what if I told you that just by
attending this TEDx talk you might live
a longer and healthier life
but stay tuned I’ll come back to that
for as long as I can remember I have
wanted to change the world as a kid I
can still remember my nightly ritual
reading under the covers of the
flashlight while making lists of things
like how to end world hunger by the end
of eighth grade when most of my friends
were relishing the summer before high
school I went to my parents and
announced that I wanted to go to college
not in three years but this year you see
it occurred to me that I really did want
to change the world and I wanted to get
started right away so the plan was clear
now I knew instinctively I couldn’t
change the world alone my dream was to
be part of a team of people who shared a
big vision and so my plan was the
following skip high school go to college
and then med school now my parents were
both educators and so they were
supportive of my plan if you can figure
out how to do it honey
we’ll help you queue the obstacle course
of standardized testing hurdles first
the graduate equivalency diploma test
then the California achievement test
then the SAT and finally the a CT with
all those behind me I was admitted to
the class of 1991 at Southeastern
Louisiana University in my home town of
Hammond Louisiana the only
non-negotiable for my parents I would
have to join a social club before the
end of my first year so as to avoid
being a complete weirdo
no problem I was off to the races
and I was just giddy that the universe
actually understood my plan now college
was a blast I really was lucky I ended
up with a group of really protective
friends who took me in under their wing
the summers I would spend on adventures
I remember the first summer I went to
NASA in Cape Canaveral Florida as part
of the space life sciences training
program there I was part of a team that
was assigned the task of designing an
operating room in zero-gravity that was
pretty crazy stuff for my 16 year old
self the next summer I spent at Michael
DeBakey summer surgical program at the
Baylor College of Medicine and there my
task was to be part of a team that got
to design surgical innovations for
issues that would come up repeatedly so
somehow by some miracle I managed to get
a seat at the table with these really
smart people trying to solve big
problems those four years of college
sped by and then it was off to LSU med
school in New Orleans and there comes a
time I remember during the fourth year
of med school after you’ve rotated
through all the different specialties
when you have to decide the path you’re
gonna take for residency that will
ultimately determine your career
direction well I loved every single
specialty this was kind of a problem
general surgery dermatology psychiatry
cardiology you name it so I remember
talking to my mentor and she encouraged
me maybe the best thing was to keep all
my doors open so internal medicine
seemed to be the most logical choice my
next stop would be Scripps Clinic Green
Hospital just down the street from here
for another four years of learning from
really talented physician scientists so
now the year was 1999 and I was lucky to
be offered a staff position to stay on
at Scripps Clinic and start my practice
so between making diagnoses sometimes
big mostly small I got to play the role
of marriage counselor accountability
coach and cheerleader
my tribe of patience and I grew to love
them as people and in turn my practice
grew quickly I really was committed to
helping prevent disease in my patients
but like any new job there were
challenges and one of my biggest
challenges was having to be at the mercy
of insurance companies when trying to
decide what treatment or testing was
best for my patients that first year of
practice I had my head down seeing
patients and I heard that a team of
scientists did something that I couldn’t
even believe possible they sequenced the
human genome I was blown away by this
accomplishment what would this mean to
humanity would this change our ability
to help people to personalize their
treatment would people live forever I
was mesmerised by this so I remember
thinking god this could be a really
interesting tool in my toolbox well then
something happened something that
changed me and my direction forever when
you go into practice at the same place
that you do your residency inevitably
you’ll come to care for a colleague or a
former professor and so it was that I
came to care for one of my very favorite
professors I’ll call him dr. P he was a
kind and gregarious man in his early 60s
a true humanitarian he would spend every
summer in the Philippines caring for
underprivileged kids well when we were
residents he always had time for us and
now that I was his colleague I was
determined to return his kindness I
remember seeing him in the stairwell one
morning that December he called up to me
hey Pam I’ll be in to see you in a
couple weeks it’s my new year’s
resolution to get a physical so I
remember being pleasantly surprised when
he actually followed through I got his
lab results on my desk nothing terribly
scary his LDL cholesterol was about 20
points higher than goal his blood sugar
was borderline I can still picture those
results on my desk with the pale pink
post-it note
in my own writing reminding me that he
would be in to see me on January the 5th
and then on New Year’s Eve on his front
