15: D.A. Wallach - Serendipity & Systems

28 Apr 2025 · 2 h 33 min

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Podcast Notes: Dialectic - Episode 15: D.A. Wallach - Serendipity & Systems

Episode Overview In this episode of the Dialectic podcast, host Jackson Dahl speaks with D.A. Wallach, a multi-talented investor, musician, and writer. The conversation explores topics ranging from the art of cold emailing, complexity science, and the healthcare industry to creativity and the evolving role of artists in society.

Key Themes and Discussions

  1. Curiosity and Serendipity
  2. Wallach emphasizes the importance of curiosity as a driving force in his life, combined with serendipity – the unplanned opportunities and experiences that shape one's path.
  3. He discusses the practice of cold emailing as a method to create serendipitous connections and opportunities.
  1. Complexity Science
  2. The conversation moves into the realm of complexity science, discussing the Santa Fe Institute and its significance in understanding complex systems.
  3. Wallach articulates the challenges of designing effective systems, particularly in bureaucratic environments like healthcare.
  1. Healthcare and Innovation
  2. Wallach critiques the current healthcare system, diving deep into the implications of free-market capitalism versus viewing healthcare as a human right.
  3. He presents the concept of "Zero Toll Medicine," proposing a system where patients have greater agency and financial incentives for personal health management.
  1. Creativity and Originality
  2. The discussion touches on the role of AI in creativity, with Wallach questioning if AI makes artists lazy or if it can enhance originality.
  3. He expresses a desire for artists to reclaim their status as influential "cool" figures in society, as they have been overshadowed by the tech industry.
  1. Personal Reflections on Music and Performance
  2. Wallach reflects on his past as a musician, discussing the contrast between performing and the lifestyle of touring.
  3. He expresses nostalgia for the creativity found in live performance while also recognizing the exhaustion that comes with it.
  1. The Future of Art and Technology
  2. The episode delves into the intersection of art, technology, and commerce, with Wallach advocating for a balance between the two.
  3. He reflects on the transformative potential of AI and how it can impact creativity and artistic expression.
  1. Paradox of Fame and Identity
  2. Wallach discusses the current culture of fame, emphasizing that many who are famous actively seek that attention.
  3. He reflects on the role of personal authenticity in an era where everyone seems to perform their identity online.
  1. Education and Parenting
  2. When discussing his daughter, he emphasizes the importance of imparting values of curiosity, ethics, and the beauty of relationships rather than rote skills.

Conclusion D.A. Wallach's multifaceted experiences provide a rich tapestry of insights into the interplay between art, technology, and systems of society. His thoughts encourage a reevaluation of how we perceive creativity, the healthcare system, and the role of artists today. This conversation serves as a reminder of the continuous journey of exploration and the potential for innovation rooted in curiosity and serendipity.

Key Takeaways

  • Curiosity and Serendipity: Embrace curiosity and harness the power of serendipitous opportunities.
  • Healthcare System: Rethink current healthcare models to empower patients and reduce bureaucratic inefficiencies.
  • Role of AI: Consider the implications of AI on creativity, challenging the narrative of laziness versus enhanced originality.
  • Authenticity: In a world of curated identities, strive for authenticity in personal and professional expressions.
  • Education Values: Focus on imparting wisdom, ethics, and curiosity to future generations over conventional rote skills.

Further Listening/Reading

  • Explore more about complexity science at the Santa Fe Institute.
  • Review the concept of "Zero Toll Medicine" for innovative healthcare ideas.
  • Delve into discussions of art and identity in the age of technology and AI.

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Transcript

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0:00Welcome to Dialectic Episode 15 with D.A. Wallach. Before we get into things, this episode is brought to you by Hampton. I think so much of company building is actually about energy. As a leader and a founder, you have to be that energy source for almost everyone in your company. And so I think having people outside of your day-to-day context can be tremendously valuable in making sure that you yourself have the energy to keep going. That's where Hampton comes in. It's a private membership for founders and entrepreneurs that pairs you with a subset of like-minded leaders who you'll meet with monthly to talk through all of the challenges of building a company.

0:40In a sense, Hampton is a one-stop shop to create a personal board of advisors, a group that you can go to for hard problems, feedback on challenges, or simply perspective so that you have the energy to keep on going. I've certainly benefited from this type of peer mentorship in my career. And given how lonely being a founder can be, having a group of people that you trust that you can zoom out from the day-to-day with is such an incredible benefit. While the heart of the Hampton membership is your intimate eight-person peer group, Hampton also has monthly and quarterly events, online speaker series, a digital community for asking the entire network of over a thousand founders questions, and more.

1:23Hampton isn't for everybody, but for founders who are on what can be both the thrill and joy of a lifetime in company building, but also an experience that can be quite lonely at times. It's an amazing way to have a community who gets what you're going through. If you've raised$3 million or have$3 million in revenue, or you've sold a company for$10 million, I'd strongly encourage you to check out Hampton. I've included a link in the description where you can learn more. And if you apply, make sure to tell them that I sent you. Thanks again to Hampton for supporting Dialectic. Now on to D.A. Wallach.

1:58Most of the guests I've had on the show so far are polymaths of sorts. I've always been interested in people who seem to live multiple lives, and D.A. has done just that. These days, he's a biotech investor focused on life sciences and healthcare at his firm, Time Bio Ventures. While he focuses on bio and health today, he was previously a generalist investor and was an annual investor in SpaceX, Spotify, and Ripple, among others. But here's where it gets interesting. He in part got into investing by way of Spotify, where he was the first artist in residence. And the reason for that is that he began his career as a recording artist.

2:36That started when, as a student at Harvard, he and his band, Chester French, were discovered by Kanye West and Pharrell Williams. D.A. went on to record multiple albums, tour with Lady Gaga and others, and record a solo album as well. Before or after the episode, you can go listen to his music on Spotify or YouTube, but I'd specifically recommend his song Glowing on YouTube, where the music video is directed by Tyler, the creator. This conversation, like D.A., goes in lots of different directions, but I see him as someone who's fascinated with markets and systems, focused on actually making a pragmatic difference on modern healthcare.

3:13and who lets serendipity, curiosity, and beauty drive how he spends his time. So we'll get into it. Here's D.A. Okay. D.A., thank you for doing this. My pleasure. It's a pleasure to meet you, too. Yeah, likewise. I want to start with, you once said, I think on an interview, that your alma mater, Harvard, is a vocational school for investment banking and management consulting, and that you're suspicious of these types of institutions and the way that they tend to reproduce inequality, social hierarchy, and homogenize lots of talented young people. Meanwhile, you also, I think on the same interview, I think it was with Peter Atiyah, you said, I cold emailed him, which is how most things start in my life.

3:58And so my question is, how have curiosity and serendipity played a factor or a guiding role in your life? Wow. Wow. Well, I'd say they're kind of like the two guiding factors because curiosity is, for me, the intrinsic motivation to pursue most things actively. And then serendipity is the kind of X factor that, I mean, that's everything you can't control, right? So your life ends up being this combination of things happening to you, which is sort of the serendipity part. and then you doing things that you want to go do and uh what i generally want to do is whatever i'm curious about so i've never thought about it that way but i guess those are kind of the two the two uh weather veins when did you start cold emailing people last are you still doing much of that oh yeah i still i cold email a lot i probably started cold emailing people in high school and probably a good broad um pattern in like interesting people is like a high amount people always talk about like oh did you sell something in high school but the cold emailing thing is probably a pretty good marker too yeah i would do i mean i did a little bit of cold emailing in high school then it really took off in college and when i was trying to get my music career going that was when i did the most cold emailing probably because the record business i think even still i'm probably less than it used to be but that's like historically always been such a gatekeeper industry where it's like you know almost everyone's story involves a quote big break and that big break is just essentially someone responding to you you know so you there's really that's like the original cold calling right game because you just have to keep cold calling until somebody responds to you and then when they do that's your big break yeah so that was definitely how we approached it which was just like cold you know send our music to anyone who might be in a position where they could open a door for us yeah and then that's been something i've always done even since then and and you know now it's more of like if i read something that that was written by someone where i think i'd like to talk to them or now i also just try to send people emails if uh i really like what they're doing in the world particularly even if there's like no agenda like you know if i don't want to you know because it's like i'm i'm such a fan of people that i'll reach out to them just to say like i'm a fan of what you're doing but i know there's nothing in it for me like i you know there's there's no reason for you to spend time with me there's really no practical reason for me to spend time with you but i just want you to know like what you're doing is great yeah but you're also spinning the serendipity wheel there a little bit yeah you never know you never know what's going to happen and i will say also you know there are some people who like this guy virgil abloh who was the designer at louis vuitton i never met him in person or maybe i met him once i don't i didn't have a relationship with him but i think i don't know if he was just like this or if it was just once he got cancer that he started doing this but like I got he he sent me a message at one point that was just a really sweet note about having loved my music and it made my day I mean it was just it was so sweet like you know what I mean I didn't know him but I obviously knew who he was and I knew how important he was so that kind of motivated me to then do that more because I realized you know you I'm not saying it's about myself but it's like you even people who have gotten a lot of a lot of love from the world a lot of them still you know have self-doubt or they don't think that they're good or they don't think that their work is good and you just never know if you telling them that they're special or that their thing is great is gonna make the difference so i know i now try to do that a little i think the other cool thing is there's there's a little bit more of a consensus at least maybe in technology circles or ambitious people circles that when you're young cold emailing is a really good thing to do and i've always admired people who have a little more credibility or success behind them and still have that because maybe to go back to the beginning of it it's it feels like it's rooted in some kind of authentic curiosity more than unlocking some door or something like that yeah and and like why i don't know in a certain sense i feel that there's one there's like one kind of serendipity which is you know people go to conferences people you know people in business fucking love conferences and i really don't like conferences i i'm very uncomfortable at conferences and the internet though is like the biggest conference ever right you know like everyone is on it and you can go and find i can go find out what jackson is into or you know i mean increasingly as people have been public you see what they post you see what they're thinking So at least to me, there's such a great opportunity that affords you to only connect with the people who you already know you're curious about or interested in talking to.

10:14Whereas if you rely on these kind of older forms of serendipity, like going to a conference. Right. It's like a scoped randomness. It's like random. Like I'm still going to spin this serendipity wheel, but like I have it a little more honed in and it's a little more likely to hit on something really cool. Exactly. And whereas if you if you're just totally open ended and you go, OK, I have the Internet at my fingertips. I'm just going to go trawl the Internet for interesting people, interesting stuff. I mean, that's still kind of my favorite activity in a way. Like, you know, I mean, there's something a little depressing about just being on the Internet all the time.

10:56But I have to say I've never gotten bored on the Internet. I still I can spend an unlimited amount of time browsing the Internet so much so that I've actually thought it would be fun. you know maybe not even just you know for me this is a little solipsistic to say but like i thought i could do a great performance art show where it was just me browsing the internet live like on twitch or something like live streaming that'd be cool actually live streaming is you mean like in person on a stage yeah twitch me you're much more practical like twitch makes I kind of like the live in person perfect bill yeah I had envisioned it as a stage show like a keynote it's like yeah but it's like in like a seated theater right right and but I thought wow this would be a great one-man show but it's not the same every night it's literally I'm in I never know what's going to happen and the audience doesn't know we're going to start on Twitter and just see what I'm just going to go on the internet and just see where I go because I always find it really interesting and entertaining.

12:08And I've always thought, I wonder how good I am at this. You know, like, obviously there is no competitive forum for web browsing. GeoGuessr is kind of close. What is it? GeoGuessr, do you know about this? No, what do you do? Oh, there's this guy, Rainbolt, and he's like the best in the world at GeoGuessr, which is this game where you get like a picture from google earth of somewhere in the world and you have to guess like you have to put a pin on a map of how close you are to the thing and this guy rainbolt is like within five kilometers every single time but that's even that's a little more scoped that's incredible your browsing yeah that's a very narrow skill i mean he sounds like a savant he's on tick tock he's like he crushes yeah yeah i mean in my show what i think would make it entertaining is that when i'm browsing there are a lot of things going on right you know i'm watching some videos i'm doing some twitter but i'm also finding obscure websites sure i don't know i just i love the internet i love browsing it i i totally agree just just surfing the web surfing the web man um the original surfing it's before before physical surfing was cool right right speaking of maybe the curiosity part of it you've talked in a few different contexts about what I would describe as sort of this fun curiosity driven orientation versus this like work ethic grind orientation you've said you don't love practicing I think that was specifically in the context of drumming there's another excerpt you say I really thought I'd try to get into Berkeley and seriously try to become a great jazz drummer I suppose that I've always lacked the discipline and practice ethic that's required for that I had to learn over time the bolts in the art I make and in life I have to turn being a dilettante into a strength.

