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Disease Knows No Politics with former NIH Director Dr. Elias Zerhouni · Get Real with Jim Weiss

0:00
Speaker 1: Hi, Jim, Hey Kate.
0:02
Speaker 2: But an episode, Oh my gosh.
0:04
Speaker 1: Yeah, oh jeez. You know a lot of the things
0:07
Speaker 1: that we have now today he helped build the foundation
0:10
Speaker 1: for in the years that he ran the NIH.
0:13
Speaker 2: One of the measures he passed as NAH director had
0:15
Speaker 2: to do with obesity. And you asked him what do
0:18
Speaker 2: we know now we didn't know then? And he said
0:20
Speaker 2: he feels he knew everything. Then it's a question of
0:24
Speaker 2: moving it forward.
0:25
Speaker 1: Well, what are the economics you know? And this is
0:27
Speaker 1: the truth of it all. It's like money drives it all,
0:31
Speaker 1: or financial interests drive it all. So I think everybody
0:34
Speaker 1: because of you, of the way things are getting approached
0:37
Speaker 1: and the disruption and the sort of counter mindset that
0:41
Speaker 1: is challenging the status quo. But I think it's never
0:43
Speaker 1: bad to challenge the status quo, which what he talked
0:46
Speaker 1: about always doing. Yeah, and his accomplishments as an immigrant
0:52
Speaker 1: he seems incredibly.
0:54
Speaker 2: Proud of, certainly, And it's a rarity to talk to
0:57
Speaker 2: somebody who worked for President Reagan, George W. Bush, President
1:01
Speaker 2: Obama and was knighted by President Sarkozy.
1:04
Speaker 1: That is yeah, yeah, it's quickly. I mean, I've known
1:06
Speaker 1: him on the board of the foundation of the National
1:08
Speaker 1: Institute of Health. And the guy always adds, like the
1:12
Speaker 1: smartest commentary all the time. So to be in the
1:16
Speaker 1: presence of someone so brilliant, so cool, also, you know,
1:20
Speaker 1: easy to talk to. And I think that's what I
1:22
Speaker 1: think people will be impressed by in this episode. Agreed, Hey, Doc,
1:29
Speaker 1: how are you good?
1:30
Speaker 3: Good? Hell are you? Jim?
1:31
Speaker 1: Thanks for being here. It's a real honor to have
1:33
Speaker 1: you here.
1:34
Speaker 3: Thank you for having me.
1:35
Speaker 1: All right, this summer you published this book, Disease Knows
1:39
Speaker 1: No Politics. What a great title like so timely? Why
1:44
Speaker 1: write the book now? What prompted you to do it?
1:47
Speaker 3: To be honest with you, it was not like for now, Okay,
1:51
Speaker 3: just it's one of those things that happens. I had
1:54
Speaker 3: a good friend of mine who has badgering me for
1:56
Speaker 3: thirteen years to write a book. So your story is special, special,
2:02
Speaker 3: No time, I don't have time. I'm busy with lot
2:04
Speaker 3: of things, and who wants to write a book. But
2:06
Speaker 3: time opened up three four years ago and I said, Okay,
2:10
Speaker 3: I'll do it. Find a way to do it effectively.
2:13
Speaker 3: The title actually is not new. We selected this title
2:17
Speaker 3: a while back with the publisher and advisors because it
2:22
Speaker 3: was actually the sentence I pronounced when I was being
2:25
Speaker 3: nominated for the job of Fedish director. If you recall
2:30
Speaker 3: at that time there was a huge controversy about stem
2:32
Speaker 3: cell research. Yes, and I wasn't funded and pro life,
2:36
Speaker 3: pro choice, you know, Bush and so on and so forth,
2:40
Speaker 3: and so there was a huge tension there. And I
2:42
Speaker 3: agree to be the Anglish director for one reason is
2:45
Speaker 3: that when I was at Hopkins, I was a you know,
2:48
Speaker 3: executive ized dean. But I tried to develop the research
2:51
Speaker 3: and we couldn't get any funding for step cell. We
2:53
Speaker 3: had Gerhardt, who was a leader in the field, they
2:56
Speaker 3: couldn't get money. So I got private money to create
2:59
Speaker 3: a engineering institute. So I knew that the thing was blocked.
3:03
Speaker 3: There was no federal money at all. And then Bush
3:08
Speaker 3: made the decision that he said, well, if the embryo
3:10
Speaker 3: has been destroyed, might as well use it for research,
3:13
Speaker 3: and so he allowed the research to be funded for
3:16
Speaker 3: the seventy eight lines that were already destroyed. He said, well,
3:20
Speaker 3: I tow that away in the trash. I mean, no,
3:22
Speaker 3: we should learn science and so on. That was a
3:24
Speaker 3: great solomonic decision. He got hated by the Democrats and
3:27
Speaker 3: hated by the Republicans because he didn't he didn't please
3:32
Speaker 3: either one of them.
3:33
Speaker 1: And I like that.
3:34
Speaker 3: I thought, wow, this guy's Nice's greaty, really good. And anyway,
3:39
Speaker 3: I met him and he told me, he said, look,
3:41
Speaker 3: I guarantee if you get this job, I want you
3:44
Speaker 3: to know that I will double the nice budget. You know,
3:47
Speaker 3: I committed to that. I'm committed to them in the campaign,
3:49
Speaker 3: and I'll do it because I believe in you guys
3:51
Speaker 3: being number one in the world and I want to
3:53
Speaker 3: stamp out HIV AIDS. And I said, well, Surpresident. Sure.
3:57
Speaker 3: And then when I was in Congress, they started badgering
4:00
Speaker 3: me about what's your position stem Cells. I said, listen,
4:04
Speaker 3: the NIGE director has to be factual, not factual. I
4:07
Speaker 3: tell you the science. You make the politics. I'm not
4:10
Speaker 3: a politician, and disease knows no politics. And it was
4:14
Speaker 3: recorded in my testimony in Congress. You'll find actually that
4:18
Speaker 3: you know the video that has me say that, I.
4:20
Speaker 1: Think we need to get that to go viral.
4:23
Speaker 3: Yeah. Again, that's when the guys were, you know, looking
4:27
Speaker 3: at the book. The title was like, well, the Life
4:30
Speaker 3: Journey of the Nish Director, The life journey of his immigrant,
4:33
Speaker 3: you know. And I was like, come on, guys, this
4:37
Speaker 3: is like vanilla, you know. And then I said, what
4:39
Speaker 3: about disease knows no politics. It's actually something that we
4:44
Speaker 3: we should say. So to make a long story short,
4:48
Speaker 3: that's why this title showed up. And then boom with
4:51
Speaker 3: the Trump election, it sort of became like front end
4:54
Speaker 3: because politics is into diseases right now, big time, much
4:58
Speaker 3: more so than ever before.
5:00
Speaker 1: But you work with Trump, right, No, I never wanted
5:03
Speaker 1: you were not there for any of the Trump periods.
5:06
Speaker 3: No. The closest I came to be asked was for
5:11
Speaker 3: the operation Warp Speed.
5:13
Speaker 1: That's right, that's right.
