Dr. William Rassman Speaks at the University of California, Irvine

Dr. William Rassman Speaks at the University of California, Irvine

October 20, 2019 2 By Stanley Isaacs


I’ll just preface of us I didn’t fail sometimes difficulties to succeed entrepreneurs is being faced with challenges all of the time They are tested over and over again problems come from around the corners where you least expect them Humankind’s program to chase progress. You’re all here for that reason This is basic to our DNA Go on talk about I’m going to use examples of my experience for the past Lincoln Steffens talked about nothing has done everything the body remains to be done We’ve done over the greatest picture is not getting painted ready to play is not yet written the latest public aside the song There isn’t an old world a perfect railroad or a good government or a second law Physics mathematics and especially our most advanced exactly the sciences of the fundamentally revives Psychology economics sociology are awaiting of Darwin whose interim awaiting an Einstein 11 character is but by the way, if you want to interrupt me at any time, I’m okay with it. I don’t mind being interrupted a Interrupting this way Okay, there are eleven successful Characteristics of an entrepreneur they’re driven to succeed and motivated by challenge and is creative and innovative The visionary and intuitive they see beyond the obvious basically out-of-the-box thinking Willingness to break rules face failures accept criticism balance back because of the entrepreneur should be tenacious and persistent Searches for new ideas have willing to take risks and break all the rules naive sometimes their abilities Beside naive what I tackled a few of these things Ability to filter ideas have keep the good ones and throw away the bad ones and that was wrinkled And that one piece is the most significant thing of a successful entrepreneurs and the successful innovator is the ability to filter the good from the bad, and It is the most important quality of a successful entrepreneur Never be satisfied with the status quo. My motto is so there’s always a better way Always be open to change the ability to build and manage teams of people is critical for any business, you know willing to challenge the existing culture Any any change in the existing culture can be difficult? I want to go back a little bit on the history. This was the intra-aortic balloon pump which is in every Coronary Care unit in the World today. I commercialized this 1969. I think I give you a little history How I got there, I was very fortunate in medical school because my last two years of medical school I got adopted by the the Chief of cardiac surgery of the medical school and he gave me access to their labs and I worked on my own research projects and I went applied for my internship I have already accumulated a body of research and the internships all competed for me because of it. I ended up at the University of Minnesota Under the tutelage of C Walton Lillehei who was the founder of modern heart surgery. He was the first one to do an open heart operation on a baby and defined almost half of all the surgery in the cardiac field done at that time He made me an offer. I couldn’t refuse just like the ‘Classic Movie Line’ said And it was that he would give me an unlimited amount of money. He took me on my own laboratory and He wanted me to work for him for a year. So in setting up the lab, it was a wonderful year I did my own research projects. I ran a valve testing system for heart valves That spun out into the St. Jude company from the same two heart valves, which we had done the original research on. The intra-aortic balloon pump came out of that research as well as an artificial heart which was tested in a human. It worked Nobody knew about that. We never published it. I came up with of all sorts balloons. I became an expert on materials and started building materials for different parts of the body from joints, hearts valves and blood vessels and If I didn’t leave the field, who knows maybe I would have gotten famous doing angioplasties. I didn’t But the Intra-aortic balloon pump was most interesting Give me a quick history of how I introduced the Intra-aortic Balloon Pump. It was January of 1969 They would seminar for 850 cardiologists. It was well attended there were five great speakers Michael DeBakey, you might be too young to remember these names. But Michael DeBakey, Denton Cooley, D. Walton Lillehei who were the three greatest cardiac surgeons of the time Dr. Willem Kolff was the inventor of the artificial kidney and Dr. Frank Hastings the director of the National Heart Institute
Heart Institute And they were the five speakers. Dr. Lillehei told me he could not make it that day, so You need to come and speak in my place. I said you got to be kidding I’m gonna be up there with those are the four people here. You’ve got to be crazy He says well, I’m gonna give you a little impediment. He says you can’t use slides It can’t use your movies Which I was very famous for because I was know for 16 mm movie productions at the time And he says you just have to do it just by your charisma and I said, oh that’s not good so I got my turn to speak and I had figured out a way To break the rules. I got the most beautiful woman and I was dating I wired her chest with leads for a electrocardiogram She walked down the hallway of the center of the lunchroom Came to the podium and was carrying the Intra-aortic Balloon in her hand Which was beating at about 180 beats per minute. She was gorgeous and Everybody pay attention to what it was and they saw it Following her heart rate and then I explained that this balloon would sit inside the aorta and be synchronized to the heart I probably was they was the best speaker of the day because of the beautiful woman I eventually married her. Anyway, I talked about the whole concept of disruptive Technology. This was a disruptive technology and the cardiologists hated it the cardiac surgeons loved