How nearly dying helped me discover my own cure (and many more) | David Fajgenbaum

0:00With no fees or minimums on checking accounts, it's no wonder the Capital One bank guy is so passionate about banking with Capital One. If he were here, he wouldn't just tell you about no fees or minimums. He'd also talk about how most Capital One cafes are open seven days a week to assist with your banking needs. Yep, even on weekends, it's pretty much all he talks about. In a good way. What's in your wallet? Terms apply. See CapitalOne.com slash bank. Capital One N.A. Member FDIC.

0:33This episode is sponsored by Kohler Smart Toilets. The objects we interact with most are often the ones we notice least. Kohler Smart Toilet challenges that assumption. What if the most overlooked space in your home could become the most considered? Their Veil Smart Toilet is a sculptural silhouette that isn't just intentional, it's a philosophy. That design changes everything. The Kohler Veil Smart Toilet is sleek, with a rounded shape that's more like architecture, than just plumbing. And it goes beyond looks. The touchscreen controls and customizable cleansing features offer a level of comfort and cleanliness that exceed expectations.

1:09It's all about elevating those ordinary daily rituals into something extraordinary through thoughtful design. Kohler has been pushing these boundaries for over 150 years, mastering that balance of stunning form and high performance function. That's a long time to get it right, and it shows in every detail. experience the difference of Kohler smart toilets find out more at Kohler.com this episode is sponsored by Quince good cooking starts with good tools and Quince makes it easy to build a kitchen you actually love they have everything you need for summer hosting beautiful functional cookware glassware and tableware from stainless steel and ceramic non-stick pans to Japanese Damascus steel knives.

1:53I have their ceramic nonstick saute pan, and it's become one of my kitchen essentials. It heats evenly, nothing sticks, and cleanup is incredibly easy. And when I'm hosting, Quince's table linens and dinnerware make setting the table feel a little more intentional. What I love most is that Quince works directly with top manufacturers and cuts out the middlemen, so everything is priced 50 to 80 % less than comparable brands. You're paying for quality, not a brand markup. When your everyday tools are well made, the whole experience changes. Upgrade your summer kitchen. Go to quince.com slash TEDHealth for free shipping on your order and 365 day returns.

2:32Now available in Canada too. That's quince.com slash TEDHealth for free shipping and 365 day returns. quince.com slash TEDHealth. this is ted health a podcast from ted and i'm your host dr shoshana ungerleiter i'm a board certified practicing internal medicine physician i just turned another year older and i have to say time is absolutely speeding up and i know that sounds like something that everyone says after a birthday but this year i really felt it in my body a little more not in a dramatic way but more like, wait, how is another birthday already here? Wasn't it just the holidays? And how are the years starting to stack up this quickly?

3:18Okay, so obviously, time is not actually moving faster. The clock is doing what the clock does. But it turns out our brains really do change how they measure time, especially as we get older. When we're young, life is full of firsts. That first sleepover, first crush, first time driving, first heartbreak, first apartment, or first real job. The first time realizing your parents are actual people with their own fears and inner lives. Those experiences get encoded in detail. Your brain pays attention because the world is new. It lays down more memory markers. So when you look back, those years feel big and full, almost stretched out.

4:04But as we get older, so much of life becomes more familiar. We drive the same roads, make the same coffee, answer the same kinds of emails. And routine can be beautiful. But the brain doesn't record sameness in the same way it records surprise and newness. So when you look back on a month or a year that was mostly made of familiar days, it can feel like it vanished. There's also this strange math of aging. A year when you're five is a huge part of your life. A year in your 40s or 50s is a much smaller slice of everything you've lived. So the brain seems to compare time against the life already behind you.

4:46And that reality hit me hard. Because it means part of what I'm feeling is not just busyness, it's perspective. It's the weight of having lived through enough life that a year no longer feels like a whole universe. And a single day? Well, it can feel like a speck. A big part of that has to do with our attention. In modern adulthood, it's constantly being pulled everywhere. Work, family, logistics, health, texts, planning, worrying, remembering to order the thing, reply to the person, schedule that appointment, or deal with whatever is quietly sitting on the mental to-do list. And when your brain is busy managing life, it has less space to notice life.

5:30Time just feels faster when we're moving through it on autopilot. So an ordinary week at home can easily collapse into almost nothing. Because of the way our brains work, recapturing our time is a naturally tricky puzzle. But I don't think the answer is to make every day extraordinary. That actually sounds exhausting. And also impossible. Most of life is not a peak experience. Most of life is dishes and errands and work and walking into a room and forgetting why you went in there. But maybe we can make time feel a little fuller. Not by doing more necessarily. Maybe by noticing more. Taking a different route.

