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Xiao Peng "One Life"
88 Plays3 years ago
Xiao graduated in 2005 with honors in chemistry from Caltech and subsequently worked as a research technician at the Broad Institute of Harvard/MIT and has an MD-PhD from the Weill Cornell/Rockefeller/Memorial Sloan-Kettering Tri-Institutional MD-PhD Program in New York City.
At the moment, she is finishing up her 4th clinical year at Johns Hopkins University as a combined paediatrics-medical genetics resident. She is going to stay there for a 5th year as a research fellow and genetics chief resident starting in July this year.
As Xiao has an unparalleled thirst for knowledge (and my guess is that she gets easily bored) she also works with a group at the university of Freiburg in Germany on the genetics and genomics of inborn errors of immunity.
Now, Xiao isn’t anyone for name or title dropping, but all of this information is necessary, I believe, to understand that some of the areas we will be covering today are in the hands of an absolute expert - even though Xiao will most probably strongly disagree with me on that.
As if all of this weren’t enough, Xiao and her boyfriend Nicolas have started a wine distribution company - one of Xiao’s great passions in life: wine and the art of wine production. Following this passion, she met my brother, a winemaker himself, and, ultimately, me. Therefore, we can safely claim that our friendship is a by-product of grapes, matured over time and getting better with the years.
The few hours a week she has for recreation, she usually fills with learning something new: like knitting, learning German (God knows why) or pottery - just to name a few. When being with her I feel positively challenged, occasionally stupid, always serving my greater understanding that life is a journey of discovery and learning, with no goal but to grow in the present moment.
SHOW NOTES
Xiao on Facebook
Joe Rogan
"The Man Without Qualities", Robert Musil, 1930-1942
Alexander von Humboldt
Johann Wolfgang von Goethe
Champagne
Joaquin Cortez
Martin Luther King
Phylloxera
Subsistence Agriculture
Frank Cornelissen, Winemaker on Sicily
Yeast
John Oliver on HBO
DNA Vaccine
RNA Vaccine
Victor McKusick
Johns Hopkins University
Neill de Grasse Tyson and Stephen Colbert, The Late Show, 2018
EnLefko Radio, Greece
Kanenas Red Wine
Heinrich Vollmer Vineyard
Get Jim
Yellow Van Stories is a Mind the Bump</
Recommended
Transcript
Balancing Fast Research Careers
00:00:17
Speaker
there's a particular pressure to have a fast track research career, do research, publish things, get grants, get the next grant, get the even higher level grant, get promoted to an assistant professorship, associate professorship, see patients 10% of the time, do research 90% of the time, become a leader in your field. I never was very interested in that to begin with. And I think what I've learned about myself maybe is that I
00:00:47
Speaker
Sometimes I question whether that's because I am just too chicken to do the hard work. But I think I've also realized that you only have one life and there has to be a balance because only when we are happy in our own lives can we provide the best service to other people.
Introduction to Yellow Van Stories
00:01:14
Speaker
Hello and welcome to a new episode of the Yellow Van Stories, your interview podcast taking you across the globe in a yellow French campervan by the name of Fonzie. I'm your host and driver Bastian. Every week I invite creators from all over the world into the van to explore with them the opportunities hidden within a crisis and more generally what life is like in their part of our globe.
00:01:40
Speaker
We have been waiting just for you and kept you a seat by the window side. Also because technically there are no others. This week we have the longest ride in the yellow van thus far so get your coffee and plunge into the upholstery. Fonzie's in first gear already and we are good to go. So buckle up and get comfortable because today we're going to Baltimore in the United States.
Xiao Peng: Medicine and Wine
00:02:12
Speaker
Here with us in the yellow van today is Xiao Peng, a physician scientist, and that means a specialist in combined pediatrics and medical geneticist at the Johns Hopkins University in Baltimore, and not to forget a wine professional as well. How that goes together and how we combine these things, we're here to talk about and a lot more. Welcome to the yellow van, Xiao.
00:02:37
Speaker
Thanks, Bosti. I've actually been physically inside the yellow van, and it was lovely. You have, I think for like 10 days or something like that, haven't you? Yes. Fonzie and I were up close and personal. Which is a perfectly good reason. It's the only way to be when you're in Fonzie, given the space allocation. I'm actually perfectly proportioned to be in Fonzie.
00:03:02
Speaker
That is absolutely true because I think you're not taller than one meters, 78. I think that's my size and I'm probably 176 because we all know how it works. We like to add a centimeter to our own height.
Building and Traveling in the Yellow Van
00:03:14
Speaker
So I believe that you must be smaller than that because for me, it's like a perfect fit. It's like when I just stretch out too much, my toes scrape the other side of, well, the end of the bed, basically.
00:03:27
Speaker
Interesting. I mean, so first of all, I have to give you lots of props for designing and building the whole thing yourself. Thank you very much. Thank you very much. I had help from my father-in-law at the time. He did a lot of the heavy lifting as well. We did it together, but it was his concept and his idea, so I can't really take credit for that.
00:03:46
Speaker
Oh, that's very cool. Yes, no, absolute big shout out to Christian for that. Yeah, absolutely. He did a lot of amazing stuff with the van. That's great. Absolutely. Yes. Because I'm trying to listen to you doing it with your father and thinking that would be really funny to watch. No, that would not have happened. No. I love your dad, but I just don't really see it.
00:04:16
Speaker
No, my dad can build things, but he is... I think camping is just not really his thing. If camping would be... Yeah, exactly. It would have to be like...
00:04:28
Speaker
there would have to be enough space, things would have to be running, electricity, like not roughing it out in any way. Then he can get on board with it, but usually building that kind of vehicle yourself is a disproportionate amount of work more. So yeah, I think no, that wouldn't have happened. Probably easier to just rent or hijack one of those. I've seen the ones that your parents drove, and those are glamorous, definitely glamorous.
00:04:57
Speaker
Yes. I hope that renting is all my parents did and no hijacking. I'm very positive they didn't, but I might have to ask them just to make sure that there's no search warrant for them. But anyway, yes, you did a great job with funds.
00:05:13
Speaker
Thank you very much. And this is why it's also actually so good to have you today because you are actually one of the former tenants or occupants of Fonzie. Exactly. That's wonderful. And thank you for the positive feedback. Thank you very much. I mean, it was overall just an incredible trip through Greece and I think it was the perfect
00:05:37
Speaker
way to experience it. So yeah, I have very, very fond memories of that time and it was actually the time that we first met.
00:05:45
Speaker
It was, and a moment to remember, absolutely. And I met you, I think, no, you first came and then you left for 10 days with my brother at the time, exactly, which we know each other through. And then you had 10 days and yes, and you really liked
Champagne and Wine Education
00:06:02
Speaker
it very much. And what's not to like about Greece in a little yellow camp event, I mean, in summer. I mean... It's beautiful.
00:06:08
Speaker
It's just beautiful. It's just gorgeous. It's just like, ah, man, I miss it. I'm going there soon. Just saying. So first of all, first of all, what are you drinking, Shao? Please share with us what you're drinking. I would love to share with you what I'm drinking.
00:06:26
Speaker
This is a wine. It's a champagne from a small producer. So I've told all of my pediatric resident friends this, but I'm just going to say it for your audience as well. Champagne is just sparkling wine that comes from a specific region in France. Everything else that is made in the Champagne Method that doesn't come from this region has different names, but I am enjoying this wine. It's called Bistrotage.
00:06:54
Speaker
It is a wine from the 2013 harvest. It was disgorged in March of 2019, so it's had some time after disgorgement to sort of do a little bit more bottle aging. Can you explain to us what disgorgement means? Because I don't think that everybody knows that necessarily. Yes. So when you make wines in the champagne method, it goes through two fermentations.
00:07:22
Speaker
At the end of the second fermentation, all of the yeast is still in your wine. There's a ton of yeast and it's got a beer kind of cap on the bottle at that time. When a wine is prepared for the market, it gets that special mushroom cap that you have to pull out, twist out.
00:07:43
Speaker
But before that, what they actually have to do is they actually have to shoot out the yeast out so that you're left without too much sediment in your champagne. And that's called disgorgement. And they usually do this before.
00:07:57
Speaker
they put the final cap on the wine and bring it to market. But some people, you might find, there's a great producer, Movio, which is not French at all, but they make wines where they keep the yeast in. So you actually have to disgorge it yourself. And I had the pleasure of having to do this during a
00:08:21
Speaker
Christmas dinner with a really good friend of mine a good number of years back where I thought that was brilliant because I had made a great ethanol dry ice bath to chill the wine, the top of the wine in so that we could get like a solid chunk of yeast out and we wouldn't lose any of the actual liquid. But I forgot to actually refrigerate the wine itself.
00:08:49
Speaker
So when I tried to disgorge the bottle, which only had this part of it chilled, we ended up with a lot of yeast on her ceiling, but it was still really hot. It was delicious, but didn't land on the ceiling, the sofa, the floor, and me.
00:09:07
Speaker
So that's what they land on the ceiling, you could still drink, right? What didn't land on the ceiling, you could still drink. I'm not that tall. And and it wasn't that good, to be honest. What we had in the glass or what made it into glass was plenty good. All right. Well, yeah, so it's I really like it. It's labeled as Champagne Francois Martineau, the winemaker. So this is actually the name of the winemaker's mom. It's not his name that's on the bottle.
00:09:34
Speaker
Um, and, uh, it comes from my boyfriend who imports it and it's very good. So I'm very happy that I get to partake of this wine and I didn't have to pay for it because most of the time I pay for the champagne. Yeah. So tell me about your wine. Oh, my wine. Yeah. You know, obviously I'm not as knowledgeable as you. I'm not a wine professional. I'm absolutely wine amateur and I'm not ashamed to admit it. Uh, even though my brother is a winter and he would always shake his head about me, but
00:09:59
Speaker
But I will enter a wine appreciation course soon, just because I do really appreciate wine. I do like wine. And also because my brother is a Wintner. So I want to also show appreciation for what he does more than what I'm doing right now, because I think what he does is amazing. And I will understand even better how amazing it is if I train myself a little more in the art of wine. I'm a little bit sad that you're not drinking one of Kristoff's wines, Basti.
00:10:29
Speaker
I don't have one here, to be honest with you. At least, no, I don't. He had some here the other day. He was here just a couple of days ago, and we tried some. They were wonderful. But they were so good that they are all gone. We finished all of them. See, that's a good sign, but it's also one of the reasons I don't have one here now. So for the moment, I have Heinrich Folmer wine, which is a German Riesling.
00:10:53
Speaker
Riesling, one you would know as well, one of the wines that Germans do very well, amongst other wines, of course. You know, there has been a large development in other wines as well, but Riesling, I think, is probably the most well-known German wine, and I think it is also still one of the wines that the Germans make the best in the world, actually. So this one is, you would obviously disagree with me. No, I was going to say, that's the sound of no one disagreeing with you. You know how much I love German. I know.
00:11:24
Speaker
See, but I also know how much you know about wine, so I'm marking my own words. But so this is not, this is a good wine. It's a very drinkable table wine that I like, that I drink regularly. And it's just, I couldn't find a very special wine because actually the occasion today beckons to have a very special wine today. But when you said that you have had
00:11:46
Speaker
You've been working long shifts and I had to basically talk you into having the champagne with me today, very understandably, because for you, it's afternoon. You've been working very hard in the hospital. Then I thought, okay, then we keep the very special wine for some other occasion. Today, I'm just going for the very good
Exploring Greek Wines and Culture
00:12:03
Speaker
wine. This is nice, very refreshing, nice on the palate, and I'm enjoying it very much having it with you. So cheers. Cheers.
00:12:13
Speaker
Cheers. I think that's absolutely fantastic and I look forward to drinking with you again. Me too. But also Lagavudlan amongst other things of course. Yes, don't get me started. Do you have a favorite Greek wine? I'm curious.
00:12:34
Speaker
Yes, I do actually. There's a red wine that I like very much. It's called Kanenas. I don't know if you know it. It means nobody. It's basically what Odysseus said to the Cyclops when he was hiding under the sheep.
00:12:50
Speaker
So, and the Cyclops asked, you know, is there anybody here? And then he just said, nobody's here. So, Kanenas is coming from that story, which I think is a great name for a wine as well. And I like that wine very, very much. And I like wines from the Nemea wine region very much. So, you like, like, Zina Mavro, Ayuriko. Yes. Yeah.
00:13:12
Speaker
Yes, Arhoretiko, of course. It is wonderful. It's a wonderful wine. It's a great wine. Yes. Do you have a special favorite Greek wine?
00:13:22
Speaker
I have a lot of Greek wines that I like. For me, favorite is hard. It's like people asking you to choose between your kids. And on any given day, if one of them is being super awesome or misbehaving, you might feel differently. But I happen to be really lucky because I'm friends with an incredible Greek wine importer who himself is Greek. I think I mentioned that to you. His name is Dionysus Revanitis.
00:13:49
Speaker
And he has a small group of Greek winemakers who are more on the natural, organic farming, artisanal wine making side. And I happen to love their wines. There's one particular
00:14:08
Speaker
set of brothers, the Totsis brothers, who we went to visit in Fonzie. Their names are Stergios and Pericles. Nice names. Very popular names. It's a lot of greasy. Yeah, definitely. And they're actually in that region, northeastern Greece, not too many hours away from Thessaloniki. And they make excellent red wines from very cool grapes. And I have
00:14:38
Speaker
I really, and very cool white grapes as well. So I really, really like their wines. They have this special old clone of Roditis called Roditis Aleppu, which makes an incredible textural wine. And then they also make wines from some really more rare indigenous varieties like Negosca and Limona.
00:15:03
Speaker
And we get yelled at when, or sorry, Limnyo, because I was going to say we get yelled at by them when we confuse Limnyo with Limnyona, which is a different red wine, red grape. But yeah, and they came to visit us recently, pre-COVID actually, so I was able to have the pleasure of
00:15:22
Speaker
seeing them in DC, which was nice. So you have a really very strong relationship also with Greece and with Greek wine, obviously. Yeah, I love Greek. I love Greek wine. I love the personalities of the different regions and the people and the history. And as you remember from probably Christophe telling you, the entire time we were driving through Greece, I kept telling him all these stories from Greek mythology and he was upset that I was quizzing him on it after.
00:15:49
Speaker
Yes, he told me as well. But one place I haven't been that I really want to go to, which is different, different in both the wine and I think probably just the culture is Crete. And I'm really, really, really hoping to be able to go to Crete sometime because there's also a producer there who I think is absolutely phenomenal.
00:16:13
Speaker
And it's his winery is called domain economy. And he makes wines from grapes that are also native to Greek like Lyotico and Mandalaria and thrapsititi. I'm having trouble sometimes with the Greek words. I don't understand that. It's all so simple and straightforward, Shao. I don't know what you're talking about.
00:16:41
Speaker
No, I totally know what you're talking about, of course. It is sometimes very challenging and nonetheless also very rewarding. It's such a beautiful language. It'll take me a lifetime to master it, if ever, but it's just so wonderful. A friend of mine who is very much into a Greek radio station that he discovered on web radio,
00:17:03
Speaker
who has actually no other close relationship with Greece, but he discovered it by chance on Web Radio, because Web Radio has a lot, you know, a lot less advertising and stuff. So obviously, so he fell in love with this radio channel in Greece called End Left Goal. And it's a great channel. They have very good music. They play very good music throughout the day.
00:17:25
Speaker
big shout out and he loves listening to it and then I just one time I was with him and he just told me you know there are these languages you wake up in the morning you hear them and they make you feel great I call breakfast languages
00:17:43
Speaker
And Greek is one of them. And I think it totally has a point. Greek is definitely one of them. It's so nice to listen to Greek because it's so mellifluous and a totally different
00:17:59
Speaker
timbre from the romance languages. So yeah, and I love how it kind of sounds like it works with the way you're breathing, you know? Yes. And it's a very sensual language in the sense as well that it really, it covers almost all the sounds that
00:18:16
Speaker
other languages have like from the soft delta to you know you have the th the theta from english you have the the r like you know the the r sounds from from spanish and and portuguese so it's such a rich effluent
00:18:33
Speaker
language. I just love it. I mean, obviously in medical terminology, Greece has been a huge influence because so many of the words that we use essentially are derived from Greek roots. Absolutely. You, of all people, all medical people, yes, of course, you are dealing with the Greek language knowingly or unknowingly or consciously or subconsciously every single day on a large scale, of course.
00:18:59
Speaker
Yeah, yeah. So before we get in, we will get back to the wine. I have a bit of some things. I mean, there's so many things that I would like to talk to you about. And considering that you have a very busy schedule throughout the week, I also don't want to want you to sit here for six or seven hours. Also, you are the one person that is always telling me
00:19:21
Speaker
My god, Basti, nobody can sit through a podcast for longer than one hour. So I will try and keep it brief. But you will have to obviously help me
Xiao's Credentials and Friendship with Bastian
00:19:30
Speaker
in doing that. So far, it's not going looking well. I'm just saying. I mean, studies have shown Basti that people's intentions are about 55 minutes at most. Sure, sure. But that's but that's more for other stuff. That's why you edit stuff, right? Like you're you guys are so good at
00:19:46
Speaker
editing so. Who do you mean with you guys? What do you mean with you guys? Gonna let down to like, you know, 30 minutes. Sure. Yes, I'm sure. Sure. Yeah. So let's just make a highlight. 30 minutes is what we'll make it on YouTube at some point when I'm going to start publishing this stuff with video as well. Any day now, by the way. So we'll return to the wine. But before that, just quickly and very briefly, where are you right now?
00:20:15
Speaker
I'm in Baltimore in my apartment. All right. Very nice. Which room? In my living room, which is where I spend most of my time. When you're not working, when you're off. When I'm not in the hospital, yes. All right. What's your favorite thing in that room if you had to pick anything?