it and for 10 years It had a difficult course to get through to clinical use until the cardiologist finally learned how to Per-Cutaneously by putting it through the femoral artery and as soon as they figured out how to do this, by putting it through the the ephemeral lottery percutaneously Then all the cardiologists in the world picked it up and that’s how it became the Standard of Care in every Coronary Care unit in the world? Probably saved ten thousand lives per year So I think if I had anything one thing to say about my life, that device was my single greatest contribution so far I’m not the inventor of that by the way, I’m just the person who made it practical and brought out a commercial system for it so I learned about the difficulty of the disruptive Technology and how it get it to be adopted When I went into the private practice or surgery I eventually got bored so my partner who had two jackasses Two milking cows and twelve sheep and I used to go over to his house and he would Show me his jackasses and they would always make a lot of He Haw And he would ride them every once in a while and I said wow, that would be fun So I said I’m gonna buy a farm so I went out and found the farm and bought the farm and moved my family from my nice house to the farm and I there was about 70 cows on the farm when I bought it I immediately expanded the operation to 150 milking cows. Of course. I didn’t know which anything though came out Which was a very difficult thing we talked about naive Well, I think you couldn’t get more naive. I didn’t know anything. I was born in Brooklyn raised in Brooklyn, New York I was in the city I wanted to be a veterinarian and the veterinary medical schools wouldn’t let me in because I had no farm experience and here I was gonna go into dairy farming Well, let me tell you I lost my shirt almost went bankrupt in the first year and then I learned quickly I learned how to milk cows, learned about cow nutrition, and how to raise crops and by the time I ended up selling the cows and the farm, I had one of the most prestigious herds in Vermont not only that but I pioneered , rather I copied what some of the farmers in the Midwest were doing, no-till farming and I was the first person to do no-till farming in Vermont and I produce probably the best crop of corn in the state that year and These were things that you just have to be open to what other people are doing And that makes a big difference if you’re aware of Breakthroughs improvements in whatever you do and you learn a lot. So I learned a lot from farming Okay, I want to talk about the time just before I stop practicing medicine. I was reading everything I could read about alternative energy back in the 1980s and by 1980 at that time we has an energy crisis, you will not remember this because you weren’t born then, but it was a Concept we would run out of oil to run our cars they were huge lines at the gas stations So I was very focused in my readings on ways of getting around oil Improving and one night at 3 o’clock in the morning I woke up and I had a dream and I dreamed of a way to extract oil from oil shale So I remember getting up out of my bed going to my desk Writing something up drawing it went back to sleep at 6:00 in the morning when I woke up in my usual time I remember getting up but I had no idea what it was until I went to my desk and read it And there it was, a description on how to extract oil from oil shale my when it had come from well It was from my reading and also from my farming background because I met somebody when I was farming that was extracting Water from whey without denaturing the protein from heating it 212 degrees to the water out. They put it in a vacuum chamber and boiled it about a hundred 100 degrees Fahrenheit and By doing that they were able to get the whey out of The water and the whey came as a protein that became good chicken feed and animal feed So I said well if that works for whey, it must work for oil shale So I submitted a patent within one week to the US Patent Office I had already accumulated a couple of patents by then and Three years later I got a rejection from the US Patent Office is probably the finest rejection that I’d ever got and I’m so proud of that because I am showing you this here is because Atlantic Richfield The big oil company had filed a patent submitted to the US patent office 3 weeks before I did I was so proud, you can take a look at my pictures and take a look at Atlantic Richfields patent They were the same and I don’t know where it came from but it was an amalgamation. What invention really is the ideas that you get and you keep the good ones and throw away the bad ones and this is what you do. Our brains are constantly amalgamating our experiences our readings and Trying to use them to make us productive and that’s what this is about. Because of my interest in energy I got involved in windmills I built the first successful commercial wind farm in the United States in Hawaii between 1980-81 while I was practicing surgery and then I quit practicing medicine in 83 and combining my efforts with a big company formed a energy company combined this company to form a very large energy company and built many of the wind mills Outside of Palm Springs, worth about a quarter of a billion dollars was built up by my company I sold the company made a lot my first fortune and I was very pleased with that. What did how did I do this? I found good People and you have to have good partners and I found two great partners to help me build this business we split up divided our Activities. My activities was computerizing the wind turning wind into money and Then I would spend a lot of time traveling all over California with kites flying kites over places where I recognized vegetation as being bent by the wind and California has great wind areas. I Identified every one of them rode much of the time Identifying them we bought rights to the land With rights of those sites and that became one of the commercial focus