Azra Raza: Can We Cure Cancer? How We (Mis)Treat Cancer, How We Can Do Better, and Why We Must

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That is the question I really
came to answer.

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Here is my solution.
This is the cure for cancer I'm

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holding in my hand and the cure
is not in the syringe.

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The cure is in the needle.
Henry Ford said something very

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important 19/09.
He said if I asked my customers

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what they want, they would have
said a faster horse.

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Instead I gave them an
automobile.

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So I'm saying that the stentanyl
is a Concorde in the time of

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horse carriages.
Azrick, your work as an

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oncologist, as a medical
professional, it's incredible

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and you've done so much in the
field.

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And your book is titled The
First Cell, which is a beautiful

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title.
And let's dissect that a bit.

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Why would you name a book The
First Cell?

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And for all those watching or
listening, this is about

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fundamentally about cancer,
something you've been

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fundamentally affected by
personally and in and in your

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work life.
In search for the first cell.

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Are we actually chasing
something far more human, a way

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to live wisely or die well?
And if you could redesign the

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entire Cancer Research apparatus
scientifically, ethically,

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philosophy, philosophically,
what would it look like?

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I think that's a great beginning
there actually, because to lay

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out right up front my concept of
the first cell is goes to the

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heart and soul of this whole
discussion that's about to come.

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In summary, the title The First
Cell and the Human Costs of

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Pursuing Cancer to the last is a
cry against human ego, pride,

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hubris, arrogance, thinking that
we can take something at end

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stage monstrous disease and
still be able to dissect

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everything, understand every
single generic change signalling

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pathway and reverse it and cure
cancer.

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So that is my concept that the
first cell is an idea where you

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don't wait for complexity to
develop and think you can solve

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it from that point on and rather
start at just trying to detect

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what is the first evidence of
that Wellness to illness

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transition.
Can we pick that up?

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That should be the earliest
consequence.

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And the second thing around this
concept of the first cell is

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those of us like you and me who
go to medical school, we really

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go to medical school with this
whole concept.

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This since whenever we decided
to go to Med school, the idea is

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go in and treat illness.
And so you automatically only

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think of treatment.
You don't think of finding it

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before it becomes treatment.
And so I'm actually challenging

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the entire Hippocratic Oath,
which is first, do no harm.

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Remember, that's how it begins.
I'm saying first preempt all

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harm.
That's the concept of the first

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thing, so.
It's a, it's a complete

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philosophical shift in thinking.
And I think when you look at

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society today, we're, we're
fundamentally, you can sort of

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see a change in, in, in this
entire world where people are

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looking at Wellness and trying
to realize that, look, when you

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wait for illnesses doesn't,
you're probably too late.

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And, and I think your work
encapsulates this perfectly.

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You're trying to make sure that
people understand that we cannot

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wait.
In fact, waiting is the problem.

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And, and as doctors today, we
shouldn't be focusing on

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treating illness.
It should be more about

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prevention and more about
looking before something occurs.

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With that said, Azra, how would
you define cancer?

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Again, that goes to the heart of
the thing.

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People think of cancer as a
genetic disease, for example.

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To me it is anything but,
because that is too reductionist

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to think the way I think of
cancer.

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And I'll give you an example of
a sand pile effect, which is if

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you start dropping sand grains
of sand one by one, they will

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make a pile and they will keep
forming a pile that becomes in

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the shape of a pyramid.
But then you drop 1 grain of

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sand and suddenly the pile
collapses.

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If you're looking for the
reasons for collapsing of the

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pile or this avalanche that
happened in the properties of

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the last grain of sand you
dropped, then you're completely

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mistaken because that last grain
of sand was no different than

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the rest of the hundreds of
thousands that came before it.

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The difference was in the pile
which had become unstable, which

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was under crisis.
And so the whole idea of cancer

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that appears is to me more, much
more of a systemic disease then

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it has been assigned credit for.
Because if you think of

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pancreatic cancer, very often it
will begin with something that

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over 150 years ago was named the
Trousseau sign, right?

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It's suddenly somebody will
present with a clot in their

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shin in their calf, sorry.
And so you are thinking clot in

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the calf.
Why would they have that?

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And they turn out to have
pancreatic cancer.

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So what is the systemic
reaction, this thromboembolic

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event that happened far away
from the organ of origin, It is

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a systemic illness and that we
are ignoring all of those

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things.
Second important thing about

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what's cancer, cancer is
directly the incidence of cancer

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is directly proportional to age.
For for instance,

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myelodysplastic syndrome, the
form of pre leukemia that I am

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an expert in the incidence is 2
per 100,000 at the age of 50,

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but at the age of 70 to 80 it is
80 per 100,000.

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So what has changed?
Aging.

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What is happening in aging?
Every system is becoming a

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little decrepit.
So it's a systematic systemic

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failure where that one last
grain of sand or one generic

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mutation could cause the whole
system to shut down.

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And those are called power laws,
where the crisis occurs in terms

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of power laws.
So I think this is the way I

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think of cancer.
This is the way I think of the

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first cell.
This is the way I think of the

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whole healthcare system that has
evolved to treat disease and

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illness and give yourself gold
medals and Nobel prizes for

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that, whereas ignoring
everything that is coming

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before.
Do you agree with me?

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I think you're absolutely right.
And there's, it's sort of, it

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sort of shows us our own
ignorance and the limits of

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knowledge.
I mean, do you think that our

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focus on late stage
interventions reflect a deeper

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failure in how medicine
understands and applies

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knowledge in general?
Well, of course you.

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Absolutely, Yeah, yeah.
I mean absolutely.

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Because the whole idea behind
behind medicine acquiring

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knowledge has been reduced to
mapping genes, identifying

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pathways, you know,
understanding the immune system,

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trying to really go into details
of of all kinds of microscopic

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events, etcetera.
But all that knowledge gives you

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power, yes, because knowledge is
power.

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But if that power is applied to
the wrong end of the treatment

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paradigm, then it can become
very dangerous and hurtful.

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And that, I'm afraid, is what we
are doing because all of that

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technology we are using to
define all these things should

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be applied to finding the first
cell and what has gone wrong at

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inception rather than waiting
and applying it at that stage.

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So here I feel there's a big
sort of big gap between all this

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mountains of petabytes of
knowledge versus using it

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wisely.
And what's the difference

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between knowledge and wisdom?
Simply, while knowledge is

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power, wisdom is using that
knowledge with empathy, with

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compassion, with mercy in your
heart.

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Because for God's sake, we are
doctors.

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We are supposed to help patients
and reduce their suffering,

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which doesn't just come with
disease.

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There are psychological traumas.
There's a whole violation which

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are not just psychic and
emotional and spiritual, but all

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kinds of violations.
So I feel like your question

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about this knowledge thing is a
very key question in medicine

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right now, because we are
accumulating mountains of

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knowledge, but at the wrong kind
of things, is what I'm saying.

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And using it badly, yes.
What do you think of that?

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Do you agree with me?
I think I do.

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And it's, it's not just, I mean,
within the Cancer Research

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field, you're right.
It's, it's, it's within

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medicine.
It's it's almost a cancer within

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medicine itself.
It's, it's ironic that that's

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exactly what's happening.
And you see this all the time

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with obesity, with heart
disease, all these typical

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illnesses that we know if you
could pre pre empt all of this,

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treat it as if it's always been
a thing that might occur.

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We can reduce risk so much.
We know that all the food that

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we it's processed to refine
carbs, all these negative

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aspects to reality, smoking,
alcohol, etcetera.

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It just doesn't stop.
But it's still so socially

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accepted and and it's and it's
become part of life in such a

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systemically infected way that
it's difficult to find the first

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cell and locate it and treat it
at this point.

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But for anyone who's not
familiar with your work and

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hasn't read the book, if you had
to describe the aim of finding

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the first cell and what that
entails, what that does, and how

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looking at it from this lens
would change the landscape of

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medicine, how would you express
this or explain it?

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That is the question I really
came to answer.

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Here is my solution.
This is the cure for cancer I'm

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holding in my hand, and the cure
is not in the syringe.

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The cure is in the needle.
What is in the needle?

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In the needle is a stent, like a
coronary stent.

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Literally.
A coronary stent was taken by

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two brilliant biomedical
engineers, Sam Shepherd and

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sorry, Sam Sia and Ken Shepherd
at Columbia University.

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And I've been working with them
for a decade on on this whole

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concept.
And what they did tab is they

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took a coronary stent and they
fabricated it with electronics.

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So they put 2 electrodes, 2
transducers and built in a

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little chip which is a computer.
And this tent is folded up, is

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present in this needle.
So this stent can be injected in

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your subclavian vein and it
stays there.

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And what it does is this is the
device, an implantable device we

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call the stentanyl.
Do you like the name Stent

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Sentinel?
Samsia came up with the name

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stentanyl.
So the stentanyl's job is

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literally to stay in your body
forever like a coronary stent

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and detect the first cell.
How does it do so well?

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The stent will create an
electric field between its two

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walls or in in its circumference
an electric field is created.

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Any cell that passes through the
electrical field is going to

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cause impedance of electricity
which is immediately recorded as

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a signal on the computer or chip
that is built onto the stent.

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So if a cell is small, it
creates a small signal which is

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recorded.
But we have shown that the first

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cell is a giant cell.
Think of it like this.

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If the largest white blood cell
is like 1415 microns in size,

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these cells can be 100 to 300
microns in size.

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Because our work has shown that
the first cell is really a

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hybrid combination of two cells
that fuse under stress.

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So think of it, this tent
sitting in your vein forever can

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detect, not only detect the
first cell going through,

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because it's a giant cell by
size and impedance of electrical

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current, they can program it to
electrocute that cell.

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This needle that you're seeing
and the stent in it has cost $50

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million, ten years of work just
to make the stent.

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So this didn't happen overnight,
but it is ready for prime time

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now.
What is my contribution to the

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stenton?
And my contribution is, OK, you

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guys make the stent and I'm
going to identify what we need

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to detect through it.
So in nine in 2015, that is

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exactly 10 years ago, I fit my
research lab with a filtration

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device and just started
filtering the blood of my

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patients who have pre leukemia
hoping to find the first

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leukemia cell.
I would just filter their blood

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and the first leukemia cell.
As you know blasts are larger

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than normal cells so I thought
by size.

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So we worked with a company from
France called Rare Cells who

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gave us their who did a
beautiful collaborative research

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project with us.
And after filtering hundreds and

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hundreds of patients, we started
finding, we saw that there are

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these giant cells.
What are they?

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And when I we went to look into
the literature, it turns out

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that people who have been
working in the area have found

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that every single person with a
solid cancer, whether the cancer

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is in the brain, in the ovaries,
in the lungs, in the liver,

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these giant cells are found
circulating in the blood and

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they are associated with relapse
and recurrence.

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So we also started finding these
giant cells.

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So while the biomedical
engineers made the stent, we

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found the cells.
And now I have been collecting

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tissues of blood, saliva, bone
marrow, biopsies, everything on

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my patients since 1984.
Today I have the largest tissue

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00:16:05,680 --> 00:16:11,360
repository in the world of
patients whose samples have been

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saved longitudinally as they go
through natural histories of

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00:16:15,680 --> 00:16:19,360
their cancer.
And so I have this entire tissue

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00:16:19,360 --> 00:16:22,320
repository.
Of course, I published hundreds

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00:16:22,320 --> 00:16:27,800
of papers studying smaller
numbers of samples from here and

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00:16:27,800 --> 00:16:32,480
made important biologic
insights, but I've always saved

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00:16:32,480 --> 00:16:35,640
extra samples from every single
sample.

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00:16:35,640 --> 00:16:39,680
I take that ultimately when the
multi omics technology, when the

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00:16:39,680 --> 00:16:42,680
right technology comes along, I
want to have all the samples to

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00:16:42,680 --> 00:16:47,320
go and find the biomarkers.
So basically my idea is

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00:16:47,600 --> 00:16:51,680
revolutionize early detection to
cure cancer.

