The Decision Tree

My Next Book: The Remedy

May 21st, 2013 Comments off

Just a quick note about my next book, The Remedy, which will be out in early 2014, published by Penguin/Gotham. It’s a tremendously exciting true story that takes place in the last decades of the 19th century. It’s about the invention of modern medicine, the pursuit of scientific glory, and the attempt to cure the world’s most deadly disease, tuberculosis (also known, at the time, as consumption).

The book traces the career of Robert Koch, a provincial German doctor who rose, through sheer determination and scientific diligence, to be the greatest scientist of the day. Koch was a self-made microbiologist, and thanks to his exacting personality, he built a body of evidence that convinced the world of the Germ Theory of Disease: that there is such a thing as germs, and that they are the cause of infectious disease — the very diseases that plagued mankind in the 19th century, tuberculosis worst among them.

The book also follows the unlikely rise of another provincial doctor, this one in England, named Arthur Conan Doyle.

Conan Doyle, of course, is known today as the author of Sherlock Holmes stories, but he was trained as a physician. The book follows Conan Doyle’s early years as he struggled, equally, to build a career as a physician and a reputation as an author. And it investigates how he diligently followed the changes to the medical profession, in particular the Germ Theory. From his small office in southern England, Conan Doyle admired the work of Robert Koch in Berlin, and eventually adapted his science into his stories: most prominently, a new detective story featuring a character named Sherlock Holmes.

What these two historic figures didn’t realize is that they were on an unlikely collision course — they would meet in one of the greatest showdowns in science, as Koch delivered the antidote the world clamored for: a Remedy for tuberculosis.

The book will be out in early 2014. I’m terribly excited about it. It’s not yet available for pre-order, but will be soon. If you want to be notified when it is available, send your email here and I’ll let you know.

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Some News

April 1st, 2013 1 comment
source: techwadi.org

source: techwadi.org

Since I left WIRED in January, everybody’s been asking me: What’s next? Today, finally, I can start answering that question.

I’m thrilled to announce that I’m joining two amazing organizations. As of today, I am 1) starting a post as Entrepreneur-in-Residence at the Robert Wood Johnson Foundation and 2) joining the Atlantic as a Correspondent, blogging on big ideas in technology and healthcare.

First, the Robert Wood Johnson Foundation: It’s a remarkable organization, with an unrivaled reach, authority, and impact. If you listen to NPR, you’ve heard the mandate: To improve the health and healthcare of all Americans. For 40 years the Foundation has ably met that standard, and with a $9 billion endowment (the fourth biggest in the U.S., after Gates, Ford, and Getty) and $400 million in annual giving, RWJF is uniquely situated to influence the future of healthcare. Not content to just fund academic research, the Foundation has also driven big changes in society, policy, and technology. I’m honored and a bit awestruck to join the effort to expand that influence.

Here in Silicon Valley, Entrepreneurs-in-Residence are typically affiliated with venture capital firms, working to evaluate portfolio investments and hatch new companies. At best, they’re interim positions that end up producing something exceptional. My role with the RWJF is modeled on those posts, with a few differences befitting a non-profit foundation rather than a VC firm.

Over the last several years, I’ve had the chance to collaborate with the folks from RWJF’s superb Pioneer program, including Brian Quinn, Paul Tarini, and Steve Downs (most notably as partners at the Living By Numbers/WIRED Health Conference last October). I’ve long admired their knack for spotting innovative ideas and nurturing them into promising projects and real results.

As EiR, I’ll work closely with Pioneer team director Brian and his group. But this post isn’t specific to the Pioneer program; I’m excited to have the chance to work with the Foundation’s leaders and other programs, which are blazing trails in Public Health, Healthcare Quality and Equality, Childhood Obesity, and other areas. My sincere gratitude to James Marks, John Lumpkin, and RWJF CEO Dr. Risa Lavizzo-Mourey for bringing me on.