00:20:33
Speaker
Oh, I hate favorite questions. You know this. No, I don't. But I'm learning. But now that I've now that it's out there, I just think it's so hard to pick favorites, you know, especially when you can just expand your heart enough to care like you just make more room in your heart to care for more things instead of always having to
00:20:50
Speaker
You know, pick a favorite, but, but we have to say, you know, we all know that you might change your mind tomorrow, but the thing is what the question is, but, but, you know, feather in the wind. Yes. But people, you know, they should know that. And if you guys out there don't know this, of course, shower could change your mind tomorrow. But I think what's nice about a favorite question is that you have to put a focus on something quickly. And that is doing something with your subconscious that can be quite, um,
00:21:20
Speaker
Revealing I believe so I gave you a bit of a breather even now you had time to think so What is it gonna be? So I'm not gonna talk about the over a hundred bottles of wine that are here that I love dearly And I'm not gonna talk about all my plants that I also love dearly I have a very special item that I only have one of so I'm gonna talk about that How about that? So as you know, I love it
00:21:47
Speaker
I'm a little bit art obsessive and I have always historically been too poor to afford any great works of art of my own. But there was a time when I was a foolish board grad student and I accidentally bid on something that I didn't think I would
00:22:07
Speaker
When and so i would have to do it with paying for it but as it turns out i did win that item and i didn't pay for it after which i didn't buy anything for a long time and it i'm very happy that i own it and it's a very.
00:22:26
Speaker
It's a very big piece of my life in that it just kind of travels with me and it kind of represents a lot of my values. And I'm very happy that the person that I live with, Nicholas, also really likes it because it also fits his aesthetic.
00:22:41
Speaker
But it is a lithograph by George Brock. This is actually signed by him. So maybe, you know, it's a little bit more special to people because the first series that was ever published is a series of 300 versions that he himself supervised and he like he actually like signed each of them. So this is one that I have.
00:23:01
Speaker
And it's special to me because, as you know, I really like George Brock. He's one of my artistic heroes in many ways. But it's also, it's a really interesting one because what I always like to say about Brock is that he can make puke colors amazing.
00:23:23
Speaker
There is nothing viscerally pleasing if you think about it, about the very vaguely sandy tan, gray tints in this particular lithograph.
00:23:33
Speaker
It depicts a scene on a beach with a boat and some cliffs. And this is a theme. So he, so just so you know, he lived in Normandy in a house with his wife by the sea coast. That's the village where he ended up dying as well. He's buried in the churchyard there.
00:23:58
Speaker
and he designed the stained glass windows for the church as well. And he recurrently came back to these prints of boats, which I like as an anagram, it's a really fun thing to say, rocks, sparks, because they, right? But they are, they're his scenes of boats on a beach and he has many of them. They're all very interesting, very diverse, very beautiful and very spiritual.
00:24:34
Speaker
the solemnity and the sort of asceticism of this particular print very much. And initially, it wasn't my first choice. But as I spend more time, it's hanging on our wall in the living room. And I usually sit in the chair that's facing it. So I see it every day. And it's one of those things that grows on you. And as you keep looking, it kind of continues to astonish you, I guess. Wow.
00:24:52
Speaker
And I happen to like the...
00:25:00
Speaker
I'm very happy that I accidentally won the auction for this particular print. And it's the only real piece of art I own. Because as you know, I usually dabble and so everything else is my own crap. But I'm very happy to own this. Very nice. Very nice stories. Well, thanks for sharing that. And that also, again, says a lot about you. That's also why I asked the question. So I would go with the normal
00:25:28
Speaker
I'd move on a little bit in the sense that I will now read you an introduction because as usual I took the time to write a little introduction about you so people also know. You also gave me plenty of information.
00:25:48
Speaker
No, but this is actually, it's absolutely wonderful. And I will get to that because, you know, usually I ask people to just throw a couple of bulletin points in my direction so that I don't forget anything that somebody might consider, you know, valuable or interesting about themselves. But you obviously exceeded that mark by far. And I will get to that though. So I would now read this introduction to everybody that's listening in.
00:26:18
Speaker
And as usual, you can, when I'm done, tell me if I've missed something, if I have put some gross misinformation in there, or if there's anything you rectify, you want to rectify. So far, it's always been very uncontroversial, but I do believe today there is a chance that it might be maybe a little more, and you might have to rectify one thing or another, because I'm not so good with medical titles and all of that, right? All good. Okay, fine. So here it goes.
00:26:47
Speaker
Shao Peng has a Bachelor of Science from the California Institute of Technology and is an alumni of the Weill Graduate School of Medical Sciences of Cornell University. At the moment, she's finishing up her fourth clinical year at Johns Hopkins University in Baltimore as a combined pediatrics medical genetics resident. She's going to stay there for a fifth year as a research fellow and genetics chief resident starting in July this year.
00:27:16
Speaker
As Schau has an unparalleled thirst for knowledge, and my guess is that she also gets easily bored, she also works with a group at the University of Freiburg in Germany on the genetics and genomics of inborn errors of immunity.
00:27:31
Speaker
Now, Shao isn't necessarily anyone for name or title dropping, but all of this information is necessary, I believe, to understand that some of the areas we'll be covering today are in the hands of an absolute expert, even though Shao will most probably strongly disagree with me on that, maybe in some cases.
Science, Religion, and Curiosity
00:27:47
Speaker
As if all of this weren't enough, Shao and her boyfriend Nicholas have started a wine distribution company, one of Shao's great passions in life, wine and the art of wine production. Following this passion, she met my brother, a winemaker himself. And at this point, a big shout out to him again as well, because we brushed on it earlier. And I think, Crystal, what you're doing is absolutely amazing. Keep going on that and keep traveling that beautiful, beautiful path of yours. And through him, she met ultimately me.
00:28:16
Speaker
Therefore, we can safely claim that our friendship is a byproduct of grapes, matured over time and getting better with the years, at least we hope so. Shao is one of the most knowledgeable people I know with a photographic memory or so it seems, at least for books and all other sources of information. And the few hours a week she has for recreation, she usually fills with learning something new, like knitting,
00:28:38
Speaker
learning German, God knows why, or pottery, just to name a few. When being with her, I feel positively challenged, occasionally stupid, but always serving my greater understanding that life is a journey of discovery and learning with no goal but to grow in the present moment.
00:28:55
Speaker
In preparation for all my guests, I always ask them to just throw a few bullet points at me, like I just said, if they like, to write the introduction for them. Shao has by far exceeded this goal, of course, and sent me an introduction to herself that I wouldn't want our listeners to miss as it says so much about who you are, who you aspire to be, and most of all, the sheer abundance of life and all of its derivatives in the sphere of culture. I would therefore like to read it word for word if I may, dear Shao. May I? Are you about to read? The introduction you sent me.
00:29:32
Speaker
I think it's absolutely wonderful. Thank you. I think it's absolutely wonderful. That was a good joke, Basti. But yeah, you can read however I have nothing to hide. Okay, no, hold on. Hold on. Here's what I do. I will read the last paragraph of it because I think this is very nice. I think that'll make everyone else less pain. Fine.
00:29:49
Speaker
Oh, you mean the OK Cupid profile I had 10 years ago?
00:29:57
Speaker
Okay, so this is what you write about yourself in your online dating profile, like you said.
00:30:05
Speaker
Opinions dialectic, the benefit of the doubt, the people I love, the ability to forgive, printed reading materials I spend a lot of time thinking about food and wine. On a typical Friday night, I'm doing stuff. That's very revealing. Or in the lab, reading Wikipedia when I should be analyzing data. The most private thing I'm willing to admit growing up, I always wanted to be a monk. I was a bit of a chauvinist. I'm working on it.
00:30:36
Speaker
So I think that's, how about the whole thing with a monk? Is that still a thing? It's in my first grade. So when I was in first grade, they made us write these autobiographies about what we wanted to be when we grew up. And for some reason, I was really into being a monk.
00:31:01
Speaker
Now, when I was a kid, my parents were very poor and couldn't afford the babysitter. So sometimes, a lot of times, I hope they don't get arrested for this. They would just leave me in the Boston Public Library or the Museum of Fine Arts, Boston, and I would hang out there until they could pick me up because they were both working.
00:31:25
Speaker
My dad actually worked three jobs in addition to being in grad school and to enable my mother to finish her PhD. And I was really happy to be left alone in such great places.
00:31:41
Speaker
And I think there, you know, there's I don't if you ever get a chance to go to the Museum of Fine Arts, Boston, it's lovely. There's a very big room that looks kind of like the rooms at the construction in Vienna, where it's like high ceiling, lots of marble. And I remember as a child, I would feel so scared whenever I was in that room, like I like still remember to this day, like thinking and feeling a draft.
00:32:11
Speaker
like a chill because they had like this really phantasmagorical El Greco painting on one corner against like a Velasquez portrait of Philip the fourth. And there was this Zurbarán painting with this monk kneeled in prayer. And so I think when I was a kid, I was really afraid of religious imagery, but at the same time, like very intrigued by it. And so I spent all my time in like
00:32:36
Speaker
these rooms with all these paintings of monks. And I must've just gotten into my head that that's like the best day job ever or something, I don't know. And now when I think about it, it's a great job because people leave you alone, you get to like work in the field or do like you get to work physically manually without having to like talk too much or like write notes all the time, for example. And you often get to make things, right? Like you live off of your own labor. And I love,
00:33:06
Speaker
that aspect. But as we've also talked about, I think lots of times, there's a lot of really wonderful parallels between the best of religion and the best of science. And not too long time ago, you know, they weren't so dichotomized as they are now.
00:33:29
Speaker
And I think the spirit of wonder and the spirit of inquiry and the spirit of scholarship are still common to both professions in the people who really truly live those lives. I think being a scientist in some ways is basically choosing to be a monk with a pipette and you still get to have a personal family.
00:33:55
Speaker
Yes, but you know, the thing is, yes, absolutely. The dichotomy hasn't always been like this. I mean, Newton, for instance, his work, the Philosophis Tractatus, something like that. My Latin is terrible. But I mean, he called it philosophical work, right? So it wasn't science in that sense. It was something that was more related to thought. And therefore, also, Newton was a very religious man as well in that sense. So yes, that was
00:34:24
Speaker
And that we consider, at least to my knowledge and understanding, one of the pivotal moments where science and religion really parted ways with the works of Newton, even though he wouldn't see it that way, because he was still very much also influenced by the Church.
00:34:43
Speaker
What you're saying there from my side as well is absolutely this dichotomy is not always serving the best purpose that we differentiate so much between thought, belief and science because it removes us also from the mystery and wonder of life itself a little bit. Well, I mean, I think part of the problem is that for a lot of people, they've come to associate the concept of a scientist or science with being a technologist.
00:35:13
Speaker
And I don't think that's the spirit of science at all. And actually, there was a really good article I think Atul Gawande had written about this. He's a physician who often writes more pieces for the general public. But he communicates very well about science and medicine. And one of the things that he pointed out, which I think is so valuable that people
00:35:37
Speaker
sometimes forget is that being a scientist really is just about critical thinking. It's about being aware of your own assumptions and trying to respect different viewpoints, trying to respect different pieces of data, trying to weigh both
00:36:03
Speaker
know, empirical knowledge and intuitive wisdom and put it all together and not be closed minded, you know, that's that's really what what it is. It's not has nothing to do with, you know, knowing technical terms or holding a pipette and things like that. And sometimes I am very disappointed with some scientists who, you know, try to create this, this impression that like,
00:36:26
Speaker
if you're religious, then you must believe in certain models of creation. People have made this weird antagonism or set up this weird dialectic between creationism and evolutionism.
00:36:48
Speaker
But evolution is simply just a process. It's a description of stuff that happens on a cellular level. It happens to language. It happens to people. It happens to everything, not just physical beings. And so evolution is a conceptual thing. And I think we've made it into this sort of, I don't know, strange battle between science and religion that
00:37:13
Speaker
didn't used to exist because it wasn't conceptually so misunderstood and people actually communicated on the right level about the right concepts. The thing I always like to remind people is that Gregor Mendel, the founder of Mendelian, basically we call everything Mendelian genetics. The starting point of your profession basically. Yeah, the basis of my profession was started by an Augustinian monk who was probably a little bit bored.
00:37:42
Speaker
and curious. With bean stalks. Yeah. Sweet pea. Sweet pea. That's what I was exactly. Sorry. I'm confusing that with Jack and the Giant Slayer. Jack and the Giant Slayer. Anyway. This is also why I love wine and winemakers, right? Because they're in some ways this last bastion of like people who are like scientists and naturalists, but also like in some sense very
00:38:09
Speaker
do a lot of things that are more hard to explain, you know, like intuitive and not everything is like, we don't have a clear answer for why a lot of things work in farming, right? Or like how certain farming practices somehow end up translating a certain way in the glass. But, you know, they have an appreciation and a respect for this and they have an appreciation and respect for the experience that's, you know, been inherited over time, you know, cultural,
00:38:39
Speaker
wisdom and learned experience as well as observations that individuals make and also like sort of that unpredictable incredible force that is nature and so winemakers like you know in a lot of ways I used to joke with my friends in grad school because we would get so frustrated you know like
00:38:58
Speaker
I can't tell you how many times we would do an experiment for four weeks and we'd drop the last part, we'd drop the gel, or one time I think I fainted and broke a tube that I'd literally been up for 48 hours trying to sort some cells into. But if you think about it, winemakers, they have maybe at least a year before they know the outcome of their experiment that year. They have to be so patient.
00:39:27
Speaker
And they have to work so hard and it's very, you know, in a lot of ways it's similar. And so I think that's incredibly admirable. Absolutely. There's also a piece that you wrote on Facebook that I'll get to a little later that is exactly addressing what you just said. Just what you just said as well. It made me think of, for one, the conversation we once had about Roger Deakins and his stance of, you believe in God, you're basically stupid.
00:39:55
Speaker
and not allowing any space for anything outside of just science, even though there might be stuff outside of science that might be science we just don't know yet for the one thing and that there might be something that is just bigger than our current understanding of things.
00:40:11
Speaker
And another thing that I thought of was I don't know if you know this but I saw this I watch the late show quite regularly with Stephen Colbert and it was this one episode where Neil deGrasse Tyson was his guest and actually they switched sides and he was the host basically and Stephen Colbert was the guest so they switched positions.
Medical Genetics and COVID Challenges
00:40:32
Speaker
And Neil deGrasse Tyson asked him about his belief and how he can believe in God, you know, after science and everything. And I don't get the answer right anymore, but it's absolutely worth watching. The response of Stephen Colbert was absolutely spot on and wonderful and great. And this is why I like the man so much because he is not just funny, but there's actually some profound
00:40:57
Speaker
Opinions and knowledge in him as well. And I like that. So just that. Just check it out. It's really good. I think it was really good summing it up very nicely. I will. I almost never watch American TV, but I really appreciate Steven Colbert.
00:41:13
Speaker
Yes, I know there's a couple, right? Also, one of my favorites is also John Oliver. There's also a question that I have to you later. He's one of my big heroes. I think if there's one person in television that I would totally trust, and there's hardly any, but John Oliver would be one of them. I would totally trust him with the information I get. Anyway, so
00:41:37
Speaker
I would say let's talk about also to understand a little bit because you know this podcast is also about understanding, having a bit of a global understanding of what people somewhere else in the world are going through right now with this whole pandemic. So I would like to know from you, could you describe to us your daily routine at the moment? You are obviously working at Johns Hopkins University, doing a lot of work there. What does it look like for you? So that's going to involve a few different layers of explanation.
00:42:06
Speaker
All right, shoot. I have my pen here. I will make notes if necessary, or open an Excel sheet, if that's what it's called for. So first of all, I think you probably are aware of this, Bastique, that COVID has affected kids and adults in different ways.
00:42:30
Speaker
I think you know that. I've heard that once or twice, yes. Yeah. So that's the first thing to understand. The other thing to understand is that lately when I've been on call, I've been on call as the genetics fellow, which is a slightly different role than saying being a pediatric
00:42:51
Speaker
uh, frontline provider, uh, in general, pediatrics. And what I mean by that is, um, that's more of a consulting role. Um, so, you know, patients come in through the emergency room and they go to either, you know, a pediatrics floor or they go into an intensive care unit or something, right? That's the same for adults as well. They, they go to some kind of floor or they go to some kind of more higher level care place, right?
00:43:20
Speaker
And our role is actually to consult, to help give advice to the primary providers about how to take care of complex patients who might have underlying genetic disorders or to help them diagnose someone who may have an underlying genetic disorder. So that's been really actually interesting in the era of COVID to us because I think our perspective might be a little bit different since the patients we take care of are generally patients with
00:43:50
Speaker
very oftentimes rare disorders that a lot of people probably haven't heard of. And I will say that even amongst doctors, whenever the word genetic disorder arises, I think a lot of people feel terrified and paranoid and paralyzed. And I think it's just also because- Why do you think that is? Sorry, just quickly. Why do you think that is? I think it's fear of the unknown.
00:44:15
Speaker
You know, when you're faced with these rare diseases that most people don't see on a regular basis in clinical practice, they're afraid that their decisions might worsen the patient rather than make them better because they don't know, they're afraid that they don't know what some of the underlying challenges might be from that patient's specific condition. And I think that's totally reasonable. That's why we exist.
00:44:39
Speaker
And Hopkins is very lucky because Hopkins has a very long tradition of human genetics. And actually, you know, there's a database called Online Mendelian Inheritance in Man that a lot of people use almost as sort of the reference database for human genetic disease around the world. And that is,
00:45:07
Speaker
physically housed at Hopkins and began with a Hopkins professor named Victor McKusick, who really just started by taking notes in his notebook of patients that he saw and he would write down their characteristics and write about what he learns from his patients over time. And I think that's a very big theme in human genetics is that our patients probably teach us much more than we can teach them.
00:45:33
Speaker
And it's fascinating because human genetics is much, much more complicated than genetics of certain other organisms. And I used to be a yeast, I used to study yeast. So I love yeast and I think yeast are an incredible model organism for genetics. But one of the reasons they are so great for doing genetics on is because they're nowhere near as complicated as human beings are.
00:45:59
Speaker
And so you can actually manipulate them a little bit and find, like draw conclusions more easily. Whereas my joke about humans is that they're sort of this like freak endpoint in evolution. And there's often usually more exceptions than rules. Like none of our patients have read the textbook on their disease. They don't follow the rules. And so, you know, we frequently find ourselves in that situation where we're very humbled
00:46:26
Speaker
Because we think someone had one thing and they had something totally different. And this is not just people at my level of an experience. It's people at all levels of training, including, you know, people who've been doing this for decades. And I think that's one of the most wonderful things about our field. And I think that's why we all love it so much.
