Francis Collins: A Life of Faith and Science

Francis Collins is a renowned American geneticist and bioethicist who has had the privilege of experiencing some of the most significant moments in scientific history. From his work on the Human Genome Project to his current role as Director of the National Institutes of Health, Collins has consistently demonstrated a commitment to both science and faith. In this conversation, we delve into Collins' experiences, perspectives, and reflections on the intersection of science and faith.

That's what I tried to put forward in my book, The Language of God: A Scientist Presents Evidence for Belief, which was published 16 years ago. It's about science and faith, trying to explain how they are compatible, complementary if you will, if you ask the right kind of question. And to my surprise, a lot of people seem to be interested in that. They're tired of hearing the extreme voices like Dawkins at one end and people like Ken Ham and Answers in Genesis on the other end saying if you trust science, you're going to hell. I thought there must be a way that these things could get along, and that's what I tried to put forward. Then I started a foundation called Biologos, which has flourished, with millions of people visiting our website, running amazing meetings, and coming to the realization that this is okay. We can love science and we can love God, and that's not a bad thing.

Life is finite, and what do you hope your legacy is? I don't know. This whole legacy thing feels a little bit hard to embrace. It feels a little self-promoting. I sort of feel like in many ways, I went to my own funeral on October 5th when I announced that I was stepping down, and I got the most amazing responses from people, some of whom I knew really well, some of whom I didn't know at all, who were just telling me stories about something that I had contributed to that made a difference to them. And that was incredibly heartwarming.

I do feel like I've been incredibly fortunate. I've had the chance to play a role in things that were pretty profound. From the genome project to NIH to Covet vaccines, and I'm satisfied with the way my life plan has panned out. We did a bunch of difficult questions in this conversation. Let me ask the most difficult one that perhaps is the reason you turn to God. What is the meaning of life? Have you figured it out yet? Expect me to put that into three sentences. I only have a couple of minutes at least hurry up.

I think science helps me with so you're going to push me into the face zone which is where I'd want to go with that. I think we are called upon in this blink of an eye to try to make the world a better place and to try to love people. To try to do a better job of our more altruistic instincts and less of our selfish instincts. To try to be what God calls us to be, people who are holy, not people who are driven by self-indulgence.

Sometimes I'm better at that than others but I think for me as a Christian is it pretty clear. I mean it's to live out the Sermon on the Mount once I read that I couldn't unread it all those beatitudes, all the blesseds that's what we're supposed to do and the meaning of life is to strive for that standard recognizing you're going to fail over and over again and that God forgives you hopefully.

I'm truly humbled and inspired by both your brilliance and your humility. And that you would spend your extremely valuable time with me today. It was really an honor, thank you so much for talking today. I was glad to, and you asked a really good question. So your reputation as the best podcaster has worn itself out here this afternoon.

Thank you so much for listening to this conversation with Francis Collins. To support this podcast, please check out our sponsors in the description. And now let me leave you with some words from Isaac Newton reflecting on his life and work. I seem to have been only like a boy playing on the seashore and diverting myself and now and then finding a smoother pebble or a prettier shell than ordinary whilst the great ocean of truth lay all undiscovered before me.

"WEBVTTKind: captionsLanguage: enthe following is a conversation with francis collins director of the nih the national institutes of health appointed and reappointed to the role by three presidents obama trump and biden he oversees 27 separate institutes and centers including nyad which makes him anthony fauci's boss at the nih francis helped launch and led a huge number of projects that pushed the frontiers of science health and medicine including one of my favorites the brain initiative that seeks to map the human brain and understand how the function arises from neural circuitry before the nih francis led the human genome project one of the largest and most ambitious efforts in the history of science given all that francis is a humble thoughtful kind man and because of this to me he's one of the best representatives of science in the world he is a man of god and yet also a friend of the late christopher hitchens who called him quote one of the greatest living americans this is a lex friedman podcast to support it please check out our sponsors in the description and now here's my conversation with francis collins science at his best is a source of hope so for me it's been difficult to watch as it has during the pandemic become at times a source of division what i would love to do in this conversation with you is touch some difficult topics and do so with empathy and humility so that we may begin to regain a sense of trust in science and then it may once again become a source of hope i hope that's okay with you i love the goal let's start with some hard questions you called for quote thorough expert driven and objective inquiry into the origins of coven 19 so let me ask is there a reasonable chance that covet 19 leaked from a lab i can't exclude that i think it's fairly unlikely i wish we had more ability to be able to ask questions of the chinese government and learn more about what kind of records might have been in the lab that we've never been able to see but most likely this was a natural origin of a virus probably starting in a bat perhaps traveling through some other intermediate yet to be identified host and finding its way into humans is answering this question within the realm of science do you think will we ever know i think we might know if we find that intermediate host and there has not yet been a thorough enough investigation to say that that's not going to happen and remember it takes a while to do this with sars it was 14 years before we figured out it was the civet cat that was the intermediate host with mers it was a little quicker to discover it was the camel with sarsko v2 there's been some looking but especially now with everything really tense between the us and china if there's looking going on we're not getting told about it do you think it's a scientific question or a political question it's a scientific question but it has political implications so the world is full of scientists that are working together but in the political space in the political political science space there's tensions what is it like to do great science in a time of a pandemic when there's political tensions it's very unfortunate pasteur said science knows no one country he was right about that my whole career in genetics especially is dependent upon international collaboration between scientists as a way to make discoveries get things done scientists by their nature like to be involved in international collaborations the human genome project for heaven's sake 2 400 scientists in six countries working together not worrying who is going to get the credit giving all the data away i was the person who was supposed to keep all that coordinated it was a wonderful experience and that included china that was sort of their first real entry into a big international big science kind of project and they did their part it's very different now continue on the line of difficult questions especially difficult ethical questions in 2014 us put a hold on gain and function research in response to a number of laboratory biosecurity incidents including anthrax smallpox and influenza in december 2017 nih lifted this ban because quote gain of functional research is important in helping us identify understand and develop strategies and effective countermeasures against rapidly evolving pathogens that pose a threat to public health all difficult questions have arguments on both sides can you argue the pros and cons of getting a function research with viruses i can and first let me say this term gain of function is causing such confusion that i need to take a minute and just sort of talk about what the common scientific use of that term is and where it is very different when we're talking about the current oversight of potentially dangerous human pathogens as you know in science we're doing gain of function experiments all the time we support a lot of cancer immunotherapy at nih right here in our clinical center there are trials going on where people's immune cells are taken out of their body treated with a genetic therapy that revs up their ability to discover the cancer that that patient currently has maybe even at stage four and then give them back as those little ninja warriors uh go after the cancer and it sometimes works dramatically that's a gain of function you gave that patient a gain in their immune function that may have saved their life so gotta be careful not to say oh gain of function is bad most of what we do in science that's good involves quite a bit of the hat and we are all living with gains of function every day i have a gain of function because i'm wearing these eyeglasses otherwise i would not be seeing you as clearly i'm happy for that gain of function so that's where a lot of confusion has happened the kind of gain of function which is now subject to very rigorous and very carefully defined oversight is when you are working with an established human pathogen that is known to be potentially causing a pandemic and you are enhancing or potentially enhancing its transmissibility or its virulence we call that epp enhanced potential pandemic pathogen that requires this very stringent oversight worked out over three years by the national science advisory board on biosecurity that needs to be looked at by a panel that goes well beyond nih to decide are the benefits worth the risks in that situation most of the time it's not worth the risk only three times uh in the last three or four years uh have experiments been given permission to go forward they were all an influenza so i will argue that if you're worried about the next pandemic the more you know about the coming enemy the better chance you have to recognize when trouble is starting and so if you can do it safely studying influenza or coronaviruses like sars mers and sarsko v2 would be a good thing to be able to know about but you have to be able to do it safely because we all know lab accidents can happen and i mean look at sars where there have been lab accidents and people have gotten sick as a result we don't want to take that chance unless there's a compelling scientific reason that's why we have this very stringent oversight the experiments being done at the wuhan institute of virology as a sub-award to our grant to eco health in new york did not meet that standard of requiring that kind of stringent oversight i want to be really clear about that because there's been so much thrown around about it was it gain a function well in the standard use of that term that you would use in science in general you might say it was but in the use of that term that applies to this very specific example of a potential pandemic pathogen absolutely not so nothing went on there that should not have happened based upon the oversight there was an instance where the grantee institution failed to notify us about the result of an experiment that they were supposed to tell us where they mixed and matched uh some viral genomes and got a somewhat larger viral load as a result but it was not epp it was not getting into that zone that would have required this higher level of scrutiny it was all bat viruses these were not human pathogens so they didn't cross a threshold within that gray area that makes for an eppp they did not and anybody who's willing to take the time to look at what epp means and what those experiments were would have to agree with what i just said what is the biggest reason it didn't cross that threshold is it because it wasn't jumping to humans is it because it did not have a sufficient increase in virulence and transmissibility what's your sense eppp only applies to agents that are known human pathogens of potent of pandemic potential these were all bat viruses derived in the wild not shown to be infectious to humans just looking at what happened if you took four different bat viruses and you tried moving the spike protein gene from one into one of the others to see whether it would bind better to the ace2 receptor that doesn't get across that threshold and let me also say for those who are trying to connect the dots here which is the most troubling part of this and say well this is how sarsko v2 got started that is absolutely demonstrably false uh these bat viruses that were being studied had only about 80 percent similarity in their genomes to sars cov2 they were like decades away in evolutionary terms and it is really irresponsible for people to claim otherwise speaking of people who claim otherwise rand paul what do you make of the battle of wars between senator rand paul and dr anthony fauci over this particular point i don't want to talk about specific members of congress but i will say it's really unfortunate that tony fauci who is the epitome of a dedicated public servant has now somehow been targeted for political reasons as somebody that certain figures are trying to discredit perhaps to try to distract from their own failings this never should have happened here's a person who's dedicated his whole life uh to trying to prevent illnesses from infectious diseases including hiv in the 1980s and 90s and now probably the most knowledgeable infectious disease physician in the world and also a really good communicator is out there telling the truth about where we are with sarsko v2 to certain political figures who don't want to hear it and who are therefore determined to discredit him and that is disgraceful so with politicians there they often play games with black and white they try to sort of uh use the gray areas of science and then paint their own picture but i have a question about the gray areas of science so like you mentioned gain of function is a term there's very specific scientific meaning but it also has a more general term and it's very possible to argue that the not to argue not the way politicians argue but just as human beings and scientists that there was a gain of function achieved at the wuhan institute of biology but it didn't cross a threshold i mean there's a it's it's uh it but it could have too so here's the thing when you do these kinds of experiments unexpected results may be achieved and that's the gray area of science you're you're taking risks with such experiments and i am very uncomfortable that we can't discuss the uncertainty in the gray area of this oh i'm comfortable discussing the gray area what i'm uncomfortable with is people deciding to define for themselves what that threshold is based on sort of some political argument the threshold was very explicitly laid out everybody agreed to that in the basis of this three years of deliberation so that's what it is if that threshold needs to be reconsidered let's reconsider it but let's not try to take an experiment that's already been done and decide that the threshold isn't what it was because that that really is doing a disservice to the whole process i wish there was a discussion even in response to uh rand paul and i know we're not talking about specific senators but just that particular case i'm saying stuff here i wish there's an opportunity to talk about given the current threshold this is not gain of function but maybe we need to reconsider the threshold and have an action that's an opportunity for discussion about the ethics of gain or function you said that there was three studies that passed that threshold with influenza that's a fascinating human question scientific question about ethics because you're playing like you said there's uh there's pros and cons you're taking risks here to prevent horribly destructive viruses in the future but you also are risking creating such viruses in the future with nuclear weapons and nuclear energy you are nuclear energy promises a lot of positive effects and yet you're taking risks here with uh mutually sure destruction uh nations possessing nuclear weapons oh my you're a lot i hope we're not going there well we're not but a lot of people argue that that's the reason we've nuclear weapons is the reason we've prevented world wars and yet they also have the risk of starting world wars and this is what we have to be honest about with the with the benefits of risks of science that you have to make that calculation of what are the pros and what are the cons i'm totally with you but i want to reassure you lex that this is not an issue that's been ignored yes that this issue about the kind of gain of function that might result in a serious human pathogen has been front and center in many deliberations for a decade or more involved a lot of my time along the way by the way and has been discussed publicly on multiple occasions including two major meetings of the national academy of sciences getting input from everybody and ultimately arriving at our current framework now we actually back in january of 2020 just before covet 19 changed everything had planned and even charged that same national uh science advisory by board on biosecurity to reconvene and look at the current framework and say do we have it right let's look at the experience over those three years and say is the threshold too easy too hard do we need to reconsider it let's look at the experience kovit came along the members of the board said please we're all infectious disease experts we don't have time for this right now but i think the time is right to do this i'm totally supportive of that and that should be just as public a discussion as you can imagine about what are the benefits and the risk and if somebody decided ultimately this came together and said we just shouldn't be doing these experiments under any circumstances if that was the conclusion well that would be the conclusion but it hasn't been so far if we can briefly look out into the next hundred years on this i apologize for the existential questions but it seems obvious to me that as gain of function type of research and development becomes easier and cheaper it will become greater and greater risk so if it doesn't no longer need to be contained within the laboratories