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Welcome to the Clinical
Center Grand Rounds,

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a weekly series of educational
lectures for physicians and

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health care professionals
broadcast from the Clinical

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Center at the National
Institutes of Health in

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Bethesda, MD.

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The NIH Clinical Center is the
world's largest hospital totally

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dedicated to investigational
research and leads the global

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effort in training today's
investigators and discovering

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tomorrow's cures.

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Learn more by visiting us online
at http://clinicalcenter.nih.gov

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WE ARE HONORED TO HAVE

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DR. FRANCIS COLLINS, A SENIOR

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INVESTIGATOR OF THE INTRAMURAL

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PROGRAM OF THE NATIONAL HUMAN

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GENOME RESEARCH INSTITUTE AND

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FORMALLY THE 16th DIRECTOR OF

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THE NATIONAL INTUITYS OF HEALTH.

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DR. COLLYNN SYSTEM A PHYSICIAN

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GENETICIST NOTED FOR HIS

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LANDMARK DISCOVERY OF

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DISEASE-RELEASED GENES AND

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PREVIOUS LEADERSHIP OF THE

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NATIONAL HUMAN GENOME PROJECT

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WHICH CULMINATED IN 2003 WITH

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THE IDENTIFICATION MAPPING AND

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SEQUENCING ALL OF THE GENINGS OF

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THE HUMAN GENOME.

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APPOINTED AS DIRECTOR OF THE NIH

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HE SERVED UNDER 3 PRESIDENTS

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UNTIL STEPPING DUN IN 2021.

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HE WENT ON TO SERVE THE BIDEN

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ADMINISTRATION AS ACTING ADVISOR

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AND CONTINUED HIS WHITE HOUSE

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SERVICE AS A SPECIAL ADVISOR TO

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THE PRESIDENT FOR SPECIAL

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PROJECTS, LEADING TO A PROGRAM

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TO ELIMINATE HEPATITIS C IN THE

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UNITED STATES.

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DR. COLLINS CURRENTLY SERVES AS

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A SENIOR INVESTIGATOR IN THE

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INTRAMURAL PROGRAM OF NHGRI

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PURSUING GENOMICS RESEARCH ON

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TYPE 2 DIABETES AND

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PROGERIATRICKIZATIONIA, THE

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DISORDER OF PREMATURE AGING.

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DR. COLLINS RECEIVED HIS

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BACHELOR OF SCIENCE AND

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CHEMISTRY AT THE UNIVERSITY OF

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VIRGINIA AND MASTERS IN

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PHILOSOPHY IN Ph.D. AND

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PHYSICAL CHEMIST RADIOY FROM

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YALE.

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HE THEN EARNED HIS MEDICAL

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DEGREE WITH HONORS FROM THE

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UNIVERSITY OF NORTH CAROLINA AND

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COMPLETED INTERNAL MEDICINE

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RESIDENCY AT MEMORIAL HOSPITAL

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AND FELLOWSHIP IN HUMAN GENETICS

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AND PEDIATRICS AT YALE

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UNIVERSITY SCHOOL OF MEDICINE.

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DR. COLLINS IS AN ELECTED MEMBER

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OF BOTH THE NATION WILL ACADEMY

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OF MEDICINE AND THE NATIONAL

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ACADEMY OF SCIENCES.

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HE IS A RECIPIENT OF THE

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PRESIDENTIAL MEDAL OF FREEDOM

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AND THE NATIONAL MEDAL OF

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SCIENCE.

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IN 2020 HE WAS ELECTED AS A

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FOREIGN MEMBER OF THE ROYAL

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SOCIETY AND WAS ALSO THE 50th

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WINNER OF THEATISMLE TON PRIZE

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WHICH CELEBRATES SCIENTIFIC AND

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SPIRITUAL CURIOSITY.

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NOW, PLEASE JOIN ME IN WELCOMING

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TODAY'S GRAND ROUND SPEAKER

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DR. COLLINS FOR HIS

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PRESENTATION, HIS SECOND DECADES

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AT THE FOREFRONT OF MEDICAL

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RESEARCH:  THE NIH CLINICAL

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CENTER.

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[ APPLAUSE ]

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>>THANK YOU VERY MUCH, JIM.

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GOOD AFTERNOON TO EVERYBODY HERE

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IN LIPSETT AUDITORIUM AND ALL

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THE PEOPLE WATCHING REMOTELY.

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IT IS GREAT THAT SOME OF YOU ARE

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HERE BECAUSE IT'S BEEN A LONG

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TIME SINCE WE'VE BEEN ABLE TO

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ASSEMBLE GRAND ROUNDS IN QUITE

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THIS NUMBER OF FOLKS GIVEN THE

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COVID CHALLENGES THAT WE'VE ALL

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BEEN GOING THROUGH WHICH ARE NOT

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ENTIRELY OVER BUT WE ARE

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DEFINITELY IN A BETTER PLACE

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THAN WE WERE IN A FEW 3 YEARS

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PAST.

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IT WILL BE CHALLENGING TO TAKE

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ON THE REQUEST THAT WAS PUT

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FORWARD TO ME TO SUMMARIZE 7

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DECADES OF MEDICAL RESEARCH IN

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45 MINUTES SO LET ME RIGHT UP

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FRONT SAY IF I LEAVE OUT AN AREA

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THAT YOU THINK WAS REALLY,

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REALLY IMPORTANT, PLEASE FORGIVE

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ME BECAUSE THE COMP LICKERMENTS

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OF THESE 70 YEARS, ARE TRULY

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BREATH TAKING AS YOU WILL SEE.

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AND YET, I COULD NO WAY, NO HOW,

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POSSIBLY COVER ALL THE THINGS

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THAT MAY HAVE DESERVED TO BE

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MENTIONED IN A TALK LIKE THIS.

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FIRST OF ALL FINANCIAL

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DISCLOSURES.

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SOMEDAY I HOPE TO HAVE SOMETHING

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ON THIS SLIDE, BUT AS A FEDERAL

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EMPLOYEE ON THE MOMENT NOTHING

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TO DISCLOSE, BUT I DO HAVE

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GRATITUDE TO DISCLOSE BECAUSE I

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DID LEAN ON SOME PEOPLE TO HELP

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ME WITH THIS PRESENTATION.

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PARTICULARLY JOHN GALLEN WHO

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GAVE A TALK LIKE THIS LAST FALL

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TO THE RESEARCH BOARD WHERE I

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BORROWED LIBERALLY FROM HIS

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IDEAS ABOUT WHICH THINGS TO TRY

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TO INCLUDE.

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AND KIM PALACE WHO RUNS THE

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HISTORY OFFICE FOR NIH WAS ALSO

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HUGELY HELPFUL TO ME AS WAS

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DEVON VALERA AND DONNIE BLISS,

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AND A FEW IMAGES FROM PEOPLE YOU

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SEE LISTED HERE.

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I'M SUPPOSED TO GIVE YOU

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LEARNING OBJECTIVES, SO FIRST OF

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ALL TO APPRECIATE WHAT HAS BEEN

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DONE OVER THE LAST SEIVET YEARS

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AND SECOND, WE'LL GET TO THAT,

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TO THINK ABOUT POSSIBLE FUTURE

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ADVANCES FOR WHICH THIS CENTER

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IS UNIQUELY POSITIONS:  THIS IS

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THE HOUSE OF HOPE, THE WORLD'S

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LARGEST CLINICAL RESEARCH

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CENTER. 

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ADMITTING PATIENTS ONLY ON

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PROTOCOLS.

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MANY OF THEM COMING HERE AS SORT

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OF THEIR BEST HOPE AND LAST

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RESORT AFTER THE REST OF MEDICAL

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CARE HAS NOT REALLY BEEN ABLE TO

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COME UP WITH ANSWERS.

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SOME SELF-REFERED, SOMETHING BY

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PHYSICIAN, SOMETHING LIKE 1500

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CLINICAL STUDIES IN PROGRESS AND

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RECOGNIZED IN MANY WAYS BUT I

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THINK A PARTICULAR 1 TO

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REMEMBER, 12 YEARS AGO, THE

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LASKER BLOOMBERG PUBLIC SERVICE

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AWARD GIVEN TO AN INDIVIDUAL, IN

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THAT CASE, GIVEN TO THE NIH

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CLINICAL CENTER AND YES, GOTTEN

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SOME ATTENTION OVER THE YEARS.

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MANY OF THE THINGS THAT HAPPEN

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HERE DO INTEREST THE PUBLIC AND

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THE PRESS.

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THIS PARTICULAR DOCUMENTARY

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CALLED FIRST IN HUMAN I THINK

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WAS A WONDERFUL REPRESENTATION

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OF WHAT THE REAL EXPERIENCE IS

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LIKE IN THIS RESEARCH HOSPITAL

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WHERE PATIENTS COME HERE,

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PUTTING THEIR TRUST IN US AND WE

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DON'T KNOW NOR DO THEY WHETHER

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THE EXPERIMENTAL APPROACH WE'RE

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GOING TO TAKE IS NECESSARILY

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GOING TO WORK OR NOT BUT IT'S A

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NOBLE ENTERPRISE AND YOU CAN SEE

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THAT IN THAT DOCUMENTARY.

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WELL, LET'S TURN BACK THE CLOCK,

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BECAUSE THAT'S  WHAT WE'RE

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SUPPOSED TO DO WHEN WE DO A 70

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YEAR ANNIVERSARY.

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CHECK THAT OUT.

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THAT BIG PILE OF DIRT IN THE

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BACK WAS GOING TO BECOME

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BUILDING 10.

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I THINK THE BUILDING IN THE

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BACKGROUND MUST BE THE CLOIOF

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THER BECAUSE I THINK THAT'S WHAT

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WOULD BE THERE AT THAT POINT AND

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WELL, BUILDING 1 WAS HERE SINCE

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THE MIDDLE AGES SO THAT'S

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OBVIOUSLY THERE AND ALWAYS WILL

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BE.

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SO THAT WAS THE BEGINNING OF

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PUTTING THAT TOGETHER, JUMP

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FORWARD A YEAR OR 2, THE

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DEDICATION OF BUILDING 10.

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A LOT OF PEOPLE CROWDED OUT

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THERE, YOU CAN SEE THE ENORMOUS

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BRICK BUILDING.

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FIRST TIME I CAME TO THE NIH

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CAMPUS I WAS IN BETWEEN Ph D

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IN PHYSICAL CHEMIST RADIOY AND

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THINKING ABOUT GOING TO MEDICAL

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SCHOOL AND I HAD THE OPPORTUNITY

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TO COME AND VISIT WITH IRA

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PASTON AND HIS LAB WHICH WAS

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REALLY WONDERFUL, HE OPENED HIS

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LAB MEETING WHO KNEW VERY LITTLE

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ABOUT BIOLOGICAL SCIENCE BECAUSE

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I WAS A CHEMIST AND WALKING

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AFTER I HAD VISITED WITH HIM UP

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IN BUILDING 37, WALKED BA PAST

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THIS AND LOOKED UP AT THIS

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BUILDING AND SAID THAT IS THE

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BIGGEST TARN BUILDING I'VE EVER

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SEEN IN MY LIFE.

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AND IN MANY WAYS IT STILL IS,

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BUT WHAT IN A PHENOMENAL

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LOCATION, WHAT A PHENOMENAL

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BUILDING IT IS FOR THINGS THAT

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HAVE HAPPENED OVER THESE 70

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YEARS, BEGINNING WITH THE VERY

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FIRST PATIENT.

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THIS IS A FARMER WHO CAME TO NIH

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AS THE FIRST PATIENT WITH A

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PROBLEM WITH PROSTATE CANCER.

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SO STEPPING FORWARD FROM THERE,

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I WANT TO WALK YOU THROUGH IN

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VARIOUS AREAS, VARIOUS THEMES

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JUST SOME OF THE MILESTONES THAT

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HAVE OCCURRED HERE OVER THESE 7

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DECADES AND AGAIN, IT'S GOING TO

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BE A LITTLE BIT PERSONAL IN

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TERMS OF WHAT I PICKED AND WHAT

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I DIDN'T BECAUSE I CAN'T

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POSSIBLY DO EVERYTHING AND

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AGAIN, I WAS BENEFITED A LOT BY

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JOHN GALLENS WHOSE KNOWLEDGE OF

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THIS IS MUCH GREATER THAN MINE

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TRYING TO MAKE SURE WE DIDN'T

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LEAVE OUT THINGS THAT WERE

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REALLY QUITE IMPRESSIVE

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LANDMARKS BUT THERE ARE TOO MANY

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EVEN OF THOSE.

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SO START WITH CANCER; AN AWFUL

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LOT OF CANCER ADVANCES HAVE

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HAPPENED IN THIS BUILDING.

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THE VERY FIRST CURE OF A SOLID

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TUMOR CARIO CARCINOMA BY MEX

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TREKSATE BY LEE AND HURTZ, WE

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OFTEN SAY WHEN WE TALK ABOUT 1

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OF THE MOST SIGNIFICANT ADVANCES

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IN CANCER RESEARCH, IT'S THE

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CURE OF CHILDHOOD A. L. L.

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THAT WAS FIRST DONE HERE IN

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1962, FREI AND FREIREICH, AND

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THEN THE CONCEPT OF CHEMO

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00:08:54,800 --> 00:08:55,080
THERAPY.

261
00:08:55,080 --> 00:08:55,920
COMING FORWARD WITH THE NAMES

262
00:08:55,920 --> 00:08:57,320
HERE ISSUES THESE WERE MOSTLY

263
00:08:57,320 --> 00:08:58,760
MEN, WE WILL SEE WOMEN LATER AND

264
00:08:58,760 --> 00:09:02,480
I'M GLAD TO SEE THAT TOO BUT THE

265
00:09:02,480 --> 00:09:04,120
REALITY OF 1965 IS THAT THESE

266
00:09:04,120 --> 00:09:06,760
WERE MOSTLY MEN LEADING THE

267
00:09:06,760 --> 00:09:09,040
RESEARCH EFFORTS HERE.

268
00:09:09,040 --> 00:09:11,080
AND THEN COMING FORWARD FROM

269
00:09:11,080 --> 00:09:11,920
CHEMO THERAPY TO IMMUNOTHERAPY,

270
00:09:11,920 --> 00:09:14,560
I HAVE TO SAY A WORD ABOUT STEVE

271
00:09:14,560 --> 00:09:16,520
ROSENBERG AND THE WAY IN WHICH

272
00:09:16,520 --> 00:09:19,720
HIS VISION ABOUT HOW TO ACTIVATE

273
00:09:19,720 --> 00:09:21,560
THE IMMUNE SYSTEM GAVE US A

274
00:09:21,560 --> 00:09:24,840
WHOLE NEW SET OF TOOLS FOR

275
00:09:24,840 --> 00:09:26,160
APPROACHING CANCER WHICH ARE

276
00:09:26,160 --> 00:09:28,160
TRULY INSPIRING A LOT OF THE

277
00:09:28,160 --> 00:09:28,960
CURRENT ACTIVITY TODAY.

278
00:09:28,960 --> 00:09:32,600
SO I WILL FOCUS BRIEFLY ON THAT

279
00:09:32,600 --> 00:09:32,720
1.

280
00:09:32,720 --> 00:09:36,000
STEVE CAME IN THIS 1974,

281
00:09:36,000 --> 00:09:37,840
STRAIGHT OUT OF HIS TRAINING AND

282
00:09:37,840 --> 00:09:41,600
IMMEDIATELY TO BECOME A BRANCH

283
00:09:41,600 --> 00:09:43,880
CHIEF AND PURSUING THIS IDEA OF

284
00:09:43,880 --> 00:09:45,440
ACTIVATING THE IMMUNE RESPONSE,

285
00:09:45,440 --> 00:09:47,520
INITIALLY WITH A LOT OF

286
00:09:47,520 --> 00:09:48,920
FRUSTRATIONS AND FAILURES, BUT

287
00:09:48,920 --> 00:09:50,320
THEN SOME SUCCESSES WITH

288
00:09:50,320 --> 00:09:52,840
MELANOMA, AND MORE RECENTLY,

289
00:09:52,840 --> 00:09:55,960
MOVING THAT FORWARD, WITH CAR

290
00:09:55,960 --> 00:10:01,120
T-CELLS, USING TILL CELLS, TUMOR

291
00:10:01,120 --> 00:10:02,400
INFILTRATING LYMPHOCYTES TO

292
00:10:02,400 --> 00:10:04,120
TARGET MUTATIONS TO THE POINT

293
00:10:04,120 --> 00:10:05,800
WHERE WHERE THERE ARE SUCCESSES

294
00:10:05,800 --> 00:10:08,920
STARTING TO,A PEER IN BREAST

295
00:10:08,920 --> 00:10:09,680
CANCER, PANCREATIC CANCER, COLON

296
00:10:09,680 --> 00:10:11,240
CANCER AND SO ON.

297
00:10:11,240 --> 00:10:12,080
AND I THINK STEVE WOULD SAY THIS

298
00:10:12,080 --> 00:10:15,840
IS THE KIND OF FACILITY THAT

299
00:10:15,840 --> 00:10:16,960
MADE IT POSSIBLE OVER THIS

300
00:10:16,960 --> 00:10:19,400
STRETCH OF TIME WITH MANY HIGH

301
00:10:19,400 --> 00:10:21,720
RISK AND MANY PROTOCOLS THAT DID

302
00:10:21,720 --> 00:10:23,760
NOT SUCCEED TO KEEP PUSHING

303
00:10:23,760 --> 00:10:24,720
FORWARD, THOSE BOUNDARIES WHICH

304
00:10:24,720 --> 00:10:25,480
MIGHT HAVE BEEN VERY DIFFICULT

305
00:10:25,480 --> 00:10:28,560
TO DO IN ANY OTHER PLACE AND NOW

306
00:10:28,560 --> 00:10:31,960
HAS UNLEASHED AN ENTIRE FIELD OF

307
00:10:31,960 --> 00:10:33,800
CANCER IMMUNOTHERAPY, MANY

308
00:10:33,800 --> 00:10:36,000
PEOPLE LOOK AT THAT AS SOMETHING

309
00:10:36,000 --> 00:10:37,200
THAT STEVE DESERVES TO BE

310
00:10:37,200 --> 00:10:39,080
CONSIDERED THE REAL FATHER OF

311
00:10:39,080 --> 00:10:42,280
THIS FIELD.

312
00:10:42,280 --> 00:10:45,560
CONTINUING WITH CANCER, MARSTEN,

313
00:10:45,560 --> 00:10:47,840
LANE, THE REMARKABLE WORK THAT'S

314
00:10:47,840 --> 00:10:50,000
BEEN DONE HERE OVER MANY YEARS

315
00:10:50,000 --> 00:10:51,080
DISCOVERING THE GENETIC BASIS

316
00:10:51,080 --> 00:10:53,080
AND COMING UP WITH THERAPEUTICS

317
00:10:53,080 --> 00:10:56,160
AS A RESILT FOR HEREDITARY

318
00:10:56,160 --> 00:10:58,240
KIDNEY CANCER.

319
00:10:58,240 --> 00:10:59,600
ROBERT PASTON AND ROBERT

320
00:10:59,600 --> 00:11:02,160
[INDISCERNIBLE] WITH AN APPROACH

321
00:11:02,160 --> 00:11:03,440
TO LEUKEMIA USING IMMUNO TOXICS

322
00:11:03,440 --> 00:11:05,760
AND VERY COOL MOLECULAR BIOLOGY

323
00:11:05,760 --> 00:11:07,400
AND ALSO A VERY COMMON DISEASE

324
00:11:07,400 --> 00:11:09,000
WHICH HAS REALLY BEEN

325
00:11:09,000 --> 00:11:10,600
TRANSFORMED BY PEOPLE RIGHT HERE

326
00:11:10,600 --> 00:11:13,800
IN THIS BUILDING, PETER, BRAD

327
00:11:13,800 --> 00:11:16,080
WOOD, WHO IN THEIR EFFORTS TO

328
00:11:16,080 --> 00:11:18,200
REALLY FIGURE OUT HOW DO YOU

329
00:11:18,200 --> 00:11:21,360
MANAGE A DISEASE THAT IS

330
00:11:21,360 --> 00:11:22,680
EXTREMELY FREQUENT, BUT OFTEN

331
00:11:22,680 --> 00:11:23,840
INDOLENT AND OFTEN TO THE POINT

332
00:11:23,840 --> 00:11:25,880
WHERE IT DOESN'T REQUIRE THE

333
00:11:25,880 --> 00:11:26,480
MOST AGGRESSIVE INTERVENTION,

334
00:11:26,480 --> 00:11:29,280
HOW DO YOU KNOW WHEN TO ACT AND

335
00:11:29,280 --> 00:11:29,920
WHEN NOT TO?

336
00:11:29,920 --> 00:11:32,960
AND THIS APPROACH OF COMBINING

337
00:11:32,960 --> 00:11:36,080
MRI IMAGING AND TARGETED

338
00:11:36,080 --> 00:11:37,160
BIOPSYING HAS STOATALLY CHANGED

339
00:11:37,160 --> 00:11:39,200
THE WAY WE APPROACH THIS

340
00:11:39,200 --> 00:11:42,800
CONDITION, TO THE BENEFIT OF

341
00:11:42,800 --> 00:11:43,800
MILLIONS OF MEN.