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00:16:51,680 --> 00:16:55,400
Don't wait for cancer to become
the end stage disease and try to

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00:16:55,400 --> 00:16:57,440
treat it, which has failed for
50 years.

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00:16:57,440 --> 00:16:59,840
You've been trying.
You haven't succeeded very much

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00:17:00,840 --> 00:17:04,280
except occasional successes.
By and large, if you have stage

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00:17:04,280 --> 00:17:09,720
4 cancer, mostly you die.
So the idea is to cure cancer,

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00:17:09,720 --> 00:17:14,520
revolutionize early detection.
Early detection means you since

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00:17:14,520 --> 00:17:18,240
no age is immune from cancer,
you need to have detection

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00:17:18,240 --> 00:17:23,359
available from birth to death.
And since cancer is a silent

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00:17:23,359 --> 00:17:26,680
killer, it can come anytime.
You can't afford to do the test

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00:17:26,680 --> 00:17:28,720
once a year or once every six
months.

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00:17:28,720 --> 00:17:32,920
You got to have continuous
monitoring of some your body

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00:17:32,920 --> 00:17:38,560
like treat the body as a machine
and just monitor for everything

252
00:17:38,560 --> 00:17:46,520
you possibly can continuously.
So this tentanyl tab can scan

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00:17:46,560 --> 00:17:51,160
the entire 5 liters of blood
that will pass through the stent

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00:17:51,160 --> 00:17:55,000
every 18 days.
So every 18 days, once the stent

255
00:17:55,000 --> 00:18:00,640
is in, we are finding the first
cell and electrocuting it right

256
00:18:00,640 --> 00:18:03,360
there.
Could you imagine a better

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00:18:03,360 --> 00:18:07,360
paradigm for any disease?
And the Stenton will be able to

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00:18:07,360 --> 00:18:11,040
detect dementia any, any
biomarkers, Because the

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00:18:11,040 --> 00:18:15,240
biomedical engineers, Ken and
Sam are so brilliant, they have

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00:18:15,240 --> 00:18:21,080
used this small molecule field
electronics transistor

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00:18:21,080 --> 00:18:25,640
technology also to detect small
pieces of protein, small pieces

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00:18:25,640 --> 00:18:29,120
of RNA, small pieces of DNA, not
just large cells.

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00:18:29,120 --> 00:18:33,920
They can do all of this now.
So any disease is going to shed

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00:18:33,920 --> 00:18:38,280
its own unique biomarkers, pick
it up early and boom, take care

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00:18:38,280 --> 00:18:41,480
of it right there.
That's my paradigm.

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00:18:42,160 --> 00:18:43,880
Do you like?
I love it.

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00:18:43,880 --> 00:18:46,920
It's pretty incredible when you,
when you look at this, you

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00:18:47,480 --> 00:18:49,360
firstly, I have many questions
come to mind.

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00:18:50,120 --> 00:18:53,320
One would be when you saw Ken
and Sam's work, at what point

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00:18:53,320 --> 00:18:54,760
did you guys first start
collaborating?

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00:18:54,760 --> 00:18:57,200
When did you realize you're onto
something with the stentanyl?

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00:18:57,640 --> 00:19:00,120
And the other thing is how's the
reception been when you look at

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00:19:00,400 --> 00:19:03,280
current oncologists and the
community, the scientific

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00:19:03,280 --> 00:19:05,920
community, how's that been with
the reception?

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00:19:09,000 --> 00:19:13,600
So how long?
Well, when I started to do the

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00:19:13,600 --> 00:19:18,520
filtration on my patients 10
years ago, I also looked to see

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00:19:18,880 --> 00:19:22,520
who can I work with in terms of
biomedical engineers.

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00:19:22,520 --> 00:19:26,280
And at Columbia, Sam Sia had
come from MIT and he had

279
00:19:26,280 --> 00:19:30,760
established he, he was there for
seven years when I discovered

280
00:19:30,760 --> 00:19:33,600
him.
And he had formed this thing

281
00:19:33,600 --> 00:19:38,560
called Lab on a Chip.
So I looked into the Columbia

282
00:19:39,120 --> 00:19:43,560
biomedical guys and I sought him
out and I went and met him.

283
00:19:43,840 --> 00:19:47,240
And in fact, he has written part
of the thing in, in my book is

284
00:19:47,240 --> 00:19:50,480
by him and about him.
I've written about him and about

285
00:19:50,800 --> 00:19:53,920
this whole concept of doing
things with him.

286
00:19:54,360 --> 00:19:57,680
So the book was published six
years ago already.

287
00:19:57,680 --> 00:19:59,640
So I had been working with Sam
for a while.

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00:19:59,640 --> 00:20:02,280
So practically 10 years we've
been working on it.

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00:20:03,240 --> 00:20:07,480
And as I said, it has taken $50
million, ten years of work.

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00:20:07,480 --> 00:20:09,520
It's a lot of stuff gone into
it.

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00:20:10,040 --> 00:20:15,800
We didn't know what we are going
to develop as we were working in

292
00:20:15,800 --> 00:20:19,520
our respective labs.
But then our things kept coming

293
00:20:19,520 --> 00:20:22,840
together.
And as I'm developing these

294
00:20:22,840 --> 00:20:25,360
markers, I don't want to test
for them once a year.

295
00:20:25,480 --> 00:20:27,760
I don't want to test for them
once every six months.

296
00:20:27,760 --> 00:20:31,200
So we keep talking about and
developing these similar things.

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00:20:31,960 --> 00:20:38,080
How has the reception been?
You know, for 40 years I have

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00:20:38,080 --> 00:20:42,520
been saying the same thing,
which is early detection and

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00:20:42,520 --> 00:20:46,080
prevention.
No one can accuse me of being

300
00:20:46,080 --> 00:20:50,640
inconsistent.
Please go back 40 years in my

301
00:20:50,640 --> 00:20:52,880
career and look at any of my
papers.

302
00:20:53,360 --> 00:20:58,000
My point was I started by
treating acute myeloid leukemia

303
00:20:58,400 --> 00:21:01,280
immediately.
Within a few years it was clear

304
00:21:01,280 --> 00:21:04,680
to me that in my lifetime this
deadly disease won't be cured.

305
00:21:04,680 --> 00:21:08,280
So I asked myself, what's a good
news we can give a cancer

306
00:21:08,280 --> 00:21:10,320
patient when we tell them their
diagnosis?

307
00:21:10,320 --> 00:21:12,400
Only good news is we found it
early.

308
00:21:13,760 --> 00:21:15,720
So how do you find leukemia
early?

309
00:21:15,720 --> 00:21:18,520
Because by the time you diagnose
there are hundreds of millions

310
00:21:18,520 --> 00:21:21,600
of cells all over.
So I said the only way to find

311
00:21:21,600 --> 00:21:26,560
it is find people who are at
risk of getting leukemia.

312
00:21:27,280 --> 00:21:30,840
And very quickly I found there
are those patients who they are

313
00:21:30,840 --> 00:21:34,000
labeled as pre leukemia or
myelodysplastic syndrome.

314
00:21:34,000 --> 00:21:40,640
So in 1984 I turned my entire
focus to MD's pre leukemia and

315
00:21:40,640 --> 00:21:43,560
following these patients as they
develop leukemia.

316
00:21:44,960 --> 00:21:48,640
So I have been saying this
constantly.

317
00:21:48,880 --> 00:21:54,360
Everyone I speak to, I give tons
of talks and podcasts and

318
00:21:54,360 --> 00:21:56,600
written a book.
I mean I'm trying everything

319
00:21:56,600 --> 00:21:58,440
possible.
People listen to me and say,

320
00:21:59,120 --> 00:22:02,120
yes, we know that early
detection is early, but the

321
00:22:02,120 --> 00:22:05,680
money, the grant money is in
finding this or establishing

322
00:22:05,680 --> 00:22:09,840
this model.
So why aren't you studying human

323
00:22:09,840 --> 00:22:12,000
samples?
Because the money is all in

324
00:22:12,000 --> 00:22:17,080
mouse models.
It's such a travesty that 2

325
00:22:17,080 --> 00:22:21,680
million patients, new patients,
are diagnosed with cancer every

326
00:22:21,680 --> 00:22:26,240
year. 2 million and a few
thousand samples are saved by a

327
00:22:26,240 --> 00:22:29,800
couple of researchers.
No one thinks of saving samples.

328
00:22:29,800 --> 00:22:32,600
Why?
Because they have developed this

329
00:22:32,600 --> 00:22:37,920
delusional system that's taking
human cells, putting them into

330
00:22:37,920 --> 00:22:42,560
some damaged immunocompromised
mouse or some Petri dish and

331
00:22:42,560 --> 00:22:46,240
treating it and developing a
treatment is going to work well.

332
00:22:46,240 --> 00:22:52,320
95% of those are still failing
today, those preclinical testing

333
00:22:52,320 --> 00:22:56,640
platforms that yields the
treatment strategies.

334
00:22:56,960 --> 00:23:01,080
The failure rate today of any
experimental therapy in cancer

335
00:23:01,360 --> 00:23:05,480
is 95%.
And the 5% that succeed, in my

336
00:23:05,480 --> 00:23:08,200
opinion, should have failed
because they're prolonging

337
00:23:08,200 --> 00:23:14,440
survival of 30% patients by 2.1
months and becoming financially

338
00:23:14,440 --> 00:23:18,880
ruined in the bargain because
the cost is 100,000 to more.

339
00:23:19,520 --> 00:23:24,320
Kartis cost $1,000,000.
I mean the whole system is so

340
00:23:24,320 --> 00:23:29,480
delusional, so sick and so
absurd that you would laugh

341
00:23:29,640 --> 00:23:33,080
unless it was tragically taking
human lives every day.

342
00:23:33,760 --> 00:23:37,560
To this day, I'm the one seeing
30 to 40 cancer patients in my

343
00:23:37,560 --> 00:23:40,760
clinic every week.
I'm the one on the frontline,

344
00:23:40,760 --> 00:23:44,480
I'm the one treating them.
So how am I going to face them

345
00:23:44,840 --> 00:23:49,240
and say that in 1977 I was
treating your acute leukemia

346
00:23:49,240 --> 00:23:52,760
with two drugs that we refer to
as seven and three, because

347
00:23:52,760 --> 00:23:55,400
seven days of Pharisee, 3 days
of Donomycin.

348
00:23:55,840 --> 00:24:00,360
Today in 2025, I have the same 2
drugs to offer you 7 and three.

349
00:24:00,960 --> 00:24:03,880
How shameful is it?
But people are doing it every

350
00:24:03,880 --> 00:24:06,720
day around me without even
thinking about it.

351
00:24:08,160 --> 00:24:12,880
So you tell me, what should be
the reception I would expect

352
00:24:12,880 --> 00:24:17,080
from this field that has treated
me so badly for 40 years?

353
00:24:18,640 --> 00:24:22,160
It, it's, it's disappointing,
but also exciting to know that

354
00:24:22,160 --> 00:24:26,240
you've, you guys have done some
groundbreaking work, even though

355
00:24:26,240 --> 00:24:29,040
the there's this tension.
I mean, I have one of my

356
00:24:29,040 --> 00:24:32,560
questions here was about hope,
honesty, and harm.

357
00:24:33,000 --> 00:24:36,040
How do you navigate the tension
between offering hope and being

358
00:24:36,040 --> 00:24:39,720
honest in the clinic, especially
when aggressive treatments do

359
00:24:39,720 --> 00:24:41,840
more harm most of the time than
good?

360
00:24:47,080 --> 00:24:53,240
Well, that question takes us to
a very important area that I'm

361
00:24:53,240 --> 00:24:56,560
interested in, which is what is
the difference between cure and

362
00:24:56,560 --> 00:25:01,280
healing?
For most of the time, we don't

363
00:25:01,280 --> 00:25:04,760
have cures for at least the
leukemias I'm treating, unless

364
00:25:04,760 --> 00:25:08,160
you send them to transplant,
which is possible for less than

365
00:25:08,160 --> 00:25:10,920
5% patients.
And the results of that are very

366
00:25:10,920 --> 00:25:14,200
horrible too.
So for most patients, the

367
00:25:14,200 --> 00:25:18,320
disease will take their lives.
And how?