5:14
Speaker 3: Yeah. And I had to work with Alex Azar who
5:18
Speaker 3: was Deputy Secretary of HHS and so he knew me
5:21
Speaker 3: and Tony foul she was at that time working with him,
5:25
Speaker 3: and they said, well, we need to do something. So
5:28
Speaker 3: he and I don't know how exactly, they came up
5:30
Speaker 3: with this warp Speed idea and they called me up
5:33
Speaker 3: and I said, look, it's a terrific idea. You should
5:35
Speaker 3: pursue it, but you got to find money. You can't
5:38
Speaker 3: do it on the cheap. So they came up with
5:41
Speaker 3: the concept and then Kushner Jared Kushner really helped them
5:45
Speaker 3: get it through the White House, and the President bought
5:48
Speaker 3: into it. Then came to recruit somebody, and so they
5:51
Speaker 3: came to me and I said, look, I can't really
5:56
Speaker 3: I'm not the guy you want. I mean, I know aboutaccines,
6:00
Speaker 3: but I didn't develop vaccines. And then this helped. If
6:03
Speaker 3: you tak you can commit to do it before the election,
6:06
Speaker 3: I said, I can't do that. You know, it depends
6:09
Speaker 3: on the attack rate, how many cases there would be
6:11
Speaker 3: over what period of time to prove that it works,
6:13
Speaker 3: and so and I said, by the way, you should
6:15
Speaker 3: take somebody like Massif slowly because he's really had the
6:19
Speaker 3: vaccine and GSK his experience and so on. So then
6:23
Speaker 3: the League came out that the White House was going
6:26
Speaker 3: to ask me. But then when they checked the background
6:30
Speaker 3: of what people said. I had said that the management
6:34
Speaker 3: of the pandemic early on right is amateur hour. It's published.
6:41
Speaker 3: He came out, if you do it, look it up.
6:43
Speaker 3: But I was saying that about the testing, you know,
6:46
Speaker 3: I wasn't saying that about Trunk. I was saying that
6:48
Speaker 3: about the testing fiasco at CDC. You know, they take
6:52
Speaker 3: the title, they don't read the text, and even though
6:54
Speaker 3: I was a Republican administration guy, they chickened out and
6:59
Speaker 3: things God, because I wasn't willing to do it. That's
7:02
Speaker 3: the closest I came to working with the Trump administration
7:06
Speaker 3: through Alexesar and Tony Fauci.
7:09
Speaker 1: Well, see things happen the way they're supposed to work out.
7:12
Speaker 1: I guess. So your creative science and public health should
7:16
Speaker 1: stay independent from politics and everyone deserves equal care. Is
7:21
Speaker 1: that something you think still achievable.
7:23
Speaker 3: It's a challenge, you know. And simply because the science
7:27
Speaker 3: is driven through politics, choices are being made which are
7:31
Speaker 3: not scientific. They're political. I'm not saying that. You know,
7:35
Speaker 3: there should be no politics in healthcare, and it's imminently political. Right,
7:40
Speaker 3: you got to make choices, and they have to, but
7:43
Speaker 3: the science should not be political. So you can't mix
7:46
Speaker 3: up politics and assessing disease. So when you're saying Mr
7:50
Speaker 3: Anda vaccines are bad, I know it. I swear to God,
7:53
Speaker 3: I don't want to fund any of it. That's not
7:56
Speaker 3: a scientific decision, it's the political decision that affects many,
8:00
Speaker 3: many potential diseases. Same thing in public health. When you say, oh,
8:05
Speaker 3: Tailan l is the cause of autism. Where did you
8:08
Speaker 3: come up with that? But it's a political thing. It's
8:10
Speaker 3: a political thing for a movement, and all the lawyers
8:13
Speaker 3: are behind it to try to invade the vaccine Fund,
8:17
Speaker 3: the vaccine compensation fund. People don't know that I've been
8:21
Speaker 3: in this thing in the crosshair of the anti vax
8:24
Speaker 3: folks when I was an atactor and one of them
8:27
Speaker 3: was a good friend. He said, Oh, you don't understand.
8:30
Speaker 3: We need to prove a link between autism and vaccines
8:33
Speaker 3: because our kids require special care and we don't have
8:36
Speaker 3: the means. We need to be compensated by the vaccine fund.
8:39
Speaker 3: And then you can see what he's doing, right Kennedy
8:43
Speaker 3: today is trying to remove the judges from the vaccine
8:47
Speaker 3: Fund and get new judges that will be willing to
8:49
Speaker 3: compensate folks. So it's a big billions of dollars class
8:54
Speaker 3: action type thing where some big law firms are going
8:58
Speaker 3: to make a lot of money. So there's eruption going
9:00
Speaker 3: on in my view. So it's just not clear to
9:03
Speaker 3: me that everything is really driven by science. Actually, we
9:07
Speaker 3: were the sort of evidence free zone right now. Everybody
9:10
Speaker 3: cherry picks what they like and then they say what
9:14
Speaker 3: they want, and you cherry pick the committees. You cherry
9:17
Speaker 3: pick the directors of CDC. If you don't like them,
9:20
Speaker 3: you fire them. The same thing at FDA. Here's a
9:23
Speaker 3: perfect storm, my friend, it's a perfect storm.
9:26
Speaker 1: And I think you know it's been going on forever.
9:27
Speaker 1: I remember when I was at Genantec. That's what our
9:30
Speaker 1: Levinson preached, and all of those guys and Sue Helman,
9:34
Speaker 1: follow the science. We'll get to the right outcome, right.
9:37
Speaker 1: And I think they did come out and refute the
9:40
Speaker 1: thing about tile and awe and autism, at least that
9:44
Speaker 1: they there wasn't a causal link. I've seen a lot
9:46
Speaker 1: of coverage, even just in the last week or so.
9:49
Speaker 3: You know, when you talk about science, I mean data
9:51
Speaker 3: carries the truth. You know, people say, in God, we
9:54
Speaker 3: trust everybody else, bring data right.
9:57
Speaker 1: All right, We're not going to solve that on this
9:59
Speaker 1: called it. Our beliefs are shaped so much by how
10:02
Speaker 1: we grew up. You had quite an interesting upbringing. Let's
10:06
Speaker 1: go back a little bit in Algeria during the War
10:09
Speaker 1: of Independence. How did your upbringing inform what you became
10:14
Speaker 1: and what you believed?
10:16
Speaker 3: So two things. One is the fact that you know,
10:19
Speaker 3: when you're a child between you know, two and eleven
10:23
Speaker 3: years old, which was my age at the time, you
10:26
Speaker 3: see a collapse of the ecosystem, the civilization, the culture
10:30
Speaker 3: around you into violence and you live with that and
10:34
Speaker 3: you see the fear in your father's eyes, in your
10:37
Speaker 3: mother's eyes that you could be a victim tomorrow. So
10:40
Speaker 3: you have this sense that life instability needs to be
10:43
Speaker 3: worked on and you need to be resilient about it.
10:46
Speaker 3: So resilience for me became very important in that controlling
10:51
Speaker 3: your fear and being resilient. That's what happens in the
10:54
Speaker 3: period of civil war. And it's never left me. I
10:57
Speaker 3: mean it's you know, people think it's oh, you can
11:00
Speaker 3: get it. You know, your mind will forget it. No,
11:02
Speaker 3: it stays with you all your life, especially if you
11:04
Speaker 3: were a kid. But there is a silver lining to it.