342
00:11:43,800 --> 00:11:45,400
OKAY, JUMPING FROM CANCER, THESE

343
00:11:45,400 --> 00:11:48,880
ARE IN NO PARTICULAR ORDER BUT

344
00:11:48,880 --> 00:11:50,440
SICKLE CELL ANEMIA, A DISORDER

345
00:11:50,440 --> 00:11:53,320
THAT ANY OF US WHO CARE ABOUT

346
00:11:53,320 --> 00:11:53,960
MEN DEALIAN DISORDERS HAVE

347
00:11:53,960 --> 00:11:57,320
STUDIED FROM THE VERY BEGINNING

348
00:11:57,320 --> 00:11:59,520
1 OF THE FIRST, IN FACT THE

349
00:11:59,520 --> 00:12:00,080
FIRST MOLECULAR DISEASE

350
00:12:00,080 --> 00:12:01,320
UNDERSTANDING WHAT THE ACTUAL

351
00:12:01,320 --> 00:12:03,840
MUTATION IS, A SINGLE LETTER

352
00:12:03,840 --> 00:12:06,800
MISSPELLED IN THE BETA GLOBIN

353
00:12:06,800 --> 00:12:07,160
GENE.

354
00:12:07,160 --> 00:12:08,960
TO VERY SIGNIFICANT THINGS I CAN

355
00:12:08,960 --> 00:12:12,360
PUT ON THIS, 1 IS GRIF ROGERS

356
00:12:12,360 --> 00:12:15,000
RESEARCH WITH COLLEAGUES, TO

357
00:12:15,000 --> 00:12:18,920
SHOW THAT HYDROXY UREA COULD IN

358
00:12:18,920 --> 00:12:20,640
FACT PROVIDE CLINICAL BENEFIT TO

359
00:12:20,640 --> 00:12:21,240
INDIVIDUALS WITH SICKLE CELL

360
00:12:21,240 --> 00:12:22,960
DISEASE AND THAT IS STANDARD OF

361
00:12:22,960 --> 00:12:24,520
CARE IN MANY PLACES INCLUDING

362
00:12:24,520 --> 00:12:26,560
NOW IN SOME PLACES IN AFRICA.

363
00:12:26,560 --> 00:12:27,920
BUT THE EXCITEMENT YOU SEE

364
00:12:27,920 --> 00:12:30,480
WRITTEN ABOUT PARTICULARLY NOW,

365
00:12:30,480 --> 00:12:33,000
ESPECIALLY THIS YEAR IS FDA IS

366
00:12:33,000 --> 00:12:34,200
CONSIDERING WHETHER TO APPROACH

367
00:12:34,200 --> 00:12:36,840
GENE THERAPY FOR SICKLE CELL

368
00:12:36,840 --> 00:12:37,760
DISEASE, MUCH OF IT COMING RIGHT

369
00:12:37,760 --> 00:12:42,200
HERE FROM THE WORK OF JOHN

370
00:12:42,200 --> 00:12:43,560
TISDALE AND COURTNEY FITS HUGH

371
00:12:43,560 --> 00:12:45,120
WORKING WITH BLUE BIRD, A

372
00:12:45,120 --> 00:12:46,240
COLLABORATOR COMPANY TO TRY TO

373
00:12:46,240 --> 00:12:48,200
SEE WHETHER YOU COULD IN FACT

374
00:12:48,200 --> 00:12:52,000
TAKE BONE MARROW CELLS OUT OF

375
00:12:52,000 --> 00:12:53,960
THE PATIENT, PROVIDE A GENE

376
00:12:53,960 --> 00:12:55,560
THERAPY VECTOR THAT WOULD ALLOW

377
00:12:55,560 --> 00:12:58,240
THE PRODECLARATION OF A LOT OF

378
00:12:58,240 --> 00:12:59,440
NONSICKLE HEMOGLOBIN AND HAVE

379
00:12:59,440 --> 00:13:00,720
SOMEBODY WHOSE HAD SICKLE

380
00:13:00,720 --> 00:13:02,040
DISEASE FOR THEIR WHOLE LIFE, AS

381
00:13:02,040 --> 00:13:08,880
YOU SEE HERE IN THE EXAMPLE OF

382
00:13:08,880 --> 00:13:09,920
JANELLE STEVENSON, ESSENTIALLY

383
00:13:09,920 --> 00:13:12,920
IT SEEMS, NOT JUST BENEFITED BUT

384
00:13:12,920 --> 00:13:13,920
POTENTIALLY CURES FOR YEARS,

385
00:13:13,920 --> 00:13:15,480
STILL SOMETHING TO LOOK AT IF

386
00:13:15,480 --> 00:13:16,160
SOMETHING HAPPENS DOWN STREAM

387
00:13:16,160 --> 00:13:18,800
BUT AS THE YEARS GO BY 1 AND 1

388
00:13:18,800 --> 00:13:21,160
COULD USE THE C-WORD.

389
00:13:21,160 --> 00:13:23,240
SIMILAR EFFORTS USING CRSPR, BY

390
00:13:23,240 --> 00:13:23,960
OTHER APPROACHES ALSO GOING

391
00:13:23,960 --> 00:13:26,040
FORWARD.  THIS IS A

392
00:13:26,040 --> 00:13:28,680
TRANSFORMATIVE MOMENT FOR THIS

393
00:13:28,680 --> 00:13:29,720
FIRST MOLECULAR DISEASE AND WELL

394
00:13:29,720 --> 00:13:33,000
IT IS TIME FOR THAT.

395
00:13:33,000 --> 00:13:36,280
TALK ABOUT INFECTIOUS DISEASES.

396
00:13:36,280 --> 00:13:38,360
I WAS NOTE HERE IN THE EARLY

397
00:13:38,360 --> 00:13:39,640
1980S BUT AN AWFUL LOT OF WHAT

398
00:13:39,640 --> 00:13:41,640
WENT ON TO THE CLINICAL CENTER

399
00:13:41,640 --> 00:13:43,360
AND RIGHTLY SO WAS DEVOTE TOTD

400
00:13:43,360 --> 00:13:45,600
HIV/AIDS LED BY TONY FAUCI AND

401
00:13:45,600 --> 00:13:46,720
CLIFF LANE AND MANY OTHER

402
00:13:46,720 --> 00:13:47,520
COLLEAGUES TRYING TO FIGURE OUT

403
00:13:47,520 --> 00:13:49,600
WHAT IS THE CAUSE OF THIS,

404
00:13:49,600 --> 00:13:51,040
DISCOVERING THE VIRAL CAUSE

405
00:13:51,040 --> 00:13:53,920
COMING UP WITH IDEAS ABOUT

406
00:13:53,920 --> 00:13:54,160
THERAPY.

407
00:13:54,160 --> 00:13:57,200
THE VERY FIRST TREATMENT FOR

408
00:13:57,200 --> 00:13:59,400
HIV, AZT, DEVELOPED BY SAM

409
00:13:59,400 --> 00:14:01,040
BURGER WHO WENT ON TO BECOME THE

410
00:14:01,040 --> 00:14:03,440
HEAD OF THE NATIONAL CANCER

411
00:14:03,440 --> 00:14:03,680
INSTITUTE.

412
00:14:03,680 --> 00:14:05,040
BUT OF COURSE OTHER INFECTIOUS

413
00:14:05,040 --> 00:14:08,320
DISEASE VS HAD A RATHER

414
00:14:08,320 --> 00:14:08,880
INTERESTING AND SIGNIFICANT

415
00:14:08,880 --> 00:14:13,600
COURSE HERE IN BUILDING 10 AND

416
00:14:13,600 --> 00:14:15,800
IN A FACILITIES NEARBY, EBOLA,

417
00:14:15,800 --> 00:14:16,760
THE VACCINE FOR THIS DEVELOPED

418
00:14:16,760 --> 00:14:18,280
OVER AT THE VACCINE RESEARCH

419
00:14:18,280 --> 00:14:19,480
CENTER IN COLLABORATION WITH A

420
00:14:19,480 --> 00:14:21,560
COMPANY BY NANCY SULLIVAN AND OF

421
00:14:21,560 --> 00:14:23,960
COURSE, 1 OF THE MOST DRAMATIC

422
00:14:23,960 --> 00:14:25,280
MOMENTS SINCE I'VE BEEN HERE IN

423
00:14:25,280 --> 00:14:27,800
30 YEARS WHEN WE WERE CALLED

424
00:14:27,800 --> 00:14:30,120
UPON, NOT ONLY TO DO RESEARCH ON

425
00:14:30,120 --> 00:14:31,720
DEVELOPING A TREATMENT BUT

426
00:14:31,720 --> 00:14:33,400
ACTUALLY TO TAKE CARE OF SOME OF

427
00:14:33,400 --> 00:14:34,560
THE SICKEST PATIENTS YOU CAN

428
00:14:34,560 --> 00:14:36,840
IMAGINE WHO WERE INFECT WIDE

429
00:14:36,840 --> 00:14:38,360
THIS REALLY FRIGHTENING VIRUS

430
00:14:38,360 --> 00:14:42,760
AND THAT INCLUDED BRINGING 2 US

431
00:14:42,760 --> 00:14:45,800
A NURSE FROM DALLAS WHO WAS

432
00:14:45,800 --> 00:14:48,440
QUITE ILL AND BEING CARED FOR IN

433
00:14:48,440 --> 00:14:50,200
OUR XECIAL CLINICAL UNIT BY NONE

434
00:14:50,200 --> 00:14:51,880
OTHER THAN TONY FAUCI HIMSELF

435
00:14:51,880 --> 00:14:55,280
AND A NUMBER OF HIS OTHER

436
00:14:55,280 --> 00:14:57,960
COLLEAGUES, WHICH THEN LED US TO

437
00:14:57,960 --> 00:14:58,560
A PRETTY OUTCOME.

438
00:14:58,560 --> 00:15:01,480
FIRST OF ALL THOUGH, THE VACCINE

439
00:15:01,480 --> 00:15:03,200
EFFORTS AS YOU CAN SEE COMING

440
00:15:03,200 --> 00:15:05,400
FORWARD WITH WHAT TURNS OUT TO

441
00:15:05,400 --> 00:15:09,480
BE A VACCINE THAT IS SAFE AND

442
00:15:09,480 --> 00:15:10,840
GOT MUCH DEBATED AND DISCUSSED

443
00:15:10,840 --> 00:15:12,640
IN PLACES LIKE THE WHITE HOUSE

444
00:15:12,640 --> 00:15:14,280
AS YOU CAN SEE WITH

445
00:15:14,280 --> 00:15:16,560
PRESIDENT OBAMA THERE AND THEN

446
00:15:16,560 --> 00:15:18,200
HERE THIS PICTURE COMING OUT OF

447
00:15:18,200 --> 00:15:21,280
THE CLINICAL CENTER AFTER THE

448
00:15:21,280 --> 00:15:22,560
ANNOUNCEMENT THAT NINNA PH AM

449
00:15:22,560 --> 00:15:25,040
WAS NO LONGER INFECT WIDE THE

450
00:15:25,040 --> 00:15:26,920
EBOLA VIRUS, TONY FAUCI, WITH

451
00:15:26,920 --> 00:15:28,160
HIS ARM AROUND HER SHOULDER,

452
00:15:28,160 --> 00:15:29,760
SOME OF HER FAMILY BEHIND HER,

453
00:15:29,760 --> 00:15:31,480
THIS WAS QUITE A DAY, I MUST SAY

454
00:15:31,480 --> 00:15:34,120
AND IT MADE YOU FEEL LIKE, WOW,

455
00:15:34,120 --> 00:15:36,840
THIS PLACE NOT ONLY HAS THE MOST

456
00:15:36,840 --> 00:15:39,280
AMAZING BASIC SCIENCE TO BE

457
00:15:39,280 --> 00:15:40,320
BUILDING A VACCINE BUT ALSO TO

458
00:15:40,320 --> 00:15:42,640
TAKE CARE OF SOME OF THE SICKEST

459
00:15:42,640 --> 00:15:43,160
PATIENTS CAN YOU POSSIBLY

460
00:15:43,160 --> 00:15:46,000
IMAGINE AND GET THEM WELL AGAIN.

461
00:15:46,000 --> 00:15:47,800
CONTINUING WITH INFECTIOUS

462
00:15:47,800 --> 00:15:49,480
DISEASE, AND I'M JUST REALIZING

463
00:15:49,480 --> 00:15:51,400
SOMEHOW WHEN I MADE THIS SLIDE 1

464
00:15:51,400 --> 00:15:53,320
THING GOT DROPPED OUT SO LET ME

465
00:15:53,320 --> 00:15:54,960
SAY WHAT SOMEHOW GOT LOST, I

466
00:15:54,960 --> 00:15:57,080
WANT TO TALK ABOUT HEPATITIS C.

467
00:15:57,080 --> 00:15:59,600
AS YOU HEARD, I AM COMPLETELY

468
00:15:59,600 --> 00:16:02,800
OBSESSED ABOUT THE IDEA THAT WE

469
00:16:02,800 --> 00:16:04,560
MIGHT ACTUALLY ELIMINATE THIS

470
00:16:04,560 --> 00:16:06,960
DISEASE THAT'S KILLING 15,000

471
00:16:06,960 --> 00:16:07,880
PEOPLE IN THE UNITED STATES FOR

472
00:16:07,880 --> 00:16:11,320
WHICH WE HAVE A HIGHER SAFE AND

473
00:16:11,320 --> 00:16:12,800
EFFECTIVE ORAL CURE WHERE 1 PILL

474
00:16:12,800 --> 00:16:15,120
A DAY FOR 12 WEEKS HAS A 98%

475
00:16:15,120 --> 00:16:16,320
CURE RATE AND YET PEOPLE ARE NOT

476
00:16:16,320 --> 00:16:18,240
GETTING IT AND THE REASON WE

477
00:16:18,240 --> 00:16:19,840
KNOW ABOUT HEPATITIS C, A LOT OF

478
00:16:19,840 --> 00:16:22,360
IT IS, BECAUSE OF HARVEY ARTHUR

479
00:16:22,360 --> 00:16:24,840
WHO IS SITTING HERE AND HIS

480
00:16:24,840 --> 00:16:25,560
COLLEAGUES IDENTIFYING THE VIRUS

481
00:16:25,560 --> 00:16:27,640
AND COMING UP WITH A STRATEGY

482
00:16:27,640 --> 00:16:28,520
THAT INDUSTRY THEN JUMPED UPON

483
00:16:28,520 --> 00:16:30,920
TO COME UP WITH A THERAPEUTIC, A

484
00:16:30,920 --> 00:16:31,720
HUGE CONTRIBUTION AND NOW WE

485
00:16:31,720 --> 00:16:32,840
JUST HAVE TO MAKE SURE THAT

486
00:16:32,840 --> 00:16:35,000
THOSE 2 EXPW HALF MILLION PEOPLE

487
00:16:35,000 --> 00:16:36,360
WHO ARE CURRENTLY INFECTED

488
00:16:36,360 --> 00:16:40,240
ACTUALLY GET ACCESS TO THE DRUG

489
00:16:40,240 --> 00:16:42,160
DESPITE SOME OF THE LIMITATIONS

490
00:16:42,160 --> 00:16:44,320
OF OUR HEALTHCARE SYSTEM AND THE

491
00:16:44,320 --> 00:16:45,960
COST, AND THAT'S WHAT I'M

492
00:16:45,960 --> 00:16:47,280
SPENDING AN AWFUL LOT OF MY TIME

493
00:16:47,280 --> 00:16:47,960
ON RIGHT NOW.

494
00:16:47,960 --> 00:16:49,440
ANOTHER THING THAT HAPPENED

495
00:16:49,440 --> 00:16:51,200
HERE, ANOTHER PERSON SITTING IN

496
00:16:51,200 --> 00:16:55,640
THE AUDIENCE, JOHN OSHAY AND

497
00:16:55,640 --> 00:16:57,320
WARREN LEONARD IS WORKINGA A

498
00:16:57,320 --> 00:16:59,080
PATHWAY THAT IS TURNING OUT TO

499
00:16:59,080 --> 00:17:01,720
BE 1 OF THE MOST IMPORTANT FOR

500
00:17:01,720 --> 00:17:02,920
AUTOIMMUNE DISEASES THAT BEING

501
00:17:02,920 --> 00:17:07,000
THE JACK STAT 3, AND THE WHOLE

502
00:17:07,000 --> 00:17:09,600
CLASS OF JACK INIBs, JACK

503
00:17:09,600 --> 00:17:10,880
INHIBITORS WHO HAVE TURNED UTR

504
00:17:10,880 --> 00:17:14,800
TO BE A GOD SEND FOR PEOPLE WHO

505
00:17:14,800 --> 00:17:16,000
SUFFER FROM RHEUMATOID ARTHRITIS

506
00:17:16,000 --> 00:17:16,560
AND LUPUS.

507
00:17:16,560 --> 00:17:17,800
AND OF COURSE INFECT

508
00:17:17,800 --> 00:17:19,480
YOURCANDIDATES DISEASE, IF YOU

509
00:17:19,480 --> 00:17:20,680
WERE IN TWEBT 11 YOU MIGHT HAVE

510
00:17:20,680 --> 00:17:24,720
BEEN AWARE AS MANY OF US WERE

511
00:17:24,720 --> 00:17:26,040
THAT OUR CLINICAL CENTER WAS

512
00:17:26,040 --> 00:17:27,400
FACING A CIRCUMSTANCE AND BEING

513
00:17:27,400 --> 00:17:29,080
VERY PUBLIC ABOUT IT AND MANY

514
00:17:29,080 --> 00:17:30,560
HOSPITALS OF FACING AND NOT

515
00:17:30,560 --> 00:17:31,400
BEING PUBLIC ABOUT WHICH IS THE

516
00:17:31,400 --> 00:17:34,600
RISK OF HAVING A HIGHLY

517
00:17:34,600 --> 00:17:41,280
RESISTANT ORGANISM IN OUR CASE,

518
00:17:41,280 --> 00:17:42,560
THE [INDISCERNIBLE], AND BEING

519
00:17:42,560 --> 00:17:44,480
HERE WITH PATIENTS THAT ARE

520
00:17:44,480 --> 00:17:45,560
IMMUNO SUPPRESSED THIS WAS A BIG

521
00:17:45,560 --> 00:17:47,960
DEAL SO HOW DO YOU FIGURE THIS

522
00:17:47,960 --> 00:17:48,200
OUT?

523
00:17:48,200 --> 00:17:50,920
THE USUAL APPROACH DIDN'T WORK

524
00:17:50,920 --> 00:17:52,440
SO WELL IN TERMS OF TRYING TO

525
00:17:52,440 --> 00:17:54,280
UNDERSTAND EXACTLY WHAT THE

526
00:17:54,280 --> 00:17:57,160
TRANSMISSIONS WERE JUST BY

527
00:17:57,160 --> 00:17:58,320
PHYSICAL PROXIMITY.

528
00:17:58,320 --> 00:18:00,280
SO JULIE AND TARA AND DAVID GOT

529
00:18:00,280 --> 00:18:03,200
TOGETHER HERE AND BASICALLY USED

530
00:18:03,200 --> 00:18:04,840
GENOME SEQUENCING TO UNDERSTAND

531
00:18:04,840 --> 00:18:07,000
HOW ISOLATIONS OF THIS

532
00:18:07,000 --> 00:18:07,920
PARTICULAR ORGANISM FROM

533
00:18:07,920 --> 00:18:08,760
MULTIPLE PATIENTS WERE RELATED

534
00:18:08,760 --> 00:18:10,120
TO EACH OTHER AND THAT WAS THE

535
00:18:10,120 --> 00:18:13,600
MOST RELIABLE WAY TO SORT OUT

536
00:18:13,600 --> 00:18:15,600
EXACTLY HOW THIS HAD PASSED

537
00:18:15,600 --> 00:18:15,840
AROUND.

538
00:18:15,840 --> 00:18:18,960
THIS ENDED UP IN THE NEW ENGLAND

539
00:18:18,960 --> 00:18:20,880
JOURNAL AS WELL AS WALL STREET

540
00:18:20,880 --> 00:18:24,560
JOURNAL AND THE ANSWER WAS THAT

541
00:18:24,560 --> 00:18:25,520
UNEXPECTED HIDING PLACE, FAUCETS

542
00:18:25,520 --> 00:18:27,040
SO A LOT OF REPLUMBING HAD TO

543
00:18:27,040 --> 00:18:28,800
GET DONE TO TAKE CARE OF THIS.

544
00:18:28,800 --> 00:18:32,000
THIS SET A STANDARD FOR THE WAY

545
00:18:32,000 --> 00:18:33,640
IN WHICH THIS HOSPITAL

546
00:18:33,640 --> 00:18:34,880
EPIDEMIOLOGY FOR RESISTANT

547
00:18:34,880 --> 00:18:35,880
ORGANISMS NEEDS TO BE DONE IF

548
00:18:35,880 --> 00:18:36,920
YOU'RE REALLY GOING TO FIND OUT

549
00:18:36,920 --> 00:18:39,560
THE ANSWERS THAT YOU NEED.

550
00:18:39,560 --> 00:18:40,520
ANOTHER CONTRIBUTION OF OUR

551
00:18:40,520 --> 00:18:42,120
CLINICAL CENTER, NOT A HAPPY

552
00:18:42,120 --> 00:18:43,320
SITUATION, BUT A GREAT

553
00:18:43,320 --> 00:18:46,400
OPPORTUNITY FOR RESEARCH AND TO

554
00:18:46,400 --> 00:18:47,320
FIND A SOLUTION.