368
00:25:18,960 --> 00:25:22,360
I mean, can you can imagine that
I've had thousands and thousands

369
00:25:22,360 --> 00:25:25,480
of these conversations
continuously with patients.

370
00:25:26,760 --> 00:25:30,760
So that's where you learn the
difference between cure and

371
00:25:30,760 --> 00:25:35,760
healing.
And the way I think of it is in

372
00:25:35,760 --> 00:25:39,440
terms of a couplet from Urdu,
which is my language.

373
00:25:40,600 --> 00:25:43,480
And I'll read the couplet
translate for you and tell you

374
00:25:43,480 --> 00:25:46,880
the meaning because you've asked
a profound question right now.

375
00:25:47,080 --> 00:25:52,080
This is not, cannot be answered
in some glib kind of way.

376
00:25:53,040 --> 00:25:56,680
Khalid, one of our greatest
poets, has a couplet that says

377
00:25:57,600 --> 00:26:04,360
Tawfiq Banda zei himmat hai
azelsi aankho mehe wo patra ju

378
00:26:04,360 --> 00:26:10,920
gohar nahuat.
Your success depends on your

379
00:26:10,920 --> 00:26:13,760
endurance.
How much can you tolerate?

380
00:26:13,760 --> 00:26:17,280
How much are you going to risk?
That's the first line.

381
00:26:18,280 --> 00:26:23,000
Endurance is important, but the
second line is so shocking.

382
00:26:25,800 --> 00:26:30,200
The teardrop in your eye is the
one that didn't become the

383
00:26:30,200 --> 00:26:33,360
Pearl.
And so when you connect the 2

384
00:26:33,360 --> 00:26:37,400
lines, let me explain it to you.
The 2 lines are connected by a

385
00:26:37,400 --> 00:26:43,200
concept in our poetry, which is
that if the seasons first rains,

386
00:26:43,640 --> 00:26:49,040
first few raindrops go into the
mouth of a clam, they become a

387
00:26:49,040 --> 00:26:53,800
Pearl.
So now Ghalib the poet is trying

388
00:26:53,800 --> 00:26:57,960
to console those raindrops that
were not the first raindrops of

389
00:26:57,960 --> 00:27:02,320
the first rain of the season
because now they have no chance

390
00:27:02,320 --> 00:27:05,560
of becoming a Pearl right by
definition.

391
00:27:06,200 --> 00:27:10,640
So Ghalib is telling them, think
of it, if you don't become a

392
00:27:10,640 --> 00:27:15,440
Pearl, you weren't lucky enough
to be the first raindrop, you

393
00:27:15,440 --> 00:27:20,400
now have a chance of becoming
that teardrop that comes out of

394
00:27:20,400 --> 00:27:24,760
the eye of a lover.
And how much more meaningful is

395
00:27:24,760 --> 00:27:27,640
that one teardrop compared to a
Pearl?

396
00:27:28,080 --> 00:27:33,240
So my point is, while cure is
that Pearl healing is that

397
00:27:33,240 --> 00:27:38,960
teardrop, that empathy, that
compassion, realizing that once

398
00:27:38,960 --> 00:27:46,560
there is no hope, then you can't
look a year in a ahead or even,

399
00:27:46,800 --> 00:27:51,960
you know, months ahead, then the
lack of hope becomes the driver

400
00:27:51,960 --> 00:27:56,680
for now, because suddenly you
can't hope to go forward.

401
00:27:56,680 --> 00:28:01,040
So now becomes important.
Everything you haven't done

402
00:28:01,040 --> 00:28:04,960
becomes more precious.
Every relationship you have not

403
00:28:04,960 --> 00:28:07,040
nourished, you need to do
something about.

404
00:28:07,520 --> 00:28:10,040
Suddenly you have a chance to do
all of that.

405
00:28:10,320 --> 00:28:14,120
So with my patience, while I'm
trying for the Pearl, the cure,

406
00:28:14,120 --> 00:28:18,480
I'm also offering the teardrop
the time with them.

407
00:28:18,800 --> 00:28:22,560
Presence rather than procedures
are as important here.

408
00:28:23,280 --> 00:28:28,000
Talking to them, helping them
navigate these last stages of

409
00:28:28,000 --> 00:28:32,160
their journey of life, helping
them reconnect with everything

410
00:28:32,160 --> 00:28:37,000
that they possibly can and have
to, and giving them not just

411
00:28:37,360 --> 00:28:42,200
false hope, but hope in other
things that's become very

412
00:28:42,200 --> 00:28:46,320
meaningful.
I hope that answers this

413
00:28:46,320 --> 00:28:48,920
question.
It does, I think it's it's it's

414
00:28:48,920 --> 00:28:52,400
a firstly, that is a very
beautiful couplet and the

415
00:28:52,400 --> 00:28:55,560
application of the way you've
brought that into the into this

416
00:28:55,560 --> 00:28:58,320
topic is also profound.
And it's a great way to sort of

417
00:28:58,320 --> 00:29:01,520
think of this and that.
Q are not being the the sole

418
00:29:01,520 --> 00:29:03,720
importance.
Do you think that capitalism and

419
00:29:03,720 --> 00:29:08,840
like within healthcare has
become the let's say, I mean, I

420
00:29:08,840 --> 00:29:11,120
don't like to this is
fundamentally A philosophical

421
00:29:11,120 --> 00:29:13,520
podcast, of course, and it's not
usually medical.

422
00:29:13,520 --> 00:29:16,080
But when I read through your
work and Mike Levin was the one

423
00:29:16,080 --> 00:29:18,320
who introduced us, who Mike's
been a guest on this channel

424
00:29:18,320 --> 00:29:20,200
many times.
And when I read through it, I

425
00:29:20,200 --> 00:29:22,880
figured that this if I'm going
to do something about medicine,

426
00:29:22,880 --> 00:29:25,480
it needs to have this deep
philosophical meaning behind it.

427
00:29:25,480 --> 00:29:27,920
And yours does.
And that's, and you've touched

428
00:29:27,920 --> 00:29:33,320
on that right now, this mind and
body connection meaning in, in

429
00:29:33,320 --> 00:29:38,480
your experience, how much have
you seen the impact of mental

430
00:29:38,480 --> 00:29:43,320
stress, mental states, grief,
resilience, and even people's

431
00:29:43,320 --> 00:29:46,640
perceptions of meaning affect
the course of their illnesses?

432
00:29:48,400 --> 00:29:54,040
A lot, hands down.
There is a lot of effect of how

433
00:29:54,040 --> 00:29:59,720
you are handling the disease
presence, mindfulness, how the

434
00:29:59,720 --> 00:30:04,600
journey becomes so much less
painful but has actual effect on

435
00:30:04,600 --> 00:30:08,280
the disease process.
In fact, because there are now

436
00:30:08,280 --> 00:30:15,320
many, many studies to show that
how these kinds of even

437
00:30:15,400 --> 00:30:19,320
breathing exercises, even
mindfulness that is practiced

438
00:30:19,320 --> 00:30:26,400
through meditation can improve
immune responses, can bring a

439
00:30:26,400 --> 00:30:31,040
more positive light for
everything.

440
00:30:31,440 --> 00:30:34,680
I mean, right now as you know
that our entire healthcare

441
00:30:34,680 --> 00:30:40,520
system is profit driven.
It is something where a patient

442
00:30:40,520 --> 00:30:43,880
has become a consumer and
illness is being treated as a

443
00:30:43,880 --> 00:30:48,360
market.
And to me, one of the most

444
00:30:48,360 --> 00:30:53,680
perverse results of this kind of
thinking is that all the

445
00:30:53,680 --> 00:30:55,680
negative studies are just
buried.

446
00:30:55,960 --> 00:31:00,240
They're not even talked about.
But the minor glimmer one

447
00:31:00,240 --> 00:31:04,480
patient responded out of 49
treated will become the anecdote

448
00:31:04,480 --> 00:31:07,800
that's talked about on every
international meeting stage.

449
00:31:08,560 --> 00:31:15,000
So I feel like this whole
revenue generating thing has has

450
00:31:15,000 --> 00:31:21,240
brought an absence of the real
physician role that we are

451
00:31:21,240 --> 00:31:26,680
supposed to play, an acceptance
of death and the necessity of

452
00:31:26,680 --> 00:31:30,160
walking people through death,
which is coming for all of us,

453
00:31:30,200 --> 00:31:34,040
is now conceived, considered a
defeat of failure.

454
00:31:34,600 --> 00:31:38,120
Well, death is not a failure.
Denying death is a failure.

455
00:31:38,600 --> 00:31:42,880
Accepting death and helping
people navigate this difficult

456
00:31:42,880 --> 00:31:48,280
journey is so important, not
just for mindfulness, but even

457
00:31:48,280 --> 00:31:52,000
for their disease that feels
less burdensome.

458
00:31:52,040 --> 00:31:57,320
Even if it is not being actually
help, which there are studies

459
00:31:57,320 --> 00:31:59,520
that show it can be actually
help.

460
00:31:59,520 --> 00:32:03,400
But I don't want to go out there
and have every scientist attack

461
00:32:03,400 --> 00:32:06,560
me and say, oh, she believes in
all this voodoo stuff of

462
00:32:06,960 --> 00:32:11,920
positive thinking, etcetera.
I think there's clearly things

463
00:32:11,920 --> 00:32:14,960
to be said for positive
thinking, yes.

464
00:32:16,400 --> 00:32:19,800
I I agree, I think that it's
very difficult.

465
00:32:19,800 --> 00:32:23,800
I mean, people want a quick fix.
They want they want the easiest

466
00:32:23,800 --> 00:32:27,200
option and sometimes the easiest
option is just not the answer.

467
00:32:27,560 --> 00:32:30,120
I mean, it takes, as you said,
endurance, effort, putting in

468
00:32:30,120 --> 00:32:35,000
the work, exercise, eating well,
diet, locating the first cell,

469
00:32:35,000 --> 00:32:38,680
which seems to be a task that
takes years, of course, to do.

470
00:32:39,240 --> 00:32:43,960
How in terms of the not, not, I
wouldn't say reception, but

471
00:32:44,520 --> 00:32:47,680
knowing that they could be
something so profoundly

472
00:32:47,680 --> 00:32:50,920
impactful like having this
device, the Stenton, having

473
00:32:50,920 --> 00:32:53,600
this, this piece of equipment
that can change the game

474
00:32:53,600 --> 00:32:56,640
completely.
Do you think that because of the

475
00:32:56,640 --> 00:33:00,040
profitable companies out there
that your work gets shoved down

476
00:33:00,040 --> 00:33:06,080
a little bit lower due to this
urge for money and and profit?

477
00:33:06,320 --> 00:33:09,320
Because I mean, it's not going
to be unless this product itself

478
00:33:09,320 --> 00:33:14,040
is sold as an expensive product.
Once we start finding cures and

479
00:33:14,040 --> 00:33:17,040
making this cheaper and easily
implementing it, it's going to

480
00:33:17,040 --> 00:33:21,480
drastically reduce costs over
time, which which wouldn't work

481
00:33:21,480 --> 00:33:24,680
with this current market.
Especially now knowing that

482
00:33:25,240 --> 00:33:28,520
within certain countries,
funding for Cancer Research has

483
00:33:28,520 --> 00:33:31,360
dropped significantly since
recent political developments.

484
00:33:33,880 --> 00:33:38,560
Yeah, well, the first idea I
have, I came from a third world

485
00:33:38,560 --> 00:33:42,800
country, I come from Pakistan.
And every year when I would go

486
00:33:42,800 --> 00:33:46,520
back to Pakistan, especially
when my parents were alive for

487
00:33:46,520 --> 00:33:52,080
the 1st 25 years, I've had to
see patients constantly because

488
00:33:52,080 --> 00:33:54,840
my mother would have a long list
of things of patients.

489
00:33:54,840 --> 00:33:58,080
I had to go visit and provide
free care to them.

