MBA vs MD: What Octopuses, Gut Bacteria, and Outer Space Stem Cells Reveal About Control

[music] [laughter] >> And so, gosh, I'm laughing because I had no idea when my audio had started recording and I was about to say something really obscene and thankfully I looked up and saw the number was counting down and it was a one. >> [laughter] >> That's the way you got to do it, man. I want to catch you off guard sometimes. >> Dude, I am just I'm always off guard and I'm fine with it.

>> Yeah, [snorts] yeah, I mean, you know, one of our friends was making fun of me today for You know, but he's part of the book club, too. I mean, it's it's not like >> Yeah, he's one of the most one of the most prolific members, but you know, that's the thing. You got to you got to throw some ridicule in there. >> Yeah, you know, you know, you got to be able to take jokes and give jokes. Some people just know how to, you know, joke around, but they don't take jokes back.

But, um you know, uh it is interesting this book we read. Wasn't a big fan of it initially, but I think the discussion >> You were you were on it initially, but it was good discussion. >> I think that it led to some good discussions about moving the cheese, you know. The book was called Who Moved My Cheese. >> Yeah.

>> When I read the book, I was like, you know, I just, you know, did not you know, I think the whole idea and the premise was good, but I didn't really enjoy reading the book as much, but I think the book club discussion on it was pretty good because everyone had different views.

There's people on different stages of their lives and different different professions and careers and everyone had different views and and and everyone had different ideas of what moving the cheese means, and I think that was a good discussion. >> Yeah, and you know, if any listener hasn't read it, I mean, it's a very short, easy read. It's like not even 80 pages.

Basic premise is your cheese is whatever your goal is, what you're looking for, and if it moves by some external force, I mean, what are you going to do? Cry about it, or you're going to adapt? I mean, that's basically in very short, simplistic terms, kind of the thesis of the book. Um promoting adaptation, promoting anticipating and acting on change. And it it really did spark an interesting discussion about you know, how we should behave in our lives, in our careers, uh because change happens.

Like things happen that are outside of your control. A boss makes a decision, a manager makes a decision that you don't like. A new workflow is enacted that you just have to utilize. You know, all of these things that are from the so-called higher-ups, the system around you, the corporate entity around you. Uh it was very interesting hearing different people's perspective, cuz a lot of us, you know, we're some of us are doctors, some are in uh business, some are finance, some are engineers.

Um so, I thought it was really cool hearing the perspective, cuz I've never worked in corporate America, you know? So, seeing that side and how people deal with the corporate structure and issues like that was very unique. I I enjoyed that.

>> Yeah, I mean, you know, and it wasn't it's it's kind of like the idea that who moved the cheese and is is the cheese getting moved from the central location, the central power that's moving the cheese, like your manager, or sometimes the cheese can be moved from, you know, somewhere supernatural, from God, or from a disaster, something where something happens to you, and those kind of discussions, you know, led a lot of people to do some deep diving into their own careers, and there's this one discussion, this heated debate we had a little bit, was, you know, how in hospital systems sometimes people who make decisions sometimes are not there, are not part of patient care, right?

They're these people who are making decisions centrally, they're enacting a policy, enacting a uh certain agenda based on Medicare um reimbursement protocols now, or whatever of great idea they had, they want to enact protocol, and they in the end they they their protocol that is it goes downstream on the patient level, and the physicians have to deal with it because it doesn't make sense to a lot of physicians why this manager who's never seen a patient is is making this decision that he has no idea about, and and the realities on the ground are different, right?

When physicians, the case managers, the nurses, the physical therapists, dieticians, the pharmacists on the floor level of the hospital are dealing with a with a patient, the dynamics are very different than what's happening in the C-suite. And something from the C-suite might seem very very um applicable or useful or good for the bottom line, but at the patient level, on the ground level, it might not be the most ideal thing. And where how do we reconcile that in in today's age?

>> Yeah, I mean, when decision-making and a workflow is enacted in a very top-down manner, I mean, it eliminates autonomy for the people that are on the front lines, but it also is a disconnect, like you're saying, Hamaya. Someone who comes in from a business background, but is not clinical at all, has never actually taken care of and listened to a patient, understood, parsed out what they're saying, come up with a diagnosis and a treatment plan, and then done it.

