Interview: The future of gene sequencing with Dr. Eric Green

0:03This is TED Health, a podcast from TED, and I'm your host, Dr. Shoshana Ungerleiter. In this week's episode, I'm joined by Dr. Eric Green, a doctor and researcher who's helped shape one of the biggest scientific shifts of our time. Dr. Green was there at the beginning of the Human Genome Project, the international effort that first launched in 1990 and then sequenced human DNA 13 years later. His work helped the medical community shift from studying DNA in small pieces to reading and using the entire human genome. This breakthrough has allowed doctors to see a patient's full genetic picture, understand what makes each person unique, and deliver more accurate diagnoses, better treatments, and earlier prevention.

0:46Until last March, Dr. Green led the National Human Genome Research Institute at the National Institutes of Health. Now, in 2026, he begins a new chapter. He became the chief medical officer at the biotechnology company Illumina earlier this year, where he'll help think through the future of genomic science and its role in medicine. Today, the cost of genomic analyses has dropped from hundreds of millions of dollars to just hundreds of dollars. And our developments aren't just financial. We now live in a world where reading DNA can help guide cancer treatment and long diagnostic odysseys for patients and families, and even raise new questions about whether we might be able to sequence DNA much earlier in life.

1:29In our conversation today, Dr. Green walks us through that first era of sequencing the human genome up to where we are now. But before we dive in, a quick break to hear from our sponsors.

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4:51Dr. Eric Green, welcome to TEDHealth.

4:54Dr. Eric Green: Oh, thanks, Shoshana. It's great to be here. So I want to start and make sure that we're all on the same page for what I think is going to be a fascinating conversation. And so before we dig into this, for somebody listening who has heard the term but has never had it explained clearly. What is genomics in plain English, and how is it different from genetics? I'll just give a teeny bit of history because I think it helps understand why there's two names for two fields that are actually incredibly overlapping. So, at the beginning of the 19th century, the field of genetics was launched, and the word genetics actually came into be.

5:34Dr. Eric Green: And basically genetics is the study of inheritance, how traits are passed from one cell to the next or from one generation of a human or any animal to the next. But notice I pointed out that field came into being in the early 19th century. That was actually even before we knew that DNA was the information molecule of heredity, let alone knowing by the mid-1950s that DNA had the famous double helical structure. That's almost like an iconic view of DNA. And so the point is, we already were studying inheritance without even knowing what the inheritance molecule was, but eventually we learned that.

6:16And then you went through the 1960s and 1970s, 1980s, scientists developed better and better tools for studying DNA, and in particular, for being able to read the building blocks of DNA, which encode all the information necessary for creating and operating a living creature. So by the late 1980s, the tools were so good that the idea started to be discussed of maybe we should get to the point where we can study and actually read out all the building blocks and all the DNA of an organism, such as human. and all the DNA of an organism is actually called a genome that had been named earlier. But the idea was, yeah, we should do that and we can do that.

7:00And that would be studying the molecule of heredity comprehensively. And it's this comprehensive spirit that really undergirds this field of genomics. So in short, they're overlapping because genetics is the study of inheritance and DNA is the molecule of inheritance and all the DNA of an organism is a genome and studying the genome of an organism is genomics. Fascinating. Okay. So that framing really helps to ground this. I think once we understand what genomics is at a high level, the natural next question is how it's already touching people's lives. So if I'm a patient walking into a clinic today, where is genomics already affecting care in really real and practical ways, even if we don't hear that word used so much?

7:49It depends what clinic that patient is walking into. Let's take a couple examples. Let's start with a happy example. A happy example is a couple just found out that the wife is pregnant. They're going to their obstetrician for an early check-in and a very early pregnancy, and they're happy they're going to have a child. and that obstetrician nowadays is very likely to offer a genetic screen of that unborn child. And what you're looking for in a genetic screen is like an abnormal number of chromosomes. The most classic of this as well known is three copies of chromosome 21, which is called trisomy 21 or Down syndrome.