of high security it feels like this is one of the greatest threats facing human civilization do you worry that at some point in the future a leaked man-made virus may destroy most of human civilization i do worry about the risks and at the moment where we have the greatest control the greatest oversight is when this is federally funded research but as you're alluding there's no reason to imagine that's the only place that this kind of activity would go on if there was an evil source that wished to create a virus that was highly pathogenic in their garage the technology does get easier and there is no international oversight about this either that you could say has the same stringency as what we have in the united states so yes that is a concern it would take a seriously deranged group or person to undertake this on purpose uh given the likelihood that they too uh would go down we don't imagine there are going to be bioweapons that only kill your enemies and don't kill you sorry we're too much alike for that to work so i don't see it as an imminent risk there's lots of uh scary novels and movies written about it but i do think it's something we have to consider what are all the things that ought to be watched you may not know that if somebody is ordering a particular oligonucleotide from one of the main suppliers and it happens to match smallpox they're going to get caught so there is effort underway to try to track any nefarious actions that might be going on in the united states or international is there an international collaboration of trying to track this stuff there is some i wish it were stronger this is a general issue like in terms of do we have a mechanism particularly when it comes to ethical issues to be able to decide what's allowable and what's not and enforce it i mean look where we are with germline genome editing for humans for instance there's no enforcement mechanism there's just bully pulpits and governments that get to decide for themselves so you talked about evil what about incompetence does that worry you i was born in the soviet union my dad a physicist worked at chernobyl that comes to mind that wasn't evil i was i don't know what word you want to put it maybe incompetence is too harsh maybe it's the inherent incompetence of bureaucracy i don't know but for whatever reason there was an accident does that worry you of course it does we know that sars for instance did manage to leak out of a lab in china two or three times and at least in some instances people died fortunately quickly contained all one can do in that circumstance because you need to study the virus and understand it in order to keep it from causing a broader pandemic but you need to insist upon the kind of biosecurity the bsl 2 3 and 4 framework under which those experiments have to be done and certainly at nih we're extremely rigorous about that but you can't count on every human being to always do exactly what they're supposed to so there's a risk there which is another reason why if we're contemplating supporting research on pathogens that might be the next pandemic you have to factor that in not just whether people are going to do something on that we couldn't have predicted where all of a sudden they created a virus that's much worse without knowing they were going to do that but also just having an accident that's that's in the mix when those uh estimates are done about whether the risk is worth it or not continuing online of difficult questions we're gonna get to fun stuff after a while we will soon i promise you are the director of the nih you are dr anthony fauci's technically his boss yep you have stood behind him you have supported him just like you did already in this conversation it is painful for me to see division and distrust but many people in politics and elsewhere have called for anthony fauci to be fired when there's such calls of distrust in public about a leader like anthony fauci who should garner trust do you think he should be fired absolutely not to do so would be basically to give the opportunity for those who want to make up stories about anybody to destroy them there is nothing in the ways in which tony fauci has been targeted that it's based upon truth how could we then accept those cries for his firing as having legitimacy it's a circular argument they've decided they don't like tony so they make up stuff and they twist comments that he's made about things like gain a function where he's referring to the very specific gain of function that's covered by this policy and they're trying to say he lied to the congress that's simply not true they don't like the fact that tony changes the medical recommendations about what to do with covet 19 over the space of more than a year and they call that flip-flopping and you can't trust the guy because he says one thing last year and one thing this year well the science has changed delta variant has changed everything you don't want him to be saying the same thing he did a year ago that would be wrong now it was the best we could do then people don't understand that or else they don't want to understand that so when you basically whip up a largely political argument against a scientist and hammer at it over and over again to the point where he now has to have 24 7 security to protect him against people who really want to do violence to him for that to be a reason to say that then he should be fired is to hand the evil forces the victory i will not do that yet there's something difficult i'm going to try to express to you so it may be your guitar playing uh it may be something else but there's a humility to you it may be because you're a man of god there's a humility to you that garners trust and when you're in a leadership position representing science especially in catastrophic events like the pandemic it feels like as a leader you have to go far above and beyond your usual duties and i think there's no question that anthony falci has delivered on his duties but it feels like he needs to go above as a science communicator and if there's a large number of people that are that are distrusting him it's also his responsibility to garner their trust to gain their trust as a as a person who's the face of science do you are you torn on this the responsibility of anthology of yourself to represent science not just the communication of advising what should be done but giving people hope giving people trust in science and alleviating division do you think that's also a responsibility of a leader or is that unfair to ask i think the best way you give people trust is to tell them the truth and so they recognize that when you're sharing information it's the best you've got at that point and tony fauci does that at every moment i don't think him expressing more humility would change the fact that they're looking for a target of somebody to blame to basically distract people from the failings of their own political party maybe i'm less targeted not because of a difference in oh the way in which i convey the information i'm less visible if tony were out of the scene and i was placed in that role i'd probably be seeing a ratcheting up of that same targeting i would like to believe that if tony fauci said that when i originally made recommendations not to wear masks that was given on the on our best available data and now we know that is a mistake so admit with humility that there's an error that's not that's not actually correct but that's a that's a statement of humility and i would like to believe despite the attacks he would win a lot of people over with that so a lot of people as you're saying would use that see that here we go here's that dr anthony fauci making mistakes how can we trust him at anything i believe if he was the sp that public display of humility to say that i made an error that would win a lot of people over that's my that's kind of my sense to face the fire of the attacks from politics you have like politicians will attack no matter what but the question is the people would you to win over the people that the biggest concern i've had is that there was this distrust of science that's been brewing and i'm maybe you can correct me but i'm a little bit unwilling to fully blame the politicians because politicians play their games no matter what it just feels like this was an opportunity to inspire people with the power of science the development of the vaccines no matter what you think of those vaccines is one of the greatest accomplishments in the history of science indeed and the fact that that's not inspiring listen i host a podcast whenever i say positive stuff about the vaccine i get to hear a lot of different opinions i bet you do the fact that i do is a big problem to me because it's an incredible incredible accomplishment of science and so i yeah i i i'm sorry but i have to put responsibility on the leaders even if it's not their mistakes that's what the leadership is that's what leadership is you take responsibility for the situation i wonder if there's something that could have been done better to give people hope that science will save us as opposed to science will divide us i think you have more confidence in the ability to get beyond our current divisions uh than i do after seeing just how deep and dark they have become tony fauci has said multiple times the recommendation about not wearing masks was for two reasons a shortage of masks which were needed in hospitals and a lack of realization early in the course of the epidemic that this was a virus that could heavily infect asymptomatic people as that changed he changed now did he make an error no he was making a judgment based on the data available at the time but he certainly made that clear over and over again it has not stopped uh those who would like to demonize him from saying well he just flip-flopped he you can't trust a guy he says one thing today and one thing tomorrow well masks is a tricky one so it is a tricky one early on i'm a co-author and a paper one of one of many but this was a survey paper overlooking the the evidence uh it's a summary of the evidence we have for the effectiveness of masks it seems that it's difficult to do rigorous scientific study on masks it is difficult there's a lot of philosophical and ethical questions i want to ask you but within this it's back to your words and anthony fauci's words when you're dealing with so much uncertainty and so much potential uncertainty about how catastrophic this virus is in the early days and knowing that each word you say may create panic how do you communicate science with the world it's a philosophical it's an ethical it's a practical question there was a discussion about masks a century ago and that too led to panic so i mean i'm trying to put myself in the mind in your mind in the mind of anthony fauci in those early days knowing that there's limited supply masks like what do you say do you fully convey the uncertainty of the situation of the of the challenges of the supply chain or do you say that masks don't work that's a complicated calculation how do you make that calculation it is a complicated calculation as a scientist your temptation would be to give a full brain dump of all the details of the information about what's known and what isn't known what experiments need to be done most of the time that's not going to play well in a sound bite on the evening news so you have to kind of distill it down to a recommendation that is the best you can do at that time with the information you've got so you're a man of god and we'll return to that to talk about some some also unanswerable philosophical questions but first let's linger on the vaccine because in the in the religious in the christian community there was some hesitancy with the vaccine still is still is there's a lot of data showing high efficacy and safety of vaccines of covid vaccines but still they are far from perfect as all vaccines are can you empathize with people who are hesitant to take the covet vaccine or to have their children take the covet vaccine i can totally empathize especially when people are barraged by conflicting information coming at them from all kinds of directions i've spent a lot of my time in the last year trying to figure out how to do a better job of listening because i think we have all got the risk of assuming we know the basis for somebody's hesitancy and that often doesn't turn out to be what you thought and the variety of reasons is quite broad i think a big concern is just this sense of uncertainty about whether this was done too fast and that corners were cut and there are good answers to that along with that a sense that maybe this vaccine will have long-term effects that we won't know about for years to come and one can say that hasn't been seen with other vaccines and there's no particular reason to think this one's going to be different than the dozens of others that we have experience with but you can't absolutely say no there's no chance of that so it does come down to listening and then trying in a fashion that doesn't convey a message that you're smarter than the person you're talking to because that isn't going to help to really address what the substance is of the concerns but my heart goes out to so many people who are fearful about this because of all the information that has been dumped on them some of it by politicians a lot of it by the internet some of it by parts of the media that seem to take pleasure in stirring up uh this kind of fear for their own reasons and that is shameful i'm really sympathetic with the people who are confused and fearful i am not sympathetic with people who are distributing information that's demonstrably false and continue to do so they're taking lives i didn't realize how strong that sector of disinformation it would be and it's been in many ways more effective uh than the means of spreading the truth this is going to take us into another place but alex if there's something i'm really worried about in this country and it's not just this country but it's the one i live in is that we have another epidemic besides covet 19 and it's an epidemic of the loss of the anchor of truth that truth as a means of making decisions uh truth is a means of figuring out how to wrestle with a question like should i get this vaccine for myself or my children seems to have lost its primacy and instead it's an opinion of somebody who expressed it very strongly or some facebook post that i read two hours ago and for those to become substitutes for objective truth not just of course for vaccines but for many other issues like was the 2020 election actually fair this worries me deeply it's bad enough to have polarization and divisions but to have no way of resolving those by actually saying okay what's true here makes me very worried about the path we're on and i'm usually an optimist well to give you an optimistic angle on this i actually think that this sense that there's no one place for truth it's just a thing that will inspire leaders and science communicators to speak not from a place of authority but from a place of humility i think it's just challenging people to communicate in a new way to be listeners first i think the problem isn't that there's a lot of misinformation i think that um people the the internet and and the world are distrustful of people who who speak as if they possess the truth with an authoritarian kind of tone yeah which was i think defining for what science was in the 20th century i just think it has to sound different in the 21st with uh it's a in the battle of ideas i think humility and love wins and that's how science wins not through having quote unquote truth because now everybody can just say i have the truth um i think you have to speak like i said from humility not authority and so it just challenges our leaders to uh go back and learn to be part of my french less assholes and uh more kind and like you said to listen to listen to the experiences of people that are good people not not the ones who are trying to manipulate the system and play a game and so on but real you know real people who are just afraid of uncertainty of hurting those they loved and so on so i think it's just an opportunity for leaders to go back and take a class on effective communication i'm with you on the shifting uh more from where we are to humility and love that's got to be the right answer that's very biblical by the way we'll get there i i have to bring up uh joe rogan i don't know if you know who he is i do he's a podcaster comedian fighting commentator and my now friend and iver mekton uh believer too yes that is the question i have to ask you about uh he has gotten some flack in the mainstream media for not getting vaccinated and when he got coveted recently taking ivermectin as part of a cocktail of treatments the nih actually has a nice page on ivermectin saying quote there's insufficient evidence to recommend either for or against the use of ivermectin for the treatment of covin19 results from adequately powered well-designed and well-conducted clinical trials are needed to provide more specific evidence-based guidance on the role of ivermecton in the treatment of covenant 19. so let me ask why do you think there has been so much attack on joe rogan and anyone else that's talking about ivermectin when there's insufficient evidence for or against well let's unpack that first of all i think the concerns about joe are not limited to his taking ivermectin that much more seriously his being fairly publicly negative about vaccines at a time where people are dying 700 000 people have died from covet 19 estimates by kaiser or at least a hundred thousand of those were unnecessary deaths of unvaccinated people and for joe to promote that further even as this uh pandemic rages through our population is simply irresponsible so yeah the ivermectin is just one other twist obviously ivermectin has been controversial for months and months the reason that it got particular attention is because of the way in which it seemed to have captured the imagination of a lot of people and to the point where they were taking doses that were intended for livestock and some of them got pretty sick as a result from overdosing on this stuff that was not good judgment the drug itself remains uncertain uh there's a recent review that looks at all of the studies of ivormectin and basically concludes that it probably doesn't work we are running a study right now i looked at that data this morning in a trial called active six which is one of the ones that my public-private partnership is running we're up to about 400 patients who've been randomized to ivermectin or placebo and should know perhaps as soon as a month from now in a very carefully controlled trial did it help or did it not so there will be an answer coming back to joe again i don't think the fact that he took divermectin and hoping it might work uh is that big a knock against him it's more the conveying of we don't trust what science says which is vaccines are