If you haven't done that workflow, you really have no clue how to handle patient care. You really have no [snorts] clue like what works, what doesn't in a clinic. Yet, somehow you are the people that are making those decisions. You are the people that are telling the actual frontline workers, the nurses, the doctors, the PAs, all of that, how to do your job, how many patients to see, what is the adequate utilization of DME resources, how many patients to give a splint to in clinic.

You know, all these different examples, which to us, to me, to you, that seem ridiculous. Like, how can someone who has no clue about that stuff tell us how to do our practice? And that loss of autonomy, that like forced top-down approach, I think it like it leads to worse patient care and a lot of burnout. >> Yeah, so you know, it kind of reminded me of this um discussion about decentralized organizations, right?

I mean, the whole paper that we read or the whole this whole study that we read about the octopus and the how octopus has two-thirds of his neurons are in its arms, in its tentacles, or in its uh uh eight different arms and that's where the neurons are spread and each arm uh can do its own thinking and and and and do something autonomously. And and a lot of times it's coordinated from a central head, but the octopus centrally does not have uh that much brainpower.

I mean, there's only like 40, you know, like a 1/3 of the neurons are in the central brain, but most of the neurons are are peripherally and the each each each arm is working on its own and doing things that are needed. And they somehow do coordinate, but they're all uh useful on their own and can work independently.

Um and that's kind of that in that paper, that it kind of correlates the idea of octopus to an organization, how an organization should be structured in that way, too, where people uh who are closest to the job have a lot more control, a lot more autonomy, a lot more uh decision-making capabilities, but maybe be weakly coordinated from a central source, right? So, that was the interesting idea of comparing an organization to an octopus.

>> Yeah, and you know, I mean, I think it's pretty fascinating. I mean, for one, Humayun, check out this shirt, bro. I got Doctor Octopus right here. >> There you go. You You wore it for the right occasion. >> I came prepared. I mean, we just came back from Universal, but we uh but I think it was fitting for for the octopus paper. I actually didn't even think about it when I put this on >> [laughter] >> this evening.

It just happened and I I'm like looking at myself in the video and I was like, oh, Dr. Octopus and we're talking about the octopus There you go. There you But yeah, I mean I think it's like first of all, it's amazing that the octopus has so-called like the nine different brains. Like the one actual brain and each of its arms are as autonomous and functional as if it had its own independent decision-making ability, yet they're coordinated together. It's almost like um I don't know.

It's kind of like in it or it makes me think of like military organization that you know, the overall military structure or even like a secret service, like a CIA structure. I mean, it's so contained and compartmentalized and everyone's hiding something from everyone, but the grand mission is still at least on paper and face value the same.

Protect the motherland, maintain superpower status, you know, neutralize threats, gain information, but each of these little subsections does their own thing, their own little I don't know, side mission or something like that that all collectively pushes towards the grand goal. I I think it's just interesting how there's not in organizations like that like the CIA or even the US military, there's not always like one central decision-making roadmap of like hierarchy.

It's kind of like splintered in a way with a unified mission. >> Yeah, I see a lot of that in uh in a lot of big pharmaceutical companies as well. Uh you know, a lot of these companies, you know, I do a lot of clinical trials and we interact with a lot of people from different companies and and a lot of them are designed in silos as well and their clinical research arm knows nothing about the sales arm uh and and the the development arm.

Every every single entity within that pharmaceutical industry is very separate and siloed. And sometimes for legal reasons, they're not even allowed to communicate with each other, right? For for example, the sales people are not allowed to know about any upcoming drugs or upcoming medications or what's going on with other medications as well that are ongoing in the in the development phase. So, they always are like, "Hey, I can't talk about it. I don't know about it.

You probably would have to talk to the medical science liaison, right?" And the medical science liaison has no idea sometimes what's going on and um you know, in terms of trial selection, right? They say, "Oh, yeah, we we just you know, see see meet with doctors and we think they're good sites, but we just submit your name and but we have no idea how study startup is done, how the study is implemented, how the study start >> So, and they really don't know even what's going on.