8:28Well, this is called prenatal genetic screening. And this has been going on for decades. But to get access to the fetal DNA, to be able to look at the chromosomes and analyze the chromosomes, it required an invasive procedure like an amniocentesis, where a long needle is poked through mom's belly, through the uterus, into the amniotic sac, got a little bit of fluid that has some of those baby cells in it, and boom, now you have access to baby DNA. My wife underwent two of those for my two children, now ages 30 and 26. So this takes us back a few decades. But that worked. It was a little risky because you could sometimes lose the pregnancy.

9:04It's unpleasant. It's expensive. And it's not done anymore at a screening level. So that couple nowadays, because of the miracles of genomics, that obstetrician will draw a small amount of blood, just an extra tube from that pregnant mom. And one tube will get sent off to a company. And that company will use these brand new methods of ultra-sensitive DNA sequencing to analyze the teeny, teeny little bits of fetal DNA that naturally float around in the bloodstream of mom. These machines are really good and they could detect it. You're just looking to see whether there's an abnormal ratio of DNA sequences that correspond to different chromosomes.

9:48And if you see too many coming from chromosome 21 and it's all done quantitatively, then you say, okay, we need to call that couple back in. Then they'll do an amniocentesis, confirm it, figure out what's going on. But that is such an inexpensive procedure compared to more expensive things like amniocentesis, more pleasant, and insurance companies are paying for it. So that's one scenario. I'll give you another scenario very common. Nowadays, cancer is so prevalent in society, and there's lots of reasons for that, including that we're living longer. But cancer is a disease of the genome. The reason why you get a tumor, the reason why you have some cells that are growing out of control is that their DNA have picked up spelling differences and making those cells grow out of control.

10:30And nowadays, for a lot of cancers, the oncologist will get a piece of that tumor and analyze the DNA and catalog the DNA differences that have now been accumulated in that tumor. And that will tell them a lot. It will tell them the kind of tumor, the subtype of tumor. It will dictate the best therapies, whether it be chemotherapy, radiation, et cetera, et cetera. And so basically, genomics has just turned oncology completely in a different direction over the last 10 and 15 years. Yeah. And you have been part of genomics since the earliest days of the Human Genome Project. Take us back to the beginning.

11:13We started talking about this earlier, but what answers were you hoping to find?

11:17Dr. Eric Green: So Shoshana, let me ask you a question. Would you get on an airplane today and fly on that airplane if you heard that the mechanics who do maintenance on that airplane and make sure it's in good shape do it without a blueprint, where they don't really know anything about how that airplane was built, they don't know the parts, they don't know anything about it? You probably wouldn't be very comfortable going on that airplane. That wouldn't be considered a safe thing to do if the mechanic was taking care of that airplane blind. Correct? No, I already have a fear of flying. So no, definitely not.

11:51Dr. Eric Green: Yeah. But that's how we practice medicine. Yeah. Going into the 1980s, we did not have the blueprint for humans. And yet there we were as physicians doing our best just to treat people, but based on what we know on the average person. So I'll take you back to 1987. It was a very historic year. first of all, the word genomics was coined in 1987. That's the beginning of the field. And at a personal level, it's when I graduated with my MD and my PhD. And never once in the pursuit of those two doctoral degrees did I hear the word genomics. When I graduated medical school in 1987, we were treating all patients as if they were average.

12:34Dr. Eric Green: So the problem that we were trying to solve is this idea of fundamentally having the blueprint of the human being and DNA and the genome is the blueprint that's necessary for creating and operating a human being. And then, of course, if we could have the individual blueprint of each patient where we had a readout of the subtle spelling differences that are in our genomes that dictate which diseases we might be more prone to, which dictate which medications are the best ones for us, which dictate a whole host of things that could be very valuable, then it'd be more like the airline industry where you would make sure that physician, that mechanic for you as a patient had everything they needed to know about you, just like they know about that 777 that you're about to get on.

13:22Dr. Eric Green: They know what every part is. They know exactly how each part works and so forth. That was the problem that was trying to be solved. Now, this was going to be a multi-generational problem, certainly a multi-decade problem, but you had to start at the beginning. And the beginning was, could we read out the blueprint of human beings. And what does that mean? Well, DNA consists of four building blocks, and it's the order of those building blocks. We abbreviate them A, G, T, and C, standing for the four chemicals that make up DNA. The human genome, one representation of the human genome is 3 billion letters.

