With nanotechnology medicine could evolve from treating disease to a practice…
In Our Own Hands
- Description
- Reviews
- Citation
- Cataloging
- Transcript
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In Our Own Hands: How Patients Are Reinventing Medicine opens with an urgent question posed by desperate patients and their families: can new technologies help us treat and prevent the most alarming and perhaps understated health threat that we face? Chronic diseases now affect over 130 million Americans and cost countless billions of healthcare dollars.
Through the stories of the impassioned, often defiant struggles of the film’s three central characters—all with complex, unresolved medical issues— In Our Own Hands explores the emergence of “participatory medicine”, enabled by a host of groundbreaking technologies that put more data about our own biological, behavioral and environmental ecosystems into our hands (and often onto our phones) than ever before possible.
We meet families who are single-handedly shifting long-standing medical paradigms, revolutionizing established treatment protocols, building social medicine networks, and supporting new open clinical and research systems— all to find answers for themselves and their children now.
We hear from thought leaders like Dr. Eric Topol, author of best seller "The Creative Destruction of Medicine," who speaks to the impact empowered patients are having on medicine as we know it; as well as a fascinating group of experts who help explain how personal genomics, a staggering list of environmental influences, and our own personal life choices combine to create health and illness. Diseases, though seemingly distinct, may be interconnected on a systems level, with answers for one illness influencing the science of another.
In Our Own Hands shows viewers the birth of this “Citizen Science” movement, and introduces a few of the courageous, imaginative individuals who are ushering in a new age of Digital Medicine. This film will change the way you think about illness and medicine’s role in keeping us well.
"This is an engaging and illuminating film that is anchored by the powerful stories of several patients and their families. It makes a compelling case for medical data collection and its promise. It also demonstrates what progress is possible when patients and caregivers become citizen scientists and health care advocates." Sharona Hoffman, Professor of Law and Bioethics, Co-Director, Law-Medicine Center, Case Western Reserve University School of Law
"An engaging introduction into the rapidly changing landscape of personalized healthcare that puts the patient in the center of discovery. Well-researched and featuring many leading academic clinical scientists sharing their insights alongside patients and caregivers in highly approachable ways." Ted Smith, PhD, Associate Professor of Environmental Medicine, Director of Center for Healthy Air, Water and Soil, University of Louisville, Board Member, Citizen Science Association
Citation
Main credits
Horn, Elizabeth (film director)
Horn, Elizabeth (film producer)
Other credits
Director of photography, Mario Furloni; editor, Rhonda Collins; composer, Christopher Hedge.
Distributor subjects
healthcare,"health care",science,illness,"eric topol","medical data","data management",wellness,"medical network",autism,"crohn's disease","social medicine","health monitoring","public health",medicine,genomics,"citizen scientists",technology,"medical technology","digital medicine",,"medical network","Eric Topol","The Creative Destruction of Medicine",paradigm,protocol,health,Keywords
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[dramatic instrumental music]
00:00:20.931 --> 00:00:23.622
[music continues]
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[bells tolling]
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- There are things in life
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which only happen to other people,
00:01:10.631 --> 00:01:12.943
until they happen to you.
00:01:15.080 --> 00:01:17.240
- Our youngest son,
Nelson, was five years old
00:01:17.240 --> 00:01:20.273
and he had a terrible accident.
00:01:21.740 --> 00:01:23.843
He was simply thinking he could fly.
00:01:25.430 --> 00:01:28.070
He just went through the window.
00:01:28.070 --> 00:01:29.933
That was it, so a couple of seconds.
00:01:31.167 --> 00:01:33.410
[sirens whirring]
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We arrived at the ER and
the neurosurgeon told us,
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"He's very, very bad,
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"so, do you want me to operate or not?"
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And I think in a couple of seconds,
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we understood what he meant
without really understanding.
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And we said, yeah, of
course, save his life.
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[heart monitor beeping]
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An entire journey started--
a long coma of three months,
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brain surgeries, all kind
of machines around beeping.
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You don't know what they do.
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We had the last room on the hallway.
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And though I was trying to
connect more with the staff,
00:02:17.987 --> 00:02:21.819
people were avoiding me, avoiding us.
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Emotionally I think they
didn't want to connect as much,
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because everybody thought
he would not survive.
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- We were sitting there
in our little bubble
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of quiet desperation.
00:02:38.344 --> 00:02:41.543
And my wife said to me, "Fix this."
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And then you start to think,
like, "Shit, I can't."
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I've been highly trained,
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so I have a good scientific
understanding, but still,
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I don't know anything about healthcare.
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And especially, I don't know
the processes of the hospital.
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Will they operate?
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Will they give up?
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- He couldn't speak, he was paralyzed.
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He couldn't move.
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We would help him sit down,
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but his muscles would not
allow that and everything.
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So he could even not sit in a wheelchair.
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The doctors try to explain
to you the best they can,
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but when a doctor tells you
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your child is going to be handicapped
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for the rest of his life,
you don't know what it means.
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And so I asked the doctor, I
said, "Okay, off the record,
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"and I know you're not supposed to answer,
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"but do you think he will ever be able
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"to sit in a wheelchair?"
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And then he told me, "I don't think so."
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And I said, "I'll take my
chance and I'll do my best,
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"and I hope one day I'll come back
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"and he will be in a wheelchair."
00:04:03.409 --> 00:04:06.159
[waves crashing]
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- Sean, when he was growing up,
00:04:24.740 --> 00:04:27.952
he had a few health problems.
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Asthma.
00:04:29.780 --> 00:04:31.160
- Ear infections.
00:04:31.160 --> 00:04:33.440
- Recurring ear infections all the time.
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So he was on antibiotics most of the time.
00:04:38.000 --> 00:04:40.100
He had been going
through months and months
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of abdominal pains, diarrhea.
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- And continually losing weight.
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He was really thin and drawn looking.
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And we got very concerned
about his health then,
00:04:53.300 --> 00:04:54.560
knowing that something was wrong
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but we didn't know what.
00:04:56.660 --> 00:04:59.450
- We kept taking him to doctors
and they kept doing tests.
00:04:59.450 --> 00:05:01.700
They kept thinking it
was gonna be C. Diff,
00:05:01.700 --> 00:05:05.330
and so, put him on another antibiotic.
00:05:05.330 --> 00:05:06.950
- So the Crohn's and Colitis camp...
00:05:06.950 --> 00:05:09.734
When I was diagnosed with
Crohn's about age 12,
00:05:09.734 --> 00:05:14.210
it's a disease that's autoimmune
and it causes inflammation
00:05:14.210 --> 00:05:16.220
throughout your digestive tract.
00:05:16.220 --> 00:05:18.020
My parents and I were
traveling through Europe,
00:05:18.020 --> 00:05:20.600
and I had just before leaving on this trip
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started to come down with diarrhea.
00:05:23.868 --> 00:05:24.865
- When we went to Europe
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is when things really
went downhill for him,
00:05:26.810 --> 00:05:30.230
snd he was incapacitated
for a lot of the trip
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because of his pain.
00:05:32.450 --> 00:05:34.760
That's when, after we
got back, we insisted
00:05:34.760 --> 00:05:37.670
that they would check
him into the hospital
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and get a diagnosis.
00:05:42.791 --> 00:05:45.374
[gentle music]
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I grew up in the '50s when
obesity, diabetes, autoimmune...
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- Crohn's.
00:05:54.694 --> 00:05:57.500
- ...even cancer were
basically unheard of.
00:05:57.500 --> 00:06:00.707
And all these things are so prevalent now,
00:06:00.707 --> 00:06:03.353
and the question is,
what's changed so much?
00:06:07.040 --> 00:06:09.380
- Over the last 50 years,
00:06:09.380 --> 00:06:11.600
while there has been a tremendous decrease
00:06:11.600 --> 00:06:14.600
in single pathogen
diseases-- measles, mumps,
00:06:14.600 --> 00:06:16.220
whooping cough and so forth--
00:06:16.220 --> 00:06:17.960
during that same 50 years,
00:06:17.960 --> 00:06:21.454
there's been an increase in
asthma, autoimmune diseases,
00:06:21.454 --> 00:06:24.233
diabetes, obesity, heart disease.
00:06:26.420 --> 00:06:29.360
- We have a kind of desperate situation.
00:06:29.360 --> 00:06:30.830
People over age 65,
00:06:30.830 --> 00:06:32.930
the average have five chronic conditions.
00:06:32.930 --> 00:06:35.655
- Everything from somebody
that's just starting
00:06:35.655 --> 00:06:38.432
to have maybe early
indications of prediabetes,
00:06:38.432 --> 00:06:40.298
all the way through to diseases
00:06:40.298 --> 00:06:42.595
that eventually kill you.
00:06:42.595 --> 00:06:44.704
- ADD is so common,
allergies are so common,
00:06:44.704 --> 00:06:46.919
anaphylaxis is so common,
00:06:46.919 --> 00:06:50.630
autism is so common, behavioral disorders.
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- Most of our healthcare system
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is designed around taking
care of chronic disease.
00:06:55.370 --> 00:06:57.470
- It's very clear we're
facing a serious problem
00:06:57.470 --> 00:06:58.340
with healthcare.
00:06:58.340 --> 00:06:59.780
And there's so many things
that need to be fixed.
00:06:59.780 --> 00:07:01.880
Everybody sort of throws
up their hands and say,
00:07:01.880 --> 00:07:03.200
"We can't fix it."
00:07:03.200 --> 00:07:05.780
We're spending billions of
dollars treating diseases
00:07:05.780 --> 00:07:08.510
we don't understand, and often poorly.
00:07:08.510 --> 00:07:10.460
Across most chronic diseases,
00:07:10.460 --> 00:07:13.700
drugs only work a fraction of the time.
00:07:13.700 --> 00:07:16.585
- Many of these diseases
start with children,
00:07:16.585 --> 00:07:21.548
and actually pediatrics is the
most quantified subspecialty
00:07:21.548 --> 00:07:23.180
in all of medicine.
00:07:23.180 --> 00:07:25.760
You know exactly how long my baby is,
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what the weight of the baby is.
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I mean, you're totally quantified,
and that's just normal.
00:07:30.830 --> 00:07:33.170
And then somehow we lose that.
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And I don't wanna lose that.
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I wanna keep that same notion
00:07:37.580 --> 00:07:40.940
of having a dashboard for your body.
00:07:40.940 --> 00:07:43.100
- The way we practice medicine today
00:07:43.100 --> 00:07:45.620
is at a population level
because we don't have
00:07:45.620 --> 00:07:48.440
the data and information
on each individual.
00:07:48.440 --> 00:07:50.780
- The average population, for example,
00:07:50.780 --> 00:07:54.860
has a temperature of
98.6, and so these days,
00:07:54.860 --> 00:07:56.870
if you walk into a doctor's office
00:07:56.870 --> 00:08:00.140
and your temperature's 98.6,
they tell you you're normal.
00:08:00.140 --> 00:08:01.940
But what most people don't realize
00:08:01.940 --> 00:08:04.070
is that there's a very
broad range actually.
00:08:04.070 --> 00:08:05.510
There's a lot of people running around
00:08:05.510 --> 00:08:10.510
whose basic temperature is 94, not 98.6,
00:08:10.559 --> 00:08:14.360
and there are others running
around 99.1 or 99.6, even.
00:08:14.360 --> 00:08:17.300
So what that means is if
you basic temperature's 94,
00:08:17.300 --> 00:08:21.170
you walk into a doctor's
office and you're 98.6,
00:08:21.170 --> 00:08:22.610
he says, "You're fine, you're normal,"
00:08:22.610 --> 00:08:24.245
because that's what
everybody's temperature is.
00:08:24.245 --> 00:08:25.953
"Go home. Everything's good."
00:08:25.953 --> 00:08:27.928
But the reality is you can be quite sick.
00:08:27.928 --> 00:08:31.640
You're up, very elevated, if
you think about 4.6 degrees.
00:08:31.640 --> 00:08:32.473
That's high.
00:08:33.500 --> 00:08:36.260
- It's only when you have that data
00:08:36.260 --> 00:08:40.010
that you have a chance
to understand, early,
00:08:40.010 --> 00:08:42.440
that something is beginning to go wrong
00:08:42.440 --> 00:08:45.233
long before there are symptoms
or you are aware of it.
00:08:47.360 --> 00:08:50.240
- Chronic diseases are tough
from a research perspective
00:08:50.240 --> 00:08:51.920
and for treatment perspectives
00:08:51.920 --> 00:08:53.960
because they're so complex.
00:08:53.960 --> 00:08:56.330
And I think that's why
it's been really difficult
00:08:56.330 --> 00:09:00.470
in the current research model
to try to crack that nut.
00:09:00.470 --> 00:09:02.810
And I think patients
have really had the sense
00:09:02.810 --> 00:09:05.390
that we're not gathering
the right information.
00:09:05.390 --> 00:09:08.043
We're not approaching
this from the right angle.