490
00:33:59,120 --> 00:34:04,160
And it's such a it's almost
criminal to not democratize

491
00:34:04,160 --> 00:34:09,679
medicine, to develop therapies
that belong to only the very

492
00:34:09,679 --> 00:34:11,760
rich few.
Even in this country.

493
00:34:11,760 --> 00:34:16,639
We are just robbing patients.
Do you know that 42% of all

494
00:34:16,639 --> 00:34:21,199
people who are diagnosed with
cancer in America, 42% that's

495
00:34:21,199 --> 00:34:25,800
nearly half will become
completely financially ruined by

496
00:34:25,800 --> 00:34:30,199
the 2nd year.
So forget third world, we in the

497
00:34:30,199 --> 00:34:33,080
first world we are we have
brought the whole system on the

498
00:34:33,080 --> 00:34:36,520
verge of a collapse because of
our greed and hubris.

499
00:34:37,639 --> 00:34:41,120
But you know Henry Ford said
something very important

500
00:34:41,120 --> 00:34:44,040
nineteen O 9.
He said if I asked my customers

501
00:34:44,040 --> 00:34:46,920
what they want, they would have
said a faster horse.

502
00:34:47,080 --> 00:34:49,000
Instead I gave them an
automobile.

503
00:34:49,480 --> 00:34:54,280
So I'm saying that this fentanyl
is a Concorde in the time of

504
00:34:54,280 --> 00:34:59,600
horse carriages.
And you know, once, once my once

505
00:35:00,000 --> 00:35:04,440
the word processor came along,
who cares about the companies

506
00:35:04,440 --> 00:35:07,040
making typewriter ribbons?
Who cares?

507
00:35:07,040 --> 00:35:09,880
The whole system flipped
immediately by itself.

508
00:35:09,880 --> 00:35:13,360
That's what I'm saying.
Once this thing comes along, no

509
00:35:13,360 --> 00:35:17,240
matter how much of opposition
there is, it's going to flip the

510
00:35:17,240 --> 00:35:20,600
system because if you don't want
to use it here, Korea and

511
00:35:20,600 --> 00:35:23,200
Pakistan and China will start
using it.

512
00:35:24,240 --> 00:35:29,600
So I think that, and you know,
I'm not some defeatist, I hope

513
00:35:29,600 --> 00:35:32,400
that's very clear to you that
I've been fighting the system

514
00:35:32,400 --> 00:35:35,720
for 40 years and if anything,
I'm more energized every day

515
00:35:35,720 --> 00:35:38,560
because I'm refusing to stop
seeing patients.

516
00:35:38,920 --> 00:35:42,640
They are my real inspiration and
until I can help them, I'm not

517
00:35:42,640 --> 00:35:46,960
going to rest.
One of my favorite books is

518
00:35:46,960 --> 00:35:50,160
Thomas Kuhn, Structure of
Scientific Revolution.

519
00:35:50,160 --> 00:35:55,600
He published that in the 60s.
But the point he made it very

520
00:35:55,600 --> 00:36:00,360
true is that there is a paradigm
that exists at the moment.

521
00:36:00,360 --> 00:36:04,400
We tend to accept that paradigm.
Currently that paradigm in

522
00:36:04,400 --> 00:36:12,000
cancer is treat cancer with with
slash, poison or burn surgery,

523
00:36:12,000 --> 00:36:15,360
chemotherapy, radiation therapy.
That is our paradigm.

524
00:36:16,080 --> 00:36:20,520
So what is happening is that all
our resources are being pushed

525
00:36:20,520 --> 00:36:24,720
into developing and supporting
this paradigm, developing

526
00:36:24,720 --> 00:36:28,680
treatments for end stage.
The anomalies that appear, for

527
00:36:28,680 --> 00:36:32,960
example, the treatments you are
developing are failing 95% of

528
00:36:32,960 --> 00:36:34,520
the time.
They're being ignored.

529
00:36:34,840 --> 00:36:37,320
The negative studies are being
buried, right?

530
00:36:37,720 --> 00:36:41,840
So nobody wants to think that
I'm investing in a company that

531
00:36:41,840 --> 00:36:47,200
has a 95% failure rate, but
everyone wants to invest in that

532
00:36:47,200 --> 00:36:50,400
treatment paradigm and no one
wants to invest in this.

533
00:36:50,760 --> 00:36:55,480
I'm saying if I get $10 million
today, within 18 months, I'll

534
00:36:55,480 --> 00:36:58,640
have it in people.
How fast?

535
00:36:58,640 --> 00:37:01,920
How can you accelerate 18
months, for God's sake?

536
00:37:02,240 --> 00:37:05,560
But you know what?
I'm meeting total resistance.

537
00:37:05,560 --> 00:37:09,200
No Ezra, no early detection
devices.

538
00:37:09,200 --> 00:37:11,600
They're not.
They're not going to be funded.

539
00:37:11,600 --> 00:37:14,680
Nobody is interested.
Well, I said we have

540
00:37:14,680 --> 00:37:17,640
electrocuting technology.
It could be treatment also.

541
00:37:17,640 --> 00:37:21,000
Well, show us first.
Well, to get there to show you I

542
00:37:21,000 --> 00:37:25,280
need this money, of course.
So that's the point.

543
00:37:25,280 --> 00:37:28,560
And I'm not asking for $10
million because I'm out there

544
00:37:28,560 --> 00:37:31,600
with my begging goal.
You can invest it in a company

545
00:37:31,600 --> 00:37:35,280
that will support me, not my
company, but that will give the

546
00:37:35,280 --> 00:37:39,040
money for this.
So what I'm what the point I'm

547
00:37:39,040 --> 00:37:43,000
trying to make is that markets
have a nasty habit of flipping

548
00:37:43,000 --> 00:37:49,560
quickly and learning and
ditching their old masters.

549
00:37:49,560 --> 00:37:53,280
If they see that there is
profitability at this end now,

550
00:37:53,280 --> 00:37:56,040
they'll flip around completely.
So I'm not worried.

551
00:37:56,440 --> 00:38:03,120
And by the way, the stent right
now cost $8080 less than $100,

552
00:38:03,920 --> 00:38:09,520
so the insertion will take $5000
the procedure and every year you

553
00:38:09,520 --> 00:38:14,280
just have to pay a subscription
fee of $5000 because the data,

554
00:38:14,280 --> 00:38:17,960
petabytes of data every second
are being generated in a cloud

555
00:38:17,960 --> 00:38:23,600
over your head and AI analyse to
alert the system on your cell

556
00:38:23,600 --> 00:38:26,000
phone.
You will just get an alert on

557
00:38:26,000 --> 00:38:29,760
your cell phone saying a giant
cell has been delected and

558
00:38:29,760 --> 00:38:31,840
electrocuted.
Immediately, yeah.

559
00:38:31,840 --> 00:38:37,240
So yeah, so for 10 years you're
only spending $55,000.

560
00:38:37,360 --> 00:38:40,800
That's it.
For 10 years, 5000 a year and

561
00:38:40,800 --> 00:38:46,680
5000 for the insertion.
Compare that $250,000 where you

562
00:38:46,680 --> 00:38:51,240
have 30% chance of response and
770% chance that you will be

563
00:38:51,240 --> 00:38:53,640
damaged physically and
financially.

564
00:38:55,240 --> 00:38:57,400
Yeah, it's a it, you said it
wonderful.

565
00:38:57,400 --> 00:39:00,840
I mean, would we're drowning in
data but starving for wisdom.

566
00:39:01,400 --> 00:39:03,320
And you're right, we're stuck in
that Coonian science loop.

567
00:39:03,320 --> 00:39:05,360
And what that was one of my
questions for you at some point

568
00:39:05,360 --> 00:39:09,200
was are we, we're just busy
refining a broken model rather

569
00:39:09,200 --> 00:39:11,760
than searching for new
technologies and, and, and

570
00:39:11,760 --> 00:39:14,520
implementing them in a way
that's clearly more cost

571
00:39:14,520 --> 00:39:18,040
effective and far more
protective and preventative?

572
00:39:20,320 --> 00:39:24,200
Absolutely, I mean.
But Coon himself pointed out

573
00:39:24,200 --> 00:39:27,680
that the change will come when
there is a crisis in confidence

574
00:39:28,760 --> 00:39:31,680
that people are, you know, there
are a lot of billionaires in

575
00:39:31,680 --> 00:39:36,080
America now. 700 billionaires
this year have been recorded and

576
00:39:36,160 --> 00:39:39,800
thousands of multi millionaires.
Now that they have all this

577
00:39:39,800 --> 00:39:41,840
money, they want to live forever
also.

578
00:39:42,120 --> 00:39:45,920
And they're realizing that the
biggest risk to their lives in

579
00:39:45,920 --> 00:39:50,360
60s and 70s is now cancer.
And they're also realizing that

580
00:39:50,360 --> 00:39:53,520
all the companies that they have
supported have not provided the

581
00:39:53,520 --> 00:39:57,640
treatment they were hoping for.
And now, as you said, Wellness

582
00:39:57,640 --> 00:40:01,320
markets are becoming much more
fashionable, of course, and

583
00:40:01,320 --> 00:40:03,960
lifestyle changes, etcetera,
which is great.

584
00:40:04,360 --> 00:40:09,120
I love all that.
And they're realizing that maybe

585
00:40:09,560 --> 00:40:15,560
early detection is a good idea.
So I think there is a crisis of

586
00:40:15,560 --> 00:40:19,440
confidence coming not from
scientists and academics, but

587
00:40:19,440 --> 00:40:22,880
from billionaires and tech
venture capitalists, etcetera,

588
00:40:22,880 --> 00:40:28,040
who are now at risk themselves.
So unless there was that

589
00:40:28,040 --> 00:40:32,040
emotional investment, I don't
think we would be able to flip

590
00:40:32,040 --> 00:40:33,760
the system.
But now I'm feeling more

591
00:40:33,760 --> 00:40:36,680
confident just because of the
reasons I said, which are

592
00:40:36,680 --> 00:40:41,400
horrible reasons, and not some
academic realizing that we were

593
00:40:41,400 --> 00:40:44,120
wrong.
And it's you have to admit, you

594
00:40:44,120 --> 00:40:47,000
have to admit that what you've
been doing hasn't worked.

595
00:40:47,000 --> 00:40:50,680
Nobody is willing to admit that.
And you're right, you see these

596
00:40:50,680 --> 00:40:54,240
social influences and people
like Brian Johnson, I think

597
00:40:54,240 --> 00:40:56,640
that's his name.
But trying to look wherever,

598
00:40:56,640 --> 00:40:59,640
yeah, you can see the impact
that they're having on people.

599
00:40:59,720 --> 00:41:03,080
Is it whether they're right or
wrong, They're the status quo is

600
00:41:03,080 --> 00:41:06,120
shifting and it's changing.
There is some sort of a change

601
00:41:06,120 --> 00:41:07,880
occurring.
Yeah, I feel that too.

602
00:41:07,880 --> 00:41:10,240
By the way, Brian Johnson is not
all that wrong.

603
00:41:10,840 --> 00:41:14,960
I treat a disease pre leukemia
and for many of my patients, the

604
00:41:14,960 --> 00:41:18,400
only problem is a very profound
anemia for which they need blood

605
00:41:18,400 --> 00:41:21,680
transfusions.
So we try treatments which are

606
00:41:21,680 --> 00:41:24,760
two or three at most and then we
have nothing to offer them.

607
00:41:24,760 --> 00:41:27,240
But they can live for years,
decades even.

608
00:41:27,800 --> 00:41:31,240
I have some patients now who
I've been treating for more than

609
00:41:31,240 --> 00:41:34,080
20 years.
One of those patients, I'll give

610
00:41:34,080 --> 00:41:36,280
her the name Donna, her son
called me.

611
00:41:37,040 --> 00:41:41,240
He said, my mother is 87 years
old, I'm 57.

612
00:41:41,240 --> 00:41:42,960
She looks younger than me.
Why?

