Searching For The Cure To Cancer, Vaccines, & Pandemics with Phillip Norris

wanted to cure a disease. That was my stated goal. That particular uh piece that you're working on. We have one project in the lab. We're working on an anti-cancer antibbody. So, it targets the immune system. Could there be another pandemic? Yeah, it is a matter of time. How much time? Nobody knows, right? So, that's the thing. There's this apprehension towards vaccinations and people may be uh sort of like, hey, I'm not going that route. In my world, in the blood banking world, there are pushes in some states to have a blood supply of people who've never been vaccinated. So, is that justified by the science? So, we did some studies. If you got a a transfusion from someone who had been vaccinated, did you do worse than if you got a transfusion from someone who hadn't been vaccinated? Philip Norris, Dr. Philip Norris, one of my favorite people in the entire world. Such an honor to have you in here today.

Thank you for coming to spend some time with us. Jock. Thank you so much for having me. I I can't imagine why you invited me, but I'm glad to be here. You One of the one of the things I always find with people who are peak performers are is incredible amount of humility. And as we get into your story, we're going to find out uh just how much of a peak performer you truly are. Hey, one of the things as you know in the show, um all of the proceeds, the profit from the show goes to a charity. you're working on some very important um uh work and I'd like to know what your charity is. Well, so I think you know I work for Vitalent which is the second biggest blood bank in the country. We're not forprofit and we have a foundation arm, Vital Talent Foundation and that supports research. We're going to talk a little about the research that I'm doing that I think really would benefit from this. Uh so if people are moved as you hear the podcast, I would love to have them vote uh donate to the Vitality Foundation.

Yeah. Yeah. And they, you know, just because we're taking money from the views doesn't mean that we can't and and put a link in where anyone can go find out about that work and donate money to it. Anyone that's been affected by cancer or other things um had a loved one that had a problem might want to go ahead and and actually donate there. Um and I think u great opportunity. Well, thanks for bringing that up. I really appreciate that cuz as you know we're we're all scrambling. Yeah. Yeah. It's a tough time. It is a tough time. Yeah. But we keep doing what we do. Yeah. Oh, that's that's uh that's why it's such an honor to have you here. So, let's get into it. Okay. Um how is rounding at uh SF General recently? Yeah. So, that was just last week. Uh it's challenging. So, it's an amazing experience. Uh as you know, I don't do a lot of doctoring. So, I trained as a physician. Most of the time are in a research lab now. So I'll do two to four weeks in the hospital year. So staying up is difficult. Uh but when I'm in there, gosh, do I love it. It just takes me right back. And I work with a really strong team of fellows and residents and pharmacists and everybody. Something about being a doctor. You get to see inside people's lives and be a part of that and hopefully interact with that for the better.

Yeah. Well, based on some of the cases that you've seen or that you've shared with me, it's a interesting experience. Well, right. So, San Francisco General is the county hospital. So, there are primarily to serve people a who have trauma. So, it's the trauma center for the city, but but b really people who don't have insurance and fall through the cracks otherwise. So, immigrants or a lot of IV drug abuse and and addicts. So seeing the toll that takes is tough. Uh but we try to help them through that process. As an infectious disease specialist, uh do you see like the IV drug use like remember the movie recreum for a dream where the person the guy winds up losing an arm. You know, there's this stuff I we we were walking um by our office in the city and then we walked past some guy and his arm was just complete cellulitis just completely swollen up and I guess they're using some other stuff that they're shooting with fentanyl or something like that and causing major infections and Yeah, there are some additives that cause big ulcers on the arms. I think that's off the street now, but we went through a phase of that and so it's really tough.

Yeah. And these are people once you get to know them, drug abuse doesn't discriminate. Uh there are people from our neighborhoods and there are people from all over the country. It's it's tough. Yeah. I mean it's like anybody I remember um you know I don't know a couple of orthopedic surgeries u ago you know I I have a resistance to or have a allergic reaction to pain medicine makes my skin itch. So they have to find this, you know, and they I want to blend a loted. Uh, and so my skin wouldn't itch the only thing that work. And I got to tell you, I was like, I got to get off this stuff. I got to get off of it as fast as I can. When I came off of that for like an entire week, I felt like my entire like everything's perfect. Everything's going great. Entire world is going to end. So you could see how that could happen to just like anybody, right? Well, so it's interesting these opioid uh pain relievers. So, we have opioid receptors on our nerves and when we get a high level of opioids in our bloodstream, the the receptors will actually downregulate uh because they're adjusting to how much is in the environment. So then if you take away that outside opioid, stop taking it, we have our endogenous opioids we make.

So the runner's high, you know, you go for a run, you feel great afterwards. Well, that's your own endorphins that are that are in your body, but that's not enough because the receptors have all been downregulated. So, to get back to normal, you still need a little bit from the outside because we've we've dialed back our receptors. So, for that to recover is really difficult. That's why a lot of people end up on methadone or buprenorphine or or a drug like that just to take away that terrible feeling. So, you start off feeling normal, you take the opioids, you feel great, then when they wear off, you feel bad. But then when you don't have them, you feel worse than you would have if you'd never had them in the first place. Yeah. Um I threw my back out in the gym recently and um they gave me tramodol and when I came off a tramodol when I was like stop taking that like my skin hurt. Interesting. Just like it's not a I don't know. They think it's a synthetic opioid or something like that. Yeah. But I mean I was literally I was hospitalized. I could not move. I had to go to the actual hospital by ambulance because I couldn't actually get out of the car. Oh, that's terrible. Yeah, it was that was so bad. Yeah. So, okay, here we are. No pain meds. No, no, no pain meds today. Uh, yeah, unless you brought some. Just kidding. Did not. Okay.

All right. So, let's go back. Origin story. Pathway to peak performance. You are definitely a peak performer. I mean the reality is you have a pretty interesting story. So let's go back take it all the way back uh to childhood. Okay. It's about you know growing up uh you know your your choices and how you eventually became a doctor and working at um at the company that you work at as well as you know all the other things that you do. Sure. Um well obviously starts with family. Uh so my parents were both on green cards. Uh they didn't get their citizen citizenship here until they were in their 70s. Um so my mom is British and my dad's Canadian. They met when they were in graduate school in London. They were at London School of Economics. And then uh my one of my dad's friends from undergraduate. He had gone to school in the States at Hobart. And so they uh his friend sponsored him for a green card here and they moved to Sacramento. They up and moved. They'd been living in Winnipeg after they got married. Uh and they moved here. And so growing up, I had a suburban Sacramento life. I don't know if you ever saw the show Eight is Enough, but it was kind of like that. Uh we didn't have I had one sister, not a whole bunch. Um but Sacramento is a great place. It's stable. It was a nice place. Uh, you know, it wasn't maybe the most exciting place.

Um, but I think that's fine for kids. Uh, I had a a wonderful upbringing. My parents were divorced when I was young. I was six. So, that was really tough. And I think that was one of the things that started to form me. Uh, we had to move a number of times when I was I guess when I was six and then eight and so I moved a number of times. Mom remarried. Um, and I have a great stepfather, still really close. That made me m be able to make friends, though. I think I was always being pushed out of my comfort zone as a young kid. One of the things that I always had, you know, you're a kid and you have to meet new people and that's really hard. I think it's hard. You don't know yourself as a kid. Um, you don't know your own value. I was skinny. Um, probably a little late to mature physically. Um, wasn't really until I was in high school that I would call myself a decent athlete. Um, but I worked at it. But I always, uh, always had intelligence. So, wherever I was, I was blessed with that. And I was always the smartest kid at school. So, that was sort of part of me. That became part of me. And academics were important in our household. You know, was I would imagine expected. Yeah. London School of Economics. Uh, you know, it was a great place. Uh, it was really neat. Dad, my dad always said, uh, you know, I was just a few years ahead of MC Jagger because he went there, too. So, he was really proud of that.

Yeah. So, they and you know, my my mom's side of the family is British, so we'd go over there in the summers to uh to see my grandparents. Uh it was always it was obviously fairly foreign coming from Sacramento which was not the fast lane at all. Uh then going back to see England was really a neat perspective. But then getting back to the academics so that was a big part of what I wanted to do. It was just expected that we would go to university. It wasn't a burden at all. It was always you're going to love this really fun time. And boy is it I don't know if you remember your university days. I remember mine. Yeah. You you wound up a cow, right? I did. I did. So, uh, which in the in in the 80s, um, must have been a lot of fun. It was so much fun. And it was a different time. You know, I see our kids, uh, applying to school these days and they've all sort of done their journey or they're in their journeys. Uh, but when I applied, I applied to three schools. Cal Stanford and Caltech and, you know, got into two, didn't get into one. Uh, but a totally different time now, right? That was Cal is my safety school. Nobody says that anymore. Yeah. And like you you'd be so lucky to get into cow now. It's like you'd have to have all AP classes and uh like two or three extracurricular and then community service on top of it. I think you know for it's like it's insane. It's a different world for these kids.

So I do feel for them. It's the goal posts have shifted but you know it's the world they live in. I think there are more kids in the same number of schools. That's part of it. It's tough for our kids. I I feel for them. Yeah. So, a cal um what do you what's your undergrad? What do you say? So, I went in I knew that I was probably peing in high school which was probably true. Uh so I I went into engineering and I couldn't really decide what kind of engineering. So there was this new field called bioengineering and it really what it was a major. It was one of the maybe the first class of bioengineers or second. This was I graduated in 1989. Uh but at that point you had to sort of do a poperri of engineering. So I did chemical and electrical and mechanical. I did all those emphasized in chemical engineering and then uh I also decided uh it couldn't get through in four years. I had too many requirements and for this new major and it wasn't all that well organized. So I then decided I had to do another semester. So I got a second degree in molecular biology. As long as I was going to stay, I'd get another one. And molecular biology is all about manipulating DNA and and engineering cells and that's really cool. Um and it's you know today there I don't know how many biotechs founded on the backs of molecular biology. So uh I was really fortunate and then I had to decide what am I going to do with my life next.

You asked why did I become a doctor and I was working as an engineer. Uh I worked in the electronics industry when you make a microchip you know that power our computers that what they do is they have a silicone wafer. So, they take a big cylinder of silicone and slice little pieces off, make wafers, and then on top of that, they'll put a layer of metal. Uh, and then they'll put what's called this photoresist compound where they basically have a pattern that they put on. And that pattern is where the wires will be, and it protects the the wires as you then etch away everything that's not covered by the pattern. And that'll leave you with a pattern of these very small wires on this silicone chip. And they do that in multiple layers to to make a microchip. And so I was working for this lab that or this company that they use plasma etchers. And what they are how they etch these chips is they take a gas in a little chamber and they use megahertz voltage which is very high energy voltage to make a plasma which is what the sun is. So it's not hot, it's neutral temperature. But basically they blast so much electricity into this gas that it will make the electrons and the positive ions fly apart from each other. And so say you have a chlorine gas in there, you suddenly have uh your chlorine ion that you can then use another electrode to accelerate down into the chip and that basically bombards the the chip and the protected areas don't get eaten and the unprotected areas do.