11:07
Speaker 3: So let me tell you what that is. Schools were
11:10
Speaker 3: not open all the time. You couldn't go to the
11:13
Speaker 3: schools when you wanted to. So my education was like
11:16
Speaker 3: Swiss cheese. There were big gas because there were things,
11:19
Speaker 3: you know, like plan biology, things that you learned well
11:22
Speaker 3: that I never had. But my father was a teacher,
11:25
Speaker 3: so he said, look, you're not going to go to school,
11:28
Speaker 3: but you go to learn by yourself. So here are
11:30
Speaker 3: the books. I want you to do that. And I
11:32
Speaker 3: have brothers, so we were all like sort of a
11:35
Speaker 3: mini schools, like at homeschooling without wanting it, that's why
11:38
Speaker 3: we did. And I learned to learn. You see that word,
11:42
Speaker 3: I learned to learn. That is something that doesn't leave you,
11:46
Speaker 3: and it's a huge asset. So it created resilience, obviously
11:51
Speaker 3: dominating your fear, which is always in the background. But
11:54
Speaker 3: also it taught me something that I wouldn't have learned
11:56
Speaker 3: if I had gone to regular school in the regular time.
12:00
Speaker 1: Teams for success in life, I think generally. So how
12:03
Speaker 1: do you and your wife pull off integrating when you
12:05
Speaker 1: asked with a few hundred dollars in your pockets so
12:08
Speaker 1: you could study at John's. How did that all happen?
12:11
Speaker 3: It happened because look, when I grew up, I grew
12:14
Speaker 3: up with math and physics. My father was teaching math
12:16
Speaker 3: and physics. He never thought I should be a doctor.
12:20
Speaker 3: He thought doctors are stupid, and he said, you're going
12:23
Speaker 3: to medicine. You're your nuts. You're better than that, son.
12:26
Speaker 3: So I said no. My wife was actually in the
12:30
Speaker 3: medical school, and you audited it for a six month
12:33
Speaker 3: when my university, you know, so I chose math. I
12:36
Speaker 3: got bored to death. The people are boring their own nerds,
12:40
Speaker 3: and I'm a different kind of guy. I like challenges.
12:42
Speaker 3: I like to post questions. So the teachers didn't like me.
12:45
Speaker 3: I didn't like them. I talked to her, I don't
12:47
Speaker 3: call them mind. He said, go to medicine. Medicines for you.
12:49
Speaker 3: I mean, you seem to be attached to people. And
12:53
Speaker 3: I had seen the suffering, and so I went to medicine,
12:56
Speaker 3: and guess what I found out. My father was right
13:00
Speaker 3: that it was boring and it was road learning, and
13:04
Speaker 3: then you had to learn and write prescription and things
13:07
Speaker 3: that if you ask a question at the time, they said,
13:10
Speaker 3: why are you asking you the question? I mean, listen,
13:12
Speaker 3: we have six hundred students here. You just learn and
13:15
Speaker 3: take your tests. And so I was going to leave.
13:19
Speaker 3: An uncle of mine, who was a radiologist, showed me
13:21
Speaker 3: the first cascan in the world, right by Hodsbrey Galsfield.
13:25
Speaker 3: He said, look, this is a fantastic revolution. I said,
13:28
Speaker 3: tell me about it, and he showed me the brand
13:30
Speaker 3: and you could see the ventricles, and so how is
13:33
Speaker 3: that made? And he described it for me. I still
13:36
Speaker 3: remember he said, Oh, well, it's an X ray tube
13:39
Speaker 3: rile around and the detector and computer that reconstructed the images.
13:45
Speaker 3: So it's math and physics and biology. That's what I
13:48
Speaker 3: want to do. And that's how I decided not so
13:52
Speaker 3: much to stay in medicine, but to do research in
13:55
Speaker 3: biomedical imaging, because I was excited about this and it
13:59
Speaker 3: was a very big beginning of it, Jim, and no
14:01
Speaker 3: one could teach you that except in the US, so
14:05
Speaker 3: I had to take all the exams. And then the
14:06
Speaker 3: dean of my medical school wrote to the denotop Kis,
14:09
Speaker 3: who was a radiologist too, and that's how they let
14:12
Speaker 3: me come for a short time, which became fifty years.
14:16
Speaker 1: That's a short journey. But it's just interesting how radiology
14:22
Speaker 1: was the root, and I think it doesn't get it's
14:25
Speaker 1: now getting. It seems to be coming back. You know,
14:28
Speaker 1: we're seeing a lot more radio therapeutics. It's like there
14:30
Speaker 1: was a period of time where it was something. Now
14:33
Speaker 1: it's become much bigger again. Talk a little bit about
14:37
Speaker 1: the importance of radiology. I don't think we get into
14:40
Speaker 1: it enough. But why is it so important?
14:43
Speaker 3: Yeah, when you say radiology, you limit yourself to what
14:46
Speaker 3: really we're talking about, which is non invasive imaging. And
14:49
Speaker 3: you do that at the microscopic level, you know, the
14:52
Speaker 3: molecular level or MRI or even at the astronomical level.
14:57
Speaker 3: It's imaging. What is its the spatial localization of biological
15:03
Speaker 3: information that you extract in a spatially temporarily resolved manner.
15:08
Speaker 3: So look at the number of Nobel Prices that have occurred.
15:12
Speaker 3: I mean, Betsig got a nomil price because he found
15:15
Speaker 3: a way to image single molecules through a physical thing
15:20
Speaker 3: that nobody really figured out before. And so when you
15:23
Speaker 3: look at radiology, you shouldn't think radiology, you think should
15:26
Speaker 3: the science of imaging, imaging, bioimaging in general, because the
15:31
Speaker 3: reconstruction algorithms, the technologies, how do they change. They changed
15:36
Speaker 3: by what they use. They use X rays, or they
15:38
Speaker 3: use sound, or they use radio waves or MRI or
15:42
Speaker 3: radioactivity for others. But they all common converge into one big, absolute,
15:48
Speaker 3: major trunk of science, which is imaging. Whether it be
15:52
Speaker 3: electron microscopy or crystallography or they're all based on the
15:56
Speaker 3: same concepts. So radiology is just a small part of it,
16:00
Speaker 3: right is at the forefront of medical applications. It's become
16:05
Speaker 3: like a pillar of medical care right now. On top
16:09
Speaker 3: of it, when you do medical imagining, you can apply AI.
16:13
Speaker 3: It's probably the field that's the most advanced in terms
16:16
Speaker 3: of applying AI.
16:18
Speaker 1: And you know, I had my clearly tests, so I
16:20
Speaker 1: know that's one of the ways the heart flow clearly tests.
16:24
Speaker 1: That was testing claque or mimography for that matter, you know, right,
16:28
Speaker 1: that's another one. Yeah, so you know how AI is
16:31
Speaker 1: going to change the way we even discovered drugs. So
16:34
Speaker 1: I think the radiology has always been a leading edge
16:37
Speaker 1: and I was lucky to I joined it because I
16:39
Speaker 1: was frustrated with core medicine and you know, my life
16:44
Speaker 1: has been a little bit of that sort of opportunistic
16:47
Speaker 1: and accidental. Well let's go to that now. Yeah, why
16:51
Speaker 1: you're vice chair of radiology at Eastern Virginia Medical School.