00:09:08.043 --> 00:09:09.178
[birds chirping]
00:09:09.178 --> 00:09:11.761
[gentle music]
00:09:24.253 --> 00:09:27.829
- The willows do what
they do every spring....
00:09:29.413 --> 00:09:32.123
Elizabeth was born perfectly healthy.
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She had language, she spoke at 15 months.
00:09:41.570 --> 00:09:42.980
But she regressed,
00:09:42.980 --> 00:09:46.327
she lost all her language,
and she actually started
00:09:46.327 --> 00:09:48.233
hitting her head on the floor.
00:09:51.680 --> 00:09:55.343
We searched for answers
with doctors far and wide,
00:09:56.900 --> 00:10:00.086
and then we got the diagnosis
that she had autism.
00:10:04.247 --> 00:10:06.697
[somber instrumental music]
00:10:21.930 --> 00:10:24.230
[music continues]
00:10:30.890 --> 00:10:34.103
It's been a long journey with
Elizabeth, it's been decades.
00:10:36.740 --> 00:10:40.493
We made a lot of progress
from that time at 15 months,
00:10:41.870 --> 00:10:44.483
and we were making
progress in public school.
00:10:45.980 --> 00:10:48.923
She got invited into the gifted program.
00:10:50.990 --> 00:10:52.970
And then all of a sudden, in 5th grade,
00:10:52.970 --> 00:10:57.970
she was exposed to strep, like
so many children in school,
00:10:58.490 --> 00:11:00.593
but she could not get over it.
00:11:02.510 --> 00:11:05.720
She was smashing her knee into her face
00:11:05.720 --> 00:11:09.503
every 40 seconds, day and night.
00:11:11.390 --> 00:11:15.140
I actually had to sleep
across her every night
00:11:15.140 --> 00:11:19.493
so she would not smash
her knee into her face.
00:11:20.720 --> 00:11:25.370
So this went on and on,
00:11:25.370 --> 00:11:27.230
and I thought, I'm gonna take her
00:11:27.230 --> 00:11:29.870
to the world's top neurologists
00:11:29.870 --> 00:11:32.090
to find out what was going on.
00:11:32.090 --> 00:11:36.263
I didn't know, maybe
her brain was swollen.
00:11:39.290 --> 00:11:43.733
We took a long, terrible ride to Boston.
00:11:44.630 --> 00:11:47.848
Literally, her father was holding her
00:11:47.848 --> 00:11:52.043
in the backseat of the car,
wrestling her for five hours.
00:11:52.880 --> 00:11:57.140
We get there, this neurologist
who we were a patient of--
00:11:57.140 --> 00:12:02.140
this was not a new thing--
looked at her and said,
00:12:02.930 --> 00:12:05.630
"This is just her autism."
00:12:05.630 --> 00:12:10.630
And I lost it at that point, and I said,
00:12:11.210 --> 00:12:15.410
"I know my daughter and I know autism,
00:12:15.410 --> 00:12:19.220
"and this is neither my
daughter nor autism."
00:12:19.220 --> 00:12:22.470
And then I took my
daughter out of that office
00:12:23.780 --> 00:12:27.871
and I said, "Never again. Never again
00:12:27.871 --> 00:12:31.010
"are we going to see a
doctor who does not believe
00:12:31.010 --> 00:12:34.313
"that autism is a treatable
medical condition."
00:12:36.902 --> 00:12:39.327
[somber instrumental music]
00:12:53.830 --> 00:12:56.163
[music continues]
00:13:11.030 --> 00:13:14.030
- So we did spend a lot of
time at the intensive care,
00:13:14.030 --> 00:13:16.043
for a couple of weeks every day.
00:13:17.690 --> 00:13:18.890
You so unhappy.
00:13:18.890 --> 00:13:22.130
You feel miserable and you
think your life is over.
00:13:22.130 --> 00:13:23.420
This is basically what you think.
00:13:23.420 --> 00:13:26.780
But still, you try to
find at a certain time
00:13:26.780 --> 00:13:31.106
the little bit of energy
to stand there and to try
00:13:31.106 --> 00:13:33.754
to understand what's
happening, to understand
00:13:33.754 --> 00:13:37.137
the environment that is
totally unknown to you--
00:13:37.137 --> 00:13:39.310
the machines, the doctors, the language.
00:13:39.310 --> 00:13:41.553
Nobody's able to give you projections,
00:13:41.553 --> 00:13:44.990
and Walter being assigned was
like, "What does that mean?
00:13:44.990 --> 00:13:46.190
"What are the statistics?"
00:13:48.860 --> 00:13:51.817
- I was looking at all the
systems of this hospital,
00:13:51.817 --> 00:13:54.518
and I saw myself and the
other dads and moms there
00:13:54.518 --> 00:13:57.794
completely helpless and trying to find out
00:13:57.794 --> 00:13:59.750
what was happening.
00:13:59.750 --> 00:14:02.767
- He was quantifying everything.
00:14:02.767 --> 00:14:05.240
He had this notebook and he was noting
00:14:05.240 --> 00:14:07.580
every single piece of information.
00:14:07.580 --> 00:14:09.260
What does that machine do?
00:14:09.260 --> 00:14:11.633
Who produces that, how
much does that cost?
00:14:13.340 --> 00:14:17.270
- Sitting there 24/7, you
are caught in a fiction
00:14:17.270 --> 00:14:21.290
of your own conspiracy and
you are trying to understand.
00:14:21.290 --> 00:14:25.340
So the only thing I
immediately came up with is,
00:14:25.340 --> 00:14:29.060
we must have a tool to understand.
00:14:29.060 --> 00:14:33.033
I thought of my youth, and
the science in my youth
00:14:33.033 --> 00:14:35.930
was the fictional part was Star Trek.
00:14:35.930 --> 00:14:37.100
And I thought like, man,
00:14:37.100 --> 00:14:41.217
it would be such a great
thing to have a Tricorder.
00:14:41.217 --> 00:14:42.783
[Chekov shouting]
00:14:47.210 --> 00:14:48.110
- What is it?
00:14:48.110 --> 00:14:51.590
- The flowers, sir. I
touched, it's like fire.
00:14:51.590 --> 00:14:54.440
- The passive collection of all that data
00:14:54.440 --> 00:14:58.790
and the insights that follow,
who would not want that?
00:14:58.790 --> 00:15:02.180
And so I thought about it a long time,
00:15:02.180 --> 00:15:07.163
and in 2010 I finally decided
to make the Tricorder.
00:15:07.163 --> 00:15:08.900
[upbeat music]
00:15:08.900 --> 00:15:12.083
And I went to the west
coast, to California.
00:15:23.600 --> 00:15:26.780
- Hi guys, how are you doing?
00:15:26.780 --> 00:15:28.850
- We're getting there.
I think things are...
00:15:28.850 --> 00:15:32.525
- It's a bit peculiar because
we had to put a complete
00:15:32.525 --> 00:15:36.023
emergency room and a lot
more, actually, in one device.
00:15:40.430 --> 00:15:43.523
What we came up with
is a very small device.
00:15:44.480 --> 00:15:47.300
You place your finger on this part,
00:15:47.300 --> 00:15:49.583
you place this electrode
on the forehead...
00:15:49.583 --> 00:15:54.050
- And then it gives you a
reading, your heart rates.
00:15:54.050 --> 00:15:56.210
It gives you also of
course your temperature,
00:15:56.210 --> 00:15:58.818
your oxymetry, your oxygenation.
00:15:58.818 --> 00:15:59.660
- ...ECG wave form.
00:15:59.660 --> 00:16:02.030
- If you wanna measure the
oxygen level in somebody,
00:16:02.030 --> 00:16:04.310
the best place to get it
is from their fingertips.
00:16:04.310 --> 00:16:07.040
And if you wanna measure
their temperature,
00:16:07.040 --> 00:16:08.660
the best place on the surface of the body
00:16:08.660 --> 00:16:10.040
is the temporal artery.
00:16:10.040 --> 00:16:12.650
And if you want to measure an EKG wave,
00:16:12.650 --> 00:16:15.260
you wanna get two electrodes
that are across the heart.
00:16:15.260 --> 00:16:16.640
But we're not gonna have
people go putting it
00:16:16.640 --> 00:16:18.650
all different places.
So we design the device
00:16:18.650 --> 00:16:20.060
you just hold it to your forehead,
00:16:20.060 --> 00:16:22.760
and very cleverly it's
checking your oxygen
00:16:22.760 --> 00:16:25.010
in your fingertip, it's
checking your temperature
00:16:25.010 --> 00:16:26.420
at your temporal artery,
00:16:26.420 --> 00:16:28.370
and there's a circuit that
goes from your left hand
00:16:28.370 --> 00:16:29.720
through your heart, around to the forehead
00:16:29.720 --> 00:16:32.003
and back to the device that gets the EKG.
00:16:33.380 --> 00:16:35.810
- And you can also tag your results, so...
00:16:35.810 --> 00:16:39.080
- It's not about doctors--
they have devices enough.
00:16:39.080 --> 00:16:40.940
It's about consumers.
00:16:40.940 --> 00:16:45.244
If the consumer has a device
where it can show his doctor,
00:16:45.244 --> 00:16:49.190
"This is my wave," you know.
00:16:49.190 --> 00:16:51.590
"This is not a particle of
my health, this is my wave.
00:16:51.590 --> 00:16:54.650
"This is who I am, these are my ranges.
00:16:54.650 --> 00:16:56.180
"This is where I had a dip.
00:16:56.180 --> 00:16:58.850
"This is where I really felt great.
00:16:58.850 --> 00:17:02.330
"And here I took this medicine
and look what happened here."
00:17:02.330 --> 00:17:03.620
"What do you think?"
00:17:03.620 --> 00:17:06.230
And there you put the doctor on a pedestal
00:17:06.230 --> 00:17:09.233
of an information analyst,
where he's really trained for.
00:17:12.230 --> 00:17:16.580
- Your body is generating
massive amounts of data
00:17:16.580 --> 00:17:17.510
all the time.
00:17:17.510 --> 00:17:20.630
It's just, you're not
bothering to measure it.
00:17:20.630 --> 00:17:22.400
Your systems are just doing.
00:17:22.400 --> 00:17:24.138
My heart's beating, right?
00:17:24.138 --> 00:17:26.076
The variation of my
heart is whatever it is.
00:17:26.076 --> 00:17:29.450
All you gotta do is hook up a
sensor and you got the data.
00:17:29.450 --> 00:17:32.814
- Medicine looks at itself
as a data-driven discipline,
00:17:32.814 --> 00:17:35.573
and yet that's so not true.
00:17:37.250 --> 00:17:41.090
We capture more data on a
flight from San Francisco
00:17:41.090 --> 00:17:42.861
to Los Angeles about that airplane
00:17:42.861 --> 00:17:45.743
than we do in most patients' charts.
00:17:46.610 --> 00:17:48.941
- Getting an understanding
of what our own numbers are
00:17:48.941 --> 00:17:51.800
will take on so much more significance.
00:17:51.800 --> 00:17:53.841
That's the direction we see this going.
00:17:53.841 --> 00:17:57.456
You will have a dashboard
into your own data
00:17:57.456 --> 00:17:59.723
that you've never had before.
00:18:01.010 --> 00:18:03.320
And if you know your own data,
00:18:03.320 --> 00:18:06.258
that could start to move you toward
00:18:06.258 --> 00:18:08.960
knowing more about yourself,
what your health issues are,
00:18:08.960 --> 00:18:11.540
what drugs you can take, what
drugs you shouldn't be taking.
00:18:11.540 --> 00:18:14.840
And adding that information
into your medical record now
00:18:14.840 --> 00:18:16.970
could really change how we treat patients.
00:18:16.970 --> 00:18:20.510
- There's so much we can learn
by having quantifiable data
00:18:20.510 --> 00:18:22.839
really easy to collect, analyze and share.
00:18:24.422 --> 00:18:26.955
[gentle instrumental music]
[birds chirping]
00:18:32.079 --> 00:18:35.079
[indistinct chatter]
00:18:36.440 --> 00:18:38.210
- Being diagnosed at age 12
00:18:38.210 --> 00:18:41.060
left me dealing with
Crohn's for quite some time.
00:18:41.060 --> 00:18:43.997
And there were periods of
time where I was in college
00:18:43.997 --> 00:18:46.510
and my symptoms flared up incredibly,
00:18:46.510 --> 00:18:50.960
and I was stuck with not very
good treatment options at all.
00:18:52.310 --> 00:18:54.151
I was on this drug called Remicade.
00:18:54.151 --> 00:18:58.910
And as soon as you leave
Remicade, you can't go back on it.
00:18:58.910 --> 00:19:01.670
Your body will build up
an intolerance to it.
00:19:01.670 --> 00:19:04.280
And there's only a few really severe drugs
00:19:04.280 --> 00:19:06.020
that can actually help treat your Crohn's.