That's how they make a microchip. So I was doing that and we were getting to the point where we were trying to get down to one micron, a very small little wires and I looked around. I said, "This is going to happen with or without me." I was an engineer at this company. I said, "I want to cure a disease." Uh my stepdad was a doctor. My second stepdad uh was a a physician was encouraging me to do this. Um my boss in the lab where I was working said, "Oh, doctors are just glorified mechanics. Don't do it. So, I had these two two opposing viewpoints. Uh, but I got to go on rounds uh with uh with my second stepfather and uh and go in the hospital and see, you know, we go read X-rays, go see patients, and it it clearly wasn't just being a mechanic. Um, you had to know the body, but there was more to it. So, I think that was what made me interested enough. I knew I wanted to do research. So, I talked to my Berkeley professors and they said, "Well, you know, if you're interested in medical research, you'll probably be better off with an MD uh than just the straight PhD." And I, you know, I think there are real success stories of people who just have an MD in research in medical research and just a PhD or both. A lot of people have both. Um, I only got one. Well, it wasn't You made it sound like you couldn't get it if you want. Like, you know, the reality is you could have gotten it if you wanted it. you could have done gone that route probably if you wanted to do that but you there must have been some sort of faster path or thought process around that.

What was that decision- making like? Yeah, great question. So the US how it's it's it's different in the US from say Canada how the MD PhD programs work. So how they work in the US is you do two years of medical school then you do your PhD then you come back and do your last two years of medical school and if you do that they'll pay for your medical school. So you get the bonus of not paying for that expensive medical school, but people who do that, they lose their classmates because they go off in the lab when their classmates are going into the hospital. Um, so that's part of the lose your comrades. U, but then also you do your PhD, then you go back into the hospital and by the time you get back to a research lab, your research can be a little stale. So you have to you lose a little momentum. So, another way to do it is to do the MD and then do all the clinical training and then just go into a lab and as a fellow, which I did, and I sort of treated it like my own little PhD. Um, but the danger of that is you get thrown into the lab and you have about two years to make it, and if you don't get papers and grants, you're out. And that's fine. 98% of MDs actually do medicine, which is what they should do, and about 2% go into the research route. So, it's a little higher risk route. It seems to have worked so far. Incredible. So, you wind up at UCSF and you're working with some pretty interesting guys.

Did weren't you doing a like a co-sponsored uh thing with Michael Mat, Dr. Mat at one point in time or something? Yeah. So, we've collaborated on a few projects. Um, and we're we haven't directly written a grant together, but we've been on some of the same papers because we each brought our own skill set uh to these manuscripts. But I, you know, I want to go back to the journey a little bit because we talk about, you know, I went to medical school. You know, I did engineering, then went to medical school. It wasn't quite as straight as that. The the path wasn't wasn't like that. So, I I'll give talks to the high school kids on career day about, you know, this is where I went to school and it was Berkeley, Columbia, Duke, and Harvard. Looks great, right? You little logos up there. I never got my first choice. Medical school, I didn't get in the first time. I had a lost year, which was fantastic. Uh, so I want to know where you worked. I want to know what you did. Yeah. Yeah. So, so I had a year and a half between I graduated in December because I had that extra half year. Uh, so that first six months I went to uh I worked as an engineer. Then I resigned uh because I thought I'd be going to medical school uh in the fall in the fall. And so I went and traveled Europe for a few months uh post college which was fantastic. Just had a backpack and hiked around. went all through Eastern Europe right after the wall fell. So neat.

Wow. You'd go, there were no, nobody spoke much English. There were no hotels because there was no tourism. Yeah. So, you would show up in the train station and families would be there waiting to greet you and you could rent a room in their house. So, I went to uh Yugoslavia, um uh Hungary, Czechoslovakia, went back when it was Czechoslovakia still. And it was incredible. Uh really neat experience and uh just seeing a a society that was, you know, getting their first taste of freedom. It was really neat. Yeah. To think about the emergence of like the those people were so repressed, so fearful of the Soviet Union that it must have been like you you're walking into like um I don't even know how to describe it. It must have been incredible. It was incredible. So I remember in L Ljubjana, Yugoslavia, we went and stayed uh my friend went with me. So I had uh two of us went backpacking through there. It was so new that we didn't really want to go alone. Uh so we went and we stayed in a a student hostel like it was a university I think. Uh we're staying in their residence hall and uh we're talking to some of their kids our age and they they looked at our mouths and they said, "Open your mouth." So, opened our mouths and neither one of us had a cavity and they just couldn't believe it. I mean, the the dental care that we had was uh just completely foreign.

The the it made us appreciate uh how we had grown up in such an uh I wouldn't say even affluent, but just the standard of living was so much higher. Oh, yeah. I would imagine it was like completely different. Um so, anyway, to get back, so that was the that was the first uh six months of my lost year and a half. Uh, and then I came back and lived with some of my buddies from Cal who were still in school and I was a really bad influence because I was not in school. Uh, I really wanted to work in a research lab because I thought it would bolster my resume a bit so I could get into medical school and I was beginning to apply for medical school but nobody wanted to hire me for a year because you have to train a person and uh they just felt like it would be more investment in me than they would get out of me. Well, at least you were honest honest enough to tell them what you were really trying to do. Yeah. say they all wanted a two-year commitment. I said, "No, no, I want to go." Yeah. Instead of like leaving them high and dry. Yeah. I've had that happen to me as an employer since. And that's not tough. It's not fun. Yeah. Uh so I did have integrity, I guess. So I was uh living with these friends of mine. My my uh parents said, "Okay, we'll pay for your med school applications, but you've got to fund yourself. You're graduated from school." So I got a credit card and I could pay the rent on that.

And uh I think I ran I had these rotating credit cards. So I got up to about $5,000 in debt and I had about six months yet left before I had to go to medical school. And I said, "Okay, it's uh it's time to do something different. I'm not getting a lab job." And uh I used to paint houses. So my dad uh was a landlord. And as a kid in high school, my summer job was to work on houses, whatever needed doing, shoveling dirt, putting roofs on, painting. I did a lot of painting. So I got pretty good at it. And so I ended up painting this guy's house. He designed the Mirage Casino. He lived up in the hills. Uh Bud Comperson, great guy. Wow. And he had this spectacular house up in the hills at Lafayette. It was in Lafayette. He was doing all sorts of faux finishing. So there was an artist who was working there. So the artist taught me how to do crackle painting where you paint glue on the paint and then paint uh paint on top of that and it crackles, makes it look antique. Uh, and I did sanded these columns, put, you know, stir sand in the paint and then uh paint those to make them look old. And then I I would take sponges uh sea sponges and pounce the uh the paint on to uh to give it sort of you use a brown and a white and you make make it look all uh old, all this brand new stuff. So that was my job for six months and I was able to pay off the credit cards and uh it all worked out. Wow.

Yeah. How interesting. Really fun to learn that. Yeah, it was really fun. I my dad made me come up come home and do his bathroom with the uh the housing. He's like, "Well, you know how to do this now." I was going to say, "Hey, on Saturday, if you just come by the house, I'd be anytime. I might be a little rusty." Yeah. I only paint my own house now. The The good news when you're when you're asking for something for for free from a friend, you know, you can't be too too upset if it doesn't come out perfect, right? Exactly. Yeah. So you uh you do you do this and what happens next? Well, so I went to medical school, right? And I thought, okay, I had a lot of fun as an undergrad. I really did. Probably too much. Uh which is why I didn't get into medical school the first time. And I thought, okay, this is going to be serious. I'm going to New York City and, you know, they're all going to be nerds. And turned out turns out I was wrong. Had a great time. Met really good friends there. Uh still lifelong friends. And medical school was different. You know, I'd gone to Berkeley, which was big, as you know, 20,000 undergrads at the time. I think there are more now. And the medical school class was 154 people. Very different experience. And we all lived in a residence hall together the first year. Most of us did. And we really got to know each other. It was like going to a small little high school almost. Yeah.

uh so made these lifelong lasting relationships and such powerful experiences all the way through medical school. You know the first years you have to dissect a body is the first thing they make you do. Um and you learn a ton but also appreciate the gift that these people have given of their bodies for us to learn. Yeah, that is a huge thing, right? I mean, if you've ever been in the cadaavver lab, it's like the notion of I remember first I was like it kind of hit me. It's like where do these Oh, yeah. That's right. People donate their body to science. Yeah. Pretty wild. What a gift. Yeah. Yeah. So, learned a lot there. Um, and then as time went on, we got to interact with patients. Medical education now, they get the students in the hospital much faster or interacting with patients much faster. But in the old days when I did it, it was pretty much two years of didactic book work and then two years full-time in the hospital rotating through the various specialties to figure out what you want to do. Yeah. And in those days too, I mean, you're just getting pounded. I mean, you got crazy hours and just always on call, right? I mean, is that sort of what's happening for you at that stage? Yeah. So, medical school, you're on rotations and you do start to get the the sleepless nights. Um I remember on the medicine rotation we had to present from memory. So we had not only we did have to know the the patient write the notes. We had to present everything from memory.

Couldn't use any notes. Uh this was the old days. They don't do that anymore. But I think it made me a better doctor being able to present from memory because it makes you remember what's important. But then after the medical school is the internship and residency years. Internship is just the first year of residency. Yeah. and I did internal medicine and I did my first year at Colombia because again I didn't get into Duke the first time and then I transferred to Duke. Uh I had a girlfriend down there. Um and I remember at Duke my second year was definitely the hardest. There was a six-month block where I had one day off and I almost went to the hospital because I had nowhere to go. I didn't know what to do with myself. I said, "Philip, you can't do this. This is Stockholm syndrome." But uh it was tough. So we had when we were in the in the intensive care units, it was every other night call. So that meant that we worked 26 hours, then you had 22 hours off, and then you worked 26. And it went on for two months, just bang, bang, bang. And you know what they said, the the only thing wrong with every other night call? You miss half the good cases. They call them the Duke Marines. And we did work hard, but we were good. You know, we got a lot of responsibility given to us. Um, so it was a really good experience. Learned a lot. Drew on that the rest of my life of being a doctor. Um, how many patients I saw during that period.