At the Atlantic, I’ll be joining the outstanding posse at TheAtlantic.com, offering irregular thoughts about technology, healthcare, and whatnot. My hope is to proffer the sort of mind grenades that made the cover of WIRED during my tenure there. My first post is up there now, about the Diabetic’s Paradox, an idea I’ve been kicking around for a while now that puts the vogue for self-tracking and self-quantification in some perspective.

I’m tremendously grateful to Bob Cohn for opening the door to theAtlantic.com — he’s built what may be the web’s best source of reporting, analysis, and synthesis. I’m proud to be able to join, in some small way, the august team at The Atlantic, which I consider the best media property around, print/digital/tablet/events, whatever.

The next few months are going to be busy and fun and full of opportunity. And there’ll be more — much more — to come. Or as we say in journalism, TK.

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Finding the upside of failed clinical trials

December 1st, 2011 Comments off

Pills by Grumpy-Puddin, http://www.flickr.com/photos/grumpy-puddin/5161814652/

Forbes reported that Astra Zeneca sponsored a drug trial where their lipid-lowering drug, Crestor, went head-to-head with Pfizer’s Lipitor, a strange battle from the start since many considered Lipitor the underdog in the battle. But the results showed no difference in outcome, which for this study was how blockages in the arteries of the heart progressed after treatment.
In other words, the trial resulted in a draw, and delivered a huge blow to Crestor, since it will retain its patent, and associated high price tag, until 2016, while Lipitor’s constituant, atorvastatin, will be available as a generic this week at a fraction of the price of the brand-name cholesterol-lowering meds (http://ti.me/tZf3j6).

This story was intriguing in many ways. First, I think it’s great that the researchers published the results of the study, which Astra Zeneca funded, in the New England Journal of Medicine. It would have no doubt been much easier to sweep these results under the carpet, where they’d join the other dark data of failed clinical trials (http://bit.ly/tn7dBr).

Second, I think it’s important to set a precedence that drugs intended to treat the same condition go head-to-head in properly designed clinical trials. As consumers and patients, we deserve to know how each treatment measures up.

So kudos to Astra Zeneca for taking the high road. The results of the trial will cost the company money in terms of decreased sales. But they made infinite strides in forging a transparent relationship with their customers.

**

Photo via Flickr / Grumpy-Puddin

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Miracle berries: the artificial sweetener that never was

October 5th, 2011 1 comment

Synsepalum dulcificum (Schumach.) Daniell By adaduitokla, http://www.flickr.com/photos/adaduitokla/6155413105/

The small, red berries of the _Richadella dulcifica_ plant are not very sweet. In fact, miraculin, the main chemical found in the berry’s flesh tastes like, well, nothing. But after eating these berries, people’s taste buds embark on an hour-long wild ride, so that any sour foods they eat — even lemons — will taste sweeter than candy. Quite trippy.

A new paper published in PNAS describes how this process works: miraculin binds to receptors in the tongue, partially blocking the taste buds that identify sweet foods under normal conditions. But if something acidic, like the juice from a sour lemon, interacts with miraculin, the molecule shape-shifts, and suddenly, the sweet taste receptors are kicked into high gear. Although the same lemons would taste sour to anyone else, miraculin makes them taste sweet.

As interesting as the finding may be, the backstory is even better.

Read more…

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The incredibly shrinking sensor

September 30th, 2011 Comments off

Google+ By Magnet 4 Marketing dot Net, http://www.flickr.com/photos/vanmarcianoart/6076488268/

Even if you only got a whiff of the product demo sessions at the Health 2.0 Conference in San Francisco this week, you noticed: sensors are getting smaller, cheaper, and more closely integrated into tools we already use.

Consider Pulse Sensor, a dime-sized device that uses a beam of light to measure a person’s heartbeat. For $25, customers get a sensor kit that plugs directly into an Arduino microcontroller, the staple device of any DIY hardware hacker. Attach the sensor to an earlobe or fingertip and the light beam measures changes in tissue volume to gauge a person’s pulse. To date, the company has already raised over $18,000 on Kickstarter.

