching all the young doctors how to do a procedure. And you see dirt in his shoes and scuffy hands.

01:55:17 Speaker_00
Then he was followed. The second president of the American Medical Association was a Dr. Agnew, who was the student of Gross.

01:55:26 Speaker_00
And he had read about the research of Lister in England and became a believer that even though we can't see these things, germs, they're real. and we need to practice strict septic procedures before we do an operation.

01:55:41 Speaker_00
A few years later, Thomas Eakins painted the Agnew Clinic, and you see that the doctors in white smocks and everybody is looking super sterile and clean. So these type of revolutions can occur just like one generation to the next.

01:55:57 Speaker_00
It's not something that takes a long time. I think that, you know, looking at what's going on today in our world, I think the fact that we burn our own house will look to be absolutely bonkers. People would say, well, let me get this right.

01:56:14 Speaker_00
You've got a super-thin atmosphere. I mean, you guys saw that from space since the 60s at least. This atmosphere around your planet is super-thin.

01:56:24 Speaker_00
You have an undeniable record of measurements of carbon dioxide into the atmosphere going up year after year after year.

01:56:33 Speaker_00
And you continue to just spew without limit greenhouse gases into this atmosphere, despite the fact that people are dying on the shorelines, dying of diseases, et cetera, et cetera.

01:56:46 Speaker_00
I think they will think we are as stupid as somebody who would light a fire in the middle of their house to try to keep warm and not bother with the smoke that they were choking on.

01:56:58 Speaker_00
And then, if I could add an addendum to that, did you guys know that the Earth receives 10,000 times the amount of solar energy, falls right on the Earth each day than it uses, 10,000 times the amount of energy it flows, and that's not to talk about the wind, and that's not to talk about the waves, and that's not to talk about the nuclear energy.

01:57:20 Speaker_00
I think the people in the future may think we were pretty stupid to be so scared of nuclear energy

01:57:27 Speaker_00
which has killed a few dozens of people, that we went ahead and just, you know, stopped all the nuclear plants and began pouring ungodly amounts of greenhouse gases into the atmosphere that will kill millions of people.

01:57:40 Speaker_00
That will seem ludicrous to them.

01:57:42 Speaker_03
I think this is, and I won't keep you too much longer, but I think this, I would be remiss if I didn't ask you to comment on or describe your own engineering projects with carbon neutrality or zero emissions as

01:57:57 Speaker_03
as an objective, because this is not just idle hand-waving for you, this is something that you've taken a keen engineering mind to.

01:58:07 Speaker_03
And I think that was not mentioned in your bio, even though it's yet another one of these examples of extreme curiosity and capability. Could you just describe what you've done in that arena, please?

01:58:20 Speaker_00
So this is another area that gives me immense enjoyment. Again, another kind of like lightning bolt to my soul is to try to create infrastructure, buildings and cars and planes and things that have a zero carbon footprint.

01:58:37 Speaker_00
And I look at it as an intellectual challenge. When I've read that people said, well, we cannot have a zero-carbon footprint society until 2050, that's what the authorities say. You know already, Tim, I'm going to say, why? Why not? Why not? Why not?

01:58:55 Speaker_00
I'm going to question that authority.

01:58:57 Speaker_00
So about three years ago, we undertook to build a new headquarters for our company in Silver Spring, Maryland, that would have a zero-carbon footprint, not in the best climate, Maryland, it's got its good seasons and its bad seasons, right in the middle of a city, Silver Spring, Maryland is a built-up suburb of Washington, D.C., and for the manufacture of medicines and stuff, which is somewhat of an energy-intensive activity.

01:59:25 Speaker_00
So we built a 150,000-square-foot, zero-carbon footprint building, which turned out to be the largest zero-carbon footprint building in the entire world. And we inaugurated it a couple years ago.

01:59:39 Speaker_00
It turns out we produce more energy than we use each year, now two years running. We did this by just thinking carefully about energy and how to manage it. So for example,

01:59:52 Speaker_00
we have underneath the building 50 wells, each of which go down 500 feet, and they exchange heat from the building with the coolness of the Earth in the summer, bring the coolness back up, and in the winter, they exchange coolness of the building with the steady temperature of the Earth in the winter to keep the building warm.

02:00:15 Speaker_00
The sides of the building are clouded with solar panels, The entire building has a brain that automatically opens the windows and closes the windows to allow natural ventilation.