613
00:41:43,320 --> 00:41:46,280
I said because every two weeks
I'm giving her blood from a

614
00:41:46,280 --> 00:41:50,720
young person for the last 17
years and she has so much energy

615
00:41:50,720 --> 00:41:55,000
for 17 years, 2 units of blood
every two weeks she's

616
00:41:55,000 --> 00:41:59,520
gallivanting the globe.
She is one day in Aspen and one

617
00:41:59,520 --> 00:42:05,840
day in South Africa going for
some, you know, wonderful

618
00:42:05,840 --> 00:42:08,440
safari.
I mean that woman has so much

619
00:42:08,440 --> 00:42:12,800
energy and looks younger than
looks your age like 30.

620
00:42:13,640 --> 00:42:15,040
Yeah, that's that's right.
Unbelievable.

621
00:42:16,240 --> 00:42:18,680
Yeah, well, and also I'm in
South Africa, so hopefully that

622
00:42:18,680 --> 00:42:21,480
Safari will help.
Yes, but I was saying Brian

623
00:42:21,480 --> 00:42:25,640
Johnson has something, well,
something there because he takes

624
00:42:25,640 --> 00:42:27,640
blood from his son.
Yes, he is.

625
00:42:27,920 --> 00:42:32,800
And I think there's, the more
he's doing, the more doctors,

626
00:42:33,000 --> 00:42:36,360
physicians, surgeons, they have
to keep up with it because if

627
00:42:36,360 --> 00:42:39,200
he, if, if they stumble upon
something that's quite unique

628
00:42:39,200 --> 00:42:42,400
and not something we know about,
we're automatically going to be

629
00:42:42,400 --> 00:42:44,800
deemed ignorant and not really
following the data.

630
00:42:45,280 --> 00:42:48,440
So, so if we're ignoring it,
it's, it's just as bad as even

631
00:42:48,440 --> 00:42:50,200
following something we think
might be wrong.

632
00:42:50,400 --> 00:42:55,000
We sort of have to be intrigued
by it, yes.

633
00:42:55,360 --> 00:42:58,960
So, yeah, it's a tough one.
It it you have.

634
00:42:59,440 --> 00:43:02,600
I mentioned Michael Evans just
now because one of the things I

635
00:43:02,600 --> 00:43:05,320
was thinking about within this
revolution that's occurring is

636
00:43:05,600 --> 00:43:08,560
the breakthroughs in scientific,
in the scientific and

637
00:43:08,560 --> 00:43:11,560
philosophical realms, and all
the shifts in changes in the way

638
00:43:11,560 --> 00:43:14,360
we think about consciousness,
humanity, meaning, purpose.

639
00:43:14,760 --> 00:43:17,000
And Michael Evans, one of those
people where he's works blurring

640
00:43:17,000 --> 00:43:20,120
the lines of what we think of a
cell, what we think a cell is,

641
00:43:20,120 --> 00:43:22,160
how it communicates.
How does a cancer cell maybe

642
00:43:22,160 --> 00:43:24,800
communicate with it the rest of
its cells knowing now that

643
00:43:24,800 --> 00:43:27,200
electrical signals transmitted
information.

644
00:43:27,440 --> 00:43:29,240
Firstly, how do you and Michael
know each other?

645
00:43:29,240 --> 00:43:31,880
Because he was the one who
highly recommended your work and

646
00:43:31,880 --> 00:43:34,960
thanks Michael for that.
And how do you think his work is

647
00:43:34,960 --> 00:43:38,320
also shaped and influenced the
field and will impact us as

648
00:43:38,320 --> 00:43:42,560
doctors one day?
Well, let me say that I love

649
00:43:42,560 --> 00:43:44,320
Michael.
Michael, I love you.

650
00:43:44,360 --> 00:43:46,520
I adore you.
I think you're the smartest

651
00:43:46,520 --> 00:43:50,080
scientist alive right now, and I
think you should get the Nobel

652
00:43:50,080 --> 00:43:52,680
Prize.
I met him serendipitously

653
00:43:52,680 --> 00:43:56,040
through a cancer and evolution
symposium that was held during

654
00:43:56,040 --> 00:43:58,200
COVID days.
I met him on Zoom.

655
00:43:58,200 --> 00:44:01,760
I've never met him in person,
but I became obsessed with the

656
00:44:01,760 --> 00:44:04,560
guy.
His work is so incredible.

657
00:44:04,920 --> 00:44:07,880
And the thing, the first thing
that fascinated me is that he

658
00:44:07,880 --> 00:44:13,800
takes this little worm called
plan, you know, planarium.

659
00:44:14,120 --> 00:44:18,240
And if you split the planarium
into two, then the head develops

660
00:44:18,240 --> 00:44:20,000
a tail and the tail develops a
head.

661
00:44:20,000 --> 00:44:24,840
So he introduces an electric
current and splits them electric

662
00:44:24,840 --> 00:44:29,760
current in the dish and when he
splits them, the tail part

663
00:44:29,760 --> 00:44:34,800
develops 5 heads.
The beauty is when you split

664
00:44:34,800 --> 00:44:39,720
that 5 headed monster into two,
now every tail part will develop

665
00:44:39,720 --> 00:44:43,400
the five heads.
So how did this, this

666
00:44:43,400 --> 00:44:47,320
information, this monstrosity
was first created, this 5 headed

667
00:44:47,320 --> 00:44:50,120
monster, but then it has become
inherited.

668
00:44:50,720 --> 00:44:54,160
Now every time you do it to that
worm, it's going to have 5

669
00:44:54,160 --> 00:44:54,800
heads.
How?

670
00:44:54,800 --> 00:44:57,960
Because no genes were changed,
nothing like that happened.

671
00:44:58,560 --> 00:45:04,960
And Michael so cleverly has
shown that 70% decisions that a

672
00:45:04,960 --> 00:45:09,760
cell makes about what it's going
to do, 70% of that those

673
00:45:09,760 --> 00:45:12,800
decisions are decided by the
cell membrane.

674
00:45:13,560 --> 00:45:16,280
And the most important thing on
the cell membrane is the

675
00:45:16,280 --> 00:45:20,960
electrical potential, the
exchange of those molecules.

676
00:45:20,960 --> 00:45:25,960
And I think he what he is doing
is exactly what I need to

677
00:45:25,960 --> 00:45:33,600
combine with my early detection
thing that clearly the ion

678
00:45:33,600 --> 00:45:38,120
channels on a fused stressed
cell that has become a giant

679
00:45:38,120 --> 00:45:40,720
cell are going to be very
different than they are on

680
00:45:40,720 --> 00:45:44,920
single cells.
And so how can we use those

681
00:45:44,920 --> 00:45:49,440
kinds of information to design
zapping treatments which are

682
00:45:49,440 --> 00:45:54,040
completely non-toxic.
And so this is what I am

683
00:45:54,960 --> 00:45:59,600
intellectually very, very
interested in, in collaborating

684
00:45:59,600 --> 00:46:02,760
with Michael.
And we keep talking about these

685
00:46:02,760 --> 00:46:06,960
things and exchanging ideas and
just talking to smart people

686
00:46:06,960 --> 00:46:09,720
like Michael.
I tell you, it is such a relief

687
00:46:09,720 --> 00:46:14,880
for me because I'm constantly
surrounded by 99.9% people I

688
00:46:14,880 --> 00:46:20,160
talk to only work on mice and
their only excuses because

689
00:46:20,160 --> 00:46:23,160
that's where the grant money is.
Their children have to go to

690
00:46:23,160 --> 00:46:26,480
college.
So I call it paycheck oncology.

691
00:46:28,200 --> 00:46:31,480
We have to work off our for our
paycheck, so we have to follow

692
00:46:31,480 --> 00:46:34,160
the money trail.
So they're very few people who

693
00:46:34,160 --> 00:46:37,000
are going to think differently
because the system just isn't

694
00:46:37,000 --> 00:46:41,120
designed to encourage that.
Luckily, I came from as an

695
00:46:41,120 --> 00:46:45,040
outsider, so I wasn't
indoctrinated with all these

696
00:46:45,040 --> 00:46:47,280
ideas.
Being a foreigner, being an

697
00:46:47,280 --> 00:46:51,200
immigrant in this country has
really helped me tip because I

698
00:46:51,200 --> 00:46:53,120
refuse to think like the rest of
them.

699
00:46:55,040 --> 00:46:57,520
It hasn't been easy, but then
life isn't easy.

700
00:46:57,520 --> 00:47:00,720
Who wants an easy life?
Yeah, now you can see that, that

701
00:47:00,720 --> 00:47:03,880
that diversity shines through
and you're able to think outside

702
00:47:03,880 --> 00:47:06,680
the box just like Mike, because
the way Mike thinks, he steps

703
00:47:06,680 --> 00:47:09,200
outside the box all the time.
It's Yeah, never really.

704
00:47:09,800 --> 00:47:11,480
Yeah, he's never really thinking
like everyone else.

705
00:47:11,480 --> 00:47:14,440
He's always questioning things.
So open minded as well.

706
00:47:14,440 --> 00:47:16,480
And even if he disagrees with
someone, he's still willing to

707
00:47:16,480 --> 00:47:21,680
have such an in depth, curious
conversation that I also sit and

708
00:47:21,680 --> 00:47:24,360
wonder like how amazing it is.
It's crazy.

709
00:47:24,920 --> 00:47:29,000
You know, he has this retreat
every year where he takes some

710
00:47:29,000 --> 00:47:32,760
people with him that he likes to
talk to and they go to Greenland

711
00:47:32,760 --> 00:47:35,800
and he's been trying to get me
to go, but I'm a biggum.

712
00:47:35,800 --> 00:47:39,280
I can't go into those places and
live uncomfortable lives.

713
00:47:39,960 --> 00:47:43,400
My dad was working in Uganda for
a while, and the only way I

714
00:47:43,400 --> 00:47:46,320
would go on a safari was if at
the end of the day I could be

715
00:47:46,320 --> 00:47:50,000
served with A5 course meal.
Otherwise, I'm not going.

716
00:47:50,000 --> 00:47:53,880
I like my comfort.
I like to read my book and, you

717
00:47:53,880 --> 00:47:56,920
know, have a civilized thing.
So I refuse to go to Greenland

718
00:47:56,920 --> 00:48:00,440
and live in that for whatever
two weeks he likes to go to.

719
00:48:00,440 --> 00:48:04,800
I'm trying to convince Michael
to hold the retreat in a nice

720
00:48:04,800 --> 00:48:09,200
park, National Park in Utah or
Montana or somewhere where we

721
00:48:09,200 --> 00:48:13,640
have civilization rather than,
you know, I'm not born for cold

722
00:48:13,640 --> 00:48:18,400
climates like they go to
Greenland and places like that.

723
00:48:18,800 --> 00:48:22,800
But I would do anything to spend
a few days with Michael, talking

724
00:48:22,800 --> 00:48:26,160
to him and just exchanging
ideas, because the emergent

725
00:48:26,160 --> 00:48:29,400
ideas will be so much better
than what we are individually

726
00:48:29,400 --> 00:48:32,800
thinking about, I'm sure.
And I think there's so many

727
00:48:32,800 --> 00:48:35,200
different applications that
could have on your work.

728
00:48:35,280 --> 00:48:38,520
I mean, when you talk, think you
have the stentanyl, you have

729
00:48:38,520 --> 00:48:41,080
this information you've got.
But his work also goes into

730
00:48:41,080 --> 00:48:44,920
things like regeneration of
limbs, metamorphosis, changing

731
00:48:44,920 --> 00:48:48,120
cellular information
fundamentally, which couldn't.

732
00:48:48,120 --> 00:48:52,640
We could then ZAP something with
new information in essence and

733
00:48:52,640 --> 00:48:55,480
fundamentally change that cell.
So not even kill it, but rather

734
00:48:55,480 --> 00:48:57,840
just change it back to a normal
cell.

735
00:48:58,200 --> 00:48:59,840
There's there's so many
different philosophical

736
00:48:59,840 --> 00:49:02,560
implications to his work and I
can see how well they could fuse

737
00:49:02,560 --> 00:49:06,240
together with yours.
Yes, completely.