00:46:46
Speaker
and continue to do it despite extreme sleep deprivation, it's because we are just constantly learning and constantly being, again, like just marveling at the things that, you know, life and biology really in nature, like throws at you. And so one of the things we were talking about with a patient yesterday
00:47:09
Speaker
is the fact that if you are afraid of ambiguity, you should never be in genetics. If you need certainty, if you need things to follow the rules, then this is not the right field for you.
00:47:23
Speaker
because you're constantly living with uncertainty. And I think for me personally, that is another sort of parallel to theology that I appreciate. And also ties in with what we were just talking about, right? Because it is actually exactly what we do not necessarily identify science with. Science to us is always clarity.
00:47:44
Speaker
or doubting the outcome of your own experiment. I think that's the most important thing to do. Doubt and inquiry, but then having at least at the end a result that either justifies or exemplifies. Well, honestly, I have to stop you there because I think we need to distinguish between science and medicine.
00:48:09
Speaker
And actually, I will say that because I was trained as a physician scientist, that was one of the biggest challenges of this particular dual training. Because, you know, as a scientist, exactly like you said, we're encouraged to question.
00:48:22
Speaker
As a physician, if you're constantly questioning, it's very unsettling both for your colleagues and your patients. And so in medicine, you often feel a pressure to have certain results and answers to give to your patients so that they don't feel uncertainty. And I think that that creates a totally different culture from science. And so when a person is
00:48:46
Speaker
forced to go between the two fields, it can be very confusing. And I think that's been a challenge. I'm not going to speak for my colleagues, but I definitely felt like that was something I had to learn how to navigate, is when to curb my questioning and my curiosity and my enthusiasm in medicine, which is very hierarchical and tends to just deliver very more like black and white statements.
00:49:09
Speaker
and try to deliver very concrete answers versus, you know, being in science where you're sort of, you know, expected to always be questioning and things like that. And that's a, and in some ways that's why we have physician scientists is have people who that can bridge these two cultures because my feeling is also that a dichotomy is growing between science and medicine as well. And sometimes that can be not,
00:49:39
Speaker
very, very detrimental to ultimately thinking about a patient in all of the ways they should. Could I just quickly, just quickly, because the reason it's not so black and white and it is a lot more uncertain, is that the human element then? Is it for one communication with human beings and your empathy that is also making it a lot more difficult to see it in black and white?
00:50:07
Speaker
Because you also want to see things and you want to see things a different way maybe as well to give hope and to engage with human beings on an empathetic level. Is that also something that's effective medicine? I think that's true of medicine. I think that's necessary to be a medical provider in general, but I think the black and whiteness is not related to that. If anything, it's probably because
00:50:31
Speaker
We feel like we have to have the answers and not confuse anyone so that we can make decisions. I think it's fear of being paralyzed about not being able to make decisions if we don't have black and white answers. But again, I think empathy is a really important piece and I've never found that
00:50:53
Speaker
telling my patients about our uncertainties has been less empathetic. If anything, I think it's been more empathetic in my personal and everyone has a different style, but my style has always been to be very honest with my patients and I find that they can handle
00:51:11
Speaker
the ambiguity when they understand that we're walking along this path with them and that we're doing the best that we can and that we explain what's going on instead of patronizing them or treating them like they wouldn't be able to understand the nuances of the situation. But I think it's different. You really have to judge it on an individual by individual basis. There's no set rule for any doctor and there's no set rule for each patient. All of our patients are different and they all have different needs.
00:51:41
Speaker
it's a collapse. So medicine is not a science. Medicine is an art. And it's an art of like, it's like I joke, it's oftentimes like personal shopping, right? Like you want for your customer what they want for themselves. But you have to offer them what they actually want, not what necessarily always what they think they want, right? So it's a, it's, it's learning about their values and their priorities. And
00:52:06
Speaker
trying to mold a plan that encompasses that as well as your patient's medical needs. And so I think if you don't have empathy, empathy is so important. Sympathy is great, but I think if you don't have empathy, you won't be able to get to that truly collaborative piece. But I kind of wanted to go back to this
00:52:36
Speaker
this thing we were talking about earlier. Yeah, about your routine and about. Yeah, because because, you know, COVID for us has been very different. The adult side, it's much more like they're slammed by lots and lots of adult patients who present with COVID. They hospitalize them, they try to keep them alive. And it's sort of like that, right?
00:52:58
Speaker
On the children's side, it's been much more complicated from what I've seen because children don't necessarily have acute COVID the way adults do. Their immune systems are not necessarily as mature. And so their bodies have reacted differently. So you'll sometimes have kids who come in with COVID.
00:53:20
Speaker
active COVID infection, but you also will have kids who come in with this post-infectious sort of what we call, you know, multi-system inflammatory syndrome. And then everything on that spectrum, you know, in between. And it's sometimes very confusing because they can have this in response to a number of other conditions, a number of other infections or, you know, it can be, so there's a lot of mimics and trying to figure out what
00:53:46
Speaker
is going on is sometimes challenging. And so there's usually a lot of different providers who have to be involved in that. And it makes thinking about these patients very complex, but very interesting. The other thing I have to say is that in Baltimore,
00:54:08
Speaker
which, you know, as you know, is has been historically plagued by a lot of, you know, systematic racism, like institutionalized racism, poverty. Just recently as well, like just a year or two ago when Trump made his comments about Baltimore and shithole and everything. So it's still a thing that is Baltimore is like it compared to other places in America that I've been where there is also a lot of urban poverty and, you know, um,
00:54:37
Speaker
and racism and ethnic tensions and things like that, Baltimore is definitely the worst. And if you look at all of the studies people have done, life expectancy for African-Americans, poverty levels, this is the number one place in America for it. And what I'm trying to get to is that there's a legacy of distrust of Hopkins
00:55:07
Speaker
And this has actually been recently elucidated in some really excellent books about it. But a lot of people historically, and a lot of my patients, like grandmothers, I have, they're lovely people. I have really funny conversations with them, but they still think people go into Hopkins and get experimented on like lab rats and like never come out. You know, so, so there's also a, oh, we have, you know, our, we have a lot of patients and they're lovely and
00:55:32
Speaker
They all have very complicated social economic situations and
00:55:39
Speaker
But, you know, there's a legacy still of suspicion, distrust, misunderstanding, specifically Hopkins. So a lot- Why? Was there, were there cases, but like way back when, I mean, or something like that? Oh, do you know that, well, first let me- Yeah, sorry. So University of Maryland, which is the other hospital system in Baltimore, probably has seen more of the inner city downtown COVID cases as a consequence. That was the thing I was trying to say.
00:56:09
Speaker
But so Hopkins, I don't know if you know, there's a cancer cell line called HeLa, which is named after Henrietta Lacks. That's just like sort of the most prominent example. Like she was an African American woman who had cancer and we made a cell line from her, but never got her permission. And this is one of the most commonly used cancer cell lines for experiments around the world, but her family was never told or compensated or anything for it.
00:56:34
Speaker
That's just one example. I'm sure there's many others. So in this particular setting, that's been one piece, I think. The other thing is we've had a lot of patients who have had COVID uncovering genetic diseases that they didn't know about earlier. So that's also been really interesting. We had a recent diagnosis.
00:57:01
Speaker
of a disorder that normally is caught earlier. It tends to present at earlier ages in a patient who, because of the infection, got sick and then we subsequently were able to diagnose them.
00:57:18
Speaker
Yeah, so it's definitely very interesting and it creates a lot of food for thought and it just really highlights that, you know, everything involves a piece of genetics. So, you know, to say, well, this is not a genetic issue, this is environmental issues, very, very misleading because everything that happens in our bodies is some combination thereof.
00:57:38
Speaker
But it does force us and force other people to really think deeply about what the degree of genetic contribution to any one patient's condition is. And I think that's one thing I also appreciate about genetics is that we really have to think about the person as an entire person, not just a single piece of them, like not just their lungs or not just their liver or something like that. We really have to think about them holistically.
00:58:03
Speaker
And we have to understand the other factors that are non-genetic that might play a strong role when we're thinking about what genetic diseases that they might have.
00:58:12
Speaker
All right. And out of all of this, is there anything that you say you are taking out of this pandemic where you say it has something that has changed through the pandemic? I mean, obviously, there's children coming in that are infected with COVID and you're looking at that, but do you gain any insights, for instance, that you couldn't have gained in any other way, something that also
00:58:43
Speaker
changes your research, something that opens other fields of your research, is there any, I mean, I'm sure it's not business as usual, right? Or how would you describe that? No, I mean, but we all just do our job. I mean, I think there's too many ways to answer that question. I think a lot of it is just personal. Like obviously when you engage with a family whose daughter has just died, you never forget that.
00:59:17
Speaker
So I guess part of it is also that my research is not on COVID and my research was already very closely involved with understanding sort of the biology and the genetics of host pathogen interactions as it relates to like cells and evolution and things like that.
00:59:37
Speaker
I don't think anything about the nature of COVID biology has been super, super surprising. I think it really just actually reinforces a lot of the paradigms that we kind of were starting to understand about viruses and its interactions with human immune systems to begin with. If anything, it's really reinforced a lot of the things that we've learned from other disorders and I think
01:00:07
Speaker
From that perspective, I don't necessarily think there's been any earth-shattering revelations. How has it affected you personally then? Because you said also in the personal side. My biggest concern is just people's psychosocial health. I have a lot of friends who are single women who are older ages oftentimes. And I
01:00:37
Speaker
It's become very, I'm very conscious of how lucky I am to have met Nicholas when COVID first began and to be able to have this companionship and this support in my life at this time. And I worry about my friends. I worry about a lot of people's mental health and what the isolation has done. That's probably my
01:01:07
Speaker
biggest thing I think most about. So what has made me really happy is that now that my salary is slightly higher, I'm able to like, you know, do something really, it's probably just to assuage my own sense of guilt or whatever. But it's nice to be able to like, you know, send gifts to your friends when you can't see them or can't meet with them and can't give them a hug. It's just you have to think of other ways to show people that you care.
01:01:37
Speaker
And for example, my friend Franzie, the winemaker and the faults, she actually mailed me a package that took several months to arrive, but it finally did. And it was actually really thoughtful because it was a gift that involved a cookbook from a friend of mine who's a chef in Austria. So she bought his cookbook and then mailed it to me in America.
01:02:08
Speaker
And it's, I mean, it's a lot of, it's a lot of hoops to jump through, but it was just a very, I still haven't cooked anything from that book, Franzie, if you're listening, don't hate me. But, you know, it's just a very thoughtful thing. And I think what I really appreciated is the fact that while we've lost the ability to communicate and have contact with people in some ways, it's also opened up other channels by which we can show people we care and other channels by which we engage with people.
01:02:38
Speaker
I think I'm definitely very grateful for that, yeah. I think this is something you can see globally, actually, and this is something that, and I say this, it feels like I say this in every podcast, but this is exactly why this podcast also came about, because I was really touched by the creativity of others, really, and what they came up with in bridging over during a time when it was just, and still is very difficult to bridge over, to have a normal contact with people you love, you care for,
01:03:07
Speaker
And that to me was very touching. And this podcast is also just another attempt of bridging the divide to some degree. And I will say people were a lot more stressed when like during the first year of COVID. I can't believe I'm saying the first year. I know. I know. But I mean, when COVID first, I would say the first six months, everyone was at a heightened level of stress, you know, I just there was a lot of uncertainty.
01:03:37
Speaker
Um, we didn't know as much as we do now. We still don't know a lot, you know, but I think like I'm also talking right now from my sort of retrospective lens now that I have two vaccines in me. And I feel like a lot of the people that I care for are safer.
01:03:55
Speaker
Um, like my parents got COVID and that terrified me. Um, so that was like, that was, I was very, very, you know, concerned. But they had a, they had a, a good, a good, I mean, non-symptomatic or, or how did they get through it? No, my mom is still symptomatic, but, uh, they didn't need any, you know, medical interventions, uh, fortunately. Um, and, uh, yeah, I think.
01:04:23
Speaker
I think everyone was extremely stressed when it was beginning, when we were evolving the way we communicate in the hospital to minimize social, you know, like to sort of minimize physical interaction with each other. We had to do a lot of strange ways of rounding together, which especially on the pediatric side, we usually do it as a big group, you know, nurses, pharmacists, doctors,
01:04:48
Speaker
you know, patients, families, like we real social worker, like we all you usually have like a pile of 10 people piling into the room because it's a whole team that supports a patient and their family. And then we had to start doing that with iPads and zooms. And so it was very interesting. Everything took like three times as long as it used to.
01:05:10
Speaker
You know, doing anything for a patient who was in an isolation room would take much longer. Like, for example, you know, if there was an acute situation, it was so much harder to get people to even be in that room because everyone was wearing all this gear. There was not a lot of ways to navigate. You couldn't just hold your phone, you know, because you were wearing all these things. I think it definitely logistically made a whole lot of things more complicated.
01:05:35
Speaker
And I'm sure on the adult side, it was probably much, much worse just because their volumes were larger. But I will say at Hopkins, I think we were particularly lucky because we did have a lot of people who understood, there's a big public health department and a lot of people who study disease epidemiology. And so we had a lot of sort of, I guess you could say frontline information from people as they were learning about COVID. And we had a lot of,
01:06:03
Speaker
people who just hopped really early on board with planning, planning what we needed, and planning what needed to be done. So I think that was really, really helpful. I think I didn't feel as worried as I might have if I had been somewhere else, I guess. Yeah.
01:06:21
Speaker
All right. I mean, you know, even in Germany, we're getting numbers from Johns Hopkins University. You know, I mean, they're like one of the, probably the global authority on, you know, COVID numbers, trends, developments. Why is that actually? Because of the big database you spoke about earlier on, or are there other reasons for that as well?
01:06:44
Speaker
Yeah. I mean, it goes back to the fact that Hopkins has a school of public health and, um, uh, a large segment of people who already study the epidemiology of disease. So I think that it was. Be given anywhere else though, because I mean, it's really lucky. No, no. And I, I, I can't really speak to, you know, what other programs it's, I don't really know what the other programs do, but, um,
01:07:11
Speaker
I don't know how that came about exactly, but I know that there were a lot of people who were already thinking about it and sort of jumped on very early on and began to collect data. So I think that was very fortunate.
01:07:26
Speaker
All right. I know you're not an epidemiologist, but something that I would like to know, because I think that's something you know very much about, is the difference about the vaccines that are at work right now. Could you explain what the difference between a DNA and an mRNA vaccine, for instance, and why one is considered better than the other, and if that's correct or not?
01:07:51
Speaker
So, I mean, the basic difference between aren't so.
01:07:58
Speaker
Let me go back and just say that there's this thing called the central dogma, and the central dogma is basically DNA to RNA to protein, and all that means is that the DNA that we have in our genes, in our chromosomes, that's sort of like the recipe books to building a person, right? And the building blocks ultimately are the proteins, right? So the proteins are what make
01:08:25
Speaker
us up and what function are sort of like the working arm of our biology, right? And the way that DNA gets turned into protein is through the production of this sort of intermediate messenger called RNA. And a lot of the regulation and control of where the protein goes, what the protein is, how much of it there is, what particular
01:08:50
Speaker
brand of it and all that stuff, the really important control element, a lot of that happens on the level of RNA. Okay, and we call that the study of that gene regulation. It's fascinating. It's one of my biggest passions in life. There's many layers of regulation. So so that's what we call the central dogma, right? So DNA is transcribed into RNA and an RNA is translated into protein.
01:09:16
Speaker
DNA is double-stranded. RNA is single-stranded. RNA tends to be much less stable than DNA is. However, obviously the vaccine producers have figured out a very good way to produce an RNA vaccine that's protected and is able to stay stable at a certain temperature for a certain amount of time. And there is not really any...
01:09:45
Speaker
You know, it's funny because I was actually asking my boyfriend about this today. I was like, have you thought about which facts like do you care which vaccine you get? Because personally, honestly, I wouldn't. I think getting a vaccine like every person you can get a vaccine into
01:10:00
Speaker
is one more person that is vaccinated. And that is ultimately the goal. Absolutely. I think it's that simple, really. AstraZeneca, whatever, 60, 80%. You know, everything is better than 0%. And everything is better than 0%. The idea is that they do studies where they look for, you know, the right, the studies look for outcomes, right? And the outcomes basically as long as they show that there is, you know,
01:10:35
Speaker
I don't see any reason why we should sort of. Obsess about these particular details i think the important thing is the clinical outcomes that are demonstrated for the vaccines.
01:10:47
Speaker
And those have thus far been pretty comparable, regardless of whether it's the two dose or the one dose. And I think that's key is basically to try to get people vaccinated. I mean, we don't have these debates about other vaccines. There's at least two versions of every other vaccine on the market, too.
01:11:09
Speaker
No, I also I don't want to open up flu vaccines. Lots. There's there's like four flu vaccines, usually on the average, you know, yearly menu. And so, you know, there's there's of course, for vaccines, there's specific formulations and, you know, specific, you know, vaccine producers, you know, will make vaccines and they'll they'll like, say, this has only been tested on this age range or this is only intended for this age range and certain indications like that. It's good to be aware of, like, it's good to be aware of, like,
01:11:39
Speaker
which are live vaccines and which are not live vaccines, attenuated vaccines, these matter for people who are immunosuppressed or immunocompromised. But in terms of the COVID vaccine, whether it's packaged in a certain way and things like that, it shouldn't make a huge difference because ultimately it's the clinical outcome that matters.
01:12:04
Speaker
Yes. It's just because I've heard people say literally like, no, they would wait until they can get a DNA with vaccine instead of an mRNA vaccine. But also, I'm not a vaccine expert. No, I'm not saying that. But you know a lot more about it than I do. And most people listening to this, I believe. So that's why I'm asking. There's many different kinds of vaccines. So my mom actually is a vaccine chemist. That's how she got COVID.
01:12:34
Speaker
because she was working at Pfizer, they wouldn't let them wear masks, which was ironic. What? That's so weird. Yeah, but there's many, many different types of vaccines and a lot of like what ends up being the right one has to do with how you provoke your immune system in the right way.