02:00:28 Speaker_00
It's a role model for many other buildings, and lots of designers and engineers have come over there. Another example is in the delivery of our organs. Right now, we refurbish organs, lungs in particular, that a decedent has donated.

02:00:44 Speaker_00
or the decedent's family has agreed to the donation. But when the transplant surgeons look at that lung, they say it's too full of fluid and mucus, we can't use it, throw it away.

02:00:55 Speaker_00
So what United Therapeutics says is give us your lonely, unwanted, unloved lungs. fly them to Silver Spring, Maryland. We will refurbish them.

02:01:04 Speaker_00
We'll show through a high-speed digital network to the transplant surgeons all across the country that the organ is good as new through this digital network and bronchoscope and x-ray and all that stuff. And then we fly the lungs back out to them.

02:01:17 Speaker_00
We've saved over 150 lives this way, Tim. How do you refurbish a lung? First you have to remove it from the dying body. A dying body is a terrible place to be.

02:01:28 Speaker_00
So we remove it from the decedent, we cool it down, so we kind of give it a, I won't say we freeze it, but we cool it down, very low temperature. We fly it to Maryland and we put it in a glass dome.

02:01:40 Speaker_00
And in this glass dome we have tubes, we have a kind of artificial blood and air pumping. So we've made a kind of isolated artificial body just for that lung.

02:01:52 Speaker_00
And we have expert technicians who work these, sorry, I don't know the exact name of the equipment, but it sucks out mucus and they operate on the lungs like it was a person, but it's just an isolated pair of lungs.

02:02:05 Speaker_00
And the transplant doctors who could be in Texas or Florida, wherever, they tell us through the digital screen and the voice, put the bronchoscope down the left side or down the right side or go further. They see this and they know what they want.

02:02:20 Speaker_00
So our technicians know how to do this. And within four hours, in almost two-thirds of the time, we were able to take what was a non-compliant, dead piece of tissue and turn it into a nicely breathing lung.

02:02:34 Speaker_00
It's so beautiful to watch, Tim, the lungs go in and out. like a butterfly's wings going up and down. In fact, you could see a video of it on that Washington Post article you were mentioning.

02:02:44 Speaker_00
And then we cool the lungs back down and we fly it to the transplant surgeon. And 100% of the time that they have accepted these lungs, they have had successful lung transplants with, like I mentioned, over 150 people walking out of the hospital.

02:02:59 Speaker_00
But I mention this because this is a lot of flying around, flying here, flying there, helicopters going back and forth, planes.

02:03:08 Speaker_00
And if I'm going to make an unlimited supply of organs, and you remember all those numbers we talked about at the beginning of the call, the hundreds of thousands of people who needs these organs, that is going to be a humongous carbon footprint.

02:03:22 Speaker_00
We could have said to ourselves, well, we're doing such a good thing, we're saving all these lives, we could be permitted to foul our atmosphere because it's balanced by the good things we're doing.

02:03:33 Speaker_00
But instead, we like to ask ourselves like the challenging question, how can we do like the good thing and the right thing at the same time? How can we manufacture all these lungs and deliver them with a zero carbon footprint?

02:03:47 Speaker_00
And the solution came from the technology of electric helicopters which are powered by renewable energy that can fly these organs from one place to the other without adding any carbon footprint at all. And I will be a little bit of a soothsayer here.

02:04:03 Speaker_00
I am absolutely convinced that in this decade, the 2020s, we will be delivering manufactured organs by electric helicopter.

02:04:13 Speaker_03
I love it. I have, I will say one, I may cheat and sneak in one or two more, but... I love talking with you. Well, likewise, this is just endlessly, endlessly interesting. So many, so many different pathways into the labyrinth.

02:04:29 Speaker_03
But I need to make sure, I suppose, since my job is supposedly interviewer, that I can find my way back out.

02:04:35 Speaker_00
Alan Watts will show you the way.

02:04:39 Speaker_03
He does have a most seductive and hypnotic voice for those who haven't heard, I recommend. I've read that a favorite saying of yours is, quote, identify the corridors of indifference and run like hell down them, end quote.

02:04:53 Speaker_03
Can you please speak to that or explain what that means for you?