738
00:49:06,240 --> 00:49:09,680
I couldn't agree more that
they'll be a whole new paradigm

739
00:49:09,680 --> 00:49:13,600
of thinking about these things,
even not just doing, but

740
00:49:13,600 --> 00:49:15,960
thinking.
Because you talked about

741
00:49:15,960 --> 00:49:18,840
knowledge versus wisdom.
And for me, one of the big

742
00:49:18,840 --> 00:49:24,400
differences is knowledge teaches
you what you should do, but

743
00:49:24,400 --> 00:49:30,240
wisdom is when should you do it
and should you or it not?

744
00:49:30,640 --> 00:49:34,800
Those kinds of decisions, I
think, are so important,

745
00:49:34,800 --> 00:49:39,600
especially to kind of reclaim
cancer from this capitalism that

746
00:49:39,600 --> 00:49:42,600
we have established to
democratize it.

747
00:49:43,280 --> 00:49:47,800
And basically I want to invert
this model because right now in

748
00:49:47,800 --> 00:49:52,320
America at least, the model is
that you go and study cancer in

749
00:49:52,320 --> 00:49:55,720
mice.
Then if you find a gene of

750
00:49:55,720 --> 00:49:59,040
interest or a pathway of
interest, then you come and ask

751
00:49:59,040 --> 00:50:03,680
is it relevant in humans or not?
I say to them, it should be just

752
00:50:03,680 --> 00:50:06,400
the other way.
You should be studying humans

753
00:50:06,400 --> 00:50:09,200
1st and then validating it in
animal models.

754
00:50:09,920 --> 00:50:12,760
But why aren't you doing that?
So their answer is we don't have

755
00:50:12,760 --> 00:50:17,160
access to human tissue and this
is where our institutions have

756
00:50:17,160 --> 00:50:21,680
abdicated their responsibilities
to the investigators because how

757
00:50:21,680 --> 00:50:25,320
is a PhD scientist expected to
get a human sample?

758
00:50:25,320 --> 00:50:28,400
They have to work with a
clinician who are full of

759
00:50:28,400 --> 00:50:31,040
arrogance themselves.
In fact, their arrogance is

760
00:50:31,040 --> 00:50:35,520
somebody came to give grand
rounds and his ego was so dense

761
00:50:35,520 --> 00:50:37,440
that light was bending around
him.

762
00:50:38,840 --> 00:50:41,080
So this is the state of their
affairs.

763
00:50:41,160 --> 00:50:43,800
How are they going to ever
collaborate with anyone?

764
00:50:43,800 --> 00:50:47,680
But which the institutional
responsibility to make all these

765
00:50:47,680 --> 00:50:51,560
samples that millions of
patients are walking around with

766
00:50:51,560 --> 00:50:57,040
make them available for study.
But because of some ridiculous

767
00:50:57,040 --> 00:51:00,880
bureaucratic hurdle of
protecting privacy or something,

768
00:51:01,200 --> 00:51:04,960
they are hurting millions and
millions of patients and nobody

769
00:51:04,960 --> 00:51:10,160
is willing to even look at it.
Yeah, it's pretty disheartening.

770
00:51:10,480 --> 00:51:12,560
It's one of those things when
you see it, we all see it all

771
00:51:12,560 --> 00:51:14,480
the time.
And and we, we know as doctors

772
00:51:14,480 --> 00:51:18,840
wouldn't be doing when we're
following the the clinical

773
00:51:18,840 --> 00:51:21,720
guideline and we're just trying
to follow it to its core because

774
00:51:21,840 --> 00:51:24,280
medical legally we have to.
There's so many other areas

775
00:51:24,280 --> 00:51:27,000
where we have to think about,
but we know inherently that this

776
00:51:27,000 --> 00:51:30,200
is not what we wanted to do.
This is not what we signed up

777
00:51:30,200 --> 00:51:31,320
for.
We came here to actually help

778
00:51:31,320 --> 00:51:34,320
people and not really just
prolong their death in a, in a,

779
00:51:34,520 --> 00:51:37,840
in almost not the best way.
And I think that raises an

780
00:51:37,840 --> 00:51:41,120
important question to you when
you think about it as a what

781
00:51:41,120 --> 00:51:44,000
would you say is a good life and
what would you say is a good

782
00:51:44,120 --> 00:51:50,480
death?
I would say that it's it's the

783
00:51:50,480 --> 00:51:54,600
kind of thing I tell tell my
students all the time.

784
00:51:55,520 --> 00:51:57,520
Never marry someone you can live
with.

785
00:51:58,920 --> 00:52:01,760
Only marry someone you can't
live without.

786
00:52:02,480 --> 00:52:09,480
See, there's a big difference.
A good life isn't just to me

787
00:52:10,520 --> 00:52:12,960
just making do with whatever is
there.

788
00:52:12,960 --> 00:52:16,040
A good life is doing things you
can't live without.

789
00:52:16,960 --> 00:52:24,560
And to me, a good death is 1
where first you feel that you

790
00:52:24,560 --> 00:52:28,400
have lived a good life.
That's very important that you

791
00:52:28,400 --> 00:52:32,800
have some satisfaction in
knowing that and success doesn't

792
00:52:32,800 --> 00:52:37,000
come in here at all.
If you don't mind, I'll read one

793
00:52:37,000 --> 00:52:39,400
other couplet which summarizes
my life.

794
00:52:40,040 --> 00:52:43,640
Just tuju jisketi usko to napaya
humne.

795
00:52:44,040 --> 00:52:46,640
That which I was looking for, I
didn't find.

796
00:52:46,720 --> 00:52:49,480
In other words, I've been
looking for a curing cancer.

797
00:52:49,480 --> 00:52:54,240
I haven't cured cancer, but the
second line is is bahani SE

798
00:52:54,240 --> 00:53:00,360
magar dekhli dunya humne.
But through this journey I

799
00:53:00,360 --> 00:53:03,680
swallowed the world.
I experienced the world.

800
00:53:04,520 --> 00:53:09,000
So what the what?
The Buddhists say that the only

801
00:53:09,000 --> 00:53:13,480
Zen you find on top of the
mountain is the Zen you brought

802
00:53:13,480 --> 00:53:17,400
with yourself.
To me, that is a good death.

803
00:53:17,480 --> 00:53:21,760
A death that comes with knowing
that you gave your all to

804
00:53:21,760 --> 00:53:24,520
whatever it was you couldn't
live without.

805
00:53:25,960 --> 00:53:29,400
That's failure.
Success is out of the question

806
00:53:29,400 --> 00:53:33,560
here.
It is what your abilities were

807
00:53:33,560 --> 00:53:38,680
in order to dedicate yourself.
And most importantly, it's all

808
00:53:38,680 --> 00:53:43,160
about love.
Love drives everything and love

809
00:53:44,480 --> 00:53:50,280
for people, love for for your
profession, love for poetry, all

810
00:53:50,280 --> 00:53:52,760
of these things are driven just
by love.

811
00:53:53,160 --> 00:53:57,280
So I think a life which has been
lived with good relationships,

812
00:53:57,280 --> 00:54:00,880
with love, with kindness, with
compassion, with doing

813
00:54:00,880 --> 00:54:04,360
everything you can that brings a
good death.

814
00:54:04,920 --> 00:54:09,880
And a good death, medically
speaking, in one is 1, where

815
00:54:09,920 --> 00:54:15,480
it's not necessarily the absence
of pain, but it is the presence

816
00:54:15,480 --> 00:54:19,600
of choice.
It's a presence of dignity.

817
00:54:20,480 --> 00:54:24,360
It's the presence of control and
knowing that I'm making the

818
00:54:24,360 --> 00:54:28,040
decision myself that a doctor
isn't giving me this treatment

819
00:54:28,040 --> 00:54:32,040
to keep himself or herself out
of jail because they have been

820
00:54:32,040 --> 00:54:34,480
been given this algorithm to
follow that.

821
00:54:34,480 --> 00:54:38,600
The third line treatment for
pancreatic cancer is dependent

822
00:54:38,600 --> 00:54:40,680
on Western New York's market
share.

823
00:54:40,680 --> 00:54:42,320
So you have to give this
treatment.

824
00:54:42,320 --> 00:54:46,880
No, a good death is knowing that
I have control over when I want

825
00:54:46,880 --> 00:54:51,000
to go to Hospice care and let
nature take its course.

826
00:54:51,520 --> 00:54:53,440
You know that to me.
I don't know.

827
00:54:53,440 --> 00:54:58,520
I and, and let's just let me
give you one more thing.

828
00:54:58,520 --> 00:55:03,760
Maybe we are running out of
time, but just a poetic thing

829
00:55:03,760 --> 00:55:09,200
here.
I measure every grief I meet.

830
00:55:09,320 --> 00:55:12,600
This is Emily Dickinson.
I measure every grief I meet

831
00:55:12,640 --> 00:55:18,120
with analytic eyes.
I wonder if it weighs like mine

832
00:55:18,280 --> 00:55:23,400
or has a different size.
I wonder if they had it long or

833
00:55:23,400 --> 00:55:27,200
did it just begin?
I cannot find the date of mine.

834
00:55:27,200 --> 00:55:33,800
It's been so long a pain.
I wonder if it hurts to live and

835
00:55:33,800 --> 00:55:40,680
if they have to try and whether
could they choose between they

836
00:55:40,680 --> 00:55:46,680
would not rather die.
That is a good dip.

837
00:55:48,160 --> 00:55:50,000
That's that's absolutely
beautiful.

838
00:55:50,360 --> 00:55:53,000
And, and I would be rumors if I
did not mention that for all of

839
00:55:53,000 --> 00:55:56,080
those watching and listening,
Azura is actually a very good

840
00:55:56,080 --> 00:55:58,640
poet as well.
And you should check on homework

841
00:55:59,960 --> 00:56:02,120
because your, your work is
pretty phenomenal as well.

842
00:56:02,400 --> 00:56:05,520
But Azura, you, you touched on
something beautifully, Dave, the

843
00:56:05,920 --> 00:56:08,960
words and, and how that matters
so much.

844
00:56:09,240 --> 00:56:15,280
And someone named Susan Sontag
warned us once against these

845
00:56:15,280 --> 00:56:17,560
metaphors of illness.
I mean, when we think of cancer

846
00:56:17,560 --> 00:56:21,600
and language, we think of things
like battles, warriors, victory.

847
00:56:22,760 --> 00:56:25,720
How do you think that this
distorts our relationship to

848
00:56:25,720 --> 00:56:32,360
disease?
Well, you know, semantics of, of

849
00:56:32,360 --> 00:56:36,160
war and battle kind of have a
binary effect that there are

850
00:56:36,160 --> 00:56:40,880
winners and there are losers.
And that to me, first of all, is

851
00:56:40,880 --> 00:56:44,000
blaming the victim.
If the cancer patient dies, it's

852
00:56:44,000 --> 00:56:46,000
their fault.
They didn't try hard enough.

853
00:56:46,000 --> 00:56:49,080
They didn't fight, they didn't
have the weapons of positive

854
00:56:49,080 --> 00:56:51,960
thinking or whatever it is
you've decided to put in their

855
00:56:52,720 --> 00:56:55,800
thing.
I mean, all this kind of stuff

856
00:56:55,800 --> 00:57:00,520
is in a way taking away the
complexity of life, the

857
00:57:00,520 --> 00:57:05,840
complexity of living, and trying
to reduce it into few phrases

858
00:57:05,840 --> 00:57:07,960
and words.
And that is just wrong.

859
00:57:07,960 --> 00:57:11,000
I think Susan Santak is
absolutely correct.

860
00:57:11,400 --> 00:57:16,400
I have always reacted against
these semantics myself, because

861
00:57:16,960 --> 00:57:21,120
really the only war going on in
a cancer patient is a civil war,

862
00:57:21,840 --> 00:57:25,000
because they have not only
cancer, now we are giving them

863
00:57:25,000 --> 00:57:27,880
poisonous treatments.
And so their whole body is

864
00:57:27,880 --> 00:57:31,840
trying to attack.
You don't know who's the enemy.