01:13:00
Speaker
and how you, you know, are able to deliver something that's both stable and causes the right reaction. And so usually by the time you have, you know, one vaccine on the market, the company has probably tested like millions of different
01:13:17
Speaker
varieties or flavors. My personal perspective, my personal view is that anything is better than zero protection against the vaccine, against the virus, right? So if it's like AstraZeneca, if it's whatever, give me what is available, right? When it's my turn, of course, that's also important. Don't give it to me before everybody else is also fair and well.
01:13:44
Speaker
But so I've just heard this more regularly. It's also quite a public debate here. That's why I wanted to ask that. So I mean, I guess so. So the first thing that I guess maybe they should understand is that historically, I guess we haven't really been giving you clic acid vaccines, right? Like most of the vaccines we traditionally get are based on like
01:14:09
Speaker
proteins or proteins connected with the sugars. So I don't know if maybe people are more freaked out about the having a nucleic acid in their body or something, but that's, I mean, there's also a lot of people right now, you know, working on gene therapy and gene editing in our, you know, in patient cells.
01:14:31
Speaker
And the thing about the nucleic acid vaccines is that you're basically giving them the virally encoded stuff so that you can make more and then your body can still fight the same thing.
01:14:46
Speaker
And, you know, when we get infected by viruses, some viruses are RNA based vaccines, some viruses are DNA based, not the viruses aren't vaccines, sorry, some viruses themselves carry like an RNA genome and other viruses carry a DNA genome. And
01:15:04
Speaker
Where's the difference though? It's not like one virus is necessarily less effective than the other viruses just because one has a DNA and one has an RNA genome. It's just oftentimes like the way in which those viruses have evolved.
01:15:21
Speaker
All right. So just for me also to, I have to ask again, just because now I'm interested. So DNA is usually a double helix, right? And an RNA is usually like one side of it that can reproduce and dock onto the DNA, right? To reproduce like something, I mean, very simple. No, no, no, no. It's back on. So what happens is you have an enzyme that reads the DNA and it makes the RNA.
01:15:46
Speaker
The RNA is not already there. The RNA gets made off of a DNA strand. Yes, but just one half of the DNA double helix, as far as I have understood it online. Yeah, it's basically you're copying one side of it. Yeah, exactly. The DNA is like your template. Yeah, exactly. The RNA serves to copy that, right?
01:16:09
Speaker
RNA is the copy. Is the copy, okay. But then in essence, there isn't not so much difference, right, to my simple mind of vaccines, whether it's RNA or DNA-based, right? Exactly. The outcome is pretty much the same in the end, right? There's some biochemical differences, obviously, like I told you, you know, RNA is less stable, but like, yes, exactly.
01:16:30
Speaker
Okay, so for everybody that's saying, I'm waiting for the DNA version of that, I think now it's safe to say that maybe you want to rewind this and listen to this because I think you shouldn't. Just get any vaccine that you can. That's very good. Thank you for clearing that up and giving me so much more insight. Yeah. I saw one program. Well, there's everything I should say maybe. Yes.
01:16:57
Speaker
in case this someone really technical is that like, it's easier to get the RNA into a cell.
01:17:05
Speaker
than it is to get the double stranded DNA. But again, these are more like stability delivery issues. They're not sort of like issues of like one is more dangerous than the other, which is what I was hearing. Yeah, okay. Yeah. So this is an osmosis question. People have figured out solutions to or you know, have to navigate solutions to. So ultimately, you know, when the virus is made, and they do the clinical trials,
01:17:29
Speaker
and they've shown that the outcomes are similar that would imply that they figured out a way to make it work. All right. Yeah, I think that's very interesting because yes, like I said, that's something I've been hearing a lot lately. There's one other question and then we close the medicine chapter and we turn to wine.
01:17:54
Speaker
But I would like to know, I watched and we talked about John Oliver in the beginning, right? And I saw one of his last programmes about the virus and where we're going from here. And it was a very interesting episode about...
01:18:10
Speaker
you know, this particular virus, but about the danger of it occurring again in the very near future because of, first of all, how natural habitats are being depleted by us and therefore animals and human beings are moving closer together, sharing more and more of their space and therefore viruses being much more prone to jump from an animal to a human being, right, and therefore spreading like this. So the very real danger of that
01:18:38
Speaker
Yes. So and he said as well that, you know, right now, potentially, and I wanted to check this number with you as well. There are I think it was something like 600 million potential viruses that could 600 million viruses that could potentially be dangerous to humans when they jump over. That is, I mean, okay, that sounds for a second. Yes. Because I think
01:19:07
Speaker
So, okay. It's a very complex conceptual thing because I think a lot of people think about viruses like living things.
01:19:26
Speaker
Viruses are not bacteria, fungi, malaria, parasite. Those are living things. Viruses are not living things. Viruses are pieces of nucleic acid with a protein sugar shell. They're like M&Ms.
01:19:50
Speaker
bad M&M sometimes. Yes. I was about to say, please, bad M&M. They're basically just pieces of nucleic acid. When they replicate, you get more of them and then they obviously can mutate. It's hard to quantify sometimes. This is the question I always wonder in my mind when someone quotes a specific number, it's like,
01:20:13
Speaker
Are they talking about that viral strain? Because when we think about HIV, the paradigm established by HIV studies is that viruses exist as a quasi-species. If you went and you tried to sequence every single virus version of HIV in one person, it's not one. It's variations on the theme. There's a whole group.
01:20:45
Speaker
of all different sequences, variants on one theme. Okay, so that's why fundamentally I wouldn't even know how to begin to answer that question because I don't know what that number specifically refers to. You know, does it refer to every single variant of that particular virus strain? Does it refer to individual different viruses that he's quoting the number for?
01:21:11
Speaker
I don't know. And we're seeing right now how quickly they can mutate, right? I mean, we are seeing that right now, how quickly a virus mutates. So that's not always. There's some viruses that are extremely stable in their sequence. It depends. But I think, you know, we have, I don't know if you realize this, but our genomes are more, are
01:21:36
Speaker
There's a bigger piece of our genome, significantly bigger piece of our genome that basically is just graveyards of viruses than actual genes that encode proteins. So the pieces, the part, do you know how, so the proportion of protein encoding genes, which is what we call the exome, that part of your genetic material is about 1.5% of your entire genetic material. Wow. Significantly more.
01:22:06
Speaker
is like human endogenous retrovirus sequence, retro transposons, foreign mobile DNA elements, all kinds of random pieces of foreign nucleic acid that have landed in our genomes. And some of them have even come to be used. They've over time evolved into human proteins. In fact, syncytin is a great example. This is a
01:22:28
Speaker
sequence of nucleic acid from a human endogenous retrovirus that now forms a protein in the syncytial trophoblast of our placentas. I mean, this is why in a lot of ways, you know, people get autoimmune diseases if they, you know, like you hear about all these weird post-infectious viral syndromes and things like that, right?
01:22:51
Speaker
There's so, the history of human beings, the history of living things is very, very tied to the history of these non-living pieces of nucleic acid, right? They evolve with us and we evolve with them. And in fact, there's a whole bunch of human genes that exist
01:23:17
Speaker
basically to detect and to fight foreign elements. And it's not just humans, it's yeast, it's bacteria. Every organism has figured out a way of handling their relationship with these foreign nucleic acid elements. What's really interesting is that some organisms don't even really care
01:23:42
Speaker
Because the architecture of their genome is such that it's not a big deal. And so actually the yeast we use for winemaking, Saccharomyces cerevisiae, budding yeast, we call it like, you know, beer yeast, wine yeast. There was a great paper from Jerry Fink and David Bartel's lab, I think in the early, like 2011 there were two papers actually.
01:24:06
Speaker
Um, where basically they were like, Oh, we wonder why, you know, budding yeast doesn't do RNA interference when all these other organisms do RNA interference and basically showed that it had evolved out its ability to cut up these foreign genetic elements into little pieces because it was more important to retain a virus.
01:24:25
Speaker
a symbiotic virus called killer virus. Because having killer virus in budding yeast enables that budding yeast to then go around killing all of the other yeast that don't have killer virus inside them. Because it like basically that virus encodes something that the yeast likes to create and then that toxin basically kills everything that doesn't also have the protective
01:24:50
Speaker
element that's also encoded. And so this is also why winemakers sometimes will inoculate because they worry about something called stuck fermentation. And stuck fermentation is what you get when your yeast aren't able to ferment your wine to the level of dryness, like get rid of all the sugar and turn it into alcohol, aren't able to
01:25:13
Speaker
ferment to the level of dryness they need and that often has to do with the composition of the yeast and so if you have this you know yeast strain that's you know producing all this stuff and the other yeast that are there that are supposed to be doing fermentation or being killed off and obviously that's a problem.
01:25:29
Speaker
So sorry, I didn't mean to make this into a wine issue, but it really shows how important and interesting it is to understand the evolution that's occurred and continues to occur between living cells
01:25:45
Speaker
And viruses not just humans it's important to understand the biology of different living organisms because we all evolve a different way of dealing with them and we all are vulnerable to different kinds of foreign. You know genetic elements and and i think you know the.
01:26:06
Speaker
That's one of the most interesting things we learned about things like the flu viruses, from many, many, many years of studying why certain flu viruses are much, much more pathogenic and lead to a significantly worse disease and how the flu virus is able to sort of
01:26:26
Speaker
change its nature, we've learned certain things about the properties of flu and how it evolves between different organisms. And I think we'll learn that for COVID as well.
01:26:41
Speaker
If you say those foreign inhabitants, so to speak, yes, like the foreign inhabitants, the leftovers. That includes viruses. Exactly. Some viruses don't go into your genomes. They just hang out. They're called epizomal. What they do is they hang out in little circles in your cell, but they don't actually inculcate themselves. They're great. We use those for gene therapy because they integrate into your genome.
01:27:09
Speaker
I also like the way that you put that, you know, the body is figuring out a relationship with them, because they don't belong to the body really, or to the original genome of whatever makes the body... But it doesn't necessarily mean that they're always harmful, and it doesn't necessarily mean... No, no, exactly. ...don't tell them a way to, yeah.
01:27:25
Speaker
But also a way that they cause any kind of mutation inside the human body, inside of us. I mean, mutation is nothing harmful. Mutation can be something positive. Do they have some sort of influence? I think that's what I want to know on our evolution in that sense. That was my whole point, right? And I just didn't get it, of course not.
01:27:54
Speaker
See, I mean, some of them we silence, right? And but you know, others they I mean, this is why we know about oncogenes, right? Like, you know, viruses that cause cancer, like, that's what I call them oncogenes.
01:28:11
Speaker
they're oncogenic viruses. So a lot of genes that we learned are important genes for causing cancer. We learned them initially from the fact that they would be carried. They're hijacked from the human genome, biovirus, and then the virus sticks it back in to our genome somewhere it shouldn't be.
01:28:35
Speaker
and someone got cancer. In fact, this was figured out by a guy who used to be the president of Sloan-Kethering where I did grad school. This is also why initially they stopped the gene therapy trials for severe combined immunodeficiency is because there was one situation involving a patient where they were using viral vectors to get
01:29:04
Speaker
the therapeutic gene into the human genome is very useful for that, right? And unfortunately, it landed somewhere that was bad and led to this person developing cancer. So there's, there's always, you know, that that risk when you have the ability of a virus to integrate into your genome, if it goes into the wrong place, it can cause problems. Definitely.
01:29:29
Speaker
That's why we and other cell types, other organism cell types have so many different strategies for trying to like
01:29:37
Speaker
get rid of them as quickly as possible before that happens. And, you know, there's great names for some of these things, you know, like there's an organism called neurospora where it does ripping and quelling, so it either rips the genetic, it's very, very graphic descriptions of what they do to try to get rid of this stuff.
01:29:59
Speaker
We have a lot of nucleic acid sensing factors inside our cells, like I said, and they're not just in immune cells, they're actually in like neurons and you have skin cells and all the places where viruses can land, right? And when you can't, and when these things don't work, you get
01:30:19
Speaker
diseases, you get really interesting, weird human diseases. Oftentimes it's because they're hyperactive, like they're thinking that there's like viruses there when there isn't a virus there. And then you get this crazy systemic auto-inflammatory problem. And that's one of the, you know, this one of the, these are the kind of groups of patients that I'm interested in. But you also can, you know, in the situation with HIV, for example,
01:30:47
Speaker
people have been studying for a long time the sort of nuclear arms race between HIV and human beings. So, you know, primates have certain enzymes that they use to try to get, to try to prevent HIV from spreading further. And we kind of inherited some of those and then we've developed our own. And then every time we develop something that like impairs a virus function, the virus then evolves another something to deal with that and it just like keeps going. It's really, really interesting.
01:31:19
Speaker
Because it's no skin off the virus. It's not that to begin. So, you know, we we are slow at evolving, but viruses are not because they're literally just like zero, like they can constantly just like make Xerox copy of themselves using us are, you know, ourselves as their factory. So they're always gonna win that battle in some ways.
01:31:43
Speaker
So that, yeah, well, that also means that we are intimately tied to, like our future is intimately tied to viruses. And it's always been, exactly. It's always been, but it will be even more so in the future because of how we are exploiting this planet. I think it will rather get more than less, right? I think that's safe to say, at least. Okay. So,
01:32:12
Speaker
With what you just said, I think that's a nice way to get to wine. I explained now why, because it doesn't feel that way. You've already made this connection though with yeast already and how that influences wine. Because I found something that you wrote on Facebook.
01:32:32
Speaker
And this ties into you of foreign elements of your body of foreignness to your own genome inhabiting you. And you wrote something that I thought was very beautiful about wine. And I have it...
01:32:52
Speaker
here. Yes, I want to read this to you. Not just to you, but it's not that long. Don't be afraid. But I thought it was very beautiful because it just, I think, ties in with your passion for wine very much and explains that very much. So you wrote on Facebook, you know, we have all these lovely fellowships and scholarships that reward people who work in the humanities, art, music, literature, etc.
01:33:16
Speaker
It has always been interesting to me that people who engage with the art or sense of taste are totally excluded from these academic privileges and rewards, even though the requirements of focus, energy, hard work, long-term dedication, observation, honing one's craft, and having a soul are tantamount, even though their work often preserves the best of what humans have figured out in terms of fruitful relationships with the Earth.
01:33:40
Speaker
They do experiments just like us, bench your clinical scientists, and yet must wait patiently for years rather than weeks for the results. They observe them and learn from the work of nature, empirically like naturalists, inculcate a deeper understanding of culture and history into their practices, not to mention often backbreaking physical labor and being subjected to the vagaries of uncontrollable and unpredictable physical forces.
01:34:06
Speaker
Isn't it about time to recognize this group of humanists? Whatever you want to name them, winemakers, vigneron, vincer, vigneioli, vigneteros, inopios. I was wondering how to pronounce that. Well, I wouldn't take it from me necessarily, but maybe you have a phone, you know, like a backup.
01:34:34
Speaker
And then you just say, this is the last paragraph, put quite simply, I can think of a few things as simple, as beautiful, as humbling or as moving as a lovely bottle of wine. There are a few things as inspirational as this collaboration between human endeavor and the awesomeness of nature of empirical knowledge and intuitive wisdom. It baffles me to no end why, in our enlightened world, it's still considered a niche lux
Wine, Identity, and Cultural Dynamics
01:34:58
Speaker
thing to invest in supporting one of the oldest and greatest fusions of art, science and siencia and sapiencia, sapiencia that still exists in the world. I have no idea what that even means, but it sounds wonderful. And there's one word for wisdom I think. A telling word for? Wisdom.
01:35:19
Speaker
Ah, okay. That makes sense. I think that's a very beautiful love declaration to wine. It ties also... Oh, sorry. I was just saying, I like the word sapienza because like many Italian words, like sprezzatura, for example, there's no exact English equivalent. You know what I mean? Yes. It means so much more than
01:35:45
Speaker
the generic English approximation. There is a bigger magnitude connected to the word in a way, right? I have that sometimes with German words, but also have it vice versa with English words in German and so on. Yes, that's the beauty of language, you know?
01:36:03
Speaker
It is unparalleled very often. So first of all, I wanted to get to this now because what we were talking about, also about virus, about the depletion of natural resources, natural habitats for animals, and therefore also our behavior in the world,
01:36:23
Speaker
basically raising the danger of viruses spreading the way that they are more and more, and this happening on a more and more regular basis as well. And that is because we are not doing what you're describing there, namely paying attention to our relationship to the world, to nature, to the cycles of nature, and to be able to live in collaboration with nature, but rather it is more or less
01:36:51
Speaker
a raping of our nature, basically. That's what somebody said that we met on a Greek island while we were doing a film on plastic waste in the Med. And there's one other sentence there. So I want to tie into that a little bit, but I also want to point out this one sentence that you said in regard to wine. And it is, wine is very much a story of immigrants.
01:37:17
Speaker
I think that's a very, very beautiful sentence as well. And I would like to ask you to indulge with us why. Why is wine a story of immigrants?
01:37:28
Speaker
So there's several different answers. On the greater historical level, I'm sure you know that how grapes got into Germany in the first place was through the activity, well, not just Germany, like a large part of Europe is the dispersive activity of Roman soldiers, right? Yeah, I totally knew that, totally. I totally knew that.
01:37:51
Speaker
Um, but you know, one thing I think, so first of all, I think I was very drunk when I read this Facebook post and I was drunk off of some very delicious wines. And I was just reflecting on, um, so, so I'm a part of this fellowship group called the SARS fellows. We get money to like look good on resumes. And it's all, I mean, no, it's, I'm being facetious, but like, you know, the people who are in this group are much more impressive than I am. They're all very accomplished doctors, lawyers,
01:38:21
Speaker
human rights activists. You're impressive enough to me just artists, musicians, dancers, pain, you know, like lots of different creative fields, many, like almost every creative field of artistry I can think of, except for winemakers. And I always think or like people who, you know, are like working as, you know, like, for example, Nicholas, who, you know, spends most of his life tasting things, right? And like being a
01:38:50
Speaker
an arbiter of like what to try to what is worthwhile to bring in and introduce people in this country to. And I think this went back to my frustration with this goes back in some ways to the fact that a lot of people who I work with think I'm a some L.A.