going to save your life we're going to trust what's on the internet that says ivermectin and hydroxychloroquine really do work even though the scientific community says probably not so let me push back in that a little bit so he doesn't he doesn't say let's not listen to science he doesn't say the vaccine don't get vaccinated he says it's okay to ask questions i'm okay with that how risky is the vaccine for certain populations what are the benefits and risks there's other friends of joe and friends of mine like sam harris who says if you look at the data it's obvious that the benefits outweigh the risks and what joe says is yes but let's still openly talk about risks and he often brings up anecdotal evidence of people who've had uh highly negative effects from vaccines science is not done with anecdotal evidence and so you could infer a lot of stuff from the way he expresses it but he also communicates a lot of interesting questions and that's something maybe you can comment on this you know there's certain groups that are healthy they have uh they're younger they have they exercise a lot they get the all you know nutrition and all those kinds of things he shows skepticism on whether it's so obvious that they should get vaccinated and the same is he makes this he kind of presents the same kind of skepticism for kids for young kids so with empathy and uh you know listening my russian ineloquent description of what joe believes what what is your kind of response to that why should certain categories of healthy and young people still get vaccinated do you think well first just to say it's great for joe to be a skeptic to ask questions we should all be doing that but then the next step is to go and see what the data says and see if they're actually answers to those questions so coming to healthy people i've done a bunch of podcasts besides this one the one i think i remember most was a podcast with a worldwide wrestling superstar very nice he's about six foot six and just absolutely solid muscle and he got coveted and he almost died and recovering from that he said i've gotta let my supporters know because you can imagine worldwide wrestling fans are probably not big embracers of the need for vaccines and he want he just turned himself into a spokesperson for the fact that this virus doesn't care how healthy you are how much you exercise what a great specimen you are it wiped him out and we see that you know the average person in the icu right now with covet 19 is under age 50. i think there's a lot of people still thinking oh it's just those old people in the nursing homes it's not going to be about me they're wrong and they're plenty of instances of people who were totally healthy with no underlying diseases taking good care of themselves not obese exercising who have died from this disease 700 children have died from this disease yes some of them had underlying factors like obesity but a lot of them did not so it's fair to say younger people are less susceptible to serious illness kids even less so than young adults but it ain't zero and if the vaccine is really safe and really effective then you probably want everybody to take advantage of that even though some are dropping their risks more than others everybody's dropping their risks some are you worried about variants so looking out into the future are you what's your vision for all the possible trajectories that this virus takes in human society i'm totally worried about the variance delta was such an impressive arrival on the scene in all the wrong ways i mean it took over the world yeah in the space of just a couple months because of its extremely contagious ability viruses would be beautiful if they weren't terrifying yeah exactly i mean this whole story of viral evolution scientifically is just amazingly elegant anybody who really wanted to understand how evolution works in real time study sars cov2 because it's not just delta it's alpha and it's beta and it's gamma and it's the fact that these sweep through uh the world's population by fairly minor differences in fitness so the real question many people are wrestling is is delta it is it is it such a fit virus that nothing else will be able to displace it i don't know i mean there's now delta ay4 which is a variant of delta that at least in the uk seems to be taking over the delta population as though it's maybe even a little more contagious that might be the first hint that we're seeing something new here it's not a completely different virus it's still delta but it's delta plus you know the big worry lex is what's out there that is so different that the vaccine protection doesn't work and we don't know how different it needs to be for the vaccine to stop working that's the that's the terrifying thing about each of these variants it's like uh it's always a pleasant surprise the vaccine seems to have still have efficacy and hooray for our immune system may i say because the vaccine immunized you against that original wuhan virus now we can see that especially after two doses and even more so after a booster your immune system is so clever that it's also making a diversity of antibodies to cover some other things that might happen to that virus to make it a little different and you're still getting really good coverage even for beta which was south africa b1351 which is the most different it looks pretty good but that doesn't mean it will always be as good as that if something gets really far away from the original virus now the good news is we would know what to do in that situation the mrna vaccines allow you to redesign the vaccine like that and to quickly get it through a few thousand participants in a clinical trial to be sure it's raising antibodies and then bang you could go but i don't want to have to do that there will be people's lives at risk in the meantime and what's the best way to keep that from happening well don't quite try to cut down the number of infections because you don't get variance unless the virus is replicating in a person so how do we uh solve this thing how do we get out of this pandemic what's like if you had a like a wand or something or uh you could really implement policies what's the full cocktail of solutions here oh it's a full cocktail it's not just one thing in our own country here in the u.s it would be getting those 64 million reluctant people to actually go ahead and get vaccinated there's 64 million people who didn't get vaccinated adults yes not even counting the kids wow 64 million wow and that astounding get the kids vaccinated hopefully their parents will see that as a good thing too uh get those of us who are due for boosters boosted because that's going to reduce our likelihood of having breakthrough infections and keep spreading it uh convince people that until we're really done with this and we're not now that social distancing and mask wearing indoors are still critical uh to cut down the number of new infections but of course that's our country this is a worldwide pandemic i worry greatly about the fact that low and middle income countries have for the most part not even gotten started with access to vaccines and we have to figure out a way to speed that up because otherwise that's where the next variant will probably arrive and who knows how bad it will be and it will cross the world quickly as we've seen happen repeatedly in the last 22 months i think i'm really surprised annoyed frustrated that testing rapid at home testing from the very beginning wasn't a big big part of the solution it seems first of all nobody's against it that's one huge plus for testing that it's everybody supports second of all like that's what america is good at is like mass manufacturer stuff like like stepping up engineers stepping up and really deploying it plus without the collection of data it's giving people freedom is giving them information and then freedom to decide what to do with that information it's such a powerful solution i don't understand well now i think the biden administration is i think emphasized like the scaling of testing manufacturers so but i just feel like it's an obvious solution get a test that costs less than a dollar manufacturer costs less than a dollar to buy and just everybody gets tested every single day don't share that data with anyone you just make the decisions and i believe in the intelligence of people to make the right decision to stay at home when the test is positive i am so completely with you on that and nih has been smack in the middle of trying to make that dream come true we're running a trial right now in georgia indiana hawaii uh and where's the other one oh kentucky basically blanketing a community with free i'm testing that's beautiful and look to see what happens as far as stemming the the spread of the epidemic and measuring it by waste water because you can really tell whether you've cut back the amount of infection in the community yeah you i'm so with you we got off to such a bad start with testing and of course all the testing was being done for the first several months in big box laboratories where you had to send the sample off and put it through the mail somehow and get the result back sometimes five days later after you've already infected a dozen people it was just a completely wrong model but it's what we had and everybody was like oh we got to stick with pcr because if you start using those home tests that are based on antigens lateral flow probably there's going to be false positives and false negatives okay sure no test is perfect but having a test that's not acceptable or accessible is the worst setting so we nih with some requests from congress got a billion dollars uh to create this program called rapid acceleration of diagnostics rad x and we turned into a venture capital organization and we invited every small business or academic lab that had a cool idea about how to do home testing to bring it forward and we threw them into what we called our shark tank of business experts engineers technology people people understood uh how to deal with supply chains and manufacturing and right now today uh there are about two million tests being done based on what came out of that program including most of the home tests that you can now buy on the pharmacy shelves we did that and i wish we had done it faster but it was an amazingly speedy effort and you're right companies are really good once they've gotten fda emergency use authorization and we helped a lot of them get that they can scale up their manufacturing i think in december we should have about 410 million tests for that month ready to go and if we can get one or two more platforms approved and by the way we are now helping fda by being their validation lab if we can get a couple more of these approved we could be in the half a billion tests a month which is really getting where we need to be wow yeah that's a dream that's a dream for me it seems like an obvious solution engineering solution everybody's behind it it leads to hope versus division i love it okay a happy story a happy story i was waiting for one yeah all right well one last dive into the not happy but you won't even have to comment on it uh well comment on the broader philosophical question so nih again i said uh joe rogan as the first one who pointed me to this nih was recently accused of funding research of a paper that had images of sedated puppies with their heads inserted into small enclosures containing disease carrying sand flies so i could just say that this this story is not true or at least the i think it is true that the paper that showed those images cited nih is a funding source but that citation is not correct yeah uh but that brings up a bigger philosophical question what that it could have been correct how difficult is it as a director of nih or just an ancient organization that's funding so many amazing deep research studies to ensure the ethical fortitude of those studies when the ethics of science is there's such a gray area between what is and what isn't ethical well tough issues um certainly animal research is a tough issue i was going to bring up it's a good example of that tough issue is in 2015 you announced that nih would no longer support any biomedical research involved involving chimpanzees so that's like one example of looking in the mirror thinking deeply about what isn't isn't ethical and there was a conclusion that biomedical research on chimps is not ethical that was the conclusion that was based on a lot of deep thinking and a lot of input from people who have considered this issue and a panel of the national academy of sciences that was asked to review the issue i mean the question that i wanted them to look at was are we actually learning anything that's really essential from chimpanzee invasive research at this point or is it time to say that these closest relatives of ours should not be subjected to that any further and ought to be retired to a sanctuary and that was the conclusion that there was really no kind of medical experimentation that needed to be done on chimps in order to proceed so why are we still doing this many of these were chimpanzees that were purchased because we thought they would be good uh hosts for hiv aids and they sort of weren't and they were kept around in these primate laboratories with people coming up with other things to do but they weren't compelling scientifically so i think that was the right decision i took a lot of flack from some of the scientific community said well you're caving in to the animal rights people and now that you've said no more research on chimps what's next certainly when it comes to companion animals um everybody's heart starts to be hurting when you see anything done that seems harmful to a dog or a cat i have a cat i don't have a dog and i i understand that completely that's why we have these oversight groups that decide before you do any of that kind of research is it justified and what kind of provision is going to be made to avoid pain and suffering and those are those have input from the public as well as the scientific community is that completely saying that every step that's happening there is ethical by some standard that would be hard for anybody to agree to no but at least it's a consensus of what people think is acceptable dogs are the only host for some diseases like leishmaniasis which was that paper that we were not responsible for but i know why they were doing the experiment or like lymphatic filariasis which is an experiment that we are supporting in georgia that involves dogs getting infected with a parasite because that's the only model we have to know whether a treatment is going to work or not so i will defend that i am not in the place of those who think all animal research is evil because i think if there's something that's going to be done to save a child from a terrible disease or an adult and it involves animal research that's been carefully reviewed then i think ethically why it doesn't make me comfortable it still seems like it's the right choice i think to say all animal research should be taken off the table is also very unethical because that means you have basically doomed a lot of people for whom that research might have saved their lives to having no more hope and uh to me personally there's far greater concerns ethically in terms of uh factory farming for example the treatment of animals in other contexts oh there's so much that goes on outside of medical research that is much more troubling that said i think all cats have to go that's just my off the record opinion that's why i'm not involved with any ethical decisions i'm just joking internet i think i love cats you're a dog i'm a dog person i'm sorry have you seen the new yorker cartoon where there are two dogs in the bar having a martini and one is saying they're dressed up in their business suits and one says to the other you know it's not enough for the dogs to win the cats have to lose ah that's beautiful uh so uh a few weeks ago you've announced that you're resigning from the nih at the end of the year i'm stepping down i'm still going to be at nih in a different capacity different capacity right and it's over a decade of an incredible career overseeing the nih as its director what are the things you're most proud of of the nih in your time here as this director may be memorable moments ah there's a lot in 12 years science has just progressed in amazing ways over those 12 years uh think about where we are right now something like gene editing being able to make changes in dna even for therapeutic purposes which is now curing sickle cell disease unthinkable when i became director in 2009 the ability to study single cells and ask them what they're doing and get an answer single cell biology just has emerged in this incredibly powerful way uh having the courage to be able to say we could actually understand the human brain seemed like so far out there and we're in the process of doing that with the brain initiative taking all that we've learned about the genome and applying it to cancer to make individual cancer treatment really precision and developing cancer immunotherapy which seemed like sort of a backwater into some of the hottest science around all those things sort of erupting and much more to come i'm sure we're on an exponential curve of medical research advances and that's glorious to watch and of course covet 19 as a beneficiary of decades of basic science understanding what mrna is understanding basics about coronaviruses and spike proteins and how to combine structural biology and immunology and genomics into this package that allows you to make a vaccine in 11 months just i would never have imagined that possible in 2009 so to have been able to kind of be the midwife helping all of those things get birthed that's been just an amazing 12 years and as nih director you have this convening power and this ability to look across the whole landscape of biomedical research and identify areas that are just like ready for something big to happen but isn't going to happen spontaneously without some encouragement without pulling people together from different disciplines who don't know each other and maybe don't know how to quite understand each other's scientific language and create an environment for that to happen that has been just an amazing experience i mean i mentioned the brain initiative is one of those the brain initiative right now i think there's about 600 investigators working on this uh last week the whole issue of nature magazine was about the output of the brain initiative basically now giving us a cell census of what those cells in the brain are doing which has just never been imaginable and interestingly most uh more than half of the investigators in the brain initiative are engineers they're not biologists in a traditional sense i love that maybe partly because my phd is in quantum mechanics so i think it's really a good idea to bring disciplines together and see what happens that's an exciting