13:55And it's just a long string of Gs, As, Ts, A, M, C, C, C, T, T, T, etc., etc.

14:01Dr. Eric Green: And embedded in that is this incredible code that results in us and results in all aspects of biology. And so scientists in the late 1980s said, we have such good tools that are getting better all the time for isolating DNA, manipulating DNA, and reading out the letters of DNA. Could we scale that up and do something as audacious as reading out all 3 billion letters? Because if we had it, you could imagine a whole set of things that would happen to better understand human biology, better understand human health, better understand human disease, and eventually create a circumstance where information about each individual patient's DNA differences could be used to tailor their medical care.

14:44And if I told you we knew how we were going to do it when the Genome Project started in 1990, and there I was, I was a resident in pathology. I just got smitten with this idea that this could be incredible. And I had an opportunity. I was in the right place at the right time at Washington University, which is one of the earliest genome centers that got involved in the Human Genome Project. And it was exhilarating because we knew we were just something historic. And it was terrifying because we had no idea how we were really going to do it. We had cursory tools. And we just knew that if given the resources and given that it wasn't competitive, it wasn't about different groups competing.

15:20Actually, it was the first example where biomedical research was done in a big consortium, analogous to the Apollo moonshot, where everybody had to get together and work together to put a person on the moon. This was biology's moonshot. And off we went, an international group of literally ended up being thousands of scientists, multiple countries, highly coordinated. And we trotted along. And we first figured out we had to organize the DNA. We had to get it ready for sequencing. And then we had to start sequencing. And by the way, when the Genome Project started, there was barely a functional internet.

15:52I mean, it was prehistoric days technologically. But you just fight your battles one at a time. You find one challenge. You figure out how to solve it. You keep moving on. Originally, we thought it would take 15 years. It ended up taking 13 years, and we did it. And 23 years ago, in April of this year, we'll celebrate the 23rd anniversary of the completion of the Human Genome Project, which has its signature accomplishment, the first readout of the 3 billion letters of the human genome. And it was historic, and it still is historic. But the finish line was getting that human genome sequence generated.

16:26But instantly, almost like overnight, that finish line became the starting line. because the finish line was what you started asking me,

16:34Dr. Eric Green: which is, you know, how are we changing the practice of medicine? But I go back 23 years, and here we have these 3 billion ordered letters, and there was no knowledge of how the code actually worked. We just had the letters. We're still trying to figure out the code. So the last 23 years have been setting up the next set of challenges. And it's just like the Genome Project. You take them one at a time, and you just inch your way closer. And so the past 23 years, in some ways, it's been just as spectacular as the Genome Project, because some of the things have happened far faster than we ever could anticipate it.

17:08Dr. Eric Green: And then the last 15 years, especially the last 10 years, we've proven it. We've proven that, yes, genomics can be used in medicine. Admittedly, it's early days. I mean, we're just seeing some of the earliest examples. Probably the best is yet to come. But it's been truly, truly remarkable how far we've come in this last 23 years.

17:29We'll be right back with more of my interview with Dr. Eric Green after this quick break. This episode is brought to you by Peloton. There's a particular kind of joy that comes from a really good workout. When your body feels free, your mind clears, and you remember why movement matters. Peloton built the cross-training Tread Plus powered by Peloton IQ to help you find that feeling more consistently. Peloton IQ personalizes your workouts, plans your sessions, tracks them, corrects your form, and offers the kind of guidance that helps you unlock new versions of yourself over time. And because real fitness isn't just about running, the Cross Training Tread Plus features a swivel screen that lets you move seamlessly from a treadmill run to strength training, on the floor, one smooth spin, no break in momentum.

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18:38This episode is sponsored by Toyota. There's a difference between having options and having the right options. When something is designed well, it doesn't just give you more choices. it gives you choices that actually make sense for how you live. That's the thinking behind Toyota's new all-electric lineup. Instead of a one-size-fits-all approach, they've built a family of vehicles, the versatile BZ, the adventurous BZ Woodland, and the expressive CHR, each one meeting people where they are. Because independence isn't about doing everything differently. It's about doing things in a way that feels natural to you.

19:12Learn more at toyota.com, the new all-electric family. Toyota, let's go places.