01:39:11
Speaker
And while I'm friends with some Somme LAAs, I am not myself one. And a lot of the people who I know who don't work in the wine industry think that the only people who are wine experts are Sommes. And I get that. It's because they're working in restaurants. They have direct contact with customers. They sort of are the face of the wine industry in many, many ways and very important ways, but they're by no means the entire
01:39:42
Speaker
humongous group of different contributors to what ends up getting a bottle of wine to a person and making them happy. And I think like, there's a whole lot of other people who do those things, you know, from the person who makes the wines themselves, you know, makes the wines to the person who
01:40:01
Speaker
gets the wines onto a boat and gets the wines over here and the people who pick the wines and the people who find these people and all this stuff, right? And the people who get the wines to be bought by a wine store or convince a restaurant to even put it on a wine list. There's a humongous group of people who are all participating in the ultimate process, who are not recognized by that.
01:40:30
Speaker
There's also a lot of socioeconomic fraughtness with the concept of wine. I think much less in Europe because you guys have a much longer history with it, but definitely in China. I mean, you really do see it very purposefully marketed as part of a glamorous, expensive luxury lifestyle rather than an agricultural product or a beverage or food item. And in America, I think somewhere in between those two.
01:41:00
Speaker
as people come to drink wine more and it is no longer just a sort of, you know, something that is scary or esoteric, right? But for me, what is really interesting is how individual winemakers have come to this profession. And we, you know, we know how Kristoff fell into it, right?
01:41:30
Speaker
But Nicholas and I were talking a little bit about how it's really impressive or interesting how sometimes an entire wine region is galvanized by the arrival of an outsider. And it's the arrival of that outsider who really causes a sea change in how people are doing things.
01:41:53
Speaker
And you see this over and over again. And the example we were talking about was actually Frank Cornelisson, who makes wine in Sicily. And to be totally fair, you know, before he was there, it's not like there weren't really great winemakers and it's not like there weren't winemakers making wine in a more sort of hands-off, more natural way. But this basically sort of
01:42:19
Speaker
eccentric Austrian guy shows up and starts making Georgian style wines, you know, on Mount Etna. And, you know, that was a very, that
01:42:31
Speaker
you know, kind of gave some momentum to this consideration of a new approach to winemaking, you know. And one sees this a lot. There's, and I know a lot of people who have uprooted themselves to a place where they have no ties because they fell in love with the land, with the people, with the tradition and no experience making wines at all, totally different perfection.
01:42:59
Speaker
and ended up where they did. And, you know, the guy I told you about who Christophe and I went to visit on the island of Tenos, Jerome Binda. That's another great example, right? He, you know, the domain De Colatus was built by him physically just on like out of bare rock. Like he moved to this island where there's more sheep than wineries or humans. And
01:43:24
Speaker
you know, finds these like old bush finds that basically crawl on the ground. They're indigenous grape varieties. No one has ever heard of them and starts making wine from them. And has built an incredibly sort of idyllic living for himself. And, you know, like he planted fruit trees, he lives off the land, he doesn't really, you know, there's, they don't really. It's subsistence agriculture, basically, right? It's subsistence agriculture. And, you know, I'm very wary of that sort of romantic
01:43:54
Speaker
view of things, because you know, like the thing that I really am very, you know, like the thing I'm very suspicious of is you when you think about like, those old Watteau paintings, like Embarkment for Sathera, where like basically you had these rich people like, you know, Marie Antoinette in her court. No,
01:44:17
Speaker
play like playing at being shepherds and shepherdesses sort of like playing at this like idyllic pastoral existence. And I see people doing this these days as well, you know, but because I, you know, I have a lot of friends who didn't grow up with any money who are winemakers, and it's in their struggle is very real. But, you know, regardless, my point is that like, it's not
01:44:47
Speaker
It's not about the glamor of the pastoral life or whatever. I just really appreciate that. They had this passion. They acted on it. And they went somewhere and did something that, rather than being just invasive and just superimposing their will, they made themselves work
01:45:13
Speaker
together and part of the natural habitat and not just like the natural habitat. I'm also talking about the human habitat, you know, like the people they lived around and did something really creative and productive with what was already there and, you know, discovered a lot of things that people on the island probably already knew about but had never brought to the attention of the rest of the world. So I think we're super grateful for people like, you know, when they're
01:45:42
Speaker
when they do that. And it's, I think having that sort of, again, different perspective as an outsider, like marveling at something that maybe the people who were on Tino's, a lot of them no longer marveled at or, you know, so they took for granted. And so I think it's really, it's a, it's a gift sometimes to be the outsider. And, you know, I have a friend, Phil Lardo, who is making wines at the Mosul and he,
01:46:12
Speaker
is like part Dutch, part Belgian. He's like a European mutt of some kind. And he had a choice. He had moved harvest in France and with Chemin Blanc, and he had also worked high risk at the Mosul with Clemensbush. And those are both lovely wine places. And the wine in those regions are both delicious. So it's a tough choice. And I think he ultimately, I mean,
01:46:39
Speaker
He ultimately, I think, made the right choice, but he, you know, it was, I'm sure it was difficult for him. And, you know, the thing you probably know about the Mosul now is that a lot of... Assume that I know nothing. That's always your safest bet. The vineyards are quite steep. You know, it's not easy work.
01:46:57
Speaker
And you also do have to fight against a lot of local entrenched. Oh, yeah, with the steep slopes, you know, just people also know that yes, at the Mosley, they have extremely steep slopes, that's, there's an inherent danger. Just villages with traditions of winemaking that may be very entrenched in sort of conventional farming, very entrenched in certain ideas.
01:47:20
Speaker
And so, yeah, like, I really admire him for just uprooting himself and moving there. And he's really doing an incredible job. He works with Uli Stein. And I just, I love that about wine. It brings so many different people together that never would have met each other otherwise. And I, you know, I'm personally grateful because
01:47:41
Speaker
without wine, I never would have met you or many of my other really good friends. And it just like all happens to us, right? Like I met Christoph at a wine tasting in Munich.
01:47:54
Speaker
Yes. I think absolutely wine is something that is social, something that connects people. I think it is something else wonderful. It is something that's crafty. It's something that is artistic. It combines all of these things together. And I think sometimes wine has become in some
01:48:13
Speaker
areas. You said China, but it has another area as well. In some areas also in Germany, where it has gained this reputation of something that's not easily accessible and you have to be trained, it's a little authoritarian. And I think that's a big problem because
01:48:30
Speaker
It shouldn't. It shouldn't be that. It should be the drink of the people, in a way. And if you think about it, if you go way back, if you go back to the medieval times, this is what people drank, all of them. Wine was basically terrible. They woke up and had a glass of wine from way back when.
01:48:48
Speaker
But it was safe because of the alcohol, of conservation level, preservation levels and all of that. So I think we should come back to something like that. So encourage more of a culture that doesn't give this feeling of vegetarian consumption, but something that is actually bringing people together. I think that's true. And something you just said, I think is also beautiful because it serves as a beautiful metaphor generally.
01:49:14
Speaker
for the influence of the outsider. Somebody that comes in from the outside has the power of not challenging, but adding to existing structures and also opening up an alternative to already existing routines. And this is something that is always valuable. And I read an article today about the identity politics of the left, so to speak, here in Germany. I think this is a whole different
01:49:41
Speaker
discussion is still even in America, the United States, a lot more hysterical even than here, I believe. But it's about how we get behind those identity politics of minorities and turn them into something positive. And this is something that is very often
01:50:01
Speaker
criticize about the left and one of the reasons why we have this schism happening, you know, this polarization in a lot of the ways. At the same time, if you say that, the author of the article whose name I don't know now, he said,
01:50:18
Speaker
that's only one way of looking at it, because we've had identity politics all the time about the normal things in our society as well, the already existing things that are being challenged by minorities. And if that's challenged, and this is considered the status quo, this is as much identity politics as anything else. So rather than seeing the minorities challenging that and causing all this unrest, basically, it should rather be seen as an opportunity to look at our society
Asian American Identity and Microaggressions
01:50:47
Speaker
and the status quo and question it, what of these things that our existence are serving us and which things aren't serving us? So rather than hiding behind a wall, you know, we are this, we are this greater part of everything and everyone, rather take in and look at the minorities to present us with an accurate reflection of what we have in place and what we should be changing maybe, if somebody's saying us, look, this is how we see each other, or this is how we see ourselves,
01:51:14
Speaker
it would be nice if you saw us just the same way that we look at ourselves. And I think this is just tying in with what you just said about wine. And it's a very, very beautiful metaphor for that, very powerful as well, I believe. Well, you know, it's funny because probably more frequently than I've ever seen in the American press recently, I would say since the advent of Black Lives Matter,
01:51:41
Speaker
I've seen more articles from Asian Americans declaring their own sense of identity and their own sort of
01:51:49
Speaker
conflicts and frustrations and ambiguities in America. And I feel like that's good. I've really seen Asians vocalize this because you know, there's the whole sort of we were set up to be the model minority, you know, like in a lot of ways we've had exactly like you said, we've had properties foisted on us that essentially paralyzed us from speaking. And this is why even when I was working in the wine industry and in medicine, I
01:52:16
Speaker
I'm a, well, you know this. I mean, I'm very outspoken, right? Like I have trouble with filtering. And it was, I think very challenging on many levels being a woman, being Asian and being allowed Asian woman together to know how to handle some of the microaggressions that I faced. And I couldn't even, because I couldn't even like put my finger on it or like,
01:52:47
Speaker
You know, verbalize it exactly. You know, how do you complain to someone if you can't even put into words what just happened, even though you know something just happened?
01:52:59
Speaker
that was deeply unsettling and inappropriate or something, and yet you can't even express to them. Or if you do try to express it to them, you're basically told you were making a big deal out of something. They, you know, you misread the situation. They never intended to, you know, that to come like that hat. I can't tell you how many conversations I've had where it's like, you're overreacting. Oh, yeah. And I just, I just never knew how to express that because I'm like, well, I can't express it because I don't even know what it is.
01:53:28
Speaker
And it makes me really happy, even though I don't always relate to some of these articles, like the specific experiences of the people who are writing these articles. I'm just so glad that like Asians are talking at least about how they feel. And I think for a long time, we just felt like we couldn't also because we felt like, especially me, I feel like I have no right to talk about anything because if you look at how
01:53:55
Speaker
bad the lives of people in Baltimore who are African American. Like I have no right to say anything. Like it was really funny. There was one night when I was walking down the street, um, because a lot of people don't think that you should be walking around the area around Hopkins at night or whatever. But I was walking down the street and I was passing this African American man. And I thought to myself, you know, it's so funny because like he has so many more reasons to be scared actually than I do walking down the street right now.
01:54:27
Speaker
Um, and so, you know, like, I think because of all those reasons, we just don't, we, we feel like we have no legitimate right to say things. And, um, I think what's nice, like you said, is that everyone has a right to feel a certain way and to everyone's entitled to their personal experiences and to try to like, um,
01:54:50
Speaker
explain their personal experiences and where they're coming from and not have it be like, well, that's your ethnic identity or that's, you know, like without having it become like a greater label. And what was funny in med school when they were trying to teach us cultural competency is literally we were handed this paper from like, I don't know, the 90s or 2000s where it was like Caucasian concept of life and they drew a little squiggly diagram and like told you this is how white people think and then
01:55:20
Speaker
Asians and talked about like Asian values and drew a little like circularly diagram. And this is how Asians think about life. And, you know, and it was like, it did that it did this ethnic breakdown. And there was a different diagram with swigglies for each of them. And like, that was cultural competence. It was like, if you're engaging with this, this type of person, these are the things you should assume are, you know, on their list of concerns. And, you know, like, I just I could not. Wow. Yeah.
01:55:49
Speaker
This is when I was in med school not too long ago. Do you see, do you see, you know, every, every, every medical program, I can't speak to other ones. I think every medical program at least does try to do some proactive, like cultural competency training. I think it just, um, I think it lags far behind the complexities of culture that currently exist. I'll just leave it at that.
01:56:18
Speaker
It's good that there's lip service at least being paid to it, but I think the true deep empathy towards our patients' experiences and their cultures, I think it's also well understood that that's not been sufficient.
01:56:37
Speaker
And in genetics, that's been a huge problem because a lot of people don't understand what genetics is and don't understand when they might need it and don't understand what we do and what we're for. And unfortunately, in underserved populations, that's worse. And so because they don't seek us out, and if we're too busy, we might not seek them out, they're probably the most underserved in terms of my field. And then the complexities of how to explain certain
01:57:07
Speaker
concepts in genetics, not in English, but in a foreign language. I mean, you see how hard it is for me to explain in English, right? Like, I had to call my mom when I had to try to explain something to someone, a Chinese, like, I had to call my mom to act to run by her what I would say to a Chinese woman.
01:57:27
Speaker
In Chinese? Well, because these Chinese people didn't have words for most of these things, like the words emerged later, you know, the words emerged as the science and the medicine evolves. And so, you know, you would think I would be comfortable talking to people from my own culture about my, you know, this is in about my field, but like, I really like had to think really hard about it, you know, and had to actually do like a lot of looking up of stuff because there's, yeah,
01:57:58
Speaker
It's really, there's a lot of really interesting nuances that come into play. So yeah, I mean, again, I totally, you know, we totally, I think we're totally on the same page. It's very, I just don't understand when people can't appreciate the differences that exist. I think it's as simple as that.
01:58:24
Speaker
Yes. I think you nailed it. Yes. Why not appreciate the differences? I also believe, you know, I believe we have all the differences and at the same time we're essentially not the same, but we share
01:58:42
Speaker
at least a common origin. I think you can be different and you can be the same. I think life is full of contradictions and I think we have to learn to live with those contradictions so we can be entirely different from each other.
01:59:00
Speaker
And I think we are also all islands in that sense. I think the soul and the human mind is just so complex that out of in every situation, there's an abundance and infinity of possible interpretations for each and every one of us. But I think if we just sum it up, the motivations behind what we do,
01:59:20
Speaker
they will very often correspond to somebody else's motivations. And I think this is what we should focus on so that the one doesn't exclude the other at all. And we can be happy to be different, to be learning from those differences and still at the end of the day to sit down and have a glass of wine and go, look, we both like the wine we're drinking. That's fantastic.
01:59:45
Speaker
Well, I think something we forget is the element of time, right? Like, we also all evolve over time. And a lot of how we think about something can be affected by what we hear from other people, you know, and it becomes a part of our repertoire. And how, you know, I think we often need to remember that, like, you know, it's funny, because I always found myself wondering when I was a kid,
02:00:14
Speaker
how my mom could be so crazy about certain things that she, like when I did them, that she told me she did as like, my mother would get in trouble for the same things, like that she, I was getting in trouble with her for. And I kept thinking to myself, did she just like become a totally different person? Does she not remember her past self? You know, and that, that is kind of scary, you know, that as we evolve, we could be entirely several hundreds of entirely different people. And you know, it could be synchronous too.
02:00:43
Speaker
definitely can be lots of different people at the same time as well. Hopefully not to the point where we need medication, but you know. But yeah, exactly like you said, you know, we're different and the same at the same time, like it's just like we harbor a lot of elements of other people in us.
Mindfulness and Wine
02:01:08
Speaker
We harbor a lot of the same risks for both goodness and evil. We harbor a lot of the same instincts, a lot of the same biochemical tendencies, a lot of the same human frailties and potentials for heroism.
02:01:26
Speaker
And so it's a personal experience and personal experience, you know, I don't have the same experience as anybody else. And I don't know how I would deal with somebody else's situation. So this whole.
02:01:41
Speaker
Idea and and air of you know judging others. I know we all do it. I do it. Don't get me wrong I am. I'm no different from anybody else. I do it. I try to break it I try not to and I try to keep an open mind it is very hard Sometimes as well because also there's this thing subconscious and everything so it's an incredibly complex process throughout life, but What what I'm trying to say is that that?
02:02:08
Speaker
It never serves us to judge because the only thing that we can judge and even that we shouldn't is our own actions based on our own experience because that's the only thing that we actually really truly know and understand. And everything else is just guesswork.
02:02:24
Speaker
Although Basti, don't you find that a lot of times the tendency to judge is associated with our own insecurities about ourselves? We're judging so that we don't, if we, if we didn't judge the other person, we might suddenly find ourselves feeling inadequate in our judgment of ourselves, right? Like that's what a lot of it stems from is our own insecurity. So I agree with you. I think we shouldn't be so hard on ourselves either.
02:02:50
Speaker
Yes. I agree with you. I agree with you. And we should also admit to ourselves that we are not perfect and that we have weaknesses and that that is perfectly fine. I discover, you know, a lot of weaknesses about myself and that's good. I also, I personally also, I'm on this, I'm on this, I'm in this place right now. I do think about, I'm
02:03:19
Speaker
going down the path of mindfulness right now, going down the path of mindfulness, that sounds super blase, but I'm interested in it. How can I just be in the present moment more than I am? And I think that's a very interesting question. And how can I do it very hard? What prevents me from doing it? Meditation is one of those things that can help you with that.
02:03:43
Speaker
But everybody has also their own way of achieving it and I'm just, you know, just looking at it, contemplating it. And I think that's a good starting point, at least. As far as I've understood, at least, mindfulness, that's a very good starting point. Contemplating it and realizing that there is no place you have to go
02:04:05
Speaker
but only the place where you already are, which is the present moment. This is the essence of everything. According to my understanding, some other people might say, no, it's something entirely different, and that might be equally true.
02:04:20
Speaker
But so with all of this, that's that's and when you do that, you realize literally that there is nothing that that you are either ahead or behind anybody else. You are just in your current state of being in your current situation in life. And there's no forward, there's no backward. It's only important that you focus on what you have right ahead of you. And I think a lot of a lot of
02:04:49
Speaker
A lot of goodness lies in that, at least. So yeah, I think wine and this all started with wine. You see the power of wine. That's the only time I can do mindfulness, basically. You're so severely ADHD that that's basically the time.
02:05:11
Speaker
Yeah, absolutely. Well, it seems to be working really well, at least from my observation right there. I just want to quickly, because what you said, like, there's now you feel there's something starting where also Asian Americans are voicing their situation and their concerns, issues, so to say, in American society and their part in it.