00:19:06.020 --> 00:19:08.554
And so you're kind of
jumping from cloud to cloud,
00:19:08.554 --> 00:19:11.183
and as soon as you let go,
it disappears behind you.
00:19:12.230 --> 00:19:14.630
When I realized I was
stuck in that sort of trap,
00:19:14.630 --> 00:19:16.520
I needed to think outside the box
00:19:16.520 --> 00:19:18.440
and find other options
that might work for me.
00:19:18.440 --> 00:19:21.386
And then I saw this flyer
on campus at UC Berkeley,
00:19:21.386 --> 00:19:23.666
and it advertised a documentary
00:19:23.666 --> 00:19:26.360
on people living with Crohn's disease
00:19:26.360 --> 00:19:27.740
and ulcerative colitis.
00:19:27.740 --> 00:19:30.008
So I showed up at this documentary,
00:19:30.008 --> 00:19:32.219
and then at the end of it, I looked around
00:19:32.219 --> 00:19:36.025
and I saw in the theater
seats all surrounding me
00:19:36.025 --> 00:19:39.958
were dozens of other patients
that have the same condition.
00:19:39.958 --> 00:19:43.760
And as soon as the
theater curtains closed,
00:19:43.760 --> 00:19:47.570
we began a spark, a magical ignition
00:19:47.570 --> 00:19:49.940
of conversation and knowledge sharing.
00:19:49.940 --> 00:19:51.159
And from that point on,
00:19:51.159 --> 00:19:54.710
we continued to gather
together every couple weeks
00:19:54.710 --> 00:19:58.377
in each other's houses
to share information.
00:20:01.610 --> 00:20:04.082
- I realized that if we were gonna learn
00:20:04.082 --> 00:20:06.234
better ways to treat conditions
00:20:06.234 --> 00:20:08.030
and learn from patients,
00:20:08.030 --> 00:20:11.030
it needed to come directly
from the patients themselves.
00:20:11.030 --> 00:20:13.430
And so that's when I started building
00:20:13.430 --> 00:20:14.840
some health tracking tools.
00:20:14.840 --> 00:20:17.042
The iPhone had recently come out,
00:20:17.042 --> 00:20:20.390
and I built a small tracker
on that device that allowed me
00:20:20.390 --> 00:20:23.693
to log my use of the restroom
and if I had any gut pain.
00:20:27.320 --> 00:20:31.430
As a patient myself, I was
going through every day
00:20:31.430 --> 00:20:34.640
and every minute of my life
living with that condition,
00:20:34.640 --> 00:20:37.280
and I would go into the doctor's office
00:20:37.280 --> 00:20:38.990
maybe every six months or so.
00:20:38.990 --> 00:20:41.120
And so my doctor would have a 5 minute
00:20:41.120 --> 00:20:44.120
or even maybe a 10 minute
summary of what was going on,
00:20:44.120 --> 00:20:46.700
and there's no way you can
take six months of data points
00:20:46.700 --> 00:20:49.380
and compress it into 5 or 10 minutes.
00:20:50.430 --> 00:20:53.463
With Crohnology, we're
taking the data collection
00:20:53.463 --> 00:20:56.213
from being exclusively
in the doctor's office
00:20:56.213 --> 00:20:59.480
at a very long fixed interval
and saying, "It's real time.
00:20:59.480 --> 00:21:01.040
"It's in the patient's pocket."
00:21:01.040 --> 00:21:02.540
- ...for the tab content.
00:21:02.540 --> 00:21:05.720
- Crohnology is now this
software network that I've built
00:21:05.720 --> 00:21:07.220
of patients around the world,
00:21:07.220 --> 00:21:10.400
and they're using the health
tracking tools that I provided
00:21:10.400 --> 00:21:12.977
to get that baseline
data before they're sick,
00:21:12.977 --> 00:21:14.210
and using it when they're sick
00:21:14.210 --> 00:21:16.381
or when they're doing
treatment experiments.
00:21:16.381 --> 00:21:17.691
- So we have some decisions to make
00:21:17.691 --> 00:21:19.370
that are fairly technical.
00:21:19.370 --> 00:21:21.650
- A friend of mine who has Crohn's
00:21:21.650 --> 00:21:23.933
says he feels like he's
a squandered data point.
00:21:24.800 --> 00:21:25.730
That's how he described his experience
00:21:25.730 --> 00:21:27.230
with the healthcare system.
00:21:27.230 --> 00:21:30.230
And so what I'm doing
is building something
00:21:30.230 --> 00:21:32.163
that allows people to not
be squandered data points,
00:21:32.163 --> 00:21:34.760
to actually to be a valuable contributor
00:21:34.760 --> 00:21:36.599
towards research and knowledge.
00:21:36.599 --> 00:21:38.570
- ...is gonna be displayed
in a consistent way.
00:21:38.570 --> 00:21:40.910
- The silicon in your pocket--
00:21:40.910 --> 00:21:42.920
which is usually a phone or a watch
00:21:42.920 --> 00:21:45.258
or all these other little
sensors or devices--
00:21:45.258 --> 00:21:50.258
is one really potent way
of collecting information,
00:21:50.480 --> 00:21:54.931
of showing information, of
engaging with you and your family
00:21:54.931 --> 00:21:57.920
and others in their health.
00:21:57.920 --> 00:22:02.600
It's pretty important in how
we sniff out what's happening.
00:22:02.600 --> 00:22:05.180
It needs to then take it
a step further, which is,
00:22:05.180 --> 00:22:06.440
well, what do we do with that?
00:22:06.440 --> 00:22:09.290
What's the longitudinal effect
of what I'm going to do?
00:22:09.290 --> 00:22:11.060
What do I do next?
00:22:11.060 --> 00:22:12.510
We don't have that right now.
00:22:13.790 --> 00:22:17.120
- In my day, we had a chronic disease
00:22:17.120 --> 00:22:21.590
sick care system for cars,
like we do today for humans.
00:22:21.590 --> 00:22:24.230
And so when smoke came
out from under the hood,
00:22:24.230 --> 00:22:26.125
you had a symptom.
00:22:26.125 --> 00:22:29.857
You go to the "doctor" in
the garage, the car doctor,
00:22:29.857 --> 00:22:31.814
and they say, "Oh man, this is terrible.
00:22:31.814 --> 00:22:33.414
"You didn't change your oil.
00:22:33.414 --> 00:22:35.750
"It's gonna cost ya. You
got a chronic disease."
00:22:35.750 --> 00:22:38.242
Y'know, whatever, "I gotta
yank your engine out."
00:22:38.242 --> 00:22:40.607
Notice that doesn't happen anymore.
00:22:40.607 --> 00:22:44.240
And the reason is because
we've gone to using electronics
00:22:44.240 --> 00:22:48.320
to take the time series
of your spark plugs
00:22:48.320 --> 00:22:50.953
and your brakes and your fuel
injection, everything else.
00:22:50.953 --> 00:22:52.430
And it just sits there recording the data.
00:22:52.430 --> 00:22:54.800
It doesn't know whether
there's anything wrong or not.
00:22:54.800 --> 00:22:56.300
It just take the data.
00:22:56.300 --> 00:23:01.190
And then, preventively, every
10 or 20,000 miles you go in,
00:23:01.190 --> 00:23:04.100
they look at your N-of-1 of your car,
00:23:04.100 --> 00:23:05.960
but they look at each of these variables
00:23:05.960 --> 00:23:10.010
against the population of cars
that have been in all kinds
00:23:10.010 --> 00:23:13.700
of different environmental interactions.
00:23:13.700 --> 00:23:15.710
And if you're in the
middle of the bell curve
00:23:15.710 --> 00:23:17.930
in each of those, you're good to go.
00:23:17.930 --> 00:23:21.320
But if you have started to
shift in one of those variables
00:23:21.320 --> 00:23:23.930
that unbeknownst to you, the car driver,
00:23:23.930 --> 00:23:26.570
then they can pick it up
immediately because you're becoming
00:23:26.570 --> 00:23:28.763
an outlier against the population.
00:23:29.680 --> 00:23:32.960
I believe within 5 to 10 years,
00:23:32.960 --> 00:23:35.540
as all of the new kinds of Apple watches
00:23:35.540 --> 00:23:37.610
or Fitbits or all these things are coming,
00:23:37.610 --> 00:23:40.275
you're getting more and more like the car.
00:23:40.275 --> 00:23:44.870
And so I think the digital
revolution is the only way
00:23:44.870 --> 00:23:48.114
that we are gonna get
from a "sick care" system
00:23:48.114 --> 00:23:50.518
to an actual healthcare system.
00:23:55.492 --> 00:23:58.433
[gentle piano melody]
00:24:03.793 --> 00:24:06.240
[music continues]
00:24:08.240 --> 00:24:13.240
- What I'm gonna do tonight
is to ask you to let go
00:24:13.240 --> 00:24:17.469
of whatever you think
you know about autism.
00:24:17.469 --> 00:24:20.569
Just suspend it-- the beginner's mind.
00:24:21.470 --> 00:24:24.528
Particularly, let go of the stories
00:24:24.528 --> 00:24:28.250
that you tell to connect the dots.
00:24:28.250 --> 00:24:30.560
I'm not saying they're right,
I'm not saying they're wrong.
00:24:30.560 --> 00:24:33.530
What I'm gonna do is throw
the pieces up in the air.
00:24:33.530 --> 00:24:37.715
They may come down differently
than you're used to hearing.
00:24:37.715 --> 00:24:40.885
Certain portions that you
may not have related before
00:24:40.885 --> 00:24:42.680
will be close together.
00:24:42.680 --> 00:24:46.310
And certain pieces will
land close to things
00:24:46.310 --> 00:24:47.750
outside of autism
00:24:47.750 --> 00:24:50.013
that you may not have
thought were related.
00:24:50.013 --> 00:24:51.546
But right now, just let go...
00:24:51.546 --> 00:24:54.791
- Compass is this
initiative to collect data--
00:24:54.791 --> 00:24:58.940
multidimensional, open
source, hosted in the cloud.
00:24:58.940 --> 00:25:03.560
- And in particular, to use
data about what's going on
00:25:03.560 --> 00:25:05.570
in the bodies of our children
00:25:05.570 --> 00:25:08.930
in order to figure out how to help them
00:25:08.930 --> 00:25:10.610
to in fact get better.
00:25:10.610 --> 00:25:13.409
- We have been through
the mill with these kids.
00:25:13.409 --> 00:25:15.175
We have a pretty damn good idea
00:25:15.175 --> 00:25:16.700
of stuff that's gonna show up.
00:25:16.700 --> 00:25:17.720
- Yes.
00:25:17.720 --> 00:25:21.148
- Physician, scientist,
parent of patients,
00:25:21.148 --> 00:25:22.990
data people, lab people,
00:25:22.990 --> 00:25:25.034
people who can help with measuring,
00:25:25.034 --> 00:25:27.349
people who can help
potentially with treating,
00:25:27.349 --> 00:25:29.023
people who can help with understanding
00:25:29.023 --> 00:25:30.740
and putting all the pieces together--
00:25:30.740 --> 00:25:33.320
when you intersect different
disciplines like that,
00:25:33.320 --> 00:25:35.795
that's when sparks fly and things happen.
00:25:35.795 --> 00:25:38.810
- We have all these anecdotal stories,
00:25:38.810 --> 00:25:42.590
all these thousands of
children that have recovered.
00:25:42.590 --> 00:25:47.382
Each one of them is in his
own or her own little island,
00:25:47.382 --> 00:25:49.257
data and all.
00:25:49.257 --> 00:25:53.690
And we've realized that
we're in Silicon Valley,
00:25:53.690 --> 00:25:56.870
we use data all the time.
We analyze it,
00:25:56.870 --> 00:26:01.193
we find patterns, we mine it
for all kinds of companies,
00:26:02.150 --> 00:26:04.760
but no one has ever collected data
00:26:04.760 --> 00:26:09.442
on all these children and
run software against it
00:26:09.442 --> 00:26:11.300
to try to find patterns.
00:26:11.300 --> 00:26:14.390
- If you can get 30 or 50 or 100 people...
00:26:14.390 --> 00:26:17.990
- Healthcare has followed
a long and storied path.
00:26:17.990 --> 00:26:20.570
I'm a physician, so when I
look at it through that lens
00:26:20.570 --> 00:26:22.430
it's sort of about following rules.
00:26:22.430 --> 00:26:23.930
Sometimes it's breaking those rules,
00:26:23.930 --> 00:26:26.150
but more often than not,
it's following those rules.
00:26:26.150 --> 00:26:27.560
When I look at it as a scientist,
00:26:27.560 --> 00:26:30.830
it's questioning rules and
trying to bring things on.
00:26:30.830 --> 00:26:33.110
But when I turn to myself as a parent,
00:26:33.110 --> 00:26:36.230
the paradigm is completely
flipped, and you will do anything
00:26:36.230 --> 00:26:37.788
and everything for your kid.