02:04:57 Speaker_00
Yes, so identify the corridors of indifference and run like hell down them means to try to find a, I'll put it in business terms, a market area that is ignored, a unmet need, but it doesn't really have to just apply to medicine.

02:05:15 Speaker_00
It can apply to any area of life. And the way I would phrase it, Tim, in just like, you know, a very natural, almost folklorish way, Is that it's better to be a big fish in a small pond and a small fish in a big pond.

02:05:31 Speaker_00
In the business school back at UCLA we one person we studied a lot was the experience of general electric under jack welch. And he had an adage which from a business sense was i think very very smart.

02:05:46 Speaker_00
You said if you can't be number one or number two in the market don't even try because you will have to spend an amount of money.

02:05:54 Speaker_00
Equal to the revenues of the number one or number two in that market to become the number one or number two in the market if you're not the number one or number two.

02:06:04 Speaker_00
You will always struggle to be profitable but if you are the number one or number two your profitability is shared so what that means translated to all of our activities. Is there is an area.

02:06:19 Speaker_00
Like for example a number of people have said you know we should get involved we when i say we my company night therapeutics should get involved in creating a vaccine for covid. And to me, well, you know, it's not a corridor of indifference.

02:06:34 Speaker_00
There are dozens of companies working on a vaccine for COVID. So that's not what we would want to do. It's very unlikely we'd ever be successful on that.

02:06:45 Speaker_00
Somebody else said, well, how about these people, the COVID long haulers, the people who have survived from a very difficult course of COVID, and they've got chronic lung problems that are bothering them months and likely years after the effect.

02:07:00 Speaker_00
I said, yes, that's a corridor of indifference. Nobody is thinking about the long haulers, the people who now have chronic lung problems because of the havoc that COVID wracked in their lungs.

02:07:13 Speaker_00
Let's develop some medicines for these chronic long haulers.

02:07:18 Speaker_03
Makes a lot of sense. That makes a lot of sense.

02:07:21 Speaker_03
On a related note, in some respects, this is a question that doesn't always work, so I'll take the blame if it doesn't, but if you had a billboard, metaphorically speaking, to get a message, a quote, a word, an image, a question, anything, out to billions of people, let's just assume they all speak English for the sake of argument, what might you put on that billboard?

02:07:46 Speaker_00
I think Apple Computer and Steve Jobs got there before me. Think different. Think different. Why is that important? Because the solutions, you know, Albert Einstein said, you can't solve a problem on the same level that it was created.

02:08:02 Speaker_00
You have to solve it on a different level. If we all think the exact same way, we will never get out of the ruts that we're in.

02:08:10 Speaker_00
The only way to get out of the problems that we face is to think differently, to go down the corridor of indifference, to question authority, to be diverse. Thinking different is the pathway to solving problems that exist today.

02:08:28 Speaker_03
Looking back at everything we've talked about and looking at all of the copious pages of notes for prep in front of me, it strikes me that you've forged many paths for yourself and helped others to do the same by thinking different,

02:08:46 Speaker_03
but also thinking brightly, coming back to Alan Watts yet again, the yin and the yang and seeing the positive, looking for the positive in different circumstances, different situations.

02:08:59 Speaker_03
Do you have any advice or recommendations for people who struggle to do that, who are maybe mired in a sense of, hopelessness might be too strong a word, but those who tend to see the glass as half full and perhaps as a result of that tend to see

02:09:15 Speaker_03
half the spectrum of options or solutions?

02:09:18 Speaker_00
It's a really difficult question to answer, Tim, because everybody's situation is so unique and so different, and I do not doubt that for many, many people, it is just a bad life, whether it started that way or ended up that way, and it's almost impossible to see a way out.

02:09:40 Speaker_00
The perspective that I take is that I try to stay in touch with my ancestors. I think about the great-grandmothers who had to bear children in the worst of possible circumstances.

02:09:56 Speaker_00
I think about all of the, like my partner Bina's great-grandmothers who were picking cotton as slaves and had to work all day being bitten up by bugs, burning in the sun, feet deep in mud, and then bear a child at the last moment.

02:10:14 Speaker_00
So whether it's like, you know, my great-grandparents from Eastern Europe or hers from the African diaspora,

02:10:21 Speaker_00
They had nothing to look forward to other than just the hope that they were gonna have some children, and that maybe those children might have a little bit of a better life than they did. And if not their children, their children's children.