So, if you talk to them about an organization, uh they say, "Oh, yeah, we met with this person." They have no idea who that person is, but sometimes it's it's hard because you communicate you you know what's going on and there's a lot of bottlenecks and you can see that in one department what what's happening is slowing everything down, but they're not communicating with each other.

And so, I do think there's a there's a role for central coordination and role in a lot of organization where centrally someone has to coordinate from all and get information from all different sources and silos and but but also be able to coordinate so these arms don't tangle with each other and don't are not in each other's way, right?

>> Yeah, I mean, it's kind of like it's kind of like patient care, you know, in terms of like the physician and patient and the administration of care where the physician [snorts] in that setting acts like the central repository of coalescing information. You gather the laboratory values, you do your history and physical examination, you gather the imaging results that are taken at an outside imaging center. You know, you you put all of these things together.

You may refer them to another specialist for some information to come back to you. You put all of these pieces of the puzzle together that are acting and working independently. Like the patient shows up to get their MRI scan. The MRI scan is not liaising with you and communicating with you and talking with you. It just patient goes, they get it done. It's independent, it's done with.

They do it fully autonomously, but all of it gets brought back to you, and then you make the ultimate decision plan with the patient that hey, this is what we're doing. This is the treatment, and then you embark on it. So, I think in that setting it kind of acts almost like I don't know, more like a hub and spokes model where the patient gets out there all of this stuff, and then you bring it back together. >> Yeah. But, then our health care system is so fragmented, too, right?

Like, you know, sometimes patients see uh internal medicine doctor, and they order a bunch of labs, but and then they see me 3 months later, and there's no way for me to sometimes get those labs, get those results, and get those imaging studies. Sometimes the patient doesn't even remember what imaging studies and what labs they got. Uh and there's no communication centrally about the information.

You know, there's no central national nationwide EMR where the information is shared, and maybe sometimes the physician that saw it does not even have an EMR. Some physicians are still on paper charts. So, that information >> [laughter] >> that information doesn't get to you completely. Then you sometimes order the same studies, and and then you realize that oh, 2 months ago they had the the labs done, but you did again, and that just drives the cost.

So, sometimes these different arms not work you know, working independently can can be costly where uh you know, it does need a central direction, some central source of information. >> Yeah, it can be independent chaos in a way. Like, the octopus arms are fighting each other. I mean, like you're saying, the patients come so often, they've already had >> [snorts] >> an X-ray or CT scan of their shoulder or their wrist, but it was done at an outside hospital that I don't have access to.

There's no third-party portal, and the patient didn't bring their disk. I'm like, sorry. [snorts] I mean, either you go back, get your disk, and bring it on a later day, or we reorder the imaging study if you think you can't find it or it's too laborious, you know, and the redundancy and the waste the wasted time of the patient and myself to actually move forward in their care pathway. It it it's huge.

And you you mentioned like a central like EHR some repository or something nationwide that everyone could collaborate and access and it would just have everything is linked together. It would be so efficient. It'd be so nice, but obviously it would put too many of these independent EHRs and portals out of business. So I think like from the selfish financial side that these companies just don't have an incentive to collaborate and do that. >> Yeah. Yeah, so that makes you think, right?

I mean, independently a lot of on the smaller scale, right? At a local level uh organizations, people, you know, octopus arms they work very well for the information that's needed right there. My system works really well within my clinic. But when it requires information from all over uh and and and coordination, then being independent siloed is not ideal. So where is that limit in in hospitals and physician systems and practices?

How much control should be centralized and how much control should be localized, right? At what point uh you know, there there's this discussion we had that okay, you know, there there's there's a physician and not all physicians are equally skilled.

I mean, all physicians may have good intentions, but some there are bad apples in every profession and there might be a physician that's that's keeping keeping uh a physician keeping patients in the hospital for too long for billing purposes or, you know, doing treatments that are not really necessary and uh everyone around them is kind of following along cuz the physician's in charge locally and there's no one really checking on and at that point a central authority is somewhat needed. Hey, Dr.

So-and-so, why is this happening? Why is this happening so often? And uh why are you keeping patients uh, 5 days longer than standard standard stay? So, there has to there there needs to be a local uh, control, local autonomy, but at some point there needs to be some central control as well to kind of guide things and set a vision and set rules and keep people in check as well, right?