thing and i will not ever forget having the chance to announce that program in the east room of that white house with president obama who totally got it and totally loved science and working with him in some of those rare moments of sort of one-on-one conversation in the oval office just him and me about science that's a gift what's it like talking to uh barack obama about science he seems to be a sponge i've heard him i'm an artificial intelligence person and i've heard him talk about ai and it was like it made me think is somebody like whispering in his ear or something because he was saying stuff that totally passed the bs test like he really understands stuff he does that means he listened to a bunch of experts on ai he was like explaining the difference between narrow artificial intelligence and strong ai like he was he was saying all this both technical and philosophical stuff and it just made me i don't know it made me hopeful about the depth of understanding that a human being a political office can attain that gave me hope as well and having those experiences oftentimes in a group i mean another example was trying to figure out how do we take what we've learned about the genome and really apply it at scale to figure out how to prevent illness not just treat it but prevent it out of which came this program called all of us this million strong american cohort of participants who make their electronic health records and their genome sequences and everything else available for researchers to look at that came out of a couple of conversations with obama and others in his office and he asked the best questions that was what struck me so much i mean a room full of scientists and we'd be talking about the possible approaches and he would come up with this incredibly insightful penetrating question not that he knew what the answer was going to be but he knew what the right question was i think the core to that is curiosity yeah it's i don't think he's even like he's trying to be a good leader he's legit curious yes legit that he almost like a kid in a candy store gets to talk to the world experts he got he somehow sneaked into this office and gets to get to talk to the world experts and it's that that's the kind of energy that uh i think leads to uh yeah to beautiful leadership in the space of science indeed another thing i've been able to do as director is to try to break down some of the boundaries that seem to be traditional between the public and the private sectors when it comes to areas of science that really could and should be open access anyway why don't we work together and that was obvious early on and after identifying a few possible collaborators who were chief scientists of pharmaceutical companies it looks like we might be able to do something in that space out of that was born something called the accelerating medicines partnership amp and it took a couple of years of convening people who usually didn't talk to each other and there was a lot of suspicion academic scientists saying oh those scientists and pharma they're not that smart they're just trying to make money and the academic scientists getting the wrap from the pharmaceutical scientists all they want to do is publish papers they don't really care about helping anybody and we found out both of those stereotypes were wrong and over the course of that couple of years built a momentum behind three starting projects one on alzheimer's one on diabetes one on rheumatoid arthritis and lupus very different each one of them trying to identify what is an area that we both really need to see advance and we could do better together and it's going to have to be open access otherwise nih is not going to play and guess what industry if you really want to do this you got to have skin in the game we'll cover half the cost you got to cover the other half i love it enforcing open access so resulting in open science millions of dollars gone into this and it has been a wild success after many people were skeptical um a couple years later we had another project called parkinson's uh more recently we added one on schizophrenia uh just this week we added one on gene therapy on bespoke gene therapy for ultra rare diseases which otherwise aren't going to have enough commercial appeal but if we did this together especially with fda at the table and they have been we could make something happen turn this into a sort of standardized approach where everything didn't have to be a one-off i'm really excited about that so what began as three projects is six and it's about to be seven next year with a heart failure project and all of us have gotten to know each other and if it weren't for that background when covid came along it would have been a lot harder to build the partnership called active which has been my passion for the last 20 months accelerating covet 19 therapeutic interventions and vaccines we just had our leadership team meeting this morning it was amazing what's been accomplished that's a pretty much a hundred people who dropped everything just to work on this about half from industry in half from government and academia and that's how we got vaccine master protocols designed so we all agreed about what the endpoints had to be and you wondered why are there 30 000 participants in each of these trials that's because of actives group mapping out what the power needed to be for this to be convincing same with therapeutics we have run at least 20 therapeutic agents uh through trials that active supported in record time that's how we got monoclonal antibodies that we know work um that's been that would not have been possible if i didn't already have a sense of how to work with the private sector that came out of amp amp took two years to get started active took two weeks we just kept the lawyers 100 people over yeah kept the lawyers out of the room and uh um now you're gonna get yourself in trouble so that i i do hope one day the story of this incredible vaccine development of vaccine protocols and trials and all this kind of details the messy beautiful details of the science and engineering and and uh that led to the manufacturing the deployment and the scientific test it's such a nice dance between engineering and the space of manufacturing the vaccines you know you start before the studies are complete you start making the vaccines just in case the if the studies prove to be positive then you can start deploying them just like so many uh parties like you said private and public playing together that's just a beautiful dance that uh is one of the is one of for me the sources of hope in this very uh tricky time where there's a lot of uh things to be cynical about in terms of um the games politicians play and the hardship experience of the economy and all those kinds of things but to me this dance was of vaccine development was done just beautifully and it gives me hope it does me as well and it was in many ways the finest hour that science has had in a long time being called upon when every day counted and making sure that time was not wasted and things were done rigorously but quickly so you're incredibly good as the leader of the nih it seems like you're having a heck of a lot of fun why uh why step down from this role after so much fun well no other nih director has served more than one uh president after being appointed by one you're sort of done and the idea of being carried over for a second presidency with trump and now a third one with biden is unheard of i just think lex that scientific organizations benefit from new vision and 12 years is a really long time to have the same leader and if i wasn't going to stick it out for the entire biden four-year term it's good not to wait too late during that to signal an intent to step down because the president's got to find the right person got to nominate them got to get the senate to confirm them which is a unpredictable process right now and you don't want to try to do that in the second half of somebody's term as president this has got to happen now so i kind of decided back at the end of may that this should be my final year and i'm okay with that i do have some mixed emotions because i love the nih i love the job it's exhausting i'm traditionally for the last 20 months anyway working 100 hours a week it's just that's what it takes to juggle all of this and um that keeps me from having a lot of time for anything else and i wouldn't mind because i don't think i'm done yet i wouldn't mind having some time to really think about what the next chapter should be and i have none of that time right now do i have another calling is there something else i could contribute that's different than this i'd like to find that out i think the right answer is you're just uh stepping down to focus on your music career but that that might not be a good plan for anything very sustainable uh but i i think that is a sign of a great leader as george washington did stepping down at the at the right time ted williams yes he quit when i think he hit a home run on his last at-bat and his average was 400 at the time no one to walk away i mean it's hard but it's beautiful to see in a leader uh you also oversaw the human genome project you mean you mentioned the brain initiative which has you know it's a it's a dream to map the human brain and there's the dream to map the the human code which is the human genome project and you have said that it is humbling for me and awe inspiring to realize that we have caught the first glimpse of our own instruction book previously known only to god how does that if you can just kind of wax poetic for a second how does it make you feel that we were able to map this instruction book look into our own code and be able to uh reverse engineer it it's breathtaking it's so fundamental and yet for all of human history we're ignorant of the details of what that instruction book looked like and then we crossed the bridge into the territory of the known and we had that in front of us still written in the language that we had to learn how to read and we're in the process of doing that and will be for decades to come but we owned it we had it and it has such profound consequences it's it's both a book about our history um it's a book of sort of the parts list of a human being the genes that are in there and how they're regulated and it's also a medical textbook that can teach us things that will provide answers to illnesses we don't understand and alleviate suffering and premature death so it's a pretty amazing thing to contemplate and it has utterly transformed the way we do science and it is in the process of transforming the way we do medicine although much of that still lies ahead you know while we were working on the genome project it was sort of hard to get this sense of a wellness because it was just hard work and you were getting you know another megabase okay this is good but when did you actually step back and say we did it it's the profoundness of that i mean there were two points i guess one was the announcement on that june 26 2000 where the whole world heard well we don't quite have it but we got a pretty good draft and suddenly people are like realizing oh this is this is a big deal for me it was more when we got the full analysis of it published it in february 2001 in that issue of nature paper that eric lander and bob waterston and i were the main authors and we toiled over and tried to get as much insight as we could in there about what the meaning of all this was but you also had this sense that we are such beginning readers here we are still in kindergarten trying to make sense out of this three billion letter book and we're going to be at this for generations to come you are a man of faith christian and you are a man of science what is the role of religion and of science and society and in the individual human mind and heart like yours well i was not a person of faith when i was growing up i became a believer in my 20s influenced as a medical student by a recognition that i hadn't really thought through the issues of what's the meaning of life why are we all here what happens when you die is there a god science is not so helpful in answering those questions so i had to look around in other places and ultimately came to my own conclusion that atheism which is where i had been was the least supportable of the choices because it was the assertion of a universal negative which scientists aren't supposed to do and agnosticism came as an attractive option but felt a little bit like a cop-out so i had to keep going trying to figure out why do believers actually believe this stuff and came to realize it was all pretty compelling that there's no proof i can't prove to you or anybody else that god exists but i can say it's pretty darn plausible and ultimately what kind of god is it uh caused me to search through various religions and see well what a what do people think about that and to my surprise encountered the person of jesus christ as unique in every possible way and answering a lot of the questions i couldn't otherwise answer and somewhat kicking and screaming i became a christian even though at the time as a medical student already interested in genetics people predicted my head would then explode because these were incompatible world views they really have not been for me i am so fortunate i think that in a given day wrestling with an issue it can have both the rigorous scientific component and it can have the spiritual component covet 19 is a great example these vaccines are both an amazing scientific achievement and an answer to prayer when i'm wrestling with vaccine hesitancy and trying to figure out what answers to come up with i get so frustrated sometimes and i'm comforted by reassurances that god is aware of that this is i don't have to do this alone so i know there are people like your friend sam harris who feel differently sam wrote a rather famous op-ed in the new york times when i was nominated as the nih director saying this is a terrible mistake you can't no you can't ham you can't have somebody who believes in god running the nih he's just going to completely ruin the place well i have a testimonial christopher hitchens a devout atheist if i could say so oh yeah was a friend of yours and referred to you as quote one of the greatest living americans and stated that you were one of the most devout believers he has ever met he further stated that you were sequencing the genome of the cancer that would ultimately claim his life and that your friendship despite their differing opinions on religion was an example of the greatest armed truth in modern times what did you learn from christopher hitchens about life or perhaps what is the fond memory you have of this man with whom you've disagreed but who is also your friend yeah i loved hitch i'm sorry he's gone iron sharpens iron and there's nothing better uh for trying to figure out where you are with your own situation and your own opinions your own world views than encountering somebody who's completely in another space and who's got the gift as hitch did of challenging everything and uh doing so over a glass of scotch or two or three uh yeah we got off to a rough start uh where in an interaction we had at a rather uh highbrow dinner uh he was really deeply insulting of a question i was asking but you know i was like okay that's fine let's let's figure out how we could have a more civil conversation and then i really learned to greatly admire his intellect and to find the jousting with him and it wasn't all about faith although it often was was really inspiring and innovating energizing and then when he got cancer i became sort of his ally trying to help him find pathways through the various options and maybe helped him to stay around on this planet for an extra six months or so and i have the warmest feelings of being in his apartment uh downtown um over a glass of wine talking about whatever uh sometimes it was science he was fascinated by science sometimes it was thomas jefferson sometimes it was faith and i knew it would always be really interesting so he's now gone yeah do you think about your own mortality are you afraid of death i'm not afraid i'm not looking forward to it i don't want to rush it because i feel like i got some things i can still do here but as a person of faith i don't think i'm afraid i'm 71. i know i don't have an infinite amount of time left and i want to use the time i've got in some sort of way that matters i'm not ready to become a full-time golfer but i don't quite know what that is i do feel that i've had a chance to do amazingly powerful things as far as experiences and maybe god has something else in mind i wrote this book 16 years ago the language of god about science and faith trying to explain how from my perspective these are compatible these are in harmony they're complementary if you are careful about which kind of question you're asking and to my surprise a lot of people seem to be interested in that they were tired of hearing the extreme voices like dawkins at one end and people like ken ham and answers in genesis on the other end saying if you trust science you're going to hell and they thought there must be a way that these things could get along and that's what i tried to put forward and then i started a foundation biologos which then i had to step away from to become nih director which has just flourished maybe because i stepped away i don't know but it now has millions of people who come to that website and they run amazing meetings and i think a lot of people have really come to a sense that this is okay i can love science and i can love god and that's not a bad thing so maybe there's something more i can do in that space maybe that book is ready for a second edition i think so but when you look back life is finite what do you hope your legacy is hmm i don't know this whole legacy so it's a little bit hard to embrace it feels a little self-promoting doesn't it i sort of feel like in many ways i went to my own funeral on october 5th when i announced that i was stepping down and i got the most amazing responses from people some of whom i knew really well some of whom i didn't know at all who were just telling me stories about something that i had contributed to that made a difference to them and that was incredibly heartwarming and that's enough you know i don't want to build an edifice i don't have a plan for a monument or a statue god help us i do feel like i've been incredibly fortunate i've had the chance to play a role in things that were pretty profound from the genome project to nih to covet vaccines and i had to be plenty satisfied that i've had enough experiences here to feel pretty good about the way in which my life plan panned out we did a bunch of difficult questions in this conversation let me ask the most difficult one that perhaps is the reason you turn to god what is the meaning of life have you figured it out yet expect me to put that into three sentences we only have a