19:32It's amazing to hear how big those early ambitions were, how much has been accomplished. And I think once you understand what sequencing reveals, it becomes easier to see why it's been so transformative so far with a long way to go still in certain areas of medicine. And you touched on this before, but cancer is one place that many have heard of about DNA testing. How has sequencing a tumor changed what doctors can do for people with cancer and where are the biggest gaps that still need work there?

20:04Dr. Eric Green: Well, I mean, let's start with the biggest gaps. I mean, the biggest gaps is that cancer is not one disease. It's hundreds of diseases. It's incredibly complicated. And even if you know what the problems are, what's going on, if it's happening in tissues that are not very accessible, it's just so complicated. And so it is one of these glass half full, glass half empty. We've learned so much more. We're doing so much better, but not for every cancer. Some cancers are still incredibly difficult and genomics hasn't been as yielding of advances. But in some cases, I mean, there's just been just some paradigm shifting work.

20:39Dr. Eric Green: I'll just give you a couple examples. You know, certainly what I was taught in medical school was, you know, there's such an incredible focus on where did that tumor come from? Was it cut out of the liver? Was it cut out of the colon? Was it cut out of the lung? That kind of thing, because, you know, then it's colon cancer or then it's lung cancer. Well, it turns out that, yeah, that's important. We want to know that. But it actually turns out that what's more informative is the genomic derangements that you find when you sequence the DNA of that tumor. And so to cut out a tumor out of the colon, you thought it was colon cancer, but it looks a lot like what you often will see in a breast cancer that is very good to treat with this regimen.

21:20Dr. Eric Green: Well, that's what's going to dictate it. You're going to say, I don't care where I cut it out of what drives decision-making nowadays are these genomic signatures. And so that's very paradigm changing. I think another paradigm-changing thing, and I hope this gets a lot of attention. Let's say a patient has cancer. You cut that cancer out, chemotherapy, treatment, whatever, and you say, oh, I hope that cancer's gone away. What's typically done is every so many months, they get an MRI or some imaging thing. If the cancer comes back, you'll detect it. The problem is by the time you see it on a radiographic study, it's come back pretty big and you've got an advanced stage.

21:57turns out increasingly what's referred to as a liquid biopsy. Liquid because you're doing it in blood and it's a biopsy because you're just sampling some DNA in blood. You can monitor the patient just with a blood draw, maybe a little bit more frequently, and look for cell-free DNA with the DNA changes that you already know that patient had and which if the tumor comes back, it's going to have those some signatures so that you catch it long before the radiographic evidence shows up, which means if you hit it again with another treatment, you're more likely going to knock it down because it'll be small.

22:29So that's very exciting. And then what's also being discussed a lot now is there's a series of genomic changes that are very frequently seen in some more common cancers. I think will come a day where healthy people will go in every, I don't know, six months, once a year, whatever. They'll get a blood draw and they'll just look in their cell-free DNA. Is there any sign of cancer in your body? And if that would happen, then you're really catching stuff early because some cancers, people may have it for two, three years without knowing. Then they show up and they've got advanced cancer. So all these are paradigm changing ideas, whether it's at the diagnostic level or whether it's at the pathology level and so on and so forth.

23:06So that's in cancer. And by the way, I mean, in cancer, genomics has gotten so complicated in a very positive way that I can't even keep up myself. I mean, there's so many different sub areas within their general field. Yeah. Cancer care shows the power of this technology. There are moments, of course, when speed is just as important as precision. And in high-stake settings like, say, the NICU or the ICU, time matters, right? So what does rapid genome sequencing look like in practice? And how can it change decisions when a patient is critically ill. Yeah. So this is another exciting area. So now we'll pivot my previous job where I was the director of the National Human Genome Research Institute at the National Institutes of Health.

23:51We put on a granting program to look at what would be the value of sequencing all babies' genomes at birth. And a number of grants were given out dealing with healthy newborns. And we gave out one grant to a pioneer in this field who said, I want to try this, but I want to do it very quickly, on those babies in an intensive care unit, especially the very advanced, what are called level four intensive care units in pediatric hospitals, or otherwise known as NICUs or neonatal intensive care units, the illest children there, oftentimes the neonatologists are just flummoxed. They just don't know what's wrong with that baby.