doorstep he died of a heart attack
I was devastated my mind was flooded
with questions what if he’d been in to
see me the week before would I have
detected his risk would I have somehow
with my schools and my my skills and my
tools would I have been able to save him
I had to admit when I look myself in the
eye in the mirror I remember thinking
I’m not sure that even with my best
intentions I would have been able to see
this coming disease was winning this was
a turning point for me I remember
thinking I have got to be part of a
change now don’t get me wrong with every
year there it would be incremental
improvements in medicine but I have
never been a fan of increments it
occurred to me that the conventional
approach that we were taking was just
not working we were still missing out we
were still losing people so I knew I
wanted to be part of a different way of
thinking I started to wonder was it the
insurance model that was broken maybe if
we had more time with our patients we’d
be able to hone our disease detecting
abilities how could I know more and know
it sooner so I thought to myself maybe
I’ll try a different model I sort of
transformed my practice into a concierge
model where you end up seeing fewer
patients and spending more time with
them now it was definitely a more
gratifying way to practice I felt like I
actually could partner with my patients
to come up with a personalized plan for
their healthcare so after doing this for
about five years after enough different
things had happened I realized even
though it was a better way to practice
my tools were still the same
fast-forwarded 2015 a team of scientists
and physicians were going to prototype a
precision health lab in La Jolla leading
the team would be none other than J
craig Venter the scientists responsible
for sequencing the human genome
the testing would include whole body MRI
whole genome sequencing and a host of
other technologies it would be called
the health nucleus and the focus would
be early detection and risk prediction
with the goal of extending the healthy
human lifespan this testing would
provide details of human health down to
a molecular level the testing would
include stool microbiome metabolomic s–
whole genome sequencing wait a second
this was the opportunity I had dreamt of
so I joined the team at human longevity
in 2015 which meant closing the doors of
my medical practice now I was like a kid
in a candy store I’d no longer had to
beg insurance companies for ordering the
tests that I thought were necessary I
was able to get access to a wide range
of information for my clients it really
allowed us to practice a more proactive
rather than reactive approach and you
didn’t need a doctor’s order an
individual could decide if they wanted
to be empowered with this information
the testing would include whole genome
sequencing which would allow us to
understand genetic predispositions to
diseases like heart disease cancer and
other conditions like Alzheimer’s whole
body MRI would allow us to detect small
brain aneurysms early stage cancers
sometimes more advanced cancers sadly
and also even metabolic conditions like
fatty liver stool microbiome testing
would allow us to look at all of the
inhabitants of our GI tracts some of
which might be associated with disease
now let me give you an example of how
this type of proactive testing works
there’s a patient that stands out in my
mind she was a 44 year old woman I’ll
call her Rebecca she was at the Health
nucleus as part of a corporate group she
was pretty diligent about her health
maintenance she would have annual
mammograms pap smears every other year
she exercised about three days a week
and then I’d say her diet was pretty
clean overall
as part of our testing protocol anyone
over the age of 35 would receive a
coronary calcium score and Rebecca was
included in that bunch I remember sort
of being surprised when I saw her
results not even a little surprised
really surprised it turns out that her
calcium score was very elevated placing
her at the 95th percentile for risk for
her age
this meant that over the next ten years
her risk of a cardiac event was
approaching 25% so when I had to sit her
down and review these results with her
she was shocked heart disease was not
even on her radar she didn’t have any
risk factors that she was aware of and
she was certainly not having any
symptoms if she had gone to her regular
doctor’s visit it’s really unlikely that
she would have had this test as part of
her armamentarium she didn’t really meet
any criteria for it a look at her
genetics did reveal that she was at
higher than average risk for heart
disease a deeper look under her genome
showed us that she was actually a pretty
poor candidate for statins which we all
know is one of the mainstays of
prevention of heart disease I consulted
a friend who’s a cardiologist and
referred her over he felt that she would
be an excellent candidate for an
injectable drug called repatha which is
a very potent inhibitor of cholesterol
production that combined with her desire
to really get motivated now and change
her habits so she reduced her alcohol
intake increased her exercise these were
the kinds of tools that I dreamt of
sharp and precise tools to help us all
guide our treatment for our patients and
to help our individual patients to live
longer healthier lives for just a second
I remember being transported back to dr.