of the company Of course that’s nothing to do with medicine so I had to get back into medicine so because my partner was control Data Corporation Control Data Corporation said look I’ve bought your company. I’d like you to work for me and Let you do whatever you want, but I have a project for you. I’d like to analyze the medical system the Hospital information systems at Later-Day Saints Hospital Which was the only artificial intelligence based Hospital information system in the world and maybe today, the only one and He said I have opinions from Arthur Anderson and other consulting companies but I never had a doctor who just practiced medicine take a look at it who doesn’t have any computer background? Essentially that was computer close the computer illiterate. So I had a now go ahead and analyze an AI system so I immediately went into the chairman of the department of AI at latter-day Saints Hospital A man named Homer Warner, he taught me about the basics of AI I started to learn about it and how the system worked. I eventually made a hundred page report and told control data corperation not to commercialize that system because it was built by spaghetti code by students and put it only many many years and Every time something try to make a change in the code the computer would crash So they ruled that nobody was able to make any changes so they had to have it cleared with the chairman and that kept the system running because they literally ran the system as the patient’s Management system that way and the students who wanted to improve it had a circuitous route So I learned about computers and that also taught me something more. I built a company that eventually computerized the medical record and I did this with my own funds, the money that I had raised and made on the windmill business. I raised money on Wall Street I became a little hot entrepreneur on Wall Street for a while. It was great to be up there Great for all very quickly and I didn’t last because the stock market crashed during one of my fundraisings and I ended up Losing the business in the process when all the investors scattered What I did at the time is I had a vision about how DATA should be managed So I learned about computer databases at that time, so I came to the conclusion Quickly that the data could be represented as shown at the bottom of the screen, here as lists and at that time data representations were only made in lists, and that time we didn’t have graphics for computers back in the 1980s Computer Workstations You did not see good quality graphics, but I have a vision that you could move between lists and bipartite graph theory to make Data representations and I submitted a US patent on that Which is what I used it would have come up with an idea A patent was issued And what would happen basically did is if you take a look over there to number 20 on the far side um left And you say well here’s a map of a data structure and it’s a complex data structure but if you want to find out all the relationships of 20 to everything else there, you can filter it out very quickly using the graph theory and here here’s the older relationship then it’s obviously a relationship of doctors to a variety of subsets of data points or files or whatever so I use this this patent which turned out to be Incorporated in every database of in the world and I had pre-empted graphic representation on database. Again I found a way to license this technology to big companies and ended up making millions of dollars on this patent So that was one of my successes Back in 1991. I formed the company called heart check America and what we did is Gone to a lecture and there was a fella talking about how you can screen the heart For early detection of heart disease, by the way, please interrupt me if you want. Okay If you screen the heart with a Cat Scan you can pick up flecks of calcium in the coronary arteries of the heart and there was a relationship between these flecks of calcium and coronary artery disease, but at that time, the standard diagnostic test for Coronary disease was not a CT Scan image for diagnostic test for determining if you had heart disease but was a stress cargiogram and Mayo Clinic published a paper back in about 1993 in which they said if you ran a cat scan of the heart and a person had no calcium present, you didn’t have to do a stress cardiogram Well, that was a break of culture and the cardiologists were outraged And my company which was a commercial company in eight cities across the United States doing test and Advertising them on radio and telling everybody if you want to find out if you had heart disease, come to one of our centers and for $400 you can get your heart checked and we’ll tell you if you have heart disease and Patients would come and we did a hundred and fifty thousand patients and the years who were in business. We have the biggest study of coronary screening number of patient in the world at the time and probably even today and we established the basic rules of early detection of heart disease and The cardiologists were dead set against it. They took positions against the American Heart Association Took positions against the American College of Cardiology took position against the test. And why did they do this? Because their bread and butter was the stress cardiogram and They got five hundred dollars or seven hundred dollars for a stress cardiogram in their office And if they got a cat scan ahead of time The patient would have no reason to address the stress electrocardiogram so they would lose seven hundred dollars and many cardiologists one two, three four of these a day That’s a lot of money So medicine and money are related (not necessarily good for the patient) Unfortunately, I’ve come to learn in medicine As in all of life money plays a big role in decisions of all sorts and How many of you want to be doctors? Okay, I don’t want to turn you off. By the way on that comment. There are a lot of people that keep their their ideals I haven’t