6:11Learning something new, even if it feels awkward. Or maybe just pausing the autopilot long enough to let your brain register the small, tender, everyday details that make a life. This could be a meal with a friend, a walk after dinner, taking a pause to notice the particular light in the kitchen at 6 p.m., the sound of someone you love laughing in the other room. And maybe that's what I'm thinking about after this birthday, not how to stop time, because we can't, but how to be a little less absent while it's happening. Because the older I get, the more I understand that the goal is not to outrun the passage of time.

6:52It's to come back to it, to this day, in this body, in this ordinary morning, living this life, while it's still asking for my attention. And that brings me to today's TED Talk from Dr. David Fagenbaum. David has learned a lot of profound things about time throughout his life and career. As a young medical student, David became critically ill with a rare disease. And at the time, he was told there was nothing more the doctors could do. What followed is not just a story about survival, but about refusing to waste the time that remained. And now, Dr. David Fagenbaum. Hi, I'm David Fagenbaum, and this is me in 2010 when all of my organs were shutting down and I was dying for the first time.

7:39My doctors came in the room and told me, David, we've tried everything. There's nothing more we can do. But I was so sick, I didn't really know what my doctors meant until my family came in the room and started hugging me goodbye and a priest read me my last rites. I was 25 years old, a former college quarterback, and a medical student who had dedicated my life to becoming a doctor after my mom died from cancer. And yet here I was, literally dying from a disease that I'd never even heard about during medical school called Castleman disease, where your immune system attacks and shuts down your vital organs for an unknown cause.

8:14There were no approved treatments. and no cures. But in a last-ditch effort to save me, my doctors gave me a combination of seven chemotherapies that weren't meant for my disease. Amazingly, they worked. I survived. I returned to medical school, and I got what I think might be the worst before-and-after picture of all time. But then I relapsed. Again and again. Five times in three years, I almost died from my disease. I'll never forget during my third relapse, when I was laying in my hospital bed with my girlfriend Caitlin and my family around me, my gown was drenched in tears. Not just because I was dying, but because all the things that I would miss out on.

8:56The family that I'd never had with Caitlin, the patients that I'd never treat, the cures that I'd never discovered in memory of my mom. See, until then, I'd been waiting and hoping that some researcher somewhere would discover a treatment that could save my life. But in that moment, I realized that hope alone is not enough. If I wanted any chance of survival, I would need to turn my hope into action to try to find a treatment to save my life. There was just one really big problem. I didn't have 15 years and a billion dollars to develop a new drug from scratch. The good news is, is that those seven chemotherapies that had saved my life, they weren't made for my disease.

9:35So I thought to myself, maybe there's another drug made for another disease that could also be repurposed for me. This concept of repurposing isn't new. You've probably all heard of Viagra before, right? Well, you may know that Viagra was repurposed from heart disease to its well-known use. But did you know it's also now utilized for a rare pediatric lung disease? And thalidomide, which is known for causing horrible birth defects, is now utilized for leprosy and the cancer multiple myeloma. Now, repurposing works because though diseases like leprosy and myeloma may appear very different, they can actually share the same underlying problems or mechanisms in the body and can therefore be treated with the same drug.

10:18And amazingly, doctors can prescribe any FDA-approved drug for any disease where they believe the benefit outweighs the risk through something called off-label prescribing. And off-label prescribing is actually very common. In fact, one in four prescriptions written every single day in the U.S. is off-labeled. So I began to study my own blood in the lab to try to find a repurposed drug for me. I discovered that a communication line of my immune system was turned into overdrive and that a decades-old transplant drug might be able to turn it off. It had never been used before for my disease, but I was out of options, so I began to test it on myself.

10:53In the three years before I started sirolimus, I nearly died five times, but since starting it, I've been in remission for over 11 years. Oh, thank you. Thank you. During this remission, I married Caitlin, who's here with us today.

11:18We had two amazing children. I wrote a book about my journey, Chasing My Cure, which is being turned into a film. And I joined the faculty at the University of Pennsylvania to continue to chase cures for rare inflammatory diseases and cancers. And then in 2022, I co-founded Every Cure, a nonprofit organization that's on a mission to unlock the full potential of each and every drug to treat each and every disease that it possibly can. Over these years, we've advanced 14 repurposed treatments for multiple diseases, saving thousands of lives, like Kyla, who began her freshman year of nursing school after we repurposed a bone marrow cancer drug to save her life, which is now being studied in clinical trials.