02:05:36
Speaker
Do you think this is something that has now picked up and it is going to become a stronger movement if it is a movement, if it is just an awareness? I mean, those are all just words. Or what are you hoping from it? Are you hoping for anything? I'm not really a collective force person, so probably
02:06:01
Speaker
And I think that gets to what the concept of Asian-American is, which itself is fraught. Because if you try to lump, and I made fun of you this earlier, but if you try to lump Koreans, Chinese, and Japanese people together, someone's going to get mad at you. I totally did that, yes. There's also so many different types of Chinese people even in America. The Chinese people who live on the east and west coast are different.
02:06:29
Speaker
uh the chinese people who live uh you know when my parents always used to drive to flushing for their chinese food which is different from the people who go to the new york city china i mean these are i'm giving you stereotypical dichotomies but you know all of this is to say there's you know there was many waves of immigration for different reasons people who speak different languages i think a lot of people
02:06:50
Speaker
don't understand that in China, there's like 56 different ethnic minorities and at least that number of languages. And so I've often been caught in situations where like, you know, an American person says to me, well, why don't you explain to this person, like, in your language? And I'm like, well, I don't speak their language. I'm sorry.
02:07:09
Speaker
Wow. But yeah, and then like, you know, then, you know, the people who come from the Indian subcontinent really want to be associated with the greater Asian, you know, it's, I mean, you know, my friends and I joke about this a lot. But I think fundamentally, it's not the same as the African American experience, because
02:07:29
Speaker
that's an entire group of indigenous people. And this is many, many, many groups of immigrants all coming at different times. I don't know if there is such a thing as a collective movement that's gonna come from that. I think it's just nice that individual people are able to...
02:07:46
Speaker
feel more open about expressing themselves. Can I just quickly tie in that? Because indigenous people is very tricky when it comes to the United States, right? Because there are no indigenous people except for, you know, Native Americans and they actually also traversed to the United States like when there was still one, you know,
02:08:11
Speaker
I mean technically Gosti there is no indigenous anything because all of the humans came to work out so I mean we can we can be semantically annoying about this term. Which is totally what I was trying to be. Which is totally what I was trying to be. African Americans were definitely here before most of the Asians were here.
02:08:32
Speaker
fine historically speaking yes as little as i know i mean maybe there was like the rando chinese person on the mayflower that i didn't know about you know me neither by the way so you say i didn't i didn't hear about that one guy one did in well yes um but yeah i think it's different and i think this also goes back to like
02:08:58
Speaker
you know, the issue of identity, which is we, it's not like it's like, you know, I also don't tend to be involved in like, like, I have a lot of friends who are very strong, the active, I would say feminists, and I respect them and I respect all of the things they do. But, you know, I,
02:09:20
Speaker
My personal preference is I don't want to be thought of as an Asian, or as a woman, or as an Asian woman, or a woman in the wine industry, or a woman who's a doctor. I'm just me. For me, my label is Shao. I don't really need any other labels, and I don't really need to be identified with anyone else is my preference. I would just like to be identified for who I am and all of the different things that go into who I am.
02:09:45
Speaker
Yes, it should be about the content of your character and not about the color of your skin or any other external factors for that sense. And I think that sentence is as valid now as it was roughly 60 years ago. So I think Martin Luther King totally nailed that one. Big shout out to Martin Luther King, who was an amazing man.
02:10:14
Speaker
Yeah. And the different, you know, for Asians, again, I have to emphasize is that there was not this, there was some, don't get me wrong, there was actually some systematic legalized racism, there's certain acts that were basically targeted against Asians in America, but not nearly to the pervasiveness and the extent and the like the
02:10:38
Speaker
the ongoing legacy that African Americans have experienced. So I think, you know, part of why, you know, I think that plays into this issue of, you know, my identity politics is that it's not just about, at this point it's, for African Americans, I don't think it's simply a gripe about like the color of your skin being different or who you are. It's like this shit has had serious repercussions for generations and generations of a group of people.
02:11:08
Speaker
Yes. The only reason I pointed that out, just to get back to that earlier, about being indigenous or more indigenous or whatever else, it wasn't a question of semantics for me. When you look at your situation, you can compare it to somebody else's, and you say that they are more indigenous than me or something like that, and you see it as varying levels of entitlement, so to say, if you will.
02:11:37
Speaker
um to their own struggle and everything else uh and their their their fight that they have to fight um i think it's understandable but wouldn't it be better to combine your forces you know rather than because isn't that in itself also again i don't think i was bringing the fact that you should stratify i i didn't imply that there's a lot of brands of asian i don't know if all the brands of asian want to play together to make a big combined force i don't know i i
02:12:05
Speaker
I like brands of Asian. I don't participate in these discussions, so I really can't speak for the many different brands of Asian. I think just because there's such a diversity of cultures, I don't know if that's a thing that people are talking about. I think it could be interesting, but again, I really don't spend a lot of time thinking about this.
02:12:33
Speaker
Yeah. All right. Fair enough. Fair enough. Yeah, but I definitely don't think that, you know, just because you're here longer, you're entitled to, you know, I definitely not like I don't think that has anything to do with anything.
02:12:49
Speaker
And I think maybe entitlement also wasn't the right term. And now we're back to semantics, but like a stronger case, maybe let me put it that way or something like that. Because yeah, I just see that sometimes I think it would just be
02:13:05
Speaker
maybe easier, but maybe that's also just me looking in from the inside, because obviously I'm white and super privileged. So, you know, that says it all, I believe. I mean, by that token, you actually can't even open your mouth. I should not. I should not. You get an entitlement. There are times... You actually just let me talk the whole time, and you're not entitled to have any opinions, really.
02:13:33
Speaker
Sure. Go right ahead. This stage is yours. And then you become the minority. Well, I think it would serve, you know, a white privileged white guy like myself, very good to be in the minority at some point, because it's, you know, I think I think we can take we will be able to take a lot from that, at least to to empathize and to understand
02:14:01
Speaker
You know the Perspective and the view of people that are minorities This is the problem because we are not we just always know this position of being the majority of being white of being privileged That it's so hard for a lot of us to empathize and to understand what other people are saying That do not belong to my to my ethnic group so to speak
02:14:27
Speaker
Which is why i said this before it's always good to read the art and the literature and look at the art of those minorities that you want to have a strong opinion about if that's what you want to do opening excel sheet now.
02:14:44
Speaker
No, sorry. I'm still listening. I'm still listening. There's an emergency call. Oh, did you get an emergency button? I think everybody here has to know that you are on call, right? No, I'm not on call anymore. You're not on call.
02:15:01
Speaker
I'm not on call. Oh, that's good to know. So I can talk a little slower now. That's great. That's fantastic.
Sustainability in Winemaking and Medicine
02:15:08
Speaker
I stopped being on call technically yesterday morning. All right. Great. Good for you. Good for you. Good for you. So just one thing about the other part of the opening to the wine that we discussed. I don't even remember.
02:15:26
Speaker
Oh, you don't remember, don't worry. But of course I will remind you, you know, I got my notes here, so you don't, I mean, you're not expected to remember all of that. Of course not. It was about, you know, wine and how it is...
02:15:41
Speaker
You said there are a few things as inspirational as this collaboration between human endeavor and the awesomeness of nature, of empirical knowledge and intuitive wisdom. So when we said earlier as well that I think when we also talked about science and about nature already and this dichotomy between the two and how them being so far apart now doesn't really serve our own purposes and sustainability that we're looking for.
02:16:11
Speaker
I was wondering how in wine we can maybe discover how to learn or live better in accordance with nature and see it more as a collaboration, as a coexistence, rather than just a
02:16:31
Speaker
a servant of our needs, right? I think this is what nature has become to us very much. Like we just see it as something that serves our needs as a producer to quell our thirst. And I think wine in that sense, well, okay, thirst, wine, anyway. So what do you think we can learn from that? Because wine making is very much in harmony also with nature and with the laws that go with that.
02:17:02
Speaker
Well, so a lot of the places where winemaking originated is in places where you literally could not survive growing anything else. So if you think about these inhospitable places to agriculture where there's just bare rock, not very much soil, not very much water,
02:17:30
Speaker
Mostly you can grow vines or you can grow olives, right? So in the our dash for example people were just like subsistence farmers super super poor for a long time and they There are three main agricultural industries I think were grape growing and then eventually they also discovered that walnut trees and mulberry trees for making for growing like silks
02:17:57
Speaker
like raising silkworms could also be somewhat lucrative. And then they had a brief period of time in the 1800s when they were like slightly above subsistence living. And then there were simultaneously three agricultural plagues that wiped out those three industries. So for one, it was Phylloxera, which was conveniently brought over on an American boat.
02:18:21
Speaker
as a gift from us. Nice. Nice. Well done. Yeah. But yeah, and then they had to relearn the whole process of actually being able to grow vines again in a way where their vines could survive with this plague. It's so interesting because we think about
02:18:44
Speaker
You think about populations that encounter new viruses or bugs, pathogens without any resistance built in. You think about the European settlers killing all of the Cortez and the Aztecs all dying of European diseases. It's gone the other direction too.
02:19:12
Speaker
Um, and Phloxra really killed off a good amount of, um, old world vineyards. Actually Germany did quite well because it was so cold and, um, they didn't survive nearly as well. So that's why in Germany, you see a lot more very, very old vineyards, which is, and, and wonderful. Very old vines. You know, that's why old vine reasoning is so good. There's that concentration.
02:19:39
Speaker
um, and that depth that you really find with older vines that you sometimes can't get with younger vines. Um, and, uh, you know, when you're, when you're there harvesting at the Mosul and you're walking amongst these older vines at a 70 degree angle from the ground, and I'm very afraid of heights. So I thought that, you know, falling in love with the Mosul was one of the worst things that I could have done choice wise. I could have gone for something flat, like the faults. Um, but.
02:20:10
Speaker
It's so crazy. Like you literally spend your day picking with, you know, your friends and you end up at the end of the day with like two plastic bins of grapes because there were like two grapes on each vine sometimes. Spent like, I mean, this is, it's not like, you know, some of these, um, more industrial places where you basically go in with a machine and you just like shake the branches and then everything falls in, you know?
02:20:38
Speaker
That's something I really, really do appreciate about the smaller winemakers, you know, who really care to spend the time to make a quality product. And, you know, they spend a lot of time every day in the vineyards, not just for harvest. Like, there's something to be done every season.
02:21:04
Speaker
in terms of taking care of your minds. And I think a lot of what winemaking is about that can teach doctors a lot is about judicious non-action. So knowing when to hold yourself back from acting out of a feeling that you need to, out of worry or acting to make yourself feel better and doing things for
02:21:33
Speaker
you know, the actual reason. I think sometimes in medicine, because we care about our patients, we often want to treat them. We want to do things in order to assuage their pain and our own pain. And sometimes it's important to step back and actually take some more time not to act and think before we choose certain interventions. And I think winemakers are a really good example of this.
02:21:57
Speaker
they're very considered, not all of them, I'm just talking about like the ones I happen to really admire and know personally. They're very deliberate and very considered and they know when they need to take themselves away from doing too much to something and letting the grapes and the year and the climate speak for itself. And I think that sort of
02:22:23
Speaker
active, not inaction, I guess, if you will, is a very mature and very difficult thing to develop. And I think it has a lot, it goes back to your whole concept of mindfulness, you know, is, it's something that I like, you know, I think,
02:22:50
Speaker
a lot of the farmers who practice them more, we think of hands-off winemaking as, oh, it's just easier. They don't have to do as much. It's actually not true at all. They spend a lot of time in their vineyards looking, learning, letting their vines tell them what is needed rather than trying to execute an algorithm or do something
02:23:19
Speaker
Uh, you know, I think that sort of, or, you know, and also in the, in the cellar tasting frequently, um, watching the evolution of a wine, um, that, you know, that sort of close observation is, is really valuable thing. And it's something that we often in a lot of different fields and in the pace of life that we have, um,
02:23:46
Speaker
are find very difficult to have the patience to take the time to listen to what
02:23:57
Speaker
nature is telling us and not just nature, but also, you know, after harvest, um, what our experiment, I guess, if you want to call the evolving line in the barrel that is telling us. Um, and so I, I really think that that's an important lesson that we can learn from, uh, the the culturists. Yes. I, I, you know, I think it's, it's, it's quite amazing for me, winemaking to make something
02:24:27
Speaker
to create something predictable from something that is non-predictable. This is the one thing. I mean, it's not that you can't predict it, but at the end of the day, at the end of a year, at the end of a year of a vintage, you want to have a good red wine. And you can just follow your experience and what goes into producing that red wine, even though the variables every year are different.
02:24:55
Speaker
than the previous year. You will have pebbles. I think the other thing is that it's not Coca-Cola. It's not meant to be identical. I mean, that's the great thing, right? Like I think the difference between, you know, it goes back to like, well, you know what JFK said, like ask not what your country, you know, ask what you can do for your country. I always feel that way about the wine I'm drinking.
02:25:22
Speaker
It's like, don't ask. I try not to ask my wines what they're going to do for me. I just try to ask them what they want to show me. And I think it's maybe a different approach to drinking wine. I think everyone should enjoy the wine they're drinking. But for me, I know personally that I will derive some kind of either visceral, intellectual, or emotional, or all three, or some combination thereof experience.
02:25:47
Speaker
from the wine so I just kind of relax and let it like talk to me and that's why I really like that you kept your wine for a long time because one of the things I think is so interesting about a wine is its life cycle like not just the one immediate drinking experience but wines are like human beings they have personalities they evolve over time. I love watching the wine evolve through its life and watching it like how it dies almost is something I'm really
02:26:15
Speaker
interested in, which is why I tend to drink a bottle of wine sometimes for weeks or even months, I keep it around just to revisit it and see where it is in its life. And sometimes it'll surprise you, you know, sometimes when you least expect it, there's this blossoming of fruit and you're like, Whoa, what do we got there? But yeah, I think we just I think we would all learn more if we just like shut the fuck up and like, let the wine or the
02:26:45
Speaker
Vine do the talking and trusted to, and it's not, and I think that's the other thing is I think, you know, there's, nature is very scary, right? Like nature has a lot of unpredictable elements and things like that. And that partnership is so fraught, but what is so interesting is how farmers are able to sustain that balance between like, you know,
02:27:15
Speaker
knowing when to intervene and knowing when to just trust that things will be okay. This is something that we as doctors face all the time, this tension. And it's hard. And sometimes even when you have tons of data, it's hard. And I think the nice thing about the tradition of history and why making is that
02:27:40
Speaker
You know, a lot of winemakers don't just have their own data. They have the data of all their colleagues who are making wine now. They also have the data of all of the colleagues that have come before them who have been working that land and working on those vines. And they've not all treated the vines well. You know, I'm not saying that everyone necessarily treats their vineyards very well or the same, but you learn from all of that. And it's an ongoing
02:28:11
Speaker
it's an ongoing exchange. And I think, so my, in full disclosure, my grandfather was a horticulturalist and he had a lot of really cool plants. So I think every one of my family, including my mother, who was, you know, grew up as a pharmaceutical chemist interested in natural products chemistry, like we all really, like, there's something very,
02:28:34
Speaker
magical about plants. And I think I told you this before, but Goethe wrote a book about plants.
02:28:43
Speaker
where he almost sort of talks about like plants having like a soul and you know they definitely have cycles like we know that that's actually pretty well understood that plants have circadian rhythms and have certain almost like I guess you could say hormonal cycles and that they talk to each other through hormones they're different from human hormones but they you know there's communication and that they all influence each other and
02:29:06
Speaker
And it's so interesting, it's so cool. And I think like, you know, trying to foist, I feel bad sometimes because I think like, especially when we work in human fields, like, you know, medicine and human genetics, we sometimes like have this tendency to be very anthropocentric. Like we tend to think about everything through analogies to what the human experience is, right? And I really like to try to get away from that and try to like,
02:29:33
Speaker
you know, appreciate what different organisms can teach us and sort of not think about everything from the lens of like how human beings work. Because like you said before, human beings are a freakin' point in evolution, you know. Yeah, we're biased. And if there's one thing that science teaches us is that we should be non-biased or at least know about our bias and do everything in our power to
02:29:57
Speaker
counteract upon that bias to come to results that will really be dependable and serve us well. I think we haven't even gotten close to that, to be honest with you, because it's all very anthropocentric, like you just said. I think we have a tendency to try to have control over elements in order to understand. There's something we call lumping versus splitting. You either deconstruct so that you can
02:30:26
Speaker
isolate contributions from individual parts or you kind of like take it all together as a group. And I think like in winemaking this, a lot of the same debate happens a lot as well. Like some people are lumpers and some people are splitters, you know, people have different personalities and approaches.
02:30:41
Speaker
And what you see in the farming part is that a lot of people who practice sort of more organic or biodynamic farming, they really do this thing in their vineyards where they plant different crops in between the vines and they try to get as much of a biodiversity of animals and insects and
02:31:04
Speaker
Other plants and you know microorganisms like fungi as much as possible because they understand that it's like. You know the biodiversity that kind of they everyone kind of talks to each other and contributes nutrients and it's like sort of symbiotic.
02:31:22
Speaker
I mean, this is like what happens in human guts, right? Like in our gut, there's a shit ton of bacteria. It's called your microbiome. And like, all of these bacteria live in symbiosis with us. And in fact, they're necessary for us to even be alive. I mean, they make our vitamin K, they do a lot of things for us. And without them, we would not maintain homeostasis. And so like,
02:31:45
Speaker
It's such an obvious concept. It's not necessarily for everyone. But it's just beautiful to see that when you're in the vineyard and see how healthy everything is versus some more traditional, like you just have a lot of people throwing lots of toxins.
02:32:10
Speaker
in the ground, you know, trying to get rid of weeds. And in some ways, I think of the analogy to cancer, because, you know, in cancer, we're still in this very primitive phase where we have people, you know, these chemotherapy drugs that basically just like carpet bomb your body, and you hope that the cancer cells die more than your body does. But you either die of the cancer or you die of the treatment for the cancer, you know, and checking an ant with an atomic bomb in a way, right?