24:29They've done studies. They're fragile. They can't figure out. They're not thriving. In fact, sometimes they could just say, I think this child will survive another 48 hours or maybe another 72. We can't figure out how to save this child. So this gentleman, Stephen Kingsmore, said, I want to try to develop a very rapid genome sequence because I believe that a lot of these children have undiagnosed rare genetic diseases. And if we knew what they had, maybe we could save them. Well, guess what? It worked. I mean, he figured out ways. It's gotten better and better now. In fact, just a couple months ago, the world record was said it was under four hours or under five hours of a genome sequence and an answer and a diagnosis.

25:07And it's been game-changing. Wow. Those examples really highlight how genomics can influence urgent life or death decisions. Can you talk a little bit about using a person's genes to predict how they'll respond to medicine or the field of pharmacogenomics and how close we are to a world where DNA helps guide which drug and dose you get first? That is happening, right?

25:31Dr. Eric Green: It is absolutely happening. I mean, every drug that gets prescribed in America, every drug works. It just doesn't work in everybody. And yet, here we go. It's back to the 1980s again. How did we learn how to practice medicine? You just pick a drug. And if that doesn't work, you pick a different drug. It's just treating the average patient, but none of us is average. As we comb through the human genome and learning about this and doing studies with information about the human genome sequences, we are learning that a lot of the variability of why people are either good responders or bad responders to a given medication, a lot of times it is because of DNA differences in genes that affect drug metabolism.

26:13Dr. Eric Green: And either that means you have the wrong drug or that you need to have a different dose of a drug. And so we don't have to have a one-size-fits-all approach anymore. We can start to get much better at not designing new drugs for each patient, but just among the 10 most commonly prescribed hypertensives, what's the best one to use? By the way, physicians aren't stupid. I mean, physicians for years have always asked, if they encounter a patient, they say, oh, you're hypertensive. Oh, tell me about your parents. Oh, yeah, your dad was hypertensive. Oh, yeah. What drug works for your dad? They will often ask that when they would try it.

26:46Dr. Eric Green: That's how we would do it. Well, we could be more precise. We could do a DNA test, what are the genomic variants, typically in drug metabolism pathways, that influence what among a list of drugs for asthma, for hypertension, for diabetes, I mean, just keep going on and on, which ones would be good and which ones would be less good or which ones you need to dose up a little or you need to be careful and dose down a little. And so this is an example where the science says this should be done more and the clinical routines haven't quite caught up. And this is a barrier, and it's a barrier for all new innovations in medicine.

27:22I mean, medicine's complicated. It's burdensome. It's getting harder, not easier. And so you can't just constantly throw things at busy healthcare professionals and just say, incorporate it into your workflow. Some of it is also because we have a complex payer infrastructure, how things get paid for. And sometimes some companies won't pay, some insurance companies won't pay for pharmacogenomic testing. and doctors are so busy, they don't want to fight the insurance company. So all these things need to be solved. And we're in the process of as a community trying to solve them. But your listeners should expect that in the coming decade, don't be surprised.

27:56As you go to your doctor, they say, all right, I want to treat that. But before I decide which medication, I want you to get a DNA test, a genetic test or a genomic test. And that will tell me which of these three or four medications I'm going to prescribe to you. Yeah. Yeah. Eric, you touched on this a little bit. All of these possibilities depend on something very practical and that is cost, right? The cost we know of sequencing has fallen dramatically over the last decades. How did that actually happen? And why does affordability matter for everyday healthcare?

28:31Dr. Eric Green: Yeah. So I told you earlier that the genome project I did and the next day we set out on the new journey and the new journey was to get to the realization of genomic medicine. And we saw a series of barriers in front of us. I will tell you that the number one barrier, and we actually published this in a vision document that came out the day the Genome Project ended, the number one barrier was the cost of genome sequencing. And here, it's just incredible what's happened. Because when the Genome Project ended in April of 2003, we had just sequenced the first human genome. It cost about a billion dollars.

29:06Dr. Eric Green: And so we talked about, in this vision document, we said we need to get DNA sequencing to be reduced in cost so profoundly that we could get to the point of sequencing a human genome for$1 ,000 or less. From a billion to a thousand, that's a million fold. Once again, we said we're going to try to do SIDA. We had no idea how we were going to do it, but it's happened. And it's happened because our institute, the National Human Genome Research Institute, gave out a whole lot of grants to smart people around the world, actually, to develop new technologies. The private sector really got involved too.