Wow. Must have been intense. It was intense. But then we got to the last year of residency and you had an option to go do three months somewhere else. So I went to Brazil. We had a a program uh with this hospital in Victoria, Brazil, which is up the coast from Rio. Now, out of curiosity, did you speak Portuguese? I mean, what the Brazil experience must have been really intense. I mean, really intense. It was great. Uh, so I knew I wanted to do infectious diseases at that point and it's a chance to see tropical medicine. It was amazing. So, no, I didn't speak I spoke I took high school French, took three years of high school French and uh when I was an intern in New York, I taught myself Spanish just reading a book on the subway to and from work because I had to I was either call a translator for every Spanish speaking patient, there were a lot, or just learn it. So, I learned enough that I could communicate. So then when it came time to go down there, they gave us these burlitz language tapes we'd put on our uh on our ears and and listen. So the first uh first and these are all young mostly single residents. The first sentence we learned was uh so eazada which means I'm single. Are you married? So we'd all walk around the hospital at Duke saying this to each other. And I since learned from the uh from the Brazilians that the the first sentence they learn in English because they all take English is the book is on the table.

So I don't know why we learned such a racy uh racy beginning but yeah it was really fun and I actually did because I had this protected time uh I was able to learn a fair bit of Portuguese. And still I had a patient this just this last week uh from Brazil uh who was newly diagnosed with HIV and we were able to talk in in Portuguese. It was really fun. Yeah. I think if you learned Spanish, you know, you're in New York City and you know you're saying Servesa, now you've got to learn how to say Servesia, right? Nice. Cvesasia Benjelada. That's how the Brazilians drink it. Ice cold. They like it so cold. Yeah. You never want to miss out on the casa, right? Oh yeah. Viperas. Um, holy smokes. Oh, you've been there, I guess. Huh? Well, you know, here's the funny thing. I have not, but my brother went there uh visited some family friends and he came back uh at I think he was maybe uh 15 years old and I don't know how he pulled this off, but he brought back a bottle of that of the Kashasa. Yeah. That was the first experience that we ever had with that. And um and let me just say it was a good one. Yeah. Isn't it great? Yeah. I remember my first day I got there, we went down to the beach. Uh there were two of us sent down together. So, another resident and I went down to the beach our first day, got some kyperinas, looked out at the water, and we said, "Oh my gosh, can you believe we're here?"

Yeah. So neat. And what was great about from a medical standpoint, uh we went all over the country. Actually, our professor took us with him to conferences. So, we got to see the up in the Amazon and really remote places and see new diseases. And one day I saw three diseases I'd never seen before. I think I was in Rio that day. Uh it was leprosy, uh measles, and um someone with uh tetanus and they had they had lock jaw and they were on the ventilator because they couldn't breathe. They were paralyzed. And you basically have to wait for the toxin to wear off. So these people can be on ventilators for a month until the the toxin gets out of the body. Are they conscious during this period of time? Well, they get sedated. Um, yeah. So, they would be if they weren't, but they get you give med someone's on the ventilator, you usually need to give some sedatives so they don't fight the ventilator. Uh, it's very rare for somebody to be able to tolerate having a breathing tube on and having the Yeah. I mean, to be intubated and conscious must be like, whoa, that's I had one woman, and this inspires me. If I ever have to go on the ventilator, I want to be like her. She let the machine do its work and stayed conscious. So, she wasn't sked out and so she was still able to write messages and communicate. Uh, but that is very rare for someone to be able to tolerate that tube uh without having to get knocked out.

Yeah, that's heavy duty stuff. It is. The leprosy case, what was that like? Well, they have a fair bit of it there. They call it Hansen's disease now uh because of the stigma attached to leprosy, but you know, we all know uh leprosy from biblical times, right? Um, so there are different, it's a really interesting bug. So it's a cousin of tuberculosis. They're they're both mcoacteria because they have these micopenolic acids in their cell walls. Um, I never knew that. That's so interesting, isn't it? Yeah. Yeah. And they're both kind of slow growing bacteria. They're mcoacteria, but they're both slow growing. So tuberculosis typically goes into the lungs and there's an acute infection then usually uh it goes dormant and stays in the lungs and then later in life it can reactivate or if people get immune suppressed it can reactivate. So that's it can do other things like there's a disease called scopula which is tuberculosis in the lymph nodes of the neck. So it has some other it can infect the spine and cause problems there but that's tuberculosis. So its cousin leprosy is also a slow growing bug and it has different forms. So there's lepromodus leprosy or we call multibasel. I'm getting a little technical but there are a lot of these uh uh tubacles in the skin. Um and there's not as much of an immune response. And then there's the other end of the spectrum where the immune system really attacks it and there aren't that many of these leprosy bugs in there, but you get a lot of damage to the nerves from the inflammation.

Manifestations are uh nerve damage. You can see little patches of numb skin or you uh the the nerves to the digits get damaged and then neuropathy and just can't like feel stuff anymore. Can't feel stuff. So then you get damaged. So that's why people you think of the lepers with their body parts falling off. It's because they don't feel so they get damaged, don't know it, and then you get little infections or infarks and skin's damaged. It's almost like the same thing you get with diabetic uh wounds, right? Yes. Exactly. So hyperaric oxygen therapy used in treatment of that um w with leprosy is that something that was available at the at that time? No. And it's a little different. So hyperbaric oxygen is delivering oxygen to the tissues, right? And in diabetes, it's really a disease of the small blood vessels, right? Yep. So that high blood sugar damages the little blood vessels. So if you have say a diabetic foot infection, there's usually not good circulation there, which is what allows the bugs to grow uh because our white blood cells can't get in there and there's not enough oxygen. So that's how hyperbaric oxygen therapy is supposed to help a diabetic foot. But that's not the same thing that happens in leprosy. Got it. So with with that where hyperbaric oxygen therapy, you're pushing oxygen compressed to that hypoxic tissue and and getting oxygen in there where it couldn't get otherwise. Uh in this particular instance, that's not effective. So tell me more about this.

This is fascinating. The leprosy. Yeah. Yeah. It was so interesting. In fact, when I came back from uh from Brazil, I had to give a presentation at Duke about what did you learn and uh this was before we really had much in the way of computers and we had computers but uh so I still have the little old slides. Remember you'd have a photo uh in a frame and I still have those slides. So I gave a talk on leprosy uh just the history through biblical times and uh and our own US. I think the the history of leprosy in the US is really interesting. the the lepous area. Uh the places where we put the lepers, uh Carville was a big one in Louisiana. Um and it shut down, gosh, this was in the '90s, so it must have shut down in the late '7s. So up until that time, we still had people living in uh segregated from society, which is incredible. Yeah, I remember Mai in Hawaii, right? Flying over uh from in those days, you couldn't just fly to Maui, right? Uh you had to fly from um Aahu. Aahu and you fly over Machai basically and there's leopard colony down there. Wow. Yeah. Wild, right? Yeah. So we have it uh here in the US armadillos will carry it. H those cute little armadillos. They can carry leprosy. So don't snuggle with armadillos. Do not snuggle with an armadillo. Don't sleep with them. Yeah. Okay. So it's a disease that uh like tuberculosis. It's close contact.

So you don't have a high burden of bugs usually. So it's you got to be around someone who's a leper which is why the segregation worked through middle ages to now. I mean it's not a very easy disease to pass on. Um and now we have drugs. So it doesn't mean the same thing it did back in the old days when it couldn't be cured. Now we have cures for it. So what is it like some sort of high power antibiotic that you're using for that or what is it? Yeah, there's a combination of antibiotics that are used. Um, so and some of them like chazamine turns the skin red. So there's some stigma attached to that because if you see someone who has this characteristic sort of ruddy complexion in an area where leprosy is active, you know that they're taking the medicines for that and it can be a permanent skin. Uh, but we can cure it. So that's the uh that's the important thing. So all right. So you you get uh tetanus, leprosy and what was the other one? Yeah. Uh I think it was measles. Measles. I had not seen Well, now we have measles all over the place, right? Because we don't vaccinate people. Uh but back then we had very high vaccination rates in the US and we very rarely saw measles case. Um and they still had trouble getting everybody vaccinated up there or down there in Brazil. I remember getting vaccinated as a kid for measles. I think MMR. Yeah, everybody does. What was the thing that was the little scar? Oh yeah. Now that's very interesting.

So that was smallox. Oh yeah. So small pox has been eradicated, right? So it lives in the freezers in some US labs and some Russian labs. That's it. Uh unless there's some hanging out in a lab we haven't identified, but as far as we know, those are the only two stocks of small pox that are left in the world. And that was a real triumph of vaccination. I think it was in the early 70s that the last cases what they would do is they'd find a case in say Nigeria and they would then do ring vaccinations. They'd vaccinate everybody around that contact of the case and then all their contacts and maybe all their contacts and that strategy was able to get the wipe out the last cases that were in humans. Really exciting. A true epidemiological exercise, right? I mean you're really that's that's really is epidemiology applied. Yeah. So uh there there's a side effect you know getting the smallox vaccine some people would have these really bad side effects like it could spread from there uh and very rarely someone would die from a smallox vaccine. Um so it wasn't an easy vaccine to take and you had to actually uh scarify the skin. You would actually take this little tool and make holes in the skin and put the small pox in there. uh the small pox vaccine and then it would give you lifelong immunity to the real small pox. Same thing with polio. I remember taking a polio I think it was like a liquid. Okay. Polio vaccine. Was that a liquid?

Well, they had two. They had the uh they have the oral polio and then they have the inactivated polio that you inject in the skin. I had that. So, um I wanted just one last thing on smallox then we're going to get to polio because that's really interesting too. So the small pox, you have it, I have it. My little sister who was born in 1970 doesn't have it because that's when they stopped. So if there's the apocalypse, you and I are going to be fine. But all those kids born after that, they're going to need revaccination. Yeah. And you know what? At some point in time in the episode, we do need to talk about like, you know, things in the recent past and what's the potential for other things in the future if you're willing to do that. Oh yeah, yeah, yeah. It's all fun. I think as a biologist uh it's really interesting to talk to you about those things. So let's talk about polio a little bit because you talked you touched I had the inactivated you had the oral. What's the difference? What why? Right. So the uh the inactivated version is a dead polio and you just get the proteins from the virus and make an immune response against it. Boom. You vaccinate one person, you vaccinated that person. Oral is very interesting. So it's an attenuated virus. So it's actually a live attenuated meaning weakened polio virus. And so the way they did it was they took a a virus from a person who had polio and paged it in uh cell lines uh for hundreds of passages.