14:01I'm not the guy who's going to shoot 10 ,000 free throws until I'm Michael Jordan. And it did happen kind of accidentally that I said, okay, yeah, I'll try singing. But the process of being an artist in the world was so compelling because of the freedom it gives you. I feel that way about everything I do, not just music. I want that ethic of being independent and open-minded, having a lot of integrity intellectually to be part of anything I do. And so maybe I'm reaching here, but it feels like you've very much continued with the spirit of that that last bit regardless of the of the domain and whether it's investing broadly or science and bio and medicine now you're clearly very curiosity driven but you also have at least from what i can tell a pretty remarkable ability to go deep and you might call yourself like a dilettante but like i from what i've read and heard and heard about you you have a kind of a radical amount of depth at least in certain contexts so i'm curious how you balance that energy we were just talking about the surfing the web pure explore energy with the ability to exploit and say i'm actually going to get really rigorous i think the rigorous part there's a level of depth i can get to where i don't need new skills you know which is basically to say using just language and conceptual thinking, you can understand a lot of molecular biology, for example, which is an area I've spent time on in the past decade, where I start to feel that tension with my sort of dilettante inner child is is when you then need to actually learn a new skill so i'll give you an example right now i'm really interested in statistics which was a subject I hated in high school, which was the only time I took it.

16:14And then through my interest in investing and in particular in systematic quantitative investing, which is something I've been curious about for the past few years, I realized there are basic concepts that are used constantly that I never really got. So, for example, I don't actually know what a standard deviation is. You know, like what? Just like, look, what is that? And so I was recommended by this really cool statistics professor at Stanford to get this old stats textbook that's been around for 30 years or whatever. And I bought it. It's a great textbook. and it's super well written because it's, it's, you know, there are no pretensions.

17:04It's made to walk someone from knowing nothing through all the basic concepts. And so I'm really enjoying that, but it's, I have trouble pushing myself to do the problem sets. You know what I mean? It's like, it's, I love reading the chapter and then, okay, I know for me to really internalize this sort of like the the scales or whatever and yeah now i need to do 10 of them right and it's kind of like when i feel like i got it i'm i'm not going to do the 10 you know and i and i'm always kind of i've had this i don't know if it's been deliberate or accidental but i've had this privilege of working um in my music career and now in my investing career with collaborators who are super deep technically.

17:58So like my bandmate Max in Chester French is really a prodigy musician and can play every instrument and write string arrangements by hand. And, you know, like that's kind of a crutch for me. It's good. I mean, it's complimentary skills is a different way of putting it. But I'm always sort of in awe of people who can do the thing I can't which is this kind of relentless, deep focus. And probably actually enjoy. Love. Yeah, yeah. Getting really, really up close to that. They love it. You know, like their happy place is doing that all day. And I get it and I admire it. And part of me wishes I were like that, but I'm not.

18:45So the best I can do is kind of work with people like that. But then when you do, they also raise your game. So you know what I mean? you go from being totally non-technical to being like much more seeming, you know, when you say like, oh, it seems like you have depth or something to say in, in biology, like, you know, I have de facto ended up knowing a lot of biology, but not nearly as much as people who that's all they do, but much more than like I did when I was a generalist investor. Right. On that theme, you've talked about sort of this inclination towards understanding the skeleton or the structure or maybe the whole of the thing rather than in the bio context memorizable facts or even just in any context like really really up and close with all of the details and I think maybe it's particularly interesting in life science and biology because most people associate those things with their high school experience of this like rote minutiae somebody you've referenced as a particular influence, I think you started reading maybe like early on tour as a musician is EO Wilson.

19:54And I'd love for you to talk a little bit about, I haven't read Consilience, but I have like a basic understanding of Consilience by Reduction. And I'd be curious for you to contrast what seems like a notion that's built around sort of like compressing really big ideas from top to bottom to reduce them down to these like really, really simple theories, usually it seems like physics. And so you have that on one side, but you also have like complexity theory and some of the Santa Fe stuff and emergence and these ideas that actually feel like it's, they get wider over time, not narrow over time. Are those two ideas actually intention?

20:32Am I misreading that? Like in hindsight, maybe I think you first read Wilson and maybe 20 years ago or 15 years ago, have your views on that type of stuff changed? Because again, you seem, as you were just getting at you seem like somebody who's really coming at all this stuff trying to understand the whole rather than trying to reduce i think that's a reasonable characterization of my goal and what eo wilson was writing about in that book consilience in particular is the idea that nature is one continuous entity, you know, so like these boundaries that we draw epistemically between molecular biology and sociology and anthropology, you can think of those as metaphorically kind of horizontal or vertical divisions.

21:44So East Asian studies, you know, as a field, so to speak, in academia is like everything about East Asia, right? Like every part of culture and history and whatever. And like that's sort of a vertical division. The vertical slice, right. And the horizontal slice is, you know, something like anthropology, where it's like, oh, we're going to look laterally across all of these different cultures and try to find common characteristics of social behavior and organization. And, you know, Wilson's point was. Reality doesn't have any of these divisions. Those are all lines that we've drawn. Top down. Yeah, because we think it's going to make it more tractable to understand something we're curious about.

22:37But we might be wrong about that. In other words, the best way to understand two things that seem unrelated in our taxonomy might be to have a different taxonomy. So I do aspire to understand as much as I can about how reality works. And I do think you get a lot out of trying to blur those disciplinary boundaries. or you can even start to get at the truth by just spending some time in each of those disciplines and then you kind of organically see where they overlap and bleed into each other part of the idea at least as i sort of understand it very basically is that he's trying to reduce at almost every level of abstraction and and basically like almost all like the the super smooth brain version of it is like most things are up uh downstream of physics basically like or physics at least resolves into all of these other things one of the things there's there's something i read from you a while ago that was sort of talking about come initially coming at sort of trying to understand the world through a lot of humanities related stuff politics and sociology and even anthropology and and one of the things that was so attractive both about that book and and moving into bio and life sciences was this notion that our current systems and models are actually just way better explaining life sciences than these other things.

24:17And part of my question is, do we just not have enough rigor that high up the abstraction or is something else happening there? Like, I guess what I'm wrestling with is, do we just need to spend more time in physics and chemistry and bio to eventually understand that? or is actually like something else happening here? This is what I'm, and maybe I'm forcing, this is what I'm trying to connect into the sort of like complexity science Santa Fe stuff is that Emergent seems to run kind of perpendicular to the E.O. Wilson stuff to me, but maybe I'm not connecting. I'd have to go reread E.O. Wilson to know how at odds his view was with that.

25:02I mean, what I remember striking me about that book was just his insistence that we strive for integrative theories across, you know, what people in complexity world call scales of organization or levels of organization. Right. And all that's meant by that is, you know, you can describe things at the level of subatomic particles and then atoms and then molecules and then organisms and then ecosystems. systems and societies and sort of like pace layers. It's like, you know, as you go up in this metaphorical way of thinking about the world, what you are doing at each scale is you're defining what an individual is.

25:52And then the theories are about how individuals interact with each other at each scale. Right. So at the subatomic physics level, you're trying to have theories that accurately describe the interactions of subatomic particles. And then at the atomic scale, you have basic chemistry. You know, how do these atoms interact with each other? What are the ways that they bind and react? And how do they form aggregates? And how do those aggregates interact? And then so on and so forth. By the time you get up to, you know, human cities, you need theories of how buildings relate to people, relate to companies, relate to apartment collapse.

26:35But he's saying, like, these are all sort of, if you take a lateral kind of understanding across a lot of these things, you can actually move up those ladders of abstraction and still have, like, some semblance of the same theory. Well, he's saying they should connect. There should be a sort of clear connection between each layer of the cake. So if we have a theory of evolutionary biology and genetic variation and heritability, that should connect with our theory of psychology, for example. And so, you know, this stuff is hotly contested, but E.L. Wilson was among those who were involved in so-called evolutionary psychology as a field, right?

27:29And like that in and of itself was meant to be a new field that bridges the theory of evolution with psychology and tries to ground observable human psychological traits in evolutionary selection pressures. Now, any of these things can be overdone. And I think you're getting at a really interesting and fundamental question, which is. Are the theories that we need to explain what happens at a particular layer? Just endemic to that layer alone. Right, right. And that is kind of, in some sense, the premise of what's done at Santa Fe Institute or what people are chasing with complexity science, which is wouldn't it be nice to have quantitative predictive theories of how a city works or how a market works?

28:26And what is enticing about that is that as of now, we just don't have theories like that. So on the one hand, we've got what appear to be highly reliable theories for Newtonian scale physics, right? I mean, we can predict when I throw a baseball exactly where it's going to go, and it's going to do that every time with very little variation. But if we want to predict what's going to happen to a company, which is, say, what venture capitalists do, or we want to predict what's going to happen to the U.S. economy, nobody has a formula that does that reliably. I mean, there are a million people telling a story about what's going to happen.

29:10Yeah, it's just a compute problem or whatever. We have no idea. Right. I mean, we just don't know how it works, basically. And so anyways, yeah, I've said enough. It's cool. One of the things that I'm interested, maybe to start with, you seem very interested in complex systems and you've spent time working in a few of them. Before we get into that, any just like broad reflections? I don't know how long you've been involved, but broad reflections on what makes Santa Fe. I think Santa Fe is like a pretty under discussed, but a whole bunch of really smart, interesting people are involved. I'd be curious what you think makes that place unique or special.

29:43santa fe institute i think is very special because it's really the birthplace of so-called complexity science but that is complexity science as such called complexity science and recently i was watching ken burns and he did ken burns did the da vinci cool it's like a three-part da vinci documentary and um watching that you go well da vinci was doing complexity science i mean he was that's exactly what he was doing he was and and basically so were a lot of scientists for most of history before science was institutionalized in the way it has been right in the past i don't know 200 years where all of these very strict disciplinary boundaries have been formed and but labels are maybe to santa fe's credit like labels are really helpful as shelling points i guess my my uh intuitive frame here would be that something like the label complexity science gives more people like agency in this domain to like think about it more explicitly well even if the taxonomy isn't perfect yeah i think what it's meant to do is it's meant to give scientists permission right to explore questions that are not native to their subspecialty or their subspecialty right and by contrast you know for the most part if you're at a big university today the exact opposite is discouraged right i mean how do you get a celebrated, you know, dissertation and then get a job.

31:30It's like be super narrow now. And so the Santa Fe Institute, on the one hand, I mean, it's got this kind of brand of, you know, really smart people. And I mean, like these like these issues that Santa Fe Institute deals in are the things that you hear the Collison guys talk about and Charlie Munger. It's like there's an aesthetic of like smart, you know, smart, interdisciplinary, peripatetic thinkers love this stuff. And that's true. But I actually think that what's cool about it is almost the opposite of that, which is that it. enables this much more innocent and open-minded type of science which is people who are just willing to go back to very basic questions about the nature of reality and it's not just the theoretical physicists who are permitted to do that at santa fe and and then part of the formula is letting people who are really smart and experienced in one area interact with people in another area and again i think like my perception i'm not i'm not a scientist i'm not a part of those technical meetings that happen at santa fe but i think my impression is a lot of it is like let people ask dumb questions about fields they're not a part of yes and it tends to unlock new routes of inquiry.

33:08Yeah, permission's a really powerful idea, I think, broadly in these types of things. And briefly alluded to it earlier, you have spent your career inside of like two very complex, complex might even be a nice way of putting it, like some people might just say like bad, messy, complicated systems, or at the very least bureaucratic systems in terms of the music industry and then now healthcare and medicine. You mentioned it earlier, you're clearly also just broadly interested in markets. You could be an investor in plenty of different contexts. Like, do you think there's a reason you're attracted to these high complexity, you could call them like hard mode areas?

33:47You know, I've never thought about that. And I, if anything, wish that they weren't like that. I mean, meaning I didn't, I did not - You didn't choose them because they were hard. I did not choose them because they were hard. and i wish they weren't hard and it's frustrating that they have that quality and so i resent it you have written especially recently quite a bit about trying to sort of like structurally resolve some of those problems in in medicine and in health care and specifically wrote about this like zero toll medicine idea recently i guess a two-part question one what goes into designing good systems, especially if they're complex?

34:32And two, is it actually realistic to imagine a world where you can either hot swap or actually replace an existing structurally entrenched system? Like you outlay in zero soul medicine specifically, you outlay this like kind of like beautiful theory of like, if you could start anew, here's how a great system could look. But also you're trying to layer it onto like the most endemically bureaucratic system ever. And so is that like, I'm curious how you think about that broadly and to what goes into actually like designing a new system that's really productive or good. And obviously you don't need to give us all of the answers in a podcast.