lost it Yet So the entrepreneurs desire to improve early diagnosis of heart disease and here I thought I was doing good, but ran into Unbelievable culture. We were hated as a company by the cardiology community eventually in the American Heart Association Converted and switched and became an endorser of this and eventually the American College of Cardiology Endorsed it they couldn’t deal with its position But there were hundreds and hundreds of articles being written on the subject and eventually the literature became overwhelming and they couldn’t deny it So here was a test that took over ten years to break in and in that timeframe there’s a great movie On Netflix that you can see (The Widowmaker) But During the entire history of this particular technology the movie had a clock ticking on how many people died while they were awaiting the cardiology community to accept this test as the norm and I think by the time the end of the movie millions of people died waiting for acceptance of the technology I remember a lawsuit that got filed by by a family in which a patient Enrolled in the coronary screening test at our office and they had the text and the tests pointed out that they were within six months of having a Disastrous event the coronary score was in the dangerous range And they went to see their cardiologist right away with that report and the cardiologist look at it says you should direct trash They know attention. There’s nothing wrong with you. I’m telling you you’re perfectly healthy the patient died that night Okay, and the family sued the doctor? And I remember as the medical director and I got involved a little bit Particular lawsuit Okay So take hard hardheadedness and stubbornness and being not open minded to change is not in the best interest of doctors or any professional individual Okay, so now it brings you to something I’m doing at the present time in 1991 having lost all my money in 1990 by 1990 all the money I had made the fortunes that I had have accumulated was all gone Wasted about know of my different ventures of all sorts I now decided to become a hair transplant surgeon so I did research for about two years and I saw that the quality of work was deforming and the doctors Anybody who have this operation that have been crazy personally. Frank Sinatra, I know from talking with Andy Williams and the last time I did a hair transplant on Andy Williams He was telling me that the night before he had dinner with Frank Sinatra and he said to me he said to me that he told Frank he was having a hair transplant He said that Frank went berserk Absolutely berserk you know Frank Sinatra had plugs put on his head and He couldn’t go out in public so they had a wear wig for his entire life. He wore a wig and Hated his doctors and every doctor that ever gave hair transplants in those days, many were hated by many of their patients because they produce this type of work shown on the right So A great statement says “A rock pile ceases to be a rock pile at the moment a single man contemplates it, bearing within him the image of a Cathedral so I I’m a typical amalgamator. I looked at all the types of technologies that were being developed out there and I went ahead and came up with my own version of this and Change the standard of care So this second man was turned into this It was the repair job I did it on that then beyond beyond grateful So I changed the standard of care at 1992 and everybody in the world slowly So by entering the hair transplant business I became a doctor who changed people’s lives and the results of people like this were transformed The man on the far right Was in Congress okay back in that time and you can see the change in him. He’s more electable, by the way Men’s Fitness did a study Presidents in the United States and you know if you’r bald, you don’t stand a chance okay, because you Have a little radio show called the Inner Man. One of those side things I am really not talking about? It was about men and their problems all types of problems I would talked about sex, Philosophy and religion and hair every once in a while And on one my hair show is somebody called it was a call-in show on talk radio And I has a call-in from a vice president of marketing and sales, and he said by the way He says I want to give you my opinion of balding men, then I said, okay And he says let me tell you something. You could never trust a balding man And that’s what Men’s Fitness said Basically, by the way, if the man is bald he is perceived to be not trustworthy and he’s in by the way he says I want you to know I’m bald and I’m the exception to the rule because I am very trustworthy He did this on all over Los Angeles Radio, he didn’t mention his name But but I think you know we develop prejudices Unfortunately sometimes Balding men become victimized by the prejudice now there’s a little bit of history of that now it could be a little bit of a history unfolding Back in the turn of the last century about the 1800 time frame the number one killer in the cities was tuberculosis and tuberculosis was a wasting disease and the first thing that happens when you have a wasting disease if you have genetic balding gene you lose your hair So women would learn very quickly that you go ahead and If you couldn’t find a man you want to marry you never pick a balding man because they were the ones who were gonna die going to die from tuberculosis so balding men would have difficulty getting women and And that’s why hats got invented and that’s why wigs got invented To try to hide that problem, of course now, we don’t die from tuberculosis, but that image still persists in our culture unfortunately and unnecessarily anyway So disruptive technologies can change people’s lives we all know that because we’ve been brought up in a disrupt world so I entered the hair transplant business and I built a huge business and Grew very fast I was literally internationally recognized as the pioneer of the field of this new technology and Back about the mid-90s