Without that selective pressure of being inside a human, it loses its ability to replicate. Well, not to replicate but to invade the nervous system. uh and to replicate to really high levels. But when you give someone a polio oral polio virus vaccine, they do shed it in their stool and then it gets into the environment and other people get vaccinated. So if you go to a village in India and give one person a polio vaccine, you're vaccinating 100 people because that virus spreads and then it ends up getting through the community. Wow. So really cool except the oral polio vaccine uh can revert if it mutates it can revert to the pathogenic form. So a lot of the polio we see in the world now is actually vaccine derived because it's it's mutated. So we have two choices. We can go give inactivated polio virus to everybody. That takes a lot more infrastructure uh than just a little sugar cube on the tongue uh to actually do all the injections. or we could re-engineer that polio virus to make it less likely to turn into the pathogenic version. And so that's what they're working on now is making a new oral polio virus vaccine. I just saw a lecture at UCSF uh last week about how they're doing that. Really interesting. So if you make the barrier uh to mutating higher, you put more mutations in, there are all sorts of tricks you can do to make the virus less likely to turn pathogenic.

Maybe then we'll have a chance to vaccinate these areas where it's still breaking out like in Pakistan and uh other areas of the world where we still see some of this revertent polio coming up. So there's a chance for eradication. Tough problem though. You think you've got it and then whack-a-ole pops up over here. Yeah. That's so crazy because you thought for a long time it was just it was not an issue and then all a sudden you hear about it starting to come back and you're like how did that happen? Yeah. You take your thumb off and the diseases will spread. Yeah. Well, now we know, right? Yeah. Um All right. So, you're in Brazil. Oh, yeah. Um drinking Kairinas. Yep. Really fun. Seeing exotic diseases. Yeah. Um and you're there for 3 months. Three months. Did you want to leave? Oh, I knew it was time to come back by the time Well, so uh it actually worked out that we had two and a half months of work and then got vacation during that period. So I had two weeks of vacation there and my dad flew down uh and so he was my banker and I was his translator. It was fantastic. We traveled uh all over the Amazon and uh we went on a helicopter tour over falls jaguas arranged by me funded by him. So it was really fun. You know I was just a poor resident at that time. Uh so we had a really great time. He actually got to participate on one of our research projects. Uh we were doing a malaria project up on the edge of uh the Amazon up there and he got to play around with that.

So he had a he had a great time. He was a businessman so for him this was exotic. Super cool. Yeah, we had a really great time. Uh so then that was over. Vacation was done and it was time to uh to come back and finish residency and then go on to the next stage fellowship. So where do you finish residency out at at Duke? I did. So I was there for two years and finished internal medicine there. So that was my internal medicine training. And so you've got an inkling that you you know you want to be an ID guy, right? Well, so I had to decide and uh I knew I wanted to do immunology research. I always wanted to be a research scientist and I got to do some of that with this uh this great guy Leonard Chess when I was at Colombia. I rotated through his lab and we were looking at TE- cell receptors and it was pretty early immunology days. Um we didn't have all the techniques we have now 30 40 years later. Um, so immunology interacts with a few different areas of medicine. If I were going to be a clinical practicing doctor, I liked pulmonary, which is the lungs, renals, the kidneys. That fits with the engineering side, right? You're dealing with acidbased imbalances, and cardiology was really interesting. So, I really like that, but the research I wasn't as interested in. So, what really goes with immunology? So rheumatology that's arthritis and all that sort of thing, right? Autoimmune diseases. For me, that was interesting uh research- wise, but the clinical side, it's chronic pain, and I just know my own personality.

It's frustrating, right? The patients are frustrated, and I didn't want to do that. So, another area that was really uh interesting is cancer immunology. And gosh, the Nobel Prize was awarded in 2018 for the people who figured out how to treat cancer with uh these immune modulatory drugs, immune checkpoint inhibitors. So, I really was interested in that in terms of uh a research direction, but for me, uh being an I rotated through oncology and so many patients die. I mean, a lot of people die of cancer and each one took a lick off of me and I just knew that was going to be really tough personally. Um, and you know, there are oncology doctors who get addicted to drugs and it's it super repressing, right? It can be. Yeah. It takes a special person. I have such respect for the oncologist. Um, and I knew that I just I probably wasn't up to that. Um, didn't have that in me. How is it that you were so self-aware? I mean, that seems to me like in your pathway to peak performance, you've got this self-awareness that a lot of people just don't have. Was that just like I mean, how how are you able to like get the perspective on things and kind of know when I think so many people uh just don't? Yeah, I think you can sort of bumble into things uh and there's nothing wrong with that. Uh life presents opportunities and you go down that pathway. There are plenty of people who are plenty successful and more so than I who had a good break and that's they saw an opportunity and took it.

So there's nothing wrong with that. Um I was fairly thoughtful I think uh in trying to choose the path. I had a vision of what I wanted to do. Not that I've achieved that vision yet, but I'm still working on it. Um and then it was actually easier. So the third area that inter intersects with immunology a lot is infectious diseases. I mean gosh, a lot of our genome is is the way it is. A lot of the variability in our genome between us is driven by infectious diseases. So the most variable part of our genome is what's called the HLA complex, the human lucasite antigen. And so these are the molecules that present foreign material on our cells for our immune system to surveil. And we each have a unique set of these HLA molecules. And it's diverse. There's a ton of diversity there as I mentioned the most diverse part and that's because if there's a new plague that comes along wipes out 99% of us 1% of us are going to have that one alil that can present the antigen well and be immune to it. So that's gives us the diversity of the immune system. So infectious diseases interacts with immunology at a very profound level and has shaped us as people. So when I was a medical student in uh New York, it was the bad days of AIDS. We had uh act basically and and you know there are couple there was another drug that came out I think DDI. These drugs had a lot of side effects and not much effectiveness.

So uh they would drop the viral load how much virus is in the blood by less than 10fold. And we're talking you know there are millions of copies in the blood. So you're taking it from a million to 100,000 or 100,000 to 10,000. You don't make much headway in terms of protecting the immune system for for going to like full-blown AIDS. Right. Exactly. So HIV infects what's called the CD4T cell. These CD4T cells are the quarterbacks of the immune system. So they they talk to uh the CD8T cells, which are the ones that go around and and kill cancer cells. They kill uh infect virus infected cells. They talk to the B cells. B cells produce the antibodies that go around and bind the virus. So these CD4 cells are really critical. And if you take them out, you still have CD8T cells, but they aren't as effective. You still have B cells, but they don't really make antibodies the way they should. So you become uh more and more immune suppressed as the CD4 cells go down. It's kind of like whopping the head off of the You know what I mean? Is all of a sudden you're Yeah, the commander's gone. you got some troops and they don't know what they're doing. Yeah. And so when I was a medical student, it was it was really rough. We'd have uh mostly gay men, some Haitian uh and other but in that at that time that was the main driver of the epidemic in the US or the main victims of the epidemic. Um and they would come in and with these terrible infections and we might be able to cure the infection or stench the infection but not fully cure it uh to get them out of the hospital but then they'd come back and eventually would succumb to these infections and and lose all their body mass.

It was just terrible. People wasting away and dying and it was it was horrible. And these were young people. These were people my age. I was in my late 20s by this point. And then in 1996 there was a remarkable conference in in Vancouver an AIDS conference where David Hoe presented the data but it was developed by the drug companies made protease inhibitors and these proteiase inhibitors protease is one of the proteins that HIV encodes. So uh a virus infected cell will make this protease and it's basically a protein that cleaves the HIV makes a long poly protein with all of its uh proteins in it and then this this protease molecule chops it up into little bits that are functional. So without it the virus is kind of stuck as a string of protein but doesn't do anything right. So once you chop it up into its components then it can assemble and do all its things. So this was the first potent drug that would actually suppress the virus to levels where we couldn't detect it in the blood. So this is where Magic Johnson has the breakthrough. Yeah. Exactly. And everybody So they called it the Lazarus syndrome. So people had given away their car, given away their house, they had three months to live, skinny, skinny, all of a sudden they put on weight, they're they're alive, they're living. Uh it was incredible. And that's why I went into infectious disease because there was a ton of immunology there. There was so much hope. It was absolutely the place to be.

Must have been so exciting to be there in that Well, I wasn't in Vancouver, but yeah. No, but to be part of that environment. Yeah. That that that feel at that point in time where there's that much momentum towards like, hey, we're going to really I mean that was just had everybody stunned and terrified. Right. Exactly. So, I finished my residency in 98, mid July of 98 or June of 98. So July of '98 I started uh my fellowship and there there I went up to Boston. I was at Mass General at Harvard working with a a fantastic mentor Bruce Walker really a giant in the field. So I again had been thoughtful. I read papers of all the people around the country uh who were doing good work and interviewed at a bunch of places. Again I put UCSF as my first choice. I always did because I wanted to come back to California. But in those days there was a ma there's a match. So, if you're going into a medical specialty, it's not that you say, "Oh, I want you. You want me." You rank them and they rank you. So, I picked up this phone. There was a computerized voice that said, "Congratulations. You have matched at Massachusetts General Hospital." And I put the phone down. I said, "No, that can't be." I was talking to my friends in the I was in the hospital and I picked it up and they said it again. I said, "Okay, I guess I'm going to Boston." But it was such an amazing period. Such a terrible choice. I know. I know. I mean to be at Harvard in those days that was really humming right?

I mean you it was uh it was so exciting and I was so lucky because my mentor who was doing really nice work he had I think maybe four or five people in the lab I think he had four postocs and a couple of faculty members who were part of his universe really fantastic guy and when I was there he went supernova he actually was on nova the TV show. No kidding. uh but raised a ton of money and since then I think he's raised gosh hundreds and hundreds of millions of dollars for AIDS research at Harvard. He's built a couple of buildings there. Uh but when I was there he was still a bit younger so I had really uh good access and interaction with Bruce uh who taught me so much about science. Uh he had these saying you know the data are the data meaning you may have your theory but the data are the data. That's what it is. Yep. He said always be your own worst critic. So don't get out over your skis. You know, you've got to be critical of your own work and is this real or not and prove it one more way. You know, you prove it this way. My dad always says something, never fall in love with your own immaculate conception. Right. That's beautiful. I like that. Yeah. And we all do that, right? I even in the hospital, I thought I had this really cool diagnosis and it turns out it was wrong. So, you have to keep your mind open uh and see what where the data take you. Yeah. Wow. What? How interesting. It was incredible. So that was 98. Uh and I went in there and wor worked in the lab.