00:26:37.788 --> 00:26:39.221
- Ramsey, your turn.
00:26:40.520 --> 00:26:44.150
- Why do some kids
recover and others don't?
00:26:44.150 --> 00:26:46.050
And sometimes they're siblings.
00:26:47.692 --> 00:26:50.777
Wouldn't it be great to at least make
00:26:50.777 --> 00:26:54.495
our journey easier by knowing
that there are certain rules?
00:26:55.370 --> 00:26:59.870
Kids that do X need Y to get better.
00:26:59.870 --> 00:27:02.390
Kids that are Z
00:27:02.390 --> 00:27:05.757
need to go in a totally different way.
00:27:05.757 --> 00:27:08.347
Two, three, four, five.
00:27:08.347 --> 00:27:10.730
- That's the most striking
thing about when you get
00:27:10.730 --> 00:27:12.939
that diagnosis of autism.
00:27:12.939 --> 00:27:15.230
In the mainstream medical community,
00:27:15.230 --> 00:27:18.530
it's literally almost
like, "Okay, so, goodbye."
00:27:18.530 --> 00:27:19.363
- Yeah.
00:27:19.363 --> 00:27:20.210
- "Good luck."
00:27:20.210 --> 00:27:24.623
There's nothing that
they have to offer you.
00:27:26.660 --> 00:27:28.962
- I think what's special about
the approach we're taking
00:27:28.962 --> 00:27:30.560
is it's discovery based.
00:27:30.560 --> 00:27:32.766
I don't come in with a preconceived notion
00:27:32.766 --> 00:27:35.630
that autism is A, B or C.
00:27:35.630 --> 00:27:38.120
I'm gonna try and measure
as many things as I can
00:27:38.120 --> 00:27:40.850
out of this and let the data
tell what might be the answer,
00:27:40.850 --> 00:27:42.380
at least for some people.
00:27:42.380 --> 00:27:43.213
- No.
00:27:43.213 --> 00:27:45.483
- It's a totally different way of thinking
00:27:45.483 --> 00:27:48.860
than medical people and
researchers are trained.
00:27:48.860 --> 00:27:52.605
They're trained in the narrow
sort of reductionist, y'know,
00:27:52.605 --> 00:27:56.420
you try to trim it down, not
make it more complicated.
00:27:56.420 --> 00:28:00.708
- The orange is CO2 and the
purple are seizures, so...
00:28:00.708 --> 00:28:02.916
- I think what we're really
desperate for right now
00:28:02.916 --> 00:28:07.565
is real time, continuous
data with large populations,
00:28:07.565 --> 00:28:09.833
and not just the traditional data.
00:28:11.030 --> 00:28:13.310
- Alright, here we go, alright?
00:28:13.310 --> 00:28:16.160
We have your sensor here,
gotta plug it into the battery
00:28:16.160 --> 00:28:16.993
as we always do.
00:28:17.935 --> 00:28:21.402
We have taken Elizabeth across the country
00:28:21.402 --> 00:28:24.560
and seen dozens of specialists.
00:28:24.560 --> 00:28:28.070
We have tried virtually
everything you can try.
00:28:28.070 --> 00:28:33.070
She has done stem cells,
she's done hyperbaric oxygen,
00:28:33.410 --> 00:28:38.410
craniosacral therapy,
neurofeedback therapy, supplements.
00:28:38.508 --> 00:28:39.867
Right over your heart.
00:28:39.867 --> 00:28:42.770
You name it, we have done it.
00:28:42.770 --> 00:28:47.240
Right now we are on a mission
with a heart monitor device
00:28:47.240 --> 00:28:49.231
that Elizabeth is wearing.
00:28:49.231 --> 00:28:50.614
It found it.
00:28:50.614 --> 00:28:54.754
And so she is being monitored,
all her vital signs.
00:28:54.754 --> 00:28:56.420
Syncing.
00:28:56.420 --> 00:28:58.943
And our researcher is in California.
00:29:02.322 --> 00:29:03.155
- Hi, Janine.
00:29:03.155 --> 00:29:06.410
- Hi, Janelle.
I do have the image, and...
00:29:06.410 --> 00:29:08.810
- We still don't really have
a clue of what's going on
00:29:08.810 --> 00:29:12.350
in many cases, and much less a therapy.
00:29:12.350 --> 00:29:14.503
And since we now have the technology
00:29:14.503 --> 00:29:16.178
and it's getting cheaper and cheaper,
00:29:16.178 --> 00:29:19.580
why not test broad ranges of factors?
00:29:19.580 --> 00:29:21.710
I mean, things that aren't even known
00:29:21.710 --> 00:29:23.779
to have something to do
with these diseases--
00:29:23.779 --> 00:29:26.420
diet, the air that people breathe,
00:29:26.420 --> 00:29:28.190
the water they're drinking.
00:29:28.190 --> 00:29:30.710
You would've had just a
bunch of random data before,
00:29:30.710 --> 00:29:32.774
but we now do have the computing power
00:29:32.774 --> 00:29:37.490
and the ability to crunch
massive amounts of data.
00:29:37.490 --> 00:29:40.310
And why not find out what
you can learn from that.
00:29:40.310 --> 00:29:43.280
You might find a correlation
that is totally unexpected
00:29:43.280 --> 00:29:46.293
that begins to explain it, and
maybe you can get a therapy.
00:29:47.563 --> 00:29:50.146
[gentle instrumental music]
00:29:56.300 --> 00:29:59.186
Mike Snyder and others are doing these
00:29:59.186 --> 00:30:02.213
really massive experiments
with continuous monitoring.
00:30:04.520 --> 00:30:06.110
It may sound rather simple,
00:30:06.110 --> 00:30:09.034
but there's almost no
data that exists on anyone
00:30:09.034 --> 00:30:11.273
that's continuous monitoring.
00:30:12.350 --> 00:30:14.090
People like Mike and others
00:30:14.090 --> 00:30:17.990
are beginning to set
up protocol standards,
00:30:17.990 --> 00:30:21.050
but this is not the sexy
part, this is not fun.
00:30:21.050 --> 00:30:22.460
This is like the railroads
00:30:22.460 --> 00:30:24.440
back when every different railroad company
00:30:24.440 --> 00:30:26.060
had a different size track.
00:30:26.060 --> 00:30:27.440
And so you had to stop,
00:30:27.440 --> 00:30:29.485
move everything onto the new train,
00:30:29.485 --> 00:30:31.465
and then go along and then do it again.
00:30:31.465 --> 00:30:33.617
And at some point, everybody
got together and said,
00:30:33.617 --> 00:30:35.310
"You know what? We need
to have one track size."
00:30:41.960 --> 00:30:44.150
- I always thought it
was incredibly strange
00:30:44.150 --> 00:30:46.040
the way we practice medicine,
00:30:46.040 --> 00:30:50.570
which is to say that we treat
symptoms after they arise
00:30:50.570 --> 00:30:53.060
and it's very disease-oriented medicine,
00:30:53.060 --> 00:30:54.140
the way things roll out.
00:30:54.140 --> 00:30:56.450
And when we do do things
for healthy people,
00:30:56.450 --> 00:30:59.870
we give them a 15 minute checkup,
measure 15 things and say,
00:30:59.870 --> 00:31:00.830
"Alright, you look fine.
00:31:00.830 --> 00:31:02.360
"Come back in two or three years."
00:31:02.360 --> 00:31:05.510
And that just doesn't seem
like the right way to operate,
00:31:05.510 --> 00:31:07.700
that we should be measuring
people when they're healthy,
00:31:07.700 --> 00:31:10.163
catch things early if
something's going wrong.
00:31:11.720 --> 00:31:14.090
We actually debated who
we should start this on.
00:31:14.090 --> 00:31:17.210
We wound up choosing me
probably for two reasons.
00:31:17.210 --> 00:31:20.480
One is I'm accessible
and very easy to do this.
00:31:20.480 --> 00:31:23.975
And the other is--
it's hard to appreciate now,
00:31:23.975 --> 00:31:25.796
although maybe there's
still elements of this now--
00:31:25.796 --> 00:31:27.162
but it was pretty controversial
00:31:27.162 --> 00:31:29.450
at the time we started this project.
00:31:29.450 --> 00:31:32.030
Studying people's DNA may be
a bad thing, not a good thing.
00:31:32.030 --> 00:31:34.280
There was a lot of
sentiment around about that.
00:31:35.150 --> 00:31:36.740
So I have three smart watches.
00:31:36.740 --> 00:31:38.150
This one's a Fitbit,
00:31:38.150 --> 00:31:39.290
this one's an Apple watch,
00:31:39.290 --> 00:31:41.090
and this one's from another company.
00:31:41.090 --> 00:31:42.350
They all measure heart rate,
00:31:42.350 --> 00:31:44.510
and they're all pretty accurate
for that, believe it or not.
00:31:44.510 --> 00:31:46.053
The heart rate measurements you get
00:31:46.053 --> 00:31:48.320
from most devices these
days is quite accurate--
00:31:48.320 --> 00:31:49.460
in fact, probably more accurate
00:31:49.460 --> 00:31:51.560
than what you can measure
in a doctor's office.
00:31:51.560 --> 00:31:53.630
They then measure a
variety of other things.
00:31:53.630 --> 00:31:55.370
So, the Fitbit will measure sleep.
00:31:55.370 --> 00:31:56.930
They all measure activity, as well.
00:31:56.930 --> 00:31:59.930
So, steps, other sorts
of activities like that.
00:31:59.930 --> 00:32:01.252
This one measures blood pressure.
00:32:01.252 --> 00:32:04.220
This ring is not really just a ring.
00:32:04.220 --> 00:32:05.630
It's actually a sensor as well.
00:32:05.630 --> 00:32:08.930
It measures activity as
well, and heart rate.
00:32:08.930 --> 00:32:10.310
I'm wearing some other device as well.
00:32:10.310 --> 00:32:13.490
I'm wearing a radiation monitor
that's sitting right here.
00:32:13.490 --> 00:32:16.100
I have a continuous glucose monitor on me.
00:32:16.100 --> 00:32:19.790
A glucose monitor tells
me exactly which foods
00:32:19.790 --> 00:32:23.180
spike my glucose, and so
I can try and avoid those.
00:32:23.180 --> 00:32:25.313
It's very personalized,
is the bottom line.
00:32:26.615 --> 00:32:29.390
[gentle piano music]
00:32:29.390 --> 00:32:30.223
When we started this,
00:32:30.223 --> 00:32:32.690
we sequenced my genome and
we predicted I was at risk
00:32:32.690 --> 00:32:34.940
for type 2 diabetes.
And wouldn't you know it,
00:32:34.940 --> 00:32:36.350
during the course of this process,
00:32:36.350 --> 00:32:38.480
I actually got type 2 diabetes,
00:32:38.480 --> 00:32:40.580
which I caught right away
because we were doing
00:32:40.580 --> 00:32:42.830
all these molecular profiles.
00:32:42.830 --> 00:32:44.570
So the bottom line, this is a big deal
00:32:44.570 --> 00:32:46.520
because it's the first time
someone used their genome
00:32:46.520 --> 00:32:48.170
to predict they're at risk for a disease
00:32:48.170 --> 00:32:50.270
and then in fact got the disease.
00:32:50.270 --> 00:32:52.640
The other reason it's a big
deal is because I actually made
00:32:52.640 --> 00:32:54.860
an association between a virus infection
00:32:54.860 --> 00:32:56.750
and type 2 diabetes for the first time,
00:32:56.750 --> 00:32:57.583
which hadn't been done.
00:32:57.583 --> 00:32:59.780
It had been done for
type 1, but not type 2.
00:32:59.780 --> 00:33:02.420
So the interpretation of
all this is that my DNA
00:33:02.420 --> 00:33:05.150
has me predisposed for type 2 diabetes,
00:33:05.150 --> 00:33:07.160
and then in conjunction
with this viral infection
00:33:07.160 --> 00:33:09.140
it's what triggered the disease.
00:33:09.140 --> 00:33:11.658
So genomics, DNA, plus environment.
00:33:11.658 --> 00:33:14.210
That's the hypothesis
that we're testing now.
00:33:14.210 --> 00:33:16.100
Ultimately I'm gonna die of something,
00:33:16.100 --> 00:33:18.260
and I wanna see the molecular
profiles that happen.
00:33:18.260 --> 00:33:20.540
If it's chronic, I'll
try and figure it out.
00:33:20.540 --> 00:33:23.156
If it's acute, the person
after me better figure it out.
00:33:23.156 --> 00:33:25.615
[group laughing]
00:33:29.480 --> 00:33:32.733
When I think we first started
on this eight years ago,
00:33:32.733 --> 00:33:34.600
everybody thought this was
just the stupidest project
00:33:34.600 --> 00:33:35.510
on the planet.