35:09I'll tell you, I wish I knew. I'm a little insecure about whether putting out an idea like the serotonin medicine thing is worthwhile. because it's to your, I mean, embedded in your question is just the truth that it's like, this isn't going to happen. You know, like I'm writing an idea about, okay, here's how I think the healthcare system should work. An ideal world, right? Yeah. Here's this ideal world. I mean, it's basically science fiction. Granted, like most things in crypto. Yeah. So it's like, that's just like me giving a science fiction idea of our healthcare system, except what's not science fiction about it is like, you don't need any new technology.

35:52Like, right. We actually could do this today. All we would need to do is agree. A benevolent dictator. Yeah. Yeah. Just like America and all of the people in it who are at odds with each other's interests. We just need to agree. Yes. DA's idea is perfect. Let's do it. Yeah. And so, you know, I try to voice that because at least it suggests that something that I believe would be better, it could happen. We don't need a ton of new technology. We don't need a crazy design. Right. And people, I'm not like a, I wouldn't identify as some kind of strong socialist, but socialists I've heard say that it's easier to imagine the end of the world than it is to imagine the end of capitalism.

36:44And it's a kind of poignant thought because obviously it should be much easier to imagine the end of any man-made creation than it is to imagine the apocalypse. But there's some, when you hear that formulated that way, you kind of go, yeah, that is true. Like it, it, I can't imagine capitalism being over. Right. And similarly, it's like, wow, can you even imagine our healthcare system not being horrible? And I think the one heartening thing is that it's not like the world has one health care system. You know, there are a lot of different countries. They all try different things. There are new countries that pop up and old countries go away.

37:31Countries aren't even that old of a thing. Right. Right. I mean, lots of renewal happening that allows for opportunities to kind of like wedge in new ideas. Exactly. I mean, I don't want to go. we don't need to go into a whole historical thing, but it's like when the Israel-Palestine war broke out, my partner and I were reading all this stuff about the end of the Ottoman Empire and basically what the seeds of the whole Israeli conflict were. And when you read that, you go like, wow, it wasn't that long ago. And in the backdrop of that was the emergence of the nation state as an idea. And then you've got like Balaji and people like this writing about the trying to come up with new ideas.

38:15And, you know, on the one hand, that stuff sounds a little fanciful. And I don't know that network states are going to be the thing, but it's not crazy by any means to imagine that the system we have right now won't change. I mean, it's almost definitely going to change in various ways. And by that, I mean, you can see the dissolution of nations, you can see the global order emerging that might just be a network of big, powerful cities or various. I mean, there are a million different ways you could imagine it playing out. And so the health care system might end up being completely different. And therefore, why not brainstorm?

39:03You know, and if I can like also what I was trying to do with that piece in particular was just make a very logical case that insurance companies don't do anything valuable. because i even myself being an investor in this industry is like you get so well adjusted to the idea that all the things that are a part of it should be yeah you know like oh yeah like of course like we we need to come up with all this technology to help insurance companies do it it's like but why do we need these insurance companies it's like seeing the water a little bit of just like what are the super for granted yeah yeah like they literally don't do anything worthwhile Like, why do we have them?

39:43Shouldn't we just get rid of them? Like, you know, I think Obama should have oriented Obamacare around getting rid of the insurance companies, maybe. But the next person could do that. I mean, Donald Trump could have decided, you know, I don't know. Part of me was thinking, wow, there are all these crazy people coming into government right now. I'll write a thing that maybe some of them will read and they'll be insane enough to try this. Not that curvy. They're trying stuff. I like the sci-fi metaphor too, because at its best, sci-fi is like, it's not about the future. It's about like helping people see the present through a new setup, through a new lens.

40:18And so hopefully in your case, it's both a like drastically different thing that also might be directionally where we can go. You talked about capitalism. You clearly are someone who's very interested in markets. I'm curious why they are energizing or interesting to you. markets have just kind of always intrigued me as a subset of you know the broader economy and i got seated with this interest in economics in high school when i had this uh hobby thing it was like my my one of my extracurriculars in high school was this thing called fed challenge okay which was basically a competition sponsored by the federal reserve where high school kids on teams have to basically the the competition is your team, which is like four or five people does like a 20 minute presentation.

41:16And it's like your overview of the current state of the macro economy in the United States and then your policy recommendations to the Fed. Wow. Does it still exist? I don't know if it still exists, but it was awesome. Like, I mean, For me, it was awesome. And it really framed how I still think about the economy. And I don't know, there's something cool about just that exercise in looking at data and trying to figure out what's going on and putting it together in a coherent narrative that then, you know, in this case, making policy recommendations, you can like act on. So as I've gotten older and then got interested in different styles of investing and different asset classes and parts of the market, that's always in the background.

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42:15Just this idea of like the markets are both a part of and happening in the context of the broader economy. and you can start by just situating yourself broadly as like, where are we in the economic cycles? Where are we in the credit cycle? Where are we in the innovation cycles? Or are these things even cyclical? Or are they just evolving patternless kind of phenomena? And then - It's back to emergence. Yeah, like once you have set the stage in that way, how does it bear on the narrow part of the market that you're looking at? And so as an example, I kind of relish being in the midst of a very crazy, challenging moment in life sciences markets and being able to vacillate between a sort of macro view and then a micro view.

43:23And it goes back to what we were talking about before. It's like, how do you connect these different scales? Because you'll hear people telling a story about what's going on in biotech, for example, like the biotech in the public markets, biotech has been in the tank for like four years. It's just brutal. and so people who are just in biotech you know they may come up with stories that are more in the terms of the science or what's going on specifically with particular investment firms or something it's kind of micro view and but then if you like zoom out you go oh actually this is like 80 percent of this is just about interest rates or whatever i'm not saying that's some like brilliant insight.

44:07I mean, people know that, but I don't know that, that perspective that you gain from zooming in and out and trying to fit the puzzle pieces together is just really interesting to me. And partly because I don't know that you ever get certainty. It's, you know, I mean, if you like, I've got a bit of a, what do you call it? Like a guilty pleasure of listening to CNBC kind of stuff or like podcasts that are just like macro talk. And I'm always thinking when I'm listening to those things, I'm like, am I actually like getting anything out of like, am I learning anything? Or is this just like a really perverted style of entertainment that I'm drawn to?

44:54Like, I just like, like my, my family makes this joke with me of like, oh, you know, there's dad again, listening to old men talk. And like, my kids will always be like, child, not kids. My child will always be harassing me about like, dad, are you just going to go listen to old men talk? And it's kind of shameful. What makes a good investor? Or what have you learned about investing? What have I learned about investing? hmm well it's it's definitely multifaceted and what makes it interesting again is that you're trying to build a composite view by going pretty deep on a bunch of individual pieces none of which is sufficient on its own no certainty either to back to your earlier point yeah i mean even yeah even like you know what you're going to do is you're going to look at all of these facets of an opportunity you're going to look at the management team and you're going to look at the financials and you're going to learn about the market and you're going to try and project sales and things in the future and then you're going to try to estimate the probability of different scenarios and each of these component exercises is highly error prone.

46:23So at the end of it, you hopefully come to a conclusion about whether you should do something or not. And then what's tough about venture capital that a lot of people pointed out is you don't find out if you're right or wrong for quite a while. Now, I will say you can find out you're wrong sooner than a long time. And also rightness is a huge gradient, huge gradient. And also, you know, like, of course, things can fail for reasons that you didn't see, but things can also succeed for reasons that you didn't see. Is it beta or alpha? Yeah. And do you do you like, yeah, is it beta or alpha? And then like also, you know, are you a genius to have invested in Amazon because you love bookstores, you know, or like did you get love?

47:18lucky because like the bookstore idea was great, but it wasn't Amazon. Right. Right. Yeah. It could have been Barnes and Noble. Like you do hear venture investors, I think often remark that it's all about the people. And so sure, I think that's true. But also what do you do with that? Like, all right. Let's say, okay, I agree. I've learned it's all about people. Should I, should I not care about the idea? Like, you know, should we not hire an IP lawyer to find out if this is actually patented? Right. Should we not do any of the other diligence that we always do? So it's not all about the people.

47:59You know, there are some like the I guess the people are definitely necessary, but not sufficient. But then other things are also, the other things are not necessary and also not sufficient. So the people are maybe the only thing that is necessary. Everything else is maybe necessary and maybe sufficient or not, certainly not sufficient. Interesting. This goes a little bit back to something you were talking about a few minutes ago, which is that so much markets is like trying to see reality clearly and obviously investing within that context. But there are plenty of investors who just all they actually care about is seeing reality as it is and capitalizing on that.

48:50You seem to have a more creative or generative approach to it. Obviously, venture capital by definition is an asset class is a little bit that way. There's a quote from you. You say the reason, and I think this was many years ago, but you say the reason I invest in technology is it's the only work humans do that is actually creative. All other types of economic activity are just moving money from one pool to another, whereas technology is what allows us to create value out of thin air. There's something about that that is really conciliate with art. It seems like for an hour of my time there, I can produce a lot more impact.

49:22And I'm curious within the investing theme, why is investing specifically the right domain or orientation for you to act in this kind of creative phase of your life. You could be building biotech companies or doing something totally different. It seems like the creativity is clearly the theme, but you're doing, you're drawn to investing for some reason. I like the creative stuff for sure, but I'm not sure how naturally talented I would be at building companies. so I've often thought of it as sort of the record producer phase of my life you know where like when I was making music I was like the obviously the artist but then in this phase the entrepreneurs are the artist and I'm more like a producer and so I like the leverage that it affords you because you don't have to just do one thing right you know I get to sit across all these companies and all these talented people.

50:26So that's interesting. The intellectual challenge of security selection, diligence, and all that is interesting. I'd say where I hope to be more creative as an investor is in trying to innovate on the investing process itself. And I'd love to innovate the off, like I'd love to innovate on the market structure in some way. I haven't done that by any means, but that's a goal of mine creatively. You know, as we're talking about the geopolitical order evolving throughout history, music evolving throughout history, biology evolving throughout history, so too has the asset management business. And if you look at the past 40 years, the most exciting thing is the index fund.

51:32You know, that's such a that was such a creative innovation. and there's this great book that robin wigglesworth wrote trillions i think it's called which is about the index fund the rise of the index fund and so i don't know a ton about him honestly but like in principle jack bogel's definitely one of my heroes and i love what he did because you know he combined a sort of brilliant investing insight with creating a product that has done a huge amount of good for everyday people who are trying to hold on to as much of their wealth as they can. And on the one hand, venture capitalists, because it's, you know, people say, oh, venture is an access class, not an asset class.

52:28And like what they mean by that is it's all about like what deals can you get into? You know, like my friend Josh Kushner can get into the hottest deals in the world. Like you want open AI, give Josh money. He's like, he's right in there. Yeah. Put all the money into open AI. And that in a way is what the venture capitalists do. So for a venture capitalist, the marketing that people often do is oriented around how great they are for the companies they invest in. So it's all like, I'm so founder friendly and I'm so awesome. I add so much value. And I kind of am skeptical of that. And I'm going to get back to Jack Bogle in a second.

53:06But I'm sort of skeptical of that because at least my intuition is that the best entrepreneurs don't really need very much from their investors. It doesn't matter who they get the money from. They really just need money. And like, yes, I'm sure, you know, whoever you have on your board might have moved the needle on this or that thing at some point. But, you know, if you said, I just want to invest in the truly the absolute best entrepreneurs in the world, they don't need anything other than money. Elon's not talking about his investors very much. He's not. And by the way, when I was starting my firm, he and I had dinner and I said, I said, look, I want to start a firm.

53:42Tell me from all of your great experience, like with investors, whatever, like what what do you need from investors? What makes a great investor? And he was like money. I mean, it was like not being I don't I forget exactly what he said, but he was like not being annoying. Right. Coming from the best capital raiser in the history of the world. Very good. Yeah. So that is just to say, I think it's kind of BS this whole like, oh, we're all about the entrepreneur. Like your customer as an investor is the people whose money you're managing. And I know that it can feel less noble to be managing money for some pension fund or whatever.

54:22I mean, we don't need to get in the merits of who you're managing money for. But let me just say, if what Jack Bogle did was give the index fund an access to low-cost, highly diversified equity investing to, you know, a billion people, that is a huge good for the world. because people work their whole lives, and pension recipients obviously do as well, so managing pension money is really important. Maybe university, I don't know. If you think universities are corrupt or whatever, then maybe that's bad, or hospitals, whoever. You don't like, yeah. Whatever institution you don't like, sure, okay, managing their money, who cares?

