EARLY YEARS: My father was an electrical engineer at the Mountain States Telephone Company. He taught courses on circuit design and electronics. When I was in high school, he made me take those courses, mostly, I think, to show off to his friends how smart his son was. I really disliked it but I learned a lot and it has really framed my thinking. I have an engineering orientation toward biology and medicine. My granddad ran a summer geology camp where students and professors from Harvard, Yale and Columbia came every summer. One of the courses I took became my project for the Westinghouse Science Talent Search. I was one of the first winners from Montana.
EDUCATION: I had three of the best teachers in high school that I had in my entire career. My chemistry teacher had gone to Caltech during World War II as a navigator and insisted I look into it. I had reservations about going to a technical school instead of a liberal arts school, but it was really a terrific decision. It gave me the background to do what I have done.
MANAGEMENT LESSONS: The organizations that make a difference in science are small, agile and able to make decisions and move effectively. The bureaucracy at academic institutions, particularly state institutions, can be stultifying for people who want to effect paradigm changes. That was true of systems biology at the UW. There were so many things I needed to do that I couldn’t do.
ADVICE TO THE UW: Of the 270 faculty members at Caltech, there were five who were superb for changing their world and providing a model for others. They brought the university unbelievable amounts of money. If you want to change [the UW’s] culture, I’d go out and try to hire a few people like that. They are hard to get, but even one of them will make an enormous difference both in the science and entrepreneurship.
SYSTEMS BIOLOGY: In a human, it’s just like figuring out how a radio works. First, you get a list of parts and see how they work individually. Then you put them in their circuits and see how they work, how they convert radio waves into sound waves. With human beings, we have biological circuits, so we have to understand the individual components [organs], and then we have to understand how the circuits are connected up, how they change over time, and what happens to the networks when we revert to disease.
THE FUTURE OF HEALTH CARE: Medicine of the future has to focus on the individual. Within eight to 10 years, each of us will have our genome sequenced. It will cost a few hundred dollars apiece. Today, we almost always wait until you get the cancer and then it’s too late. But there are more than 100 genes where if you have the variant, we can actually tell you something that will improve your health. If you have Lynch syndrome, for example, you have an 80 percent chance of getting colon cancer by the time you are 50. If you start getting colonoscopies at 25 and clip out the cancer growths as they come, you can keep people free of the disease.
DIAGNOSTICS: We can also use blood as a window on disease. Someday, a smartphone might be able to prick your thumb and take a drop of blood and take 2,500 measurements of your 50 major organs. My vision is that each individual will be surrounded by a virtual cloud of billions of data points. It should include data from your social networks that show where you’ve gone and what you’ve been exposed to. There will be tools that will let us reduce that [data] to hypotheses about health and disease. The doctor will help you interpret all that information. If you are starting down the path of cancer or cardiovascular disease—a sign of a “perturbed network”—you can respond to it early. One approach is we can re-engineer perturbed networks with drugs. It will take multiple drugs. Once we learn how to do that, we can make drug discovery really inexpensive.
DRUG DEVELOPMENT: Most complex diseases like diabetes and Alzheimer’s aren’t one disease. We need to stratify these diseases into subtypes so that we can go to the drug companies that have 130 drugs for Alzheimer’s and test each of these drugs against each subtype. If you look at the drug in the context of the stratified disease, you are very likely to find the right drug for the right subtypes.
PATIENT PARTICIPATION: Medicine is going to be driven by patients, not doctors, as when AIDS activists forced the drug companies and the government to offer triple therapy. They converted AIDS from a lethal disease to a chronic disease.
WELLNESS: We need to focus on optimizing wellness. We’ll have gadgets that make measurements of various vital signs in real time so that you’ll be able to see how you respond to drinking, overeating or being out in the sun too long. Today, you don’t get feedback except to be nagged to stop eating. In the future, you’ll see how your physiology changes when you do things like exercise.
INFORMATION TECHNOLOGY SYSTEMS: [Our approach] is going to require looking at things differently than most IT vendors are looking at them today. A lot of IT organizations are digitizing the classic health care data. They aren’t thinking of the data of the future like social networks, which determine where you’ve gone, what you’ve been exposed to and who you’ve been exposed to. All that kind of information is very important as a part of what the environment has done to you.
MEDICAL SCHOOLS: We are setting up a network of clinical centers with Ohio State that will use various assays [tests] we have developed here to carry out pilot projects. In the case of heart failure, for example, we would try to understand the basic mechanisms that lead to heart failure. We then create diagnostic tools to define where a patient is in that process. Then we think about new drugs within the context of mechanisms that we understand.
REAL-WORLD IMPACT OF SYSTEMS BIOLOGY: When I started, my friends were very skeptical of this approach. But last year, the National Academy of Sciences published a report called The New Biology that described systems biology to a T and said it was the future of medicine and biology. An institute in Spain rated [our research papers] number one in the United States and third in the world in terms of impact on science.
SPINOFFS: We have spun out five companies in the 10 years since the institute was founded. We also helped create the Accelerator Corporation, which has spun out another 12 to 13 companies. Integrated Diagnostics, which we started two years ago, is developing diagnostic tools.
GREATEST HOPE: I’d like to see [the systems biology approach to medicine] adopted by a nation. It would be terrific if it were Luxembourg [which signed a $100 million agreement with the institute in 2008 that includes establishment of a center for systems biomedicine].
SCIENCE EDUCATION: In the past, most elementary teachers didn’t understand much science. As a result, most elementary students didn’t get any science until they got to middle school. But it’s in elementary school that you can stoke the fires of passion for science. We have an educational program that focuses on professional teacher training, giving teachers the tools so they both understand the content and the approach to teaching students. One of the spectacular results we’ve had in the Seattle district is the enormous progress that schools with primarily minorities have made in reaching the state average when they’ve taken these programs. The teachers become better teachers and better teachers produce better students.