555
00:18:47,320 --> 00:18:49,960
VACCINES OF COURSE, WE HAVE TO

556
00:18:49,960 --> 00:18:53,920
TALK ABOUT BECAUSE THIS HAS BEEN

557
00:18:53,920 --> 00:18:54,840
ANOTHER PHENOMINALLY IMPORTANT

558
00:18:54,840 --> 00:18:56,720
CONTRIBUTION OF NIH AND ITS

559
00:18:56,720 --> 00:18:58,200
CLINICAL CENTER.

560
00:18:58,200 --> 00:18:59,360
NEELSZON AND ROBBINS

561
00:18:59,360 --> 00:19:01,000
PARTICULARLY FOR THE H-FLU

562
00:19:01,000 --> 00:19:04,840
VACCINE WHICH IS TRANSFORMED THE

563
00:19:04,840 --> 00:19:05,960
EXPERIENCE OF VERY YOUNG

564
00:19:05,960 --> 00:19:08,680
CHILDREN BY MAKING THIS NO

565
00:19:08,680 --> 00:19:12,280
LONGER THE TERRIBLE CAUSE OF

566
00:19:12,280 --> 00:19:13,400
MENINGITIS AND OFTEN PREMATURE

567
00:19:13,400 --> 00:19:16,280
DEATH THAT IT USED TO BE,

568
00:19:16,280 --> 00:19:19,600
HEPATITIS A, B, AND ROTO VIRUS

569
00:19:19,600 --> 00:19:21,760
VACCINES WORKED ON BY THE TRIO

570
00:19:21,760 --> 00:19:23,520
YOU SEE LISTED HERE AND MANY

571
00:19:23,520 --> 00:19:23,760
OTHERS.

572
00:19:23,760 --> 00:19:25,440
MY LAB'S IN BUILDING 50, THOSE

573
00:19:25,440 --> 00:19:28,600
IN BUILDING 50, YOU SEE THAT

574
00:19:28,600 --> 00:19:29,200
PARTICULAR ELECTRON MICROSCOPE

575
00:19:29,200 --> 00:19:33,480
IN THE LOB THAT'S WAS USED BY

576
00:19:33,480 --> 00:19:34,440
ALBERT KAPIKIAN, THAT WAS THE

577
00:19:34,440 --> 00:19:36,960
WAY IN WHICH MANY OF THESE

578
00:19:36,960 --> 00:19:38,240
VIRUSES WERE FIRST IDENTIFIED TO

579
00:19:38,240 --> 00:19:42,720
BE ABLE TO DEVELOP THE VACCINE

580
00:19:42,720 --> 00:19:43,840
STRATEGIES.

581
00:19:43,840 --> 00:19:48,120
HPV VACCINE TECHNOLOGY, NOW A

582
00:19:48,120 --> 00:19:48,920
SEEN BEING USED--VACCINE BEING

583
00:19:48,920 --> 00:19:50,800
USED ACROSS THE WORLD AS A WAY

584
00:19:50,800 --> 00:19:51,520
OF PRESENTING CERVICAL CANCER

585
00:19:51,520 --> 00:19:52,960
AND OF COURSE MOST RECENTLY OUR

586
00:19:52,960 --> 00:19:57,560
HEROS FROM THE VACCINE RESEARCH

587
00:19:57,560 --> 00:19:58,600
CENTER, AND THEIR TEAMS AND I

588
00:19:58,600 --> 00:20:00,240
WILL COME BACK TO THAT IN A

589
00:20:00,240 --> 00:20:00,480
MOMENT.

590
00:20:00,480 --> 00:20:01,800
RIGHT NOW I WILL HIGHLIGHT THIS

591
00:20:01,800 --> 00:20:05,000
1 BECAUSE THIS WAS ALSO A REALLY

592
00:20:05,000 --> 00:20:07,400
GOOD EXAMPLE OF 2 SUPERB

593
00:20:07,400 --> 00:20:08,440
MOLECULAR BIOLOGISTS WHO WOULD

594
00:20:08,440 --> 00:20:09,920
NOT HAVE CALLED THEMSELVES

595
00:20:09,920 --> 00:20:11,440
VACCINE EXPERTS OR

596
00:20:11,440 --> 00:20:12,320
VACCINOLOGYISTS BUT JUST GOT

597
00:20:12,320 --> 00:20:13,600
INTERESTED IN A WAY THAT YOU

598
00:20:13,600 --> 00:20:16,320
MIGHT BE ABLE TO TAKE THIS

599
00:20:16,320 --> 00:20:18,560
PARTICULAR VIRUS AND MAKE

600
00:20:18,560 --> 00:20:20,640
SOMETHING IMMUNOGENIC THAT WOULD

601
00:20:20,640 --> 00:20:23,960
BE PROTECTIVE AND PUBLISHED

602
00:20:23,960 --> 00:20:25,240
PAPERS LIKE THIS AND THEN WITHIN

603
00:20:25,240 --> 00:20:29,040
A FEW YEARS WHAT DO YOU KNOW,

604
00:20:29,040 --> 00:20:29,720
FDA APPROVE THANKSGIVING AND AS

605
00:20:29,720 --> 00:20:31,440
A RESULT OF THAT, THE LASKER

606
00:20:31,440 --> 00:20:35,320
AWARD GOING TO DOUG AND JOHN A

607
00:20:35,320 --> 00:20:36,440
FEW YEARS AGO.

608
00:20:36,440 --> 00:20:37,640
A GREAT STORY OF BASIC

609
00:20:37,640 --> 00:20:40,480
SCIENTISTS TURNING OUT TO BECOME

610
00:20:40,480 --> 00:20:44,720
CLINICAL SCIENTISTS IN A HEROIC

611
00:20:44,720 --> 00:20:45,920
WAY.

612
00:20:45,920 --> 00:20:48,240
MENTAL ILLNESS, ANOTHER OBVIOUS

613
00:20:48,240 --> 00:20:49,080
PARTICULARLY DEEP CONCERN OF ALL

614
00:20:49,080 --> 00:20:51,360
OF US AS WE SEE AROUND US THE

615
00:20:51,360 --> 00:20:52,320
STRUGGLES THAT HAVE BEEN

616
00:20:52,320 --> 00:20:53,680
HAPPENING, THEY WERE THERE

617
00:20:53,680 --> 00:20:57,840
BEFORE BUT COVID HAS CERTAINLY

618
00:20:57,840 --> 00:20:58,480
ACCENTUATED THOSE.

619
00:20:58,480 --> 00:21:00,360
NIH HAS BEEN IN THAT SPACE ALSO

620
00:21:00,360 --> 00:21:01,760
IN A BIG WAY.

621
00:21:01,760 --> 00:21:03,600
ALONG THE FIRST CLINICAL TRIALS

622
00:21:03,600 --> 00:21:05,160
OF LITHIUM WAY BACK IN 1969

623
00:21:05,160 --> 00:21:07,200
WHICH IS NOW STANDARD OF CARE

624
00:21:07,200 --> 00:21:09,960
FOR PEOPLE WITH BIPOLAR DISEASE.

625
00:21:09,960 --> 00:21:15,120
THE FIRST TREATMENT OF CHILDHOOD

626
00:21:15,120 --> 00:21:17,840
SCHIZOPHRENIA BY JUDY RAPPA

627
00:21:17,840 --> 00:21:19,360
PORT.

628
00:21:19,360 --> 00:21:24,560
AND RECENTLY KETAMINE IN

629
00:21:24,560 --> 00:21:25,360
SUICIDAL DEPRESSION, COMING UP

630
00:21:25,360 --> 00:21:27,040
WITH A BETTER WAY OF PREVENTING

631
00:21:27,040 --> 00:21:27,280
SUICIDE.

632
00:21:27,280 --> 00:21:29,720
LET ME SAY A WORD ABOUT CARLOS'

633
00:21:29,720 --> 00:21:29,920
WORK.

634
00:21:29,920 --> 00:21:36,560
I'VE HAD THE CHANCE TO MEET WITH

635
00:21:36,560 --> 00:21:39,360
HIM WHEN HE TREATS A PATIENT AND

636
00:21:39,360 --> 00:21:40,760
HEAR THE INTERVIEW OF WHAT THE

637
00:21:40,760 --> 00:21:42,240
PATIENT IS GOING THROUGH AND FOR

638
00:21:42,240 --> 00:21:44,080
SOME OF THESE FOLKS THAT HAVE

639
00:21:44,080 --> 00:21:46,000
HAD THE MOST RESISTANT FORM OF

640
00:21:46,000 --> 00:21:46,920
CLINICAL DEPRESSION FOR DECADES

641
00:21:46,920 --> 00:21:50,600
SOME OF THE STORIES YOU HEAR

642
00:21:50,600 --> 00:21:52,320
FROM REALLY DRAMATIC, FROM

643
00:21:52,320 --> 00:21:53,840
DESPAIR TO HOPE AFTER HOURS OF

644
00:21:53,840 --> 00:21:56,280
AN INFUSION OF JUST THE RIGHT

645
00:21:56,280 --> 00:21:58,880
DOSE OF INTRAVENOUS KETAMINE,

646
00:21:58,880 --> 00:22:00,800
THIS MOLECULE NOT OF COURSE A

647
00:22:00,800 --> 00:22:01,720
PANACEA FOR EVERYTHING BUT

648
00:22:01,720 --> 00:22:03,480
CLEARLY FOR SOME OF THESE

649
00:22:03,480 --> 00:22:07,120
INDIVIDUALS IN A WAY THAT IS

650
00:22:07,120 --> 00:22:08,600
TRANSFORMED OUR UNDERSTANDING OF

651
00:22:08,600 --> 00:22:09,760
HOW DEPRESSION WORKS AND GIVEN A

652
00:22:09,760 --> 00:22:11,640
LOT OF PEOPLE AN OPPORTUNITY TO

653
00:22:11,640 --> 00:22:14,520
HAVE THE CLOUDS LIFTED THAT HAVE

654
00:22:14,520 --> 00:22:17,120
BEEN THERE FOR THEIR ENTIRE

655
00:22:17,120 --> 00:22:17,360
LIVES.

656
00:22:17,360 --> 00:22:20,120
AND THEN RARE DISEASES, A LOT OF

657
00:22:20,120 --> 00:22:22,040
WHAT WE DO INVOLVES THE STUDY OF

658
00:22:22,040 --> 00:22:23,880
RARE DISEASES, MANY OF THEM IN

659
00:22:23,880 --> 00:22:25,640
CHILDREN, WE'RE FORTUNATE TO

660
00:22:25,640 --> 00:22:29,840
HAVE THE CHILDREN'S  INN DOWN TE

661
00:22:29,840 --> 00:22:32,080
HILL TO MAKE IT POSSIBLE FOR

662
00:22:32,080 --> 00:22:33,640
THESE KIDS AND THEIR PARENTS TO

663
00:22:33,640 --> 00:22:34,680
COME AND BE INVOLVED IN RESEARCH

664
00:22:34,680 --> 00:22:34,920
STUDY.

665
00:22:34,920 --> 00:22:36,400
SOME OF THEM START OUT AS

666
00:22:36,400 --> 00:22:37,880
NATURAL HISTORY STUDIES AND THEN

667
00:22:37,880 --> 00:22:40,400
MOVE FORWARD TO THE IDEA OF

668
00:22:40,400 --> 00:22:40,880
POSSIBLE THERAPEUTICS.

669
00:22:40,880 --> 00:22:46,440
MY OWN LAB'S HAD THAT

670
00:22:46,440 --> 00:22:48,480
EXPERIENCE, WITH PROGERIA, THIS

671
00:22:48,480 --> 00:22:50,160
RAREST FORM OF PREMATURE AGING.

672
00:22:50,160 --> 00:22:53,360
FOR A WHILE WE HAD A TRIAL GOING

673
00:22:53,360 --> 00:22:56,360
ON HERE, SUBSEQUENT TO THAT

674
00:22:56,360 --> 00:22:56,960
PROGERIATRICKIZATIONIA HAS AN

675
00:22:56,960 --> 00:22:57,720
APPROVED DRUG AND WE'RE IN THE

676
00:22:57,720 --> 00:22:58,800
PROCESS OF SETTING UP THE

677
00:22:58,800 --> 00:23:01,040
POSSIBILITY OF A REALLY BOLD

678
00:23:01,040 --> 00:23:04,480
APPROACH TO DO A CURE USING IN

679
00:23:04,480 --> 00:23:05,560
VIVO GENE EDITING THAT TRIAL IF

680
00:23:05,560 --> 00:23:07,680
WE CAN GET IT STARTED WILL BE

681
00:23:07,680 --> 00:23:08,960
RUN AT BOSTON CHILDREN'S BUT SO

682
00:23:08,960 --> 00:23:11,520
MUCH OF THE EVIDENCE WAS

683
00:23:11,520 --> 00:23:14,040
ORIGINALLY DERIVED HERE IN THAT

684
00:23:14,040 --> 00:23:15,640
INITIAL NATURAL HISTORY STUDY.

685
00:23:15,640 --> 00:23:17,400
SO THERE'S A LOT THAT HAPPENED

686
00:23:17,400 --> 00:23:21,160
HERE OVER TIME, PEOPLE MAY HAVE

687
00:23:21,160 --> 00:23:23,600
FORGOTTEN THE VERY FIRST HUMAN

688
00:23:23,600 --> 00:23:28,240
GENE THERAPY FOR ADHD AND THERE

689
00:23:28,240 --> 00:23:30,840
WAS A LOT OF BUZZ BACK THEN BUT

690
00:23:30,840 --> 00:23:32,280
NOW IT SEEMS THERE'S A NEW TRIAL

691
00:23:32,280 --> 00:23:34,120
EVERY WEEK BUT THIS WAS THE VERY

692
00:23:34,120 --> 00:23:35,440
FIRST 1.

693
00:23:35,440 --> 00:23:38,560
DAN CASTENER'S WORK STARTING

694
00:23:38,560 --> 00:23:40,080
WITH THE MEDITERRANEAN FEVER BUT

695
00:23:40,080 --> 00:23:41,880
THEN DEFINING A WHOLE NEW CLASS

696
00:23:41,880 --> 00:23:43,960
OF AUTOIMFLA AMATORY DISEASES

697
00:23:43,960 --> 00:23:45,400
HAS TURNED INTO AN UNDERSTANDING

698
00:23:45,400 --> 00:23:46,920
ABOUT A CATEGORY OF ILLNESS THAT

699
00:23:46,920 --> 00:23:48,440
WE JUST DIDN'T HAVE BEFORE.

700
00:23:48,440 --> 00:23:57,440
AND THEN I HAVE TO MENTION THE

701
00:23:57,440 --> 00:23:59,040
UNDIAGNOSED DISEASES PROGRAM

702
00:23:59,040 --> 00:24:01,920
FOUNDED BY BILL AND HIS TEAM,

703
00:24:01,920 --> 00:24:03,880
OVER TIME DOZENS CLINICIANS

704
00:24:03,880 --> 00:24:05,840
SEEKING TO HELP OUT PEOPLE WHO

705
00:24:05,840 --> 00:24:09,680
HAVE HAD A DIAGNOSE NEVER REALLY

706
00:24:09,680 --> 00:24:10,440
MADE AVAILABLE DESPITE MANY

707
00:24:10,440 --> 00:24:11,680
EFFORTS TO DO SO.

708
00:24:11,680 --> 00:24:14,000
THE MEMBERS ARE PRETTY

709
00:24:14,000 --> 00:24:15,520
STAGGERING HERE, I GOT THESE

710
00:24:15,520 --> 00:24:17,680
FROM BILL, A NUMBER OF MEDICAL

711
00:24:17,680 --> 00:24:20,200
RECORDS THAT HAVE BEEN SCANNED

712
00:24:20,200 --> 00:24:23,120
OVER 5000, OVER 1500 HAVE BEEN

713
00:24:23,120 --> 00:24:25,560
ADMITTED AND EVALUATED OVER THIS

714
00:24:25,560 --> 00:24:27,000
14 YEAR PERIOD.

715
00:24:27,000 --> 00:24:31,920
FORTY% CHILDREN AND YOU CAN SEE

716
00:24:31,920 --> 00:24:33,200
NEUROLOGICAL IS NOR THAN HALF,

717
00:24:33,200 --> 00:24:35,840
MOST OF THESE POKE WHO IS GET

718
00:24:35,840 --> 00:24:37,680
EXOHMS OR WHOLE GENOMES AND A

719
00:24:37,680 --> 00:24:40,280
LOT OF DIAGNOSIS GET MADE AND

720
00:24:40,280 --> 00:24:40,760
PUBLICATIONS.

721
00:24:40,760 --> 00:24:43,080
AS A RESULT YOU KEY WHERE THOSE

722
00:24:43,080 --> 00:24:44,880
ARE, A LOT OF IMPACT, A LOT OF

723
00:24:44,880 --> 00:24:45,920
NEW DISEASES HAVE BEEN

724
00:24:45,920 --> 00:24:48,920
IDENTIFIED AND THIS IS ALSO A

725
00:24:48,920 --> 00:24:49,800
TERRIFIC TEACHING OPPORTUNITY,

726
00:24:49,800 --> 00:24:51,760
THE WEEKLY PATIENT ROUNDS

727
00:24:51,760 --> 00:24:53,640
ATTRACT LOTS OF YOUNG TRAINEES,

728
00:24:53,640 --> 00:24:55,840
THE POST BACKS IN MY LAB ALL

729
00:24:55,840 --> 00:24:58,360
LOVE GOING TO UDP, PATIENT

730
00:24:58,360 --> 00:25:00,760
ROUNDS BECAUSE YOU SEE HOW

731
00:25:00,760 --> 00:25:03,240
EXPERIENCED CLINICIAN TRY TO

732
00:25:03,240 --> 00:25:06,800
THINK THROUGH A CHALLENGING

733
00:25:06,800 --> 00:25:08,400
PROBLEM, SORTING THROUGH ALL THE

734
00:25:08,400 --> 00:25:10,840
DATA, WHAT DO WE KNOW ABOUT

735
00:25:10,840 --> 00:25:11,880
PHYSICAL FINDING, ABOUT THE

736
00:25:11,880 --> 00:25:12,840
MEDICAL HISTORY, LAB RESULTS AND

737
00:25:12,840 --> 00:25:15,360
WHAT SHOULD WE DO NEXT TO TRY TO

738
00:25:15,360 --> 00:25:16,560
SORT THIS OUT.

739
00:25:16,560 --> 00:25:20,120
AND THIS HAS BECOME NOT JUST AN

740
00:25:20,120 --> 00:25:21,400
NIH CLINICAL CENTER EFFORT, IT

741
00:25:21,400 --> 00:25:23,640
SPREAD OUT TO BECOME A NATIONAL

742
00:25:23,640 --> 00:25:25,240
NETWORK, THE UNDIAGNOSED DECS

743
00:25:25,240 --> 00:25:28,760
NETWORK AND NOW INTERNATIONALLY

744
00:25:28,760 --> 00:25:31,920
THE UDNI, ALL OF THAT BASICALLY

745
00:25:31,920 --> 00:25:34,720
TRIGGERING OFF WHAT BEGAN HERE

746
00:25:34,720 --> 00:25:39,440
WITH DEDICATION OF BILL AND MANY

747
00:25:39,440 --> 00:25:41,840
OTHERS.

748
00:25:41,840 --> 00:25:43,920
SO THAT'S A WHOMP THROUGH JUST A

749
00:25:43,920 --> 00:25:45,080
FEW THINGS, I HOPE YOU'RE

750
00:25:45,080 --> 00:25:47,000
LOOKING AT THAT BEING PRETTY

751
00:25:47,000 --> 00:25:49,080
MUCH IN AWE, BECAUSE I HAD, I

752
00:25:49,080 --> 00:25:50,720
WAS PUTTING THIS TALK TOGETHER,

753
00:25:50,720 --> 00:25:52,680
I KNEW OF SOME OF THESE AND

754
00:25:52,680 --> 00:25:53,680
VAGUELY AWARE OF SOME OF THE

755
00:25:53,680 --> 00:25:57,720
OTHERS ASK TO SEE THIS TRACK

756
00:25:57,720 --> 00:26:00,000
RECORD OF THIS NUMBER OF MAJOR

757
00:26:00,000 --> 00:26:01,640
ADVANCES THAT CHANGED THE COURSE

758
00:26:01,640 --> 00:26:03,040
OF MEDICINE OF ALL ALL COMES

759
00:26:03,040 --> 00:26:05,000
FROM THIS CLINICAL CENTER, THIS

760
00:26:05,000 --> 00:26:08,560
BUILDING IS PRETTY DARN

761
00:26:08,560 --> 00:26:10,000
PHENOMENAL, NO PLACE ELSE ON

762
00:26:10,000 --> 00:26:12,800
EARTH THAT COMES CLOSE TO THAT

763
00:26:12,800 --> 00:26:13,280
LEVEL OF ACHIEVEMENT.

764
00:26:13,280 --> 00:26:14,520
SO WE SHOULD SAY CONGRATULATIONS

765
00:26:14,520 --> 00:26:16,880
TO THE CLINICAL CENTER AND THEN

766
00:26:16,880 --> 00:26:18,880
WE SHOULD THINK ABOUT, OKAY, NOW

767
00:26:18,880 --> 00:26:19,240
WHAT?

768
00:26:19,240 --> 00:26:21,480
SO ARE YOU READY TO GO ON TO

769
00:26:21,480 --> 00:26:22,680
THAT PART?