55:07But I don't view it that way. I mean, I think it's like, you know, helping people preserve capital, particularly if they're people who really need that money. like to retire on. The goal of the industry should be to constantly do a better job of that for people. And so - It's a verse though, because so much of what it seems on the external piece of it and the marketing around it now, all of that is that your customer is the entrepreneur. And so there's like a little bit of a dotted line there that I think most entrepreneurs don't think at all about who's even where the money's coming from, which is an interesting sort of like misdirection and all this.

55:51Totally. And I just think it's I think the whole thing is I mean, we're just talking about venture. I think the whole thing is better when it's transparent and straightforward. And I always tell entrepreneurs, I'm like, look, it's this is not my money. You know, this is other people who have worked their whole lives to make this money, have entrusted me to go and find the best risk adjusted returns in healthcare. And that's what we're doing. We think your company is one of those. And here's what our incentives. Let's be commercial together. Right. Yeah. And it's not like, yeah, like we're, I'm not using that as cover to be like needlessly ruthless or something, but I just think it's just being honest.

56:35Here's what my incentives are. Here's what I'm trying to do to do a good job. Totally. And if the company performs in this way, then I will have done a great job for our customers. And if the company doesn't perform in that way, then here are the things we're going to need to be thinking about to try and mitigate a disaster. It's a really, it's a refreshingly different take. Like, I also just broadly like the idea of the idea of challenging these, again, like seeing the water, like challenging these baseline defaults of mechanisms that haven't always been there. I was talking with some friends last week about like how the employee stock option plan is like kind of what actually enabled startups and venture capital.

57:22And even that like showed up in like this 40s or 50s, I think. So it's, yeah, it's cool. I mean, it all resolves all the way back up to the sci-fi discussion in Zero Toll Medicine. Like, are there things that we can actually like, oh, these things are just totally locked in and maybe not? Yeah, and I think, I mean, venture now is going to change. Private market investing is changing. The nature of securitization with things like crypto may change. So going back to the earlier discussion, what excites me is thinking about how we can potentially innovate on the investment products as we're investing in a market that in and of itself is fascinating.

58:17life sciences and healthcare. So you've got change in the themes that you're investing in, but then you've also got change in the asset management business itself. And that's where we want to innovate is we want to be an innovator in the asset management business. So that's where I, you know, after 15 minute cul-de-sac here, that's where I envision having an opportunity be creative cool i like that a lot speaking in the context of kind of like creative you likened technologists to being sort of the most creative part of the economy there's a an old bit you have where you say for most scientists like most artists the point of it all is the work itself the song or the discovery or the technology yet in both cases the importance or power of that creative accomplishment is amplified by commercialization.

59:11What's the point of your great idea if it never gets the listeners or patients? And obviously, we're not also going to solve this today. Commerce and creativity are kind of like always sitting in tension. But are there any patterns that you've noticed throughout your life or more recently as an investor in the creative people, again, whether they're in the art context or more solidly in the science and tech context of creative people who are good at commercializing, or at least have an attunement to commercializing stuff. I think the commercialization or promotion part is it's doing you know so like the creative part can be just thinking.

59:58oh you know in science yeah and then i mean then there is like a there's there's a sort of intermediate doing which is like doing the experiment writing the song recording the record shooting the movie or whatever but then there's this follow-through which is a lot more doing and i think you kind of have to have a love of that too and and not everyone has the love of both because you can love making the music, but then you hate being on stage or you hate doing interviews or you hate doing photo shoots or like - You hate raising money. You hate selling customers. Yeah, oh yeah. Like I love investing, but I hate raising money.

1:00:41Well, it's like, well, that's, but that's not the job. Like a lot of that job is raising money. So it's these people who really like both. and it's it's very hard in general to compete with people who like doing the thing if you don't like it and they like it good luck competing with them there's this amazing anecdote uh that my friend graham duncan highlighted about novak djokovic in the financial times and you've seen this and it's it's like how do you go on playing at this level for so long and he's just like i like hitting the tennis ball yeah and they're like what do you mean everybody likes that he's like no watch them you You could tell that's and I do.

1:01:21And I want I love Graham. But to I this substantive thing is maybe that that also maybe gets at the two at the thinking and the intermediate doing and then the doing doing. There are also people who just love that last mile. They just love the market. They just love conferences. They just love TED talks. every end and you know they just thought gas heaven forbid yeah they just love podcasts they don't read they and i don't like that culture i really don't like that that kind of superficial culture which is in a lot of ways it's just an extension of of gossip magazines you know it's it's might nominally be a science you know might nominally be about science but it's really just about talking about people and who's doing what and who's dating who and who's starting a company with who.

1:02:20And there are investors who are like that. It's just all about the the social drama and the what's hot right now. And I hate that. Yeah. And I would I describe that stuff as unsubstantive versus what I'm calling the substance, which is like. Do you really love the music do you really love the process of discovering a new molecule do you really find material sciences genuinely interesting some of this is like where do you get your dopamine i part of what you're describing is these people who are actually like enamored with the full end to end of the process because by the way most people sort of tend to one end of that and if you're getting your dopamine from anything other than like making something and selling it or whatever permutation of that, you're probably likely to skew towards one end of the thing.

1:03:18Yeah, that might be. There's, there's also a sort of the, the, what I'm calling the substantive part is kind of more insular. It's, it's, you know, you're, to use your phrase, you're like getting your dopamine from discovery or creation. And then the other part is kind of inherently social. It's all about other people. You know, on the one hand, yes, you want people to hear your music or watch your movie. But I think that's kind of inextricably linked with wanting to hear everyone tell you how great you are. Oh, wow, you're such a genius. And that song's so brilliant. and you're but there's people who only to your earlier point like or to use a different analogy we're talking about the front like there's people who are really good at surfing the internet and then there's people who are really good at surfing the internet and commercializing it as an investor right you actually kind of do need well there are plenty of people who who like to do some aspect of the creative thing but when it comes to to which is why i kind of think like it's almost like your dopamine being linked to the full feedback loop versus one slice of it yeah it's it's it's kind of like, you know, you could write the greatest song ever.

1:04:37And then the question is, are you satisfied with that? You know, do you listen to it and go, wow, I did it done. Or do you feel like, okay, I think I did it. Now I need a bunch of social confirmation in order to sleep at night. And I mean, a lot of artists and a lot of business people have that psychology, which is they're kind of narcissistic and they're very insecure. And so, yeah, they're sort of like they have that internal fire to make the stuff, but that's not enough. They need they need everyone to tell them how great they are. And that drives them through that last mile. Yeah, it's like different kinds of fuel.

1:05:24What one, it's a little bit in the weeds, but one thing you've talked about in the context of investing in, in health and biotech is this notion that you're kind of like more excited by older technologies, like things that are a little bit more Lindy. You said, I love gene and cell therapy, but to me, those are brand new technologies. They're very intellectually exciting, but also risky to invest in. I'm specific. and this is sort of just selfish because I feel like I was hearing about it so much until maybe more recently is like gene editing and CRISPR specifically is like, it's funny. I actually just saw a Paul Graham tweet about this where he was, it was like, I don't know, all the gene editing companies are down like crazy the last few years.

1:06:05And his contention was, were, I don't know, it's like the 2000s internet stock bubble. I'm curious, maybe if there's anything broadly on that note of like how, how to think about the why now for an emerging technology. And then two, just curious if you have any actual specific perspective on the, on the gene editing stuff is it very much feels like the future is like unevenly distributed from the outside looking in, but it's also pretty opaque to me. And I suspect a lot of people of like a thing that could just be the most important technology of our lives. But I heard about a lot about it in 2015.

1:06:37And now I, I guess it's boring or not progressing fast enough. it's starting to have some success stories in human clinical trials very recently, like the past couple months. And that's really cool. But it is still very early technology. So what is early technology in biological sciences? Or does it depend on the context? If you think about developing a new drug, there are many different dimensions of risk. So I'll just mention a few. One, what organ tissue system in the body are you trying to affect? So let's say you're trying to fix literally a broken heart. You're trying to fix, you know, thickening of the cardiac tissue.

1:07:28So you have to figure out how to get the medicine to the heart specifically. Now, you also have to think about where else it's going to go. So if that medicine is also going to hit a bunch of other parts of the body, you got to be sure it's not going to screw them up. And it might screw them up by doing the exact thing that you want them to do in the heart. But you only really want that to happen in the heart. You don't want it to happen everywhere else. So you have to think about delivering to the right place. You have to think about the drug actually working when it gets there. You have to be cognizant of all the other places it could go and the damage it could do there.

1:08:13You have to figure out how much you need to give to affect the right level of activity and how long you need to be giving that amount of the drug. you have to think about the patient's immune system and the way that it will react to the drug is the body going to mount an immune response to this and generate say anti-drug antibodies that then neutralize the effect of the medicine you have to think about how much it's going to cost to manufacture the drug is that going to be commercially viable you have to think about about how much the U.S. government will pay for that drug and what the economists are going to conclude when they think about the economic impact of everyone paying for that drug to treat this disease versus paying less for a slightly worse drug, but one that may have significant enough benefits that the cost benefit favors that one.

1:09:17So anyways, I'm just giving you a sense of how many dimensions there are yes and so i mean i always refer to this metaphor of you know when you're playing like a fighting video game and you know you scroll through the the the characters and you see all the bars yeah yeah it's like so every drug has like its own yeah it's like a player card you know it's got its own set of bars right for all the different criteria and you know it's it's a very challenging science so all of that is to say that when you have a brand new technology like dna editing the technology until you have tried it in people a bunch of times is fundamentally a big question mark is this going to work in people even if it works in monkeys and everything else still is it going to work is it going to cause a problem that's just the foundational technology.

1:10:12And on top of that, you have all of those other component risks. Gene editing is a type of technology that's also like going at a very low level of abstraction relative to maybe a antibiotic or something. That's right. And in particular, one thing it's doing is it's potentially permanently editing the DNA. So in principle, it may be irreversible. So if it does the wrong thing, it could pose a huge risk and it could you know let's say let's say that crisper goes and puts a mutation in the wrong place and it gives the person cancer yeah how many people do we need to test it in to know that it doesn't do that in one out of 5 000 patients right because if this becomes a mainstream heart disease medication it's going to be given to hundreds of thousands if not millions of people so you can't afford for it to give cancer to one out of every 5 ,000.

1:11:06But let's say your first human clinical trial is 100 people or 20 people, and it works beautifully in all of them. How do you know whether you've mitigated that risk of giving people cancer or not? Because the incidence is much lower than you would be able to ascertain in that small study. So... Lindiness is good here, is the idea. Well, it's just you are, if you're just trying to make money as an investor in new drugs, your goal is to mitigate as many of the risks as possible and to kind of isolate what's the bet you're making got it you know the more that the bet you're making can be isolated to one narrow question the better because then you just need to be right or wrong about that but when you have a brand new technology like CRISPR being explored as a human drug, you've got a bunch of question marks that you're having to deal with all at the same time.

1:12:05I'm glad people take that risk, but it's definitely more risky. And that's why you can look at technologies like antibodies or by specific antibodies that have been around for 30 years. And they've already been tested in so many different contexts with so many different patients that you've put to bed a lot of those risks. And now if your idea is we want to try an antibody drug against a target that we've never gone after. Got it. Well, now that's a narrow risk. You know, you know, all the other things have you can you can sort of take for granted. And now it's just this one narrow question. Something like GLP-1s, I don't know anything.

1:12:51I'm a total layman here. Seem like they kind of come out of nowhere, conversely. Have they actually just been around way longer than I realized? Is it that it's actually far more scoped and narrow and less complex than something like CRISPR? How does a drug like that kind of go from, again, it's the classic futures here, not evenly distributed yet, or suddenly and then gradually and suddenly. how would you comp something like that which just again like three years ago never heard of it now and not to mention it it doesn't just seemingly solve obesity but it seems like it's maybe the miracle drug for everything so that's a great example of the of the gradually then suddenly thing and i say that because this was kind of percolating in big pharma companies for over a decade and there's a longer history behind it too like you know we actually make GLP-1 naturally, and it's something your body secretes that has a physiological function in normal, healthy people, the original idea was, oh, maybe we can have a synthetic version of it.

1:13:57And I believe the original molecule was derived from the Gila monster venom. It's a fun story. Because the human version of GLP-1 has an incredibly short half-life. so it's not you couldn't just make the human version of it that we make in our bodies and use it as a drug because the drug would have such a short half-life it's basically not a drug yeah and so they found this gila monster venom contained a sort of similar molecule but its structure gave it a longer half-life and so that was like the first version but it also didn't have all the properties that would be ideal for a anti-obesity drug.