>> Yeah, I mean it's even even in like, you know, the founding of the of the United States uh, anniversary's coming up but like the three different houses of government the checks and balances between them that they each keep each other in check and prevent each other from overstepping or at least in theory ideally they should do that. Um, that's the same thing, right?

Like the judicial, legislative, and executive all work relatively independently but they have oversight and checking of each other so that they actually maintain as if it was a single entity, a single organiza- organism rather than just just splinter off and be your own independent thing. Cuz if there's no centralization in some way, some either oversight or control or checking in or coordination of in in some respect, you might as well not even be connected.

>> Yeah, well that kind of begs the question, right? With with how uh, fast the AI systems are growing, can AI be the central coordinator where things and uh, human decision-making and human thinking is very good at the local level where we're working in our silos and making decisions but uh, using artificial intelligence as a central coordinating system that's kind of guiding things or the other way around, right?

Locally we have a lot of artificial information where we're getting back and forth automations at a local level but centrally there's a human human that's kind of coordinating everything. >> Yeah, and overseeing maybe, right? >> You can it can go either way. It's hard to know where it will go and it will it'll have to be like who ends up being smarter in terms of how the world functions and how uh where the world is going.

Is it Is it going to be an AI overlord that's kind of coordinating all our actions and us working at a local level in a certain skill set that humans are needed for? Or will it be us kind of guiding AI agents in doing tasks locally for us? Uh and that kind of kind of ties in well with the with the octopus analogy as well, you know, will the brain be >> Right. >> centralized is will it be 60 60% AI 30% human or will it be uh 60% human 30% AI? Uh >> It's a good question.

It's a It's almost a scary question in a way. I mean, it's just I just see so many examples in real life, in my life, in the workplace, and historical examples, whenever you give up control, you give up decision-making ability, even if there's potential benefits of efficiency and all this stuff, giving up control and autonomy never leads to happiness. >> Yeah.

Well, that brings us to our next study that's kind of interesting as well where there's multiple studies uh you know, there's uh personally, I'm going to say I'm I'm I've been kind of a hater on remote work sometimes because uh remote work has been inefficient uh you know, and whenever someone's doing meetings, um you don't even know who's really participating in the meetings.

Everyone kind of has their teams on in the back and listening and doing some work on their computer while the meeting's going on and then someone will say something and they'll hear their name and they'll say, "Oh, wait, wait. Sorry, I was on mute. What did you say again? Uh what was that again?" >> forgot to turn my mic on. Sorry. It's like people say that all the time.

>> So, remote work has kind of brought in a little bit less engagement in a lot of ways, but and it's kind of made people disengage and maybe um you know, you know, the social skills and the social motivations of being at work has gone down, but it has decreased the amount of stress and increased sometimes productivity of people where uh when when they're working remotely, that commute time where they're spending 20 minutes one way, 20 minutes the other way, this adding 50 minutes of extra stress being in the car and then that's taken away and they can just get up, maybe take care of their kids, exercise, work out, and then then kind of focus on on work in in in blocks and maybe take a lunch break with their wife and then go back to work.

That's That's shown some improved uh you know, uh balance in their life as well where they people are less stressed and they're they're getting deeper sleep. So, that's kind of three studies showing improved sleep and improved sleep uh health uh when people are working remotely. >> Yeah, and you know, the the law the lack of a commute it makes a lot of sense, right? I mean, I think that study was like 8,000 patients. It's a pretty good study.

It It showed about 29, basically 30 minutes, 29 extra minutes on average that uh remote workers were able >> Yeah, it's and all the studies show it is when people got to choose when they can go in, when they can be remote is what improved their stress level and productivity.

It wasn't uh uh and I see a lot of utility for hybrid work where some days uh you know, people are going in and and and some people and then when there's meetings, they go in, they they take it some of them meet with clients and days they could work from home, they have the option to do that.

Like you have physicians, I think that's a way that's somewhere we can also kind of design our lives that way where there are days we can use as admin days where we can stay at home and work from home, you know, maybe do notes or imaging studies or you know, even do telehealth visits from home where we have that flexibility sometimes. It's very limited in our in our in our space where physicians are mostly not able to do remote work, but there's some specialties they can, right?