I got bored again And I said, oh wait a minute there gotta be a better way to do this. So because of my way of thinking about it before I used to cut out a piece of scalp cutting up under a microscope and That was a technology I devised But I figured that a lot of guys didn’t like the scars that they would get from the strip surgery So I said well what if you took it out one hair at a time and I invented this thing called fue and it took me about five years six years of Experimenting with it and then eventually built a robot to do it We played with the robot in our office first before patented it, We eventually turned over the patents to a commercial company and made a lot of money again That’s about it. I got about 50 patents. You just keep every idea You know It’s not unusual for me to wake up in the middle of the night write something down and the next morning appear with my lawyer patent lawyer. This is kind of common thing for me So we invented this device and this on the right you can see The hair follicles that are cut and a little light beam identifies each of the follicular groups We’re going to take out and you see hair grows in These little groups of 1, 2, 3, 4, and 5 hairs each and then the drill comes in and just cores out these groups with the robot About 1991 my one of my when that attorney calls me since going since I want you to come to Torrance I want to show you a new company that has a whole bunch of technologies. Many may be commercial, Would you look into them for me? and so I went down there and this company Intelligent optical systems and there I met a physicist who had a patent submitted which was built on a machine about the size of three refrigerators that would basically Read a surface of molecules on a microarray And immediately on seeing this and reading the patent I realized that there was a biochip here. And so I acquired the technology building our own system with a great partner Essentially you have a polarized light, we now we use an LED then we use an arc lamp, which was very high wattage and very hot and now we use a 25-cent led to run the whole thing it runs through a prism using reflected light and then you put a microwave on the surface and Since you’re biologists you all know what a microarray is so the system reads the changes of polarized light as chemical reactions occur on the surface. So we built built a company around that The Immobilize ray on the left you can see antigens on the surface of a sensor surface and on the right you can see antibodies that are attached to the antigens on the sensor surface The reactions are recorded I had the idea you can do this from a drop of blood you’re going to put a drop a blood on a microfluidic device and then you could filter out the blood cells and then you could run the serum diluted On the same surface and then you detect diseases on the microarray And we has an example of four-plex Microarray with controls you could see that the technology region shows the changes in the size of the molecules on the far right (1-4 nano-meters). This system is a mass detector And in doing this we ran these tests against a commercial systems which showed Concordance of 99% for our results against the commercial system We saw specificity of 100% and Sensitivity of 96%. This is a typical example of a microarray a reaction hits 500 seconds are shown on the X Axis and you can see over time as the reaction must occur, its the chemistry Now this is not the way I envisioned the commercial system to be working because nobody wants to see this clinically They just want to know whether it’s possible Hey doctor, do I have SLE? Do I have this disease or don’t I have this disease and that’s what they want to know Okay, so it recognizes the disease quickly. there was an opportunity to the biochip because lab tests very expensive if you do a just a series of Blood tests for autoimmune disease you might spend five six seven hundred dollars. The cost for testing for us is a nickel Test so we are really down to the low end at the cost and we can do a test in 15 minutes and we can do it on the platform on a drop of blood. So the Problems of Medicine is the concept that the patient presents with symptoms gets lab tests and x-rays and more lab tests my lab tests and more lab tests and doctors are very heavily dependent on lab tests because 70% of all diagnoses are based in lab tests. I think the art of physical diagnosis is gone Unfortunately. I was trained heavily in physical diagnosis But I think today we are very technically trained and that’s not perfect so the doctor guess isn’t the most likely diagnosis or prescribes a drug based on his knowledge of the disease and If it does not work The doctor may abandon will change the diagnosis or change the treatments and other approaches trying The cycle from diagnosis to treatment is an iterative process until success or failure results There is minimal use of genetic or proteomic biologic makers today to confirm, stage or track the progress of disease It take time for those of you in medical school to learn this. You’re going to see these changes, of that I’m sure. It will occur under your watch There is very little precision medicine today for the diagnosis and treatment of disease to be scientifically validated But as more and more genetic and protein markers become available, the technology will become once more accurate more efficient So I think our goal is to try to use technology to make us more accurate. We’ve all seen IBM’s Watson use The computer geniuses today now Watson Leased out to help doctors and hospitals And help them With diagnosis when they having trouble and diagnosis is a real problem and in some patients it’s life threatening So the impact of trial and error medicine people with acute diseases who don’t have time on their side acute illnesses may progress while doctors wait on planed tests and try to make a diagnosis While morbidity rise, diagnostic and treatment period are prolong? human suffering intensifies and with