1:14:42It got developed for a long time as a diabetes product. And one of the challenges was that if you gave people the drug at a therapeutic dose, meaning at a dose that would likely be biologically effective, then they would get really sick. And it took years to figure out that you could basically step people up on dosage to get them to tolerate a therapeutically relevant dose. So now when people start on GLP-1 drugs, they are stepped up over the course of weeks or a couple months to the actual target dose because that avoids them getting this like severe nausea and GI issues and whatever. So it's a fascinating story because I don't think people who are working on it knew how big it would be.

1:15:35Another thing that's interesting is that it didn't come from like a startup biotech company. It came from inside of big pharma. And there's an interesting dimension to that, which is that perhaps they had a longer duration of capital and therefore an ability to take a longer duration risk than even the venture capitalists in biotech. And so that gave them the attention span and the runway. Slow build. Exactly. Yeah, and maybe one kind of obvious conclusion here, you talked through some of this is also just like CRISPR got a lot of headlines. And we see this in other parts of technology, too, got a lot of headlines probably well before because of how substantial it was well before it was anywhere near in 2015.

1:16:21It was probably the very, very beginnings of just like the science side, let alone the medical side. And I think that's a broader phenomena. I have a theory, which is that in the 90s, when the internet kind of got popping, every business person was so caught off guard by it. And then you had this like decade plus of like every company just like hiring a quote IT guy to like figure out, oh, like what should we do with the internet? Right. And I think that was a sort of traumatic collective experience for a whole generation of baby boomers. And then in the past 20 years, these Internet companies made people so rich.

1:17:06And then like people like in my journey, like millennials like me, we saw people our age become billionaires like 22. Right, right, right, right. And everyone was so envious of that, that I think the baby boomers and the millennials together vowed to never, ever let this happen again. We will never be caught by a technology that exceeds our expectations. And so the way that that has been accommodated is now anytime there's a whiff of an important innovation, people way overdo it. And it's much more than even like when people talk about, people compare AI to like building out fiber optic networks and stuff like this for the internet.

1:17:53It's like, it goes way beyond that. This is like people going crazy over CRISPR when it comes out, people going crazy over crypto when it comes out, now AI. We also have the tools to speculate more explicitly and with way more scale and all these things. It's interesting, though, this also rhymes with, I haven't read it yet, but the Bern Hobart's new book. I think it's part of what he seems to be arguing is that this phenomenon that you just described, maybe it's amplified now, but it's actually like a pretty important part of these technologies, like fully diffusing, which is interesting. Like the bubble is actually sort of part of the necessary gravity well to get enough interesting people to work on it.

1:18:31So it's I don't know. Yeah, that could totally be. And I'm not saying there's anything wrong with it. I mean, I think I think it's great for the technology and it's probably great for the world. I'm not sure it's great for the first investors. Fair. Yeah. You've taken a, we talked, already talked a bit about the zero toll medicine stuff. It seems broadly that you are taking a very like market like incentives design approach to a lot of aspects of health and healthcare. You have a line where you say zero toll medicine would engage each citizen as a stakeholder in the healthcare costs of the entire society and could provide direct incentives for individuals to proactively be involved.

1:19:16somewhere else you said, like a literally simple example, a patient gets money for curing herself at a lower than average cost. So there's this one view that's like healthcare and medicine that is structurally about individual incentives, which is really, I think, interesting and relies on sort of the shape of markets. And then you also elsewhere kind of acknowledge more of a slightly socialist kind of top-down view. You say, put patients in control of their own healthcare spending, eliminate vast amounts of administrative costs and complexity, and drive far more efficient market-based competitive pricing.

1:19:48It is rooted in libertarian and socialist idealism alike, exploiting the virtues of decentralized decision-making and markets while realizing the civilized goal of healthcare as a fundamental right of American citizenship. Obviously, healthcare itself, the system is sort of sitting in this tension, but I think that last part in particular sounds quite paradoxical to me. And maybe this goes back to like, I'm just trying to paint like an idealistic future. But do you think that that type of tension can really like, can we actually get the full kind of free market version that also assumes this world that says everyone should have health care?

1:20:28I think the socialist part of it is just a question of who pays for health care. And so my strong commitment there is that let's all ensure each other. When we're born, we have no idea how sick or healthy we're going to be throughout our lives. One thing that we do know is we're all born effectively disabled and dependent. And most of us in the later years of our life are disabled and dependent. And so and no one gets out alive. So I think it's a wise and ethical decision for us to socialize the costs of taking care of each other. and immediately people's response to that might though be then you run into trouble around individual incentives which is part part of so much of what you're suggesting and so what seems interesting is a again as a lay person who doesn't fully understand the complexity of this stuff is that more individual ownership and more individual incentives feel really good but it it seems like in conflict with what you just said today we have a system where we socialize about 50 % of medical costs in our country.

1:21:48I'm arguing that we should socialize, if not 100%, 80%, 90%. But right now, we've already agreed in America, we're going to share about 50 % of the costs with each other. Then the question becomes, how do we get the best bang for our buck? Right, right, right, right. And that, I believe, is answered by the individual alignment of incentives. today you've got a system where if i've got back pain and i get referred to an orthopedic specialist that physician's economic incentive is to do surgery on me whether or not that's really what i need yeah and that surgery is very expensive and to the extent that because they get paid by the way when they do the surgery they get paid when they do surgery so it would be much better if I actually had a reason besides aversion to surgery to understand what my treatment options are, what the likely outcomes of those options are, and what the costs of those options are.

1:23:03And then as an informed adult, to be able to make the choice that's best for me. And in general, the choice that is best for the patient is also likely to be the choice that's best for the costs that the society is sharing. Now, there are some complicated edge cases here. In particular, end of life care is a very challenging one, because what we tend to do in America is we perform surgeries and expensive treatments on people until the day they die. So people who have terminal illnesses and for whom extensive treatment to the bitter end is going to lead to a very low quality of life, we tend to still treat those people intensively because medicine lives in this kind of paradigm of wanting to fix.

1:24:00We've incentivized that. And we've incentivized it. Right. I mean, everyone involved is going to make much more money treating this cancer patient an extra five times until the end of their life. And when you look at doctors themselves and the choices that they make about their own care at the end of life, a fascinating fact is that they choose much less care because they know what it entails. And they know what the quality of life is going to be like. And they go, you know what? I'd rather not get another surgery. And that's just a product of knowledge. It's a product of knowledge. Even maybe upstream incentives, it's just like actually understanding what's going on versus most people, by the way, you're playing into an incentivized system that has more care and you're fearful.

1:24:45And you're like, you have unknown unknowns. You're just like, I guess I'll opt in. Right. I mean, you're terrified because it's terrifying to be a patient. And honestly, one of the, I think, major shifts in the philosophy of medicine that we hopefully are in the midst of is we're moving out of a long history of paternalism where the physician is basically like a religious leader. Right, right, right. And what the - Has a special title. Yeah. And what the patient has been taught to do is submit to the doctor. Almost to the point where you'll hear patients say things like, I don't even want to know.

1:25:30Like, I don't need to know that, like, oh, I don't know. They're delegating understanding. Because it's it feels like a relief to just defer to someone. Oh, doctor, you I'll just trust you and you just make all the choices for me. And that's the least stressful thing. Right. But I actually think I think for many more people than we assume. Being empowered with transparent knowledge is much more reassuring. And that's certainly true. I mean, it's easy for me to say as, you know, this kind of medical nerd. But I would argue the LLM stuff is showing this, starting to show this. I think it is because people go on there and they want to know what's going on.

1:26:23They want to know the truth. And it's not perfect. but the LLMs are increasingly, you know, outperforming real physicians in not only medical knowledge provision, but also in, quote, bedside manner. And so we are, without exaggeration, truly in the early innings of the era of AI doctors, free, high-quality medical knowledge for every person on Earth. this is i think without question you know maybe the biggest thing that's ever happened to medicine from the time that it started wow and medicine i i give talks about this like medicine started as a total bs which funny witchcraft it was not a real thing it was a fake science and amazingly over time it has actually started to merge with actual science and become a more fact and evidence-based human activity.

1:27:29And now embodying medical knowledge in machines, in computers, is the next big step. And it's actually going to be much better for patients because one of the great afflictions of this era and of all medicine up until now is there's so much variability in the knowledge of the people who are providing medical care. And so it's completely unfair to folks who don't have access to the best doctors that they get a far inferior style of medicine. Given that we haven't had AI to date, what we've tried to do is we've tried to educate physicians in a machine-like way to think in a machine-like manner and to calculate probabilities in a rigorous and consistent way to follow treatment algorithms in a consistent way.

1:28:24But we all know computers are better at being computers than people are. Yeah, I'm really fascinated by the notion that perhaps even I've heard you've heard the statistics about whatever the AI doctor is better, the human or even the human plus the AI. It's interesting to imagine a world where something about that interface is actually implicitly causing the patient to take more agency and ownership, perhaps because it's less paternalistic or something. That's a mission psychology. And it's not the doctor's fault necessarily. It could be. You started to talk about it and you've written extensively about it if people are more interested in going super in the weeds, but broadly this idea of the universal standard of care, evidence-based medicine, and you've talked too about this idea of streaming medicine and kind of like an, almost like an open kind of global database that has more standardization as you were just getting at.

1:29:19If you were to try to distill that into, what is the most important domino to fall towards getting us a little bit closer to that? Is it this LLM stuff? Is it something else? Is it an education problem? Is it a system problem? obviously it's super complex and it's going to take a really long time but i'm curious if there's anything that's you're feeling you're seeing the heat yeah i think it i think it has partially happened already with the llms there's a ways to go in terms of figuring out how they fit into the practice of medicine or maybe even how the practice of medicine fits into them which might be the right way to think about it.

1:29:59So, you know, what the Gen 1 efforts are trying to do is they're saying like, OK, you know, what does it what does it mean for hospitals and doctors to just start using auto transcription software and then you put some AI in the software and it kind of error corrects or suggests things for the doctor to ask. But it's really superimposing this like incredibly radical disruptive technology over the clunky old bad system and transcription is a nice trojan horse though it is a nice trojan horse and it's it's working you know and it the reason it's working by the way is that physicians hate having to fill out notes at the end of the day so they spend a lot of time doing that so it's like it solves their pain point but if you really want to build the model of the future.

1:30:53It doesn't start with the existing doctor's office and the existing nature of a medical visit. It's going to be a totally new experience. And I think we just need to keep de-risking the LLMs or whatever they evolve into such that we can be confident that not only are they able to deliver the right answer to very specific questions given a set of inputs, but that they can be incorporated into a more interactive process with the patient. So there's this Bayesian thing that happens when a doctor is diagnosing someone, which is the doctor has to figure out what's the next piece of information that is going to most rapidly advance the diagnosis.

1:31:48And so if you go to chat GPT, it's like, yeah, it was great. If I go to chat GPT and I'm like, give it my MRI file and my whole patient history and, you know, whatever else I've got. It's like supposed to in one response, just interpret all of that and tell me what's going on. But like the way it will really work is, oh, I've got this like rash, you know, and then the AI needs to ask you another question. And then at some point, it's going to say, oh, I what what's this blood marker value? And then you're going to need to go and get that blood test and come back. That's the gap. The blood test to the LLM.

1:32:29So that's a iterative, interactive process with the patient that involves acquiring information, not just through a chat. It requires potentially imaging, molecular diagnostics and other inputs. And so we got to figure out how it gets productized in a way that accommodates all that. Right. Yeah. Those friction points are usually where you have churn in the process too. You said, I think in a Nick built an interview for a while ago, you said the last 50 years have been about computers networking. The next 50 are going to be about playing with living systems in deterministic way. We're on the verge, if not in the middle of an intelligence explosion that obviously people are kind of losing their minds over.

1:33:17And it's artificial intelligence, whatever that means. That can be a loaded word. Sometimes it's a word we skip over. There's also a notion of like people like Neri Oxman have talked about this idea of sort of like a natural intelligence. You have this line that I thought was cool that I think was more almost in a spiritual context, but I think you had told Nick, the universe is unfolding in a particular direction and it selects for things that help it get there wherever it is trying to go and it tends to discard things that stand in the way of that do you think is your sense and again you can take this in a scientific ish way or a totally non-scientific ish way do you think there is a difference between the artificial intelligence we found ourselves developing and this sort of natural slower wiser universe intelligence or are those kind of the same thing is it worth trying to distinguish between the two this stuff's very high-minded uh the again these these quotes you keep uh resurfacing feel very serious uh i don't know that i could give you quotes like this today but um maybe my brain has been withering but it's like Yeah, I mean, look, there's clearly this amazing history of human beings trying to understand themselves, trying to understand the world and building systems to do that.