770
00:26:22,680 --> 00:26:25,000
WHAT ABOUT THE NEXT 70 YEARS?

771
00:26:25,000 --> 00:26:28,440
WELL, OKAY, I CAN'T POSSIBLY TRY

772
00:26:28,440 --> 00:26:30,400
TO MAKE PREDICTIONS OVER 70

773
00:26:30,400 --> 00:26:30,680
YEARS.

774
00:26:30,680 --> 00:26:32,600
I MIGHT BE ABLE TO TRY TO GUESS

775
00:26:32,600 --> 00:26:37,680
OVER 5 OR MAYBE 10.

776
00:26:37,680 --> 00:26:39,080
WE'RE IN THIS EXPONENTIAL PHASE

777
00:26:39,080 --> 00:26:40,560
OF PROGRESS IN BIOMEDICAL

778
00:26:40,560 --> 00:26:42,560
RESEARCH, MUCH OF IT DRIVEN BY

779
00:26:42,560 --> 00:26:44,120
TECHNOLOGY AND SO, 1 HAS TO BE A

780
00:26:44,120 --> 00:26:45,480
LITTLE FOOL HARDY TO IMAGINE YOU

781
00:26:45,480 --> 00:26:47,600
CAN SEE MUCH BEYOND THE NEXT

782
00:26:47,600 --> 00:26:47,800
HILL.

783
00:26:47,800 --> 00:26:49,440
BUT LET'S TRY AND SAY A LITTLE

784
00:26:49,440 --> 00:26:52,240
BIT ABOUT WHERE ARE SOME AREAS,

785
00:26:52,240 --> 00:26:53,600
ANYWAY, THAT THE CLINICAL CENTER

786
00:26:53,600 --> 00:26:55,240
IS PARTICULARLY WELL POSITIONED

787
00:26:55,240 --> 00:26:56,720
TO TAKE ON, AND MOST OF THESE

788
00:26:56,720 --> 00:27:00,000
YOU WILL SEE HAS ALREADY BEGUN

789
00:27:00,000 --> 00:27:02,520
TO POSITION ITSELF BY STRONG

790
00:27:02,520 --> 00:27:04,480
LEADERSHIP AND VISION ON THE

791
00:27:04,480 --> 00:27:05,920
PART OF THE CLINICAL CENTER

792
00:27:05,920 --> 00:27:08,760
GOVERNING BOARD, ON THE PART OF

793
00:27:08,760 --> 00:27:11,120
OUR REMARKABLE CEO JIM GILLMAN,

794
00:27:11,120 --> 00:27:13,120
ON ALL THE OTHERS WHO LEAD THIS

795
00:27:13,120 --> 00:27:16,200
EFFORT, JOHN GALLEN AND ROLE AS

796
00:27:16,200 --> 00:27:17,880
CHIEF SCIENTIST, EVERYBODY WHO

797
00:27:17,880 --> 00:27:19,240
SEES THE OPPORTUNITY AT THE

798
00:27:19,240 --> 00:27:20,640
CLINICAL CENTER TENDS TO HAVE

799
00:27:20,640 --> 00:27:22,200
IDEAS ABOUT WHERE IT SHOULD GO

800
00:27:22,200 --> 00:27:22,440
NEXT.

801
00:27:22,440 --> 00:27:23,720
SO I HAVE SOME, TOO.

802
00:27:23,720 --> 00:27:25,240
FIRST OF ALL, WE WILL HAVE TO BE

803
00:27:25,240 --> 00:27:28,480
SURE THAT THE FACILITIES

804
00:27:28,480 --> 00:27:29,440
MAINTAIN THE CUTTING EDGE

805
00:27:29,440 --> 00:27:31,040
CAPABILITIES TO LET THINGS

806
00:27:31,040 --> 00:27:32,360
HAPPEN THAT OTHERWISE ARE HARD

807
00:27:32,360 --> 00:27:32,760
TO DO.

808
00:27:32,760 --> 00:27:34,640
AND I THINK WE WOULD ALL AGREE

809
00:27:34,640 --> 00:27:36,600
AND THAT'S NOT EASY BECAUSE

810
00:27:36,600 --> 00:27:38,320
CONGRESS DOESN'T REALLY ENJOY

811
00:27:38,320 --> 00:27:40,640
THE IDEA OF GIVING A LOT OF

812
00:27:40,640 --> 00:27:42,360
MONEY TO MAINTENANCE AND WE HAVE

813
00:27:42,360 --> 00:27:43,760
OUR OWN ISSUES OF MAINTINANCY

814
00:27:43,760 --> 00:27:45,120
WITH OUR OWN CURRENT PHYSICAL

815
00:27:45,120 --> 00:27:48,080
PLAN BUT WE ARE SEEING SOME

816
00:27:48,080 --> 00:27:49,000
EXPANSION OF THAT CAPABILITY AND

817
00:27:49,000 --> 00:27:51,400
I OF COURSE HAVE TO MENTION THAT

818
00:27:51,400 --> 00:27:54,040
BIG CONSTRUCTION THAT YOU SEE

819
00:27:54,040 --> 00:27:57,920
OVER THERE, GETTING GOING FOR

820
00:27:57,920 --> 00:28:01,320
THE RLM, THE SURGERY RADIOLOGY

821
00:28:01,320 --> 00:28:02,320
MEDICINE BUILDING LABORATORY

822
00:28:02,320 --> 00:28:04,000
THAT,'S A PICTURE FROM THE

823
00:28:04,000 --> 00:28:06,160
GROUND BREAKING, THAT'S ANDREA

824
00:28:06,160 --> 00:28:07,520
PALM, DEPUTY SECRETARY OF HHS

825
00:28:07,520 --> 00:28:09,320
AND SOME OTHER PEOPLE YOU KNOW

826
00:28:09,320 --> 00:28:10,800
QUITE WELL, AND WHAT'S THIS

827
00:28:10,800 --> 00:28:13,680
GOING TO LOOK LIKE?

828
00:28:13,680 --> 00:28:15,360
RIGHT NOW IT LOOKS LIKE A LOT OF

829
00:28:15,360 --> 00:28:16,960
DIRT ON THE GROUND BUT THIS MAY

830
00:28:16,960 --> 00:28:19,600
BE THE EASIEST WAY IN THE MODEL

831
00:28:19,600 --> 00:28:21,640
YOU CAN SEE AT THE ATRIUM OF THE

832
00:28:21,640 --> 00:28:23,040
CLINICAL CENTER, ALL THE THINGS

833
00:28:23,040 --> 00:28:24,120
OVER THERE WITH THE ORANGE ROOFS

834
00:28:24,120 --> 00:28:28,040
THAT WILL BE THIS NEW FACILITY,

835
00:28:28,040 --> 00:28:28,920
THE SRLM, SUBSTANTIAL ADDITION

836
00:28:28,920 --> 00:28:31,840
IN TERMS OF OUR FOOTPRINT AND

837
00:28:31,840 --> 00:28:33,800
OUR CAPABILITYINGS OF BEING ABLE

838
00:28:33,800 --> 00:28:35,680
TO DO RESEARCH OFFERING REALLY

839
00:28:35,680 --> 00:28:37,320
IMPORTANT THINGS LIKE OPERATING

840
00:28:37,320 --> 00:28:39,080
ROOMS, GIVEN THAT OUR CURRENT

841
00:28:39,080 --> 00:28:42,400
OPERATING ROOMS ARE REALLY QUITE

842
00:28:42,400 --> 00:28:44,320
DATED AND MANY OTHER THINGS AS

843
00:28:44,320 --> 00:28:45,640
WELL IN RADIOLOGY AND LAB

844
00:28:45,640 --> 00:28:45,960
MEDICINE.

845
00:28:45,960 --> 00:28:48,040
IT TOOK US QUITE A FEW YEARS OF

846
00:28:48,040 --> 00:28:49,360
ADVOCATING FOR THE FUNDS FOR

847
00:28:49,360 --> 00:28:50,640
THIS TO DO, BECAUSE YOU CAN'T

848
00:28:50,640 --> 00:28:54,240
BUILD A BUILDING LIKE THIS,

849
00:28:54,240 --> 00:28:55,080
UNLESS CONGRESS SPECIFICALLY

850
00:28:55,080 --> 00:28:56,480
APPROPRIATES THE MONEY FOR IT

851
00:28:56,480 --> 00:28:57,880
AND AGAIN, CONGRESS IS OFTEN

852
00:28:57,880 --> 00:28:59,080
TIMES MORE INTERESTED IN SAYING

853
00:28:59,080 --> 00:29:00,960
WE'RE GOING TO GIVE YOU MONEY TO

854
00:29:00,960 --> 00:29:02,040
CURE CANCER AND WE WILL GIVE YOU

855
00:29:02,040 --> 00:29:03,440
MONEY TO BUILD A BUILDING BUT

856
00:29:03,440 --> 00:29:05,520
YOU CAN'T BUILD THE--YOU CAN'T

857
00:29:05,520 --> 00:29:07,800
CURE THE CANCER WITHOUT THE

858
00:29:07,800 --> 00:29:08,080
FACILITIES.

859
00:29:08,080 --> 00:29:10,000
ULTIMATELY, WITH A LOT OF

860
00:29:10,000 --> 00:29:12,920
CAJOLES AND ARM TWISTING THIS

861
00:29:12,920 --> 00:29:15,480
BECAME POSSIBLE AND IT WILL BE

862
00:29:15,480 --> 00:29:15,720
HAPPENING.

863
00:29:15,720 --> 00:29:18,120
SO THAT'S GOING TO HAVE A LOT OF

864
00:29:18,120 --> 00:29:19,640
CONSEQUENCES FOR MANY OF THE

865
00:29:19,640 --> 00:29:22,760
PROTOCOLS THAT WE ARE ABLE TO

866
00:29:22,760 --> 00:29:23,640
RUN HERE.

867
00:29:23,640 --> 00:29:25,720
CELL THERAPY, IS AN AREA THAT

868
00:29:25,720 --> 00:29:27,600
CLEARLY IS JUST BURSTING WITH

869
00:29:27,600 --> 00:29:30,240
POTENTIAL, I MENTIONED SOME OF

870
00:29:30,240 --> 00:29:32,640
STEVE ROSENBERG'S WORK AND SOME

871
00:29:32,640 --> 00:29:36,320
OF JOHN TISDALE'S WORK SO FOR

872
00:29:36,320 --> 00:29:37,680
THINGS LIKE HEMATOPOIETIC STEM

873
00:29:37,680 --> 00:29:40,120
CELLS AND CAR T-CELLS AND OTHER

874
00:29:40,120 --> 00:29:42,280
CREATE OF CANCER APPROACHES WHAT

875
00:29:42,280 --> 00:29:45,000
YOU NEED IS A FACILITY THAT CAN

876
00:29:45,000 --> 00:29:46,840
IN A GMP WAY MANAGE THAT SORT

877
00:29:46,840 --> 00:29:49,280
AND TO BE HIGHLY EFFICIENT AND

878
00:29:49,280 --> 00:29:49,480
SAFE.

879
00:29:49,480 --> 00:29:51,720
AND A LOT OF INVESTMENT HAS BEEN

880
00:29:51,720 --> 00:29:53,200
MADE HERE AT NIH TO BE ON THE

881
00:29:53,200 --> 00:29:55,400
PATH AND WE'RE GETTING CLOSE TO

882
00:29:55,400 --> 00:29:56,560
HAVING THE KIND OF SCALE THAT WE

883
00:29:56,560 --> 00:29:59,200
THINK WILL BE NEEDED FOR ALL THE

884
00:29:59,200 --> 00:30:00,520
PEOPLE WHO ARE REALLY ANXIOUS TO

885
00:30:00,520 --> 00:30:02,400
BEGIN TO USE THOSE FACILITIES SO

886
00:30:02,400 --> 00:30:05,520
I WILL SHOW YOU 2 OF THOSE NEW

887
00:30:05,520 --> 00:30:08,840
FACILITIES THAT ARE GETTING

888
00:30:08,840 --> 00:30:09,280
CLOSE.

889
00:30:09,280 --> 00:30:10,800
THIS IS T-10 B WHICH WAS

890
00:30:10,800 --> 00:30:12,240
BASICALLY BUILT IN WHAT USED TO

891
00:30:12,240 --> 00:30:16,000
BE THE PATIO ON THE EAST SIDE OF

892
00:30:16,000 --> 00:30:18,840
BUILDING 10 AND YOU CAN SEE THE

893
00:30:18,840 --> 00:30:21,720
FLOOR PLAN THERE, IT MEETS GMP

894
00:30:21,720 --> 00:30:24,680
SPECIFICATIONS, IT IS SCHEDULED

895
00:30:24,680 --> 00:30:26,640
TO OPEN, VERY SOON IN THE NEXT

896
00:30:26,640 --> 00:30:28,960
FEW MONTHS.

897
00:30:28,960 --> 00:30:30,880
IT HAS 4 CULTURE ROOMS AND ALL

898
00:30:30,880 --> 00:30:32,160
THE THINGS YOU WOULD WANT TO DO

899
00:30:32,160 --> 00:30:36,080
TO BE ABLE TO DO THIS IN A VERY

900
00:30:36,080 --> 00:30:37,240
HIGHLY WELL CONTROLLED FASHION.

901
00:30:37,240 --> 00:30:40,120
AND THEN THERE'S THIS OTHER NEW

902
00:30:40,120 --> 00:30:41,320
BUILDING WHICH IS TO BE

903
00:30:41,320 --> 00:30:43,840
CONSTRUCTED BY THE FALL AND TO

904
00:30:43,840 --> 00:30:45,320
OPEN IN SUMMER OF NEXT YEAR

905
00:30:45,320 --> 00:30:50,880
WHICH YOU PROBABLY ALSO HAVE

906
00:30:50,880 --> 00:30:53,800
SEEN  UNDER CONSTRUCTION.

907
00:30:53,800 --> 00:30:54,880
BETWEEN THE 2 OF THESE WE WILL

908
00:30:54,880 --> 00:30:57,480
HAVE PROBABLY THE BEST

909
00:30:57,480 --> 00:30:58,520
CAPABILITIES OF ANY CENTER

910
00:30:58,520 --> 00:30:59,600
OUTSIDE OF INDUSTRY TO BE ABLE

911
00:30:59,600 --> 00:31:01,760
TO DO THESE KINDS OF PROTOCOLS

912
00:31:01,760 --> 00:31:03,320
SO THAT ALSO REFLECTS AN AWFUL

913
00:31:03,320 --> 00:31:04,400
LOT OF THINKING OR PLANNING OVER

914
00:31:04,400 --> 00:31:07,080
THE COURSE OF ABOUT 10 YEARS TO

915
00:31:07,080 --> 00:31:07,440
GET US THERE.

916
00:31:07,440 --> 00:31:09,600
ONE OF THE THINGS THAT THE CELL

917
00:31:09,600 --> 00:31:10,600
THERAPY CENTERS MIGHT DO, IS

918
00:31:10,600 --> 00:31:13,680
GOING TO BE IN THE AREA OF GENE

919
00:31:13,680 --> 00:31:16,000
THERAPY, BECAUSE SOME OF THE

920
00:31:16,000 --> 00:31:17,800
GENE THERAPIES WILL INVOLVE

921
00:31:17,800 --> 00:31:18,280
SIMILAR APPROACHES.

922
00:31:18,280 --> 00:31:22,080
HERE'S RAW --WHERE I WANT TO MAA

923
00:31:22,080 --> 00:31:23,480
PARTICULAR POINT THAT I'M NOT

924
00:31:23,480 --> 00:31:25,520
QUITE SURE HOW WE'RE GOING TO

925
00:31:25,520 --> 00:31:27,080
HAVE AN EASY ANSWER TO AND THAT

926
00:31:27,080 --> 00:31:28,720
IS THAT A LOT OF THE GENE

927
00:31:28,720 --> 00:31:30,240
THERAPIES THAT ARE GOING TO BE

928
00:31:30,240 --> 00:31:32,680
COMING FORWARD TO BE MOST

929
00:31:32,680 --> 00:31:34,600
SUCCESSFUL WILL NEED TO BE DONE

930
00:31:34,600 --> 00:31:35,920
AT THE EARLIEST MOMENT IN THE

931
00:31:35,920 --> 00:31:36,880
LIFETIME OF THE INDIVIDUAL AND

932
00:31:36,880 --> 00:31:39,600
PARTICULARLY IF YOU'RE TALKING

933
00:31:39,600 --> 00:31:42,200
ABOUT A RARE GENETIC DISEASE,

934
00:31:42,200 --> 00:31:45,040
THOSE OFTEN HAPPEN TO NEED THEIR

935
00:31:45,040 --> 00:31:48,000
INTERVENTIONS EARLY.

936
00:31:48,000 --> 00:31:49,640
AN EXAMPLE, AN EXAMPLE WHICH HAS

937
00:31:49,640 --> 00:31:51,000
INSPIRED MANY OF US BECAUSE IN

938
00:31:51,000 --> 00:31:52,400
MANY WAYS THIS WAS SORT OF THE

939
00:31:52,400 --> 00:31:55,240
MOMENT WHERE YOU BEGAN TO SEE

940
00:31:55,240 --> 00:31:58,560
THAT GENE THERAPY COULD BE

941
00:31:58,560 --> 00:32:01,560
ALMOST MIRACULOUS, THAT'S SPINAL

942
00:32:01,560 --> 00:32:03,920
MUSCULAR ATROPHY, A DEC WHICH IS

943
00:32:03,920 --> 00:32:05,120
AUTOSOMAL RECESSIVE AND KIDS

944
00:32:05,120 --> 00:32:07,920
BORN WITH THIS ARE FLOPPY AND

945
00:32:07,920 --> 00:32:11,960
BASICALLY, THEY HAVE WHAT YOU

946
00:32:11,960 --> 00:32:13,240
MIGHT CALL AN INFANTILE VERSION

947
00:32:13,240 --> 00:32:15,400
OF ALS WITH THE MOTOR NEURONS

948
00:32:15,400 --> 00:32:18,920
BASICALLY DYING OFF AND IF NO

949
00:32:18,920 --> 00:32:19,840
INTERVENTION HAPPENS AND UNTIL

950
00:32:19,840 --> 00:32:20,960
RECENTLY THERE WAS NO

951
00:32:20,960 --> 00:32:22,200
INTERVENTION THAT WORKED THESE

952
00:32:22,200 --> 00:32:24,040
CHILDREN WOULD DIE ESSENTIALLY

953
00:32:24,040 --> 00:32:25,320
OF SUFFOCATION BY ABOUT A YEAR

954
00:32:25,320 --> 00:32:28,800
OR YEAR AND A HALF.

955
00:32:28,800 --> 00:32:30,080
YOU CAN'T IMAGINE ANYTHING MUCH

956
00:32:30,080 --> 00:32:31,360
MORE HEART BREAKING THAN THIS

957
00:32:31,360 --> 00:32:34,440
AND IT'S NOT THAT RARE A

958
00:32:34,440 --> 00:32:34,800
DISEASE.

959
00:32:34,800 --> 00:32:36,160
BUT THIS IS 1 OF THOSE WHERE A

960
00:32:36,160 --> 00:32:38,760
LOT OF RISK TAKING WAS TAKEN

961
00:32:38,760 --> 00:32:40,360
BOTH BY RESEARCHERS AND BY

962
00:32:40,360 --> 00:32:43,000
FAMILIES TO SEE WHETHER IT MIGHT

963
00:32:43,000 --> 00:32:44,320
BE POSSIBLE, WITH THE GENE

964
00:32:44,320 --> 00:32:46,240
THERAPY TO DO SOMETHING ABOUT

965
00:32:46,240 --> 00:32:47,880
THE DYSFUNCTIONING GENE THAT IS

966
00:32:47,880 --> 00:32:49,720
NEEDING TO BE FIXED IN THE

967
00:32:49,720 --> 00:32:50,800
SPINAL CORD.

968
00:32:50,800 --> 00:32:51,840
THAT SOUNDS REALLY HARD.

969
00:32:51,840 --> 00:32:54,600
IT WAS REALLY HARD BUT WITH AN

970
00:32:54,600 --> 00:32:56,480
AAV 9 GENE THERAPY VECTOR

971
00:32:56,480 --> 00:32:59,280
APPROPRIATELY LOADED, WITH THE

972
00:32:59,280 --> 00:33:02,160
RIGHT P A YLOAD, THIS WAS THEN

973
00:33:02,160 --> 00:33:04,640
BEGUN FOR A FEW KIDS.

974
00:33:04,640 --> 00:33:07,480
I HAVE TO SHOW YOU A PICTURE OF

975
00:33:07,480 --> 00:33:09,480
1 OF THEM.

976
00:33:09,480 --> 00:33:11,760
THIS IS MATEO, MATEO HAD A

977
00:33:11,760 --> 00:33:13,880
SISTER WHO HAD SMA AND DIED AT

978
00:33:13,880 --> 00:33:17,560
ABOUT A YEAR SO THE FAMILY KNEW

979
00:33:17,560 --> 00:33:19,360
THAT THEIR KIDS WERE AT RISK.

980
00:33:19,360 --> 00:33:21,440
SO HE WAS DIAGNOSED WITHIN A

981
00:33:21,440 --> 00:33:23,640
COUPLE WEEKS AT BIRTH AND GOT

982
00:33:23,640 --> 00:33:24,800
THE GENE THERAPY AS I REMEMBER

983
00:33:24,800 --> 00:33:26,760
WHEN HE WAS ONLY A MONTH AND A

984
00:33:26,760 --> 00:33:31,040
HALF OLD AND THERE HE IS.