Psychiatry, there there's Yeah. Some for sure maybe maybe orthopedics, cardiology not as much and even then I do take days where like today was a day I had no patient interaction. Today was a day where I caught up with a lot of my work. My my office we had a lot of stress testing going on.

So I have to be in the office when stress testing is happening because you know patients are going through stress test so I have to be available but that's the time I used to do a lot of my admin work, a lot of my meetings, a lot of my research work, a lot of my um um you know uh personal things that I need to take care of and then afternoons I only do televists on Wednesdays now.

So that Wednesday afternoon I I I'm still at my computer doing televists and this is something I could have done from home maybe if I if I had a nurse practitioner or PA that could be monitoring the patients but I prefer to be here when the stress test is going on. That's why I work from my office.

Uh but some specialties can and I think there should be more more uh encouragement in doing that in in medicine where physicians who want to work from home some days like radiologists or psychiatrists or endocrinologist they should be able to.

I mean you know and that's kind of if there's a top-down manager that is coming in and wants all doctors to be in office no matter what and being sitting in their cubicles and writing notes there with a bunch of other doctors if that's what they want uh that's not going to be productive.

Giving the doctors autonomy of choosing their schedule choosing when they can come in, what time they want to start the clinic, what days they want off will always make for more productive physician, more productive nurse practitioner, uh provider, nurse, uh you know in my opinion. Yeah.

I mean I mean if a physician gets told that you can only spend 8.6 seconds per patient for the day and you have to see 35 patients in in this day and with each patient you can you spend maximum of this much time and uh please do not take too much time between rooms cuz that's how they these these MBAs design these schedules um a physician is not going to be happy. I mean a a patient's not going to be happy.

And at the end of the day the the the node where where you're trying to service that that that deciding factor is the patient, right? And if the patient's not happy, they're going to change and switch practices. They're going to a different doctor. And that's what happens so many times, man. I can't even tell you how many times it's happened where um there there's a lot of different practices in my area, cardiology practices, great physicians, great doctors, you know, and great people.

Some of these these are very smart people. I rely on them. I I reach out to them. I ask them to do some procedures for me. Um but their practices were they were private practice and then practices got overtaken by private equity groups or or hospital systems and their patients started coming to me because they said that they uh they were not happy anymore. Their service their practices changed. The quality of care changed. The staff changed.

Every every everyone that was uh there was not responding the way it was and the physician was not engaged as much. And you know, the I I've personally benefited from that cuz you know, my practice grew because because it's good for me. Good for me because a lot of the the those patients left and came to my practice. I mean, I don't like stealing patients from other doctors, but this is a patient choosing, right? >> Yeah. Yeah. I don't run this. Yeah. >> It takes a lot, man.

It takes a lot to maintain that kind of service level because and it takes me and some of more experienced staff to stay on top of things, right? When you hire someone new, they they they're they're nervous. They're learning. And they're just so stuck because they're told to do this this this because that's how it's easy to teach things in in processes and checklists, right?

A lot of the new staff, which is very new in the workforce, they're younger and they're trying to learn, and for them it's the checklist that they have to get through, you know, and for them they're they're they're nervous, too, and it requires someone who has more emotional intelligence, some some kind of human interaction skills for years and years that we build as physicians to kind of train them, right?

When But when when you're when a manager who's never even talked to a patient or taken care of patient is the one doing the training and doing the feedback, that gets lost a lot of times. And in my practice, it's me, and it's one of my, you know, lead nurses that is kind of has been with our practice for a while, and she has 20 years of experience.

She is the one who's who's kind of giving feedback on how to and she's doing it through her her interaction with patient and teaching the patients teaching the the staff how to do things, right? And me giving feedback constantly, "Hey, this patient's mad. Make sure you apologize. Make sure you tell them um this is why this happened.

Like make sure you communicate with them." Like And you have to be kind of paranoid about these things because it's my practice, and I'm the patient-facing person, right? I'm the one who's seeing a patient and um kind of getting that direct feedback because as you said, they talk to your doctors. I'm I'm their doctor, and they're going to complain to me. So so I have that sense to kind of make that change, but a manager who has no patient interaction does not talk to anyone.