less than ideal or optimized drugs used Drug toxicity is a major problem today as treatments are not customized to the patient’s genetics or sex their organ systems or with the biology of the disease status. This is a real significant thing in our technology system, we’ve actually grown organs on Surfaces, and we’ve tested the organs against diseases and drugs and then we’ve given drugs to see responses Trying to determine the toxicity of a drug and the dose relationship to toxicity is not its not a fun experience for the patient or the doctor and it is today nemesis of the process Delays are very costly of dollars, suffering and human lives I Want to step to just stop for a minute and intend to say let’s assume that you are a cancer patient and if you’re on a very potent drug which is a White blood cell suppressant And On Friday night Friday after you see a doctor at your last visit until one day Once Saturday, something happens to you, you know We don’t run medicine Saturday and Sunday. You have something wrong – you go to the emergency room. So it’s not unusual for people to have plummeting White Cell Counts on Saturday While on chemotherapy and die by Sunday This is not uncommon. Some people can get so sick So if you take that patient that the patient who realizes that with a fever they’re not doing well they get to the hospital the average cost of a patient is seventy-five thousand dollars a day for That patient to make it back into the hospital system but all they needed was a blood count and They can have this type of system. I’m talking about sitting at home checking their blood twice a day Just follow the doctor with the test results, there’s no reason why that shouldn’t be done today with today’s technology Prescribed drugs are sixty percent efficient today technology can change that Diagnostic tests, do not exist that show up who will and who will not respond to drugs That’s a big problem. So we use the same drugs when the person is going to respond or not There are approximately thousands of different enzymes that control how humans metabolize drugs But what science do we have is not practically integrated into clinical medicine at present Partly because of the ineffective use of technology And this once again to those of you who would be doctors This is a great opportunity. If you like to do innovative stuff, this is where the opportunity is So, what did we build we built a point of care system which is still in development It would you take a drop of blood you pass it through a microfluidic cassette which is my upper, right? So the drop of blood gets processed and then is read on a sensor surface and in 15 minutes at an incremental cost of a nickel a test And it’s read The entire system operation could be operated by somebody with no intelligence and training Because you just stick the finger for a drop of blood and put the drop on a surface or the cassette You can walk away because the processes runs by itself So personalized medicine Blood and serum bathes every living cell and carries away proteins and other molecules that can produce a window into the body’s health that can detect the imbalance in particular proteins and markers, which consider the presence and the stage entities Can supply information derived from diagnostic tests at the bedside depending upon the tests in just minutes Can determine potential drug toxicity and optimize drug selection through companion diagnostic testing? Eliminating many of the drug risks on a patient specific basis and chips can enable the disease marker development So Our approach to personalized make a diagnosis sooner and treat diseases earlier with better precision customized therapies maximize efficiency with drugs Minimize the side effects that deliver the right dose of the right drug to the right patient at the right time What precise understanding of why individuals respond differently to the same drug treatment is critical to understand that medications and dosages must be optimized against the patient’s individual biological makeup and the various forms of pathology and physiology eliminate the suffering from significant drug side effects by identifying those patients who are not responding favorably to a particular drug and Develop the science of personalized drug treatment and the 21st century tools to tackle what is a two million adverse drug side effects and over 100,000 deaths in the United States a year at a cost of one hundred and eighty billion dollars as a reasonable target Yes Speaking of time I Think what will happen is we do characterize patients characterize patients in terms There’s true status of whether diseases You basically understand the treatment Before you actually going to use it if you can Let’s assume then I’m using a drug on you at which your which is known for liver toxicity in some people it would be great to have a biopsy of your liver Having you liver cells growing on the surface or a testable system, have the drug tested against that liver before we administer the drug and see whether you’re going to respond favorably on a or unfavorably to the drug These hundred thousand deaths we’re talking about are people who don’t respond favorably to the drugs Yes as an inventor How far away are we from? from You know from from that Goal, you know from personalized medicine and that at the level that you’re speaking of Well, then we’re a long way away. I’ve taken well I’ve done is produced a tool. Okay I’m just just a dumb tool maker You know, my goal is to produce very fast quick laboratory tests and be able to get precision testing of all types Very quickly, then give it to the hands of the knowledge doctor, but I think the modern doctor can’t really integrate everything in his head anymore. That’s why IBMs Watson does a better job at making a diagnosis How many times you see as a doctor? I’m aware of People that have been in the healthcare system Then have been misdiagnosed and they can treat it for disease A they really have disease B Disease A looks