12:00And Michael, who walked his son down the aisle on his wedding day after we repurposed a melanoma drug to treat his rare cancer, which is now being used all over the world for that rare cancer. With every one of these discoveries, all I can think about is how many more life-saving drugs are sitting at our local pharmacies that could be life-saving for patients with diseases today. Because, see, us humans, we've developed 4 ,000 drugs for about 4 ,000 diseases. but there are over 14 ,000 diseases that don't have a single approved therapy. That means that one in 10 of us and our kids will develop a rare disease without any approved treatments.

12:40And many more of us will develop diseases with limited treatment options. We know that many of these FDA-approved drugs could treat many more of these diseases and for less than 1 % of the cost of new drug development and way faster. So why aren't we repurposing drugs? Well, the short answer is that it's just not profitable to pursue a new use for an existing medicine, especially for a rare disease and the 80 % of drugs that are already generic. It just costs too much to do the clinical trials, and companies can't expect to make back the cost in sales. Instead, we focus on new drugs for profitable diseases, and no one, not the NIH, not the FDA, not pharma, no one has taken responsibility for systematically unlocking these hidden cures.

13:29Until now, we're utilizing artificial intelligence to scan across the world's knowledge of all 4 ,000 drugs and all 18 ,000 diseases to find the most promising opportunities to save and improve lives. You can think about it a bit like Netflix, which uses data on the actors, the directors, and the movies that you watch and the interconnectedness between them to predict which movies you might like to watch in the future. Well, we do something similar, but instead we use the world's knowledge of all approved drugs and all diseases and the connectedness between them to predict which drugs might be useful in new ways, much faster than any team of humans ever could.

14:05And then we use artificial intelligence to look across the millions of drug disease matches to identify the best opportunities to reduce suffering and have the greatest impact possible. Then we take those specific programs forward. We study them in the laboratory, in clinical trials, and sometimes we go right to spotlighting them because the work has already been done to prove that they're effective. Now, when we first were dreaming about creating Every Cure, my co-founders, Grant Mitchell, Tracy Sikora, and I, we knew all of this was possible in theory, but we didn't really know how we were going to turn it into reality or how we were going to fund it.

14:42Clinical trials are not cheap. But then I got an email, actually from a member of the TED community, telling me about something called the Audacious Project, which selects 10 nonprofits every year solving the world's biggest challenges. And just knowing that Audacious existed and knowing that this community here was supporting this kind of work, it gave us the courage to really take this leap and to start this organization. We got started and then we applied for funding and we were so hopeful we would get it and then we weren't selected. But then we applied again and just a few months ago we received this really transformative funding.

15:18Thank you all so much. Truly, thank you. Between this funding from the Audacious Project and also from a federal agency in the U.S. called ArbaH, we are building an AI-powered engine to repurpose 15 to 25 treatments by 2030 and with additional funding to be able to repurpose dozens and even hundreds more treatments. Now, we've only been running our full pipeline for a few months, but we're already helping patients. The very first time we used a high-scoring drug from our algorithm was for a patient with Castleman disease, the disease that I have. But unfortunately, the treatments we discovered for me weren't working for this patient.

15:54He was getting ready to say goodbye to his wife and his daughter because he was getting ready to be transferred to hospice care. We recommended this number one drug from our platform, and amazingly, it saved his life. He's been in remission now for over two years. Thank you. Thank you.

16:14Now, this is an example where we discover to repurpose treatment, but sometimes we actually uncover matches that already exist. They're just not being utilized. For example, one day I was reviewing through the results of our platform, and I came across Leucovorin, this cheap vitamin derivative, where there was data to suggest that it could help to improve speech in a subgroup of patients who have antibodies against the folate receptor, so therefore they don't get folate into their brain. I was so amazed to learn about the work being done by Richard Fry. He had done the first of three randomized controlled trials that showed a benefit for this medicine in this subgroup of patients.

16:47And I learned about Mason, who was nonverbal for three years, and within three days of starting Luke of Warren, began to say his first words. And then, yes, it's incredible.

17:02And then Ryan was basically nonverbal for five years and had never shared a complete thought or feeling with his parents and was told by doctors that he probably would never share a feeling with them. Within two weeks of starting Leucovorin, he turned to his dad when he was leaving for work and said, Daddy, I love you. It's just incredible. It's just incredible.

17:29What's also incredible is that there's a blood test that can help to identify kids like Mason and Ryan that is available to help to find these patients, and it's still barely being utilized. This is why we started EveryCure, to unlock these hidden treatments and make sure they reach every patient they can possibly benefit. Like we did for Joseph, who was dying from Poem Syndrome, which is a rare cancer, and on his 30th birthday was saying goodbye to his girlfriend Tara because his doctor had tried everything that he thought was possible. We recommended three drugs that are commonly used for multiple myeloma, which is similar to Poem Syndrome, in a last-ditch effort to save him.