865
00:57:31,840 --> 00:57:34,880
Is the cancer the enemy or this
poison coming in?

866
00:57:34,880 --> 00:57:37,400
The enemy.
The body is confused and there's

867
00:57:37,400 --> 00:57:40,720
a civil war going on.
There is no other war, for God's

868
00:57:40,720 --> 00:57:44,160
sake.
And again, the other thing that

869
00:57:44,160 --> 00:57:51,120
this language does, at least as
far as I'm concerned, is it kind

870
00:57:51,120 --> 00:57:56,520
of paints the paints.
By by using this military

871
00:57:56,880 --> 00:58:01,320
language, you are making
patients into generals who have

872
00:58:01,320 --> 00:58:07,440
the decision power or doctors
into these captains of the ship.

873
00:58:07,440 --> 00:58:11,200
And none of that is true.
For God's sake, all of us are

874
00:58:11,320 --> 00:58:12,960
ignorant.
We don't know.

875
00:58:12,960 --> 00:58:17,920
There is a just one example
after my own husband died with a

876
00:58:17,920 --> 00:58:23,080
five year battle of cancer.
My daughter was only four when

877
00:58:23,080 --> 00:58:25,040
he was diagnosed so she's very
little.

878
00:58:25,040 --> 00:58:31,400
When he died she was 8 and some
after he's dead like 2-3 weeks

879
00:58:31,400 --> 00:58:34,120
later.
She developed a flu and was

880
00:58:34,120 --> 00:58:37,960
pretty sick with it but slowly
started getting better.

881
00:58:37,960 --> 00:58:41,080
Week later she was much better,
except one morning she woke up

882
00:58:41,080 --> 00:58:44,560
and came out of her room crying
inconsolably.

883
00:58:45,560 --> 00:58:48,880
So as a mother, my heart sank
immediately that something is

884
00:58:48,880 --> 00:58:50,560
wrong.
I said, shares out what?

885
00:58:51,000 --> 00:58:52,520
Are you sick?
Are you worse?

886
00:58:52,520 --> 00:58:55,000
What's happening?
And she couldn't even answer me

887
00:58:55,000 --> 00:58:59,520
for a few minutes.
Finally she said no Mommy, I'm

888
00:58:59,520 --> 00:59:04,640
feeling much better now.
But now I know how horrible it

889
00:59:04,640 --> 00:59:08,320
feels to be sick and how good it
feels to get better.

890
00:59:08,320 --> 00:59:17,280
And my dad never got better.
You're taking all this

891
00:59:17,280 --> 00:59:23,400
experience away by saying Harvey
lost the battle to cancer.

892
00:59:24,600 --> 00:59:30,760
What about all that suffering
and pain and the anguish of of

893
00:59:31,120 --> 00:59:33,960
of just leaving such a young
child behind?

894
00:59:34,080 --> 00:59:36,560
What?
Where is all that gone suddenly?

895
00:59:38,200 --> 00:59:40,280
That's such a profound thing to
say as a four year old.

896
00:59:40,640 --> 00:59:43,120
And it and it takes you back to
this one thing of where we all

897
00:59:43,120 --> 00:59:46,080
have 99 problems or 1000
problems until you only have

898
00:59:46,080 --> 00:59:47,600
one.
And that's sickness.

899
00:59:48,160 --> 00:59:51,800
The moment you have that one
thing that's strikes you an

900
00:59:51,800 --> 00:59:54,760
illness, a disease, a cancer,
that's when you realize

901
00:59:54,760 --> 00:59:58,400
everything you've been thinking
about was was such surface level

902
00:59:58,640 --> 01:00:00,320
BS.
Yeah.

903
01:00:00,480 --> 01:00:03,120
And at some point.
Yeah, and then at some point you

904
01:00:03,120 --> 01:00:06,760
struck with this one life
changing event that will forever

905
01:00:06,760 --> 01:00:10,800
change who you are and who
everyone around you is, which is

906
01:00:10,800 --> 01:00:14,480
pretty crazy.
And by the way, young people

907
01:00:14,480 --> 01:00:17,160
know this difference.
So Sharzad's best.

908
01:00:17,240 --> 01:00:20,240
Sharzad's first loses her father
as a child.

909
01:00:20,240 --> 01:00:25,480
And as a young adult of 22, her
best friend Andrew, not her

910
01:00:25,480 --> 01:00:29,640
boyfriend R Andrew was gay.
But her best friend dies of

911
01:00:31,120 --> 01:00:36,360
deadly glioblastoma multiforme,
the most horrible brain cancer

912
01:00:36,360 --> 01:00:38,920
known to mankind.
He's dying at 22.

913
01:00:39,720 --> 01:00:45,080
So a week before he's dead in
the hospital, the team just

914
01:00:45,400 --> 01:00:49,920
comes and hands him ADNR form to
sign Do not resuscitate.

915
01:00:51,640 --> 01:00:54,080
He said, I'm not signing it.
I don't want to die.

916
01:00:54,080 --> 01:00:59,120
Send them off.
But that evening tip his mother

917
01:00:59,120 --> 01:01:03,000
left and his father came to
relieve her to spend the night

918
01:01:03,000 --> 01:01:06,360
with his son.
As soon as the father came,

919
01:01:06,360 --> 01:01:10,280
Andrew called the team back and
said bring me the form, I'll

920
01:01:10,280 --> 01:01:13,480
sign it now.
I couldn't do it in front of my

921
01:01:13,480 --> 01:01:21,320
mother because she wouldn't be
able to take 22 year old is

922
01:01:21,320 --> 01:01:25,920
protecting his mother.
Monuments should be built to

923
01:01:26,000 --> 01:01:30,160
this quiet courage, this
reverence.

924
01:01:30,160 --> 01:01:34,800
We should be hanging our heads
down in reference to Andrew.

925
01:01:37,280 --> 01:01:40,600
Your, your life other has been
personally touched by this and

926
01:01:40,960 --> 01:01:44,720
you've impacted the field in so
many incredible ways because of

927
01:01:44,720 --> 01:01:47,120
that.
The legacy that you, your

928
01:01:47,120 --> 01:01:50,920
husband has left you with as
well, and the way he's impacted

929
01:01:50,920 --> 01:01:52,680
you.
How do you feel that that's

930
01:01:52,680 --> 01:01:58,320
changed how you perceive this,
this, this world and cancer as

931
01:01:58,360 --> 01:02:06,200
all?
I think you hit it on the head

932
01:02:06,200 --> 01:02:09,880
because I didn't change really
as an oncologist, even though I

933
01:02:09,880 --> 01:02:13,680
was his oncologist, but I was
already an oncologist for 20

934
01:02:13,680 --> 01:02:17,160
years when he was diagnosed.
So it didn't change my style,

935
01:02:17,160 --> 01:02:19,960
but what it changed is my
perceptions forever.

936
01:02:20,880 --> 01:02:25,880
And as Bruce said, to discover
new lands, you don't need to.

937
01:02:26,240 --> 01:02:29,360
You just need to have new eyes.
You don't need to travel.

938
01:02:30,160 --> 01:02:35,440
And so just the same thing I was
seeing as amputating a leg to

939
01:02:35,440 --> 01:02:39,520
cure a child with cancer.
Now I'm seeing and feeling good

940
01:02:39,520 --> 01:02:41,840
about it, that we cured the
child.

941
01:02:42,240 --> 01:02:46,440
Now I suddenly see that
amputation as a travesty, as a

942
01:02:46,440 --> 01:02:49,400
horrible crime.
How are we still doing it 50

943
01:02:49,400 --> 01:02:54,200
years and 100 years later?
So I think that what it has done

944
01:02:54,200 --> 01:03:03,600
for me is to discover the
difference between discerning

945
01:03:04,680 --> 01:03:10,680
when to act and not.
Can we or should we become

946
01:03:10,680 --> 01:03:13,880
suddenly very important?
Because I am now deciding not

947
01:03:13,880 --> 01:03:17,200
just as a doctor, but as also
from the patient's perspective,

948
01:03:17,200 --> 01:03:20,640
because Harvey handed me his
decision power.

949
01:03:21,640 --> 01:03:27,080
And the most interesting thing
to me was that for five years

950
01:03:27,080 --> 01:03:31,280
that he was sick, everything I
did, arranging for babysitters

951
01:03:31,280 --> 01:03:36,640
or making sure that my lab is
running, any, any decision I had

952
01:03:36,640 --> 01:03:39,480
to make was always guided by
Harvey's illness.

953
01:03:39,480 --> 01:03:41,720
Do I have to give him chemo at
this time?

954
01:03:41,720 --> 01:03:45,920
So I must do this at that time,
you know, So for five years, the

955
01:03:45,920 --> 01:03:50,800
focus of attention of every
choice I made in life was his

956
01:03:50,800 --> 01:03:54,640
illness.
And he dies, and suddenly I'm

957
01:03:55,120 --> 01:03:57,640
feeling disoriented.
Of course the death was

958
01:03:57,640 --> 01:04:00,080
expected.
That's not the point.

959
01:04:00,080 --> 01:04:02,560
The point is that focus was
suddenly gone.

960
01:04:03,520 --> 01:04:09,000
And again, Emily Dickinson, I
felt a cleavage in my mind, as

961
01:04:09,000 --> 01:04:15,400
if my brain had split.
I tried to match it seam by

962
01:04:15,400 --> 01:04:20,080
seam, but could not make them
fit the thought behind.

963
01:04:20,080 --> 01:04:24,400
I strove to join unto the
thought before, but sequence

964
01:04:24,400 --> 01:04:27,800
raveled out of reach like balls
upon the floor.

965
01:04:29,920 --> 01:04:37,000
The disorientation and the
appreciation of what patients

966
01:04:37,000 --> 01:04:39,880
and families are going through
that they can't.

967
01:04:40,160 --> 01:04:44,800
You see, when you are in that
active mode, adrenaline is

968
01:04:44,800 --> 01:04:47,520
driving everything you are doing
and you have no time to think.

969
01:04:48,000 --> 01:04:52,080
You need time you need.
I needed years even to go back

970
01:04:52,080 --> 01:04:56,840
and listen to music and the way
I healed myself for two years I

971
01:04:56,840 --> 01:05:02,480
couldn't concentrate on anything
until I decided to reread the

972
01:05:02,480 --> 01:05:06,360
100 greatest books of Western
literary tradition, starting

973
01:05:06,360 --> 01:05:11,920
with Sophocles and and Aeschylus
and working my way down to

974
01:05:11,920 --> 01:05:16,840
Thackery and Dickens and and
James to now Rushti and

975
01:05:17,880 --> 01:05:21,280
Ferrante.
I mean to, to really, because

976
01:05:21,280 --> 01:05:23,920
that's all I know how to do.
I'm a big reader, as you can

977
01:05:23,920 --> 01:05:25,760
see.
My I just said I'm owner of

978
01:05:25,840 --> 01:05:30,040
thousands of books everywhere.
So that reset my mind.

979
01:05:30,040 --> 01:05:34,320
But then it made me realize what
patients and and their families

980
01:05:34,320 --> 01:05:38,040
go through.
Patient dies, but now you know,

981
01:05:38,040 --> 01:05:42,240
how long is it going to come
back to real to their old life

982
01:05:42,240 --> 01:05:44,680
or ever?
Will they ever get back to that?

983
01:05:44,680 --> 01:05:47,480
And what do they think about
what decisions they would have

984
01:05:47,480 --> 01:05:50,080
changed?
And in my book, The First Cell,

985
01:05:50,080 --> 01:05:54,200
I think something that is very
unique in the book is that there

986
01:05:54,200 --> 01:05:56,800
are 7 chapters.
Each is about a patient.