Read more…

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Sharing data on social media

September 26th, 2011 Comments off

facebook like button By Sean MacEntee, http://www.flickr.com/photos/smemon/5684115572/

People use Facebook, Twitter, or other social media sites as channels for self-expression. But whether updating or uploading, people are telling their social stories with only two tools: text and images.

But what if social media wasn’t confined to words and pictures, but instead, allowed users to uploaded graphs or tables? In other words, could data, pure data, become a token in our social currency?

Read more…

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Storm Surge

September 5th, 2011 4 comments

Temple in the rain @ China By Yorick_R, http://www.flickr.com/photos/yorickr/5905162253/

The idea that climate change is linked to the spread of a disease is not new. Some bacteria and viruses, after all, piggyback on an animal or insect, and the infectious advance depends on the host’s reaction to climbing temperatures. Consider dengue, a disease once anchored to tropical climates by its host’s penchant for heat and humidity, which is now pushing further north with its mosquito transits as the upper latitudes get warmer. But according to a study published this past June in PNAS, it’s not only climbing temperatures that are worrisome; in the past, even heavy rains have altered the course of disease, though often in divergent directions.

During the third plague pandemic (China, 1850-1964), researchers found that, for better or worse, the seasonal rains were a strong predictor of how the disease spread. There, storms governed Pestilence’s toll, prodding the disease in the arid north, and quelling it in the humid south.

Rats are the primary host for the bubonic plague, and in general, the more that infected rats move, the more the disease will spread. In the dry north, they figure, the rains quenched the parched landscape, causing the rats, and the disease, to stir. In the southern part of the country, the rains only served to make the humidity worse, perhaps forcing the rats to sit tight.

Keeping tabs on the spread of infectious disease is one thing; understanding the interaction of pathogens, hosts, and behavior is yet another.

Photo via Flickr / Yorick_R

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The value of the meet-up

September 5th, 2011 Comments off

hands wikipedia aussiegall By nojhan, http://www.flickr.com/photos/nojhan/3204073130/

The brilliance of Wikipedia is that anyone, at any time, can contribute to the project, and in doing so, the collective knowledge of the world’s largest encyclopedia keeps improving and expanding. In last week’s issue of The New Yorker, Lauren Collins brought up an interesting point about Wikipedia worth sharing; one that anyone interested in dealing with virtual communities should absorb.

To put it simply: in the burgeoning world of virtual communities, there is still a good reason to bring people together in real life. In the course of a few hours on a Saturday afternoon in June, with a group of its curators and 20+ Wikipedia volunteer contributors, the British Library was able to update over 30 of the online encyclopedia’s topics tied to collections housed within its walls. Something tells me this would have been difficult to do with a scattered online group.

I think this example also shows how an organization can harness and direct crowdsourced work in a way that’s a win for both sides. Here, the British Library staff was able to get the content that mattered to the organization updated in Wikipedia for free. And the volunteers? Rather than feeling like they were being exploited, they were empowered by their own sense of accomplishment, and powerfully rewarded by the recognition they received from the library curators and their peers. (And I guess getting mentioned in The New Yorker doesn’t hurt either.)

*Side note: This wasn’t a central theme of the story, but Collins also points out a site called Wikipedia Vision, where visitors get a real-time snapshot of what’s being edited at Wikipedia, and by whom. Text bubbles briefly superimpose on the site’s world map, showing the location of the editor, and what they’re working on. Even people who monitor traffic on websites with analytics tools like ChartBeat, like I do at PLoS Blogs, will appreciate Wikipedia Vision’s slick interface and open nature.

Photo via Flickr / nojhan

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That little bit of exercise

August 16th, 2011 Comments off

Read the post here.

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Madness and greatness

August 16th, 2011 Comments off

Read the post here.

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