16:54
Speaker 1: You're also a consultant for the WHO and the White
16:58
Speaker 1: House under Reagan. How did that have How did you
17:00
Speaker 1: stumble into that or just it happens?
17:03
Speaker 3: No, No, the Virginia thing, I had to do it
17:05
Speaker 3: because my wife wanted to do her residency after we
17:09
Speaker 3: had our first two children. She had a residency in
17:12
Speaker 3: Eastern Virginia Medical School. And at the same time, by chance,
17:16
Speaker 3: one of my teachers from Hopkins became MA chair in
17:19
Speaker 3: Eastern Virginia, and so he said, I'll figure out a
17:23
Speaker 3: way for you to come and we make sure your
17:26
Speaker 3: wife gets the residency that she wanted. And I didn't
17:29
Speaker 3: have a visa to stay, and they said, we'll figure
17:32
Speaker 3: out your visa. So that was the reason I went there.
17:35
Speaker 3: But he had promised me research time and the lab,
17:39
Speaker 3: and that's when I started to do my independent research.
17:43
Speaker 3: And I created a technology that really could differentiate cancer
17:48
Speaker 3: from malignant legions in the lawn. And I created a
17:50
Speaker 3: company for it. And the book says why I did
17:53
Speaker 3: because nobody wanted to do it. The big companies didn't
17:55
Speaker 3: want to do it because the market would have been disrupted.
18:01
Speaker 3: But that invention was actually I taught that to my residence.
18:06
Speaker 3: It turns out one of the residents went at the
18:08
Speaker 3: Tesla Naval Hospital and she was in the team that
18:12
Speaker 3: took care of the resident of the President, and he
18:15
Speaker 3: had a nodule and they couldn't do what they couldn't
18:18
Speaker 3: They couldn't tell what to do because he had a
18:20
Speaker 3: long answer, and they said we need to do something,
18:22
Speaker 3: and we operated, and she said, wait, wait, wait, I
18:25
Speaker 3: know my professor and Virginia he developed this test and
18:30
Speaker 3: he could tell us if it's benigna and malignant, if
18:32
Speaker 3: we should operate or juice, wait or do nothing. That's
18:36
Speaker 3: how I got in touch with the White House through
18:38
Speaker 3: my resident.
18:39
Speaker 1: So what I was.
18:40
Speaker 3: Doing in the research I did in Virginia. So you see,
18:44
Speaker 3: went to Virginia because my wife had a lab discovered
18:48
Speaker 3: something that was really fascinating that had really, you know,
18:52
Speaker 3: imagine as a solution to a lot of people who
18:55
Speaker 3: were getting operated for nothing. A resident of mine was there.
18:59
Speaker 3: She goes to the Navy hospital and calls me up
19:03
Speaker 3: one day and said, we need you for a VIP.
19:05
Speaker 3: Well it turns out to be was Reagan. So hell
19:08
Speaker 3: a VIP.
19:09
Speaker 1: That's kind of funny. Your wife sounds amazing without them
19:13
Speaker 1: or nothing. As you know, I lost mine at the
19:15
Speaker 1: end of last year to cancer. And the partnership we
19:19
Speaker 1: had was remarkable, how we worked together, and it sounds
19:22
Speaker 1: like you two did too.
19:24
Speaker 3: We met when we were in high school. We're a
19:25
Speaker 3: swimming team right. So there's a part of being in
19:28
Speaker 3: the same team. That's one and two. We went to
19:32
Speaker 3: the same medical school. But the other thing that binds
19:35
Speaker 3: you and bonds, you know, the bonding is when you
19:39
Speaker 3: come to a different country on your own. It's like
19:41
Speaker 3: you're going to isolated island. We have no friends, no family,
19:46
Speaker 3: no support. So who do you turn to? You turned
19:48
Speaker 3: to your wife, she turns to you. And the luck
19:52
Speaker 3: have it that we had beautiful children and she decided
19:55
Speaker 3: to sacrifice her career really for mine, and I cannot
19:59
Speaker 3: forget that. I can not ignore that. So we stayed
20:02
Speaker 3: bunded because it was like a couple in the ocean
20:06
Speaker 3: of America's opportunities, right, the American dream. You can't leave it,
20:11
Speaker 3: you know, without some support, if you're an immigrant with
20:15
Speaker 3: no real roots here.
20:17
Speaker 1: Well, I love that. That's a great story. And I
20:20
Speaker 1: obviously the partnership bringing out the best in each other,
20:23
Speaker 1: all those things you know so important. Then you get
20:26
Speaker 1: this role of a lifetime, right. You know, what were
20:28
Speaker 1: you thinking when George Bush calls and asks you to
20:32
Speaker 1: serve as the director of NAH I.
20:35
Speaker 3: Thought they had made a mistake. They had the wrong number.
20:38
Speaker 1: Why was that?
20:40
Speaker 3: Because I never thought that it would ever be considered.
20:43
Speaker 3: You know why. I mean, you know how they called
20:45
Speaker 3: me when I became an int director. Who Who's this? Who? So?
20:52
Speaker 3: So I said, well, are you sure you want to
20:55
Speaker 3: talk to me? And they said, yeah, yeah, you have good,
20:59
Speaker 3: good recommendations and people know you. And I had been
21:01
Speaker 3: elected to the National Academy by then. You know, I
21:05
Speaker 3: was like, what was it forty nine years old or
21:08
Speaker 3: something like that, and so they looked for that. Then.
21:12
Speaker 3: The second reason is that I had ideas that were
21:16
Speaker 3: pretty novel for the time. And the first idea was
21:20
Speaker 3: I call convergence, which is the conmergence of physical and
21:24
Speaker 3: biological sciences, just like what I experienced. And when I
21:28
Speaker 3: was at Hopkins, I recruited people from different fields in
21:32
Speaker 3: my lab, which was a revolution because in those days
21:35
Speaker 3: you recruit doctors, that's it. No, No, I need the physicists.
21:39
Speaker 3: So I created the first multidisciplinary lab at Hopkins, which
21:43
Speaker 3: became very successful, which led me to become the chair
21:46
Speaker 3: of my department, and then right after that the executive
21:49
Speaker 3: Izdin in charge of research, and my motto was break
21:53
Speaker 3: disciplinary silos, break the barriers, let the teams come together.
21:59
Speaker 3: That's how science is being done now, it's not going
22:02
Speaker 3: to be done otherwise. Today it's like, of sure, course,
22:05
Speaker 3: of course, But at that time it was really revolutionary.
22:08
Speaker 3: It was even featured in science and a new unique lab.
22:12
Speaker 3: And because of that I got noticed and I was
22:15
Speaker 3: always saying NIH has a problem. And then publicly, even
22:19
Speaker 3: when I was at the on the council of the
22:22
Speaker 3: National Cancer Institute, I said, we have a structural problem.