18:06And amazingly, they worked. Instead of planning Joseph's funeral service, Joseph and Tara are planning their wedding day, and Joseph's here with us today from Seattle. Joseph, I'm so glad you're here. Woo!

18:22How many of us have sat with someone we loved, like Caitlin did, and like Tara did, and like Mason's parents did, and heard the words, we've tried everything, there's nothing more we can do. What if we haven't tried everything? What if there's a solution out there for them and thousands, maybe even millions more of their disease? And what if we all came together to find these solutions? Because we can't do it alone, and we need your help. Please join us to unlock every cure so that no patient suffers when there's a lifesaving cure sitting on the pharmacy shelf, and instead of hearing, we've tried everything, they can hear, we have something.

19:01Thank you all so, so much. Thank you.

19:11David, this feels miraculous. Like you're telling me that there are dying people waiting for a drug to be discovered, but actually they can just go down to their corner pharmacy and there might be a cure for them at an affordable price? That's right. It's like too good to be true. That's right. Well, it is, except for the fact that it's just not profitable to do this. So that's why it exists. These opportunities that are there, we can help a lot of people, but in the current system, there's just no incentives to do it. One of the other interesting things to me, I studied the history of medicine, and what's so interesting is, for a lot of history, medicines were cure-alls, right?

19:52Like the 19th century patent medicine that was like for your indigestion and your infertility and your da-da-da-da-da. And then so much of modern medicine was evidence-based, targeted, like laser-focused therapies. And it's almost like you're saying, no, no, no, no, we need to broaden it out again. That's exactly right. And in fact, companies will oftentimes consider 15, 20, or even 30 diseases for a given drug, but they have to pick the one or two to focus on. And oftentimes those dozens of opportunities just sort of get lost. And so we're trying to uncover them, try to find what's really been falling through the cracks.

20:28What can ordinary people do to help? Well, the first thing is that we really want you guys to all be a part of this solution. So if you've ever received a drug that was repurposed for your disease, received a drug off-label, tell us about it. Go to everycure.org slash ideas. And we also, as I mentioned earlier, these trials are very expensive. So donating to us at everycure.org slash donate. And of course, part of this is running campaigns to get the word out about these treatments. So if you see us sharing about treatments that can help patients, please, please help to amplify that.

21:03that was dr david fagenbaum at ted 2025 and that's it for today's episode thank you so much for listening ted health is a podcast from ted and i'd love to hear your thoughts about this episode send me a message on instagram at shoshana md this episode was produced by me shoshana Ungerleiter, and Jess Shane. Edited by Alejandra Salazar and fact-checked by Vanessa Garcia-Woodworth. Special thanks to Maria Lages, Farrah Degrunge, Daniela Balarezo, Constanza Gallardo, Tansika Sungmarniwang, and Roxanne Highlash.

21:50Hey, Yetis. This is Nick and Jack from the Best One Yet podcast. Now, the last company we worked at, they used Paylocity and everything just worked. It wasn't until launching our own media business, this show, that we realized how rare that is. Because Paylocity is one delicious burrito of operational needs. They roll up HR, finance, and IT seamlessly into one delicious bite. When everything wraps together like that all at once, your workforce, your tech stack, your business, you don't need more tools, you don't even need cilantro. You need one solution. And that is why Paylocity built a single platform to connect HR, finance, and IT with AI-driven insights and automated workflows that simplify the complex and power of what's next.

22:28Or as we call it, a delicious operational burrito. Yes, we do. Experience a one place for all your HCM needs, besties. So start now at paylocity.com slash one. Paylocity.com slash O-N-E. With no fees or minimums on checking accounts, it's no wonder the Capital One Bank Guy is so passionate about banking with Capital One. If he were here, he wouldn't just tell you about no fees or minimums. He'd also talk about how most Capital One cafes are open seven days a week to assist with your banking needs. Yep, even on weekends, it's pretty much all he talks about. In a good way. What's in your wallet?

23:05Terms apply. See CapitalOne.com slash bank. Capital One N.A. Member FDIC. We've all heard that social media is taking away kids' childhoods, giving them social anxiety and increasing rates of teen depression. Social media has been labeled the culprit. But what if it's not? What has been really shocking to me as I've stood here and kind of watched this debate unfold and seen how things are translated to the broader public is that there's just this massive gap between what evidence has been generated to date and rigorous studies have found and expert panels have concluded, which is essentially that there's very tiny correlations between social media and mental health.

23:49That was developmental psychologist Candice Odgers, who joined us for a special interview to unearth the research that debunks social media as the cause of the mental health decline for our teens. What else is causing it and what are the solutions for a path forward? Find out in the full episode of TED Talks Daily wherever you listen to podcasts. Thank you.