29:42Dr. Eric Green: And it was a beautiful example of the public and the private sectors really working together. And they started commercializing things and they did a lot of R &D and they took advantage of the discoveries, the academic scientists that we were funding were making. And so there's been a whole industry of new technology companies in the DNA sequencing arena. And just inch by inch, and then mile by mile, we've reduced the cost so that today it's less than$1 ,000. You can sequence a human genome for just a few hundred dollars, and there's every reason to believe it'll keep going down. We may see it get down to$100.

30:15Dr. Eric Green: Now, that's a diagnostic test. Just imagine a comprehensive view of a patient's blueprint for less than$1 ,000. I mean, MRIs cost more. Most pests cost more. So, yeah. So that has been a true technological triumph of a post-human genome project. And it's been game-changing because now it's quite possible and quite feasible to do this. I mean, it still requires some amount of money. So insurance companies at first were a little bit resistant, but they're catching on now. It's complicated economics. Healthcare is complicated, but genomics saves lives. And in the long run, that should be our number one priority.

30:49Absolutely. So as genomics becomes cheaper and more common, another challenge comes into focus here, and that's making sure the information actually helps people rather than overwhelming them. Genomic information obviously is powerful. It can also create anxiety, confusion, information overload. How can physicians most effectively communicate this information with their patients? and how do you think about what results should be returned and when and how to keep it truly helpful?

31:22Dr. Eric Green: These are great questions. There's a number of things I want to say before I try to answer. First thing to say is, to the credit of the genomics community, from the very beginning of the Human Genome Project, literally on day one and now carried forward even to now, has been the co-funding of research into looking at the ethical, legal, and social implications of genomic advances. That leads to a whole set of issues around privacy, around what do people want to know and not want to know, what's the right way to gate giving information out to people, and a whole set of things about personal choice.

31:58Dr. Eric Green: And by studying it, we could better anticipate what people's concerns are going to be. And by the way, like everything else in society, people are very heterogeneous. Some people want to know nothing. Some people want to know everything. Some people can, they understand the concept of risk. Some people can't even get their head around statistics and risk. But at the end of the day, people should have a choice. People should be able to do whatever they want to do, and they need to work in partnership with their healthcare providers to get the best possible care. And increasingly, that will mean getting genomic information.

32:29Dr. Eric Green: Now, this plays into lots of conversations. And I don't think we should be judging what people do and do want to know. I think they should be able to make their own choice. But it's going to require a lot of education, not only of the patients, can require a lot of education of the healthcare professionals. And notice I didn't say doctors. I said healthcare professionals because it's an ecosystem of professionals that interface with patients and doctors and nurses and physician assistants and pharmacists and genetic counselors. And there is a literacy gap that needs to be addressed. We just have this big to-do list of all the challenges we need to face, but that's among Yeah.

33:08And I want to make this more concrete with a personal example that shows how these issues can play out in real life. I learned that I carry a BRCA2 mutation after my father was diagnosed with pancreatic cancer. I hadn't known BRCA mutations were associated with pancreatic cancer. And I went to medical school only a decade ago. We're just over that. And that realization really changed how I understood my own risk and the choices I was making about my own health. And what is a story like that? Tell us about where genomic education and clinical guidelines and then real world practice are still falling short because nobody thought, even though my grandmother had pancreatic cancer, were Ashkenazi Jews.

33:50It was like no one thought ever to test me for a genetic mutation.

33:54Dr. Eric Green: But now, but here's the point. And I mean, I'm not going to speak for you, but if somebody like you is now in prevention mode, right, because you can have higher frequency of surveillance and surgery, you have options and you're a family that has dealt now with cancer. And it probably changes your attitudes once you have that. This is another example, moving it away from you, but a very common example is families encounter colon cancer all the time. And if it's a young person in that family gets colon cancer, they will often analyze those individuals and read their genomes to look to see whether they have mutations.