P’s case what if I had had this kind of
knowledge would he still be here now the
beauty of this approach is that for each
of the patients that chooses to go
through this testing we gather a really
large volume of data the challenge of
this approach is that we gather a really
large volume
data so currently all of this
information is reviewed by a team of
geneticists Byron fermentations
radiologists internist like myself and a
summary of all that is created now as
powerful as that brain trust is I really
believe that will be machine learning
that allows us to make more rapid
analytical decisions and change the face
of human health now today this type of
testing is not covered by insurance
it’s an out-of-pocket expense but I
believe that as we’re able to show
better outcomes and longer lives with
higher quality this will become a more
routine way of thinking about health
maintenance so while today we’re able to
actually look at every single letter of
someone’s genetic code it still shocks
me that we still only understand what
about 2% of the human genes actually do
but as science advances and we make more
correlations between DNA and health it’s
my belief that with your genome and the
database you’ll receive continual
updates so you can understand more about
yourself and your health this takes
knowing more and knowning it sooner to a whole new level thank you
attending this TEDx talk you might live
a longer and healthier life
but stay tuned I’ll come back to that
for as long as I can remember I have
wanted to change the world as a kid I
can still remember my nightly ritual
reading under the covers of the
flashlight while making lists of things
like how to end world hunger by the end
of eighth grade when most of my friends
were relishing the summer before high
school I went to my parents and
announced that I wanted to go to college
not in three years but this year you see
it occurred to me that I really did want
to change the world and I wanted to get
started right away so the plan was clear
now I knew instinctively I couldn’t
change the world alone my dream was to
be part of a team of people who shared a
big vision and so my plan was the
following skip high school go to college
and then med school now my parents were
both educators and so they were
supportive of my plan if you can figure
out how to do it honey
we’ll help you queue the obstacle course
of standardized testing hurdles first
the graduate equivalency diploma test
then the California achievement test
then the SAT and finally the a CT with
all those behind me I was admitted to
the class of 1991 at Southeastern
Louisiana University in my home town of
Hammond Louisiana the only
non-negotiable for my parents I would
have to join a social club before the
end of my first year so as to avoid
being a complete weirdo
no problem I was off to the races
and I was just giddy that the universe
actually understood my plan now college
was a blast I really was lucky I ended
up with a group of really protective
friends who took me in under their wing
the summers I would spend on adventures
I remember the first summer I went to
NASA in Cape Canaveral Florida as part
of the space life sciences training
program there I was part of a team that
was assigned the task of designing an
operating room in zero-gravity that was
pretty crazy stuff for my 16 year old
self the next summer I spent at Michael
DeBakey summer surgical program at the
Baylor College of Medicine and there my
task was to be part of a team that got
to design surgical innovations for
issues that would come up repeatedly so
somehow by some miracle I managed to get
a seat at the table with these really
smart people trying to solve big
problems those four years of college
sped by and then it was off to LSU med
school in New Orleans and there comes a
time I remember during the fourth year
of med school after you’ve rotated
through all the different specialties
when you have to decide the path you’re
gonna take for residency that will
ultimately determine your career
direction well I loved every single
specialty this was kind of a problem
general surgery dermatology psychiatry
cardiology you name it so I remember
talking to my mentor and she encouraged
me maybe the best thing was to keep all
my doors open so internal medicine
seemed to be the most logical choice my
next stop would be Scripps Clinic Green
Hospital just down the street from here
for another four years of learning from
really talented physician scientists so
now the year was 1999 and I was lucky to
be offered a staff position to stay on
at Scripps Clinic and start my practice
so between making diagnoses sometimes
big mostly small I got to play the role
of marriage counselor accountability
coach and cheerleader
my tribe of patience and I grew to love
them as people and in turn my practice
grew quickly I really was committed to
helping prevent disease in my patients
but like any new job there were
challenges and one of my biggest
challenges was having to be at the mercy
of insurance companies when trying to
decide what treatment or testing was
best for my patients that first year of
practice I had my head down seeing
patients and I heard that a team of
scientists did something that I couldn’t
even believe possible they sequenced the
human genome I was blown away by this
accomplishment what would this mean to
humanity would this change our ability
to help people to personalize their
treatment would people live forever I
was mesmerised by this so I remember
thinking god this could be a really
interesting tool in my toolbox well then
something happened something that
changed me and my direction forever when
you go into practice at the same place
that you do your residency inevitably
you’ll come to care for a colleague or a
former professor and so it was that I
came to care for one of my very favorite
professors I’ll call him dr. P he was a
kind and gregarious man in his early 60s
a true humanitarian he would spend every
summer in the Philippines caring for
underprivileged kids well when we were
residents he always had time for us and
now that I was his colleague I was
determined to return his kindness I
remember seeing him in the stairwell one
morning that December he called up to me
hey Pam I’ll be in to see you in a
couple weeks it’s my new year’s
resolution to get a physical so I
remember being pleasantly surprised when
he actually followed through I got his
lab results on my desk nothing terribly
scary his LDL cholesterol was about 20
points higher than goal his blood sugar
was borderline I can still picture those
results on my desk with the pale pink
post-it note
in my own writing reminding me that he
would be in to see me on January the 5th
and then on New Year’s Eve on his front
doorstep he died of a heart attack