985
00:33:31,040 --> 00:33:35,560
THIS IS ABOUT AGE 2 AND A HALF.

986
00:33:35,560 --> 00:33:41,200
OKAY, GET THAT ELEVATOR BUTTON.

987
00:33:41,200 --> 00:33:44,520
OKAY, MATEO, I THINK, TIME TO GO

988
00:33:44,520 --> 00:33:51,360
TO WORK AND LOOK AT THIS ...

989
00:33:51,360 --> 00:33:53,360
THAT'S WITH HIS DAD, I ALWAYS

990
00:33:53,360 --> 00:33:56,240
GET CHOKED UP WATCHING THAT SO

991
00:33:56,240 --> 00:33:58,120
THAT IS A LITTLE BOY WHO WITHOUT

992
00:33:58,120 --> 00:33:59,040
THIS INTERVENTION WOULD SIMPLY

993
00:33:59,040 --> 00:34:00,720
NOT HAVE HAD A CHANCE OF BEING

994
00:34:00,720 --> 00:34:01,400
WITH US.

995
00:34:01,400 --> 00:34:03,240
AND THAT HAS HAPPENED NOW WITH

996
00:34:03,240 --> 00:34:05,840
THOSE THAT GET TREATED AS EARLY

997
00:34:05,840 --> 00:34:07,640
AS POSSIBLE IN REMARKABLE WAYS.

998
00:34:07,640 --> 00:34:10,080
THE LONGER YOU WEIGHT, THE LESS

999
00:34:10,080 --> 00:34:12,920
RESULT YOU GET BECAUSE ONCE THE

1000
00:34:12,920 --> 00:34:14,040
ANTERIOR HORN CELL HAS DIED YOU

1001
00:34:14,040 --> 00:34:15,160
CAN BE THE BRING IT BACK.

1002
00:34:15,160 --> 00:34:16,240
I BRING THIS UP PARTICULARLY

1003
00:34:16,240 --> 00:34:17,640
BECAUSE I AM SOMEBODY WHO CARES

1004
00:34:17,640 --> 00:34:19,480
A LOT ABOUT GENETIC DISEASES,

1005
00:34:19,480 --> 00:34:21,720
AND A LOT OF THE RARE DISEASES

1006
00:34:21,720 --> 00:34:23,280
THAT WE WILL WANT TO TREAT, WE

1007
00:34:23,280 --> 00:34:24,680
WILL WANT TO TREAT THEM REALLY

1008
00:34:24,680 --> 00:34:26,000
EARLY AND THEREFORE I AM WORRIED

1009
00:34:26,000 --> 00:34:27,160
THAT WE ARE GOING TO HAVE TO

1010
00:34:27,160 --> 00:34:30,360
COME UP WITH SOME KIND OF A

1011
00:34:30,360 --> 00:34:32,000
SOLUTION FOR THE PROBLEM THAT WE

1012
00:34:32,000 --> 00:34:36,040
CURRENTLY HAVE IN TERMS OF

1013
00:34:36,040 --> 00:34:37,880
PEDEIATE RICKS FOR KIDS THAT ARE

1014
00:34:37,880 --> 00:34:39,520
YOUNGER THAN AGE 2 ASK THAT'S A

1015
00:34:39,520 --> 00:34:40,840
HARD PROBLEM AND I DON'T HAVE A

1016
00:34:40,840 --> 00:34:41,840
GOOD SOLUTION TO IT BUT I WANT

1017
00:34:41,840 --> 00:34:44,240
TO PUT IT OUT THERE AS PART OF

1018
00:34:44,240 --> 00:34:45,080
THIS LOOKING FORWARD.

1019
00:34:45,080 --> 00:34:46,920
BECAUSE I WOULDN'T WANT THE NIH

1020
00:34:46,920 --> 00:34:47,760
CLINICAL CENTER NOT TO BE IN THE

1021
00:34:47,760 --> 00:34:49,960
PLACE TO BE ABLE TO ACT UPON

1022
00:34:49,960 --> 00:34:53,680
SOME OF THOSE OPPORTUNITIES AND

1023
00:34:53,680 --> 00:34:58,400
THEY'RE GOING TO BE COMING.

1024
00:34:58,400 --> 00:34:59,720
VACCINES IS WHAT WE CAN DO AND

1025
00:34:59,720 --> 00:35:01,960
HAVE DONE IN OUR REPUTATION HERE

1026
00:35:01,960 --> 00:35:04,640
IS ASTOUNDING, AND I THINK

1027
00:35:04,640 --> 00:35:05,720
ALMOST THE WHOLE WORLD NOTICED

1028
00:35:05,720 --> 00:35:10,720
THAT IN THE CONTEXT OF COVID. 

1029
00:35:10,720 --> 00:35:12,000
HERE IS THAT VISIT FROM

1030
00:35:12,000 --> 00:35:14,320
PRESIDENT BIDEN WHO CAME TO NIH

1031
00:35:14,320 --> 00:35:16,400
WITHIN 2 WEEKS OF BEING

1032
00:35:16,400 --> 00:35:17,240
INAUGURATED TO HEAR ABOUT WHAT

1033
00:35:17,240 --> 00:35:18,480
WAS HAPPENING AND HOW THE

1034
00:35:18,480 --> 00:35:19,920
VACCINE HAD BEEN PUT TOGETHER

1035
00:35:19,920 --> 00:35:22,200
AND YOU SEE BARNY GRAHAM ON THE

1036
00:35:22,200 --> 00:35:23,840
LEFT AND YOU SEE [INDISCERNIBLE]

1037
00:35:23,840 --> 00:35:26,200
ON THE RIGHT AND TONY FAUCI IS

1038
00:35:26,200 --> 00:35:27,720
THERE AND I'M THERE AND THE GUY

1039
00:35:27,720 --> 00:35:30,360
IN THE DARK SUIT THAT'S JEFF

1040
00:35:30,360 --> 00:35:32,640
[INDISCERNIBLE] WHO IS CURRENTLY

1041
00:35:32,640 --> 00:35:33,680
THE PRESIDENT'S CHIEF OF STAFF

1042
00:35:33,680 --> 00:35:36,440
AND IT WAS A DRAMATIC MOMENT TO

1043
00:35:36,440 --> 00:35:38,200
BE SURE AND A TESTIMONY TO THE

1044
00:35:38,200 --> 00:35:39,600
VISION THAT WENT INTO THE

1045
00:35:39,600 --> 00:35:42,560
FOUNDING OF THAT BRC WAY BACK

1046
00:35:42,560 --> 00:35:43,200
DURING THE CLINTON

1047
00:35:43,200 --> 00:35:44,480
ADMINISTRATION AND THE WAY IT

1048
00:35:44,480 --> 00:35:46,000
HAS EMERGED AS SUCH A POWER

1049
00:35:46,000 --> 00:35:48,840
HOUSE OF SCIENTIFIC INNOVATION.

1050
00:35:48,840 --> 00:35:50,960
BUT THEY'RE ALSO IN NEED OF MORE

1051
00:35:50,960 --> 00:35:52,680
CAPABILITIES SO I WAS GLAD TO

1052
00:35:52,680 --> 00:35:54,560
SEE AND I DON'T QUITE THINK I

1053
00:35:54,560 --> 00:35:58,440
KNEW WHAT THIS CONSTRUCTION WAS

1054
00:35:58,440 --> 00:36:00,720
ALL ABOUT, THAT'S THE NEW NORTH

1055
00:36:00,720 --> 00:36:02,240
TOWER VACCINE RESEARCH CENTER,

1056
00:36:02,240 --> 00:36:05,320
THIS IS AN ARTIST CONCEPTION,

1057
00:36:05,320 --> 00:36:06,840
ONCE ITS BUILT WILL GREATLY

1058
00:36:06,840 --> 00:36:07,440
EXPAND THEIR CAPAC IT--DIGITAL

1059
00:36:07,440 --> 00:36:09,280
TO TAKE ON EVEN MORE OF THE

1060
00:36:09,280 --> 00:36:12,400
CHALLENGES THAT YOU KNOW WILL BE

1061
00:36:12,400 --> 00:36:13,600
ASKED TO ADDRESS.

1062
00:36:13,600 --> 00:36:16,800
ANOTHER AREA THAT WE I THINK

1063
00:36:16,800 --> 00:36:18,240
HAVE MADE A SIGNIFICANT

1064
00:36:18,240 --> 00:36:22,520
STATEMENT ABOUT BECAUSE OF ITS

1065
00:36:22,520 --> 00:36:23,480
REALLY SERIOUS IMPACT ON

1066
00:36:23,480 --> 00:36:28,920
INDIVIDUALS AND FAMILY SYSTEM

1067
00:36:28,920 --> 00:36:29,600
ALZHEIMER'S DISEASE.

1068
00:36:29,600 --> 00:36:30,320
MUCH OF ALZHEIMER'S DISEASE

1069
00:36:30,320 --> 00:36:31,840
RESEARCH HAS BEEN GOING ON IN

1070
00:36:31,840 --> 00:36:32,760
OUR GRANTEE COMMUNITY AND

1071
00:36:32,760 --> 00:36:35,080
CERTAINLY IN INDUSTRY AND WE'RE

1072
00:36:35,080 --> 00:36:37,080
FINALLY AT THE POINT NOW WHERE

1073
00:36:37,080 --> 00:36:38,360
WE HAVE THERAPEUTICS WHICH

1074
00:36:38,360 --> 00:36:40,760
THEY'RE FAR FROM PERFECT BUT IF

1075
00:36:40,760 --> 00:36:41,760
ADMINISTERED TO PEOPLE VERY

1076
00:36:41,760 --> 00:36:43,800
EARLY DO SEEM CAPABLE OF SLOWING

1077
00:36:43,800 --> 00:36:45,520
DOWN THE DISEASE, WE WANT TO SEE

1078
00:36:45,520 --> 00:36:48,600
THAT EVEN BETTER AND SO AGAIN,

1079
00:36:48,600 --> 00:36:51,120
IN A VISIONARY WAY, THE BUILDING

1080
00:36:51,120 --> 00:36:53,120
THAT WAS JUST DEDICATED ABOUT A

1081
00:36:53,120 --> 00:36:54,960
YEAR AGO, IS NOW POPULATED WITH

1082
00:36:54,960 --> 00:36:58,920
PEOPLE WHO ARE GOING TO BE

1083
00:36:58,920 --> 00:37:00,280
TAKING PARTICULARLY INTERESTING

1084
00:37:00,280 --> 00:37:02,400
AND CREATIVE APPROACHES BOTH TO

1085
00:37:02,400 --> 00:37:04,720
ALZHEIMER AND TO RELATED

1086
00:37:04,720 --> 00:37:05,720
DEMENTIAS, THIS IS AT THE

1087
00:37:05,720 --> 00:37:06,880
DEDICATION OF THAT BUILDING

1088
00:37:06,880 --> 00:37:08,520
WHICH YOU CAN SEE THE SIGN IS

1089
00:37:08,520 --> 00:37:11,840
THE ROY BLUNT CENTER AND THAT IS

1090
00:37:11,840 --> 00:37:14,560
SENATOR BLUNT AND STANDING NEXT

1091
00:37:14,560 --> 00:37:15,520
TO HIM CONGRESSMAN TOM COAL.

1092
00:37:15,520 --> 00:37:17,440
I HAVE TO STOP FOR A MINUTE AND

1093
00:37:17,440 --> 00:37:19,800
SAY THOSE 2 INDIVIDUALS HAVE

1094
00:37:19,800 --> 00:37:22,000
BEEN OVER THE COURSE OF SOME 7

1095
00:37:22,000 --> 00:37:25,000
OR 8 YEARS 1 OF THE MOST

1096
00:37:25,000 --> 00:37:26,920
SIGNIFICANT REASONS WHY NIH'S

1097
00:37:26,920 --> 00:37:32,360
BUDGET HAS GROWN BY 57% SINCE

1098
00:37:32,360 --> 00:37:32,600
2015.

1099
00:37:32,600 --> 00:37:33,560
INCREDIBLY DEDICATED TO WHAT WE

1100
00:37:33,560 --> 00:37:35,320
DO HERE AND SO, IT WAS WONDERFUL

1101
00:37:35,320 --> 00:37:39,160
TO BE ABLE TO RECOGNIZE SENATOR

1102
00:37:39,160 --> 00:37:43,160
BLUNT IN THAT REGARD BY PUTTING

1103
00:37:43,160 --> 00:37:45,760
TOGETHER OF THIS CENTER WITH ALL

1104
00:37:45,760 --> 00:37:47,720
THAT IT CAN OFFER AND AGAIN

1105
00:37:47,720 --> 00:37:51,240
SENATOR BLUNT AND HIS WIFE

1106
00:37:51,240 --> 00:37:52,440
ABBY IS THERE.

1107
00:37:52,440 --> 00:37:56,280
SO MUCH POSSIBILITY THERE.

1108
00:37:56,280 --> 00:37:56,920
PRECISION MEDICINE, ANOTHER

1109
00:37:56,920 --> 00:37:58,320
FAVORITE TOPIC OF MINE.

1110
00:37:58,320 --> 00:37:59,280
YEAH, I'M BEING A LITTLE BIT

1111
00:37:59,280 --> 00:38:01,120
PERSONAL IN TERMS OF THE THINGS

1112
00:38:01,120 --> 00:38:03,400
THAT I PICK HERE.

1113
00:38:03,400 --> 00:38:04,080
PRECISION MEDICINE BEING THE

1114
00:38:04,080 --> 00:38:05,840
OPPORTUNITY TO TRY TO

1115
00:38:05,840 --> 00:38:08,120
INTORPERATE INTO THE WAYS THAT

1116
00:38:08,120 --> 00:38:11,840
WE PREVENT AND TREAT DISEASE,

1117
00:38:11,840 --> 00:38:14,000
EVERYTHING ABOUT THE INDIVIDUAL,

1118
00:38:14,000 --> 00:38:15,840
THE OPPOSITE OF

1119
00:38:15,840 --> 00:38:16,320
ONE-SIZE-FITS-ALL.

1120
00:38:16,320 --> 00:38:17,760
AND 1 WAY TO DO THAT OF COURSE

1121
00:38:17,760 --> 00:38:19,760
IS TO HAVE GENOME SEQUENCES ON

1122
00:38:19,760 --> 00:38:20,880
EVERYBODY AND ANOTHER WAY TO DO

1123
00:38:20,880 --> 00:38:23,200
IT IS TO HAVE REALLY RIGOROUS

1124
00:38:23,200 --> 00:38:27,000
DATA ON ENVIRONMENTAL EXPOSURES,

1125
00:38:27,000 --> 00:38:28,480
BEHAVIORS, SOCIOECONOMIC STATUS,

1126
00:38:28,480 --> 00:38:29,440
SOCIAL DETERMINANTS OF HEALTH,

1127
00:38:29,440 --> 00:38:31,040
EVERYTHING YOU CAN THINK OF THAT

1128
00:38:31,040 --> 00:38:32,240
PLAYS OUT AND IN ORDER TO MAKE

1129
00:38:32,240 --> 00:38:34,760
SENSE OF THAT AND REALLY

1130
00:38:34,760 --> 00:38:35,840
UNDERSTAND THE RELATIONSHIPS TO

1131
00:38:35,840 --> 00:38:37,360
MEDICAL OUTCOMES YOU NEED A VERY

1132
00:38:37,360 --> 00:38:41,080
LARGE STUDY, SO THAT YOU CAN

1133
00:38:41,080 --> 00:38:43,520
ACTUALLY BEGIN TO TELL WHAT ARE

1134
00:38:43,520 --> 00:38:45,120
THE DRIVERS OF WHETHER SOMEBODY

1135
00:38:45,120 --> 00:38:47,400
IS HEALTHY OR IS BEGINNING TO BE

1136
00:38:47,400 --> 00:38:48,920
FALLING INTO A CHRONIC ILLNESS.

1137
00:38:48,920 --> 00:38:52,120
SO WE ARE AT A VERY CRITICAL

1138
00:38:52,120 --> 00:38:53,640
JUNCTURE AND AN INTERESTING 1 IN

1139
00:38:53,640 --> 00:38:56,960
THIS COUNTRY BECAUSE WE HAVE

1140
00:38:56,960 --> 00:38:57,960
SUCH A STUDY.

1141
00:38:57,960 --> 00:39:00,040
ALL OF US STARTED 4 OR 5 YEARS

1142
00:39:00,040 --> 00:39:04,960
AGO IS NOW UP TO 600 AND

1143
00:39:04,960 --> 00:39:05,840
SOMETHING THOUSAND ENROLLEES.

1144
00:39:05,840 --> 00:39:07,600
I HOPE MANY OF YOU ARE ALREADY

1145
00:39:07,600 --> 00:39:09,360
INVOLVED IN ALL OF US BUT IT'S

1146
00:39:09,360 --> 00:39:11,360
NOT TOO LATE BECAUSE WE'RE GOING

1147
00:39:11,360 --> 00:39:11,920
FOR A MILLION.

1148
00:39:11,920 --> 00:39:17,360
IF YOU WANT TO JOIN, JOIN

1149
00:39:17,360 --> 00:39:17,680
ALLOFUS.ORG.

1150
00:39:17,680 --> 00:39:20,120
I'M IN IT I HAVE MY WHOLE GENOME

1151
00:39:20,120 --> 00:39:21,520
SEQUENCE BACK AND THERE'S LOTS

1152
00:39:21,520 --> 00:39:23,080
OF INTERESTING STUFF IN THERE.

1153
00:39:23,080 --> 00:39:26,960
AND ALL OF US IS ALSO UNIQUE IN

1154
00:39:26,960 --> 00:39:28,240
SEVERAL OTHER WAYS BESIDES THE

1155
00:39:28,240 --> 00:39:30,760
FACT THAT IT'S PROVIDING GENOME

1156
00:39:30,760 --> 00:39:31,880
SEQUENCES, IT IS GIVING ALL THE

1157
00:39:31,880 --> 00:39:33,520
DATA BACK TO PEOPLE SO YOU KNOW

1158
00:39:33,520 --> 00:39:36,800
IF YOU'RE PART OF THIS, WHAT

1159
00:39:36,800 --> 00:39:38,560
THEY KNOW AND IT IS ALSO HIGHLY

1160
00:39:38,560 --> 00:39:40,800
DIVERSE IN THE WAY IN WHICH THE

1161
00:39:40,800 --> 00:39:41,240
DESIGN WAS DONE.

1162
00:39:41,240 --> 00:39:44,000
YOU CAN SEE FROM THE PIE CHART

1163
00:39:44,000 --> 00:39:46,680
JUST ABOUT HALF, BUT ONLY ABOUT

1164
00:39:46,680 --> 00:39:49,560
HALF ARE WHITE AND THEN THERE IS

1165
00:39:49,560 --> 00:39:51,520
A STRONG REPRESENTATION OF RACE

1166
00:39:51,520 --> 00:39:52,720
AND ETHNICITY AND ALSO OVER ON

1167
00:39:52,720 --> 00:39:54,680
THE RIGHT YOU WILL SEE OTHER

1168
00:39:54,680 --> 00:39:57,520
KINDS OF DIVERSITY IN TERMS OF

1169
00:39:57,520 --> 00:39:59,840
INCOME, EDUCATIONAL ATTAINMENT,

1170
00:39:59,840 --> 00:40:00,480
SEXUAL ORIENTATION, GEOGRAPHY,

1171
00:40:00,480 --> 00:40:04,240
DISABILITY AND SO ON.

1172
00:40:04,240 --> 00:40:05,200
NO OTHER COHORT STUDY I THINK IN

1173
00:40:05,200 --> 00:40:06,720
THE U.S. OR MAYBE ANYWHERE HAS

1174
00:40:06,720 --> 00:40:09,040
MADE THIS KIND OF AN EFFORT TO,A

1175
00:40:09,040 --> 00:40:12,440
CHIEF SUCH A DIVERSE POPULATION

1176
00:40:12,440 --> 00:40:12,840
OF PARTICIPANTS.

1177
00:40:12,840 --> 00:40:16,760
AND YEAH, IF YOU ADD IT ALL UP,

1178
00:40:16,760 --> 00:40:19,320
80% IF YOU COUNT THE THINGS ON

1179
00:40:19,320 --> 00:40:20,880
THE RIGHT ARE UNDERREPRESENTED.