And so I did a year of clinical work where it was just, you know, 12 hours a day of seeing infectious disease patients. Uh and that was a grind. It was hard, long days. Um again, I trained before the duty hour things came in. Uh I think they may have been in on paper, but they actually didn't get executed, which was fine. I actually think that our system uh even though I was tired, I made one mistake when I was an intern. I forgot to check a potassium level in a patient. Came in the next morning. This is at Colombia. And there were these big elevators that went uh up and down and I was going up the one and I saw my medical student coming down looking perturbed, anxious. I said, "Oh no." And it was Mrs. T. I won't say her name. Uh, and so I went right to her room and of course she was having a seizure and the neurology resident was there and said, "Well, you realize that her metabolic imbalance is propos I was predisposing her to the seizure and I because I had forgotten to check the potassium was after a 36-hour shift." And that was the only mistake I made and it was fixable. So that's quantifiable, right? You see, he made a mistake. He was tired. Uh, but what we don't see is what happens now is there's a handoff. Uh when I would work a 36-hour shift, I would see the patient come in. I'd see them through the night, through the next day, and I would know, are they better or worse than when they walked in the door.

Now, with signouts, uh you know, Mr. H is a little sick. Keep an eye on him. But you don't know if he's sicker or not more sick. Uh so that's the disadvantage of the current system with the sort of shift work that we do. I admire you so greatly for actually that's not something you had to talk about on the show, but I think that's incredible that you actually have the courage to actually say that. Um many people would just not want to talk about something like that. It's admirable that you would actually um you know call that out and and and say that and then also talk about sort of what's happening today. It's interesting. My uncle had uh was in the is in the hospital today. Oh, I'm sorry. Yeah. had um normal pressure hyphilis and um and all of a sudden he's you know starting to lose his ability to move. Next thing you know um the craziest thing about it was he's um they're they want to go in and you know drain it. And um so the neurologist like oh well you know I'm going to be going out of town so let's just go ahead and you know we'll wait to do the procedure. I'm like, "No, no, no. This is where you need to understand how that he's not the only neurosurgeon in the in Miami. Let's get another or you need to do that now. He had four cardiac arrests um in the process of this trying to get this procedure done." Oh gosh. Yeah. I mean, it's like you really have to know um the health care system to know how to actually navigate it sometimes.

I think sorry to interrupt and tell you my own personal story about that but I think it is interesting to think about you know the notion of handoffs and um you know when I was in the hospital overnight for my back I I had I think two or three different doctors one came in and told me I had scoliosis. I'm like no no no I don't have I don't have scoliosis. My muscles are spasming. My lower back is tweaked. you know, now you twist to just get get the muscles to relax and we'll be fine. Sure enough, that's what it was. So, yeah. Yeah. All right. So, you've uh you you've got the fellowship. Yes. So, I'm work so I do the the year of clinical um see a lot of patients which I think is really important to build the knowledge base. Uh and then after that I went to uh uh the lab and I would have clinic once a week, one afternoon a week. So I still stayed a little bit clinical but really went in the lab and this was when my chance I remember the first day I walked in and I was working with uh so Bruce was my main mentor and I had Eric Rosenberg was sort of the junior mentor. He was not that much older than I but he done really well and got a faculty spot. So, I was working with him and I went in to talk to Eric and said, uh, you know, I want to go, uh, away for a week, uh, vacation. Who, how do I do that? What paperwork do I fill out? Who I tell? I said, nobody. You just do it. You're self-employed now. So, that really hit me. Uh, as a scientist, it's not that you're punching a clock and somebody's tracking your hours.

You could work six hours, you can work 12. Nobody cares. What they care about is what you produce, right? Papers, right? Yeah. papers are the the coin of the realm. Uh so if you don't write the papers, nobody's going to fund you. And then of course the real coin of the realm is grants. You have to write grants. So my first year before I even got in the lab that clinical year when I was working really hard, I wrote five grants which was a lot. But I realized Oh my gosh, that's I mean you you were working you were working overtime, right? Yeah. So I did have a lot of help from my mentors uh writing the first grants because I didn't know diddly squat really. So, they helped me. Uh, the one that came through, I went down to New York. My buddy was turning 30 and this is pre Uber. We were standing on the corner uh upper east side and uh wanted to get a cab and it started to rain. So, what happens when it rains in New York? Cabs are gone. It's like the lights turn on, the cockroaches went away. So, there was a woman on the corner in front of us and we said, "Hey, uh, you're going downtown. Can we share the cab? We'll pay for it. Just let us sit in your cab." And she said, "Sure." And then we got to chatting and she actually ran an HIV uh advocacy called cable positive uh that raised awareness of HIV through funded through the cable TV industry and they wanted to get into research a bit.

So I I didn't know any of this but I told her all about what I was doing in the lab up in Boston and uh we exchanged cars and I got a $50,000 grant out of that that cab ride and then was able to renew it. So, it was really a $100,000 cab ride, which was a lot of money back in the 1990s, dude. You know, so here's the thing. You know, you could look at that statistically and say, what are the odds, right? And then I think the way we would view it as that was pre-ordained. That was something that must have had there. There's something in that. I think so. I mean, I was really blessed. I really was. Yeah. That there's some real power in that. Yeah. I hadn hadn't really thought of it that way. I always thought of it as lucky. But you're right, there's some Yeah. Yeah. There's some at work there. Yeah. So, uh, she's wonderful person. Molly Padian was really my first benefactor. What a fantastic story. I mean, like, I mean, fun. Yeah, that is really cool. Right. And I was just talking about research to everybody. You talk about flow and I was really into what I was doing and I could still have fun and go to New York and help my friend turn 30, but I was also really into what I was doing. I think if you look at a lot of successful people, they're really into what they're doing. Passionate. Passionate. It's not something that you just go. It's like you it I don't know. For me, I'm not tell me. I'm not going to No, I want to hear it. What I'm going to say is that um you know, I I don't think of myself that all that successful, but what I Well, I do.

Thank you. Uh what I would say is that it never turns off. It never turns off. Ah, it's just something that is just it's just there all the time. Well, you know, I would I would I'm going to differ from you there. Uh so I had uh we're going to flash forward. We can go back to Boston because there's a lot more to talk about there. Yeah. Yeah. Uh but I want to talk a little about my later career. I guess I'm mid to late career at this point. And you know, there was a competition to see who was going to run our research institute when the when the founder retired. And I did not win that. And I Yeah, it was hard. Yeah, really hard uh for me personally to get over it. And so I would say that I lost my passion for a while. I you know, I had a different perspective cuz I had this path that I thought I was on. Um and I would say it's just coming back. It's been a couple years. It's been hard. Now, you know, hearing what you're saying, I would have to agree with you in the sense that what we have some of these setbacks that can really uh derail us. And, you know, it's kind of like the mystics didn't feel presence of God for long periods of time, right? These um points in time where people are sort of like, you know, hey man, this doesn't match the picture. I I did all the work. What where's the outcome? Right. Yeah. Poor Job. Yeah. Oh. Oh, yeah. But we could just spend the entire afternoon talking about Job. Yeah, that's uh that's one to get into another podcast for that. I like that.

Yeah. Have you back? Yeah, that's what Listen, you know what? Here's the thing. I always ask the people that uh that I really want to spend time with, I always come back. Um, and you know, you're certainly every time I'm around you, Philip, you just really are a guy that I just go, man, the energy of this guy, it's like you, you know, you feel like anything great can happen. I can't believe you're telling me that cuz I look at what you do. I don't know how many companies you run. I mean, they're all under an umbrella, but what you do, you have your finger in so many pies. And not just work. I mean, you do the the work on the the boat, uh, FDR's yacht, you do charity work. I I just can't fathom how you do everything you do. Well, you know, it's funny. Um I think it's just, you know, you get into like a flow state around, you know, if I have to spend a lot of time sitting around not doing anything, I'm not Yeah. Not good. It's not good. Yeah. I'm never bored. Yeah. You know what I I think I mean what's so what's so interesting is you you know you know so much and I remember when we were in the pandemic you know we're just getting information from you u I wasn't getting it directly I was getting it through the recctor of our church but right being advised about sort of what you know and what the bishop was saying and what we could and could not do which I personally at the time felt you know uh and who's far be it for me to say but I felt like it was a little heavy-handed.

Um, but then again, we did have we had a lot of old people and uh it was a pretty serious situation going on at that point in time. Yeah, as we looked through the retrospect scope, uh clearly we should have been more open, especially for our kids. We can handle being isolated, but for the kids it was a tough Yeah, our kids, both of our kids were smack dab in the middle of that. Um, and uh, that was I mean, can you imagine like just going to school for um, you know, 8 hours a day or whatever it was in your room online. Um, yeah, Brittanna was going into her freshman year at Redwood, but she'd gone to Mil Valley Middle middle middle school, which was a different group of friends, right? So, she was now at a high school where she knew nobody and couldn't meet them because it was all online. So, I mean, very isolating. I remember when we had uh confirmation for both uh Brent and for Phoebe out at Blackie Pasture. Black East Pasture. Y right confirmation. That was wild. It was wild. Our uh so our eldest child, Cleo, went to school in Montreal. She went to Miguel. She came home for Christmas and she was in a basically it was like a hotel room. It had its own bathroom in the room and couple beds. She was in there alone. Uh, and she wasn't allowed to leave that room for two weeks because of the Montreal authorities. And if she walked out the door, they uh, they'd kick her out of the dorms. Wow. So, it was like being in prison. Really, two weeks stuck in a room.

They would bring food to her door, but that was it. Uh, so we would do Zoom calls every day with her to try to bear it through. But to do that to these kids is is not brutal. Yeah. So, clearly we made mistakes. So, now I know why she says the internship with us was so good. She was out of prison. Like, man, this is this is great. Yeah. Yeah. That was a really She enjoyed your That was her first uh data analytics experience. Yeah. Everybody on the team, everybody on the team's like, "Can we get her to come back?" I'm I'm like, "No, she's never coming back here." She's uh she's doing so she's, as you know, at Georgia Tech doing her masters now. And I think this summer she has a she's with a private equity firm doing AI, trying to apply AI in that private equity space, which I think is really challenging. So, we'll see. Oh, far she does. That's going to be heavy duty equation work. Yeah. Oh, that's what she does now. She has her math major and she's learning how to do the coding to be able to translate the the algorithms into machine learning code. So, yeah, she's well beyond where I I am. That's for sure. Yeah, it's so crazy to think like sometimes your son doing similar thing. Yeah, Jack. Yeah, he's you know, I think what we're going to see with this this uh generation of kids is uh is amazing. When we grew up, we just didn't have a lot of the things access to the information.