like disease B each So you treat disease A and it’s not working but disease B is taking its toll on the patient Okay, we need better tools and and doctors are Cast in their old habits Many of the doctors of my generation and the previous and following generation or of any age Still haven’t learned to integrate new tools and new technologies, Those of you who are going into medical school now Hopefully will be thinking modern medicine Modern tools and a better approach and will ask questions every time they tell you you always ask the teacher Why you doing it this way, why? There’s nothing wrong with asking why And always challenge what you’re told never believe what you told is what you told is always true I don’t know the answer to when that’s going to be all available. It’s going to take decades to truly unfold Medical specialties such as radiologists pathologists are primarily diagnostic, you know, obviously They will feel present. If I’m a technologist that could replace them all many of them. So there’s this inherent resistance by the medical field because the bread and butter will be taken away. A great example is the x-ray Has limitations when is read by a human? Okay, but a computer with AI can really actually with great precision Okay, will the radiologist allow an AI Reading system to come into their offices to read their x-ray the answer’s no They’ll never allow it Because what would be the cost? To them personally, they won’t be able to pay the mortgage payments, they won’t be able to send their kids to college life would change They’re too old to change their specialty So medicine has this problem. So when I talked at the beginning about those issues of the culture Issues the culture issue. Is that may turn out to be the biggest enemy here because we have We have the big change takes generations to truly happen But people like you guys when you come into medicine will come in there with a fresh brain And hopefully you’ll say hey, I want to get in on this cutting edge. I want to basically think Technology. I want to integrate technology into what I do for the benefit of my patients And hopefully that will change things But but you’re right and all of these fields the cardiogram could be read better by a machine than it can by a cardiologist everything can be If you integrate all the lab tests there was a paper written in England recently a computer can make the Diagnosis 80 or 90 percent of the time just by looking at all the lab tests and just putting some basic Patient data in there. Okay, and the doctor may not be that good So it’s it’s it’s both optimistic and pessimistic Giving us two sides of a coin. I guess the similar problem as with, you know cab drivers or uber drivers, right? So self-driving cars content so many people lose the income So this whole concept of disruptive technologies in medicine is like asking a fast moving elephant to turn on a dime It really doesn’t happen fast even if you say that it will affect people’s lives which it will It’s not going to change Very fast it just won’t change fast So there has to be a constant push from for the new people entering the field to demand change Of course if you become a radiologist You’re gonna join the group of radiologists and we’re not gonna let that AI system in there Right, so you couldn’t become a radiologist, I see your shaking your head yes. Yes, but you’re gonna just be making as much money as you can and say the hell with the AI stuff It’s gonna be gone. Yes Especially drug companies, sorry Their point is to make the most amount of money and then in health care By curing the patient you lose money If they’re cured like people with type 2 diabetes if they change their diet, they wouldn’t need on these drugs but it’s not in the best interests of these drug companies to return So they just want to find a drug that’s like helps them but the these patients have to continually take these these drugs so that they make money Like how do you balance between making money in the medical field and helping people at the same time? Answer is Okay, there’s a great video you should all watch the YouTube its a 90 minute video: “How not to die” Okay. The doctor is an Asperger’s doctor With a complete photographic memory, but if you want to change your life Read that and it will address your question Because he talks about where the money is and Why it’s not in the interest Many companies to make us healthy It’s in the interest to keep us sick and to keep us on bad diets to do all the wrong things Okay, and just watch commercials on television to tell you that But how not to die in that YouTube Worth it. It drove me to a new diet It’s changed Just by watching so it’s worth reading as there are simple life solutions and a very simple and low cost We have obesity as a big epidemic in the United States almost half the population, and diabetes comes along with it Hypertension. The How not to Die Book addresses that directly Mean everything we’ve been showing and I know it’s not easy. How are you able to convince others to help you. How about big companies to cooperate with you I Know suppose back when share that you most everything once upon a time saving our lives, but then here you are again in our lives You’ve gotta be crazy, I think you I could have accumulated quite a fortunate in my life if I Wasn’t driven by my need to make change I’ve been my worst own enemy for my own personal fortune because as so many people who are rich and famous, have made it and lost it, made it and lost it I go through the cycles again as I’ve done before I Think that the you have to think about what drives you what is it that drives you in life? That single most important thing For me, I won’t change what drives me I am Who I am and I just keep persisting I come up with new ideas all the time. I’m starting new businesses all the time Even working out something with max right now Very exciting work every opportunity I just I see something I wanted because I believe and I used this ability to