22:26
Speaker 3: We've created these institutes on organ's art, lung, brain, and
22:31
Speaker 3: yet at the same time, what was created in nineteen
22:34
Speaker 3: forty five, the fifties and so on, which was organ
22:37
Speaker 3: based did not really reflect the molecular classification and the
22:42
Speaker 3: molecular pathways of disease. I said, you know, look at immunology,
22:46
Speaker 3: it's all over. Look at how we found the treatments
22:50
Speaker 3: for HIV through research in virology with retroviruses by Harold
22:55
Speaker 3: Varmus and all these guys. And the ACT was not
22:59
Speaker 3: designed for each he was designed for lastic. So how
23:02
Speaker 3: do we have these silos when nature and science is
23:06
Speaker 3: all interpenetrating. Well, I'll tell you somehow. The president of
23:11
Speaker 3: my university was called by the White House. Do you
23:13
Speaker 3: know a guy that could be the unition factory, and
23:16
Speaker 3: they said he told them Bill Brodie. He said, look,
23:19
Speaker 3: I'm going to give you my right arm. But there
23:22
Speaker 3: is one guy. He made the marketing for me. And
23:26
Speaker 3: so that's how I got that call. Because the people
23:29
Speaker 3: were giving my name and my number out of the
23:31
Speaker 3: Natural Academy of Medicine also my university, say you should
23:35
Speaker 3: look into that guy, and that's what started the ball rolling.
23:38
Speaker 1: Anything that convinced you to do it, that Bush said,
23:41
Speaker 1: or anyone said to you that made you think, okay,
23:45
Speaker 1: it's worth taking a shot.
23:47
Speaker 3: When they said they were committed to doubling the NIH budget,
23:50
Speaker 3: they wouldn't back off. When they said that they wanted
23:54
Speaker 3: to make the difference in HIV aged globally, I said, well,
23:57
Speaker 3: these guys are serious. And when they said, I asked him.
24:00
Speaker 3: I said, you understand that I'm an immigrant, and you
24:03
Speaker 3: understand I'm a Muslim, and you want to appoint me
24:07
Speaker 3: after nine to eleven And they say, yeah, it's okay.
24:10
Speaker 3: The President only looks at your character and if you're
24:13
Speaker 3: a citizen in good standing and you fit this what
24:16
Speaker 3: we need, you'll be considered. I thought that was pretty
24:19
Speaker 3: open minded, and I said, okay, but the key thing
24:23
Speaker 3: was because I tell you, there is a reaction of wow,
24:27
Speaker 3: my god, the White House calls me, and then you
24:29
Speaker 3: go to fear. Wow, I might get in the front
24:33
Speaker 3: page of the New York Times and the Washington Post
24:35
Speaker 3: with a scandal and so on. So I, in my
24:38
Speaker 3: due diligence, is the one guy who convinced me. You
24:41
Speaker 3: know the last thing. It was Harold Armas and I
24:45
Speaker 3: recount that in the book. He knew me because I
24:48
Speaker 3: had worked on his department MSK as an advisor, and
24:52
Speaker 3: I was on the National Cancer Institute, so I was
24:55
Speaker 3: somewhat known. And the people at Hopkins who we are
24:58
Speaker 3: saying good things, and he said, look, it's actually the
25:02
Speaker 3: right thing to do. I said, look, I don't have
25:03
Speaker 3: your pedigree. I'm not a Nobel laureate. And he said,
25:06
Speaker 3: don't worry about that. He said, your story is a
25:09
Speaker 3: convincing story of leadership adaptation, and you came from nowhere.
25:14
Speaker 3: Look where you are at Hopkins, and people would love
25:16
Speaker 3: that and that's what the institution needs. So that's how
25:21
Speaker 3: it clicked. And that's the moment when I said, oh,
25:24
Speaker 3: I'll take the plunge.
25:25
Speaker 1: I mean, and look what happened. So walk us through
25:28
Speaker 1: a few of the big achievements under your leadership and
25:30
Speaker 1: how they laid the groundwork for today. What were some
25:34
Speaker 1: of the big things.
25:35
Speaker 3: I would summarize it in three number one. I was
25:38
Speaker 3: very convinced that the peer review system was conservative, and
25:42
Speaker 3: I created the Pioneer Award, the New Innovator Award, a
25:46
Speaker 3: series of awards that did not have the standard peer
25:50
Speaker 3: review process, which is a terrible thing. I mean, the
25:53
Speaker 3: peer review process is good at preventing bad science, it's
25:57
Speaker 3: terrible at identifying great science. Because you have these diverse
26:02
Speaker 3: panels which are mandated, by the way, by federal law,
26:06
Speaker 3: and you can't escape them. You got to have representation
26:09
Speaker 3: and diversity. The north to south east, the west is
26:11
Speaker 3: a tomato, zucchini, a carrot, you know, and they come together,
26:16
Speaker 3: and you know what happens when you have a group
26:18
Speaker 3: like that, You have a regression to the met Yes,
26:21
Speaker 3: and I said, forget that. So I would say my
26:23
Speaker 3: first contribution that I wanted was that the Pioneer Award,
26:27
Speaker 3: which has been considered by the Academy very successful. Then
26:32
Speaker 3: the second was what I was just telling you about
26:34
Speaker 3: the physical sciences and biological sciences coming together with computational sciences.
26:40
Speaker 3: I doubled the funding of non biomedical fields when I
26:44
Speaker 3: was the director. The third one was an organizational change
26:49
Speaker 3: where I said, you know, each institute has very strong
26:52
Speaker 3: on constituencies and advocacy groups. You don't want to mess
26:55
Speaker 3: up with that. But you wanted them to work better.
26:58
Speaker 3: And so what I did the road map for medical research,
27:02
Speaker 3: and the roadmap for medical research was based on one sentence.
27:06
Speaker 3: I said, look me in the eye, let's talk. Tell
27:09
Speaker 3: me what NIH should do in science today that no
27:14
Speaker 3: instituo can do. And I let that go. And I
27:19
Speaker 3: convened three hundred people from all walks of science and
27:22
Speaker 3: they're okay. I mean, it was amazing. It was July August.
27:27
Speaker 3: Only one guy turned me down because he was in
27:29
Speaker 3: Australia with his family. And so it tells you the
27:32
Speaker 3: power of the influence that you have, which I didn't
27:35
Speaker 3: appreciate actually. And then they came and we had like
27:38
Speaker 3: all these ideas about we need to do this, we
27:41
Speaker 3: need to do that, and then we crystallized that into
27:43
Speaker 3: a roadmap which basically said next generation of scientists, you know,
27:47
Speaker 3: as we call the scientific teams of the future. The
27:51
Speaker 3: molecular pathways of disease, which was the reclassification effort of
27:56
Speaker 3: all diseases.
27:57
Speaker 1: And that was huge. That's huge.
27:59
Speaker 3: That was huge. And then the re engineering of the
28:02
Speaker 3: clinical research enterprise, which was basically the Tweet team, so
28:08
Speaker 3: leading edge science, multidisceminary science and focus on reclassification of
28:13
Speaker 3: diseases and their understanding to a reform act. Congress has
28:18
Speaker 3: bought it. They voted for the reform in two thousand
28:20
Speaker 3: and six.
28:21
Speaker 1: It sounds like it's not that long ago, but I
28:24
Speaker 1: guess it is. The other one you got started that's
28:26
Speaker 1: taking flight now is the focus on mental health and
28:29
Speaker 1: behavioral disorders, right, So talk to me a little bit
28:32
Speaker 1: about that. I mean, I would say it took a
28:35
Speaker 1: long time for social media and the phone and all
28:38
Speaker 1: these things that have affected the kids for that to
28:40
Speaker 1: get better recognized. Of course, going through COVID and what
28:44
Speaker 1: that probably caused. Do you think we're far enough there?