couple of minutes at least hurry up well that's not a question i think science helps me with so you're going to push me into the face zone which is where i'd want to go with that i think welcome what is the meaning why are we here what are we put here to do i do believe we're here for just a blink of an eye and that our existence somehow goes on beyond that in a way that i don't entirely understand despite efforts to do so i think we are called upon in this blink of an eye to try to make the world a better place and to try to love people to try to do a better job of our more altruistic instincts and less of our selfish instincts to try to be what god calls us to be people who are holy not people who are driven by self indulgence and sometimes i'm better at that than others but i think that for me as a christian is it pretty clear i mean it's to live out the sermon on the mount once i read that i couldn't unread it all those beatitudes all the blesseds that's what we're supposed to do and the meaning of life is to strive for that standard recognizing you're going to fail over and over again and that god forgives you hopefully to put a little bit of love out there into the world that's what it's about francis um i'm truly humbled and inspired by both your brilliance and your humility and that you would spend your extremely valuable time with me today it was really an honor thank you so much for talking today i was glad to and you asked a really good question so your reputation as the best podcaster has worn itself out here this afternoon thank you so much thanks for listening to this conversation with francis collins to support this podcast please check out our sponsors in the description and now let me leave you with some words from isaac newton reflecting on his life and work i seem to have been only like a boy playing on the seashore and diverting myself and now and then finding a smoother pebble or a prettier shell than ordinary whilst the great ocean of truth lay all undiscovered before me thank you for listening and hope to see you next time youthe following is a conversation with francis collins director of the nih the national institutes of health appointed and reappointed to the role by three presidents obama trump and biden he oversees 27 separate institutes and centers including nyad which makes him anthony fauci's boss at the nih francis helped launch and led a huge number of projects that pushed the frontiers of science health and medicine including one of my favorites the brain initiative that seeks to map the human brain and understand how the function arises from neural circuitry before the nih francis led the human genome project one of the largest and most ambitious efforts in the history of science given all that francis is a humble thoughtful kind man and because of this to me he's one of the best representatives of science in the world he is a man of god and yet also a friend of the late christopher hitchens who called him quote one of the greatest living americans this is a lex friedman podcast to support it please check out our sponsors in the description and now here's my conversation with francis collins science at his best is a source of hope so for me it's been difficult to watch as it has during the pandemic become at times a source of division what i would love to do in this conversation with you is touch some difficult topics and do so with empathy and humility so that we may begin to regain a sense of trust in science and then it may once again become a source of hope i hope that's okay with you i love the goal let's start with some hard questions you called for quote thorough expert driven and objective inquiry into the origins of coven 19 so let me ask is there a reasonable chance that covet 19 leaked from a lab i can't exclude that i think it's fairly unlikely i wish we had more ability to be able to ask questions of the chinese government and learn more about what kind of records might have been in the lab that we've never been able to see but most likely this was a natural origin of a virus probably starting in a bat perhaps traveling through some other intermediate yet to be identified host and finding its way into humans is answering this question within the realm of science do you think will we ever know i think we might know if we find that intermediate host and there has not yet been a thorough enough investigation to say that that's not going to happen and remember it takes a while to do this with sars it was 14 years before we figured out it was the civet cat that was the intermediate host with mers it was a little quicker to discover it was the camel with sarsko v2 there's been some looking but especially now with everything really tense between the us and china if there's looking going on we're not getting told about it do you think it's a scientific question or a political question it's a scientific question but it has political implications so the world is full of scientists that are working together but in the political space in the political political science space there's tensions what is it like to do great science in a time of a pandemic when there's political tensions it's very unfortunate pasteur said science knows no one country he was right about that my whole career in genetics especially is dependent upon international collaboration between scientists as a way to make discoveries get things done scientists by their nature like to be involved in international collaborations the human genome project for heaven's sake 2 400 scientists in six countries working together not worrying who is going to get the credit giving all the data away i was the person who was supposed to keep all that coordinated it was a wonderful experience and that included china that was sort of their first real entry into a big international big science kind of project and they did their part it's very different now continue on the line of difficult questions especially difficult ethical questions in 2014 us put a hold on gain and function research in response to a number of laboratory biosecurity incidents including anthrax smallpox and influenza in december 2017 nih lifted this ban because quote gain of functional research is important in helping us identify understand and develop strategies and effective countermeasures against rapidly evolving pathogens that pose a threat to public health all difficult questions have arguments on both sides can you argue the pros and cons of getting a function research with viruses i can and first let me say this term gain of function is causing such confusion that i need to take a minute and just sort of talk about what the common scientific use of that term is and where it is very different when we're talking about the current oversight of potentially dangerous human pathogens as you know in science we're doing gain of function experiments all the time we support a lot of cancer immunotherapy at nih right here in our clinical center there are trials going on where people's immune cells are taken out of their body treated with a genetic therapy that revs up their ability to discover the cancer that that patient currently has maybe even at stage four and then give them back as those little ninja warriors uh go after the cancer and it sometimes works dramatically that's a gain of function you gave that patient a gain in their immune function that may have saved their life so gotta be careful not to say oh gain of function is bad most of what we do in science that's good involves quite a bit of the hat and we are all living with gains of function every day i have a gain of function because i'm wearing these eyeglasses otherwise i would not be seeing you as clearly i'm happy for that gain of function so that's where a lot of confusion has happened the kind of gain of function which is now subject to very rigorous and very carefully defined oversight is when you are working with an established human pathogen that is known to be potentially causing a pandemic and you are enhancing or potentially enhancing its transmissibility or its virulence we call that epp enhanced potential pandemic pathogen that requires this very stringent oversight worked out over three years by the national science advisory board on biosecurity that needs to be looked at by a panel that goes well beyond nih to decide are the benefits worth the risks in that situation most of the time it's not worth the risk only three times uh in the last three or four years uh have experiments been given permission to go forward they were all an influenza so i will argue that if you're worried about the next pandemic the more you know about the coming enemy the better chance you have to recognize when trouble is starting and so if you can do it safely studying influenza or coronaviruses like sars mers and sarsko v2 would be a good thing to be able to know about but you have to be able to do it safely because we all know lab accidents can happen and i mean look at sars where there have been lab accidents and people have gotten sick as a result we don't want to take that chance unless there's a compelling scientific reason that's why we have this very stringent oversight the experiments being done at the wuhan institute of virology as a sub-award to our grant to eco health in new york did not meet that standard of requiring that kind of stringent oversight i want to be really clear about that because there's been so much thrown around about it was it gain a function well in the standard use of that term that you would use in science in general you might say it was but in the use of that term that applies to this very specific example of a potential pandemic pathogen absolutely not so nothing went on there that should not have happened based upon the oversight there was an instance where the grantee institution failed to notify us about the result of an experiment that they were supposed to tell us where they mixed and matched uh some viral genomes and got a somewhat larger viral load as a result but it was not epp it was not getting into that zone that would have required this higher level of scrutiny it was all bat viruses these were not human pathogens so they didn't cross a threshold within that gray area that makes for an eppp they did not and anybody who's willing to take the time to look at what epp means and what those experiments were would have to agree with what i just said what is the biggest reason it didn't cross that threshold is it because it wasn't jumping to humans is it because it did not have a sufficient increase in virulence and transmissibility what's your sense eppp only applies to agents that are known human pathogens of potent of pandemic potential these were all bat viruses derived in the wild not shown to be infectious to humans just looking at what happened if you took four different bat viruses and you tried moving the spike protein gene from one into one of the others to see whether it would bind better to the ace2 receptor that doesn't get across that threshold and let me also say for those who are trying to connect the dots here which is the most troubling part of this and say well this is how sarsko v2 got started that is absolutely demonstrably false uh these bat viruses that were being studied had only about 80 percent similarity in their genomes to sars cov2 they were like decades away in evolutionary terms and it is really irresponsible for people to claim otherwise speaking of people who claim otherwise rand paul what do you make of the battle of wars between senator rand paul and dr anthony fauci over this particular point i don't want to talk about specific members of congress but i will say it's really unfortunate that tony fauci who is the epitome of a dedicated public servant has now somehow been targeted for political reasons as somebody that certain figures are trying to discredit perhaps to try to distract from their own failings this never should have happened here's a person who's dedicated his whole life uh to trying to prevent illnesses from infectious diseases including hiv in the 1980s and 90s and now probably the most knowledgeable infectious disease physician in the world and also a really good communicator is out there telling the truth about where we are with sarsko v2 to certain political figures who don't want to hear it and who are therefore determined to discredit him and that is disgraceful so with politicians there they often play games with black and white they try to sort of uh use the gray areas of science and then paint their own picture but i have a question about the gray areas of science so like you mentioned gain of function is a term there's very specific scientific meaning but it also has a more general term and it's very possible to argue that the not to argue not the way politicians argue but just as human beings and scientists that there was a gain of function achieved at the wuhan institute of biology but it didn't cross a threshold i mean there's a it's it's uh it but it could have too so here's the thing when you do these kinds of experiments unexpected results may be achieved and that's the gray area of science you're you're taking risks with such experiments and i am very uncomfortable that we can't discuss the uncertainty in the gray area of this oh i'm comfortable discussing the gray area what i'm uncomfortable with is people deciding to define for themselves what that threshold is based on sort of some political argument the threshold was very explicitly laid out everybody agreed to that in the basis of this three years of deliberation so that's what it is if that threshold needs to be reconsidered let's reconsider it but let's not try to take an experiment that's already been done and decide that the threshold isn't what it was because that that really is doing a disservice to the whole process i wish there was a discussion even in response to uh rand paul and i know we're not talking about specific senators but just that particular case i'm saying stuff here i wish there's an opportunity to talk about given the current threshold this is not gain of function but maybe we need to reconsider the threshold and have an action that's an opportunity for discussion about the ethics of gain or function you said that there was three studies that passed that threshold with influenza that's a fascinating human question scientific question about ethics because you're playing like you said there's uh there's pros and cons you're taking risks here to prevent horribly destructive viruses in the future but you also are risking creating such viruses in the future with nuclear weapons and nuclear energy you are nuclear energy promises a lot of positive effects and yet you're taking risks here with uh mutually sure destruction uh nations possessing nuclear weapons oh my you're a lot i hope we're not going there well we're not but a lot of people argue that that's the reason we've nuclear weapons is the reason we've prevented world wars and yet they also have the risk of starting world wars and this is what we have to be honest about with the with the benefits of risks of science that you have to make that calculation of what are the pros and what are the cons i'm totally with you but i want to reassure you lex that this is not an issue that's been ignored yes that this issue about the kind of gain of function that might result in a serious human pathogen has been front and center in many deliberations for a decade or more involved a lot of my time along the way by the way and has been discussed publicly on multiple occasions including two major meetings of the national academy of sciences getting input from everybody and ultimately arriving at our current framework now we actually back in january of 2020 just before covet 19 changed everything had planned and even charged that same national uh science advisory by board on biosecurity to reconvene and look at the current framework and say do we have it right let's look at the experience over those three years and say is the threshold too easy too hard do we need to reconsider it let's look at the experience kovit came along the members of the board said please we're all infectious disease experts we don't have time for this right now but i think the time is right to do this i'm totally supportive of that and that should be just as public a discussion as you can imagine about what are the benefits and the risk and if somebody decided ultimately this came together and said we just shouldn't be doing these experiments under any circumstances if that was the conclusion well that would be the conclusion but it hasn't been so far if we can briefly look out into the next hundred years on this i apologize for the existential questions but it seems obvious to me that as gain of function type of research and development becomes easier and cheaper it will become greater and greater risk so if it doesn't no longer need to be contained within the laboratories of high security it feels like this is one of the greatest threats facing human civilization do you worry that at some point in the future a leaked man-made virus may destroy most of human civilization i do worry about the risks and at the moment where we have the greatest control the greatest oversight is when this is federally funded research but as you're alluding there's no reason to imagine that's the only place that this kind of activity would go on if there was an evil source that wished to create a virus that was highly pathogenic in their garage the technology does get easier and there is no international oversight about this either that you could say has the same stringency as what we have in the united states so yes that is a concern it would take a seriously deranged group or person to undertake this on purpose uh given the likelihood that they too uh would go down we don't imagine there are going to be bioweapons that only kill your enemies and don't kill you sorry we're too much alike for that to work so i don't see it as an imminent risk there's lots of uh scary novels and movies written about it but i do think it's something we have to consider what are all the things that ought to be watched you may not know that if somebody is ordering a particular oligonucleotide from one of the main suppliers and it happens to match smallpox they're going to get caught so there is effort underway to try to track any nefarious actions that might be going on in the united states or international is there an international collaboration of trying to track this stuff there is some i wish it were stronger this is a general issue like in terms of do we have a mechanism particularly when it comes to ethical issues to be able to decide what's allowable and what's not and enforce it i mean look where we are with germline genome editing for humans for instance there's no enforcement mechanism there's just bully pulpits and governments that get to decide for themselves so you talked about evil what about incompetence does that worry you i was born in the