filter Good and bad. I think that’s that’s There was a great book written about Innovation and that was the same message with the entire book The great innovators are the people who tell the difference between good and bad You can filter that process So you have to ask yourself? Who who are you? What drives you and how much you’re influenced by the group? If you’re a person that has to have acceptance by the group you won’t make it Like you won’t do what I did. I’m an outsider. I’m not necessarily loved At the meetings at the hair meetings I got a great kick when at one point They did an analysis of all the prominent doctors. They said they’d give you an odd analysis the top ten doctors and I was what that’s probably Doctors when they got to my name, they said you can’t figure him out at all Okay, he’s bright that’s clear But nobody understands what he is and why he does what he does and I don’t understand why I do what I do It’s my thing Yes Everything that you thought showed us some really inspiring and I really own my question is You were talking about you have to figure out what drives you like what drives you to do? All this stuff because on all these things all these new businesses and ventures that you were talking about are really innovative But I feel like they wouldn’t have came if they didn’t call me from like a really strong foundation And like purpose or like what is that? so what feels you to want to continue making all these new ventures because I feel like knowing that would kind of be helpful for myself and others to also act that act in that way I’ve asked that question I Was a non performer in high school a non performer in college Middle class. I don’t know how I got into medical school. So my like I didn’t have the grades somebody gotta my turn the on the interview and that guy said he’s gonna take a chance on me and I was reasonable and he took me in and And something clicked between my second and third year of medical school And all the the first two years taught me I was almost as smart as the rest of the guys in my class That was the first achievement Because I was actually a week after I arrived in medical school, I was packing to leave A senior came into my room at the dorm and he says, what are you doing? I says I’m leaving I said all the guys and they’re out of my class. I’m not in that class anymore I can’t compete with these guys. I’ll never make it And he said let me tell you something. They’re at 82 people in your class 86 He said the guy who gets the 86 MD gets the same degree as the guy gets first in the class He gave me a whole new vision So I targeted the 86th MD But I eventually realized who I was You know many people in medicine are very strong people Okay Bill and Melinda Gates defiined the ideal point care system for testing For hundreds of tests at one time on less than a drop of blood with the answers in less than 30 minutes Simple readout should be positive and negative Nickel a test roughly good sensitivity and specificity used by a minimally trained person The cassettes that contain the chemistries are sealed so they won’t activate until you activate the system Contains all of the reagents and needed water and no need for specialized laboratory equipment And the ability to detect multiple pathogens and the ability to distinguish between those pathogenic organism and the variant strains and sometimes. We could do as many as 900 tests on a single drop of blood if we wanted to First showed this to one of the great founders of the business. he said you could put all the tests known in medicine on that chip and then there would be no need to do all the other tests and to run my laboratory. He ran a company in San Diego Inova, which is and then he thought about it And we talked a little bit and I said, you know what happened is if if somebody had been paid for not all of the test They pay for only three But the test that they didn’t pay for showed that he had cancer one because it’s a cancer marker Or cancer the pancreas there was a cancer Marker or there was some other disease. He then said We’ll turn those off if they don’t pay for it. They won’t get the result So the software would turn off the test that you don’t want. Of course that brings in a lot of moral issues to the forefront Well, the laboratory today can’t run a limited number of tests So they will maximize the number of tests a particular machine is designed for and they will only report to the test you pay for And nobody knows this. This is a well-kept secret And then when you want it again later they’ll go back and run it again, and they’ll run the other tests, but they a Cost factor and if they run the same test over and over again same machine doing the same process over and over again, it’s cheaper So so much of what we talked about many years ago is a problem today So, what do you take home about entrepreneurs I guess that’s really the leading question It always needs more money than you think. I’m still looking for money to finish up my funding of my biotech company It takes more time than you think. I’ve been 17 years doing this biotech venture Take great Partners to complement your skills. I got a great partner in the biotech company who’s helped do things I can’t do Test your reality continuous and be able to turn on a dime There is no such thing as stability in any entrepreneurial effort. Everything is changing all the time Be prepared for disappointment By always rising above it It’s hard you get knocked down and you’ve got a pop right back up and like it never happened again, not easy Solutions to problems come at the most unexpected times and places I’m in the middle of the night thing when you do much of our processing when we sleep Solutions to typical problems are often out of the box. They almost always out of the box Play your hunches and always empower people around you and That will give you success So Albert Einstein says anyone who has never made a mistake has never tried anything new. I think that’s very relevant