02:10:36 Speaker_00
So their only purpose in life, their only hope in life, their only joy in life was to make a generation, and that maybe that generation would be better. Now, here we are in America, or really most any other country in the world.

02:10:50 Speaker_00
We're at a point now where like eight out of 10 people have a smartphone with access to all the world's knowledge and information, with access to countless amounts of music and training through YouTube.

02:11:04 Speaker_00
There are many people in the world still in dire circumstances, but the vast majority of people are doing better than people have ever done before in history.

02:11:13 Speaker_00
So I say to myself, and I would ask somebody else looking through the world darkly right now, looking at the glass half full, I would say, how much worse it must have been in the past.

02:11:26 Speaker_00
What do I owe to my grandparents and great-grandparents and great-great-grandparents who suffered and toiled, who barely managed to survive to produce another generation. What do I owe to them?

02:11:39 Speaker_00
I owe to them to make the absolute most possible out of my life, and that's what I'm going to do.

02:11:45 Speaker_03
Hot damn, Martin. I'm ready to get out there and get amongst it. I have so enjoyed. this conversation. There are 79 more hours we could do just in round one. I won't subject you to that.

02:11:57 Speaker_03
And I'm so grateful that you were willing to make the time to have this conversation. Thank you so much.

02:12:08 Speaker_00
My pleasure being with you, Tim.

02:12:10 Speaker_03
And is there anything else you would like to say, to suggest or ask of those listening before we bring this to a close?

02:12:19 Speaker_00
Two of my best friends and people who I think are the smartest, most creative, most happy, loving people I know, Paul Mann and D.A.

02:12:29 Speaker_00
Wallach both said to me that your podcast is the best, and Martin, if Tim Ferriss invites you on this podcast, you have to go on it, so thank you, D.A., and thank you, Paul.

02:12:41 Speaker_03
Well, thanks to them also for me. I have, for many months, my whole team knows this. been hoping to have you on. I had high hopes coming into it. You exceeded all of those high hopes, which seems to be a pattern for you.

02:12:58 Speaker_03
And I'm just very grateful and happy that we had a chance to connect. So thank you again. And for everyone listening, you can find Martine on Instagram at Transbinary, Twitter at SkyBiome. We will link to everything in the show notes that

02:13:17 Speaker_03
have mentioned in this conversation, the books and everything you can imagine that we discussed will be available in the show notes at Tim.blog.com forward slash podcast.

02:13:27 Speaker_03
And until next time, be kind, practice love night, think different, think brightly, and thanks for tuning in. Hey guys, this is Tim again. Just one more thing before you take off and that is Five Bullet Friday.

02:13:42 Speaker_03
Would you enjoy getting a short email from me every Friday that provides a little fun before the weekend? Between one and a half and two million people subscribe to my free newsletter, my super short newsletter called Five Bullet Friday.

02:13:54 Speaker_03
Easy to sign up, easy to cancel. It is basically a half page that I send out every Friday to share the coolest things I've found or discovered or have started exploring over that week. It's kind of like my diary of cool things.

02:14:07 Speaker_03
It often includes articles I'm reading, books I'm reading, albums perhaps, gadgets, gizmos, all sorts of tech tricks and so on that get sent to me by my friends, including a lot of podcast guests.

02:14:19 Speaker_03
And these strange, esoteric things end up in my field, and then I test them, and then I share them with you. So, if that sounds fun, again, it's very short, a little tiny bite of goodness before you head off for the weekend, something to think about.

02:14:33 Speaker_03
If you'd like to try it out, just go to Tim.blog slash Friday, type that into your browser, Tim.blog slash Friday, drop in your email, and you'll get the very next one. Thanks for listening.

02:14:45 Speaker_03
This episode is brought to you by Shopify, one of my absolute favorite companies, and they make some of my favorite products.

02:14:51 Speaker_03
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02:15:06 Speaker_03
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02:15:14 Speaker_03
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02:16:23 Speaker_03
Shopify.com slash Tim. Go to Shopify.com slash Tim to take your business to the next level today. One more time, all lowercase, Shopify.com slash Tim. This episode is brought to you by 8Sleep. I have been using 8Sleep pod cover for years now. Why?

02:16:41 Speaker_03
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02:17:09 Speaker_03
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02:18:10 Speaker_03
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