02:32:38
Speaker
It's carbon-bombing, right? And so that is to try to kill off every single bad cancer cell you have. But then cancer cells actually are a very heterogeneous group of cells we're learning. As people start to sequence individual cancer cells, we're learning that it's basically like HIV. It's like a quasi-species. Each has its own different kind of genetic repertoire. And so in some ways, it's probably hard to kill it off entirely because you probably kill off
02:33:05
Speaker
all but one and then that one sweeps to dominance and takes over the whole colony, then you're dealing with a second cancer. So maybe in the future, one thing that oncologists can think about is trying to do more of a cytostatic approach, more like what farmers are doing in the vineyards where you just try to get everything to live in a balance rather than try to kill everything off because trying to kill everything off hasn't really worked. All you've done is generate resistance clones.
02:33:30
Speaker
And so if you just keep the tumor from growing further and just keep it in place, maybe that's a better solution. I don't know. But yeah. Is that all about balance in the end though? Isn't it all about equilibrium and how we can maintain that? I think this is what I'm the all I get. I believe it's something you should seek out consciously all the time to create an equilibrium. Absolutely. Yeah.
02:33:56
Speaker
I just quickly, because you said Goethe earlier, Johann Wolfgang von Goethe, one of the great German poets. Amazing that you know him anyway. I mean, I know him because I'm German, so that's quite obvious. We celebrate him. But he wrote a book on plants and also because he was very much taken in by Alexander von Humboldt.
02:34:19
Speaker
And Alexander von Humboldt, as far as I know, there were still street parades in his name in the United States until like 100-150 years ago. And now no one knows who he is. And now nobody knows who he is, even though there are cities in the United States still named after him, right? And the cheese, maybe. Do you think that the cheese?
02:34:37
Speaker
Yeah, there's a cheese named Humboldt Fog. I wonder if it's original. Maybe it's named after a city or a town that was named after him. I don't know. Possibly. I would think that's a pretty safe guess that that's probably the case. But because some of the concepts you just said are concepts that Alexander von Humboldt actually postulated.
02:34:58
Speaker
like already 200 years ago, like he already had an idea of the equilibrium of nature, that if you take away from something too much, something will grow in its place. And that this will really, in the long run, shift the relationships in nature. And he was one of the first ones to postulate that and to say that, and who had a holistic approach to nature,
02:35:27
Speaker
Even since him, I believe we haven't had a lot of people, because if we had had a lot of people since him postulating that, the world wouldn't look the way that it is right now.
Globalization, Climate, and Vaccine Distribution
02:35:39
Speaker
So he was really a
02:35:42
Speaker
And, you know, a visionary in that sense, somebody who for the first time put all of this on paper and gave it a theory, a framework. And I think we should really revisit some of his writings and some of his works. I mean, this is why all we do all the time is just reinvent the same wheel that someone else probably knew before, right? It's like, you know, how fashion cycles every few years kind of thing. I'm big in fashion. I mean, as you can tell, I just, I follow it.
02:36:12
Speaker
I think a lot of people probably understand that. I think the problem is putting it into practice. I think there's a lot of things that we may understand, but because it's not foremost in our consciousness or any of our immediate priorities, even if we might understand it, even if we might agree with the concept, no one's making decisions based on that. And I think that's part of the problem because it's not
02:36:41
Speaker
It's not on the radar as an important contributor to our everyday decision-making. Yes, it is. And maybe sometimes also because it is not widely proliferated, you know? I think that's also because I don't... Well, there's also a social aspect of it. I'll tell you like very basic level, you know, in Germany, I get, I feel...
02:37:09
Speaker
When I throw away a piece, I feel like there's eyes watching me everywhere if I put the plastic in the wrong bin in Germany. Like I feel ashamed because in Germany, you feel like there's greater social consciousness about this at baseline civically amongst the population. In America, I would throw away a plastic bottle in the garbage and I would feel guilty about it, but I wouldn't think, oh my God, someone's gonna like,
02:37:38
Speaker
You know, look at me sketchily for that or something, you know what I mean? Because people do it so often and so frequently and people don't even know necessarily if when they put something in the recycling, if actually even makes it into the recycling. Yes.
02:37:55
Speaker
It's not all great here in Germany either. Yeah, of course not. I think a lot of the times we take a lot of care of separating our trash and putting it in different containers and bins for that. But very often, all that separated trash will end up in one big bin and then it's being burnt or something like that, or it's being shipped, which is also a very popular solution.
02:38:22
Speaker
to some Asian countries like Indonesia or also China, Bangladesh, where then they have to deal with the problem, burn it, or do whatever with it. So, yes, on paper we're looking quite good, but we are also just very much, and this is the most euphemistic way I can put this, outsourcing our problems to other places.
02:38:47
Speaker
That's scary. I mean, one of the countries where there's more of a civic level of cognizance about it is at that level. That is a very scary comment on the state of things, right?
02:39:00
Speaker
Yeah. And I think it's hard sometimes to perceive the urgency even though we see it in natural disasters and everything all the time because we don't feel it. It's not like, oh, I feel back pain because there's global warming. You know what I mean? Yeah, exactly. I think aren't getting worse. And so actually- It's abstraction, a level of abstraction. What I think has been really interesting is that we have a lot of patients whose allergies have gotten worse and for whom global warming has really affected
02:39:28
Speaker
a certain set of conditions, you know? And for those people, I definitely, you know, I think they really feel it more. And maybe that's a way that can be gotten across. But, you know, I know for me, it's not, you know, everyone, we're running around thinking about five million things. We always think, well, how can it hurt to be
02:39:57
Speaker
noncompliant one time or how can you know, and it's that sort of mentality because we are not constantly being reminded in some like immediate enforcement kind of way about how much we're hurting the world. And I don't I don't know of a good solution to that. We are
02:40:18
Speaker
like you just put like, you know, like trying to people. Yes. You know, today I was I was I was thinking, you know, it's amazing because for a lot of political discussions, we develop so much hysteria, you know, around those topics when it comes to
02:40:36
Speaker
And now we tie in with identity politics again, in the sense that, you know, if there's a minority that voices, you know, they're concerned that, look, this is how we see ourselves, you would like to just for you to see ourselves the same, which is such a legitimate claim. Right. This is the least you can do. And still there is.
02:40:55
Speaker
Yes, and still there is so much hysteria, but if we do that, don't be this way. Don't be so fucking sensitive. All of that around that way, it's just such a legitimate claim. And when it then comes to global warming and the climate crisis, it's very often like, yeah, but you've got to consider. There's no hysteria in a lot of the ways. Greta Thunberg, she is
02:41:17
Speaker
like maybe I don't even want to call it hysteria because what she's displaying is realism. She's one of the very few people that is displaying realism and she's still being ridiculed by many and especially older white privileged men, right, who cannot deal with her saying it like it is. So... Well, just think about it. I mean, she's how old? Like she's maybe 10 years younger than we are, 20? I don't know how old she is, but she's younger, right? She's 20 years younger than me. She's half my age, to be honest with you.
02:41:47
Speaker
So it's funny because I always think about this. I'm like, well, when the world goes to pot, hopefully I'll be dead by then. But maybe when the world goes to pot for her, she'll still be alive. That really fucking sucks. She'll have to go on Mars or something. We don't. We'll be dead.
02:42:03
Speaker
I can understand why she's panicking. Yes, of course. But then at the same time I have a niece and a nephew and I'm thinking about what their world would look like. So not to be antagonistic in any way. I understand people that have problems. I understand there's also information around that is very clearly trying to
02:42:26
Speaker
uh, disrupt and very clearly trying to drive an agenda despite all the known facts that we haven't despite all the signs. I understand that. So I, just to be clear, I'm not blaming anybody except for maybe really the people, the dark forces at play. And I think there are forces that are claiming that it's all going to be fine. And then walk into a room and say, look, I have a snowball in my hand. There is no global warming, you know, like those are the people that I'm addressing here.
02:42:52
Speaker
Well, the other thing, boss, is that, you know, I think this it's also the whole, you know, climate change and the whole like our current the issues with our current ecosystem is another reflection of where socioeconomic disparities have just been a total like shit.
02:43:12
Speaker
Because if you think about the people who can afford to take the moral high ground, who can afford to eat organic produce and do the more globally responsible things, the people who can shop at Whole Foods versus the people in Baltimore who live in a food desert and can only shop at the local gas station, they have no choice. We've put them in that situation and then we shame them.
02:43:39
Speaker
for not being more eco-responsible. Yes, absolutely. Which is also one of the questions that I very often ask myself, you know, it's the question of the consumer versus politics as well.
02:43:55
Speaker
I believe very often I see politics putting it on the consumer entirely. Look, you're the consumer, you decide what you buy. If there is a demand for non-biologically or organically produced products, then the market will just serve that need and that demand.
02:44:17
Speaker
It's not as simple as that because that means you take politics entirely out of the responsibility of what's going on in the world and also disregard the power of politics in shaping certain policies and certain ideas and certain developments, right? And that's absolutely there without any doubt. At the same time, of course, like to say that consumers shouldn't be mindful of what they're doing, that's also the exact
02:44:44
Speaker
same bullshit, we should, as much as we can with our capabilities, with our resources, be mindful. But that is very wildly differing from one consumer to the other. That's a reality. And it should be something that includes both, and where it responsibly isn't shifted from one group to the other again, but where it's really a communal effort in all aspects of it. And this is what's still missing to a large degree, I believe.
02:45:15
Speaker
Yeah, I mean, I think it's also because it's difficult when you have so many different political systems. I mean, in America, you know, you've probably read a little bit about the frustration with vaccines being given out, right? Because America is very, you know, that all of the sort of built in issues associated with the federalist system, you know, where every same agenda making
02:45:41
Speaker
And just every state gets to make a lot of the decisions on how to execute certain things, right? That's really coming to the fore now. I mean, it was already obvious, I think, to people who work in healthcare just because every state has such different rules about insurance and about newborn screening and other things.
02:46:06
Speaker
also to people in the wine industry, because every state has different alcohol policies. In America, wine is regulated by the same agency that regulates guns, because it's just as dangerous. But yeah, I mean, navigating the politics, the system that's been built without destabilizing it is always tricky, right?
02:46:35
Speaker
It's how do you get this many groups of people on board on the same page.
02:46:41
Speaker
Yes. Well, one beginning would be to have an open, transparent, and non-biased information policy, right? But we're far away from that, obviously, because there are different agendas at play. Well, it's not too bad. I mean, even when you try to give people information, everyone will always still be at risk of filtering the information differently through the lens of their own inherent biases.
02:47:10
Speaker
Of course, yes. And that's one part also of our human existence, of the human state. So it's something we also have to accept, of course. And acceptance doesn't mean that you shouldn't do anything against it, or that you shouldn't necessarily
02:47:34
Speaker
challenge it, but you can accept things. But I think to be honest with you, you have to first accept things in order to change them. I think there's no other way. And so yes, so this is one part of it. What I take away from what you just said, what you just said, it's a little bit because we're traversing a lot of different fields here, which I think is very beautiful because
02:47:55
Speaker
I also see that these things are connected, environment and the virus are connected. Wine making is showing us also serving as metaphors out of this, possibly at least. So there's this whole galvanizing experience for me now in all of this. And what I'm taking away from this conversation in that sense now is also that
02:48:24
Speaker
and the things you said about wine making that
02:48:28
Speaker
It's okay not always knowing precisely what the outcome is of things, right? Maybe this is something that we also have to accept. We don't know exactly what the outcome is. Maybe there will be wine at the end, right? There will be a red wine at the end, or there will be white wine at the end. But I, at this point, cannot tell you exactly this is what it will taste like. This is what the characteristics are. But I'm looking forward to it, and I'm sure it will be pleasing to my palate in one way or the other.
02:48:57
Speaker
I think right now we're living in a world where we want to know exactly what the red wine is, exactly what it tastes like, so that we can sell it and market it ahead of time before it even sees the light of day. I think the other thing, sorry. No, no, I was done. I was done, just in case it wasn't clear. I was totally done. I had it interrupting. So that's such a good point because I think we think about this a lot. And I also am totally guilty of this, right?
02:49:27
Speaker
Not only do I want a certain outcome, I want my way of getting to that outcome, right? It's like we kind of tend to obsess about not just getting the outcome we want, we need it to happen the way we think is best.
02:49:42
Speaker
Um, but you know, in many situations, they're not just, there is not just one right answer and we may not end up in exactly the same place from every single path, but we'll probably end up at least in a place that we're happy with. You know, and I think sometimes exactly like you said, we have to let go of like that fixed
02:50:04
Speaker
necessity of always following the path that we've already planned that we think is the right one and be a little bit more flexible in terms of our expectations and trust a little bit in the outcome.
02:50:23
Speaker
Yes, and react also to what is happening around us, incorporate what is happening around us into our current state of affairs. I think sometimes it's so paralyzed that we just, because we're so paralyzed by consideration of all the possibilities that could happen and all the bad things that could happen that we do nothing and then we really let something bad happen.
02:50:46
Speaker
Yes, exactly. Which point and case pretty much for what's going on in the world right now in a way. And we've been letting this happen for a long time and only now we are starting to get an idea of what this means for our world, for our planet and for our global community in a way. And I think that this is
02:51:08
Speaker
We have to start thinking more of this world as a global community than ever before. It is already a globalized world, but I think we haven't embraced the concept of making this world a community. We haven't done that yet.
02:51:24
Speaker
We have we're looking at this world as a globalized world from the view of economics, from the view of also very often the rich countries taking from the poor. It's that, you know, it's a globalized world. It's nice because now we can produce everything for cheap and China to use that as an example, ship it to the Western countries and then sell it there for cheaper because labor there is a lot cheaper than the US. OK.
02:51:48
Speaker
anymore. Well, yeah, obviously, outsourcing to other countries, which I think has already started to happen. Oh, yeah, it's already starting to happen. So while we're recording this, yes, I'm sure there's a lot of other levels of that going on. But, you know, I think the essence of that is still exactly that. Absolutely. I mean,
02:52:10
Speaker
It's, it's funny because, you know, all of the popular show, there's so many popular dystopian TV shows everywhere. I think I don't know about what's on German TV, because I mostly just watch German murder mysteries, but I know I just met American TV anyway. But I do, I do watch a lot of it as well. You know, there's so many shows about like the dystopian future where because people couldn't get their act together to like collaborate, there's all this like,
02:52:40
Speaker
you know, like everyone ends up basically living a miserable fractured existence where everyone's just trying to like kill each other off for survival. And you're just like, well, I mean, clearly people are aware that's a possibility, so.
02:52:58
Speaker
doing anything about it. That's a whole other question, absolutely. This is where I usually insert joke about, in the Robert Meazeal book, The Man Without Qualities, it's like, well, we could have meetings to talk about it, but then we'll just have meetings about having meetings to talk about talking about it.
02:53:22
Speaker
I think you just summarized the whole book, which is about 1,589 pages of that. I think you have absolutely nailed it. Well done. Well done. So everybody, whoever is attempting to read that book, Shao just totally nailed it. To be honest with you, I didn't finish it because after, I think, page 304, I was like, wow, this is very repetitive. I cannot have it anymore.
02:53:47
Speaker
And I usually always finish the books that I read, but I couldn't. Don't get me wrong, it's still I believe it's a great book, but it is also a book that is showing exactly and capturing that moment in history, what was going on, the bureaucracy, the machinery that was behind all of this, and therefore also
02:54:09
Speaker
showing why this happened. But after page 400, I was like, yeah, I get it. I really get it. But then that's just me. And I am stupid. I have a very limited, you know, understanding of things. So it might very well have to do with that. So I don't want to discourage anyone to read it because it is even if you just go for 400 pages, it's a very good book. I mean, I encourage even if you just want to read it for the chapter headings, just because the chapter title is really funny and you could just skip the book.
02:54:38
Speaker
because it's really funny. We should do a book club or something. I think that's exactly right. Well, I have an idea. It's the book club for lazy people. We start the book club for lazy people. You just read the chapters. That's great. Michael. Yeah, it's like we would love this book. It's called How to Talk About Books You Haven't Read, and it is so funny. I mean, it's clearly written by someone who likes to read for other people who like to read as well.
02:55:06
Speaker
But it's really, really funny. I should send it to you. Oh, please send it to me. So I got the book for a friend of mine who was trying to pick up chicks and wanted to know how he could talk about books he hadn't read. But I ended up keeping the book because the book itself was over 100 pages, so he said it's way too long for him to read. And he wanted a summary of the book.
02:55:32
Speaker
But I think the demographic of guys that are trying to pick up chicks, I think that's a very strong one as well, right? It's like, how do I come across as very clever or very well-read when I'm not? So you see, the book club for lazy people, I think we should definitely brainstorm that a little more. I think there's a lot of potential in that.
02:55:51
Speaker
Did you ever, there's a guy who writes for The Guardian, I think, who summarizes books in a really funny way. No, I read that. Oh, I got to find it for you. You would love this. I'd love to attend it to me. It's basically kind of like book club for lazy people, except all these summaries are written by a guy who probably read the books multiple times. And that's why he's able to like capture the essence of the book, but like very widdly and in like a like a one or two page article.
02:56:20
Speaker
Nice, I would like to do that. And when you send it to me, I will link to it, of course, as well. So can I ask you...
02:56:29
Speaker
In closing, pretty much. Great, because my belly hurts. Well, you've been very patient with us. I can't sit up in a chair anymore for longer than like a few hours. I have to improve the padding on Fonzie's seats, obviously. You're very, very clear about that. That's not Fonzie's fault. I love you. I love you. Thank you for defending Fonzie. You're the greatest traveler. I mean, what can I say?
Pandemic Connections and Telemedicine
02:56:58
Speaker
So I would like to know, first of all,
02:57:02
Speaker
First of all, I mean, it's really not that much, but do you have in your daily routine as well a little bit, do you have any inspirational story for us that happened during the pandemic? And I'm always asking this question where people kind of overcame limitations and restrictions of the pandemic by means of creative self-expression. You know what we talked about earlier, bridging over in a time when
02:57:29
Speaker
physical contact is almost considered harmful or a transgression. I mean, I feel like that happens every day. It's like the favorite question now, you know, what comes to mind first?