1:34:49Universities, academic traditions, math, all kinds of tools. And I don't necessarily think that AI is a new, I think it's consistent with that. I just think it's the next tool. So people can have these kind of interesting abstract conversations about is AI conscious or what's the difference between the kind of intelligence that is happening in an AI program versus in a living organism's brain. but it does seem that intelligence can take other forms than just cognition and that's the more kind of animist spirit i personally find consciousness to be uh almost I don't know. To me, it's almost like a boring topic.

1:35:58I don't know how to put it, but there's something something about me just finds consciousness to be almost a useless topic. But intelligence or information being processed by intelligence seems more self-explanatory, seems more just observably. Yeah, grounded. Real. And so I guess you see evidence of it sort of depends if you call things intelligence, right? And David Krakauer runs the Santa Fe Institute always makes this point that complexity science can sort of be thought of as the exploration of designed systems. and so evolution can be thought of as a design process now that doesn't necessarily demand that there be a designer well i was going to say what is a non-designed yeah what systems aren't designed if that if you're going to take that kind of cut on it yeah that's a that's a great question you have to ask and maybe that's his point you have to ask David Krakauer.

1:37:23But, well, no, I mean, I think, yeah, like, you know, fundamental physics does not feel like it's a design. You know, quantum mechanics is not necessarily a design system. Then something like evolution, you know, it's clearly a process taking place where genetic entities, genomes, are being throughout time crafted. Yes. Now, there's almost is a will or something. There's, you know, I don't know what it is, but there there is a process happening. And that process is throughout time manipulating information and leading to new organizations of information, new structures. So. Yeah, I don't know. There's there's something there's something about that, that I forget where we started.

1:38:21I'm not just one step down or slightly closer to reality, although still a little heady on this topic and then we can move on. But there's out of my depth here. Yeah, I think we all are. There's a notion that I think is adjacent to medicine, but it applies to kind of all technology, which is like there's the sort of like hyper progress view, which is just we should keep innovating. And then there's a view that says, like, actually, there's like stuff in the natural world that's Lindy and it shouldn't be tampered with. there's a there's a part in the intro to the beginning of infinity by david deutch where he talks about like the myth of spaceship earth and how it's actually like you're better off believing like literally the opposite of that and as much as the earth is great like it's actually like 99 of species die and the replacement rate's barely above one if he was writing this from oxford england a thousand years ago he would quickly die and so in some sense like earth has been shaped by life.

1:39:15You could take this as far as you want. But like one place I can see this applying in the not so distant future is like, what does it mean to be human? To what degree are we going to change ourselves with technology? Some of this is ethical. Some of this is sort of practical. Does it feel like these types of things are relevant in the work you're doing today? Or Or are these like a little bit further out around, I don't know, I think of something like stem cells. And there was a back to the timing stuff, like there was a blip there that everyone got really riled up about. We've seen stuff like Neuralink.

1:39:52We've seen blips here and there. It feels like this type of framework is going to quickly like enter the zeitgeist in a way that's a little bit more relevant of like what myth of progress in technology do you believe? maybe i'm reaching but it feels like what yeah it feels like that could be something that we actually have to face a lot more clearly soon yeah we could yeah but then i'm not sure it i'm not sure it matters you know like i think there's a real fixation on the sort of sci-fi big exciting high concept transformation of everything and i just try to stay more grounded and focused on fixing real problems for real people and people who are alive today and suffering as opposed to whatever happens next so i don't know how fast this stuff is arriving i mean you could take CRISPR, which we've talked about before.

1:41:02And it's like, yeah, I mean, that may end up being the technology that we use for Gattaca. And, you know, we'll probably be editing embryos at some point, not too far from now. And that could be interesting. And it could, you know, the first thing we'll probably do with that is prevent heritable diseases. So great. Like incremental launch up the ladder. Yeah. Like I would love to see that. That's great. I mean, I don't want people born with these like congenital illnesses that ruin their lives. Yeah. 99 % of people are going to tolerate that. 100%. So I just think always better to focus on the useful and obviously great possibilities of the new technology.

1:41:46And let's let's run at those and make them happen. And then. Sure, we need mechanisms to worry about all the risks and all the crazy stuff, but. I just don't I mean. We're not going to stop. It just seems obvious that we're not going to stop. So there's this, in a way, it's a bit of a performative move that people make to just, you know, you sound smart by sounding the alarm on things and being hysterical and worrying. And at least to me, it's just not interesting to have that attitude. And meanwhile, I think what I always find a little bit disingenuous about those supercritical voices is these people tend to have very little to say about the disasters that we've already wrought upon the actual earth today and upon people today.

1:42:56I never hear these people who are worried about runaway AI talking about how we, you know, help people in Bangladesh or how we stop killing hundreds of millions of animals every year for no reason. So I think it's almost a cop out to play in theory land. I think it's more of a pose than it is. And it's a way of sort of having cred in a particular community where everyone likes to outdo each other by showing how futuristic and crazy they are. A couple of questions about sort of like art and creativity and maybe starting on closer to the AI front. There's an old interview that I think is incredibly prescient where you're talking about computers.

1:43:46and this is, I think, right as Time Machine is coming out. You say, one of the big challenges I've thought about in making this record is that the role of computers has become so inescapable and computers offer so many possibilities for creativity, but they also make you lazy. They make it so convenient to do things in a certain way that almost everybody goes for that default position. I feel like we're going through this transition where everyone's trying to figure out what the machines and computers are good at and what the appropriate balance of responsibilities is between the human and the machine With my music, I'm trying to think carefully where they can each fulfill their strong suit.

1:44:21Fast forward 10 years, you can press a button and generate, if not a song, like something close to a song. And if not a film, at least a really incredible Ghibli image. There's a theme here that like you were sensing even then, like AI allows or computers allow us to skip over the details. When you build something by hand, you have to get really up close with all the details. and it reminded me of uh something else i heard you talking about which was this interaction where i think you were with pharrell and you guys met herbie hancock and for you described pharrell as this very like kind of like theoretical musician who had historically kind of like avoided getting too technical and his fear was that it would maybe cause him to miss some of the forest through the trees or whatever and herbie told him your words at least in recall it's just going to give you more colors.

1:45:13It doesn't cost you anything. It gives you more things you can say with those ideas you've got. And I realize I'm connecting a few things here, but I'm curious how you relate to this idea of adding more texture or rigor or resolution, whether it be in the narrow of kind of the work you do in investing or more broadly in creativity in life. Yeah, that comment Herbie hancock had really goes back to the first topic we talked about which is this depth you know versus breath kind of thing because that technical depth in music really does unlock your expressive capabilities and i think the new possibilities that the automated music making bring to the table are that they obviously let people start to express themselves and get a taste of it with a very low price of admission.

1:46:19Right, right. And so they're really cool and they're empowering in that way. But the greatest artists are going to still be the ones who have an ability to be very granular. and so you there's so i mean one of the things that's so great about music is there's so much subtlety that's possible right in the the way that a guitar player bends a string slightly you know real masters have a command of all of those subtle choices and so the range of ideas and impulses that they can express is enormous you know someone like herbie hancock can basically say anything in music and probably not saying the same thing more than once ever too which is pretty remarkable.

1:47:28That's right. He has so many tools in his toolkit. I think there is that spectrum among creators, which is basically how vast are your powers. And the point I'm making is that having Suno to be able to generate songs for you is really cool, but it it's giving you what feel like a lot of powers but for you to really for you to do what herbie hancock does you would need to program suno yeah it's just way more horsepower without any of the other things in a car and it's like a blunt analogy but i mean i think i play tennis and I think about it like in tennis, you know, like this is a common thing with any hobby.

1:48:28Like, of course, amateurs can often fall for the mistake, as I do, of thinking, oh, I just need a different piece of gear. Like, oh, if I just had Djokovic's racket. Yes, yes. Right. And of course, that's like how companies sell you tennis rackets. They say, well, the guy plays with this. And then you get the racket and obviously you don't play like Djokovic. so and that's clearly that's true with the piano now and and but the difference is if you gave me a piano it's immediately obvious that i'm not herbie hancock if you give me suno right this is the question then i think what's fascinating is if you give me suno how do you know i'm not Pharrell.

1:49:11And I believe that telling the difference probably actually requires the listener to be quite educated. That's a different musical world if you live in that world then. It really is because it's a world where the musical need of the lowest of the of the average consumer may easily be met right by or but maybe maybe the the need will uh the floor on that will rise that would be a maybe slightly more optimistic view is that like it raises everybody's musical literacy that could be i mean that that would be a great outcome is if everyone said you know sort of judged human artists then against the ai stuff and said your song stinks because it just sounds like all these ai songs so why do i need to hear it um there is this sort of sad niche of music too which is a lot of there there are some really great musicians who have not had a lot of success commercially and then they end up in the world of commercial music you know basically making tons of music that is played in you know television ads and background music on real housewives and no, I'm not, there's nothing wrong with that.

1:50:34Like, and there are people who do that who love doing that. But I always think it's like slightly, there's something a little sad about it because sometimes you'll hear in that music a really kind of slick idea and you go, oh, I hear. They're trying to play with it. You know, I hear the talent. The life, yeah. in that person who has been consigned to make background music, but could have been Herbie Hancock. It's a little, you know, anyways, the, yeah, you could have the same kind of thing happen though with, I don't know. I mean, all the commercial music will probably just end up being totally free.

1:51:15Yeah. All music for utility. Why anything for utility? Why would we not automate? Yeah. And then it becomes a thing of like, well, then what do people want from quote real music and you know i don't know there's just there's something i think it is ultimately communication medium and so when you i mean i went and saw lady gaga at coachella this past weekend and it was incredible one of the great shows maybe of all time wow and it was really cool for me to see in particular because we toured with her on her first tour so i remember some of those songs, seen them 15 years ago every night. And it was clear then.

1:51:58And it was even more obvious this past weekend how brilliant she is. And it's not just the music, it's the dancing and the costumes and the stage presence. It's all this stuff. But we're a long way from being able to automate that, you know, and it's hard for me to put my finger on what that is. but you know there aren't many of those artists and people tend to agree on who they are and they tend to be very popular and to sell out stadiums and i think that will continue for for a while on the note of performance it seems like one of the things you liked least about being a musician was touring there's a line in some interview where you said i don't usually I usually don't perform because I don't have a great way of performing.

1:52:52And I think you were just talking about like in my day to day life now. What's your relationship to and I'm being maybe deliberately heady here, but like what's your relationship to performance today more broadly in the sense that you're you are someone who is pretty public online. Granted, it's much more Twitter than Instagram. You do writing. You're speaking. you also have some element of like fame hanging over uh at least your adult life very charitable um what is yeah i i wonder if there's any reflections on what it was about the touring part that was you didn't connect with and two like yeah how do you think about maybe your external life i i didn't like the lifestyle of being on tour it's just very boring and really exhausting but I think I did actually like performing and I recently was like watching some videos of old shows and uh and I'm saying I that was actually really fun I and what made that fun was I think that it was highly performative I mean it was a character in a way yeah and you know I got about Lady Gaga right yeah like you know to be able to go on stage and kind of play this character of rock star, or at least as I imagined it, it was fun, you know, and, and energizing.

1:54:20And so I could do that again. Like, I don't know, I part part of me is kind of nostalgic about it. But then I would say, in the past few years, I've been very interested in a different concept of performance and this gets into public communication performance whatever the first thing i'd say is you know like fame is at this point a really kind of corny that what i would put it this way in the past people used to get famous and then they would like they'd be famous and they couldn't undo it. And now everyone is competing for attention so intensely that anyone who's famous, you can be almost certain really wants to be famous.

1:55:15Right, you can opt out passively almost. Yeah, because it requires so much work to be famous today and to stay famous. You have to fight for mindshare relentlessly. And so on the one hand, And I just, one, I'm not good at that game at the level it's being played today. And two, I don't want to do it. And I'm not even sure I'd be successful at it. But then in the limited spheres where I'm doing a podcast with you or writing something or posting on Twitter or whatever it is, my goal has almost been to like not have a character. You know, it's like everyone has in this social media mediated system become so fixated on performing who they want everyone to think they are.

1:56:10And people really, you can tell, I mean, they're almost designing who they, they're inadvertently becoming a person based on what they think. And maybe that's always been that way. I mean, I don't know if just going into the town square. Yeah, but we have way more chances. We have way more surface area and time of our lives doing it, at least with the internet. It becomes a creative act, I guess is what I'm saying. it because to the extent that everyone is effectively deciding to become a broadcast personality at all times, they are getting to choose who the character is they want to be. And you can see it in every sphere, right?