00:33:35.510 --> 00:33:39.080
And then even as we first
rolled out our publication,
00:33:39.080 --> 00:33:41.060
our first findings,
most people didn't get it.
00:33:41.060 --> 00:33:43.400
A lot of pushback about,
why would you study
00:33:43.400 --> 00:33:45.625
one person in incredible detail?
00:33:45.625 --> 00:33:48.380
And I get it, we don't
have to be making billions
00:33:48.380 --> 00:33:50.810
of measurements on
people like we do on me.
00:33:50.810 --> 00:33:52.790
We're doing that as a research project.
00:33:52.790 --> 00:33:55.460
But we should be measuring a
lot more than we currently do
00:33:55.460 --> 00:33:57.407
in the current healthcare system.
00:33:58.949 --> 00:34:01.550
The power of what you can
do from following people
00:34:01.550 --> 00:34:03.008
at an individual level,
00:34:03.008 --> 00:34:05.720
to me the whole thing's a no-brainer.
00:34:05.720 --> 00:34:09.110
We'll be able to better
stratify disease like diabetes,
00:34:09.110 --> 00:34:11.600
like autism, into its different subtypes,
00:34:11.600 --> 00:34:13.520
and then treat people accordingly.
00:34:13.520 --> 00:34:14.690
- What I believe is gonna happen
00:34:14.690 --> 00:34:17.182
is that we're probably gonna
throw out all the old labels,
00:34:17.182 --> 00:34:19.280
things that we call autism
00:34:19.280 --> 00:34:22.236
and chronic fatigue and lupus and MS.
00:34:22.236 --> 00:34:25.490
We may eliminate those
altogether and start to get down
00:34:25.490 --> 00:34:28.430
to the next deeper level,
which are subtypes,
00:34:28.430 --> 00:34:30.800
where people have more
similarity, and they know this
00:34:30.800 --> 00:34:33.500
because they have access to
data they've not had before.
00:34:33.500 --> 00:34:36.543
- That's gonna be something
that the consumer owns,
00:34:36.543 --> 00:34:39.080
and it's about their health.
00:34:39.080 --> 00:34:41.000
So they have a vested interest in it.
00:34:41.000 --> 00:34:43.160
So that really resets everything
00:34:43.160 --> 00:34:46.973
into a different era
of information parity.
00:34:49.181 --> 00:34:51.864
[instrumental music]
[indistinct chatter]
00:34:57.860 --> 00:35:00.863
- Hi guys, how are you?
00:35:02.210 --> 00:35:03.043
I just realized...
00:35:04.220 --> 00:35:05.390
- In Silicon Valley,
00:35:05.390 --> 00:35:08.570
they say that everyone
wants to change the world.
00:35:08.570 --> 00:35:11.150
To be honest, we wanna change our world.
00:35:11.150 --> 00:35:11.983
- Walter and I,
00:35:11.983 --> 00:35:14.600
we are a couple for 20
years, and we've always been
00:35:14.600 --> 00:35:17.043
entrepreneur in science and technology.
00:35:17.043 --> 00:35:20.065
And eight years ago, we
became citizen doctors.
00:35:20.065 --> 00:35:23.810
We are who we are as people,
as a couple, as parents,
00:35:23.810 --> 00:35:26.213
also our background in science and tech.
00:35:26.213 --> 00:35:28.977
Put it on your forehead, you
can also use it on your chest.
00:35:28.977 --> 00:35:31.192
When you have a child with special needs--
00:35:31.192 --> 00:35:34.033
and it can be brain trauma injury, autism,
00:35:34.033 --> 00:35:36.474
or specific chronic disease--
00:35:36.474 --> 00:35:39.890
our kids are very unique,
and most of the time,
00:35:39.890 --> 00:35:44.633
that's the answer for when
medicine cannot help us.
00:35:45.500 --> 00:35:47.630
"It's unique, we don't
know, never heard of it,"
00:35:47.630 --> 00:35:49.550
or, "We don't know, we
don't have enough data"
00:35:49.550 --> 00:35:52.160
or "We don't have enough
clinical research."
00:35:52.160 --> 00:35:54.560
And so that's how it started with us.
00:35:54.560 --> 00:35:57.680
How do we go after that unicity?
00:35:57.680 --> 00:35:59.510
How do we understand that unicity?
00:35:59.510 --> 00:36:04.510
What are the tools we need to
capture how unique our son is,
00:36:04.970 --> 00:36:06.860
to measure in real time and being able
00:36:06.860 --> 00:36:08.810
to understand and act upon it?
00:36:08.810 --> 00:36:11.540
- So we just put in an order
for some new circuit boards...
00:36:11.540 --> 00:36:14.060
- What we are looking at is for patients
00:36:14.060 --> 00:36:17.480
and consumers to have a better
relationship with the doctor,
00:36:17.480 --> 00:36:18.771
a better conversation.
00:36:18.771 --> 00:36:20.663
So having the data is one thing,
00:36:20.663 --> 00:36:24.230
but having that data being
actionable for the doctor
00:36:24.230 --> 00:36:27.590
is very important because if
it's not cleared by the FDA,
00:36:27.590 --> 00:36:30.320
there's no way the doctor will look at it.
00:36:30.320 --> 00:36:33.439
Yeah, so I'm kind of
struggling here, because...
00:36:33.439 --> 00:36:35.714
- We were about to ship in March.
00:36:35.714 --> 00:36:39.738
So we post because the
unit had some problems.
00:36:39.738 --> 00:36:42.470
- But that way we can reduce
those signal noises...
00:36:42.470 --> 00:36:43.520
- So we have some issues,
00:36:43.520 --> 00:36:46.009
but problems are also opportunities.
00:36:46.009 --> 00:36:48.070
They're here to be solved.
00:36:48.070 --> 00:36:49.100
- At the same time,
00:36:49.100 --> 00:36:54.100
we expanded our efforts in
what we call wet biomarkers--
00:36:54.350 --> 00:36:57.860
blood and urine and
saliva testing at home,
00:36:57.860 --> 00:37:00.170
in the comfort of your
home or on the road.
00:37:00.170 --> 00:37:02.139
- Things that you would
find in the urine could be--
00:37:02.139 --> 00:37:05.930
They could be indicators
of liver problems,
00:37:05.930 --> 00:37:07.349
kidney problems.
00:37:07.349 --> 00:37:09.290
And generally if you're
gonna see a problem,
00:37:09.290 --> 00:37:10.460
it's gonna come out in the urine,
00:37:10.460 --> 00:37:11.470
and so it's gonna be looking...
00:37:11.470 --> 00:37:14.810
- It's not easy.
We have a lot of bad days,
00:37:14.810 --> 00:37:17.762
because starting a company
and keeping the course
00:37:17.762 --> 00:37:20.750
and hiring people, raising the money,
00:37:20.750 --> 00:37:23.540
that's one part.
It's really hard also
00:37:23.540 --> 00:37:27.630
to build products that work
really, really well right away,
00:37:27.630 --> 00:37:30.740
especially in hardware,
especially in medical.
00:37:30.740 --> 00:37:33.830
But I think that the day that we became
00:37:33.830 --> 00:37:38.180
the parents of a child with medical issues
00:37:38.180 --> 00:37:42.680
that are today not solvable, not curable,
00:37:42.680 --> 00:37:45.083
I think that our destiny was set.
00:37:46.120 --> 00:37:47.503
[indistinct conversation]
00:37:48.507 --> 00:37:50.770
Yup, that's the name of the song.
00:37:52.443 --> 00:37:53.605
- Not too loud.
00:37:53.605 --> 00:37:54.830
- Not too loud?
00:37:55.730 --> 00:37:57.945
You're the one telling me not too loud?
00:37:57.945 --> 00:37:59.387
It's a joke, right?
00:37:59.387 --> 00:38:00.220
- Okay.
00:38:01.459 --> 00:38:02.780
- It's a journey.
00:38:02.780 --> 00:38:07.013
You have to embrace the journey
in order to make it happen.
00:38:08.240 --> 00:38:10.673
You have to want it very, very badly.
00:38:14.535 --> 00:38:17.118
[gentle music]
00:38:18.532 --> 00:38:21.365
[water lapping]
00:38:30.230 --> 00:38:32.630
- Cranberry Lake is idyllic for me.
00:38:32.630 --> 00:38:36.023
I grew up here,
my children grew up here.
00:38:38.482 --> 00:38:43.482
The house was built in 1923,
and my parents and grandparents
00:38:43.970 --> 00:38:46.223
joined together to purchase it.
00:38:48.320 --> 00:38:52.940
We swim and sail and kayak
and paddle boat and ski,
00:38:52.940 --> 00:38:56.318
and just anything you can do on the water.
00:38:56.318 --> 00:38:57.680
- Hi guys.
00:38:57.680 --> 00:39:01.403
It really is an important
destressor for us.
00:39:07.610 --> 00:39:10.100
There are days that are really hard,
00:39:10.100 --> 00:39:12.173
really, really difficult.
00:39:13.610 --> 00:39:15.983
It's like being in a storm
on my little sailboat.
00:39:17.120 --> 00:39:19.707
You're tossed, you capsize,
00:39:19.707 --> 00:39:22.310
you're trying to get back on course.
00:39:22.310 --> 00:39:25.430
You don't know sometimes
even where you're going.
00:39:25.430 --> 00:39:28.103
But you keep going,
you have to keep going.
00:39:29.831 --> 00:39:31.520
- Oh, that is so good.
00:39:33.920 --> 00:39:37.580
- I believe that Elizabeth can be well.
00:39:37.580 --> 00:39:41.600
And more importantly, Elizabeth
has asked me to find a cure.
00:39:41.600 --> 00:39:45.977
She wants a voice, she's
told me she wants to speak.
00:39:45.977 --> 00:39:48.920
- I,N,G, "living."
00:39:48.920 --> 00:39:52.040
- I'm incredibly thankful
she's found typing,
00:39:52.040 --> 00:39:55.640
so she can tell us all
that's in her beautiful mind.
00:39:55.640 --> 00:39:56.473
- N.
00:39:56.473 --> 00:39:59.300
- But she wants to speak.
00:39:59.300 --> 00:40:00.770
- S, "is."
00:40:00.770 --> 00:40:04.974
- I get calls from moms all the time,
00:40:04.974 --> 00:40:09.350
asking me how to move forward.
00:40:09.350 --> 00:40:11.870
And every child with autism is different.
00:40:11.870 --> 00:40:14.000
I don't have all the answers.
00:40:14.000 --> 00:40:14.960
- S.
00:40:14.960 --> 00:40:18.710
- But together, we are pushing the doctors
00:40:18.710 --> 00:40:22.520
and the scientists into new areas.
00:40:22.520 --> 00:40:24.650
There's a new model for medicine,
00:40:24.650 --> 00:40:28.070
and the patients are in this equation.
00:40:28.070 --> 00:40:31.820
Patient-centered care, personalized care.
00:40:31.820 --> 00:40:32.960
That's what we need,
00:40:32.960 --> 00:40:37.568
because this is not a
one-size-fits-all disease.
00:40:38.880 --> 00:40:41.768
- "Living in silence is no real life."
00:40:45.505 --> 00:40:47.755
[gentle instrumental music]
00:40:51.260 --> 00:40:52.312
- ...like a treatment,
00:40:52.312 --> 00:40:53.531
'cause there are some
kids that have, like,
00:40:53.531 --> 00:40:55.228
a different diagnosis, but they...
00:40:55.228 --> 00:40:56.581
- Same treatment.
00:40:56.581 --> 00:40:57.414
- Yeah.
00:41:02.450 --> 00:41:05.990
So I've been asked to come
here and share with you guys
00:41:05.990 --> 00:41:09.650
a bit of my story living
with Crohn's disease,
00:41:09.650 --> 00:41:11.300
the journey that I've taken
00:41:11.300 --> 00:41:14.420
through trying to cure
the darn thing, right?
00:41:14.420 --> 00:41:17.485
And what I wanted to do
is share with you guys
00:41:17.485 --> 00:41:19.210
a set of stories.
00:41:19.210 --> 00:41:22.010
Some of them are stories
that are of serious hardship,
00:41:22.010 --> 00:41:24.020
some of them are more lighthearted,
00:41:24.020 --> 00:41:25.550
but hopefully there's
some lessons in there
00:41:25.550 --> 00:41:27.380
that I wanna share with you as well.
00:41:27.380 --> 00:41:28.283
As Paul mentioned...
00:41:28.283 --> 00:41:30.350
To me, it's a really hopeless situation
00:41:30.350 --> 00:41:33.830
if a patient is suffering
where they have to go
00:41:33.830 --> 00:41:36.470
to the restroom, 5, 10, 15 times a day,
00:41:36.470 --> 00:41:38.540
they're losing weight dramatically,
00:41:38.540 --> 00:41:43.400
and they are grasping at straws
at ways to prevent having
00:41:43.400 --> 00:41:45.290
to have their intestine cut out.