1180
00:40:20,880 --> 00:40:24,320
ALL THESE FOLKS ARE CONSENTED TO

1181
00:40:24,320 --> 00:40:26,160
MAKE THEIR MEDICAL RECORDS

1182
00:40:26,160 --> 00:40:28,280
AVAILABLE, TO HAVE THEIR GENOME

1183
00:40:28,280 --> 00:40:30,760
SEQUENCED TO HAVE LOTS AND LOTS

1184
00:40:30,760 --> 00:40:32,560
OF QUESTIONNAIRES THAT THEY FILL

1185
00:40:32,560 --> 00:40:33,600
OUT ABOUT THEIR OWN HEALTH

1186
00:40:33,600 --> 00:40:34,520
BEHAVIORS AND MEDICAL EXPERIENCE

1187
00:40:34,520 --> 00:40:36,200
APPROXIMATES, AND THIS IS NOW

1188
00:40:36,200 --> 00:40:38,040
AVAILABLE TO RESEARCHERS AND THE

1189
00:40:38,040 --> 00:40:39,320
RESEARCHER WORK BENCH IN A

1190
00:40:39,320 --> 00:40:40,600
FASHION THAT THE RESEARCHERS

1191
00:40:40,600 --> 00:40:42,480
PROMISE NOT TO TRY TO IDENTIFY

1192
00:40:42,480 --> 00:40:44,720
INDIVIDUALS AND THE DATA IS

1193
00:40:44,720 --> 00:40:45,640
ESSENTIALLY ANONYMIZED SO YOU

1194
00:40:45,640 --> 00:40:48,040
CAPTAIN TELL WHO IS WHO BUT YOU

1195
00:40:48,040 --> 00:40:49,240
CAN DO A HUGE AMOUNT OF

1196
00:40:49,240 --> 00:40:50,080
INTERESTING RESEARCH HERE AND

1197
00:40:50,080 --> 00:40:51,120
THAT IS REALLY STARTING TO KICK

1198
00:40:51,120 --> 00:40:52,080
UP IN A BIG WAY.

1199
00:40:52,080 --> 00:40:53,960
BUT I PUT THIS IN FRONT OF YOU

1200
00:40:53,960 --> 00:40:56,720
BECAUSE I THINK THERE IS A

1201
00:40:56,720 --> 00:40:57,560
REMARKABLE OPPORTUNITY HERE

1202
00:40:57,560 --> 00:40:58,400
INVOLVING THE CLINICAL CENTER,

1203
00:40:58,400 --> 00:41:00,160
WHICH IS NOT HAPPENED QUITE YET,

1204
00:41:00,160 --> 00:41:07,680
BUT IT'S BEGINNING TO BE

1205
00:41:07,680 --> 00:41:08,160
DISCUSSED.

1206
00:41:08,160 --> 00:41:12,040
AFTER ALL, 603,000 PARTICIPANTS.

1207
00:41:12,040 --> 00:41:14,680
245,000 OF THEM ALREADY HAVE

1208
00:41:14,680 --> 00:41:17,000
HIGH GENOME ACCESS SEQUENCES,

1209
00:41:17,000 --> 00:41:18,040
ALREADY ACTIVE ACROSS THE

1210
00:41:18,040 --> 00:41:18,280
GENOME.

1211
00:41:18,280 --> 00:41:20,400
IMAGINE THAT YOU COULD LOOK

1212
00:41:20,400 --> 00:41:21,440
THROUGH 245,000 GENOME

1213
00:41:21,440 --> 00:41:21,720
SEQUENCES.

1214
00:41:21,720 --> 00:41:23,480
YOU ARE GOING TO FIND SOME

1215
00:41:23,480 --> 00:41:26,880
INTERESTING AND SURPRISING

1216
00:41:26,880 --> 00:41:27,280
THINGS.

1217
00:41:27,280 --> 00:41:30,400
YOU WILL FIND PEOPLE WHO SEEM TO

1218
00:41:30,400 --> 00:41:31,560
HAVE LOST BOTH FUNCTIONAL COPIES

1219
00:41:31,560 --> 00:41:33,280
OF A GENE WE THOUGHT WAS

1220
00:41:33,280 --> 00:41:34,280
IMPORTANT AND YET THEY'RE

1221
00:41:34,280 --> 00:41:35,440
ENROLLED IN THIS STUDY SO THERE

1222
00:41:35,440 --> 00:41:39,120
MUST BE SOME WAY THAT DOING OKAY

1223
00:41:39,120 --> 00:41:39,360
ANYWAY.

1224
00:41:39,360 --> 00:41:41,960
WE SPENT A LOT OF TIME LOOKING,

1225
00:41:41,960 --> 00:41:43,920
TRY TO UNDERSTAND GENE JUNCTIONS

1226
00:41:43,920 --> 00:41:46,040
BY STUDYING MICE, HERE WE HAVE A

1227
00:41:46,040 --> 00:41:48,320
CHANCE TO STUDY PEOPLE BECAUSE

1228
00:41:48,320 --> 00:41:49,680
NATURE HAS ALREADY DON FOR US

1229
00:41:49,680 --> 00:41:51,920
THE HUMAN KNOCK OUT PROJECT WE

1230
00:41:51,920 --> 00:41:53,240
HAVE TO GO AND DISCOVERY IT AND

1231
00:41:53,240 --> 00:41:54,880
THERE WILL BE PEOPLE WHO HAVE A

1232
00:41:54,880 --> 00:41:55,920
GENO TYPE THAT WILL TELL YOU

1233
00:41:55,920 --> 00:41:58,800
THEY SHOULD HAVE A DISEASE THIS

1234
00:41:58,800 --> 00:41:59,800
IS A DISEASE, IT'S ALREADY

1235
00:41:59,800 --> 00:42:01,080
STARTING TO POP UP BUT THEY

1236
00:42:01,080 --> 00:42:02,800
DON'T SEEM TO SO THIS IS AN

1237
00:42:02,800 --> 00:42:03,960
OPPORTUNITY AND UNBI ASSED WAY

1238
00:42:03,960 --> 00:42:05,640
TO FIGURE OUT WHAT PEN TRANCE IS

1239
00:42:05,640 --> 00:42:06,200
REALLY IS LIKE.

1240
00:42:06,200 --> 00:42:11,880
SO YOU COULD CALL THIS AND THIS

1241
00:42:11,880 --> 00:42:14,240
IS SOMETHING LES BEESEEKER HAS

1242
00:42:14,240 --> 00:42:16,760
DONE IN ANOTHER STUDY CALLED

1243
00:42:16,760 --> 00:42:18,280
CLINSEQ, WHICH IS BASICALLY GENO

1244
00:42:18,280 --> 00:42:20,480
TYPE FIRST.

1245
00:42:20,480 --> 00:42:22,640
YOU WILL NOT PICK TO TORT OF

1246
00:42:22,640 --> 00:42:23,840
APPROACH SOMEBODY FOR RESEARCH

1247
00:42:23,840 --> 00:42:25,280
BECAUSE OF THEIR PHENOTYPE,

1248
00:42:25,280 --> 00:42:27,960
BECAUSE OF THEIR GENO TYPE.

1249
00:42:27,960 --> 00:42:29,280
THE PATIENTS WHO ARE PART OF ALL

1250
00:42:29,280 --> 00:42:31,440
OF US HAVE ALL BEEN CONSENTED

1251
00:42:31,440 --> 00:42:34,480
FOR RECONTACT, SO THIS IS

1252
00:42:34,480 --> 00:42:35,440
ETHICALLY ALLOWABLE AND THE

1253
00:42:35,440 --> 00:42:38,000
QUESTION IS, WHERE DO YOU START?

1254
00:42:38,000 --> 00:42:39,600
WHICH GENO TYPES WOULD BE MOST

1255
00:42:39,600 --> 00:42:41,600
APPROPRIATE TO BEGIN TO EXPLORE?

1256
00:42:41,600 --> 00:42:44,200
AND THEN HOW DO YOU DECIDE HOW

1257
00:42:44,200 --> 00:42:45,880
TO DO SOMETHING TO FIGURE OUT

1258
00:42:45,880 --> 00:42:47,360
WHAT THE PHENOTYPE IS, WHEN YOU

1259
00:42:47,360 --> 00:42:51,000
DON'T REALLY QUITE NOW KNOW WHAT

1260
00:42:51,000 --> 00:42:51,560
YOU'RE LOOKING FOR.

1261
00:42:51,560 --> 00:42:53,960
I DON'T KNOW ANY PLACE ON THE

1262
00:42:53,960 --> 00:42:55,120
PLANET THAT'S BETTER SITUATED TO

1263
00:42:55,120 --> 00:42:58,600
DO THAT TYPE OF GENO TYPE FIRST

1264
00:42:58,600 --> 00:42:59,960
PHENOTYPING THAN THE NIH

1265
00:42:59,960 --> 00:43:01,000
CLINICAL CENTER.

1266
00:43:01,000 --> 00:43:03,120
IF WE HAVE THE APPROPRIATE

1267
00:43:03,120 --> 00:43:03,720
COMBINATIONS OF CLINICIANS

1268
00:43:03,720 --> 00:43:05,480
BECAUSE THIS SOUNDS LIKE THE

1269
00:43:05,480 --> 00:43:07,240
UNDIAGNOSED DISEASES PROGRAM,

1270
00:43:07,240 --> 00:43:07,960
DOESN'T IT?

1271
00:43:07,960 --> 00:43:09,400
EXCEPT THERE YOU'RE STARTING

1272
00:43:09,400 --> 00:43:10,720
WITH A PUZZLING PHENOTYPE, HERE

1273
00:43:10,720 --> 00:43:12,440
JIEWR STARTING WITH A PUZZLING

1274
00:43:12,440 --> 00:43:13,640
GENO TYPE AND TRYING TO SORT

1275
00:43:13,640 --> 00:43:14,640
THAT OUT.

1276
00:43:14,640 --> 00:43:17,640
IT DOES SEEM THAT THE CLINICAL

1277
00:43:17,640 --> 00:43:18,800
CENTER IS THE KIND OF PLACE THAT

1278
00:43:18,800 --> 00:43:20,240
WAS SORT OF DESIGNED TO DO THIS.

1279
00:43:20,240 --> 00:43:21,920
THIS COULD BE A PILOT, IF IT

1280
00:43:21,920 --> 00:43:24,120
LOOKS LIKE THIS IS USEFUL

1281
00:43:24,120 --> 00:43:25,440
ACTIVITIES, MANY OTHER ACADEMIC

1282
00:43:25,440 --> 00:43:27,160
CENTERS MAY WANT TO DO THINGS

1283
00:43:27,160 --> 00:43:28,400
THAT ARE SIMILAR BUT FOR US TO

1284
00:43:28,400 --> 00:43:30,080
BEGIN TO START IT OFF AND SEE

1285
00:43:30,080 --> 00:43:33,480
WHAT WE CAN LEARN, I THINK WOULD

1286
00:43:33,480 --> 00:43:35,440
BE A VERY INTERESTING AND

1287
00:43:35,440 --> 00:43:36,400
EXCITING OPPORTUNITY AND I

1288
00:43:36,400 --> 00:43:38,760
SUSPECT A LOT OF CLINICIANS

1289
00:43:38,760 --> 00:43:40,640
WOULD KIND OF GET AN INTERESTING

1290
00:43:40,640 --> 00:43:43,760
EXPERIENCE OUT OF BEING PART OF

1291
00:43:43,760 --> 00:43:45,120
SUCH A TEAM TO SORT OUT WHAT ARE

1292
00:43:45,120 --> 00:43:47,840
THE RIGHT THINGS YOU WANT TO DO

1293
00:43:47,840 --> 00:43:49,360
WITH YOUR PARTICIPANT PATIENT IN

1294
00:43:49,360 --> 00:43:50,920
TERMS OF FIGURING OUT WHAT ARE

1295
00:43:50,920 --> 00:43:52,760
THE CONSEQUENCES OF A PARTICULAR

1296
00:43:52,760 --> 00:43:54,800
SURPRISING DNA GENO TYPE.

1297
00:43:54,800 --> 00:43:57,400
SO WE'LL SEE WHERE THAT GOES,

1298
00:43:57,400 --> 00:43:58,440
THIS IS ACCOUNTIVELY BEING

1299
00:43:58,440 --> 00:43:59,600
DISCUSSED BY A FEW OF US RIGHT

1300
00:43:59,600 --> 00:44:03,640
NOW ANDY WOO WILL SEE WHERE IT

1301
00:44:03,640 --> 00:44:03,840
GOES.

1302
00:44:03,840 --> 00:44:06,000
COMING CLOSE TO WINDING UP HERE,

1303
00:44:06,000 --> 00:44:07,920
BUT 2 OTHER POINTS, I WANT TO

1304
00:44:07,920 --> 00:44:11,400
MAKE ABOUT CHALLENGES FOR THE

1305
00:44:11,400 --> 00:44:15,480
NEXT 70 YEARS, AND THIS IS 1

1306
00:44:15,480 --> 00:44:17,040
THAT TENDS NOT TO BE ON

1307
00:44:17,040 --> 00:44:19,880
EVERYBODY'S MINDS BUT IT SHOULD

1308
00:44:19,880 --> 00:44:20,040
BE.

1309
00:44:20,040 --> 00:44:23,560
I CAN CERTAINLY TELL YOU THAT

1310
00:44:23,560 --> 00:44:26,720
BACK IN 2015 WHEN WE HAD AN

1311
00:44:26,720 --> 00:44:29,160
ISSUE IN THE PHARMACY WHERE

1312
00:44:29,160 --> 00:44:30,160
THERE WERE CONCERNS ABOUT SAFETY

1313
00:44:30,160 --> 00:44:33,480
OF SOME OF THE COMPOUNDS THAT

1314
00:44:33,480 --> 00:44:34,520
WERE BEING PREPARED, THIS BECAME

1315
00:44:34,520 --> 00:44:36,160
VERY MUCH OF INTEREST TO THE

1316
00:44:36,160 --> 00:44:38,640
U.S. CONGRESS, TO THE POINT

1317
00:44:38,640 --> 00:44:41,720
WHERE WE WERE REALLY QUITE

1318
00:44:41,720 --> 00:44:43,760
ALARMED THAT THIS WAS SUCH A

1319
00:44:43,760 --> 00:44:46,120
CONCERN THAT IT MIGHT REALLY

1320
00:44:46,120 --> 00:44:47,760
DAMAGE OVERALL CERTAINTY OF OUR

1321
00:44:47,760 --> 00:44:48,680
ENTIRE ENTERPRISE AND THAT WAS A

1322
00:44:48,680 --> 00:44:50,120
CONCERN BUT OF COURSE MORE

1323
00:44:50,120 --> 00:44:52,160
IMPORTANTLY THIS, IS NOT

1324
00:44:52,160 --> 00:44:55,160
SOMETHING YOU SHOULD JUST DECIDE

1325
00:44:55,160 --> 00:44:56,120
OH WELL, MISTAKES HAPPEN.

1326
00:44:56,120 --> 00:44:57,280
THESE ARE PATIENTS THAT WE'RE

1327
00:44:57,280 --> 00:44:59,360
TAKING CARE OF, THEY COME HERE

1328
00:44:59,360 --> 00:45:00,320
TRUSTING US TO DO EVERYTHING

1329
00:45:00,320 --> 00:45:02,400
THAT WE CAN TO GIVE THEM THE

1330
00:45:02,400 --> 00:45:03,920
BEST CARE WE CAN AND THAT MEANS

1331
00:45:03,920 --> 00:45:06,600
WE HAVE TO BE TUNED IN TO ALL OF

1332
00:45:06,600 --> 00:45:08,320
THE SAFETY ISSUES AS MAYBE THE

1333
00:45:08,320 --> 00:45:11,120
MOST IMPORTANT THING THAT WE'RE

1334
00:45:11,120 --> 00:45:12,040
WE'RE DEDICATED TOO.

1335
00:45:12,040 --> 00:45:15,480
THAT REQUIRED A CHANGE IN THE

1336
00:45:15,480 --> 00:45:17,600
CULTURE, BACK IN THOSE DIFFICULT

1337
00:45:17,600 --> 00:45:19,320
DAYS, WE HAD A RED TEAM THAT

1338
00:45:19,320 --> 00:45:22,440
CAME AND HELPED US WITH THAT, WE

1339
00:45:22,440 --> 00:45:25,240
HAD EXPERT LIKE PAUL O'NEIL AND

1340
00:45:25,240 --> 00:45:25,880
PETER [INDISCERNIBLE] WHO CAME

1341
00:45:25,880 --> 00:45:28,040
AND GIVE US INFORMATION ABOUT

1342
00:45:28,040 --> 00:45:29,200
WHAT OTHER INSTITUTIONS THAT HAD

1343
00:45:29,200 --> 00:45:32,160
FACED UP TO THIS HAD DONE.

1344
00:45:32,160 --> 00:45:33,560
WE HIRED JIM GILMAN AND WE

1345
00:45:33,560 --> 00:45:35,960
BROUGHT TOGETHER A WHOLE TEAM

1346
00:45:35,960 --> 00:45:37,560
THAT WOULD CHANGE THE WAY IN

1347
00:45:37,560 --> 00:45:38,480
WHICH WE APPROACH PATIENT

1348
00:45:38,480 --> 00:45:38,760
SAFETY.

1349
00:45:38,760 --> 00:45:43,440
WE KNEW THIS WAS HARD.

1350
00:45:43,440 --> 00:45:45,240
THIS STUDY WAS DONE 25 YEARS AGO

1351
00:45:45,240 --> 00:45:49,240
BY THE NATIONAL ACADEMY OF

1352
00:45:49,240 --> 00:45:52,320
MEDICINE, BASICALLY TO ERR IS

1353
00:45:52,320 --> 00:45:53,280
HUMAN, ESTIMATE THAD SOMETHING

1354
00:45:53,280 --> 00:45:55,560
IN THE NEIGHBORHOOD OF 50,000,

1355
00:45:55,560 --> 00:45:56,720
MAYBE A HUNDRED THOUSAND DEATHS

1356
00:45:56,720 --> 00:45:58,040
WERE HAPPENING EVERY YEAR

1357
00:45:58,040 --> 00:45:59,080
BECAUSE OF MEDICAL ERRORS AND

1358
00:45:59,080 --> 00:46:00,920
MANY OF THOSE ARE PREVENTIBLE,

1359
00:46:00,920 --> 00:46:02,160
AND IF YOU THINK WE MUST HAVE

1360
00:46:02,160 --> 00:46:03,560
FIXED THAT BY NOW.

1361
00:46:03,560 --> 00:46:04,760
HERE'S A STUDY JUST PUBLISHED A

1362
00:46:04,760 --> 00:46:06,840
YEAR AGO BUT IT WAS BASED UPON

1363
00:46:06,840 --> 00:46:10,040
DATA BACK IN OCTOBER OF 2018.

1364
00:46:10,040 --> 00:46:12,200
A QUARTER OF MEDICARE PATIENTS

1365
00:46:12,200 --> 00:46:15,160
EXPERIENCED HARMS, HALF OF THOSE

1366
00:46:15,160 --> 00:46:16,560
WERE PREVENTIBLE IN

1367
00:46:16,560 --> 00:46:18,600
OCTOBER 2018, THERE'S A MORE

1368
00:46:18,600 --> 00:46:19,520
RECENT NEW ENGLAND JOURNAL

1369
00:46:19,520 --> 00:46:20,640
ARTICLE THAT HAS SIMILAR RESUMS

1370
00:46:20,640 --> 00:46:22,160
SO WE HAVE TO TAKE THIS

1371
00:46:22,160 --> 00:46:22,600
SERIOUSLY.

1372
00:46:22,600 --> 00:46:24,760
THIS IS SUCH AN IMPORTANT ISSUE

1373
00:46:24,760 --> 00:46:26,120
AND MANY PEOPLE WOULD POINT OUT

1374
00:46:26,120 --> 00:46:28,280
WE WOULD NEVER TOLERATE THIS IN

1375
00:46:28,280 --> 00:46:30,040
MUCH OF ANY OTHER INDUSTRY,

1376
00:46:30,040 --> 00:46:31,000
CERTAINLY NOT THE AIRLINE

1377
00:46:31,000 --> 00:46:32,960
INDUSTRY WHERE MISTAKES ARE LIKE

1378
00:46:32,960 --> 00:46:34,720
OH, WELL, WE HAVE TO HAVE THE

1379
00:46:34,720 --> 00:46:37,240
SAME ATTITUDE AND WE HAVE TO BE

1380
00:46:37,240 --> 00:46:38,840
WILLING TO SAY THIS IF YOU

1381
00:46:38,840 --> 00:46:39,760
DISCOVER SOMETHING HAS GONE

1382
00:46:39,760 --> 00:46:41,200
WRONG, THAT YOUR A HERO IF YOU

1383
00:46:41,200 --> 00:46:43,880
TALK ABOUT IT AS OPPOSE TO NOT

1384
00:46:43,880 --> 00:46:44,680
TALKING ABOUT IT.

1385
00:46:44,680 --> 00:46:45,680
A BIG ADVANCE THAT HAPPENED THAT

1386
00:46:45,680 --> 00:46:47,480
I GOT TO BE PART OF THIS, QUITE

1387
00:46:47,480 --> 00:46:51,560
A FEW TIMES, IS THE PATIENT

1388
00:46:51,560 --> 00:46:53,080
HUDDLE, EVERY DAY, BRINGING

1389
00:46:53,080 --> 00:46:54,440
TOGETHER THERE IN THE MEDICAL

1390
00:46:54,440 --> 00:46:55,960
BOARD ROOM ALL THE PEOPLE MOST

1391
00:46:55,960 --> 00:46:57,600
INVOLVED IN PATIENT CARE SAYING

1392
00:46:57,600 --> 00:46:58,920
OKAY, IN THE LAST 24 HOURS, IS

1393
00:46:58,920 --> 00:46:59,880
THERE ANYTHING THAT UPON HAD

1394
00:46:59,880 --> 00:47:01,960
THAT WE NEED TO LEARN FROM THAT

1395
00:47:01,960 --> 00:47:03,560
WAS A CLOSE CALL OR EVEN

1396
00:47:03,560 --> 00:47:04,640
SOMETHING THAT WENT BEYOND A

1397
00:47:04,640 --> 00:47:06,160
CLOSE CALL AND THEN HAVING THE

1398
00:47:06,160 --> 00:47:07,680
METRICS AND KEEPING TRACK OF ALL

1399
00:47:07,680 --> 00:47:10,320
THAT, TO KNOW HOW WE ARE DOING

1400
00:47:10,320 --> 00:47:11,960
IN THIS SPACE, IS REALLY

1401
00:47:11,960 --> 00:47:12,240
CRITICAL.