34:30Dr. Eric Green: Because if you find out that you have Lynch syndrome mutations, okay, so you have to get more frequent colonoscopies. But you'll live a longer life because if we catch that tumor early, you are far more likely not to die of that cancer. And so this is the power of prevention. And genomics will hopefully lead us to the point where it won't be about genomic medicine, where medicine is treating illness. It'll be about genomic health or genomic prevention, where we are using genomics to prevent disease or at least catch it early enough that it has much reduced morbidity and mortality. Yes. This episode is brought to you by Capital One.

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37:06Dr. Eric Green: So I never even considered that I'd be a government employee, but I followed an opportunity in 1994 to go to the institute at NIH funding the Human Genome Project and be part of a new program there, a government-based genomics program. I was working on the Human Genome Project, and I got there in 94. And within a couple of years, I started picking up leadership positions. And then by 2009, I had the opportunity to become the director of the institute at NHGRI. And so I was there. So I was a federalist public servant for 31 years, and I was the leader of one of the 27 institutes and centers that make up the National Institute of Health for 15 years.

37:43Dr. Eric Green: I did depart. I retired from federal service in March of last year of 2025. That's the polite way of saying it. I retired. I was forced to retire. When the new Trump administration came in, there has been an assault on the NIH and certainly an assault on the leadership. Institute directors serve five-year terms. I happen to have a renewal date. That was just a couple months after inauguration. The new NIH director hadn't even arrived, and they just chose on three days' notice not to renew me. They'd subsequently done similar things. Well, they either terminated or done similar things of not renewing.

38:18Dr. Eric Green: Now about six or seven other instant directors. I'm also seeing the NIH is in a downward spiral, and it's hard to watch when you have so much of your life, your heart, and your soul in an organization. That's the reality. So I retired from federal service. There is no way I was going to retire from any aspect of advocating for genomics or trying to see genomic medicine become a reality and have done some consulting since then and even found a number of things to do to try to help institutions think about genomic medicine implementation and so forth. But then in the late part of 2025, an opportunity came up, which was just too hard to consider turning down.

38:58I told you the incredible technology advances that took place in developing new methods for DNA sequencing. And the leading company in that sort of the, as my son refers to it, they're the Apple of the smartphone world. In terms of being iconic, is a company called Illumina. And I know Illumina well. I have many friends that have worked there. When I was an HCI director, I would always interact with the CEO of Illumina. And they approached me to say, basically, do you want to come work at Illumina and be our chief medical officer and help us really see the vision that you have and we have that genomics would become an integral part of healthcare?

39:33And it just made total sense almost from the time they approached me. It's different than being in the government, but it's still about problem solving. It's still about facilitating. It's still about advocating. It's still about educating. I'll just be doing it as a public servant. I'll be doing it as a senior leader of a publicly traded company. So I know the routines will be different, but the motivations are all the same. Well, congratulations. My goodness, they are so lucky to have you. So as we close here, I'd love to zoom back out to the big picture. And as you look ahead, what do you think matters most for all of us to be paying attention to now as it relates to science and public health?

40:10Dr. Eric Green: I would just say, be prepared to speak the language of genomics with your healthcare professionals, because I can almost guarantee that it's going to be so integral in the practice of medicine over the next five and 10 years that they will need to understand some of those things to be able to get the best possible care. Wow. Dr. Eric Green, this was fascinating. So much work to be done, but it is such an exciting time in medicine. So thank you so much for this conversation. Absolutely. It's a pleasure talking to you. Thanks.

40:45And that's our show for today. Thank you so much to Dr. Eric Green for joining us. 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 ShoshanaMD. 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 Lajas, Farah Degrange, Daniela Balarezo, Constanza Gallardo, Tansika Sangmarniwang, and Roxanne Hylash.

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42:50I'm obsessed with the One Size Liquid Blotting Paper Spray. It's the first of its kind blotting spray that mattifies for up to eight hours. It's unreal. There's also the Summer Friday Shade Drops SPF 50, which basically lives in my bag at this point. Oh, and the Kayali Eden Plush Pear smells so good. It's sweet, warm, and addictive. Like, people literally stop me and ask what perfume I'm wearing, which you know I love. So if you want the makeup, skincare, hair, and fragrance products everyone's about to be obsessed with, shop only at Sephora.