Uh they don't care about that patient interaction as much. They care about the bottom line and the efficiencies and the process they've built. And that's kind of where things get a little difficult, where, you know, and the trainings trainings get a little worse, too. So um you know, it's uh the top-down approach can a lot of times, unless someone at the system level knows the details, um um you know, it doesn't work as well.

But sometimes, you know, like in our next example, uh something that that from the bottom up at the local level can dictate the whole organization, right? And that's another discussion we were having in the book club is what kind of impact does um entry-level or patient uh or public-facing employees have in the organization? And there's this interesting study about gut bacteria, right?

Gut bacteria is pretty much the only place that uh uh our gut is probably the only place that um is that's inside our body but is exposed to the outside world. Like there's there's no other part of our body that's really exposed to the outside world besides our skin, you know, uh besides the gut that's inside the body.

And there's an interesting study where they studied over 650 different gut bacteria and they they analyzed it in uh against uh you know, your lipids and triglycerides and A1C and body weight and BMI and they identified certain type of gut bacteria that were associated with were associated with better um metabolic outcomes, right?

Um so it was an interesting study which showed that the gut could have a report card where what kind of gut bacteria microbiome is present uh can dictate how your whole body reacts to food and other external resource sources. And then some of the gut bacteria that they identified were also they were more associated with more um plant-based food as well.

Um yeah, I mean you know, it's a known fact that you know, and and I see it in practice all the time where you know, you prescribe uh 50 mg of losartan to one patient their blood pressure just drops, you know. And then you you prescribe 50 mg losartan to another patient and they it doesn't even touch their blood pressure, their blood pressure starts going up. Patients respond to medications so differently even with GLP-1s, you know, with with with tirzepatide or semaglutide.

When you prescribe them some patients with just a 0.25 mg dose 2.5 mg dose they lose 10 lb in the first month. And you're like, "Wow, you're a super responder." Whereas some patients can get on the highest and the highest and highest dose and they don't lose weight. Uh what is really the reason that's happening? And I think uh your your gut microbiome has a has a lot to say to that, right?

There's There's two types of thing and I think we were talking about this before, you know, should we rely on statistics or calculus? Like, you know, I prefer calculus over statistics. Statistics takes in all the population and and only the known factors that are common between them and creates a percentage. This many percentage of patients lost this much weight on this medication, right? But then there's calculus, which is the known variables within your body.

And how those variables act and cause a certain change and uh outcome in in in in one particular person. And I think as science advances, I think we're going to get better and better not using as much of population health and journal statistics and and actually practice medicine with calculus where we understand a person's different different attributes, right? Their their body um composition. Their gut microbiome um and their you know, lymphatic activity of how the fluids are moving.

Um and and and their hemoglobin and and different different variables in their body and then we can uh we'll be better able to assess uh a a medication plan for them, right? Uh we'll be able to create a better treatment plan, more customized treatment plan for longevity. I think that's true true uh uh longevity treatment for the future rather than what we're doing right now with all these different hacks that people are promoting.

I think personalized medicine based on everyone's uh attributes is where things are going to go. And I think AI is going to play a huge role in that in identifying these factors and being able to uh find these patterns just like you know they were able to find 600 different bacteria and and match them with so many different variables and find patterns. What kind of bacteria, microbiome, what kind of body composition is better for this kind of patient? Um yeah. Yeah, it's exciting.

I mean, I can see, you know, having this this this device or what whatever kind of digital device we have in the future kind of constantly getting your data, you know, from your from your your your smart watch, from your Whoop band, from your Aura ring, from your um you know, glasses that have camera.

Um the Yeah, yeah, the Whatever Well, I'm just saying this if you you know, the weight scale in your house and the um you know, you know, the mirror that's that's watching you with you know, gathering data. There's they came up with a new machine which is, you know, um kind of powered by the Butterfly AI chip.

Uh it's going to be a whole body ultrasound that's going to define your body composition and within seconds, you know, your body's going to get submerged in a in a body of water and it's going to take pictures and within 15 seconds at the very low cost they'll be able to create an image of your whole body and kind of develop um do a full body ultrasound pretty much assess your liver liver fat, belly fat uh and amount of visceral fat as well and and kind of create a profile for you, right?