1402
00:47:12,240 --> 00:47:15,080
IF WE'RE GOING TO SAY, WE ARE,

1403
00:47:15,080 --> 00:47:16,720
THE LARGEST, AND MOST EFFECTIVE

1404
00:47:16,720 --> 00:47:17,400
RESEARCH HOSPITAL IN THE WORLD,

1405
00:47:17,400 --> 00:47:21,560
WE HAVE TO BE EFFECTIVE AT THIS,

1406
00:47:21,560 --> 00:47:21,720
TOO.

1407
00:47:21,720 --> 00:47:23,280
AND FINALLY, I DO WANT TO SAY

1408
00:47:23,280 --> 00:47:26,600
JUST A WORD ABOUT THIS CRITICAL

1409
00:47:26,600 --> 00:47:29,160
SET OF NEW INITTIAIVE ITS, AND

1410
00:47:29,160 --> 00:47:32,360
NEW ATTITUDES THAT WE HAVE

1411
00:47:32,360 --> 00:47:33,880
DEVELOPED HERE PRETTY MUCH IN

1412
00:47:33,880 --> 00:47:36,600
THE COURSE OF THE LAST 2 OR 3

1413
00:47:36,600 --> 00:47:37,880
YEARS BUT CERTAINLY GOING BACK

1414
00:47:37,880 --> 00:47:39,040
FURTHER ABOUT YOU WE BROUGHT IT

1415
00:47:39,040 --> 00:47:40,800
MUCH MORE TO THE FRONT AND THAT

1416
00:47:40,800 --> 00:47:43,520
HAS TO RELATE TO HOW IMPORTANT

1417
00:47:43,520 --> 00:47:48,160
IT IS THAT WE WORRY ABOUT OUR

1418
00:47:48,160 --> 00:47:49,680
REPRESENTATION IN EVERY WAY.

1419
00:47:49,680 --> 00:47:52,000
THAT WE RECOGNIZE AS AN

1420
00:47:52,000 --> 00:47:53,040
INSTITUTION, WE ARE AN

1421
00:47:53,040 --> 00:47:54,840
INSTITUTION THAT HAS BEEN

1422
00:47:54,840 --> 00:47:57,720
BROUGHT THROUGH A CULTURE THAT

1423
00:47:57,720 --> 00:47:58,800
HAS STRUCTURAL RACISM BUILT INTO

1424
00:47:58,800 --> 00:48:00,840
IT, AND WE CAN'T SAY THAT THAT'S

1425
00:48:00,840 --> 00:48:02,720
NOT ALSO PART OF OUR HISTORY AND

1426
00:48:02,720 --> 00:48:04,560
WE HAVE TO COME UP WITH WAYS TO

1427
00:48:04,560 --> 00:48:08,120
FOCUS ON THAT MORE EXPLICITLY

1428
00:48:08,120 --> 00:48:10,200
AND THAT MEANS FOCUSING IN AN

1429
00:48:10,200 --> 00:48:12,080
INTENTIONAL WAY ON HEALTH

1430
00:48:12,080 --> 00:48:13,520
DISPARITIES NOT JUST TO ADMIRE

1431
00:48:13,520 --> 00:48:15,280
THE PROBLEM BUT TO COME UP WITH

1432
00:48:15,280 --> 00:48:16,960
SOLUTIONS TO FOCUS ON OUR

1433
00:48:16,960 --> 00:48:18,440
INTERNAL WORKFORCE AND

1434
00:48:18,440 --> 00:48:21,960
PARTICULARLY ON THINGS LIKE

1435
00:48:21,960 --> 00:48:23,000
DISCRIMINATION AND HARASS, AS

1436
00:48:23,000 --> 00:48:24,160
WELL AS OUR EXTERNAL WORKFORCE

1437
00:48:24,160 --> 00:48:25,680
AND THIS IS WHAT THE UNITE

1438
00:48:25,680 --> 00:48:29,360
INITIATIVE IS DOING IN A REALLY

1439
00:48:29,360 --> 00:48:30,640
REMARKABLE WAY INVOLVING PEOPLE

1440
00:48:30,640 --> 00:48:31,480
AT BOTH LEVELS AT BOTH

1441
00:48:31,480 --> 00:48:33,680
IMPOSSIBLE TO BUILD RAMURAL AND

1442
00:48:33,680 --> 00:48:35,760
EXTRAMURAL AND I WANT TO SAY HOW

1443
00:48:35,760 --> 00:48:38,680
IMPRESSED I HAVE BEEN WITH THE

1444
00:48:38,680 --> 00:48:40,080
ACCOMPLISHMENTS THAT HAVE BEEN

1445
00:48:40,080 --> 00:48:43,640
MADE SO FAR AND THE DETERMINE

1446
00:48:43,640 --> 00:48:46,080
NATION THAT DOES NOT SEEM TO BE

1447
00:48:46,080 --> 00:48:47,520
WANING AT ALL AND YOU CAN READ

1448
00:48:47,520 --> 00:48:49,320
MORE ABOUT THIS IN THE PROGRESS

1449
00:48:49,320 --> 00:48:50,840
REPORT PRACTICES MA RIBERNARD

1450
00:48:50,840 --> 00:48:51,480
AND OTHER COLLEAGUES.

1451
00:48:51,480 --> 00:48:52,560
SO THINK ABOUT THOSE THINGS AS

1452
00:48:52,560 --> 00:48:53,760
SORT OF THINGS ABOUT THE FUTURE,

1453
00:48:53,760 --> 00:48:56,760
WE DID THE PAST, WE DID THE

1454
00:48:56,760 --> 00:48:58,280
FUTURE, FINALLY, I THINK JUST

1455
00:48:58,280 --> 00:49:00,920
COMING BA BEING TO WHAT A

1456
00:49:00,920 --> 00:49:02,520
PRIVILEGE IT IS, SPEAKING FOR

1457
00:49:02,520 --> 00:49:04,200
MYSELF BUT I HOPE I'M SPEAKING

1458
00:49:04,200 --> 00:49:06,040
FOR ALL OF YOU TO BE ABLE TO BE

1459
00:49:06,040 --> 00:49:08,080
PART OF THIS HOUSE OF HOPE, TO

1460
00:49:08,080 --> 00:49:10,160
THINK ABOUT WHAT IT HAS DONE

1461
00:49:10,160 --> 00:49:11,280
OVER THESE 70 YEARS TO RECOGNIZE

1462
00:49:11,280 --> 00:49:13,680
THE PEOPLE THAT WE ARE MOST TO

1463
00:49:13,680 --> 00:49:14,640
BE GRATEFUL TOO ARE THE PATIENT

1464
00:49:14,640 --> 00:49:15,920
WHO IS HAVE COME HERE AND PUT

1465
00:49:15,920 --> 00:49:18,320
THEIR TRUST IN US AND NOT ALL OF

1466
00:49:18,320 --> 00:49:19,880
THEM HAVE HAD THE HAPPY OUTCOME

1467
00:49:19,880 --> 00:49:21,880
AND YET, THEY WERE WILLING, EVEN

1468
00:49:21,880 --> 00:49:23,640
IF IT WASN'T GOING TO HELP THEM,

1469
00:49:23,640 --> 00:49:25,040
TO KNOW THAT WE WERE GOING TO

1470
00:49:25,040 --> 00:49:27,680
LEARN SOMETHING THAT MIGHT HELP

1471
00:49:27,680 --> 00:49:28,200
THE NEXT PERSON.

1472
00:49:28,200 --> 00:49:31,400
IT IS THE HOUSE OF HOPE AND IT

1473
00:49:31,400 --> 00:49:32,960
IS OUR 70th BIRTHDAY, SO I

1474
00:49:32,960 --> 00:49:35,360
GUESS WE SHOULD CELEBRATE THAT

1475
00:49:35,360 --> 00:49:37,960
BUT ALSO IF IT'S ABOUT HOPE,

1476
00:49:37,960 --> 00:49:39,680
RECOGNIZE THAT HOPE IN MANY WAYS

1477
00:49:39,680 --> 00:49:41,520
IS SOMETHING YOU CAN'T JUST

1478
00:49:41,520 --> 00:49:43,920
THROW OUT THERE LIKE A NICE

1479
00:49:43,920 --> 00:49:48,360
IDEA, IT HAS CONSEQUENCES, HOPE

1480
00:49:48,360 --> 00:49:51,000
IN EVERY SPHERE OF LIFE IS A

1481
00:49:51,000 --> 00:49:51,400
PRIVILEGE.

1482
00:49:51,400 --> 00:49:53,000
WE ARE PRIVILEGED TO BE IN THE

1483
00:49:53,000 --> 00:49:56,000
HOUSE OF HOPE AND IT ATTACHES TO

1484
00:49:56,000 --> 00:49:56,240
ACTION.

1485
00:49:56,240 --> 00:49:57,520
THIS CLINICAL CENTER IS A HOUSE

1486
00:49:57,520 --> 00:49:59,680
OF HOPE BUT IT'S A HOUSE OF

1487
00:49:59,680 --> 00:50:02,080
ACTION AND I'M PROUD TO BE ABLE

1488
00:50:02,080 --> 00:50:05,200
TO TELL BUT IT AND TO HAVE SPENT

1489
00:50:05,200 --> 00:50:06,720
MY LAST 30 YEARS HERE TO SEE THE

1490
00:50:06,720 --> 00:50:08,600
WAY IN WHICH THIS HAS EVOLVED

1491
00:50:08,600 --> 00:50:10,320
AND WILL CONTINUE TO EVOLVE IN A

1492
00:50:10,320 --> 00:50:11,840
WAY THAT WILL SAVE MANY LIVES

1493
00:50:11,840 --> 00:50:13,640
AND REDUCE LOTS OF SUFFERING BUT

1494
00:50:13,640 --> 00:50:15,440
ONLY BECAUSE OF ALL OF YOU AND

1495
00:50:15,440 --> 00:50:18,600
YOUR COMMITMENT TO KEEPING THAT

1496
00:50:18,600 --> 00:50:20,120
DREAM GOING IN A WAY THAT HAS

1497
00:50:20,120 --> 00:50:22,840
NEVER HAD A BETTER CHANCE THAN

1498
00:50:22,840 --> 00:50:25,040
RIGHT NOW BUT IT'S GOING TO TAKE

1499
00:50:25,040 --> 00:50:27,240
EVERY BIT OF ENERGY AND

1500
00:50:27,240 --> 00:50:29,200
CREATIVITY AND RISK TAKING THAT

1501
00:50:29,200 --> 00:50:30,040
HAS CHARACTERIZED THIS CLINICAL

1502
00:50:30,040 --> 00:50:32,160
CENTER FROM THE VERY BEGINNING

1503
00:50:32,160 --> 00:50:32,600
BACK IN 1953.

1504
00:50:32,600 --> 00:50:40,120
THANK YOU ALL SO MUCH.

1505
00:50:40,120 --> 00:50:50,360
[ APPLAUSE ] 

1506
00:50:52,680 --> 00:50:53,040
NTHANK YOU FRANCIS.

1507
00:50:53,040 --> 00:50:54,920
SO THANKS FOR A WONDERFUL

1508
00:50:54,920 --> 00:50:55,280
PRESENTATION.

1509
00:50:55,280 --> 00:50:56,920
WE DO HAVE TIME FOR QUESTIONS,

1510
00:50:56,920 --> 00:50:58,200
THERE IS AN OPPORTUNITY FOR

1511
00:50:58,200 --> 00:51:03,360
THOSE OF YOU ON VIDEOCAST TO

1512
00:51:03,360 --> 00:51:06,160
SEND QUESTIONS DR. BURKLOW WILL

1513
00:51:06,160 --> 00:51:07,480
FIELD THOSE AND PASS THEM ALONG

1514
00:51:07,480 --> 00:51:08,640
TO US FROM 1 OF THE MICROPHONES

1515
00:51:08,640 --> 00:51:11,000
BUT IF YOU HAVE A QUESTION, IT

1516
00:51:11,000 --> 00:51:21,520
NOW WOULD BE THE TIME TO HEAD TO

1517
00:51:30,880 --> 00:51:32,040
THE MICROPHONE.

1518
00:51:32,040 --> 00:51:33,200
CLEARLY YOU ANSWERED EVERYTHING

1519
00:51:33,200 --> 00:51:35,360
THAT WAS ASKED AND THANK YOU

1520
00:51:35,360 --> 00:51:37,680
VERY MUCH FOR A WONDERFUL

1521
00:51:37,680 --> 00:51:39,320
PRESENTATION AND I JUST WANT TO

1522
00:51:39,320 --> 00:51:41,440
SAY OUR PATIENTS ARE OUR HEROES.

1523
00:51:41,440 --> 00:51:44,280
I DID HAVE A FEW THINGS THAT

1524
00:51:44,280 --> 00:51:45,640
CAME IN FROM VIDEOCAST.

1525
00:51:45,640 --> 00:51:47,320
YOU DID A GREAT JOB OF

1526
00:51:47,320 --> 00:51:48,800
ADVERTISING THE ALL OF US STUDY,

1527
00:51:48,800 --> 00:51:50,240
I DID GET A QUESTION, HOW DO

1528
00:51:50,240 --> 00:51:52,000
PEOPLE SIGN UP FOR THE ALL OF US

1529
00:51:52,000 --> 00:51:52,320
STUDY?

1530
00:51:52,320 --> 00:51:55,040
THAT WOULD BE GOOD TO REPEAT

1531
00:51:55,040 --> 00:51:55,440
THAT.

1532
00:51:55,440 --> 00:51:57,280
>>THANK YOU FOR WHOEVER
ASKED

1533
00:51:57,280 --> 00:51:57,880
THAT QUESTION.

1534
00:51:57,880 --> 00:52:04,520
YEAH, WE ARE STILL LOOKING FOR,

1535
00:52:04,520 --> 00:52:07,000
YOU KNOW ANOTHER 380,000 PEOPLE.

1536
00:52:07,000 --> 00:52:11,360
IT'S VERY EASY.

1537
00:52:11,360 --> 00:52:12,760
JOINALLOFUS.ORG, GO TO THAT AND

1538
00:52:12,760 --> 00:52:15,080
YOU WILL SEE THE STEPS, YOU WILL

1539
00:52:15,080 --> 00:52:15,840
BE ASKED GO THROUGH MATERIAL AND

1540
00:52:15,840 --> 00:52:17,240
TELL YOU ABOUT THE STUDY AND

1541
00:52:17,240 --> 00:52:18,560
SOMETHING ABOUT THE WHAT THE

1542
00:52:18,560 --> 00:52:20,400
CONSENT WILL INVOLVE AND THE

1543
00:52:20,400 --> 00:52:22,160
FACT THAT THERE WILL NEED TO BE

1544
00:52:22,160 --> 00:52:23,440
PHYSICAL MEASUREMENTS AND A

1545
00:52:23,440 --> 00:52:25,120
BLOOD SAMPLE BUT IT'S PRETTY

1546
00:52:25,120 --> 00:52:25,360
SIMPLE.

1547
00:52:25,360 --> 00:52:27,720
THAT'S THE PLACE TO START.

1548
00:52:27,720 --> 00:52:29,680
AND I THINK IF YOU JOIN, YOU

1549
00:52:29,680 --> 00:52:31,680
WILL LEARN A LOT ABOUT YOURSELF

1550
00:52:31,680 --> 00:52:32,920
THAT YOU MIGHT OTHERWISE NOT BE

1551
00:52:32,920 --> 00:52:37,720
GIVEN THE CHANCE TO DO.

1552
00:52:37,720 --> 00:52:39,760
>>THANK YOU DR. COLLINS.

1553
00:52:39,760 --> 00:52:41,160
ANOTHER QUESTION, MORE OF A

1554
00:52:41,160 --> 00:52:42,240
COMMENT, THANK YOU VERY

1555
00:52:42,240 --> 00:52:45,880
HIGHLIGHTING THE WORK WITHIN THE

1556
00:52:45,880 --> 00:52:46,720
CLINICAL CENTER INVESTIGATORS.

1557
00:52:46,720 --> 00:52:48,520
ONE COMMENTER DID WANT TO SAY

1558
00:52:48,520 --> 00:52:54,160
THAT OF COURSE OUTSIDE THE NIH,

1559
00:52:54,160 --> 00:52:55,440
WE'RE [INDISCERNIBLE] WAS THE

1560
00:52:55,440 --> 00:52:57,600
SIGNIFICANT CONTRIBUTION OF NIH

1561
00:52:57,600 --> 00:52:59,760
BIOLOGICAL AND MEDICAL SCIENCE

1562
00:52:59,760 --> 00:53:01,480
OF THE 20th CENTURY, I KNOW

1563
00:53:01,480 --> 00:53:03,440
YOU HIGHLIGHT CLINICAL CENTER

1564
00:53:03,440 --> 00:53:03,760
INVESTIGATORS.

1565
00:53:03,760 --> 00:53:04,680
>>YEAH, AND I STRUGGLE
WIDE

1566
00:53:04,680 --> 00:53:06,880
THAT A BIT BECAUSE WALKING IN

1567
00:53:06,880 --> 00:53:11,080
HERE TODAY WENT PAST THE DISPLAY

1568
00:53:11,080 --> 00:53:12,720
FOR MARSHAL NUREMBERG LIKE A

1569
00:53:12,720 --> 00:53:13,560
PHENOMENAL CONTRIBUTION THAT WAS

1570
00:53:13,560 --> 00:53:15,080
MADE RIGHT HERE AT NIH.

1571
00:53:15,080 --> 00:53:16,280
I THOUGHT MY TASK WAS TO TALK

1572
00:53:16,280 --> 00:53:17,680
MORE ABOUT THE CLINICAL CENTER

1573
00:53:17,680 --> 00:53:18,440
THEREFORE THE CLINICAL

1574
00:53:18,440 --> 00:53:19,560
APPLICATIONS BUT I COULD HAVE

1575
00:53:19,560 --> 00:53:21,080
EASILY SPENT MORE TIME ON SOME

1576
00:53:21,080 --> 00:53:23,040
OF THE OTHER BASIC SCIENCE

1577
00:53:23,040 --> 00:53:27,600
ACHIEVEMENTS WHICH ARE EQUALLY

1578
00:53:27,600 --> 00:53:27,840
STUNNING.

1579
00:53:27,840 --> 00:53:30,240
>>THANK YOU AGAIN DR.
COLLINS

1580
00:53:30,240 --> 00:53:32,960
FOR SUCH A GREAT TALK.

1581
00:53:32,960 --> 00:53:34,360
I'M DR. JOYCE CHUNG AT THE

1582
00:53:34,360 --> 00:53:35,520
CLINICAL CENTER I WANTED TO ASK

1583
00:53:35,520 --> 00:53:37,200
IF YOU COULD COMMENTOT

1584
00:53:37,200 --> 00:53:38,000
INCREDIBLE OPPORTUNITIES FOR

1585
00:53:38,000 --> 00:53:40,440
TRAINING HERE, WE HAVE A LOT OF

1586
00:53:40,440 --> 00:53:43,040
POST BACKS, WE HAVE A TREMENDOUS

1587
00:53:43,040 --> 00:53:44,720
NUMBER OF PEOPLE WHO COME HERE

1588
00:53:44,720 --> 00:53:46,000
TO LEARN AND LAUNCH THEIR

1589
00:53:46,000 --> 00:53:47,960
CAREERS SO I WAS WONDERING IF

1590
00:53:47,960 --> 00:53:50,720
YOU COULD TALK ABOUT THAT

1591
00:53:50,720 --> 00:53:51,160
CONTRIBUTION AS WELL.

1592
00:53:51,160 --> 00:53:52,680
>>I WOULD LOVE TO.

1593
00:53:52,680 --> 00:53:54,520
AS A TRAINING OPPORTUNITY, IT'S

1594
00:53:54,520 --> 00:53:57,640
HARD TO OVERSTATE HOW REMARKABLE

1595
00:53:57,640 --> 00:54:00,000
IT IS TO BE IN THIS PLACE AND OF

1596
00:54:00,000 --> 00:54:01,000
COURSE THAT'S PARTLY BECAUSE OF

1597
00:54:01,000 --> 00:54:03,840
THE CLINICAL CENTER AND THE

1598
00:54:03,840 --> 00:54:05,760
ACTUAL PROTOCOLS BUT IT'S ALSO

1599
00:54:05,760 --> 00:54:07,640
BECAUSE OF THE AMAZING BASIC

1600
00:54:07,640 --> 00:54:08,800
SCIENCE THAT SURROUNDS US ON

1601
00:54:08,800 --> 00:54:10,520
THIS CAMPUS AND ALSO UP IN

1602
00:54:10,520 --> 00:54:11,480
BALTIMORE AND IN NORTH CAROLINA

1603
00:54:11,480 --> 00:54:13,320
AND A COUPLE OTHER PLACES.