00:41:45.290 --> 00:41:46.700
Hi, I'm Sean,
00:41:46.700 --> 00:41:50.283
and I'm going to swallow parasitic worms.
00:41:51.172 --> 00:41:55.520
Why? Because I have a digestive
illness that I believe
00:41:55.520 --> 00:41:58.550
these parasitic worms
might be able to treat.
00:41:58.550 --> 00:42:01.850
If you can make data
out of that experience,
00:42:01.850 --> 00:42:06.410
that means that no one's
suffering is for naught, right?
00:42:06.410 --> 00:42:08.840
Each patient can then be
a bit of a trailblazer
00:42:08.840 --> 00:42:11.090
to help sort of carry the torch forward.
00:42:11.090 --> 00:42:16.077
You live with your condition
for 99.999% of your life,
00:42:16.077 --> 00:42:18.590
and your doctor sees
you for that tiny bit.
00:42:18.590 --> 00:42:19.441
So you need to know these...
00:42:19.441 --> 00:42:21.440
Where I want the ball to move
00:42:21.440 --> 00:42:25.160
is that I want researchers
to take very seriously
00:42:25.160 --> 00:42:27.890
that set of data and be able to use it
00:42:27.890 --> 00:42:30.140
to make conclusions that get written back
00:42:30.140 --> 00:42:32.810
in that same book that
doctors are referencing
00:42:32.810 --> 00:42:34.393
to treat new patients.
00:42:35.993 --> 00:42:38.576
[gentle music]
00:42:46.610 --> 00:42:50.840
- I had discovered through
doing longitudinal time series
00:42:50.840 --> 00:42:54.350
of my blood and stool that I had a form
00:42:54.350 --> 00:42:58.460
of inflammatory disease,
basically Crohn's disease,
00:42:58.460 --> 00:43:00.260
but limited to the large intestine--
00:43:00.260 --> 00:43:02.760
a piece of the large
intestine, the sigmoid colon.
00:43:03.770 --> 00:43:08.600
And so I started doing MRIs,
and when I got out of the tube
00:43:08.600 --> 00:43:10.591
I would say, "Give me my data."
00:43:10.591 --> 00:43:12.050
And they would cut me a disc,
00:43:12.050 --> 00:43:15.500
I'd bring it to my virtual
reality expert at my institute,
00:43:15.500 --> 00:43:18.720
and we'd convert, say,
150 slices front to back
00:43:18.720 --> 00:43:20.679
into a transparent layer.
00:43:20.679 --> 00:43:25.679
Here's the aorta, here's it
splitting into the iliacs--
00:43:26.330 --> 00:43:28.670
these are the arteries
that go down your legs.
00:43:28.670 --> 00:43:31.533
Because I was monitoring in 3D,
00:43:31.533 --> 00:43:35.150
I could look at the thickness
of the wall of a portion
00:43:35.150 --> 00:43:38.030
of my colon and noticing
that over the years
00:43:38.030 --> 00:43:40.070
it was getting thicker and thicker,
00:43:40.070 --> 00:43:43.520
and the opening that everything
has to go through to get out
00:43:43.520 --> 00:43:45.655
was getting smaller and smaller.
00:43:45.655 --> 00:43:50.655
And here you have a 3D
printout of that part.
00:43:51.380 --> 00:43:55.310
I realized that at the
current rate of change,
00:43:55.310 --> 00:43:58.610
I was going to probably internally explode
00:43:58.610 --> 00:44:01.760
within the next six months,
and so I decided,
00:44:01.760 --> 00:44:04.553
I believe it's time for
a surgical intervention.
00:44:05.810 --> 00:44:08.210
Now, I'm not a fan of surgery.
00:44:08.210 --> 00:44:09.043
On the other hand,
00:44:09.043 --> 00:44:11.930
I'm not a fan of having
an internal explosion.
00:44:11.930 --> 00:44:13.910
So I went and talked to the surgeon, said,
00:44:13.910 --> 00:44:17.690
"Do you have time for a 30
slide PowerPoint presentation
00:44:17.690 --> 00:44:20.930
both in 3D and time series of biomarkers,"
00:44:20.930 --> 00:44:21.763
and everything else.
00:44:21.763 --> 00:44:25.580
And by the time I finished
that, she said, "Okay."
00:44:25.580 --> 00:44:27.590
- The idea here is that this information
00:44:27.590 --> 00:44:30.560
is coming to you before surgery,
00:44:30.560 --> 00:44:31.760
and so your brain has had time
00:44:31.760 --> 00:44:33.560
to sort of integrate it into everything.
00:44:33.560 --> 00:44:35.690
And now you just sort of
want all of this stuff
00:44:35.690 --> 00:44:37.400
put together for you
in the operating room.
00:44:37.400 --> 00:44:40.671
So you're looking at what
you need in the moment.
00:44:40.671 --> 00:44:43.550
At times I would look at
my 3D model and tell them
00:44:43.550 --> 00:44:45.080
to kind of angle it in a way
00:44:45.080 --> 00:44:48.333
that sort of mimics what
I'm seeing interops.
00:44:48.333 --> 00:44:50.000
It was integrated in a
way that I didn't see it
00:44:50.000 --> 00:44:51.680
for the first time at that moment.
00:44:51.680 --> 00:44:54.440
I was already visualizing
it before surgery.
00:44:54.440 --> 00:44:56.480
My brain was already working
on it before surgery.
00:44:56.480 --> 00:44:57.590
So when I got in there,
00:44:57.590 --> 00:45:00.040
at least I've had time to
process it from before.
00:45:00.950 --> 00:45:02.120
- My surgeon, I think,
00:45:02.120 --> 00:45:05.360
is a very special early-adopting doctor.
00:45:06.352 --> 00:45:08.990
And so she probably saved,
by her estimation,
00:45:08.990 --> 00:45:10.880
45 minutes or an hour and a half
00:45:10.880 --> 00:45:12.530
of me being under anesthesia,
00:45:12.530 --> 00:45:16.163
which means a great deal in
terms of patient recovery.
00:45:17.090 --> 00:45:18.700
I had done 10,000 steps,
00:45:18.700 --> 00:45:20.575
five miles the day before the surgery.
00:45:21.458 --> 00:45:24.503
I was back to doing
10,000 steps in two weeks.
00:45:26.900 --> 00:45:30.500
It was finding that path
00:45:30.500 --> 00:45:33.583
where the patient-doctor relationship
00:45:33.583 --> 00:45:35.972
could be taken to a new level.
00:45:35.972 --> 00:45:39.226
Of course, because Crohn's disease or IBD
00:45:39.226 --> 00:45:43.911
is a autoimmune disease with a
human genetic susceptibility,
00:45:43.911 --> 00:45:47.180
it could in principle
come back in the future.
00:45:47.180 --> 00:45:49.970
But we know that human
genome only accounts
00:45:49.970 --> 00:45:54.380
for about 20% of IBD.
80% is environment,
00:45:54.380 --> 00:45:57.443
and a lot of that environment
is your microbiome.
00:45:58.670 --> 00:46:01.820
We pulled this down from the
Human Microbiome Project.
00:46:01.820 --> 00:46:04.790
It's like 100 million reads per person.
00:46:04.790 --> 00:46:08.210
- The microbiome is something
that's really a new frontier.
00:46:08.210 --> 00:46:09.230
- There are these microbes
00:46:09.230 --> 00:46:10.700
that are helping you digest your food,
00:46:10.700 --> 00:46:13.970
the bacteria that are in you
that are working with you.
00:46:13.970 --> 00:46:16.430
There's actually more bacteria in our body
00:46:16.430 --> 00:46:18.080
than there are cells in our body.
00:46:18.080 --> 00:46:23.080
90% of the DNA-bearing cells
in your body are not human.
00:46:23.420 --> 00:46:25.111
They're the microbes.
00:46:26.344 --> 00:46:28.927
[gentle music]
00:46:31.700 --> 00:46:33.620
The front lines of your immune system
00:46:33.620 --> 00:46:36.110
is actually in your large intestine.
00:46:36.110 --> 00:46:38.935
That's your largest immune organ by far.
00:46:38.935 --> 00:46:42.830
And you have hundreds of species
and thousands of strains.
00:46:42.830 --> 00:46:47.387
If those get so far away from
healthy that the immune system
00:46:47.387 --> 00:46:51.447
essentially recognizes them as "bad guys,"
00:46:51.447 --> 00:46:53.210
the immune system goes after them
00:46:53.210 --> 00:46:55.640
and then you are the casualty.
00:46:55.640 --> 00:46:59.559
And yet that microbial
world is entirely outside
00:46:59.559 --> 00:47:00.863
of medicine as we know it.
00:47:01.940 --> 00:47:04.880
If you look at the major
scientific journals,
00:47:04.880 --> 00:47:09.590
you'll see that emulsifiers,
artificial sweeteners,
00:47:09.590 --> 00:47:12.740
a whole bunch of these things
are messing up the microbiome
00:47:12.740 --> 00:47:15.140
in ways that the people
who developed these foods
00:47:15.140 --> 00:47:16.493
didn't have any idea.
00:47:18.860 --> 00:47:21.977
I believe that the phenomena
00:47:21.977 --> 00:47:24.430
of a lot of these autoimmune
diseases is an interplay
00:47:24.430 --> 00:47:27.590
between the immune system
and your gut microbiome.
00:47:27.590 --> 00:47:31.400
So if I look, for instance,
at this particular microbe,
00:47:31.400 --> 00:47:34.340
you'll see that that I'm about 0.038,
00:47:34.340 --> 00:47:38.485
so about 4% of the total
abundance across all the phyla
00:47:38.485 --> 00:47:40.280
is the Bacteroidetes.
00:47:40.280 --> 00:47:43.070
If I look down here at a healthy person,
00:47:43.070 --> 00:47:46.380
this is an average of 25 people, it's 88%.
00:47:46.380 --> 00:47:49.940
So I've had a mass extinction event.
00:47:49.940 --> 00:47:54.469
I'm fortunate that my disease
is not as debilitating
00:47:54.469 --> 00:47:57.020
as so many of these people are.
00:47:57.020 --> 00:47:59.884
To give those people some
hope that this data approach
00:47:59.884 --> 00:48:03.560
is going to bring new insights,
00:48:03.560 --> 00:48:05.570
new ways of evaluating therapy,
00:48:05.570 --> 00:48:06.406
and I think...
00:48:06.406 --> 00:48:09.531
The great hope is that
we will be able to tune,
00:48:09.531 --> 00:48:14.240
to garden your microbiome
back to relative health.
00:48:14.240 --> 00:48:17.450
While you don't cure someone
of a lifetime disease
00:48:17.450 --> 00:48:19.943
like this, you can keep it in remission.
00:48:23.828 --> 00:48:25.994
[gentle instrumental music]
00:48:36.249 --> 00:48:39.357
[violin melody]
00:48:46.220 --> 00:48:48.500
- Sometimes when a company starts to grow
00:48:48.500 --> 00:48:49.991
and becomes important,
00:48:49.991 --> 00:48:54.923
you can have disagreement
on the vision and strategy.
00:48:56.120 --> 00:48:59.591
So Walter and I, we left Scanadu
two years and a half ago.
00:49:00.475 --> 00:49:03.358
As founders, we just
felt it was better for us
00:49:03.358 --> 00:49:07.392
to let other people manage the boat
00:49:07.392 --> 00:49:10.790
and for us to do other
things in healthcare.
00:49:10.790 --> 00:49:13.343
And doc.ai, it's not that different.
00:49:14.531 --> 00:49:16.070
Doc.ai is a medical research companion
00:49:16.070 --> 00:49:17.510
for patients, consumers,
00:49:17.510 --> 00:49:20.077
but also for the healthcare industries.
00:49:20.077 --> 00:49:22.487
- 50 Million people affected
by allergies, and you see...
00:49:22.487 --> 00:49:26.306
- I think for us it's the
same mission, the same battle.
00:49:26.306 --> 00:49:28.070
We just wanna enable people
00:49:28.070 --> 00:49:30.893
to have a better
understanding of their health.
00:49:36.470 --> 00:49:37.730
I have a lot of questions
00:49:37.730 --> 00:49:41.390
when it comes to my son
that nobody can answer.
00:49:41.390 --> 00:49:43.940
Our doctors have been very
straightforward about that.
00:49:43.940 --> 00:49:44.773
Like, "You know what?
00:49:44.773 --> 00:49:45.830
"This is trial and error."
00:49:45.830 --> 00:49:47.450
So, just to give you an example,
00:49:47.450 --> 00:49:49.861
Nelson has epilepsy among other things.
00:49:49.861 --> 00:49:52.010
So he takes a ton of medications,
00:49:52.010 --> 00:49:53.768
like maybe 10 pills per day.
00:49:55.443 --> 00:49:58.580
However, we have no idea
which ones are truly working
00:49:58.580 --> 00:49:59.783
and which ones are not.