28:48
Speaker 1: You know, at least we're on our way. I don't know, Oh, Jim,
28:51
Speaker 1: that's the frontier, you know. And it's frustrating because when
28:55
Speaker 1: I was doing the roadmap, I was very underwhelmed by
28:58
Speaker 1: the proposals from the mental health folks and the neurology folks,
29:04
Speaker 1: the institutes. I said, you guys are too conventional of
29:07
Speaker 1: in We've got to do better. And so brought them together.
29:11
Speaker 1: There were great directors that I had recruited, you know,
29:13
Speaker 1: story lenders on INSUL and we sat down and we say,
29:16
Speaker 1: what's missing.
29:18
Speaker 3: What's missing? What's missing is the fact that you don't
29:21
Speaker 3: really understand the brain at the molecular level. You think
29:25
Speaker 3: you do. You understand him as a cellular level, you know,
29:28
Speaker 3: with the cells, but at the molecular level during a
29:31
Speaker 3: disease state. What happens molecularly during schizophrenia, you know, when
29:35
Speaker 3: you have a schizophrenic delusional episode, what are the chemical
29:40
Speaker 3: changes that occur? Well, we don't know that, you know why.
29:42
Speaker 3: We don't know that because we think the brain is taboo,
29:45
Speaker 3: that you can only examine the brain through its mental
29:48
Speaker 3: health representations. What schizophrenia is an effect, is not a cause.
29:53
Speaker 3: And so I try to shake that mentality, you know,
29:57
Speaker 3: and say, let's be bolder, guys. And so so the
30:00
Speaker 3: ideas started to come up, you know, like Tommy Issall
30:03
Speaker 3: came up with his managing bipolars with a cell phone
30:07
Speaker 3: and the brain initiative was drown the blueprint for brain,
30:11
Speaker 3: which really started to break the barrier of this being taboo.
30:15
Speaker 3: You know, you cannot get a CSF the tap in
30:19
Speaker 3: clinical trials in the US, ninety percent of the time
30:21
Speaker 3: people say no, you can biop see the brain mini
30:25
Speaker 3: We do microbiopses and animals and so on. You can
30:28
Speaker 3: with microdialysis you can see what happens. You don't do
30:31
Speaker 3: that in humans. The IRBs will tell you no. And
30:34
Speaker 3: I give them the example. The first guy who put
30:36
Speaker 3: a catheter in the hertforcement in nineteen thirty eight got
30:41
Speaker 3: fired by his chief and then you got the Nobound
30:45
Speaker 3: Prize twelve years later.
30:47
Speaker 1: Sounds like your depicts and story. These stories are so
30:51
Speaker 1: common now. Things that are accepted as common were controversial before.
30:56
Speaker 1: So it's been twenty five years since obesity was labeled
30:59
Speaker 1: a health What do we know now that you wish
31:03
Speaker 1: you'd known then?
31:05
Speaker 3: We knew a lot then, a lot more then than
31:08
Speaker 3: people think. And the problem is the politics of it
31:13
Speaker 3: got in no way. This disease knows no politics. That's
31:16
Speaker 3: an example of it. Because we looked at it and
31:19
Speaker 3: we projected said this is a pandemic. It's going to
31:22
Speaker 3: damage with a lot of people. The one thing we
31:24
Speaker 3: didn't quite understand was we saw more cancers with obesity,
31:29
Speaker 3: more diabetes. So the notion of metabolic syndrome came about
31:34
Speaker 3: at that time, and high blood pressure and so on.
31:37
Speaker 3: But then when we said, okay, what has changed, and
31:40
Speaker 3: we realized that the environment had changed. So we did
31:43
Speaker 3: this research on what we called the built environment. And
31:46
Speaker 3: there was a researcher that said, if we built every
31:49
Speaker 3: building in the US with no elevators until the third floor,
31:53
Speaker 3: so you had to go in stairs, obcly we'll go
31:56
Speaker 3: down by twenty five percent. I mean, this kind of
31:58
Speaker 3: crazy statistics. But the biggest problem, and this is where
32:02
Speaker 3: the current administration is going to have a little bit
32:04
Speaker 3: of a shock when they talk about chronic diseases and obesity.
32:09
Speaker 3: They don't realize that it's embedded in our supply chain.
32:13
Speaker 3: For the food we could use to consume about twenty
32:16
Speaker 3: pounds of sugar in nineteen twenty. Now it's in the
32:18
Speaker 3: hundreds of pounds per individual. And corn syrup is probably
32:23
Speaker 3: the number one addictive thing that drives diabetes and obesity.
32:29
Speaker 3: If you try to change that, you get absolutely killed.
32:33
Speaker 3: And I did. I went to Congress and I said,
32:35
Speaker 3: we need to tax sugar. Yeah wow, you know how
32:38
Speaker 3: that went. You know, they say, you know, if you'll
32:41
Speaker 3: get fired before we tax sugar because we tax sugar.
32:45
Speaker 3: They had the head of appropriation. He said, alist I
32:48
Speaker 3: love you, but if we tax sugar, I'll get fired
32:51
Speaker 3: at my job like this by the agricultural lobbyist. And
32:55
Speaker 3: I don't know if you know, Kennedy promised not to
32:58
Speaker 3: influence the agricultural policy is at his hearings because I
33:02
Speaker 3: know the subsidies for corn syrup in agriculture sixty billion
33:09
Speaker 3: dollars a year. Oh wow, it's bigger than the NIH budget.
33:13
Speaker 3: And you're going to tell these guys that you want
33:15
Speaker 3: to fix obesity by destroying their business and their subsidy
33:19
Speaker 3: and taxing.
33:20
Speaker 1: What they do.
33:21
Speaker 3: I mean, it's like when the tobacco companies, we're fighting
33:24
Speaker 3: against tobacco being a toxin. So I think there are
33:28
Speaker 3: structural impediments that have nothing to do with about medical
33:31
Speaker 3: research or the obesity crisis has to do with social issues,
33:36
Speaker 3: socio economic issues and the built environment that we're built
33:39
Speaker 3: for ourselves.
33:40
Speaker 1: I think this stuff works itself out over time. I mean,
33:43
Speaker 1: you know, you've got the GLP one. So there's a
33:46
Speaker 1: lot of talk about the change of food.
33:48
Speaker 3: Doesn't address the fundamental reasons why it's the corporate infrastructure,
33:53
Speaker 3: agricultural structure. But I think what tends to happen over
33:57
Speaker 3: time when you have a pandemic is that you know
34:00
Speaker 3: will be a selection because some people will be responsive
34:04
Speaker 3: and self correcting, like people stop smoking. You see that
34:07
Speaker 3: the health movements. But at the end of the day,
34:10
Speaker 3: what needs to happen is a public health intervention of
34:13
Speaker 3: some kind. Then I think is the next step. Just
34:16
Speaker 3: like we use statins and we really reduce the rate
34:19
Speaker 3: of cardiovascular disease and athroscrosis to huge that right, Just
34:24
Speaker 3: like we treated hypertension and we reduce the mortality mobility
34:28
Speaker 3: of cardiovascular disease by two thirds, the same thing is
34:32
Speaker 3: going to happen here. You've got to come up with
34:35
Speaker 3: pills and things that are easier, cheaper, more widespread than
34:39
Speaker 3: the injectable GLP one. And I think that's happening, and
34:43
Speaker 3: I think over time we will spread the public health
34:46
Speaker 3: intervention that is needed.