1:56:53I mean, you see it with the tech people. They sort of want to perform like a kind of autism to sound like Peter Thiel or Zuckerberg, or they want to, you know, a lot of it is like we were talking about before. It's like, I want to really show everyone how fucking visionary and out outlandish my ideas are, or you want to show that like you're sore or orthogonal, you're going to do like defense tech because that's like badass or like America stuff. Often those in themselves are copying an affect of some person. I'm going to be weird. Like you are going to be an asshole like Steve Jobs. 100%. And so what's interesting to me is to try and have no semiotics.

1:57:40I'm very interested in that idea. Can, you know, I'm interested in artists who do that too. Like, can you, can you dress in a way, for example, that says nothing clear where it's like sort of, you know, could you dress nicely? But not in a way that signals explicitly membership in any particular tribe. Well, this reminds me a little bit of when authentic sometime in the early 2010s, authenticity itself became an aesthetic. When that really broke all the rules, it's like, oh, wait, what even what it what it what is. But yeah, that's it's like, what's the vanilla ice cream? And yeah, vanilla is maybe an imperfect metaphor.

1:58:25but or how do you just you know like how do you writing essays is kind of fun because it it it's sort of as close as you can get to just like direct ideas yeah you know just like yeah plug into my brain right here's what i'm thinking right and i i don't know i kind of like that and i like substack quite a bit because you do have a kind of rena you have a renaissance of like really smart people on there writing more stuff than I can read. And I, I'm sure I've only discovered like a small fraction of them, but even that it's like, wow, like, you know, back to browsing the internet, like the internet's so big and there are so many people and they're so talented.

1:59:09Like they're so smart. There's so many smart people on the internet and we haven't, I don't even know how many smart people there are in China or India or people, you know, where they're writing on the internet and I can't read it. So it's like in that context, like, what do you say? Like, what do you, what is there to say? Why even say anything? Is it, is there anything that's not already being said, you know? And, and I, that's why I think, why are you saying things you don't have, you don't need to, well, I'm only trying to say things if I have what I feel is like an original thought, you know?

1:59:46So there's like zero toll medicine thing. Like I was thinking about that for months and trying to kind of clarify it in my head. And I thought, okay, I haven't heard this before. And when I previewed it in conversation with a bunch of smart healthcare people, they, it was seemed like a new idea to them. So I thought, okay, this is worth writing. But when I'm tempted to, you know, write a screed about the tariffs, it's like, why? Like, that's, by the way, this won't matter in a week. Yeah. It's just totally duplicative. it's a great point waste of time labor yeah yeah and and i'd rather matt iglesias write it or whoever you know i don't know maybe on the far end opposite end of the spectrum of that you've pointed at beauty as something like a moral criteria a couple of random tidbits once there's just some old place where you're asked about the music and you said if if there were one quality to it all that that i'm going to prioritize is beauty there's also a uh amazing instagram story highlight that i came across where you say philosophers come up with all sorts of reasons to attribute moral valence to different entities i increasingly feel the beauty is the only criteria needed subjective though it may ultimately be living with a dog is one experience that reinforces this the dazzling structure of another creature is a sufficient reason to respect it it's very embarrassing i met yoshi today i think i think i can validate that very beautiful dog what does it mean or feel like to be motivated by beauty I mean, maybe it's a kind of counterpart to the curiosity thing.

2:01:34It's just a it's just like a North Star. Like, I guess. Maybe it's just a personality trait, like I'm just. Drawn to it, I feel like it is I feel like it matters and I want. And I don't know, I guess it's just I want that principle to order my life however possible, not to like a I mean, there are people I know from like the fashion world almost who are like fascist about beauty. It's like that. I mean, if you watch that movie, The Phantom Thread, which I love. Amazing. P.T. Anderson movie. It's like that character is kind of a you know, that's a that's a beauty fascist. Right. You know, it's just a total intolerance of the actual.

2:02:27Mess of the world and wanting to control everything and make it perfect and whatever. Right. But that is like the art instinct fundamentally is that you want to create things in in whatever. I mean, whatever you think is beautiful. I mean, I guess the thing is, it is fundamentally aesthetic. And is it? I think so. Huh. OK. Meaning, I guess I'm just saying, if ideas flow together perfectly, we would call that logical. I mean, you can say it's beautiful, but that it really is logical. Whereas if the sound of the language in a poem or in someone's novel or essay, if it sounds mellifluous and rhythmic and whatever, then you would call that beautiful.

2:03:23So it's it's inherently about the aesthetic quality of things. And so. I think that can be present in any medium it can be I mean I like interior design I like fragrance I did a fragrance a couple years ago I like music I like architecture I'm for whatever reason I'm less drawn to painting and like you know 2D visual art maybe I don't know exactly why I try to get into it but poetry I'm not like the biggest fan of but i don't know basically across all these things you can find a lot of beauty and that's what in a way everyone's kind of chasing and then there's the critique tom wolf the novelist had a book called the painted word which was like a critique of modern art and the the phrase, the painted word gets at the idea that a lot of modern conceptual art was only interesting in terms of the essay that you would write about.

2:04:38Meaning like, and, you know, he was probably like too hard on modern art. Like there probably is a lot of beauty in there. In fact, I love a lot of modern or contemporary art, but there's still I think that is the same point that you know it's sort of like the aesthetic qualities of a thing are where beauty lives yeah not the conceptual yes yes which is more of a the world of words and and I think as someone who you know I'm fairly like you know I did well on and language stuff and standardized tests and things like that. And so to me, the world of language is a world of like logic. And then the arts are like a world of beauty and aesthetics.

2:05:30And I have trouble, you know, to me they're kind of compartmentalized in my life. Well, there's something, at least I relate to the notion of the non or post verbal things being closer to feeling or presence yeah and in that i i there's sort of some notion of beauty that i like which is just it's almost like something that happens to you i think that's right there's a good there's a book i just read that brian eno and uh a friend of mine helped him helped him write called what art does it's great it's really short it'll i think it will become a classic cool thing that artists and people love and talk about and uh that's worth reading everyone listening should go get that book cool you have lived many lives in some sense there's a uh there's a line in a book a novel i read a few years ago that i think about a lot it says uh it isn't a sadness but a joy that we don't do the same thing for the length of our lives and i don't know if I'm coping, I guess I'm validating my own zagging decisions.

2:06:36If you'll indulge me, there is a, an interview you did with Damien for interview ag that plays with this idea to me and also maybe was predictive of where you were going to go. This was 10 years ago. Damien says, if someone told you that you had, and this is Damien Chazelle, who you know from college and people probably know as a director. if someone told you that you had to cut all the work out of your life except for one avenue like you could make music but you couldn't work in investment or you could work in business but you couldn't make music which would you pick do you even see them as different or do you see them as one piece of work and you go on to say I see them all as being part of the same thing and for me that thing is how do I push the world in direction that I want it to go with as much leverage as possible by leverage I mean how does one how does an hour of my time have the biggest impact it can possibly have.

2:07:29If I had to cut something out, I'm not sure. Music and art for me are so sacred. I don't want to be corny, but it's almost religious or ethical. I don't think its value is the same as the value that exists in the economic or political worlds. And then you go on to talk about kind of art and commerce. And then finally, so I guess if I had to give up any part of my professional life, it would be music and it would become a hobby. That's when I enjoy it the most. But when I've done that in the past, you get frustrated that other people don't take your work as seriously because this isn't your job.

2:07:57You're not doing it professionally. And that way it's not real. So what I like by contrast in investment in business is that there's zero ambiguity. You measure it by real outcomes. It produces and create value by helping people do what they're doing for less money or produce more value for the same amount of labor. That was 10 years ago. Again, it seems like some of that maybe happened. in this multifaceted kind of winding life, have you felt at times boxed in? Have you felt like this was natural evolution that was sort of there right in front of you? Was it something you were stopping and being conscious of?

2:08:40Do you think, maybe not to be too prescriptive, but do you think your life in 10 years will look as different as it did 10 years ago? hmm no i have no idea but hearing that being being reminded of uh that conversation with damien i'd say 10 years later i feel less kind of uh high-minded messianic about this stuff about stuff about like you know changing the world and all that not that i don't think that's important but i think what was going on is i was starting to hang out with tech people and so i was starting to get influenced by this kind of you know millenarian psychology of like you know like the world's ending we have to save it every company every software company is somehow changing the world.

2:09:46I mean, the point where all that stuff, it became corny and a kind of a cliche. And, you know, Elon was saving the world with Tesla and taking us interplanetary. And I mean, that that ethos inspired a whole generation, of course. So it's been a powerful force and a powerful narrative. But I think I'm just naturally such a contrarian that when something becomes so ubiquitous, I end up revolting. And so I don't know. Now I almost find myself more favoring the art side of things, not in my own day-to-day life. I mean, now I run an investment firm and I have a job and it's high stakes. It's other people's money and take that seriously.

2:10:40But if I have to think about where the world's gone and where I think the energy needs to be kind of corrected, it it seems that art and artists have become super uncool in a very tragic way where you'd like go to stuff in LA and it would just be all of these like musicians kissing ass to some billionaire it's like wait wait wait this seems backwards you know what i mean and i i so i kind of feel like the you know the like the dorks took over or maybe they're just copying your playbook i don't know the musicians also the dorks really took over and they got like what went from being the kind of tech outsider underdog right right loser they're running government now they're running everything now yeah so i don't know just the way things should work is there should be a bad we're due for a backlash of bohemian cool i think that's probably coming i hope it's coming because i'm so tired of just the same i'm just so tired of like the culture that is defined by podcasts where nerds argue about whether ai is going to take over civilization and like frustrate us becoming a space-faring species and i don't i don't even like the problem is it has like no vibe it has like it has no aesthetic it has no edge you know like the edgelord isn't edgy the edgelord is just an asshole the edgelord is just racist it's not there's nothing charming about it and so i don't know i've kind of been going back and talking to a lot of my friends be it actors musicians whatever and just saying like guys look like you know i'm sort of i got a foot in each of these walls right now i think you need to step your game up and and revolt and you need to stop inviting the nerds to the party you gotta get more art these artists on podcasts they gotta gotta get on well or something else yeah it's probably not podcasts i mean i think your podcast should remain but i was like i don't know if i'm laughing with you or at myself no no we could do we could do with far fewer podcasts but then i wonder like Like, is the podcast just a stepping stone to every conversation being recorded always?

2:13:36Well, the AIs are just going to, they're going to just, you don't need to listen to this whole conversation we've had. You just need like a tweet with seven bullet points. Right. Yeah. Right. Hopefully somebody will do that for this interview, by the way. But that then, yeah, that becomes then the goal is like a good podcast would be one that can't be summarized. and you know like the ideas are too deep for the ai to i'm trying my best justice no man i think we're me too there's a question that i love which is there's the classic question what would you do with a billion dollars which i think is actually kind of a mediocre question and kind of hard to answer my friend david senra who's a podcaster uh has this inversion of this question famous he's well you're a famous podcast i'm not i'm not i'm not um his inverse question he says what what would you not stop doing for a billion dollars?

2:14:27Meaning what in your life would you hold on to? Would you not give up? Hmm. And there's probably lots of things you could say, but I'm curious, given, again, maybe in the light of that conversation with Damien and the fact that you've done a lot of different things, you did give up professional music making. It would just be my people. You know, like, I think relationships are the only valuable thing. so I think if you if you don't think of relationships instrumentally but as the end right and you go okay I'm gonna choose what I do professionally based on who that leads me to spend time with yeah I think that's the right approach or at least for me that's the right approach so yeah I don't know I mean I'd be totally happy not working i'd be i'd be happily give up work that's the first thing i'd give up you know i could give up music i could i don't know it's my people though just being with the people i like spending time with is the that's kind of the only important thing a few final questions as i kind of run through a lightning round as we wrap up you've played with and talked about like anonymity or pseudonymity in the past not extensively with your music but uh there's there's an old interviewer talking with peter about like led zeppelin how it was cool that they didn't put their faces on on the album you said something along the lines of like i do kind of regret not being around when there was that level of like magic about who is making the thing you heard and you did make one i think when glow first came out you did it honestly directed by Tao, the creator, I might add, which was an amazing bit of trivia, really cool video.

2:16:15Maybe that gets back to the performance question a little bit, but I'm curious if that was ever something you considered playing with more dynamically, or even as you think about the way your ideas are delivered now, there's a whole bunch of loaded ideas that come with your name and who you are and who you've been. It seems that the internet at least has become way more tolerant of this type of thing in certain pockets, but I'm curious if you have any reflections on it. I go back to what I said before. I think it's so hard to stand out today and to be heard or noticed. And at this point, I don't even have a very large audience of any kind.