02:57:49
Speaker
I think, you know, we've just come up with really creative ways to be able to still spend time with each other. Of course, it's a little bit actually easier for those of us who work in the hospital because we literally don't see anyone else except for each other. But, you know, one thing that we always talk about is before in genetics, we used to hang out in the genetics fellow office and like
02:58:14
Speaker
share stories and talk in person. Once the pandemic happened, that was really hard. We kind of realized how much we all missed that element of just the spontaneous run-in and gathering of a group of people.
02:58:36
Speaker
You know, something that one of my colleagues who actually happens to live on the same floor as I do, what we do is he comes over with his mask and I pour him a glass of some kind of spirit that I have and he pours me a glass of some kind of spirit that he has and then we go back to our room and we get on virtual video chat and we drink while we chat about, you know, patients and medicine and things like that.
02:59:06
Speaker
It's nice, I mean, it's not a lot, and it's kind of goofy that you kind of have to do it like that, but that's one thing that I think was like a very heartwarming little detail to have, you know? And a lot of this type of stuff I have found that I talk, I'm talking a lot more to people I didn't used to talk to as much actually when we didn't have COVID because of this. And I have a really good friend of mine who's currently very, very pregnant,
02:59:36
Speaker
And she and I go and take really long walks in the park together. And we talk about stuff and we sometimes get to work together for the first time on the same patient. So before we never really had that experience where, you know, she was working on one particular service and I was working on another. And now sometimes, you know, we're still working on those independent services, but we're taking care of the same patient and we're offering sort of our different perspectives on that same patient.
03:00:04
Speaker
I think that experience has also brought us closer in a different way, which is really nice. Yeah. That's wonderful. Yeah, sorry. Carry on. I totally forgot. Actually, what I should have told you about is what happened recently, which I totally forgot about. But for a while, I was
03:00:23
Speaker
doing these wine tastings with the pediatric residents where we would sit in a room in person and we taste some wines and stuff. And I would tell them about it. We'd talk about it. It was really fun. It was very relaxed. And exactly what we were talking about earlier, which is trying to make wine not esoteric or fancy, but just a relaxed, fun experience where it's just enjoyable.
03:00:46
Speaker
We weren't able to have this annual pediatrics prom that we used to do where everyone got dressed up and like went to a fancy party basically.
03:00:54
Speaker
So instead we have this incredible experience because our program director is really cool and she knows a lot of really interesting people. She got this French chef who lives in the Languedoc, like near Nimes, actually it's like the border of the Languedoc in Provence, to wake up at one o'clock in the morning to teach a cooking class to all of the pediatrics residents. And they got me to do a wine tasting, like a virtual wine tasting beforehand.
03:01:21
Speaker
And my boyfriend helped by getting us the wines delivered from his warehouse in Virginia to the hospital. I think that was probably the most amount of alcohol that our security guard had ever seen coming through the door at one time. I was probably wondering what's going on with these doctors. But yeah, it was super fun. I mean, it was just like everyone was in their kitchen cooking as a lady from,
03:01:46
Speaker
you know, like literally awake in the middle of the night in the long a duck, like walked us through how to make like, you know, chocolate mousse and cocoa van and on dive salad. And, you know, we got to see everyone in their individual kitchens drinking and cooking and everyone was making funny comments in the zoom. And it was I mean, I wasn't really planning to stay for the whole thing, but it's actually so like there's so much camaraderie and it was just so entertaining that I ended up saying so I thought that was like really great.
03:02:17
Speaker
Nice. Yeah, we're very lucky. We're very we wouldn't I think it'd be much, much harder if we didn't have a job where you are, fortunately, you know, with other people in the job, you know. And I think one of the hardest elements has been not being able to touch our patients sometimes, you know, because we do a lot of virtual telemedicine visits now.
03:02:47
Speaker
not being able to see them face to face, not being able to talk to them face to face, not being able to physically examine them, which is kind of the bread and butter of being a doctor. But we are lucky in other ways, we're very lucky to have a supportive community and to still be allowed to work at our jobs and to be allowed to go to work with other people, which a lot of people have lost that, a lot of people have lost their entire job community.
03:03:16
Speaker
with restaurants closing, you know, all of the people who work in hospitality. So I feel very blessed and privileged to still be able to be in a job where we still have all of those luxuries. I understand that because I feel very privileged as well. Because yes, I have
03:03:39
Speaker
space. That's one of the first things to feel privileged for, right? I have a whole floor to myself, basically. And I can leave the house whenever I want to. And generally, yes, absolutely. I think for me as well, with all of that, I'm glad that you are, so I feel.
03:04:04
Speaker
But no, all I'm saying is I can... You'll tell me anyway, which is great. No, no, I'm just saying that because obviously, you know, why would you ask? But I'm just, I'm just, you know, thinking, you know, it's coming out of me now, it's bursting forth. It's just, I just want to relate, you know, I can just relate to that. I also feel very privileged in that sense. That's all I want to say. That I think, if anything, that's what this whole pandemic has also shown me.
03:04:33
Speaker
Very much. Can I just ask you, what is the current situation actually in the US? Are you still in an official lockdown around Baltimore?
03:04:44
Speaker
That's a great question. I'm still very far away from the point where I would feel comfortable walking into a restaurant and eating inside, but there are people eating inside as we speak in Baltimore restaurants. I mean, usually they wear a mask, but when you're eating, you
03:05:06
Speaker
are probably not going to be wearing a mask. It's sort of practical, let's face it. One of the big controversies that's happening right now is the CDC is telling state governments that premature opening might lead to a resurgence, but a lot of people are starting to relax policies and allow businesses to reopen.
03:05:33
Speaker
CDC is the health agency for everybody that I don't know. I've been getting more and more emails from New York City restaurants, for example, telling me that they're going to reopen and things like that. So, yeah, I don't know. I really feel how devastating and how frustrating the whole COVID experience has been for my friends in the restaurant and hospitality industry. I mean, their lives have been decimated, essentially, by COVID.
03:06:03
Speaker
I see this as an opportunity for them, but obviously as a healthcare provider, I'm terrified of the consequences. So I'm very, I'm very ambivalent. But you have been vaccinated now, right? Yes, yes. I mean, but you know, just being vaccinated doesn't mean a person should go. You could still be carrying, right? You could still be carrying them just because it's not known yet, right? Like the flu. I mean, you can still get the flu if you get the flu vaccine, right? Yeah.
03:06:33
Speaker
Yeah. So basically you're still, you restricting yourself and your own radius of action in that sense is because of the care for others, right? It's not just me. I mean, I think as a healthcare provider, you're obligated to consider the safety of your patients. But that's what I mean. You're looking out for whoever's in your care and whoever you get in contact with. You have to be, you have to be cognizant of your choices. Yeah. And so
03:06:59
Speaker
you know, Nicholas and I have also faced some tough decisions with regard to like hanging out with our friends and like who to hang out with and we're not hanging out with and things like that. And I think fortunately, we're generally anti social people. So it's not like a big deal. You showed that today, three hours, 12 minutes on the clock is super a social. I mean, I have to I mean, bossy, that's just because I took some extra energy pills for this, you know.
03:07:26
Speaker
No, but I mean, the other thing is if you, you know, this is a good example. A lot of my friends live on the other side of the Atlantic, so it's not like I'm going to be able to hang out with them anytime soon anyway. Another reason to be, you know, a lot more asocial, absolutely. So like you just said, I don't think you're asocial at all. I think quite the opposite is true.
03:07:46
Speaker
But one very important point that I want to just quickly indulge on just a little bit. So everybody who has been vaccinated, this is a very good point. You know, in caring for others, it still doesn't mean that now it's the Wild West and you can just go walk and roam around as you please. You should still be careful and mindful of where you go and who you meet with. I think that doesn't change even when you have been vaccinated.
03:08:12
Speaker
Especially if you think about the number of different variants that are emerging that we don't fully understand. So this is a very important point to make, I believe.
Reflections on Pandemic Priorities
03:08:23
Speaker
And I would like to know from you, how has the pandemic actually changed you?
03:08:31
Speaker
In closing, how has it changed you? If you look back one year ago and now you spoke about your friends earlier and being cut off from them in a little bit and your single friends that lack basic human interaction, how has it changed you, though, one year after now? My hair is much longer. Suits you very well just for the record. Thank you. You're welcome.
03:09:01
Speaker
I have significantly more back pain because I spend way more time at the computer, way more time. But no, I mean, I'll flip and CSI it. I think it puts a lot of things in perspective when something this devastating happens to the entire world population, right? It kind of makes you just step back and think about what your priorities are. Think about the fact that
03:09:31
Speaker
Like, what kind of person you want to be? Because I feel like I'm much more conscious now of taking a moment when there are frustrations or situations. I think I'm a much more, I will use your word, mindful person of the consequences of that and all of the tensions that everyone is dealing with and all of the struggles that I might not understand people are having.
03:10:00
Speaker
I think it really makes you think, do I want this, and I've thought about this a lot more, also, especially in my relations with my parents, is, you know, do I want this to be the last thing I say to someone? And I know that sounds really morbid, but I think about that all the time. Like, if I were to die, or if they, or, you know, the other party were to die, do I want this to be the last thing, the last memory we have of each other? Do I want this to be the last thing that I say to them?
03:10:30
Speaker
And I think that's changed how I interact with people, actually. That sounds profound. No, it really does. I think it's a very... Because when you say that to me, it's kind of like...
03:10:52
Speaker
treat every day like it could be you or somebody else's last. And that does sound morbid in a way, if you will. But at the same time, it also sounds incredibly powerful because you make every moment count. You are mindful. This ties in with the mindfulness we had earlier as well. You are mindful of your interactions and you are
03:11:16
Speaker
conscious and aware in the present moment a lot more, at least the way that you explained that just to me now, that's what is coming across to me. All right. And in closing, now really in closing,
03:11:37
Speaker
I'm such a photographer, it's like one more image, one more picture, one more picture, really, last picture now, that's it, that's it, after that, no, the film is full while we're in the digital age, that doesn't happen anyway, anyway. What opportunities do you see in the pandemic? Because just to qualify quickly, I, you know, I'm not saying this is not
03:11:59
Speaker
me being hopelessly optimistic, but I do believe that every crisis comes with its opportunities. And I think, actually, I learned lately that the Chinese word for crisis is weiji, right?
03:12:20
Speaker
which comes from struggle or fight and means chance and opportunity, like way and then G means chance and opportunity.
03:12:32
Speaker
It's one of those very multi-manifold means. Yes, and you can probably pronounce it and intonate it 10 different ways, and I probably didn't go the wrong times now. So I think there's a lot of wisdom in that. The question in the end is always, do we see the opportunities and put them into
03:12:56
Speaker
Reality or do we discard them and put them aside? But I think there are opportunities in there So what would they be for you if you look at it now a year later?
03:13:05
Speaker
Well, first I will say that from my perspective as a doctor, one really great thing has been telemedicine. And I hate it in many ways. And I think, like I said before, it's hard not to be able to continue to exercise your skills as a doctor in terms of the physical examination of a patient, having them actually present. But I do see that telemedicine has opened up
03:13:33
Speaker
some degree of opportunity for patients who would otherwise not be able to come to us to be seen. And I think I like that aspect of it. I like the fact that it's opened opportunities for patients to whom we would otherwise be much more difficult to access. And as a consequence, I think we've actually seen some of our patients that we used to have a really hard time getting to come to us more frequently, which I think is a really good thing.
03:13:59
Speaker
I think it's forced us to adapt our practice in a way that might actually have equalized some of the socioeconomic disparities. I mean, by no means are we close to equal, but it's helped I think in some ways because we are forced to be more creative in terms of communication. And we do use services that people have or equipment that people have
03:14:26
Speaker
more. So if they don't have internet, we'll use the phone if they don't, you know, well, whereas before, I think we kind of expected the patient to be responsible for the, you know, all the communication on their end a bit more for getting to us. But I think personally, it's also made me think about what I want to be or do
03:14:47
Speaker
which I think we're always thinking about. And I think as a physician scientist, there's a particular pressure to have a fast track research career, do research, publish things, get grants, get the next grant, get the even higher level grant, get promoted to an assistant professorship, associate professorship, see patients 10% of the time, do research 90% of the time, become a leader in your field. I never was very interested in that to begin with, and I think
03:15:17
Speaker
What I've learned about myself maybe is that sometimes I question whether that's because I am just too chicken to do the hard work. But I think I've also realized that you only have one life and there has to be a balance because only when we are happy in our own lives can we provide the best service to other people without
03:15:47
Speaker
approaching ourselves. I feel that, you know, especially I've been on call this past week, there's been a number of disasters and because I wasn't in my optimal, you know, state of physical and mental health, you know, things could have been done better had I been, you know, and I think one has to respect that at some point, you can't
03:16:11
Speaker
You can't expect that you're always going to be superhuman and you can't expect that you're always going to be able to fulfill all of everyone's expectations. Respect your own humanity. Yeah. And I think like I have a stronger sense now for what I potentially could contribute and how I could potentially contribute it without
03:16:36
Speaker
the degree of suffering that, you know, I think sometimes people kind of expect from doctors, especially doctors who are also researchers. I'm by no means like, you know, feel clear about a path, but I think it's, I've come to terms a little bit more with, you know, the sense for
03:16:59
Speaker
there's going to be many opportunities that I might have to say no to. And I think I'm a little bit more comfortable with that. I'm more comfortable with potentially disappointing a lot of people who I respect and who support I'm grateful for.
03:17:17
Speaker
And I think I never, so, you know, we've talked about this before, like I never wanted to be a doctor because I had this like horrific wrist roll thing ever since I was a kid of like sticking people with needles or like looking at their blood, other people's blood. But I think this past year has just cemented for me how glad I am to and how privileged I feel to be in this profession. So.
03:17:45
Speaker
That's wonderful. I think there's nothing stronger than a sense of belonging. If this year has managed that, then that goes a long way. It was a very long way. Wow. I was going to ask you something else, but I think we would leave it at that, because no, it's wonderful in closing. And all I can say to you is that I thank you so much. I feel so blessed and so grateful for you two.
03:18:14
Speaker
have taken this very long ride with me in the yellow van. The irony of this is that you will be by far the longest interview, the only person who has told me from the start, no, you should cut it down to an hour. Nobody's going to listen to that shit. That's incredibly ironic. I love it. I love it. I will not take a minute out of it just for that reason.
03:18:40
Speaker
And yeah, maybe you can just release it in like 30 minute segments over the next, you know, few years. Oh, yeah. Repurposing. That's the sound bite. Exactly. That's the big thing now. Yeah, maybe I'll think about it. But I think no. I think no. I think no. I think all in one go. Whoever wants to sleep.
03:19:02
Speaker
Basti I will feel better anyway because someone will see how long the podcast is and then you will only have maybe one other person And so like he's gonna be like oh I guess I kind of have to listen because my boyfriend made this but no one else is going to
03:19:22
Speaker
No, no, no. My approach is another one. My approach is like, well, three and a half hours. That's as long as Joe Rogan's interviews are. That guy's got to be good. Maybe. I think the chances of that are very slim, but, you know, hope dies last. Yeah. I mean, hopefully, you know, people have some good knitting or five other things they're doing. Get a look at you. Exactly. Good background noise for Excel spread sheeting. You know, if anyone's like analyzing a genome, for example, it's probably good background noise because it's just the right level of minimal distraction.
03:19:52
Speaker
Exactly. Or somebody who is exactly like just, you know, drinking a bottle of wine or maybe two during that length, something like that. We will see. I think we have to put it to the test and ask people to write back to us what kind of tasks, menial tasks they were able to accomplish during the length of this
New Features for Yellow Van Stories
03:20:12
Speaker
podcast. So please, if you're listening into this, please write to us. Leave us a voice message, which is a new feature on our new website, on the Yellow Wind website.
03:20:20
Speaker
Give us a voicemail, tell us what all you accomplished, what you were listening to this episode. Shaoud was an absolute privilege, as always, speaking to you. Thank you so, so much. I learned a lot. A lot. My head is still spinning a little bit. But I know who to turn to if I have any further questions. So thank you very much. It was an absolute pleasure. Thanks, Vasti. It was great to see you. And I'm going to call your parents soon.
03:20:50
Speaker
And if you do have additional questions, I refer you to Wikipedia or Google. Fine. Done. Doesn't this reflect on the joy you had during this conversation? That's fine. Duly noted. Thank you very much. And with that, I'm kicking you out of the elevator. Bye, Rusty. Good to see you. I'm good to talk.
03:21:15
Speaker
And this marks the end of this week's trip in the Yellow Van. All information about Xiao and her work you can find in the show notes along with all relevant links to today's conversation. Thank you very much for coming along in the Yellow Van today. We hope you enjoyed your time on the road with us. I sure enjoyed my time with you.
03:21:36
Speaker
If you feel I missed some essential questions or follow-ups, like I'm sure I did, send them to us and we will have them answered for you. Today I have a few announcements to make. Since last week, the Yellow Van has a shiny new garage, meaning a brand new website.
03:21:55
Speaker
My favorite new feature is the voice message recording for a more personal exchange. And you can now rate the show, read a blog for upcoming guests and random thoughts, visit dedicated episode pages and soon to come read the transcripts of entire episodes, if that's the kind of thing you're into.
03:22:16
Speaker
So get in touch with us on YellowvanStories.com to let us know what you think, where I messed up or to let us know what you accomplished during this three hour long XXL episode like Mow the Lawn, Rescue a Kitten or developing a foolproof plan for world domination.
03:22:37
Speaker
Also, if you want to support Fonzie with a bit of fuel money, you can now find the tip jar at buymeacoffee.com forward slash yellow van. This podcast is a mind the bump production.
03:22:50
Speaker
We hope to welcome you back next week for a brand new episode. We'll be keeping your seat and we'll be cooling that imaginary drink of your choice. Please note, a selection of teas and instant coffee is available as well. After all, some of you might just be starting your day depending on what side of the planet you are on. Until then, stay healthy, keep loving, and always remember, we're all in this together. Take it away, Jim.
03:23:23
Speaker
I'm talking about bills and fees
03:23:45
Speaker
All you standin' for your rights It's the fact of your life
03:24:39
Speaker
You're standing for the rats