987
01:05:57,920 --> 01:06:01,040
And at the end of the book I go
back to families of those

988
01:06:01,040 --> 01:06:04,920
patients I have lost and ask
them what decisions would you

989
01:06:04,920 --> 01:06:08,600
have changed now that you have
luxury of time and this

990
01:06:08,600 --> 01:06:11,560
perspective you have developed
that, oh, I shouldn't have done

991
01:06:11,560 --> 01:06:14,920
this or done that.
And no other book I ever saw has

992
01:06:14,920 --> 01:06:17,880
done this.
And the weirdest thing is that

993
01:06:17,880 --> 01:06:21,960
every family member has come out
saying they wouldn't have

994
01:06:21,960 --> 01:06:24,440
changed any decision because
they didn't have any other

995
01:06:24,440 --> 01:06:29,200
choice, because to say don't
treat would have been taken away

996
01:06:29,200 --> 01:06:33,760
even those last glimmers of hope
and would have accelerated their

997
01:06:33,760 --> 01:06:36,840
departure, perhaps their beloved
one's departures.

998
01:06:36,840 --> 01:06:41,120
And how could the mother of a 22
year old Andrew or 38 year old

999
01:06:41,120 --> 01:06:44,640
woman, or even me, Harvey's
wife?

1000
01:06:44,640 --> 01:06:48,720
How would I decide these things?
You want the loved one to be

1001
01:06:48,720 --> 01:06:51,960
there forever.
The only thing people complain

1002
01:06:51,960 --> 01:06:56,040
about was patients, families 10
years later are complaining

1003
01:06:56,040 --> 01:07:02,000
about is the doctor's attitudes.
For Andrew, the doctor was just

1004
01:07:02,000 --> 01:07:04,880
one floor up.
For the last three months that

1005
01:07:04,880 --> 01:07:06,840
Andrew was admitted to the
hospital.

1006
01:07:06,840 --> 01:07:10,600
That doctor never descended 1
staircase to come and say hello

1007
01:07:10,600 --> 01:07:13,320
to him.
When Andrew waited every day for

1008
01:07:13,320 --> 01:07:16,560
him, they would send teams of
Hospice care, teams of

1009
01:07:16,560 --> 01:07:20,400
palliative, teams of pain
management, and even a team

1010
01:07:20,400 --> 01:07:27,080
handing him this form to sign.
Think of that, that that is the

1011
01:07:27,080 --> 01:07:30,840
inhumanity that has come into
everything, and that is what

1012
01:07:30,840 --> 01:07:35,760
changed my perceptions forever
after being on the other side of

1013
01:07:35,760 --> 01:07:38,760
the bed, standing on both sides
simultaneously.

1014
01:07:39,040 --> 01:07:43,360
Those are experiences I don't
wish upon my enemy, but it

1015
01:07:43,360 --> 01:07:47,760
taught me something.
Yeah, I think, yeah, I think

1016
01:07:48,480 --> 01:07:51,120
firstly, thank you for sharing
those personal stories as well.

1017
01:07:51,120 --> 01:07:53,240
I know it takes a lot to do to
share that.

1018
01:07:53,240 --> 01:07:55,840
It obviously brings a lot of
emotion out of here as well.

1019
01:07:56,320 --> 01:08:00,000
But yeah, as, as we just touched
on that, all problems go away

1020
01:08:00,000 --> 01:08:03,680
and one problem becomes so
magnified to a point where it

1021
01:08:03,680 --> 01:08:07,360
fundamentally changes where you
are when that problem is gone.

1022
01:08:07,960 --> 01:08:10,960
Because it was the years after
that were more were actually

1023
01:08:10,960 --> 01:08:12,840
quite hard and difficult to deal
with as well.

1024
01:08:13,360 --> 01:08:15,440
If not for your love for the
books and doing those things

1025
01:08:15,440 --> 01:08:18,399
that you love, it would be very
difficult for anyone to get back

1026
01:08:18,399 --> 01:08:21,640
from that.
And it's, it's, and I think all

1027
01:08:21,640 --> 01:08:25,479
of this reflects the deeper
problems within medicine, Cancer

1028
01:08:25,479 --> 01:08:29,319
Research, doctors as a problem
us, the way we follow the

1029
01:08:29,319 --> 01:08:31,640
guidelines, go through
algorithms, forget that we're

1030
01:08:31,640 --> 01:08:35,040
there for the patient first.
I mean, there's AI mean

1031
01:08:35,040 --> 01:08:36,520
Hippocrates.
A lot of people back then, we

1032
01:08:36,520 --> 01:08:38,760
knew there's certain things very
important.

1033
01:08:38,960 --> 01:08:42,279
I mean, one of the smaller
things like I think it was

1034
01:08:42,279 --> 01:08:45,319
Hippocrates who says eat thy
food as thy medicine or one day

1035
01:08:45,319 --> 01:08:47,080
you'll eat thy medicine as thy
food.

1036
01:08:47,640 --> 01:08:51,479
Just small things like that.
Just those small things where

1037
01:08:51,479 --> 01:08:54,560
you just shift, shift your
thinking a little bit, change

1038
01:08:54,560 --> 01:08:57,240
the perspective, change the lens
you view the world and

1039
01:08:57,240 --> 01:08:59,560
fundamentally changed the
medical field.

1040
01:08:59,840 --> 01:09:02,800
And with that, Azra, I mean, as
a closing, maybe can you tell me

1041
01:09:02,800 --> 01:09:05,479
if we started with this, but
maybe we can also end with it.

1042
01:09:05,880 --> 01:09:10,720
Your ideal world of healthcare,
Cancer Research and just this

1043
01:09:10,720 --> 01:09:12,680
field as a whole.
Maybe wonder we could dissect

1044
01:09:12,680 --> 01:09:16,399
certain papers in more a detail,
but for now is a nice round of

1045
01:09:16,520 --> 01:09:18,720
how would you see the future of
medicine?

1046
01:09:18,720 --> 01:09:20,960
Let's think of the thousands of
doctors coming up.

1047
01:09:21,319 --> 01:09:24,359
How would you like them to treat
patients with cancer and what

1048
01:09:24,359 --> 01:09:25,479
would you like to see in the
future?

1049
01:09:26,240 --> 01:09:29,640
Well, my closing statement would
be that everything we've been

1050
01:09:29,640 --> 01:09:32,680
doing in cancer is wrong.
We need to think very

1051
01:09:32,680 --> 01:09:34,479
differently.
Everything we're doing in

1052
01:09:34,479 --> 01:09:37,800
research is wrong.
Yes, there are successes, but

1053
01:09:37,800 --> 01:09:41,800
they don't justify the number of
lives we have hurt and the

1054
01:09:41,800 --> 01:09:45,720
number of resources, both
financial and intellectual, we

1055
01:09:45,720 --> 01:09:49,040
have wasted over the years.
So people keep saying, well, we

1056
01:09:49,040 --> 01:09:52,640
have car T, we have treatment
for this, but that's too few

1057
01:09:52,640 --> 01:09:56,120
compared to.
So going forward, I think we

1058
01:09:56,120 --> 01:10:00,360
need to shift our focus from the
last cell to the first cell in

1059
01:10:00,400 --> 01:10:03,640
all of healthcare.
We need to go for early

1060
01:10:03,640 --> 01:10:09,400
detection and prevention and
revolutionize ways of ways of

1061
01:10:09,400 --> 01:10:12,560
early detection.
We, we have amazing technology,

1062
01:10:12,560 --> 01:10:16,000
We need to apply it at the right
end of the field, not the wrong

1063
01:10:16,000 --> 01:10:19,120
end, or it will become more and
more dangerous and worse.

1064
01:10:20,200 --> 01:10:25,080
So I feel that the last thing,
of course, is that it's, it's

1065
01:10:25,080 --> 01:10:27,360
what, what is so beautifully
said.

1066
01:10:27,360 --> 01:10:32,000
Surgeons must be very careful
when they test their knives, for

1067
01:10:32,000 --> 01:10:37,200
underneath their fine incisions
rests the culprit life.

1068
01:10:38,880 --> 01:10:42,360
The problem is not that there's
a wart you can't cut off, but

1069
01:10:42,360 --> 01:10:44,800
what lies underneath is real
life.

1070
01:10:44,800 --> 01:10:48,520
That life does come with warts
and pain and suffering.

1071
01:10:48,520 --> 01:10:50,960
And they will.
There is no end to it.

1072
01:10:50,960 --> 01:10:53,960
You're not going to get rid of
it by early detection and

1073
01:10:53,960 --> 01:10:55,640
prevention.
There'll be other kinds of

1074
01:10:55,640 --> 01:10:58,880
suffering.
So humanity must be taken as a

1075
01:10:58,880 --> 01:11:02,880
complex thing.
Life must be given its full,

1076
01:11:02,880 --> 01:11:08,560
complex colors.
It's, it's literally just as you

1077
01:11:08,560 --> 01:11:12,560
said, changing your thinking in
a way where the human becomes

1078
01:11:12,560 --> 01:11:16,760
the center of things and love
becomes the driving force and

1079
01:11:16,760 --> 01:11:20,000
love for the human, love for
preventing their suffering,

1080
01:11:20,000 --> 01:11:24,000
their anguish becomes the moving
engine of your life.

1081
01:11:24,000 --> 01:11:26,880
I think that is what I'd like to
leave everyone with.

1082
01:11:28,280 --> 01:11:31,720
And I think your message is very
beautiful and and should be well

1083
01:11:31,720 --> 01:11:33,760
received.
And I hope that people leave

1084
01:11:33,760 --> 01:11:36,920
this episode thinking about
this, taking this seriously and

1085
01:11:36,920 --> 01:11:39,120
even looking into Cancer
Research and looking into this

1086
01:11:39,120 --> 01:11:41,360
field with a different set of
eyes.

1087
01:11:42,000 --> 01:11:45,720
No, I want them to look into the
Stenton and then please come up

1088
01:11:45,720 --> 01:11:50,360
and help me because go to my
website, asraraza.com and you

1089
01:11:50,360 --> 01:11:52,680
can find all kinds of details
there.

1090
01:11:52,680 --> 01:11:56,480
And the more people that help
me, the faster I can get into

1091
01:11:56,480 --> 01:12:00,040
patients and all of humanity is
going to benefit from it.

1092
01:12:00,160 --> 01:12:04,600
I seriously mean it.
This is not some abstraction or

1093
01:12:04,600 --> 01:12:06,680
pie in the sky.
This is all real.

1094
01:12:06,680 --> 01:12:09,880
This is being done by the finest
scientists in the world.

1095
01:12:09,880 --> 01:12:14,480
So unless you are not a believer
in science, you need to step up

1096
01:12:14,480 --> 01:12:16,880
and support the people doing the
right things.

1097
01:12:17,600 --> 01:12:19,720
And I'll put links to all of
those, Azra, and you can send me

1098
01:12:19,720 --> 01:12:22,320
any further ones that you'd like
me to put up on as well.

1099
01:12:22,640 --> 01:12:25,080
Thank you so much Azra, for the
for your time, for your

1100
01:12:25,080 --> 01:12:29,320
incredible work and for being so
the activist you are within this

1101
01:12:29,480 --> 01:12:32,960
field.
Thank you because you are the

1102
01:12:32,960 --> 01:12:36,280
one who have come up with the
you came up with the most

1103
01:12:36,280 --> 01:12:39,080
thoughtful, provocative,
interesting questions.

1104
01:12:39,080 --> 01:12:44,000
You weren't afraid to ask me
about any, whether anything in

1105
01:12:44,000 --> 01:12:47,480
my life, whether it's deeply
personal or highly contentious,

1106
01:12:47,480 --> 01:12:51,800
professionally speaking, you
asked it and you really have the

1107
01:12:51,800 --> 01:12:56,120
full spectrum of the human
patient to the most cutting edge

1108
01:12:56,120 --> 01:12:58,240
signs.
So congratulations, at such a

1109
01:12:58,240 --> 01:13:02,200
young age, you have incisive
thinking and you are interested

1110
01:13:02,200 --> 01:13:05,640
in new ideas.
I really am very grateful to be

1111
01:13:05,640 --> 01:13:08,400
on your podcast because the
people listening to you must

1112
01:13:08,400 --> 01:13:11,320
also be of the same caliber if
they're listening to you.

1113
01:13:11,360 --> 01:13:12,680
So thank you very much.