I mean, you know, it wasn't Oh, inside Clipedia Bratannica. I remember that. It literally read my mind. You literally I was like I was I remember we got the Yeah. Right. Okay. I know how to break that. Um it's like, you know, now you think about it, these kids have had access to information and the access to information now with AI. Uh it's incredible. I mean, how many times a day do you use Gemini, Chat, GBT, Forlexity, uh whatever to to look up? I mean, you know, I'm not using quad really to look things up, but reality is like these models are so incredible and if you know how to prompt them correctly, you can get information that's just insane. Yeah, people complain about the hallucinations. I find that they're much less and if you do your prompts right. Uh, and the I use chat GPT mostly now just cuz that's what I have access to and their links are in there. You can check, you have to double check the references, but it's so much better than I've been using it for about 18 months and it's night and day. And this is the worst it's going to be. From here, it gets better. I mean, it's insane how um funny story. Yeah. So, Coad is now able to, you know, it's capable of deception and like, you know, they ran some scenarios. We're going to shut it down. It's going to black. Yeah. It's like, oh, I'll shut myself down. Look over here. Not not happening, right? Um, I had something with Grock where I was basically working on a project for like four hours on a Saturday.

Oh, dare. In voice mode. It was really stupid on my part because I should have checked to make sure that it could capture this and and put it into memory, but it could only it could only operate in that session and it was I got to tell you Gro 5 when it shifts is going to be insane. That is a great model, you know, tied to XAI. It's it's phenomenal. I just I just think like um you know I guess uh Elon's selling X to X AI now which makes sense right in the notion that it's being fed continuously. Uh one of the guys now I'm drawing a blank on his name. I don't know why I could possibly do that left Meta recently and really believes that large language models are not you know AI is not going to be trained that way. It's going to come through having uh them watch video and it's a incredible time. It really is. Yeah. And you have to keep up because otherwise we're going to be the people writing on stone tablets when everybody else is on a computer. Yeah. Yeah. I mean it it it feels like when we were in 1996 or 95 and we're sort of like, you know, you've got mail, right? You know what I mean? And we're about to break through on a whole another level with aentic AI and automation. Yeah. That it's just going to be so phenomenal. The interesting thing about it is you think about all of these companies uh need GPUs, but Google has really got the entire I think Google has just got it nailed.

Their entire AI supply chain is just I mean they've tensor processing units versus GPUs, they've got it all the way down uh and such a massive amount of search related information um query related information. It's really a phenomenal time. So from a medical standpoint, speaking of Harvard, they just came out with a uh a new model to detect uh disease and I mean they're I think University of Toronto has something going on. I mean there just all these different models all over the all over the Oh yeah. Yeah. It's so UCSF we're going to get access to uh chat GPT in a in a closed environment uh in 2026. Oh cool. Everybody with a UCSF email will will get that. Wow. Yeah. So the big thing uh you know I'm at Vitalent which is a the second biggest blood bank in the US and we collect almost a million units of blood a year and we have a lot of data all those people. Yeah. Uh but of course we can't just put that out on the web and throw it into chat GPT or cloud or anything. So we need to have a closed system. So that's the I think if you're a bank, if you're a hospital, whatever, you need to have uh an environment that's sort of a closed off environment and then you can do retrieval augmented generation or rag to interact with your data but not have it leak out. So security is a big deal as you can imagine. We're moving slowly and cautiously, but uh again we're working towards getting access to these large language models that can interact with our data.

So, right now I get to use it. Uh, I can put things up there that are not sensitive, but uh, you know, you lose your intellectual property. There all sorts of things you can do if you put the wrong stuff up there or any personal information you certainly can't put up there. Yeah. I mean, I was having a conversation with uh someone this morning. Um they're talking about the notion of you know well who who the trust war and she's like I don't think anybody I mean at this stage of the game the notion of any kind of privacy or anything like out the window right it's gone. Yeah. Yeah. It's pretty wild. Well even with genetic sequencing we would do genetic sequencing on research participants and say you know this is all coded and you're you're you will never be linked to this. And then there's a pretty famous paper a few years ago where they took this data that had been uploaded and all anonymized and they could actually go back and and find people through their genetic code that could figure it out. Our ability to protect privacy is getting less and less and less. Yeah. And of course we carry around this little tracking beacon with us everywhere. It's listening to everything you say. It is. It is. Even though I turn it off. Yeah. It's all there. It's all listening. It's It's pretty wild. Um can we go back to Harvard? Yeah, let's do it. Okay, so here I I just finished this clinical bit. Started in the lab, take a vacation whenever you want, right?

So, uh I was so focused and this is terrible. When my first child was born, she was born at Mass General, Cleo, and Alex had a very long uh labor. The Cleo was antied, meaning kind, which made it harder. And so, uh the doctor said, "That's going to be about 12 hours. Uh this is this is nowhere near uh ready or 10 hours." And I said, "Okay, great." I had a lab in the next building over. So, I went and ran an experiment all day and came back. And now looking at that with my 58-year-old self, like, Philip, what the hell? I was so focused on making it, right? So f And Alex was like, "Yeah, sure, honey. Go uh go do it." She was so supportive. Uh and looking back, like, what the heck was I thinking? Of course, I was there for the the key moments, but you know, you get so in wrapped up when you're young into getting ahead, I think, that you forget the perspective or you don't have the perspective yet. Yeah. Another time, uh, now Cleo was probably, and her name was Katie. I was in San Francisco at this point and she was maybe 18 months and, uh, it was one of my rare duties on on night duty. I think Alex had been up several nights and so she was crying. And I went downstairs and looked her in the crib and I said, "What's wrong?" She said, "I want a hug." And I said, "Go back to sleep." Went back upstairs. And I told this to a colleague of mine. He looked at me like I had three hits. He said, "Philip, there are a finite number of hugs in this world."

I said, "Okay, you're right." So, uh, I think you can get too intense, too focused, and a lot of people are like that. Well, I don't know if a lot are. I certainly was. Uh, and I'm becoming to appreciate it more now. How to have that the balance. Yeah. You know, it's funny. I mean, I think back on a lot of stuff where I can totally relate to that. Yeah. Yeah. Missed opportunities, but but they are that's part of life, right? And nobody's going to bat a thousand. Yeah. So, anyway, Harvard grinding through trying to write papers and it was hard. It was uh really hard. And there was the guy who worked 16 hours a day was getting a little farther ahead. I worked 12. I said, "Okay, I'm going to get in at 7:00. Come on." I said I'd like to work later and Alex said, "Dinner's going to be at 7:00. You can either make it or not." So, I said, "Okay, I'll be home at 7:00." Uh, and then I could read in the evenings if I wanted. But anyway, I was trying to do 12 hours a day. I thought that would get me to where I wanted to go. And it it did. Although the people who worked harder, it's very competitive environment there. Very wonderful people. Uh, and not destructive competitive, but just But no, they're they're you can work. Yeah. All the overachievers. Uh, so uh made it through. got some papers published and um it was near the end of my time there. I got to work with the Gates Foundation. One of the people had a a big grant to introduce HIV drugs into Africa. You probably remember I do.

They had drugs in the US. So 96 was when these proteas inhibitors came out. Now we're in like 2001 2002 and we're still not they're too too expensive to to get to the Africans and they might not take them because they'd have resistance uh because their health health systems weren't as robust as ours. a lot of excuses and India began producing cipa began producing these inks generically and uh when the president of Nigeria uh Obasanjo he uh obasanjo said I'm going to buy 10,000 uh enough doses to treat 10,000 people for a year uh to begin HIV treatment but the doctors hadn't been trained so I was part of a team that got to go over there and help train doctors in Sagal and Nigeria to give these medicines and it one of the most rewarding, you know, I was in this lab, the ivory tower lab, and really trying to do good work on imanology of HIV, but then you get out into the real world and see the need and the huge impact you can have for relatively little money. So, that's been a part of my my work uh ever since is going over to Africa to help with HIV diagnostics or therapy uh uh work and research. So that's really been a rewarding it's not a big part of my job maybe 10% but whenever I get over there I think gosh that's really uh an amazing place uh and the people are are are amazing so I feel fortunate to able to to interact at that level there's another thing that Gates Foundation was involved with in Africa was the river blindness right from mosquitoes um it's actually a fly is it a Okay.

Yeah. So, don't don't ask me. Yeah. Well, it's actually uh a worm alsois uh is the river blindness. Okay. Uh and he's done a lot of good work on a on a ton or he the foundation has done a lot of good work on a on a number of diseases that they pick out. They're still doing that. Yeah. He's trying to accelerate his giving out. I don't know if you've heard that. He's trying to step it up so it's all gone in 10 years. Wild. Yeah. So you're in uh the ivory tower. Yeah. You go to Africa. Yeah. And then I come back. So it's near the end of my time at Boston, right? And I had a weekly I had a monthly meeting with boost by this point. So I was a junior faculty. So it was uh I was an instructor. So not on the professor, but almost professor. And uh so it was time for me to get a real job. And I went in for my my monthly meeting with Bruce and he said, 'Well, so how many grants do you have? I said, 'Well, I've got a couple. I've got the maybe I had three at that point. Um, which was a lot for a young guy. How many papers? Didn't have many papers. I had one and a few more on the way. Uh, and he said, "You should leave." And the mentor mentee relationship is so powerful, especially in academia. Uh, he sort of controls the fate. And I almost started crying. I I was uh you know sort of jump shock shock shock. Yeah, shock and I I He saw that I kind of jumped. He said, "No, no, no. This is not me wanting. You can you could stay as long as you want, but I see that the NIH funding is tightening up, which it has.

The pay lines have come way down. Um he said, "You may not get your RO1 on the first try, and Harvard doesn't need another Bruce Walker. They've got me. You have this amazing skill set. go out and see if you can get a startup package. You know, he'd be fine if I stayed in the lab and kept public publishing papers in his lab, but he was really a great mentor looking out for me so that I could leave at the best time to get a good job. So, Alex is from Toronto, my wife, and uh so we looked in Toronto and we looked in San Francisco for jobs. So, it's basically Stanford, UCSF, and University of Toronto. And uh I called around. and I talked I immediately went to my network and uh one of my friends at the Gladstone Gladstone is a great research institute here in San Francisco affiliated with UCSF. I called up Doug Nixon and said, "So Doug, uh what do you think? Are there any jobs opening at the Gladstone?" He said, "You know, we just filled two assistant professor positions, so there's no startup package, but you should call this guy Mike Bush. He has money in space. He's over at the blood bank." And I said, "He and he does good work." I said, ' Okay, I'll call Mike Bush. Cole called Mike, who's a professor, and uh said, you know, Doug Nixon told me to give you a call. He said you had some startup money and some space and uh and I'm I'm this guy from Harvard looking for a job. He said, "No, we don't have any money. We don't have any space, but but tell me a little so little about yourself." And I said, "Well, no problem. I have uh three grants. You know, I've got my own money. I just really need some space."