soviet union my dad a physicist worked at chernobyl that comes to mind that wasn't evil i was i don't know what word you want to put it maybe incompetence is too harsh maybe it's the inherent incompetence of bureaucracy i don't know but for whatever reason there was an accident does that worry you of course it does we know that sars for instance did manage to leak out of a lab in china two or three times and at least in some instances people died fortunately quickly contained all one can do in that circumstance because you need to study the virus and understand it in order to keep it from causing a broader pandemic but you need to insist upon the kind of biosecurity the bsl 2 3 and 4 framework under which those experiments have to be done and certainly at nih we're extremely rigorous about that but you can't count on every human being to always do exactly what they're supposed to so there's a risk there which is another reason why if we're contemplating supporting research on pathogens that might be the next pandemic you have to factor that in not just whether people are going to do something on that we couldn't have predicted where all of a sudden they created a virus that's much worse without knowing they were going to do that but also just having an accident that's that's in the mix when those uh estimates are done about whether the risk is worth it or not continuing online of difficult questions we're gonna get to fun stuff after a while we will soon i promise you are the director of the nih you are dr anthony fauci's technically his boss yep you have stood behind him you have supported him just like you did already in this conversation it is painful for me to see division and distrust but many people in politics and elsewhere have called for anthony fauci to be fired when there's such calls of distrust in public about a leader like anthony fauci who should garner trust do you think he should be fired absolutely not to do so would be basically to give the opportunity for those who want to make up stories about anybody to destroy them there is nothing in the ways in which tony fauci has been targeted that it's based upon truth how could we then accept those cries for his firing as having legitimacy it's a circular argument they've decided they don't like tony so they make up stuff and they twist comments that he's made about things like gain a function where he's referring to the very specific gain of function that's covered by this policy and they're trying to say he lied to the congress that's simply not true they don't like the fact that tony changes the medical recommendations about what to do with covet 19 over the space of more than a year and they call that flip-flopping and you can't trust the guy because he says one thing last year and one thing this year well the science has changed delta variant has changed everything you don't want him to be saying the same thing he did a year ago that would be wrong now it was the best we could do then people don't understand that or else they don't want to understand that so when you basically whip up a largely political argument against a scientist and hammer at it over and over again to the point where he now has to have 24 7 security to protect him against people who really want to do violence to him for that to be a reason to say that then he should be fired is to hand the evil forces the victory i will not do that yet there's something difficult i'm going to try to express to you so it may be your guitar playing uh it may be something else but there's a humility to you it may be because you're a man of god there's a humility to you that garners trust and when you're in a leadership position representing science especially in catastrophic events like the pandemic it feels like as a leader you have to go far above and beyond your usual duties and i think there's no question that anthony falci has delivered on his duties but it feels like he needs to go above as a science communicator and if there's a large number of people that are that are distrusting him it's also his responsibility to garner their trust to gain their trust as a as a person who's the face of science do you are you torn on this the responsibility of anthology of yourself to represent science not just the communication of advising what should be done but giving people hope giving people trust in science and alleviating division do you think that's also a responsibility of a leader or is that unfair to ask i think the best way you give people trust is to tell them the truth and so they recognize that when you're sharing information it's the best you've got at that point and tony fauci does that at every moment i don't think him expressing more humility would change the fact that they're looking for a target of somebody to blame to basically distract people from the failings of their own political party maybe i'm less targeted not because of a difference in oh the way in which i convey the information i'm less visible if tony were out of the scene and i was placed in that role i'd probably be seeing a ratcheting up of that same targeting i would like to believe that if tony fauci said that when i originally made recommendations not to wear masks that was given on the on our best available data and now we know that is a mistake so admit with humility that there's an error that's not that's not actually correct but that's a that's a statement of humility and i would like to believe despite the attacks he would win a lot of people over with that so a lot of people as you're saying would use that see that here we go here's that dr anthony fauci making mistakes how can we trust him at anything i believe if he was the sp that public display of humility to say that i made an error that would win a lot of people over that's my that's kind of my sense to face the fire of the attacks from politics you have like politicians will attack no matter what but the question is the people would you to win over the people that the biggest concern i've had is that there was this distrust of science that's been brewing and i'm maybe you can correct me but i'm a little bit unwilling to fully blame the politicians because politicians play their games no matter what it just feels like this was an opportunity to inspire people with the power of science the development of the vaccines no matter what you think of those vaccines is one of the greatest accomplishments in the history of science indeed and the fact that that's not inspiring listen i host a podcast whenever i say positive stuff about the vaccine i get to hear a lot of different opinions i bet you do the fact that i do is a big problem to me because it's an incredible incredible accomplishment of science and so i yeah i i i'm sorry but i have to put responsibility on the leaders even if it's not their mistakes that's what the leadership is that's what leadership is you take responsibility for the situation i wonder if there's something that could have been done better to give people hope that science will save us as opposed to science will divide us i think you have more confidence in the ability to get beyond our current divisions uh than i do after seeing just how deep and dark they have become tony fauci has said multiple times the recommendation about not wearing masks was for two reasons a shortage of masks which were needed in hospitals and a lack of realization early in the course of the epidemic that this was a virus that could heavily infect asymptomatic people as that changed he changed now did he make an error no he was making a judgment based on the data available at the time but he certainly made that clear over and over again it has not stopped uh those who would like to demonize him from saying well he just flip-flopped he you can't trust a guy he says one thing today and one thing tomorrow well masks is a tricky one so it is a tricky one early on i'm a co-author and a paper one of one of many but this was a survey paper overlooking the the evidence uh it's a summary of the evidence we have for the effectiveness of masks it seems that it's difficult to do rigorous scientific study on masks it is difficult there's a lot of philosophical and ethical questions i want to ask you but within this it's back to your words and anthony fauci's words when you're dealing with so much uncertainty and so much potential uncertainty about how catastrophic this virus is in the early days and knowing that each word you say may create panic how do you communicate science with the world it's a philosophical it's an ethical it's a practical question there was a discussion about masks a century ago and that too led to panic so i mean i'm trying to put myself in the mind in your mind in the mind of anthony fauci in those early days knowing that there's limited supply masks like what do you say do you fully convey the uncertainty of the situation of the of the challenges of the supply chain or do you say that masks don't work that's a complicated calculation how do you make that calculation it is a complicated calculation as a scientist your temptation would be to give a full brain dump of all the details of the information about what's known and what isn't known what experiments need to be done most of the time that's not going to play well in a sound bite on the evening news so you have to kind of distill it down to a recommendation that is the best you can do at that time with the information you've got so you're a man of god and we'll return to that to talk about some some also unanswerable philosophical questions but first let's linger on the vaccine because in the in the religious in the christian community there was some hesitancy with the vaccine still is still is there's a lot of data showing high efficacy and safety of vaccines of covid vaccines but still they are far from perfect as all vaccines are can you empathize with people who are hesitant to take the covet vaccine or to have their children take the covet vaccine i can totally empathize especially when people are barraged by conflicting information coming at them from all kinds of directions i've spent a lot of my time in the last year trying to figure out how to do a better job of listening because i think we have all got the risk of assuming we know the basis for somebody's hesitancy and that often doesn't turn out to be what you thought and the variety of reasons is quite broad i think a big concern is just this sense of uncertainty about whether this was done too fast and that corners were cut and there are good answers to that along with that a sense that maybe this vaccine will have long-term effects that we won't know about for years to come and one can say that hasn't been seen with other vaccines and there's no particular reason to think this one's going to be different than the dozens of others that we have experience with but you can't absolutely say no there's no chance of that so it does come down to listening and then trying in a fashion that doesn't convey a message that you're smarter than the person you're talking to because that isn't going to help to really address what the substance is of the concerns but my heart goes out to so many people who are fearful about this because of all the information that has been dumped on them some of it by politicians a lot of it by the internet some of it by parts of the media that seem to take pleasure in stirring up uh this kind of fear for their own reasons and that is shameful i'm really sympathetic with the people who are confused and fearful i am not sympathetic with people who are distributing information that's demonstrably false and continue to do so they're taking lives i didn't realize how strong that sector of disinformation it would be and it's been in many ways more effective uh than the means of spreading the truth this is going to take us into another place but alex if there's something i'm really worried about in this country and it's not just this country but it's the one i live in is that we have another epidemic besides covet 19 and it's an epidemic of the loss of the anchor of truth that truth as a means of making decisions uh truth is a means of figuring out how to wrestle with a question like should i get this vaccine for myself or my children seems to have lost its primacy and instead it's an opinion of somebody who expressed it very strongly or some facebook post that i read two hours ago and for those to become substitutes for objective truth not just of course for vaccines but for many other issues like was the 2020 election actually fair this worries me deeply it's bad enough to have polarization and divisions but to have no way of resolving those by actually saying okay what's true here makes me very worried about the path we're on and i'm usually an optimist well to give you an optimistic angle on this i actually think that this sense that there's no one place for truth it's just a thing that will inspire leaders and science communicators to speak not from a place of authority but from a place of humility i think it's just challenging people to communicate in a new way to be listeners first i think the problem isn't that there's a lot of misinformation i think that um people the the internet and and the world are distrustful of people who who speak as if they possess the truth with an authoritarian kind of tone yeah which was i think defining for what science was in the 20th century i just think it has to sound different in the 21st with uh it's a in the battle of ideas i think humility and love wins and that's how science wins not through having quote unquote truth because now everybody can just say i have the truth um i think you have to speak like i said from humility not authority and so it just challenges our leaders to uh go back and learn to be part of my french less assholes and uh more kind and like you said to listen to listen to the experiences of people that are good people not not the ones who are trying to manipulate the system and play a game and so on but real you know real people who are just afraid of uncertainty of hurting those they loved and so on so i think it's just an opportunity for leaders to go back and take a class on effective communication i'm with you on the shifting uh more from where we are to humility and love that's got to be the right answer that's very biblical by the way we'll get there i i have to bring up uh joe rogan i don't know if you know who he is i do he's a podcaster comedian fighting commentator and my now friend and iver mekton uh believer too yes that is the question i have to ask you about uh he has gotten some flack in the mainstream media for not getting vaccinated and when he got coveted recently taking ivermectin as part of a cocktail of treatments the nih actually has a nice page on ivermectin saying quote there's insufficient evidence to recommend either for or against the use of ivermectin for the treatment of covin19 results from adequately powered well-designed and well-conducted clinical trials are needed to provide more specific evidence-based guidance on the role of ivermecton in the treatment of covenant 19. so let me ask why do you think there has been so much attack on joe rogan and anyone else that's talking about ivermectin when there's insufficient evidence for or against well let's unpack that first of all i think the concerns about joe are not limited to his taking ivermectin that much more seriously his being fairly publicly negative about vaccines at a time where people are dying 700 000 people have died from covet 19 estimates by kaiser or at least a hundred thousand of those were unnecessary deaths of unvaccinated people and for joe to promote that further even as this uh pandemic rages through our population is simply irresponsible so yeah the ivermectin is just one other twist obviously ivermectin has been controversial for months and months the reason that it got particular attention is because of the way in which it seemed to have captured the imagination of a lot of people and to the point where they were taking doses that were intended for livestock and some of them got pretty sick as a result from overdosing on this stuff that was not good judgment the drug itself remains uncertain uh there's a recent review that looks at all of the studies of ivormectin and basically concludes that it probably doesn't work we are running a study right now i looked at that data this morning in a trial called active six which is one of the ones that my public-private partnership is running we're up to about 400 patients who've been randomized to ivermectin or placebo and should know perhaps as soon as a month from now in a very carefully controlled trial did it help or did it not so there will be an answer coming back to joe again i don't think the fact that he took divermectin and hoping it might work uh is that big a knock against him it's more the conveying of we don't trust what science says which is vaccines are going to save your life we're going to trust what's on the internet that says ivermectin and hydroxychloroquine really do work even though the scientific community says probably not so let me push back in that a little bit so he doesn't he doesn't say let's not listen to science he doesn't say the vaccine don't get vaccinated he says it's okay to ask questions i'm okay with that how risky is the vaccine for certain populations what are the benefits and risks there's other friends of joe and friends of mine like sam harris who says if you look at the data it's obvious that the benefits outweigh the risks and what joe says is yes but let's still openly talk about risks and he often brings up anecdotal evidence of people who've had uh highly negative effects from vaccines science is not done with anecdotal evidence and so you could infer a lot of stuff from the way he expresses it but he also communicates a lot of interesting questions and that's something maybe you can comment on this you know there's certain groups that are healthy they have uh they're younger they have they exercise a lot they get the all you know nutrition and all those kinds of things he shows skepticism on whether it's so obvious that they should get vaccinated and the same is he makes this he kind of presents the same kind of skepticism for kids for young kids so with empathy and uh you know listening my russian ineloquent description of what joe believes what what is your kind of response to that why should certain categories of healthy and young people still get vaccinated do you think well first just to say it's great for joe to be a skeptic to ask questions we should all be doing that but then the next step is to go and see what the data says and see if they're actually answers to those questions so coming to healthy people i've done a bunch of podcasts besides this one the one i think i remember most was a podcast with a worldwide wrestling superstar very nice he's about six foot six and just absolutely solid muscle and he got coveted and he almost died and recovering from