34:48
Speaker 1: Do you think the US is under threat as a
34:50
Speaker 1: leader in healthcare innovation and how do we change it?
34:53
Speaker 1: What can we do.
34:54
Speaker 3: You know, my analysis is that we're facing a commitedy
34:57
Speaker 3: of errors, if you will, because the ecosystem of biomedical
35:01
Speaker 3: research was created in nineteen forty five, not just biomedical,
35:05
Speaker 3: and it was created on the compact between industry, between universities,
35:09
Speaker 3: and between government. All three played a big role during
35:13
Speaker 3: the war and that was sort of fast forward for
35:17
Speaker 3: the civilian part of the world, and for seventy five years,
35:21
Speaker 3: that's what has led to the supremacy of the United States.
35:25
Speaker 3: So there are about seven components when you look at that,
35:29
Speaker 3: and I'm an engineer, so I look at that in components.
35:33
Speaker 3: Number one is federal funding because it funds is the
35:36
Speaker 3: basic science. Number two is universities because they find the
35:39
Speaker 3: knowledge and they trained the generation of scientists that you need.
35:43
Speaker 3: Number three is the industry pharma. Number four is immigration
35:48
Speaker 3: because you need the talent that you don't have. And
35:51
Speaker 3: number five is philanthropy, which is now taxed. So look,
35:56
Speaker 3: everything is in the challenge. Funding. They want to cut it. Universities,
36:00
Speaker 3: they want to punish them. Pharma they have pricing issues
36:03
Speaker 3: and we want to make pharma buckle. And then the philanthropy,
36:07
Speaker 3: well they're politically this so we text them. Now, as
36:09
Speaker 3: you talk to a president of the university, he's got
36:11
Speaker 3: to pay two hundred million dollars in taxes. He said,
36:14
Speaker 3: you know how many scholarships I could give for that?
36:17
Speaker 3: And then venture capital, you know, is very scared right now.
36:21
Speaker 3: There's a lot of uncertainty. It's a perfect storm. The
36:25
Speaker 3: key thing, though, is that others are going the other way.
36:28
Speaker 3: So today China announced a new visa called the k Visa,
36:32
Speaker 3: where people can go in even if they don't have
36:34
Speaker 3: a jump looking for a position, and they're attracting top
36:38
Speaker 3: quality talent. Here we're mixing up the h one B
36:42
Speaker 3: visa one hundred thousand dollars on people who we need
36:46
Speaker 3: because we are four percent of the world population in
36:50
Speaker 3: twenty five percent of the economy. You cannot train enough
36:54
Speaker 3: people in the US for supporting that size. And every
36:58
Speaker 3: graduate program right now is fifty percent none yous born.
37:02
Speaker 3: The essence of what made us strong is being challenged,
37:06
Speaker 3: and I think that's why I answered, Yeah, if cooler
37:09
Speaker 3: heads don't prevail soon, we're going to be in deep trouble.
37:13
Speaker 3: And at this point there's no coordination. The funding issue
37:16
Speaker 3: for the federal government is a deficit question the universities
37:21
Speaker 3: is a political question, it's ideological. And then the thing
37:24
Speaker 3: about pharma, which is true, I mean the prices are
37:27
Speaker 3: too high. It's again a populistic thing that we want
37:31
Speaker 3: to do and the people want it done, but it
37:33
Speaker 3: didn't understand the consequences on the total ecosystem of government.
37:38
Speaker 3: And you know, universities in the industry.
37:41
Speaker 1: Are you talking to the current folks about this? Are
37:44
Speaker 1: they listening to you?
37:45
Speaker 3: Do you think they deny that they wanted to destroy
37:49
Speaker 3: the system? They say, oh, it's exaggerated, as you guys
37:53
Speaker 3: are talking about guys falling and so on, and no, no, no,
37:56
Speaker 3: we don't intend that. The president was absolutely to keep
37:59
Speaker 3: you know, America first number one. But they're not going
38:03
Speaker 3: on the basis of evidence. They're going on the basic opinions.
38:06
Speaker 3: And I keep telling them, look, you know, if you
38:08
Speaker 3: look at the number of scientists we have and engineers
38:11
Speaker 3: two point eight million, China has four point two already
38:14
Speaker 3: growing faster. They went from three hundred thousand students to
38:18
Speaker 3: twelve million students, a lot of them in STEM and
38:22
Speaker 3: they're going to pick and choose the best in the world.
38:24
Speaker 3: And look at our own company's arm labs. I mean,
38:27
Speaker 3: they are fifty percent foreign board. What do you want
38:30
Speaker 3: to do and this idea that all the jobs that
38:34
Speaker 3: are creating in America, no matter what, need to go
38:37
Speaker 3: to American boys and American girls and no one else.
38:41
Speaker 3: That's a very very dangerous thing when you have three
38:45
Speaker 3: hundred and thirty million people as opposed to one point
38:47
Speaker 3: four I mean, Jim, let's pick the smartest person, you know,
38:51
Speaker 3: is it a one in a million person? Probably?
38:54
Speaker 1: This.
38:55
Speaker 3: That means that in the US, if the one in
38:57
Speaker 3: a million talent, the Einstein of the world, you have
39:01
Speaker 3: three hundred of them, three hundred and thirty of them.
39:03
Speaker 3: China with one point four billion has fourteen hundred of them.
39:06
Speaker 3: India has the same number. So look at the belt,
39:10
Speaker 3: it's not there. We need to get that done.
39:12
Speaker 1: It'll let some of those guys in just a middle FNIH,
39:15
Speaker 1: because we both serve on the board. Do you think
39:18
Speaker 1: an organization like that can help bridge some of these gaps?
39:22
Speaker 3: Well, you know, FNIH was designed by Congress to help
39:26
Speaker 3: because Congress realized that there were cultural frictions between the
39:32
Speaker 3: government and IH and the industry because there was a
39:35
Speaker 3: government organization yet at the same time and I was
39:39
Speaker 3: the driver of innovation. So how do you get industry
39:42
Speaker 3: in NIH at the same table. And you notice that
39:45
Speaker 3: because of that, the Congress created this and created a
39:49
Speaker 3: sort of a safe harbor environment that would be transparently
39:53
Speaker 3: managing the relationships without industry getting into the NIH business.
39:58
Speaker 3: Because what everybody's afraid of is that you get industry
40:02
Speaker 3: or special interest driving the scientific agenda. So I say,
40:08
Speaker 3: these knows no politics. And I should say also the
40:12
Speaker 3: profits should not know disease, right and the opposite. And
40:16
Speaker 3: so that's the reason why FNI is so important. There
40:19
Speaker 3: is one for the FDA as well. FDA is even
40:22
Speaker 3: really more difficult because people are accusing and even Kennedy
40:26
Speaker 3: the sector. Kennedy accuses the FDA to be the control
40:29
Speaker 3: of industry because they get the user fees, you know
40:33
Speaker 3: when you think that way. And there is oil and
40:36
Speaker 3: water when it comes to government and private industry, as
40:39
Speaker 3: you well know across all government, you know, whether it
40:42
Speaker 3: being military or health. So you've got to have these
40:46
Speaker 3: buffer institutions like FNIH.