00:50:01.040 --> 00:50:02.750
And we don't know on the longer term
00:50:02.750 --> 00:50:04.643
what the real side effects will be.
00:50:10.400 --> 00:50:12.860
The more I'm involved with my son's health
00:50:12.860 --> 00:50:15.260
and the healthcare system in general,
00:50:15.260 --> 00:50:18.380
the more I understand that medicine
00:50:18.380 --> 00:50:21.491
is this huge research project, okay?
00:50:21.491 --> 00:50:23.510
And it's research for everybody.
00:50:23.510 --> 00:50:26.493
You really want people
to get the sense of,
00:50:26.493 --> 00:50:28.730
those are the four actions you can...
00:50:28.730 --> 00:50:30.530
- Everyone wants to learn,
00:50:30.530 --> 00:50:33.080
and now suddenly we can
do that learning curve.
00:50:34.515 --> 00:50:36.230
And why is that so important,
that learning curve?
00:50:36.230 --> 00:50:39.113
Because you can help others.
00:50:39.950 --> 00:50:43.648
- Our app enables people,
patients or caregivers
00:50:43.648 --> 00:50:45.773
to join research projects.
00:50:46.979 --> 00:50:49.250
Research is very slow, very expensive.
00:50:49.250 --> 00:50:50.753
It's still in silos.
00:50:51.740 --> 00:50:54.530
It's very easy to join a research project
00:50:54.530 --> 00:50:57.170
that is trying to use all that data
00:50:57.170 --> 00:51:00.020
that has been collected
to build predictive models
00:51:00.020 --> 00:51:01.650
around a very specific question.
00:51:01.650 --> 00:51:04.700
So it could be epilepsy and medication,
00:51:04.700 --> 00:51:07.193
it could be Crohn disease and supplements.
00:51:09.350 --> 00:51:13.220
Hi, Sean. Do you see us?
00:51:13.220 --> 00:51:14.980
- I do see you two.
00:51:14.980 --> 00:51:17.180
- So Sean, when we met each other,
00:51:17.180 --> 00:51:20.682
we started to discuss about
the core of what doc.ai does.
00:51:20.682 --> 00:51:23.750
And so he said, "I think
that would be awesome
00:51:23.750 --> 00:51:27.623
"if we could have a research
project with my community,"
00:51:27.623 --> 00:51:29.610
and said, "Okay, but what kind of problems
00:51:29.610 --> 00:51:31.220
"are you trying to solve?"
00:51:31.220 --> 00:51:35.000
- If we continue to exist in this paradigm
00:51:35.000 --> 00:51:38.150
where only things that fit well
00:51:38.150 --> 00:51:42.980
into a traditional research
paradigm will be studied,
00:51:42.980 --> 00:51:46.160
we're gonna continue to miss out on things
00:51:46.160 --> 00:51:49.340
like dietary changes, lifestyle changes...
00:51:49.340 --> 00:51:50.763
- Something that stayed
with me, he told me,
00:51:50.763 --> 00:51:53.598
"You know, we all take supplements."
00:51:53.598 --> 00:51:54.673
It was like, oh, that's interesting,
00:51:54.673 --> 00:51:56.210
because right away it's reminding me
00:51:56.210 --> 00:51:58.460
of what we do with epilepsy,
with medication.
00:51:58.460 --> 00:52:00.620
I said, "But do you have
a list of supplements?"
00:52:00.620 --> 00:52:03.796
He said, "Yeah, we have about
50 supplements we all take.
00:52:03.796 --> 00:52:05.210
"And it's trial and error.
00:52:05.210 --> 00:52:07.970
"It works for certain people
and it doesn't work for others.
00:52:07.970 --> 00:52:09.185
"We don't know why and how."
00:52:09.185 --> 00:52:13.699
So we have the PI.
Dr. Sahli is from Kansas City,
00:52:13.699 --> 00:52:14.861
he's very excited.
00:52:14.861 --> 00:52:17.900
He's saying that what we
do is research on steroids.
00:52:17.900 --> 00:52:20.360
So he's like, "Wow, let's do it."
00:52:20.360 --> 00:52:21.500
- All right, wow.
00:52:21.500 --> 00:52:23.960
- We also e-connected with this community,
00:52:23.960 --> 00:52:26.480
and we had almost 200 people
00:52:26.480 --> 00:52:28.760
not knowing what the
research was like, "We're in.
00:52:28.760 --> 00:52:30.218
"Whatever you do, we're in."
00:52:30.218 --> 00:52:33.298
The protocols, we propose that
people collect their phenome,
00:52:33.298 --> 00:52:36.290
their exposome, their
physiome and their microbiome.
00:52:36.290 --> 00:52:37.760
Anything you do in healthcare
00:52:37.760 --> 00:52:39.770
when you're trying to help move the needle
00:52:39.770 --> 00:52:41.210
is extremely difficult.
00:52:41.210 --> 00:52:43.389
You get cheered and you get destroyed
00:52:43.389 --> 00:52:45.267
because you want to innovate,
00:52:45.267 --> 00:52:48.230
especially when you are
not a medical doctor.
00:52:48.230 --> 00:52:50.090
But I don't care, I'm a caregiver.
00:52:50.090 --> 00:52:54.230
I think I have enough
experience in what's possible
00:52:54.230 --> 00:52:55.293
and what's not.
00:52:56.177 --> 00:52:58.868
Anything that can help
move the needle faster
00:52:58.868 --> 00:53:00.276
we should pursue.
00:53:00.276 --> 00:53:01.430
I think that's gonna be exciting.
00:53:01.430 --> 00:53:04.400
- If we wait for the medical
establishment to embrace data,
00:53:04.400 --> 00:53:08.237
we'll wait a long time. We
have to be radical, I think,
00:53:08.237 --> 00:53:09.830
in order to affect change.
00:53:09.830 --> 00:53:11.750
- But merely collecting the data--
00:53:11.750 --> 00:53:13.490
which we're very good at now, I mean,
00:53:13.490 --> 00:53:15.146
we really know how to do that.
00:53:15.146 --> 00:53:20.146
Other aspects of life--
marketing, various industries,
00:53:20.600 --> 00:53:23.363
all of that-- we've learned
to interpret the data.
00:53:23.363 --> 00:53:25.280
Health, we're just
getting started with it,
00:53:25.280 --> 00:53:26.990
and it's infinitely more complicated
00:53:26.990 --> 00:53:28.520
than almost anything else.
00:53:28.520 --> 00:53:33.020
And so I would say that having
the data is the first step,
00:53:33.020 --> 00:53:36.440
but having the interpretation
of that data and the effective
00:53:36.440 --> 00:53:39.083
use of it, that's where
the hope comes from.
00:53:42.648 --> 00:53:45.423
[gentle instrumental music]
00:53:54.800 --> 00:53:56.630
- I do teach at a technical institution.
00:53:56.630 --> 00:53:58.642
I teach design and software there.
00:53:58.642 --> 00:54:01.340
But I find that you
have to make things real
00:54:01.340 --> 00:54:02.270
in the real world,
00:54:02.270 --> 00:54:04.760
and so that's why I
started a design studio
00:54:04.760 --> 00:54:07.040
in the healthcare and biology space.
00:54:07.040 --> 00:54:08.570
This is called hGraph.
00:54:08.570 --> 00:54:11.210
It's one symbol or one way to look
00:54:11.210 --> 00:54:13.103
at all of your health in one picture.
00:54:15.200 --> 00:54:17.930
My story probably is a
lot like other people's,
00:54:17.930 --> 00:54:21.050
where we don't think about
health for a long time.
00:54:21.050 --> 00:54:25.460
You get a checkup and you see things
00:54:25.460 --> 00:54:26.540
that you hadn't seen before.
00:54:26.540 --> 00:54:27.920
You get a blood result going,
00:54:27.920 --> 00:54:29.090
"Oh, what the heck was that?"
00:54:29.090 --> 00:54:30.560
And so from there, I'm like, well,
00:54:30.560 --> 00:54:34.340
how do you start to visualize
or see what's happening in me?
00:54:34.340 --> 00:54:36.770
So there's this green
zone, that's the good zone.
00:54:36.770 --> 00:54:38.570
If you're out of it, not so good,
00:54:38.570 --> 00:54:40.217
but if you're inside of it you're okay.
00:54:40.217 --> 00:54:43.220
And this gives you a quick
picture, and there's a score.
00:54:43.220 --> 00:54:45.830
And then this is sort of one zone of that.
00:54:45.830 --> 00:54:47.330
This is my Cleveland Heart labs.
00:54:47.330 --> 00:54:49.550
I've gotten better since then.
00:54:49.550 --> 00:54:52.040
All of my data, including
my entire sequence,
00:54:52.040 --> 00:54:53.480
genome sequence, has been open sourced
00:54:53.480 --> 00:54:54.980
and downloadable on GitHub.
00:54:54.980 --> 00:54:57.803
So feel free to plant it
on a crime scene somewhere.
00:54:59.660 --> 00:55:01.370
You need to see your health
00:55:01.370 --> 00:55:03.270
and you also need to see it over time.
00:55:06.601 --> 00:55:07.790
- Ramsey, come here.
00:55:07.790 --> 00:55:10.760
I have two boys.
Jimmy has autism,
00:55:10.760 --> 00:55:13.640
and we tried different
treatments with him,
00:55:13.640 --> 00:55:17.150
and I tried to track his
reactions to those treatments.
00:55:17.150 --> 00:55:18.500
Okay, deal?
00:55:18.500 --> 00:55:20.150
- How are you tracking it now?
00:55:20.150 --> 00:55:22.520
- Excel spreadsheets, it's really sad.
00:55:22.520 --> 00:55:25.160
That's my database, it's
an Excel spreadsheet,
00:55:25.160 --> 00:55:28.400
which is not very usable, frankly.
00:55:28.400 --> 00:55:30.260
I can't run reports against it.
00:55:30.260 --> 00:55:32.630
I can just use my eyes to look at it
00:55:32.630 --> 00:55:35.000
and see if I can find any patterns
00:55:35.000 --> 00:55:38.630
or anything that repeats or that changes
00:55:38.630 --> 00:55:41.720
so I can make decisions on
what to do next with him.
00:55:41.720 --> 00:55:45.470
10 drops of this one, one drop
of vitamin D, and castor oil.
00:55:45.470 --> 00:55:48.518
But it's very limited, my
brain is very limited too.
00:55:48.518 --> 00:55:52.010
You have to fill it all
the way to here, okay?
00:55:52.010 --> 00:55:55.880
- Nadia, I can sympathize, my
own son is on the spectrum.
00:55:55.880 --> 00:55:59.180
And so part of what I'm
doing in healthcare is, well,
00:55:59.180 --> 00:56:02.690
how do I see his progression or not?
00:56:02.690 --> 00:56:05.120
Right now, there are really
no interpretation tools
00:56:05.120 --> 00:56:08.570
or services that give me
something back that I can use.
00:56:08.570 --> 00:56:11.240
There are parents like me that have kids
00:56:11.240 --> 00:56:13.040
that have specific needs
00:56:13.040 --> 00:56:14.780
that we're scratching
our heads every day--
00:56:14.780 --> 00:56:17.840
"Well, why is this happening,
why is that going on?"--
00:56:17.840 --> 00:56:21.050
that we have no real action plan for.
00:56:21.050 --> 00:56:23.900
And that to me is the critical
thing that we need to build
00:56:23.900 --> 00:56:28.220
and design and evolve
for parents, for adults,
00:56:28.220 --> 00:56:30.808
for kids to manage their own health.
00:56:30.808 --> 00:56:33.475
[gentle music]
00:56:36.097 --> 00:56:37.760
- Whole picture of health,
00:56:37.760 --> 00:56:39.827
because it's so difficult to understand
00:56:39.827 --> 00:56:41.727
and visualize how your health...
00:56:41.727 --> 00:56:44.901
- My two sons, their health is captured
00:56:44.901 --> 00:56:46.070
in a big giant binder.
00:56:46.070 --> 00:56:48.611
This is what, 2020 almost.
00:56:48.611 --> 00:56:49.970
Here we are still thinking about,
00:56:49.970 --> 00:56:52.430
"Well, is that gonna get faxed to me?"
00:56:52.430 --> 00:56:53.603
That's insane.
00:56:54.560 --> 00:56:57.410
One of the biggest questions
we need to answer around health
00:56:57.410 --> 00:56:59.540
is how we look at our health data--
00:56:59.540 --> 00:57:01.940
all of our health data, in one picture.
00:57:01.940 --> 00:57:05.418
- The idea is to have one view,
one dashboard for our health
00:57:05.418 --> 00:57:07.010
that lets us see what's working
00:57:07.010 --> 00:57:09.213
and what's not working, like here.
00:57:09.213 --> 00:57:12.470
And with enough of this kind
of information from families
00:57:12.470 --> 00:57:14.865
and from patients with
autism, in this case,
00:57:14.865 --> 00:57:18.080
we might be able to treat
each flavor of autism
00:57:18.080 --> 00:57:20.990
or each chronic disease more precisely.