that he said i've gotta let my supporters know because you can imagine worldwide wrestling fans are probably not big embracers of the need for vaccines and he want he just turned himself into a spokesperson for the fact that this virus doesn't care how healthy you are how much you exercise what a great specimen you are it wiped him out and we see that you know the average person in the icu right now with covet 19 is under age 50. i think there's a lot of people still thinking oh it's just those old people in the nursing homes it's not going to be about me they're wrong and they're plenty of instances of people who were totally healthy with no underlying diseases taking good care of themselves not obese exercising who have died from this disease 700 children have died from this disease yes some of them had underlying factors like obesity but a lot of them did not so it's fair to say younger people are less susceptible to serious illness kids even less so than young adults but it ain't zero and if the vaccine is really safe and really effective then you probably want everybody to take advantage of that even though some are dropping their risks more than others everybody's dropping their risks some are you worried about variants so looking out into the future are you what's your vision for all the possible trajectories that this virus takes in human society i'm totally worried about the variance delta was such an impressive arrival on the scene in all the wrong ways i mean it took over the world yeah in the space of just a couple months because of its extremely contagious ability viruses would be beautiful if they weren't terrifying yeah exactly i mean this whole story of viral evolution scientifically is just amazingly elegant anybody who really wanted to understand how evolution works in real time study sars cov2 because it's not just delta it's alpha and it's beta and it's gamma and it's the fact that these sweep through uh the world's population by fairly minor differences in fitness so the real question many people are wrestling is is delta it is it is it such a fit virus that nothing else will be able to displace it i don't know i mean there's now delta ay4 which is a variant of delta that at least in the uk seems to be taking over the delta population as though it's maybe even a little more contagious that might be the first hint that we're seeing something new here it's not a completely different virus it's still delta but it's delta plus you know the big worry lex is what's out there that is so different that the vaccine protection doesn't work and we don't know how different it needs to be for the vaccine to stop working that's the that's the terrifying thing about each of these variants it's like uh it's always a pleasant surprise the vaccine seems to have still have efficacy and hooray for our immune system may i say because the vaccine immunized you against that original wuhan virus now we can see that especially after two doses and even more so after a booster your immune system is so clever that it's also making a diversity of antibodies to cover some other things that might happen to that virus to make it a little different and you're still getting really good coverage even for beta which was south africa b1351 which is the most different it looks pretty good but that doesn't mean it will always be as good as that if something gets really far away from the original virus now the good news is we would know what to do in that situation the mrna vaccines allow you to redesign the vaccine like that and to quickly get it through a few thousand participants in a clinical trial to be sure it's raising antibodies and then bang you could go but i don't want to have to do that there will be people's lives at risk in the meantime and what's the best way to keep that from happening well don't quite try to cut down the number of infections because you don't get variance unless the virus is replicating in a person so how do we uh solve this thing how do we get out of this pandemic what's like if you had a like a wand or something or uh you could really implement policies what's the full cocktail of solutions here oh it's a full cocktail it's not just one thing in our own country here in the u.s it would be getting those 64 million reluctant people to actually go ahead and get vaccinated there's 64 million people who didn't get vaccinated adults yes not even counting the kids wow 64 million wow and that astounding get the kids vaccinated hopefully their parents will see that as a good thing too uh get those of us who are due for boosters boosted because that's going to reduce our likelihood of having breakthrough infections and keep spreading it uh convince people that until we're really done with this and we're not now that social distancing and mask wearing indoors are still critical uh to cut down the number of new infections but of course that's our country this is a worldwide pandemic i worry greatly about the fact that low and middle income countries have for the most part not even gotten started with access to vaccines and we have to figure out a way to speed that up because otherwise that's where the next variant will probably arrive and who knows how bad it will be and it will cross the world quickly as we've seen happen repeatedly in the last 22 months i think i'm really surprised annoyed frustrated that testing rapid at home testing from the very beginning wasn't a big big part of the solution it seems first of all nobody's against it that's one huge plus for testing that it's everybody supports second of all like that's what america is good at is like mass manufacturer stuff like like stepping up engineers stepping up and really deploying it plus without the collection of data it's giving people freedom is giving them information and then freedom to decide what to do with that information it's such a powerful solution i don't understand well now i think the biden administration is i think emphasized like the scaling of testing manufacturers so but i just feel like it's an obvious solution get a test that costs less than a dollar manufacturer costs less than a dollar to buy and just everybody gets tested every single day don't share that data with anyone you just make the decisions and i believe in the intelligence of people to make the right decision to stay at home when the test is positive i am so completely with you on that and nih has been smack in the middle of trying to make that dream come true we're running a trial right now in georgia indiana hawaii uh and where's the other one oh kentucky basically blanketing a community with free i'm testing that's beautiful and look to see what happens as far as stemming the the spread of the epidemic and measuring it by waste water because you can really tell whether you've cut back the amount of infection in the community yeah you i'm so with you we got off to such a bad start with testing and of course all the testing was being done for the first several months in big box laboratories where you had to send the sample off and put it through the mail somehow and get the result back sometimes five days later after you've already infected a dozen people it was just a completely wrong model but it's what we had and everybody was like oh we got to stick with pcr because if you start using those home tests that are based on antigens lateral flow probably there's going to be false positives and false negatives okay sure no test is perfect but having a test that's not acceptable or accessible is the worst setting so we nih with some requests from congress got a billion dollars uh to create this program called rapid acceleration of diagnostics rad x and we turned into a venture capital organization and we invited every small business or academic lab that had a cool idea about how to do home testing to bring it forward and we threw them into what we called our shark tank of business experts engineers technology people people understood uh how to deal with supply chains and manufacturing and right now today uh there are about two million tests being done based on what came out of that program including most of the home tests that you can now buy on the pharmacy shelves we did that and i wish we had done it faster but it was an amazingly speedy effort and you're right companies are really good once they've gotten fda emergency use authorization and we helped a lot of them get that they can scale up their manufacturing i think in december we should have about 410 million tests for that month ready to go and if we can get one or two more platforms approved and by the way we are now helping fda by being their validation lab if we can get a couple more of these approved we could be in the half a billion tests a month which is really getting where we need to be wow yeah that's a dream that's a dream for me it seems like an obvious solution engineering solution everybody's behind it it leads to hope versus division i love it okay a happy story a happy story i was waiting for one yeah all right well one last dive into the not happy but you won't even have to comment on it uh well comment on the broader philosophical question so nih again i said uh joe rogan as the first one who pointed me to this nih was recently accused of funding research of a paper that had images of sedated puppies with their heads inserted into small enclosures containing disease carrying sand flies so i could just say that this this story is not true or at least the i think it is true that the paper that showed those images cited nih is a funding source but that citation is not correct yeah uh but that brings up a bigger philosophical question what that it could have been correct how difficult is it as a director of nih or just an ancient organization that's funding so many amazing deep research studies to ensure the ethical fortitude of those studies when the ethics of science is there's such a gray area between what is and what isn't ethical well tough issues um certainly animal research is a tough issue i was going to bring up it's a good example of that tough issue is in 2015 you announced that nih would no longer support any biomedical research involved involving chimpanzees so that's like one example of looking in the mirror thinking deeply about what isn't isn't ethical and there was a conclusion that biomedical research on chimps is not ethical that was the conclusion that was based on a lot of deep thinking and a lot of input from people who have considered this issue and a panel of the national academy of sciences that was asked to review the issue i mean the question that i wanted them to look at was are we actually learning anything that's really essential from chimpanzee invasive research at this point or is it time to say that these closest relatives of ours should not be subjected to that any further and ought to be retired to a sanctuary and that was the conclusion that there was really no kind of medical experimentation that needed to be done on chimps in order to proceed so why are we still doing this many of these were chimpanzees that were purchased because we thought they would be good uh hosts for hiv aids and they sort of weren't and they were kept around in these primate laboratories with people coming up with other things to do but they weren't compelling scientifically so i think that was the right decision i took a lot of flack from some of the scientific community said well you're caving in to the animal rights people and now that you've said no more research on chimps what's next certainly when it comes to companion animals um everybody's heart starts to be hurting when you see anything done that seems harmful to a dog or a cat i have a cat i don't have a dog and i i understand that completely that's why we have these oversight groups that decide before you do any of that kind of research is it justified and what kind of provision is going to be made to avoid pain and suffering and those are those have input from the public as well as the scientific community is that completely saying that every step that's happening there is ethical by some standard that would be hard for anybody to agree to no but at least it's a consensus of what people think is acceptable dogs are the only host for some diseases like leishmaniasis which was that paper that we were not responsible for but i know why they were doing the experiment or like lymphatic filariasis which is an experiment that we are supporting in georgia that involves dogs getting infected with a parasite because that's the only model we have to know whether a treatment is going to work or not so i will defend that i am not in the place of those who think all animal research is evil because i think if there's something that's going to be done to save a child from a terrible disease or an adult and it involves animal research that's been carefully reviewed then i think ethically why it doesn't make me comfortable it still seems like it's the right choice i think to say all animal research should be taken off the table is also very unethical because that means you have basically doomed a lot of people for whom that research might have saved their lives to having no more hope and uh to me personally there's far greater concerns ethically in terms of uh factory farming for example the treatment of animals in other contexts oh there's so much that goes on outside of medical research that is much more troubling that said i think all cats have to go that's just my off the record opinion that's why i'm not involved with any ethical decisions i'm just joking internet i think i love cats you're a dog i'm a dog person i'm sorry have you seen the new yorker cartoon where there are two dogs in the bar having a martini and one is saying they're dressed up in their business suits and one says to the other you know it's not enough for the dogs to win the cats have to lose ah that's beautiful uh so uh a few weeks ago you've announced that you're resigning from the nih at the end of the year i'm stepping down i'm still going to be at nih in a different capacity different capacity right and it's over a decade of an incredible career overseeing the nih as its director what are the things you're most proud of of the nih in your time here as this director may be memorable moments ah there's a lot in 12 years science has just progressed in amazing ways over those 12 years uh think about where we are right now something like gene editing being able to make changes in dna even for therapeutic purposes which is now curing sickle cell disease unthinkable when i became director in 2009 the ability to study single cells and ask them what they're doing and get an answer single cell biology just has emerged in this incredibly powerful way uh having the courage to be able to say we could actually understand the human brain seemed like so far out there and we're in the process of doing that with the brain initiative taking all that we've learned about the genome and applying it to cancer to make individual cancer treatment really precision and developing cancer immunotherapy which seemed like sort of a backwater into some of the hottest science around all those things sort of erupting and much more to come i'm sure we're on an exponential curve of medical research advances and that's glorious to watch and of course covet 19 as a beneficiary of decades of basic science understanding what mrna is understanding basics about coronaviruses and spike proteins and how to combine structural biology and immunology and genomics into this package that allows you to make a vaccine in 11 months just i would never have imagined that possible in 2009 so to have been able to kind of be the midwife helping all of those things get birthed that's been just an amazing 12 years and as nih director you have this convening power and this ability to look across the whole landscape of biomedical research and identify areas that are just like ready for something big to happen but isn't going to happen spontaneously without some encouragement without pulling people together from different disciplines who don't know each other and maybe don't know how to quite understand each other's scientific language and create an environment for that to happen that has been just an amazing experience i mean i mentioned the brain initiative is one of those the brain initiative right now i think there's about 600 investigators working on this uh last week the whole issue of nature magazine was about the output of the brain initiative basically now giving us a cell census of what those cells in the brain are doing which has just never been imaginable and interestingly most uh more than half of the investigators in the brain initiative are engineers they're not biologists in a traditional sense i love that maybe partly because my phd is in quantum mechanics so i think it's really a good idea to bring disciplines together and see what happens that's an exciting thing and i will not ever forget having the chance to announce that program in the east room of that white house with president obama who totally got it and totally loved science and working with him in some of those rare moments of sort of one-on-one conversation in the oval office just him and me about science that's a gift what's it like talking to uh barack obama about science he seems to be a sponge i've heard him i'm an artificial intelligence person and i've heard him talk about ai and it was like it made me think is somebody like whispering in his ear or something because he was saying stuff that totally passed the bs test like he really understands stuff he does that means he listened to a bunch of experts on ai he was like explaining the difference between narrow artificial intelligence and strong ai like he was he was saying all this both technical and philosophical stuff and it just made me i don't know it made me hopeful about the depth of understanding that a human being a political office can attain that gave me hope as well and having those experiences oftentimes in a group i mean another example was trying to figure out how do we take what we've learned about the genome and really apply it at scale to figure out how to prevent illness not just treat it but prevent it out of which came this program called all of us this million strong american cohort of participants who make their electronic health records and their genome sequences and everything else available for researchers to look at that came out of a couple of conversations with obama and others in his office and he asked the best questions that was what struck me so much i mean a room full of scientists and we'd be talking about the possible approaches and he would come up with this incredibly insightful penetrating question not that he knew what the answer was going to be but he knew what the right question was i think the core to that is curiosity yeah it's i don't think he's even like he's trying to be a good leader he's legit curious yes legit that he almost like a kid