1604
00:54:13,320 --> 00:54:15,440
ALMOST ANYTHING YOU WANT TO KNOW

1605
00:54:15,440 --> 00:54:17,320
ABOUT, THERE'S NUMBER AT THE NIH

1606
00:54:17,320 --> 00:54:19,080
WHO'S IN THE SORT OF TOP 10 OR

1607
00:54:19,080 --> 00:54:21,600
15 EXPERS IN THE WORLD AND THE

1608
00:54:21,600 --> 00:54:25,560
PLACE IS ALSO QUITE OPEN TO

1609
00:54:25,560 --> 00:54:27,480
ACCEPTING PEOPLE TO JUST WALK IN

1610
00:54:27,480 --> 00:54:28,240
AND ASK QUESTIONS.

1611
00:54:28,240 --> 00:54:29,840
I WILL PARTICULARLY SAY A WORD

1612
00:54:29,840 --> 00:54:30,960
ABOUT THE POST BACK PROGRAM

1613
00:54:30,960 --> 00:54:36,920
BECAUSE MY LAB HAS BENEFITED

1614
00:54:36,920 --> 00:54:38,080
FROM THAT 4 POST BACKS IN MY

1615
00:54:38,080 --> 00:54:39,840
LAB, WE WILL HAVE 5 BY NEXT

1616
00:54:39,840 --> 00:54:40,200
WEEK.

1617
00:54:40,200 --> 00:54:42,200
THESE ARE FOLK WHO IS COME HERE

1618
00:54:42,200 --> 00:54:44,600
WITH INCREDIBLE TALENT AFTER

1619
00:54:44,600 --> 00:54:45,200
THEIR UNDERGRADUATE TRAINING

1620
00:54:45,200 --> 00:54:46,360
TRYING TO FIGURE OUT WHETHER

1621
00:54:46,360 --> 00:54:47,440
RESEARCH IS REALLY THEIR CALLING

1622
00:54:47,440 --> 00:54:49,840
OR WILL THEY GO TO MEDICAL

1623
00:54:49,840 --> 00:54:51,680
SCHOOL OR MD-Ph.D. OR Ph.D.

1624
00:54:51,680 --> 00:54:52,800
OR NONE OF THE ABOVE AND THEY

1625
00:54:52,800 --> 00:54:54,960
BRING THAT SKILL AND CREATIVITY

1626
00:54:54,960 --> 00:54:57,240
AND THAT DRIVE AND THEY MAKE AN

1627
00:54:57,240 --> 00:54:59,880
ENVIRONMENT JUST THAT MUCH MORE

1628
00:54:59,880 --> 00:55:01,240
EXCITING BY THEIR PRESENCE.

1629
00:55:01,240 --> 00:55:04,120
AND I THINK WE GIVE THEM A

1630
00:55:04,120 --> 00:55:05,400
PRETTY GOOD CHANCE, ALSO TO GET

1631
00:55:05,400 --> 00:55:06,920
THEIR ANSWERS TO WHAT IT IS THAT

1632
00:55:06,920 --> 00:55:09,280
THEY MIGHT WANT TO DO NEXT.

1633
00:55:09,280 --> 00:55:10,840
SO THAT'S THE POST BACKS,

1634
00:55:10,840 --> 00:55:12,240
CERTAINLY ALSO THE POST DOCKS,

1635
00:55:12,240 --> 00:55:13,440
ALTHOUGH RIGHT NOW WE HAVE SORT

1636
00:55:13,440 --> 00:55:15,520
OF A NATIONAL SHORTAGE OF POST

1637
00:55:15,520 --> 00:55:16,400
DOCKS AND THAT'S CERTAINLY

1638
00:55:16,400 --> 00:55:21,200
HAPPENING A BIT HERE AT NIH AS

1639
00:55:21,200 --> 00:55:21,400
WELL.

1640
00:55:21,400 --> 00:55:26,720
THE POST DOCS ARE JUST ANENTIOUS

1641
00:55:26,720 --> 00:55:29,120
SENTIAL PART OF WHAT WE GET TO

1642
00:55:29,120 --> 00:55:30,560
DO AND GRADUATE STUDENTS LET ME

1643
00:55:30,560 --> 00:55:32,040
ALSO SAY THAT WE DON'T HAVE A

1644
00:55:32,040 --> 00:55:35,320
GRADUATE PROGRAM WE CAN GIVE

1645
00:55:35,320 --> 00:55:37,400
DEGREES AND WE HAVE A LOT OF

1646
00:55:37,400 --> 00:55:38,360
PEOPLE DO THEIR GRADUATE WORK

1647
00:55:38,360 --> 00:55:41,200
HERE AND GET THEIR DEGREES AT

1648
00:55:41,200 --> 00:55:43,320
OTHER INSTITUTIONS AS PART OF

1649
00:55:43,320 --> 00:55:44,120
THAT PARTNERSHIP PROGRAM.

1650
00:55:44,120 --> 00:55:45,440
THIS PLACE WOULD NOT FUNCTION

1651
00:55:45,440 --> 00:55:46,160
WITHOUT THE TRAINEES AND

1652
00:55:46,160 --> 00:55:47,200
CERTAINLY WOULD NONAPOPTOTIC THE

1653
00:55:47,200 --> 00:55:49,000
BE ANY FUN SO I'M GLAD YOU ASK

1654
00:55:49,000 --> 00:55:51,280
THE QUESTION AND I THINK IF

1655
00:55:51,280 --> 00:55:52,000
ANYBODY'S LISTENING WHO'S THINK

1656
00:55:52,000 --> 00:55:53,640
BEING WHERE THEY MIGHT WANT TO

1657
00:55:53,640 --> 00:55:54,800
DO FUTURE TRAINING, CHECK US

1658
00:55:54,800 --> 00:56:03,200
OUT, WE'RE ON THE WEB.

1659
00:56:03,200 --> 00:56:03,480
[LAUGHTER]

1660
00:56:03,480 --> 00:56:04,760
>>THANK YOU VERY MUCH
IT'S

1661
00:56:04,760 --> 00:56:06,080
REALLY HUMBLING TO SEE IT AND BE

1662
00:56:06,080 --> 00:56:07,080
PART OF IT.

1663
00:56:07,080 --> 00:56:12,760
CAN YOU COMMENTOT ROLE

1664
00:56:12,760 --> 00:56:13,800
TECHNOLOGY PLAYS BROADLY IN

1665
00:56:13,800 --> 00:56:14,840
THESE INNOVATIONS AND HOW WE

1666
00:56:14,840 --> 00:56:16,280
SHOULD TALK ABOUT THE

1667
00:56:16,280 --> 00:56:18,160
INNOVATIONS IN THE CLINICAL

1668
00:56:18,160 --> 00:56:18,400
CENTER?

1669
00:56:18,400 --> 00:56:21,120
>>YEAH, I THINK IT PLAYS
A HUGE

1670
00:56:21,120 --> 00:56:21,360
ROLE.

1671
00:56:21,360 --> 00:56:22,640
I SHOULD HAVE HAD SOMETHING

1672
00:56:22,640 --> 00:56:23,360
ABOUT THE TRANSFUSION

1673
00:56:23,360 --> 00:56:24,080
CAPABILITIES HERE IN THE

1674
00:56:24,080 --> 00:56:25,600
CLINICAL CENTER AS A TECHNOLOGY

1675
00:56:25,600 --> 00:56:28,120
THAT HAS MADE A HUGE MEMBER OF

1676
00:56:28,120 --> 00:56:29,280
THINGS POSSIBLE BUT IT'S

1677
00:56:29,280 --> 00:56:31,600
CERTAINLY ALSO WHAT I'M TALKING

1678
00:56:31,600 --> 00:56:33,200
ABOUT SELLING GENE THERAPY,

1679
00:56:33,200 --> 00:56:34,280
THOSE ARE ALL TECHNOLOGY DRIVEN,

1680
00:56:34,280 --> 00:56:36,480
THE KINDS OF THINGS THAT ARE

1681
00:56:36,480 --> 00:56:38,400
DONE IN INTERVENTIONAL RADIOLOGY

1682
00:56:38,400 --> 00:56:40,600
BY SOMEBODY LIKE BRAD WOOD ARE

1683
00:56:40,600 --> 00:56:41,200
ALSO TRANSFORMATIVE IN THE

1684
00:56:41,200 --> 00:56:42,760
ABILITY TO TAKE CARE OF PATIENTS

1685
00:56:42,760 --> 00:56:44,960
AND I'M SURE THE CHANCES OF

1686
00:56:44,960 --> 00:56:46,800
DOING EVEN MORE OF THAT WITH THE

1687
00:56:46,800 --> 00:56:47,840
NEW BUILDING WILL GO UP.

1688
00:56:47,840 --> 00:56:48,920
SO IT'S EVERYTHING FROM THE FACT

1689
00:56:48,920 --> 00:56:51,280
THAT WE CAN DO SINGLE IS CELL

1690
00:56:51,280 --> 00:56:52,440
BIOLOGY RUE TEENLY WHICH I WOULD

1691
00:56:52,440 --> 00:56:54,320
BT HAVE SAID WE COULD DO 5 YEARS

1692
00:56:54,320 --> 00:56:58,280
AGO, TO DEALING WITH STEM CELLS,

1693
00:56:58,280 --> 00:57:01,720
THE VERY FIRST HUMAN TRIAL OF

1694
00:57:01,720 --> 00:57:03,560
AUTOOUS IPS DEDRIVED CELLS FOR

1695
00:57:03,560 --> 00:57:11,360
THE RETINA, BEING DONE HERE BY

1696
00:57:11,360 --> 00:57:13,280
CAMILLE [INDISCERNIBLE] AND THAT

1697
00:57:13,280 --> 00:57:14,160
ALSO INCLUDES ARTIFICIAL

1698
00:57:14,160 --> 00:57:15,240
INTELLIGENCE MACHINE LEARNING

1699
00:57:15,240 --> 00:57:17,360
WHICH WE ALL WOULD AGREE IS AN

1700
00:57:17,360 --> 00:57:18,640
OPPORTUNITY FOR MEDICINE THAT IS

1701
00:57:18,640 --> 00:57:21,920
REALLY JUST BEGINNING TO GET

1702
00:57:21,920 --> 00:57:23,200
GOING AND I WOULD HOPE THAT IN

1703
00:57:23,200 --> 00:57:26,240
THE COMING YEARS WE WOULD GET

1704
00:57:26,240 --> 00:57:27,360
EVEN STRONGENER THAT SPACE AS

1705
00:57:27,360 --> 00:57:27,600
WELL.

1706
00:57:27,600 --> 00:57:30,480
SO I'M KIND OF A TECHY AS CAN

1707
00:57:30,480 --> 00:57:32,160
YOU CAN TELL BUT IF YOU LOOK AT

1708
00:57:32,160 --> 00:57:33,520
WHAT'S HAPPENING AT THE

1709
00:57:33,520 --> 00:57:38,120
FOUNDATION OF BREAK THROUGHS IN

1710
00:57:38,120 --> 00:57:41,120
BIOMEDICAL RESEARCH IT'S OFTEN A

1711
00:57:41,120 --> 00:57:42,600
TECHNOLOGY THAT'S MAKING IT

1712
00:57:42,600 --> 00:57:42,840
HAPPEN.

1713
00:57:42,840 --> 00:57:45,880
>>THANK YOU AGAIN FOR
YOUR TALK

1714
00:57:45,880 --> 00:57:48,040
DR. COLLINS I'M GINA MOODY FROM

1715
00:57:48,040 --> 00:57:49,800
NIH, I WAS CURIOUS IF YOU WOULD

1716
00:57:49,800 --> 00:57:51,720
HAVE ADVICE FOR PEOPLE EMERGING

1717
00:57:51,720 --> 00:57:52,920
AS CLINICAL INVESTIGATORS AND

1718
00:57:52,920 --> 00:57:55,200
HOW WE HAVE GOOD STEWARDSHIP OF

1719
00:57:55,200 --> 00:57:56,360
THE OPPORTUNITY WE'VE BEEN

1720
00:57:56,360 --> 00:57:57,760
GIFTED WITH MY BEING HERE?

1721
00:57:57,760 --> 00:58:00,840
>>WELL WE WANT MORE AND
MORE OF

1722
00:58:00,840 --> 00:58:01,440
THOSE GIFTED CLIENICAL

1723
00:58:01,440 --> 00:58:02,680
INVESTIGATORS TO COME HERE

1724
00:58:02,680 --> 00:58:04,640
BECAUSE THE CLINICAL CENTER

1725
00:58:04,640 --> 00:58:06,880
REALLY DOESN'T WORK UNLESS WE

1726
00:58:06,880 --> 00:58:09,600
HAVE THOSE FOLKS WITH A DREAM OF

1727
00:58:09,600 --> 00:58:11,720
SOME CLINICAL PROGRAM THAT THEY

1728
00:58:11,720 --> 00:58:14,120
WANT TO START OF SOME KIND OF A

1729
00:58:14,120 --> 00:58:15,520
CLINICAL PROTOCOL THEY WANT TO

1730
00:58:15,520 --> 00:58:17,240
WRITE AND SO I HOPE THEY WILL

1731
00:58:17,240 --> 00:58:19,240
SEE THIS AS A TRULY UNIQUE

1732
00:58:19,240 --> 00:58:20,080
OPPORTUNITY TO LIVE OUT THAT

1733
00:58:20,080 --> 00:58:21,160
KIND OF A DREAM.

1734
00:58:21,160 --> 00:58:22,520
MAYBE YOUR QUESTION IS ALSO

1735
00:58:22,520 --> 00:58:24,240
ASKING ARE WE MAKING SURE THOUGH

1736
00:58:24,240 --> 00:58:28,400
THAT WE'RE USING THE RESOURCES

1737
00:58:28,400 --> 00:58:29,240
AS RESPONSIBLY AS POSSIBLE

1738
00:58:29,240 --> 00:58:30,840
BECAUSE THIS IS BOTH AN EXPENSE

1739
00:58:30,840 --> 00:58:33,440
AND ALSO YOU'RE ASKING PATIENTS

1740
00:58:33,440 --> 00:58:35,080
TO TAKE PART IN A PROTOCOL AND

1741
00:58:35,080 --> 00:58:37,080
YOU WANT TO BE SURE IT'S BEEN

1742
00:58:37,080 --> 00:58:39,600
WELL DESIGNED TO HAVE THE

1743
00:58:39,600 --> 00:58:41,080
MAXIMUM LIKELY BENEFIT AND

1744
00:58:41,080 --> 00:58:43,040
REDUCING THE RISKS AS MUCH AS

1745
00:58:43,040 --> 00:58:43,600
POSSIBLE.

1746
00:58:43,600 --> 00:58:44,720
BETWEEN THE IRB SYSTEM AND THE

1747
00:58:44,720 --> 00:58:48,240
FACT THAT INSTITUTES HAVE THEIR

1748
00:58:48,240 --> 00:58:49,680
SCIENTIFIC REVIEW, PROCESS FOR

1749
00:58:49,680 --> 00:58:50,880
CLINICAL PROTOCOLS, WE'RE IN A

1750
00:58:50,880 --> 00:58:52,480
PRETTY GOOD PLACE THERE IS I

1751
00:58:52,480 --> 00:58:53,520
HOPE THAT'S SOMETHING THAT

1752
00:58:53,520 --> 00:58:55,000
PEOPLE UNDERSTAND THAT THIS

1753
00:58:55,000 --> 00:58:56,640
ISN'T JUST SORT OF RANDOM IDEA

1754
00:58:56,640 --> 00:58:59,080
OF SOMEBODY STARTING A PROTOCOL

1755
00:58:59,080 --> 00:59:00,280
WITHOUT SOME OVERSIGHT.

1756
00:59:00,280 --> 00:59:01,040
THE OVERSIGHT'S IMPORTANT.

1757
00:59:01,040 --> 00:59:03,920
WE DON'T WANT IT TO BE TOO RISK

1758
00:59:03,920 --> 00:59:04,760
AVERS, HOWEVER BECAUSE AN AWFUL

1759
00:59:04,760 --> 00:59:06,720
LOT OF THINGS THAT TURN OUT TO

1760
00:59:06,720 --> 00:59:07,880
BE, THE BIG BREAKTHROUGHS, YOU

1761
00:59:07,880 --> 00:59:08,920
DON'T KNOW IF THEY WILL WORK AND

1762
00:59:08,920 --> 00:59:10,560
YOU HAVE TO FIGURE OUT HOW TO

1763
00:59:10,560 --> 00:59:12,200
EXPLAIN THAT TO A PARTICIPANT IN

1764
00:59:12,200 --> 00:59:13,600
A WAY NATHEY KNOW WHAT THEY'RE

1765
00:59:13,600 --> 00:59:15,120
GETTING INTO, AND IF THEY WANT

1766
00:59:15,120 --> 00:59:16,760
TO TAKE THE RISK THEN WE SHOULD

1767
00:59:16,760 --> 00:59:23,000
NOT BE SO PATERNALISTIC AS TO

1768
00:59:23,000 --> 00:59:24,800
DENY THAT.

1769
00:59:24,800 --> 00:59:26,440
>>DRO COLLINS, I'M WITH
THE

1770
00:59:26,440 --> 00:59:27,360
CLINICAL CENTER, AND WONDERING

1771
00:59:27,360 --> 00:59:31,120
IN ALL OF THIS NEW TERRITORY

1772
00:59:31,120 --> 00:59:34,320
WHAT YOU'RE THINKING ABOUT

1773
00:59:34,320 --> 00:59:37,440
BIOETHICS CONCERNS, THE MEANING

1774
00:59:37,440 --> 00:59:40,040
AND PURPOSE QUESTIONS IN THE

1775
00:59:40,040 --> 00:59:42,640
2-SECONDS WE HAVE LEFT?

1776
00:59:42,640 --> 00:59:42,920
[LAUGHTER]

1777
00:59:42,920 --> 00:59:43,600
>>YEAH, BIOETHICS IN
2-SECONDS

1778
00:59:43,600 --> 00:59:45,280
THAT WILL NOT BE EASY BUT I DO

1779
00:59:45,280 --> 00:59:46,800
APPRECIATE YOUR RAISING IT

1780
00:59:46,800 --> 00:59:48,880
BEFORE WE WALK OUT OF THIS ROOM

1781
00:59:48,880 --> 00:59:50,280
BECAUSE THAT HAS TO BE PART OF

1782
00:59:50,280 --> 00:59:51,320
EVERYTHING THAT WE'RE DOING.

1783
00:59:51,320 --> 00:59:53,920
WE ARE WORKING AT THE EDGE OF

1784
00:59:53,920 --> 00:59:54,800
THE POSSIBLE.

1785
00:59:54,800 --> 00:59:55,880
WE ARE WORKING SOMETIMES AT THE

1786
00:59:55,880 --> 00:59:57,320
EDGE OF WHAT IT MEANS TO BE

1787
00:59:57,320 --> 00:59:58,600
HUMAN IF WE'RE TALKING ABOUT

1788
00:59:58,600 --> 01:00:01,320
INTERVENTIONS WITH THE BRAIN FOR

1789
01:00:01,320 --> 01:00:01,960
INSTANCE WHICH INCREASINGLY

1790
01:00:01,960 --> 01:00:03,480
WE'RE GOING TO BE DOING OR

1791
01:00:03,480 --> 01:00:05,240
MODIFYING THE GENOME.

1792
01:00:05,240 --> 01:00:07,920
SO I THINK FAT THACT WE HAVE A

1793
01:00:07,920 --> 01:00:10,880
VERY STRONG BIOETHICS UNIT HERE,

1794
01:00:10,880 --> 01:00:13,920
WHICH A LOT OF PLACES DON'T

1795
01:00:13,920 --> 01:00:15,240
NECESSARILY HAVE WITH DR. GRADY

1796
01:00:15,240 --> 01:00:17,280
IS SOMETHING WE SHOULD BE

1797
01:00:17,280 --> 01:00:18,680
TAPPING INTO WITH THE STRENGTH

1798
01:00:18,680 --> 01:00:20,080
THAT'S THERE AND HAVING OUR EYES

1799
01:00:20,080 --> 01:00:22,320
WIDE OPEN AND TRYING TO

1800
01:00:22,320 --> 01:00:23,720
ANTICIPATE BEFORE IT'S SUDDENLY

1801
01:00:23,720 --> 01:00:26,040
AN OH MY GOSH, WHY DID WE DO

1802
01:00:26,040 --> 01:00:26,280
THAT?

1803
01:00:26,280 --> 01:00:27,520
WHERE ARE WE GOING?

1804
01:00:27,520 --> 01:00:28,840
WHAT SHOULD WE BE THINKING ABOUT

1805
01:00:28,840 --> 01:00:32,520
AS FAR AS THE GUARD RAILS AND

1806
01:00:32,520 --> 01:00:33,440
THE GUIDELINES.

1807
01:00:33,440 --> 01:00:34,360
>>THANK YOU.

1808
01:00:34,360 --> 01:00:35,080
>>THANK YOU.

1809
01:00:35,080 --> 01:00:38,480
>>FRANCIS  THANKS AGAIN
FOR A

1810
01:00:38,480 --> 01:00:39,560
GREAT TALK AND THANKS FOR

1811
01:00:39,560 --> 01:00:41,000
EVERYBODY THAT HAD THE COURAGE

1812
01:00:41,000 --> 01:00:42,600
TO ASK A QUESTION AND THANK YOU

1813
01:00:42,600 --> 01:00:43,960
ALL FOR ATTENDING AND HAVE A

1814
01:00:43,960 --> 01:00:45,640
GREAT DAY.

1815
01:00:45,640 --> 01:00:45,880
THANKS.

1816
01:00:45,880 --> 01:00:56,120
[ APPLAUSE ]