He said, "Oh, really?" talked for 15 minutes and I draw him. He's such a great guy and he's a really good friend. Uh he just stepped down as the director of our institute and uh he's still still working. He's coming up he lives in San Diego now but still works for the institute and he's been such a great mentor uh throughout my career the last 20 years at the blood bank and uh I feel so blessed to have had these amazing mentors along the way. I think as you talk to people on your podcast I'm sure that you hear about mentorship. It's like it's it's one of the key things. I I often ask people like, "Okay, well, how do you how do you think that that whole process works and um and I think everybody has a different take. So, I'd love to hear your your take on on how does one go about I mean, a young person today, you're going to need that. And so, often times you don't know how to do it. Um, so it's important to hear multiple multiple takes on that. As we're sitting here, I was just thinking, how did I end up with these great mentors? One is being receptive, right? So, I've had mentees who just wanted to battle the whole way and it was hard to help them. Uh, so I think being open and not having an authority or a chip on one shoulder, uh, is tough. A lot of people don't get along with their bosses. Those people I've noticed, don't often go as far as fast. Uh so being humble and um and receptive I think if you're the young person um picking picking well when you go to your job finding the right person that's a really and it doesn't doesn't have to be the most successful person or but really the personality that matches uh that matches your mindset or what you want out of it.

It may not even be personality. It may be a skill set that you want. Um but being thoughtful about picking positions if you have that opportunity and that luxury uh to pick the right mentors. And then the other thing I you know I had these main mentors who were my bosses but I always sought out mentors outside of my organization. Um and having that those outside advocates for me has been particularly powerful. Um and they have a perspective and also the ability to leverage other relationships that I may not have thought of. Let's break the equation down though. Yeah. Um, so you identify the person, that's number one, understanding. So, hey, this is someone that can help me achieve something uh that's important to me. Um, you there's the approach. Uh, so now you're sort of like getting m making your case for, you know, why take me under your wing. Mhm. And then there's the um being willing to actually listen because I don't think any men or mentee relationship is going to last very long if you ask a mentor to uh take you under their wing and then they then you you know take selectively permeable around uh I like that you know the the information they're sharing. Yeah. So I'll give you an example. Uh gosh 15 years ago I was selected as sort of one of the young leaders in our blood bank and so they said they were going to pair me with someone senior. We're headquartered in Scottsdale. So, they're going to pair me with someone senior. I think the options were like CEO, CFO, head of HR, uh, head of legal, and they paired me with the head of HR.

Went, "Oh, geez, HR, they're always in the way, you know, there it so there was a chance for me not to be very permeable, right?" Because my interactions with HR was they're always making stupid rules. Uh, and I didn't get it. So this guy Larry Ree was head of HR and we had a a monthly call and we'd spend an hour and he would have me design the topics and he would help but I had to come with come to him with a topic and I learned so much and it's helped me so much uh a HR isn't just problems there actually if you have a good solid HR it sets the tone for the whole company um and it's there is something to staying out of trouble so there are some rules that have to be followed that are you know they're laws So knowing that is helpful, but also just how to interact with people. I really didn't have a lot of management formal management training. It's just sort of you innately have it or you don't. That's a problem a lot of scientists have, you know, uh you're a good scientist, you get promoted and you you don't have the people skills. Um so you I think how it works is you kind of get uh it favors those who naturally have it. We don't have enough training at least in my field in that. So, I was receptive to that mentor and got a whole lot more out of it than I expected. Uh, even though my first knee-jerk reaction was this was not the mentor I would have picked. Turned out to be a great thing. So, the next thing we're doing, our company uh has decided we went through a really rough period.

We were selling blood for less than it cost to make and the company was losing money and we're just sort of stringing along for years. The the the hospitals formed these group purchasing organizations and it commoditized blood. So then the Red Cross is pitted against vital talent and we're both racing to the bottom and not covering cost is trying to keep our market share. It was a real mess. That's finally working its way through and prices are now coming up to the level where we're actually covering our costs and now the company can breathe a little bit and they're trying to develop the next generation of you know management. So they they've put a new coaching program in and coaching uh I don't know what does coaching mean to you? Gosh. I mean oh I coached a lot of soccer. Yeah. Okay. That was my first thought, right? I love my my high school water polo coach. Yeah. Yeah. Yeah. Oh, you know what? Water polo water polo players are no joke. You don't want to you don't you don't want to mess around with water polo players, man. They're dirty and they're strong. Oh man, I got to tell you. And they can hold their breath. Yes. Uh so yeah, you don't want to be at the bottom of the pool with one of those guys. Yeah. Yeah. We used to in high school, we had a game called Pinchy Pinchy. You basically would wrestle one-on-one and whoever pinched said uncle and you'd let them up, but it was just full on anything goes. Yeah. Yeah. Yeah. Yeah. So, what a great game. Um, so there's that coaching, which is what I thought of.

Uh, and then what I learned when I was with this HR person 15 years ago, coaching was really holding people's feet to the fire. Uh, trying to get underperformers to to come up to snuff. Uh, and the new coaching that I'm learning is uh is really the coach does very little talking kind of like you are here and you just let the other person rattle on. But but they're supposed to come to you with a problem or what they want to talk about and the coach doesn't just reflect what they say but helps direct how they think about uh their problems or their issues and break down internal barriers. So for this program I have to do 60 hours of instruction and a 100 hours of coaching to become this certified coach and I'm really excited. So I uh next week I have my first part of my uh coaching as I get three hours of a real professional coach coaching me and his specialty is the flow state. Isn't that uh appropo? Now I'll have to come back to the podcast after I've done a few sessions. I know. I can't wait. I'm so excited. This is so so awesome. is transforming. But already I've done a few sessions where we practice on each other, all the people in this program, and it's changed how I do things. It's really revitalized my energy. And so I need to write grants. That was my problem. Uh I get so bogged down. I'm vice president of this company. I'm a doctor. I've staff I supervise. Wasn't doing my job of writing grants or one of my jobs, which is really important, probably the most important to raise the money.

So, and I tended to do my workflow of stuff would come in, I'd bang it out, but I wasn't having my blocks of time anymore. I used to work from home on Wednesdays, still do. Uh, but before Zoom, I I would actually have a day where I could focus and get into my flow state. So, now what I'm trying to do is uh as I read my emails, I just put them aside in an archive box and do them at the end of the night after dinner. So things that are sort of not high brain power, I'm pushing to later in the day to allow myself room for the flow state because I'd lost my flow state. Lost it. It's so great to hear you talk about that and time management and the way that you know you're managing your time because I always say like, you know, these different shifts of my job. Yeah. in these different roles and I've got to actually partition time. Uh so a lot of times I mean it's it's 8 o'clock at night. I'm going through emails because that's you know I always say to certain people I'm like hey if you want to get don't email me that's that's if it's anything that's urgent that's not where you're going to get me you know text me. So so the coaching side of it it's sort of like the first phase of it. It's like you got to decide if you're going to be a Bobby Knight or a John Wooden, right? Uh and holding your feet to the fire, right? Yeah. Yeah. You know, like the Bobby Knights are the guys screaming at you. Nobody liked, right? Those coaches suck. Yeah. Uh and u and I found myself in coaching being one of those guys at times. Yeah. Well, it's hard when you're competitive.

Yeah. And then the other side of it is just really coming to this realization that it is really heavy on the reward side and the creativity around refraraming um not pointing out failure, you know, pointing failure out really reinforces failure. It gets you to focus on it. So getting people to like reframing it and like, oh man, you know, it's interesting how I think if you maybe crossed the ball a little bit. Um maybe that seemed like you got a little deep in there and and I wonder what it would be like asking questions, right? Asking questions. Wonder what it would be like if he crossed the ball earlier and then letting them come back and so it's a collaboration. Yeah. Top down. Yeah. I mean like you know I mean there's a time for top down too you know which you got to take an order you got to take an order but yeah good is when it is but um yeah it's really interesting so that's super exciting for you it's fun it's a new chapter it's almost like being in therapy not that I've really done therapy but it's good it's it's good to introspect and a lot of the coaches will start off with a little mindfulness exercise to get the body centered uh and able to leave the last meeting behind. So, is this like some sort of meditation with box breathing or something like that? You're doing some Yeah. You know, you feel your feet grounded on the floor and you take some big breaths and it's just one to two minutes just to get uh you know, you have an hour session just to get things on a on a plane where you can communicate and and leave all the stress behind and then really introspect.

I wonder, you know, I'm curious what your thoughts are. I wonder if people actually had a discipline around that throughout the day. uh almost like the notion of standing up and doing 10 squats an hour, right? Just body weight squats uh per hour. Uh now is like they're saying that that's the equivalent of walking the 10,000 steps. Oh, interesting. Uh or some variation of that. Don't hold me don't hold me to the actual math arithmetic on it. But um I wonder if if people actually put that into practice where they actually just took that time and sort of like said, "Okay, I'm going to take my break now, reset my CNS and um and get into, you know, how much better they would perform. Yeah, I think clearing the brain a little between I mean I have meeting me meeting during the day. I'm sure you can relate. So, uh, a little brain clearing it would refocus. And I find that just with these I've only done a few of these coaching sessions, just being able to listen and be more present in my listening when I'm interacting with my employees or peers because I get so distracted if I'm on a conference call. So, my definition of a boring conference calls when I'm not talking, right? So, so I if I'm just kind of a passenger on the call, this happens to all of us. Oh, be I have another screen going with the the news or whatever. Trying to do another email or whatever it is. Uh, and I'm trying to calm it down and be a little more present and see see how that works. I don't know if it's going to work or not. Yeah, it would be really interesting to hear what your experience is like.

And the other thing as I get older, I find that I do get tired like after dinner, I can't do the creative work I used to. I used to be able to just go right back at it and be full on at 8:00 p.m. to 11:00 p.m. That was pretty good hours cuz I didn't have any meetings. Yeah. And now I I realize I'm just tired. And I was doing something like drinking an extra glass of wine at dinner so I didn't have to work uh something because I was just so tired. So now giving myself permission and giving these tasks that are you know reading a journal or writing a letter of recommendation or all these little things I have to do doing that during that sort of twilight period of the day I think is going to help me a lot. Well, and I think you know what's interesting about you is like you are a guy that you know oftentimes like you know we'll be at breakfast like I gotta go because I gotta go I gotta go play tennis. Uh or I'm riding my bike. It's like I'm like hey Phil it's like it's like storming outside. It's crazy and I'm riding my bike to work like okay. Um you know you're a guy that's really in shape. You really take care of yourself. you've got, you know, I think you have a just a super life balance and um and you know, you're you're a great role model for so many uh people. It'll be really interesting to hear what you know, what that next level brings for you. Mhm. So, a quick question for you. We had co and you know, there's always that thing I think in everyone's back of everyone's mind that's made them very uneasy.