in a candy store gets to talk to the world experts he got he somehow sneaked into this office and gets to get to talk to the world experts and it's that that's the kind of energy that uh i think leads to uh yeah to beautiful leadership in the space of science indeed another thing i've been able to do as director is to try to break down some of the boundaries that seem to be traditional between the public and the private sectors when it comes to areas of science that really could and should be open access anyway why don't we work together and that was obvious early on and after identifying a few possible collaborators who were chief scientists of pharmaceutical companies it looks like we might be able to do something in that space out of that was born something called the accelerating medicines partnership amp and it took a couple of years of convening people who usually didn't talk to each other and there was a lot of suspicion academic scientists saying oh those scientists and pharma they're not that smart they're just trying to make money and the academic scientists getting the wrap from the pharmaceutical scientists all they want to do is publish papers they don't really care about helping anybody and we found out both of those stereotypes were wrong and over the course of that couple of years built a momentum behind three starting projects one on alzheimer's one on diabetes one on rheumatoid arthritis and lupus very different each one of them trying to identify what is an area that we both really need to see advance and we could do better together and it's going to have to be open access otherwise nih is not going to play and guess what industry if you really want to do this you got to have skin in the game we'll cover half the cost you got to cover the other half i love it enforcing open access so resulting in open science millions of dollars gone into this and it has been a wild success after many people were skeptical um a couple years later we had another project called parkinson's uh more recently we added one on schizophrenia uh just this week we added one on gene therapy on bespoke gene therapy for ultra rare diseases which otherwise aren't going to have enough commercial appeal but if we did this together especially with fda at the table and they have been we could make something happen turn this into a sort of standardized approach where everything didn't have to be a one-off i'm really excited about that so what began as three projects is six and it's about to be seven next year with a heart failure project and all of us have gotten to know each other and if it weren't for that background when covid came along it would have been a lot harder to build the partnership called active which has been my passion for the last 20 months accelerating covet 19 therapeutic interventions and vaccines we just had our leadership team meeting this morning it was amazing what's been accomplished that's a pretty much a hundred people who dropped everything just to work on this about half from industry in half from government and academia and that's how we got vaccine master protocols designed so we all agreed about what the endpoints had to be and you wondered why are there 30 000 participants in each of these trials that's because of actives group mapping out what the power needed to be for this to be convincing same with therapeutics we have run at least 20 therapeutic agents uh through trials that active supported in record time that's how we got monoclonal antibodies that we know work um that's been that would not have been possible if i didn't already have a sense of how to work with the private sector that came out of amp amp took two years to get started active took two weeks we just kept the lawyers 100 people over yeah kept the lawyers out of the room and uh um now you're gonna get yourself in trouble so that i i do hope one day the story of this incredible vaccine development of vaccine protocols and trials and all this kind of details the messy beautiful details of the science and engineering and and uh that led to the manufacturing the deployment and the scientific test it's such a nice dance between engineering and the space of manufacturing the vaccines you know you start before the studies are complete you start making the vaccines just in case the if the studies prove to be positive then you can start deploying them just like so many uh parties like you said private and public playing together that's just a beautiful dance that uh is one of the is one of for me the sources of hope in this very uh tricky time where there's a lot of uh things to be cynical about in terms of um the games politicians play and the hardship experience of the economy and all those kinds of things but to me this dance was of vaccine development was done just beautifully and it gives me hope it does me as well and it was in many ways the finest hour that science has had in a long time being called upon when every day counted and making sure that time was not wasted and things were done rigorously but quickly so you're incredibly good as the leader of the nih it seems like you're having a heck of a lot of fun why uh why step down from this role after so much fun well no other nih director has served more than one uh president after being appointed by one you're sort of done and the idea of being carried over for a second presidency with trump and now a third one with biden is unheard of i just think lex that scientific organizations benefit from new vision and 12 years is a really long time to have the same leader and if i wasn't going to stick it out for the entire biden four-year term it's good not to wait too late during that to signal an intent to step down because the president's got to find the right person got to nominate them got to get the senate to confirm them which is a unpredictable process right now and you don't want to try to do that in the second half of somebody's term as president this has got to happen now so i kind of decided back at the end of may that this should be my final year and i'm okay with that i do have some mixed emotions because i love the nih i love the job it's exhausting i'm traditionally for the last 20 months anyway working 100 hours a week it's just that's what it takes to juggle all of this and um that keeps me from having a lot of time for anything else and i wouldn't mind because i don't think i'm done yet i wouldn't mind having some time to really think about what the next chapter should be and i have none of that time right now do i have another calling is there something else i could contribute that's different than this i'd like to find that out i think the right answer is you're just uh stepping down to focus on your music career but that that might not be a good plan for anything very sustainable uh but i i think that is a sign of a great leader as george washington did stepping down at the at the right time ted williams yes he quit when i think he hit a home run on his last at-bat and his average was 400 at the time no one to walk away i mean it's hard but it's beautiful to see in a leader uh you also oversaw the human genome project you mean you mentioned the brain initiative which has you know it's a it's a dream to map the human brain and there's the dream to map the the human code which is the human genome project and you have said that it is humbling for me and awe inspiring to realize that we have caught the first glimpse of our own instruction book previously known only to god how does that if you can just kind of wax poetic for a second how does it make you feel that we were able to map this instruction book look into our own code and be able to uh reverse engineer it it's breathtaking it's so fundamental and yet for all of human history we're ignorant of the details of what that instruction book looked like and then we crossed the bridge into the territory of the known and we had that in front of us still written in the language that we had to learn how to read and we're in the process of doing that and will be for decades to come but we owned it we had it and it has such profound consequences it's it's both a book about our history um it's a book of sort of the parts list of a human being the genes that are in there and how they're regulated and it's also a medical textbook that can teach us things that will provide answers to illnesses we don't understand and alleviate suffering and premature death so it's a pretty amazing thing to contemplate and it has utterly transformed the way we do science and it is in the process of transforming the way we do medicine although much of that still lies ahead you know while we were working on the genome project it was sort of hard to get this sense of a wellness because it was just hard work and you were getting you know another megabase okay this is good but when did you actually step back and say we did it it's the profoundness of that i mean there were two points i guess one was the announcement on that june 26 2000 where the whole world heard well we don't quite have it but we got a pretty good draft and suddenly people are like realizing oh this is this is a big deal for me it was more when we got the full analysis of it published it in february 2001 in that issue of nature paper that eric lander and bob waterston and i were the main authors and we toiled over and tried to get as much insight as we could in there about what the meaning of all this was but you also had this sense that we are such beginning readers here we are still in kindergarten trying to make sense out of this three billion letter book and we're going to be at this for generations to come you are a man of faith christian and you are a man of science what is the role of religion and of science and society and in the individual human mind and heart like yours well i was not a person of faith when i was growing up i became a believer in my 20s influenced as a medical student by a recognition that i hadn't really thought through the issues of what's the meaning of life why are we all here what happens when you die is there a god science is not so helpful in answering those questions so i had to look around in other places and ultimately came to my own conclusion that atheism which is where i had been was the least supportable of the choices because it was the assertion of a universal negative which scientists aren't supposed to do and agnosticism came as an attractive option but felt a little bit like a cop-out so i had to keep going trying to figure out why do believers actually believe this stuff and came to realize it was all pretty compelling that there's no proof i can't prove to you or anybody else that god exists but i can say it's pretty darn plausible and ultimately what kind of god is it uh caused me to search through various religions and see well what a what do people think about that and to my surprise encountered the person of jesus christ as unique in every possible way and answering a lot of the questions i couldn't otherwise answer and somewhat kicking and screaming i became a christian even though at the time as a medical student already interested in genetics people predicted my head would then explode because these were incompatible world views they really have not been for me i am so fortunate i think that in a given day wrestling with an issue it can have both the rigorous scientific component and it can have the spiritual component covet 19 is a great example these vaccines are both an amazing scientific achievement and an answer to prayer when i'm wrestling with vaccine hesitancy and trying to figure out what answers to come up with i get so frustrated sometimes and i'm comforted by reassurances that god is aware of that this is i don't have to do this alone so i know there are people like your friend sam harris who feel differently sam wrote a rather famous op-ed in the new york times when i was nominated as the nih director saying this is a terrible mistake you can't no you can't ham you can't have somebody who believes in god running the nih he's just going to completely ruin the place well i have a testimonial christopher hitchens a devout atheist if i could say so oh yeah was a friend of yours and referred to you as quote one of the greatest living americans and stated that you were one of the most devout believers he has ever met he further stated that you were sequencing the genome of the cancer that would ultimately claim his life and that your friendship despite their differing opinions on religion was an example of the greatest armed truth in modern times what did you learn from christopher hitchens about life or perhaps what is the fond memory you have of this man with whom you've disagreed but who is also your friend yeah i loved hitch i'm sorry he's gone iron sharpens iron and there's nothing better uh for trying to figure out where you are with your own situation and your own opinions your own world views than encountering somebody who's completely in another space and who's got the gift as hitch did of challenging everything and uh doing so over a glass of scotch or two or three uh yeah we got off to a rough start uh where in an interaction we had at a rather uh highbrow dinner uh he was really deeply insulting of a question i was asking but you know i was like okay that's fine let's let's figure out how we could have a more civil conversation and then i really learned to greatly admire his intellect and to find the jousting with him and it wasn't all about faith although it often was was really inspiring and innovating energizing and then when he got cancer i became sort of his ally trying to help him find pathways through the various options and maybe helped him to stay around on this planet for an extra six months or so and i have the warmest feelings of being in his apartment uh downtown um over a glass of wine talking about whatever uh sometimes it was science he was fascinated by science sometimes it was thomas jefferson sometimes it was faith and i knew it would always be really interesting so he's now gone yeah do you think about your own mortality are you afraid of death i'm not afraid i'm not looking forward to it i don't want to rush it because i feel like i got some things i can still do here but as a person of faith i don't think i'm afraid i'm 71. i know i don't have an infinite amount of time left and i want to use the time i've got in some sort of way that matters i'm not ready to become a full-time golfer but i don't quite know what that is i do feel that i've had a chance to do amazingly powerful things as far as experiences and maybe god has something else in mind i wrote this book 16 years ago the language of god about science and faith trying to explain how from my perspective these are compatible these are in harmony they're complementary if you are careful about which kind of question you're asking and to my surprise a lot of people seem to be interested in that they were tired of hearing the extreme voices like dawkins at one end and people like ken ham and answers in genesis on the other end saying if you trust science you're going to hell and they thought there must be a way that these things could get along and that's what i tried to put forward and then i started a foundation biologos which then i had to step away from to become nih director which has just flourished maybe because i stepped away i don't know but it now has millions of people who come to that website and they run amazing meetings and i think a lot of people have really come to a sense that this is okay i can love science and i can love god and that's not a bad thing so maybe there's something more i can do in that space maybe that book is ready for a second edition i think so but when you look back life is finite what do you hope your legacy is hmm i don't know this whole legacy so it's a little bit hard to embrace it feels a little self-promoting doesn't it i sort of feel like in many ways i went to my own funeral on october 5th when i announced that i was stepping down and i got the most amazing responses from people some of whom i knew really well some of whom i didn't know at all who were just telling me stories about something that i had contributed to that made a difference to them and that was incredibly heartwarming and that's enough you know i don't want to build an edifice i don't have a plan for a monument or a statue god help us i do feel like i've been incredibly fortunate i've had the chance to play a role in things that were pretty profound from the genome project to nih to covet vaccines and i had to be plenty satisfied that i've had enough experiences here to feel pretty good about the way in which my life plan panned out we did a bunch of difficult questions in this conversation let me ask the most difficult one that perhaps is the reason you turn to god what is the meaning of life have you figured it out yet expect me to put that into three sentences we only have a couple of minutes at least hurry up well that's not a question i think science helps me with so you're going to push me into the face zone which is where i'd want to go with that i think welcome what is the meaning why are we here what are we put here to do i do believe we're here for just a blink of an eye and that our existence somehow goes on beyond that in a way that i don't entirely understand despite efforts to do so i think we are called upon in this blink of an eye to try to make the world a better place and to try to love people to try to do a better job of our more altruistic instincts and less of our selfish instincts to try to be what god calls us to be people who are holy not people who are driven by self indulgence and sometimes i'm better at that than others but i think that for me as a christian is it pretty clear i mean it's to live out the sermon on the mount once i read that i couldn't unread it all those beatitudes all the blesseds that's what we're supposed to do and the meaning of life is to strive for that standard recognizing you're going to fail over and over again and that god forgives you hopefully to put a little bit of love out there into the world that's what it's about francis um i'm truly humbled and inspired by both your brilliance and your humility and that you would spend your extremely valuable time with me today it was really an honor thank you so much for talking today i was glad to and you asked a really good question so your reputation as the best podcaster has worn itself out here this afternoon thank you so much thanks for listening to this conversation with francis collins to support this podcast please check out our sponsors in the description and now let me leave you with some words from isaac newton reflecting on his life and work i seem to have been only like a boy playing on the seashore and diverting myself and now and then finding a smoother pebble or a prettier shell than ordinary whilst the great ocean of truth lay all undiscovered before me thank you for listening and hope to see you next time you\n"