00:57:20.990 --> 00:57:23.490
- Parents with kids who
have chronic disease,
00:57:23.490 --> 00:57:26.636
they just can't manage
it with encyclopedias
00:57:26.636 --> 00:57:30.800
of printed material. But
with this health dashboard,
00:57:30.800 --> 00:57:34.850
we get this first-time-ever
broad view of our entire health.
00:57:34.850 --> 00:57:36.860
- Just so you see where
the trend is going.
00:57:36.860 --> 00:57:37.693
- Yeah.
00:57:37.693 --> 00:57:38.720
- Okay.
00:57:38.720 --> 00:57:41.600
- There's gotta be a
cultural revolution here
00:57:41.600 --> 00:57:43.460
to personal control,
00:57:43.460 --> 00:57:47.210
personal responsibility for
keeping your body healthy.
00:57:47.210 --> 00:57:49.220
- Dietary change or exercise
00:57:49.220 --> 00:57:52.550
or medications or other remedies.
00:57:52.550 --> 00:57:54.530
All of those can be relevant.
00:57:54.530 --> 00:57:55.742
So the question is,
00:57:55.742 --> 00:57:58.223
how do we help the individual
sift through those?
00:57:59.808 --> 00:58:03.380
- When I started this
whole mission with my son,
00:58:03.380 --> 00:58:06.920
I did look into a number of
kids that were recovered.
00:58:06.920 --> 00:58:09.140
And so I talked to their
parents and I asked them,
00:58:09.140 --> 00:58:12.770
"How did you do it?," and they
all had different answers.
00:58:12.770 --> 00:58:14.815
Literally all of them.
What works for one
00:58:14.815 --> 00:58:16.130
does not work for the other.
00:58:16.130 --> 00:58:17.630
There are subgroups.
00:58:17.630 --> 00:58:21.920
There are some kids that do
really well when we address
00:58:21.920 --> 00:58:25.820
environmental toxins,
heavy metals, allergens
00:58:25.820 --> 00:58:28.294
and things like that.
If we address that,
00:58:28.294 --> 00:58:30.770
then they get better
and maybe even recover.
00:58:30.770 --> 00:58:32.060
- Your's did well by diet, right?
00:58:32.060 --> 00:58:32.947
- Exactly.
00:58:32.947 --> 00:58:34.805
- So they couldn't eat the fish...
00:58:34.805 --> 00:58:35.963
- For my son, for Jimmy,
00:58:35.963 --> 00:58:39.410
I literally removed
all grains, all sugars,
00:58:39.410 --> 00:58:42.530
and it's been unbelievable.
I mean, he's been amazing.
00:58:42.530 --> 00:58:44.420
He's very attentive at school.
00:58:44.420 --> 00:58:45.590
He's very patient.
00:58:45.590 --> 00:58:49.100
We don't have any
tantrums unless he cheats
00:58:49.100 --> 00:58:51.770
with a little bit of
fries or French fries.
00:58:51.770 --> 00:58:53.543
So he's that sensitive to it.
00:58:54.825 --> 00:58:56.420
- He has a trigger like this.
00:58:56.420 --> 00:58:58.270
- Collecting data that we can,
00:58:58.270 --> 00:59:00.590
of people who do have
autism and who don't--
00:59:00.590 --> 00:59:04.010
how vital signs change, how
growth is happening over time,
00:59:04.010 --> 00:59:05.960
chemical exposures that are there--
00:59:05.960 --> 00:59:08.000
- We need to collect this information
00:59:08.000 --> 00:59:11.269
with our clinicians
and with our care teams
00:59:11.269 --> 00:59:13.730
and family members and kids.
00:59:13.730 --> 00:59:15.851
- If we can start to embrace that
00:59:15.851 --> 00:59:17.750
and then share that out with other people,
00:59:17.750 --> 00:59:19.970
what's working for us, what's not working,
00:59:19.970 --> 00:59:22.640
then that's where the
magic will start to happen.
00:59:22.640 --> 00:59:24.620
- We can learn so much from that.
00:59:24.620 --> 00:59:27.170
We're just at the
beginning of an explosion
00:59:27.170 --> 00:59:30.320
in medical knowledge from shared data.
00:59:30.320 --> 00:59:31.940
- Let's not waste time.
00:59:31.940 --> 00:59:35.360
Let's move this thing forward
as fast as we possibly can.
00:59:35.360 --> 00:59:37.580
So it's not just one disease
that we're trying to solve.
00:59:37.580 --> 00:59:39.424
We're trying to solve all of healthcare.
00:59:40.266 --> 00:59:42.400
- It's pretty clear that the 21st century
00:59:42.400 --> 00:59:47.392
is gonna be the century
where biology and IT,
00:59:47.392 --> 00:59:51.410
basically all the major
technologies begin to converge.
00:59:51.410 --> 00:59:54.020
We deliberately drive the
changes in the microbiome
00:59:54.020 --> 00:59:55.160
that you're looking for.
00:59:55.160 --> 00:59:58.640
I think that we will
have possibilities emerge
00:59:58.640 --> 01:00:00.050
that we can't even imagine.
01:00:00.050 --> 01:00:01.545
- ...universe of health.
01:00:01.545 --> 01:00:03.078
- I wish I could go back to medical school
01:00:03.078 --> 01:00:04.940
and kind of start over
because this is the time
01:00:04.940 --> 01:00:07.160
where it's really gonna
be rockin' and rolling
01:00:07.160 --> 01:00:09.293
for the future of medicine and healthcare.
01:00:10.700 --> 01:00:13.730
- I mean, I've seen this movie before.
01:00:13.730 --> 01:00:16.850
There is gonna be total
disruption of medicine
01:00:16.850 --> 01:00:19.550
and healthcare in the next 5 to 10 years.
01:00:19.550 --> 01:00:20.483
It's inevitable.
01:00:30.050 --> 01:00:31.730
- In the last couple of months,
01:00:31.730 --> 01:00:35.963
Elizabeth has had tremendous
regulation of her body.
01:00:37.550 --> 01:00:40.670
"Hi, you're outside."
01:00:40.670 --> 01:00:42.080
Yes!
01:00:42.080 --> 01:00:43.488
Yes, we are outside.
01:00:43.488 --> 01:00:45.029
It's been amazing.
01:00:45.029 --> 01:00:48.529
She has gone from a child
who had self-injury,
01:00:48.529 --> 01:00:52.433
to a child who's going to be
attending college this fall.
01:00:54.680 --> 01:00:57.350
She's gonna study social innovation
01:00:57.350 --> 01:01:01.880
because she wants to revolutionize
what autism education is,
01:01:01.880 --> 01:01:05.720
where kids are not expected
to have any capability,
01:01:05.720 --> 01:01:08.000
especially if they're nonverbal.
01:01:08.000 --> 01:01:10.790
And she wants us to know
that being nonverbal
01:01:10.790 --> 01:01:13.490
does not mean that you're not thinking.
01:01:13.490 --> 01:01:15.410
It just means there's a motor problem.
01:01:15.410 --> 01:01:17.510
You can't get the words out of your mouth.
01:01:21.678 --> 01:01:23.203
Alright, just a second.
01:01:24.350 --> 01:01:27.290
Dan is a student at Harvard.
01:01:27.290 --> 01:01:28.550
Okay, there we go.
01:01:28.550 --> 01:01:30.350
They are connecting.
01:01:30.350 --> 01:01:33.050
"Great to see you too.
01:01:33.050 --> 01:01:36.530
"I missed you yesterday."
01:01:36.530 --> 01:01:38.390
They understand each other.
01:01:38.390 --> 01:01:42.830
They talk about what it's
like to be in a silent cage.
01:01:42.830 --> 01:01:45.410
They type about how their brains work.
01:01:45.410 --> 01:01:49.220
They type about how they
wanna change autism education.
01:01:49.220 --> 01:01:51.586
Right here for you, Dan.
01:01:51.586 --> 01:01:53.944
She typed, "Education saved us."
01:01:55.640 --> 01:01:58.970
Winning for Elizabeth
is what I'm focused on
01:01:58.970 --> 01:02:00.860
right at this moment,
01:02:00.860 --> 01:02:05.123
but what she's focused on is
winning for all the children.
01:02:11.556 --> 01:02:14.522
[gentle music]
[water flowing]
01:02:21.230 --> 01:02:22.340
- So I'm feeling great.
01:02:22.340 --> 01:02:24.533
My health is actually extremely good.
01:02:25.700 --> 01:02:28.520
I got results from a colonoscopy
01:02:28.520 --> 01:02:31.460
where I was in really good condition,
01:02:31.460 --> 01:02:34.520
actually showed no signs of inflammation.
01:02:34.520 --> 01:02:37.340
So it was really exciting
'cause I got to live my life
01:02:37.340 --> 01:02:38.890
like a healthy person for once.
01:02:40.490 --> 01:02:43.490
- It's real relief to a
parent to see something
01:02:43.490 --> 01:02:46.340
that's devastating to turn
into something very positive.
01:02:46.340 --> 01:02:48.320
- It's been an amazing journey.
01:02:48.320 --> 01:02:50.870
I'm feeling really good now,
I feel positive.
01:02:50.870 --> 01:02:53.660
I feel like he's done so much,
01:02:53.660 --> 01:02:57.023
and I know patients can
do a lot themselves.
01:02:58.280 --> 01:02:59.480
- The community's talking
01:02:59.480 --> 01:03:01.820
and maybe they can
resolve their own issues
01:03:01.820 --> 01:03:03.420
by taking it in their own hands.
01:03:10.558 --> 01:03:13.183
[gentle music]
[indistinct chatter]
01:03:15.548 --> 01:03:17.148
- Then it's over here, I can...
01:03:21.632 --> 01:03:23.998
[elevator dings]
[music continues]
01:03:33.050 --> 01:03:35.390
- Coming from a place where we were told
01:03:35.390 --> 01:03:38.918
that he would not be able to do anything,
01:03:38.918 --> 01:03:40.460
coming from global aphasia--
01:03:40.460 --> 01:03:42.890
which is not being able to speak at all--
01:03:42.890 --> 01:03:44.723
to speaking three languages.
01:03:48.260 --> 01:03:52.670
From "he will never be
able to walk" to walking.
01:03:52.670 --> 01:03:55.027
How was your dance party, it was good?
01:03:55.027 --> 01:03:56.710
Wanna say hi to everyone, or?
01:03:56.710 --> 01:03:58.301
Yeah?
01:03:58.301 --> 01:04:00.650
We have a path, and
sometimes we have the energy,
01:04:00.650 --> 01:04:02.150
sometimes we don't.
01:04:02.150 --> 01:04:04.790
Sometimes we have the
right type of support,
01:04:04.790 --> 01:04:06.640
sometimes we don't.
01:04:08.006 --> 01:04:12.020
For me, what worked was to
wake up every single morning,
01:04:12.020 --> 01:04:16.130
thinking, today I'm
gonna do the best I can.
01:04:16.130 --> 01:04:16.963
This one?
01:04:16.963 --> 01:04:17.838
Thank you.
01:04:18.854 --> 01:04:20.086
Ah, look.
01:04:21.170 --> 01:04:22.220
Those are mine!
01:04:22.220 --> 01:04:24.110
Those are my cards.
01:04:24.110 --> 01:04:25.667
- No, it's my cards.
01:04:25.667 --> 01:04:27.334
- No, it's a game, and...
01:04:27.334 --> 01:04:31.035
- This is my cards.
This is my cards.
01:04:32.330 --> 01:04:33.863
- You will be told many times,
01:04:33.863 --> 01:04:35.960
"Why are you even doing this?"
01:04:35.960 --> 01:04:37.610
Just follow your gut feeling.
01:04:37.610 --> 01:04:39.470
If you feel you have to do it, do it.
01:04:39.470 --> 01:04:41.240
There's nobody to tell
you it's the right thing
01:04:41.240 --> 01:04:42.290
or the wrong thing to do.
01:04:42.290 --> 01:04:46.640
And there's nothing to measure
that, it can be anything.
01:04:46.640 --> 01:04:49.409
The best you can is what you can.
01:04:49.409 --> 01:04:51.680
Focus on what really matters
01:04:51.680 --> 01:04:55.220
and surround yourself with
people who really care.
01:04:56.379 --> 01:04:59.212
[all laughing]
01:05:02.439 --> 01:05:05.472
[gentle instrumental music]
01:05:24.787 --> 01:05:27.737
[music continues]
01:05:58.436 --> 01:06:01.077
[music continues]
01:06:34.464 --> 01:06:37.030
[music continues]
01:07:08.668 --> 01:07:10.851
[music continues]
Distributor: Bullfrog Films
Length: 67 minutes
Date: 2020
Genre: Expository
Language: English
Grade: 7-12, College, Adults
Color/BW:
Closed Captioning: Available
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