40:50
Speaker 1: Agreed, So thanks, you were messed not to cover it.
40:53
Speaker 1: Given what we do there. Do you stay in touch
40:56
Speaker 1: with Bush and Obama? Do you talk about these things.
41:00
Speaker 3: Not really no, no, no, no, no. They they're very
41:03
Speaker 3: cagey if by saying anything, talking about anything, you know,
41:06
Speaker 3: and yeah, they're very conscious of the weight of their words.
41:10
Speaker 3: I talk about the fact that healthcare in each reform,
41:14
Speaker 3: and I wrote the chapter there that I think is controversial,
41:18
Speaker 3: which I like, talking about ways of approaching the health
41:22
Speaker 3: care and disaster. We're living.
41:25
Speaker 1: Well, we're in the middle of it, proving again there's
41:27
Speaker 1: nothing more important than your house exactly, which is what
41:30
Speaker 1: we're all about. So look, I just wanted to do
41:33
Speaker 1: this and bring it full circle before we ask a
41:35
Speaker 1: couple of fun questions. In two thousand and eight, President
41:38
Speaker 1: Sarkozy named you a Knight of the French Legion of
41:43
Speaker 1: out Here. A knight. I don't know what they do
41:45
Speaker 1: in France. It's how did they say, Sir Offier? What
41:50
Speaker 1: did that mean? As an Algerian who experienced the flight
41:54
Speaker 1: for freedom from France, I mean, what did that mean
41:56
Speaker 1: to you?
41:57
Speaker 3: It was amazing. It was almost like cognitive dissonance, you know.
42:00
Speaker 3: And I did it because I really worked on issues
42:03
Speaker 3: that hadn't been resolved. And then when I told my mother,
42:05
Speaker 3: I said, oh, you're going to get this legion doneur
42:09
Speaker 3: and she said, don't take it, turn it down. I said,
42:12
Speaker 3: what do you mean now, She said, yeah, turn it down.
42:15
Speaker 3: Because she was an anti French. She wanted the freedom
42:18
Speaker 3: in it. And I said why do you say that.
42:20
Speaker 3: She said, well, you know, the people who got the
42:22
Speaker 3: legions on her in my time were all traders, they
42:25
Speaker 3: all collaborators, They collaborated with the colonialists. And I said, mom,
42:29
Speaker 3: it's a different time, it's a completely different story. And
42:33
Speaker 3: she said no, no, no, And I said, you know, they
42:36
Speaker 3: never gave it to an Algeria after the independence, you know,
42:39
Speaker 3: and oh really, And she eventually understood why it was
42:44
Speaker 3: important to be recognized by the former colonial power as
42:49
Speaker 3: somebody who really renders services to friends in the US.
42:52
Speaker 3: Because I'm a foreigner, I'm not French. So to get
42:56
Speaker 3: the legions on her, you know, the list of Americans
42:58
Speaker 3: who got the legions on her, and it's very very
43:01
Speaker 3: high level, I mean Eisenhower on pattern, and it's not
43:04
Speaker 3: a run of the middle list.
43:06
Speaker 1: Oh, it's a big deal.
43:07
Speaker 3: And then she met him. You know, we were Sarkozzi
43:10
Speaker 3: in the Za, and so they talked to me about,
43:13
Speaker 3: you know, being from the United States, and so on.
43:15
Speaker 3: So she came to him. She said, listen, mister president,
43:17
Speaker 3: you got to know he's Algerian. Eh, he's Algerian, I said, Mom.
43:24
Speaker 3: He said, no, no, I want him to know. And
43:26
Speaker 3: he said, I know, Madam, I know, I know. He's
43:28
Speaker 3: a degree. And so we ended up, you know, having
43:31
Speaker 3: a good moment. That's amazing, got a great story.
43:34
Speaker 1: I love that. Moms are everything. Right.
43:36
Speaker 3: He came to my hearing. You know, my mother she came.
43:40
Speaker 3: She was here and she came to the hearing with
43:43
Speaker 3: Ted Kennedy and Ted Kennedy looked to say, who is this.
43:47
Speaker 3: This is my mother. That's my mother here.
43:50
Speaker 1: Really, that's cool.
43:52
Speaker 3: I'm glad you brought your mother. You know. Mothers are important.
43:55
Speaker 3: He was thinking about his own mother, you know, and he.
43:58
Speaker 1: Was kidding, Wow, that's incredible. That's great. Yeah, mothers really
44:04
Speaker 1: drive it all. Two questions I always ask before we
44:07
Speaker 1: take off. It's been I could talk way longer, you know.
44:10
Speaker 1: I always like to ask, what is your dream vacation. Ah,
44:14
Speaker 1: that's a great question. Add the swimming vacation, snorkeling, scuba
44:22
Speaker 1: diving in the Mediterranean, or somewhere nice where I can
44:26
Speaker 1: wake up swim a mile and a half two miles
44:29
Speaker 1: because I'm a swimmer, have a great breakfast, then go
44:33
Speaker 1: and start spearfishing. Cool. I didn't know you did that.
44:37
Speaker 1: That's interesting, all right.
44:39
Speaker 3: And that's because my brain is imprinted by the sea,
44:42
Speaker 3: because I grew up by the sea, and so that,
44:45
Speaker 3: to me is always my definition of a great vacation.
44:48
Speaker 3: It's cool to be like a fish in the water.
44:51
Speaker 1: And it reveals so much about people. Yeah, this is
44:53
Speaker 1: another one that does that. If you're being sent to
44:57
Speaker 1: a desert island and you can only take one hour
45:00
Speaker 1: album with you, what would the album be?
45:02
Speaker 3: Ooh, this is a great question too. I'll tell you what.
45:06
Speaker 3: My favorite piece of music is a twenty fifth symphony
45:09
Speaker 3: by Mozart. That's one, but it's not the only one.
45:12
Speaker 3: Is that co equals too because of Algerian music too
45:15
Speaker 3: is in my blood too. And I like to plead
45:17
Speaker 3: the luth myself.
45:19
Speaker 1: Oh wow, and you could probably make a loot on
45:21
Speaker 1: the island, so yeah, that could possibly happen.
45:26
Speaker 3: You sound very good.
45:27
Speaker 1: I'm excited to get this out there. Let's keep at it.
45:31
Speaker 1: You're just challenging people to be better. Simple enough.
45:35
Speaker 3: Anticipatory complaints is look good?
45:37
Speaker 1: That's right? All right? Hey everyone, thanks for joining me
45:43
Speaker 1: on the Get Real podcast. You know, I hope you
45:45
Speaker 1: feel a little healthier hanging out with me. You know,
45:48
Speaker 1: it's going to be a lot of fun passing this
45:51
Speaker 1: along the others. Please subscribe below, Please share. I'm excited
45:55
Speaker 1: not just to talk about healthcare, but a lot of
45:58
Speaker 1: other fun topics. It's about making healthy. Talk about healthcare
46:03
Speaker 1: is not a lecture.
46:05
Speaker 3: This is supposed to be fun.
46:06
Speaker 1: And look forward to spending more time with you in
46:09
Speaker 1: the future.