Um, I mean, in our businesses, we see it with our clients, uh, where they're they're just uneasy about what's next. I mean, there's always in the back, could there be another pandemic? We want to like lull ourselves into the thought process that u this these super bugs or these things. The long story short is is there um in your mind like there's some people who are just like, oh, it's just a matter of time before we're there. What are your thoughts on that? Yeah, it is a matter of time. Now, how much time? Nobody knows, right? So, that's the thing. So, our last big pandemic, I guess, was the 1918 flu. And then almost 100 years to the year, it was 2019. So, we're we're 101 years. Boom. We had another huge worldwide pandemic. In between, there have been diseases that, you know, the definition the WHO definition of pandemic. I think the H1N2 flu qualified as pandemic, but it was really just the flu. and it just spread all over the place. So, we're going to have diseases that spread all over the place, but what about a disease with higher mortality and I would say at some level we dodged a bullet. So, I was lucky enough to work on the SARS one outbreak. So, in that outbreak that was in 2003, there was a physician from Guangcho, China came down to Hong Kong and rode an elevator uh with this elderly couple. their son had won uh a night at the hotel metropol or a stay at the hotel metropol. So his parents came from Toronto rode the elevator with that uh physician from China got infected with SARS one which is SARS Kovv at that point or SARS and then went back to Toronto and spread it within within Toronto and that outbreak half the people infected were healthcare workers.

It didn't transmit person to person as well, but it was much higher mortality than SARS KV2. SARS KV2 was sort of a 1 to 2% mortality. That was closer to 10%. Really bad. And some like the some ethnic groups, the Filipinos did very badly and a lot of the nurses were Filipino. So the doctors up in Canada said, "We need help." So they asked the US physicians, infectious disease physicians to volunteer. about half of the US ID docs volunteered and I was lucky enough to be chosen. Uh so I got to work at one of the hospitals, North York General, uh in in Toronto, really at the end of the of the outbreak. So we had this 800 bed hospital with eight patients recovering from SARS and eight recovering from something else, but we couldn't do any transfers because we were spreading SARS from hospital to hospital and it brought a whole health system to its knees. It was unbelievable. how that works. So when we saw the first when we saw SARS KV2 come out that's why there were a lot of the gloving you know we're supposed to wear gloves it was all contact that virus didn't get very high levels that spread person to person by air whereas SARS KV1 SARS KV2 did the second coming um but the good news it was much more transmissible so obviously killed a lot more people because it infected a lot more people but the per person mortality was much lower what if what if it had combined the transmissibility of SARS KV2 with the lethality of SARS 1 that would be a disaster.

So we had a warm-up uh but it could be worse. Um I don't want to raise anxiety but that is you know there there's influenza H5N1 is one of the flu uh and it seems to be getting less pathogenic but in the beginning it was killing half the people it infected. again very hard to transmit person to person uh because of where the receptors are uh for that virus. They're deep in the lungs. Virus is way down there. Yeah. Yeah. Exactly. So, it's very rare for person to bird. It's very rare for even birdto person transmission. Um and it's bad luck. But so there's the potential out there that you get a virus uh usually it's a virus that's going to do this because it spreads so quickly uh that is highly transmissible and highly lethal. That could happen. you know, we think that the SARS KV2 is disrupted. That would be really something. If you're having, you know, 10% of the population dying, that would be disastrous. And now, you know, I think there's this apprehension towards, you know, you mentioned vaccinations, right? Yeah. There's this apprehension towards vaccinations and people may be uh sort of like, hey, I'm not uh not not going that route when something we certainly fasttracked u the COVID vaccine. Yeah. And there may be some not so great things that came from that. There's lots of talks about seeing more clots now than I've ever seen before and and a number of other things. I guess the spike proteins wreak havoc in in lots of different ways. What are your thoughts about that in terms of you know Yeah, really good question.

So um in my world, in the blood banking world, there are pushes in some states to have a blood supply of people who've never been vaccinated. There aren't many of those people. So that would be a really hard thing logistically to do. So we've looked that's really interesting, right? You want that pre 2019 prevaccination blood. Well, you want somebody who never got a vaccine to donate blood and have a separate blood bank. Uh so is that justified by the science? So we did some studies collaborating with a a physician Nared Rubinian who's from Tibbron here. Um and he's at Kaiser. So he has big data from Kaiser and we know which donors from Vitalent we gave to these Kaiser patients and we know were these donors infected or vaccinated or both. And so on with big numbers of patients in a health care system like that we can look and say if you got a a transfusion from someone who had been vaccinated did you do worse than if you got a transfusion from someone who hadn't been vaccinated? And what we found was there's no difference. Uh so there's no health signal there that it's bad to get blood from somebody who's been vaccinated. What we did find is very interesting if if the person had been recently infected not not recently vaccinated but recently infected uh their platelets which are little blood clotting uh uh cells are more effective because uh when you get in when you get infected and you you have COVID your immune system gets ramped up and your platelet numbers go up and they're activated.

So when they get into the patient, that patient is uh less likely to require a red cell transfusion and their platelets go up a little more with that recently infected blood. But that that the vaccine itself was safe. Another thing we looked at uh is there are auto antibodies that happen after you get infected with SARS and auto antibodies or antibodies directed against our own proteins. So in collaboration with the Chan Zuckerberg Biohub investigators, we looked at auto antibodies in people who we had a sample before they got infected or vaccinated and then they either got infected or they got vaccinated then infected. So if you get SARS KV2, you develop a bunch of auto antibodies. We know this. If you get vaccinated, you develop very few auto antibodies, just a couple of those that the the SARS infected people do. Then if you go on to get infected, you don't make the auto antibodies. So the vaccine protect protects against that. So all the safety signals look like the vaccine is safe uh from what we've done. Now there are some studies they did autopsy studies of people who had died uh and they'd had an the mRNA vaccine and some of them had had a heart attack before they got vaccinated. And that mRNA vaccine looks like it got taken up by the the immune cells in the heart in the damaged heart tissue. So they could actually find vaccine there. They've also done studies of people with strokes and found that the mRNA vaccine was in the blood vessels where the stroke was. So it looks like those little nano particles will home to tissue that is damaged or inflamed.

This is why you see myio what is it myocarditis um happening with well that's also very interesting. So young men in particular you give them the vaccine and a certain percentage are going to get inflammation around the heart. What is interesting though is that it's if after the the mRNA vaccine you can get that um myocarditis, but it's tfold less than if they got infected. So those kids if they get COVID, they have 10 times the chance of getting the myocarditis. So they're still better off getting vaccinated and not getting infected. Um so now we're at the current day and you know should everybody get the vaccine? And the other thing that I important data point is you know when nobody had immunity it saved lives like nobody's business because if you got SARS KB2 and didn't have any immunity to it much worse outcomes no matter what your age now if you're our age you're less likely to die anyway but still there's excess mortality if you hadn't been vaccinated you get sicker and more likely to die and remember all the ventilators are full the morgs are full it was a disaster so now everybody's been vaccinated or vaccinated and infected I'm sure we all have been uh what does the vaccine do now? So the vaccine now you get a booster, it boosts the antibbody level for about four to 6 months and then it's like you didn't have the boost. You're back down to where you are today. So then it's an individual choice. Uh so for myself, I don't take the vaccine anymore because it makes me sick for a day and I I just rather risk it.

I'm not going to get sick, you know, three days a year to to prevent one COVID every couple years. So that's my choice. Now my 87year-old mother has no side effects from the vaccine and she's older so she does take it and I think that is kind of the right way to think about it. It's your own risk benefit uh of how the vaccine interacts with you. Yeah it's sort of so complex uh it's really complex and they're new vaccines you know we don't we don't completely understand uh how they work their distribution and we're very interested in looking at that in our in my lab as well. Yeah. All right. So um pathway to peak performance. You said okay earlier um that you have not reached your goal. Yes. Wanted to cure a disease. That was my stated goal. So what do you think? We have one project in the lab. We're working on an anti-cancer antibbody. So it targets the immune system. Um and it works in mice. And so I need to raise enough money to be able to take that through to a monoconal antibbody which is a a drug that can be patented. So we have a process now need to get it to the drug stage where it can be patented and then developed. You know you give that to a drug company and they'll they'll take it. So one of the things I'm working on in my coaching is how do I do that? It was really fascinating. I was talking to my coach and I said uh I need to raise money for the lab and I'm doing that first and then I'll work on the anti-cancer antibodies.

Wait a minute. Why can't you do both in parallel? Okay. So, I need to sort of restructure my time so I make time for the grant writing and make time for the uh for the immune therapy project. That particular uh piece that you're working on. Yeah. Yeah. Is a huge the impact would be huge for humanity. And you know, who cares about me? It's the people who need the therapy. Yeah. I mean uh you get to be an instrument of of uh good in a way that is so powerful. Um and you know as you said you saw it when your rotation through on oncology like what that is for like people and um gosh that is I like the way you're thinking. So, Vitalent, where I work, is a nonprofit. Uh, it's a nonprofit blood bank and we have a foundation, the Vitalent Foundation, 5013C, uh, or C3, I can never remember. Anyway, uh, so I think, you know, you can raise money with the podcast, but anybody listening, I want them to donate to the Vitalent Foundation so that we can cure cancer. I like that, you know. I mean, I just think that that is so great. Um, and I really, you know, I really believe in you. Oh, fantastic. I really I really just have great faith in you as a person. You're just really a great a great um example of somebody who's really just put their mind to something. You you persisted through difficult times. You never gave up. You always have a great attitude. Now, I'm not, you know, I'm not living with you, right? So, we don't have to bring Alex on the show. Yeah, I do know your wife. Um Yeah, I know. Yeah. And uh and she is phenomenal.

She is. Yeah. I think we both married up, right? Oh, we certainly did. We're punching above our weight. Yeah, exactly. Um the long story short is, you know, man, it's just been such a pleasure to spend this time with you and I'm so excited about where you're headed and what you're doing. Thank you for all the contributions that you've made and um I can't wait to have you back. I want to hear about this coaching. Uh and and I think that in the pathway to peak performance, right, we all need coaches. We all need mentors. We all need to find out what it is that we want to do. How we get there is the is the mystery. Um but along the way, the right person can say that one thing to you that can just shift it in a heartbeat. So that'll be super exciting to see what happens. Yeah, Jock, I'm so humbled you had me on here. Thank you very much. Yeah, I'm humbled. Are you kidding me? Great to see you, my friend. That was great. Thank Thank you. Hey, thanks everyone for watching the show. Please remember to like, comment, and subscribe. It really helps us out here at the channel. And share the video with someone who might be interested in supporting the charity that our guest uh mentioned in the episode. Thanks again. We'll see you soon.