2:16:55I feel like a total civilian. So yeah, to be, I mean, I don't know. Maybe I would get a bigger audience if I did things anonymously. I mean, I sort of thought that when I did that glowing video, I put it out. I'm glowing, I'm sorry. No worries. Because I thought, like, the band, you know, the band was not that big either, but we had actually garnered a lot of hatred from, like, Pitchfork magazine. No way. Pitchfork was, like, really mean about us and some of these other things. And I always resented that we didn't, like, get fans from a particular quarter, which at the time was kind of like the Brooklyn music-obsessed, kind of like...

2:17:46Aficionado. Aficionado crowd. Like, we got... I mean, I'm grateful to have had the opportunity to do it at all. And I got enough external validation for our music from musicians. Some pretty notable musicians. Who I love. I really liked you guys. And it's like, what more could I want, you know, than to have musicians who I really admire say, your music's good? Because you never know. I mean, it's a completely subjective thing. Right. And so, and you always wonder. I mean, I get so insecure when I make music because then it's like, you go show it to people and sometimes they just you can tell they don't like it or you can tell they you can tell it just does nothing for them and it's kind of like like maybe i do i suck like i don't know but then the truth is there is no sucking really it's just it's a subjective thing by the way the other side of that is i don't know i always think of that that there's that pharrell video where he hears maggie rogers music the first time and it's like yeah there's nothing quite like it's so cool it's so cool and seeing her see him right show her and say it's great yeah now he is a master at that because he is the greatest salesman in history but it is it is genuine it is it's both genuine and incredibly effective like i've seen that face yeah well because it's like he'll he'll i mean he can do anything he meaning he can he writes the whole song he makes all the music he sings it and then a lot of the songs he's produced the artist comes into the studio and he plays them like 10 songs that he's made and it's like they're kicking wow so i mean he is up the shelf he is selling them a song and like he's incredible at doing that crazy like he really makes people feel amazing about their music and feel like they're really brilliant and he's he's done that to me so i i will believe that it's totally sincere but anyways anonymity is that what we were talking yeah it was in we sorry we got somewhere else interesting i rambled you studied african-american studies and got a certificate in qu which i'm certainly pronouncing wrong which is a kenyan language and i think also maybe cornell west was a teacher that was a lifetime ago what was your relationship with that like why was that interesting it was just great i cornell unfortunately was not there he had left like a year or two before because he got in this big fight with larry summers who was the president of harvard and larry summers has been a lot of fights anyways it was it was a great experience i had amazing teachers and uh henry lewis gates is a famous professor there at harvard he was he kind of built that african-american studies department that i was in so he was a luminary who i got to hang out with a lot and he was awesome and uh i loved it because it was totally interdisciplinary so i got interested in african-american studies in high school because i was in milwaukee which is like by some measures the most racially segregated city in america really i didn't know and so i was very interested in just like how did it get this way and how could it be fixed How did racial identity develop in the way that it did in America?

2:21:21And I also just think the story of black people in America is kind of the best story ever. It's I mean, it is just. It's an unbelievable history. It's larger than life. The characters are amazing. there's tragedy there's comedy there's beauty there's justice there's obviously even more injustice and the story's not over and so it was just catnip for me and uh and it was a great it was a great department a lot of music in that story too which is cool a lot of music the best music speaking of you said your uh favorite drummer is elvin jones yeah he was at least was yeah selfishly do you have a favorite jazz album or at least a recommendation hmm you were a drummer you were i believe you lost the drumming job in what became your band to damien who we talked about earlier yeah he's a better drummer i'd say my favorite jazz album I really like something else, the Cannonball Adderley record.

2:22:38I don't know. I think that's a great record. I love Supreme, the Coltrane album. That's kind of as good as it gets. I like Wes Montgomery a lot. There's so many. The thing about that era of jazz is it's kind of like all good. I mean, it's not all good, but it's so many of those albums are just sort of like five players going to Rudy Van Gelder's studio and recording six of their tunes. And you could have seen something equally as good watching them in a club any night of the week. And they could have chosen to do six different songs and it would have been equally good. So there is a lot of quality in that.

2:23:25It's a tragedy. We got the world of many podcasts being recorded and not so many of those performances being recorded. Yeah, man, that'd be cool if people were doing like tons of music recordings the way. I mean, they are, though. I mean, that's the thing about Spotify. It's like I even struggle to think about making music and putting it out because I don't know what the numbers are. But it's, you know, hundreds of thousands of new songs being uploaded per day or something crazy like that. 20 ,000 I'm off by an order of magnitude maybe but like still it's it's more than you could ever listen to and like a lot of listeners I struggle to find new stuff we have any crazy as someone who's probably even if you're not saying it incrementally better than the average person at that I think this comes up all the time part of this I think is the products and the platforms part of it is the abundance and the infinite choice do you have any tips or thoughts on finding great new music honestly i use the spotify discover weekly yeah thing that's personalized to me okay do you play any role in that product i didn't no but it feeds me a new you know it feeds me a new i had a role in some other parts of spotify not that not those automated playlists but it feeds me a bunch of songs i've never heard every week that are somehow related to stuff i've listen to so i do find good stuff that way but it i wish it would now take me another concentric circle out right right and i think that's the challenge it feels like it's hard to click click farther yeah it's hard to get out of your filter bubble or whatever what do you love about la la i think is the most open-minded city maybe in the world i don't want to speak for the chinese cities which i've not been to but la is a place where crazy people from all over the world come here and then the city doesn't really have a culture so what ends up happening is every person creates and then inhabits their own fantasy world so on the one hand what what's not nice about la is it's super atomized.

2:25:46Right. And with that, you don't really have real community. There are pockets of it, but it's hard to have community in LA. And there's this quality in LA, particularly in the, you know, where the air is thin, where it's kind of like, you know, if you disappeared tomorrow, no one would notice. And LA is transient. People are always, you know, particularly in the sort of transnational global elite of people who, you know, oh, I'm in New York this year. Now I'm in LA for the next couple of years. Then I went to Austin. Then I, it's like, it's always in motion, which is good and bad, but it's, it's one thing that's nice about it is everyone comes here.

2:26:29So I don't love traveling. I mean, I do it, but it's not, I don't live for it. And, uh, living in LA, you don't even travel that much because if you want to see someone, you just like wait a month and there'll be an L you got random podcasters showing up in your living room 100 there's an amazing uh la essay on patrick collison's website and i'll send it to you after it you captured it which is like he's like it's just you and you're just alone in the parking lots there's no one's gonna save you wow he wrote this patrick didn't write it he recommends he's got like a list of of places i should remember who wrote it my final question i didn't mean to imply that those guys are not really smart by the way earlier i mean i think consensus they're really smart.

2:27:11I don't know them. I know they like doing smart stuff. You have a young daughter. Yes. You actually talked about this on one of the interviews. You were sort of supposed, this is before you had her, about like maybe one of the challenges for you being able to impart your kids with that value of like rote skill building or practice. And yet it sort of feels like we're living in a world today. And I would have to imagine for her as an adult where like rote skill is not that meaningful or valuable. You had one little thing, which was, hey, you should just have to like sit in front of a piano for 30 minutes every day.

2:27:47And you don't really have to have any specific guidelines there. Yeah. What values or what skills, what learning approaches, what do you think is important to teach her for a future that is very uncertain? I don't think it's about skills at all. And I think it's old school. I mean, I think all the old school stuff is still what's important. I think it's history, which is kind of the only real subject. It's history. It's values and ethics, the way of being able to think about moral questions and understand them from multiple perspectives and turn them inside out. that kind of critical thinking i think that you get through philosophy i think some sense of engineering is valuable and as we've talked about a lot this are you know the curiosity and the taste for beauty are important to me to impart so and so you know the going with the ethical stuff all the social how do you how you treat people what what are good manners i mean these are the things that people are lacking arguably and i think people have been saying oh it's all going to hell yeah the kids are yeah they've been saying that forever but you know it's always hard to see through that intergenerational fog what's really going on but by a lot of accounts it does appear that this, you know, like Gen Z in particular has really struggled with mental illness and anxiety and all kinds of stuff.

2:29:38So those become modern challenges that you have to try to counteract somehow. And I don't think it's, you know, a trad lifestyle or whatever. I mean, it's not how we're approaching it. But yeah, trying to I don't think, you know, trying to hold off on a phone as long as humanly possible and try and let her live in the in the real world with a dose of web browsing. Yes, she needs to know how to surf. Talk about a skill. But I mean, think about that, right? Like there's a real difference between flipping through TikTok videos and surfing the web. Yeah. You know, like you can't surf TikTok. You know what I mean?

2:30:28Training wheels. It's training wheels. And it's like, just get out there on the web. Don't go. Don't get outside. Get out on the web. Isn't that funny, though, that it's like what we what what people assumed in a previous generation was that you needed to protect these kids from like the darkness. Yeah, it's like, oh, the web is so vast. They're like all these like creepy back alleys they might stumble into. But it's like, no, actually, what you needed to to to protect them from was a completely, you know, like a hyperbaric chain monolith. that that mark zuckerberg built for them or whatever or that who i don't know the tiktok guy's name you know alex you i guess originally yeah alex you like created this hyperbaric chamber for them where like they're utterly incapable of of you know getting outside rubber rooms yeah it's right and like that's actually what makes them go crazy it's not being able to see everything everywhere i i agree so i think yeah surfing the web there should be maybe we need to do like surfing the web classes how to and it's like do you even need to teach like safely i remember that's curiosity right when we you know when we were in middle school we were like getting the anarchist cookbook off of off of like you know irc yeah and like that was fun i mean unless a pedophile tricked you into coming over to their house that was harmless so there were like you know there was that and there were like a few other things that you really didn't want but by the way we were using our real names you were it was chill yeah it was totally chill what do you hope she says about her dad your daughter you know just badass motherfuckers you know the rock times two yeah baby yeah this was wonderful hey man my pleasure a lot of fun Cool.

2:32:25Covered a lot of ground. We did. Hey, before I leave you, if you enjoyed the episode, please leave a rating and subscribe on Spotify, Apple, or YouTube. You can also find full transcripts on my website at jacksondoll.com slash dialectic. And obviously everything's linked in the description. If you have notes, feedback, or guest ideas, you can email me at pod, P-O-D, at jacksondoll.com. See you next time.

From the publisher

D.A. Wallach (Website, X, Substack, Spotify) is an investor, musician, writer, and polymath. Today he co-runs Time BioVentures, backing frontier life-science and healthcare startups. Before that, he was an investor in in SpaceX, Spotify, Emulate, Beam Therapeutics, and Ripple, among others, and toured the globe as half of Chester French. He also released music as a solo artist and was Spotify’s first Artist-in-Residence.
Our conversation moves from engineered serendipity—the art of a well-aimed cold email & surfing the web—to complexity science, the Santa Fe Institute, and what better systems might look like. We dive into markets and medicine: investing with a creative mindset; timing in biotech including CRISPR and GLP-1s; and the tension between free-market innovation and healthcare as a human right. D.A. unpacks how incentives shape everything from venture bubbles to hospital billing and how LLMs might move us closer to a universal standard of care.
In the back half we talk creativity, beauty, art, and performance. We discuss whether AI makes us lazy or amplifies originality, DA's many lives across art, tech, and business, and end on his plea for artists to reclaim their throne of "cool". I hope you're inspired by D.A's combination of curiosity and depth and are reminded that you don't have to stay in one lane, regardless of how impressive it might be.
Full episode transcript and all linked references available here.
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Timestamps:

(0:04) Hampton

(1:56) Intro to D.A.

(3:29) Curiosity, Serendipity, and the Power of Cold Emails

(9:21) Web Surfing & D.A.'s Potential One-Man Show

(13:28) Learning to Go Deep: Explore vs. Exploit

(19:18) Complexity Science, EO Wilson

(29:20) What Makes Santa Fe Institute Special?

(33:13) Complex and Bureaucratic Systems: How do you design a good system? And how do you change entrenched systems?

(40:25) D.A.'s Attraction to Markets and the Fed Challenge

(45:19) What Makes a Good Investor?

(48:30) Creativity in Investing, Index Funds, Elon's Take on a Great VC, and Venture Capital's Real Customer

(58:45) What Makes for Commercially Successful Creatives: Doing

(1:05:24) Gene Editing & CRISPR, What "Early" Means in Biotech, and Isolating the Bet You're Making

(1:12:48) GLP-1, Slow Burn Technological Innovation, FOMO, and Bubbles

(1:18:49) Healthcare Incentives: The Tension between Free Market Capitalism and Healthcare as a Right

(1:24:53) Patient Agency, LLMs, and Shifting Away from Pater...

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