So, all Yeah, yeah, they just announced that I actually Midjourney. Midjourney is a company that uh came out and what they were doing is producing AI generated images and videos, you know, for a while uh and that's what people were using for they were putting in prompts and they were just creating pictures.

Now, everyone else gets got so good at it with Nano Banana and Chat GPT with their imaging capabilities, Midjourney kind of pivoted and became a medical imaging company and they use Butterfly, you know, the Butterfly ultra ultra sound. Yeah, they use their chips uh to power that and they created this this uh imaging um machine.

And what they're planning on doing is opening up different spas like spots around the country where they will have uh you can go in and get a whole body ultrasound composition scan and it'll be pretty it can be done pretty cheaply and within seconds, right? Within minutes, I think. Uh so, you know, those kind of imaging modalities and uh point ways to kind of gather data, you'll be able to create much more personalized care for each patient.

Um and and that's going to going to be more micro-level data that's dictating a big uh change in medicine, right? Unlike a top-down approach that's dictating what needs to be done, this will be from the patient point of view where patients at the bottom uh are providing their details as to us, right? Through their blood pressure machines at home or through these rings, we're getting that data and then giving back their care to them. And that's I'm excited about that.

I think that's where the change is going and a lot of people are scared about how AI is going to change medicine, right? And I I think uh a lot of doctors will learn how to move away from population journal data and move on to more personalized medicine based on each patient uh and their attributes. So, you know, that's and then we'll eventually move on to making stem cells and artificial hearts uh for each patient.

That kind of brings us to our uh yeah, our fourth story where, you know, it was kind of interesting. You know more about space, so, you know, maybe you should kind of introduce this topic Yeah, I mean, it's it's amazing and, you know, uh a lot of people kind of poke fun at the race to space.

A lot of these people are doing for the vanity and just to, you know, put their name out there, but you know, a lot of these breakthroughs, like a lot of this research that happens and some some of these projects oh, why are these people just growing random random stem cells in space, right? Doing these kind of projects could be expensive, but they lead to sometimes breakthrough discoveries, right?

You never know what kind of what kind of uh experiment, what kind of um you know, unusual thing that you're doing might lead to something amazing. A lot of the breakthrough treatments that we know have come in because someone was doing some out there experiment, right? Uh there's there's a device that we use in in uh cardiology. It's called OCT, and it's it's a device uh for uh imaging intravascularly and looking at the plaque and the plaque structure.

And initially, I mean, you know, it was OCT was done in in in eye in in in within the eye and the retina as well, but uh you know, someone thought that this could be done within blood vessels as well, and then they they uh cardiologists thought something that's being done in in the eye, and they they took that idea and brought that into cardiology and and created this device for a cardiologist as well.

So, a lot of times some some random technology, some random experiment can lead to some breakthrough discovery elsewhere, right? Um I mean, heart failure and heart transplant is is brutal on patients, right? Being on LVADs uh congestive heart failure being on five, six, seven different medications to maintain their heart failure, and their uh morbidity and mortality is so high.

Having a stem cell grow uh a cell uh heart tissue that will not reject be rejected by your body, and being able to either use to repair the heart into function well and getting rid of the scar tissue in the heart that's making the heart weak, or regenerating a new heart to be able to transplant it. Or kidneys, or even in leukemia treatment, right?

It could be huge for leukemia treatment where you could actually uh um allow patients to get those um uh healthy blood cells that they need instead of the the leukemia cells that run through the blood cell.

It can be break It was done Yeah, and it was done because someone decided to see, "Hey, what happens when you, you know, grow stem cells in space, you know, in the space station?" Um so, it's a lot a lot of exciting stuff, and I think that's where I have a lot of disagreements when people say that, you know, science uh you know, a lot of the research that's being done They make fun of the different things that a lot of these professors and PhDs are studying different labs across the universities, and they're having a hard time getting funding because NIH is underfunded, and and um they're not able to apply for grants, but uh because apparently their experiments do not seem as as efficient or as profitable in the future, but science doesn't always have to be profitable or efficient.

It has to be finding an answer that we don't know, and once we find that answer, we can apply to many different fields and find find breakthroughs and discoveries great discoveries for cancer and and heart failure and and bones and bones. All right.