I was devastated my mind was flooded
with questions what if he’d been in to
see me the week before would I have
detected his risk would I have somehow
with my schools and my my skills and my
tools would I have been able to save him
I had to admit when I look myself in the
eye in the mirror I remember thinking
I’m not sure that even with my best
intentions I would have been able to see
this coming disease was winning this was
a turning point for me I remember
thinking I have got to be part of a
change now don’t get me wrong with every
year there it would be incremental
improvements in medicine but I have
never been a fan of increments it
occurred to me that the conventional
approach that we were taking was just
not working we were still missing out we
were still losing people so I knew I
wanted to be part of a different way of
thinking I started to wonder was it the
insurance model that was broken maybe if
we had more time with our patients we’d
be able to hone our disease detecting
abilities how could I know more and know
it sooner so I thought to myself maybe
I’ll try a different model I sort of
transformed my practice into a concierge
model where you end up seeing fewer
patients and spending more time with
them now it was definitely a more
gratifying way to practice I felt like I
actually could partner with my patients
to come up with a personalized plan for
their healthcare so after doing this for
about five years after enough different
things had happened I realized even
though it was a better way to practice
my tools were still the same
fast-forwarded 2015 a team of scientists
and physicians were going to prototype a
precision health lab in La Jolla leading
the team would be none other than J
craig Venter the scientists responsible
for sequencing the human genome
the testing would include whole body MRI
whole genome sequencing and a host of
other technologies it would be called
the health nucleus and the focus would
be early detection and risk prediction
with the goal of extending the healthy
human lifespan this testing would
provide details of human health down to
a molecular level the testing would
include stool microbiome metabolomic s–
whole genome sequencing wait a second
this was the opportunity I had dreamt of
so I joined the team at human longevity
in 2015 which meant closing the doors of
my medical practice now I was like a kid
in a candy store I’d no longer had to
beg insurance companies for ordering the
tests that I thought were necessary I
was able to get access to a wide range
of information for my clients it really
allowed us to practice a more proactive
rather than reactive approach and you
didn’t need a doctor’s order an
individual could decide if they wanted
to be empowered with this information
the testing would include whole genome
sequencing which would allow us to
understand genetic predispositions to
diseases like heart disease cancer and
other conditions like Alzheimer’s whole
body MRI would allow us to detect small
brain aneurysms early stage cancers
sometimes more advanced cancers sadly
and also even metabolic conditions like
fatty liver stool microbiome testing
would allow us to look at all of the
inhabitants of our GI tracts some of
which might be associated with disease
now let me give you an example of how
this type of proactive testing works
there’s a patient that stands out in my
mind she was a 44 year old woman I’ll
call her Rebecca she was at the Health
nucleus as part of a corporate group she
was pretty diligent about her health
maintenance she would have annual
mammograms pap smears every other year
she exercised about three days a week
and then I’d say her diet was pretty
clean overall
as part of our testing protocol anyone
over the age of 35 would receive a
coronary calcium score and Rebecca was
included in that bunch I remember sort
of being surprised when I saw her
results not even a little surprised
really surprised it turns out that her
calcium score was very elevated placing
her at the 95th percentile for risk for
her age
this meant that over the next ten years
her risk of a cardiac event was
approaching 25% so when I had to sit her
down and review these results with her
she was shocked heart disease was not
even on her radar she didn’t have any
risk factors that she was aware of and
she was certainly not having any
symptoms if she had gone to her regular
doctor’s visit it’s really unlikely that
she would have had this test as part of
her armamentarium she didn’t really meet
any criteria for it a look at her
genetics did reveal that she was at
higher than average risk for heart
disease a deeper look under her genome
showed us that she was actually a pretty
poor candidate for statins which we all
know is one of the mainstays of
prevention of heart disease I consulted
a friend who’s a cardiologist and
referred her over he felt that she would
be an excellent candidate for an
injectable drug called repatha which is
a very potent inhibitor of cholesterol
production that combined with her desire
to really get motivated now and change
her habits so she reduced her alcohol
intake increased her exercise these were
the kinds of tools that I dreamt of
sharp and precise tools to help us all
guide our treatment for our patients and
to help our individual patients to live
longer healthier lives for just a second
I remember being transported back to dr.
P’s case what if I had had this kind of
knowledge would he still be here now the
beauty of this approach is that for each
of the patients that chooses to go
through this testing we gather a really
large volume of data the challenge of
this approach is that we gather a really
large volume
data so currently all of this
information is reviewed by a team of
geneticists Byron fermentations
radiologists internist like myself and a
summary of all that is created now as
powerful as that brain trust is I really
believe that will be machine learning
that allows us to make more rapid
analytical decisions and change the face
of human health now today this type of
testing is not covered by insurance
it’s an out-of-pocket expense but I
believe that as we’re able to show
better outcomes and longer lives with
higher quality this will become a more
routine way of thinking about health
maintenance so while today we’re able to
actually look at every single letter of
someone’s genetic code it still shocks
me that we still only understand what
about 2% of the human genes actually do
but as science advances and we make more
correlations between DNA and health it’s
my belief that with your genome and the
database you’ll receive continual
updates so you can understand more about
yourself and your health this takes
knowing more and knowning it sooner to a whole new level thank you
Please follow and like us: