Jennifer Doudna on CRISPR, One-Time Cures, and Science Communication

In this special episode of The Future of Medicine, host Euan Ashley sits down with Jennifer Doudna, Nobel laureate and co-discoverer of CRISPR-Cas9, to explore the dramatic ascent of genome editing and what it means for the future of medicine. From the promise of precision therapy that could be “one-and-done” to the challenges of translating groundbreaking science into scalable treatments, this conversation dives deep into science, ethics, policy, and the art of communicating complex ideas to the public.

What you’ll hear:

• A primer on the CRISPR revolution: how a discovery two decades ago has evolved into a potential deluge of targeted therapies.
• Precision therapy that’s more than a symptom fix: the idea of genome editing as a “precision surgery” that could cure diseases rather than require lifelong treatment.
• From one patient to many: the path from an N-of-1 success to scalable, population-wide strategies, including the role of the microbiome in health and disease.
• Real-world regulatory perspectives: how agencies are thinking about repeatable, off-the-shelf genome-editing tools and what it takes to translate a breakthrough into a therapy.
• The regulatory and scientific roadmaps: the steps scientists and clinicians must navigate to bring CRISPR-based therapies to patients rapidly and safely.
• The power and responsibility of storytelling: why scientists must improve public communication and how clear, non-jargony narratives can build trust.
• Combating misinformation: reflections on the moment when science is under scrutiny and how researchers can connect with diverse audiences.

Guest bio: Jennifer Doudna is a pioneering biochemist and a leading figure in the CRISPR gene-editing revolution. As a founder of the Innovative Genomics Institute, her work has opened new frontiers in biology and medicine. Her research continues to shape how we think about disease mechanisms, therapy development, and the ethics of powerful new technologies.

Why this episode matters: CRISPR technology is at a pivotal moment — one that could redefine what’s possible in medicine within a generation. This episode offers an insider’s view of where the science stands, what’s required to move from amazing results to real-world therapies, and how we, as a society, can navigate the opportunities and responsibilities that come with transformative science.

Notes for listeners:

• Not a distant dream: the conversation highlights tangible progress toward therapies that could be delivered in months rather than years, with the potential to affect thousands of patients.
• A balanced view: along with the excitement, the episode addresses safety, ethics, and the essential role of clear communication in building public trust.
• Public-facing science: practical thoughts on how researchers can explain their work to non-scientists — helping to bridge the gap between the lab and everyday life.

Call to action: If you enjoy The Future of Medicine, subscribe for more conversations with leading scientists shaping the next era of healthcare. Please rate and review the podcast to help others discover these important discussions. Share with friends and colleagues who are curious about how science becomes medicine.

Chapters

• 0:00 Introduction to Jennifer Doudna
• 1:01 The CRISPR Revolution: A Decade of Change
• 5:00 The Inspiring Case of Baby KJ
• 8:30 Collaboration and Innovation in Gene Therapy
• 13:10 Microbiome Editing
• 17:30 Partnerships and Funding in Genomic Research
• 20:00 Future Directions in Genome Editing
• 24:01 The Importance of Academic and Industry Collaboration
• 28:01 On Science Storytelling and Communication
• 29:07 Big Thoughts on Life and the Universe
• 32:45 Closing Thoughts on the Future of Precision Medicine

Transcript

0:00:00.160,0:00:06.160
What am I most excited about? Bespoke CRISPR 
therapies. Dr. Jennifer Doudna is a Nobel

0:00:06.160,0:00:11.760
Prize laureate and CRISPR pioneer turning gene 
editing into real cures. A child treated with

0:00:11.760,0:00:16.640
a therapy that was created for him. We talk 
about her efforts to help treat a child with

0:00:16.640,0:00:22.560
a devastating genetic disease. This is probably 
not a one-off case and new ways to help improve

0:00:22.560,0:00:27.200
health by working with the microbes that 
live in and around us. We're in a moment

0:00:27.200,0:00:32.240
where science is really under attack. Science 
communication is more important than ever.

0:00:32.240,0:00:37.840
What do we do? Welcome to Stanford Department of 
Medicine's inside look at the future of medicine.

0:00:37.840,0:00:42.000
Well, Jennifer, welcome to Stanford. Thank 
you. Real pleasure to be here. Yeah. Thanks so

0:00:42.000,0:00:47.200
much for coming. Coming down down the coast 
to visit us. Easy ride. Yes. Pretty good.

0:00:47.200,0:00:51.680
I was preparing for the conversation with 
you today and I realized that it was only

0:00:51.680,0:00:56.160
about 10 years ago, just a little bit 
over 10 years that your paper in 2012 in

0:00:56.160,0:01:00.080
Science that really kicked off the CRISPR 
revolution. For some reason in my head,

0:01:00.080,0:01:05.280
so much has happened. It seemed like it must 
be much longer, but 2012 — in that decade,

0:01:05.280,0:01:09.920
I mean, so much has happened. Your life 
has changed a little bit in a few ways.

0:01:09.920,0:01:15.200
What has surprised or delighted you the most 
in the last kind of 10 years or so since that?

0:01:15.200,0:01:20.720
So many things have happened as you said and 
some of it has been on the science front and

0:01:20.720,0:01:26.640
some of it's been on the frankly larger scale 
of public policy and where medicine is headed,

0:01:26.640,0:01:30.320
where agriculture is headed but with 
these kinds of tools now that we have

0:01:30.320,0:01:34.720
for manipulating DNA. It's really been very 
interesting to see all of that unfolding.

0:01:34.720,0:01:45.280
What am I most excited about? I guess certainly 
top of mind today is the opportunity to create

0:01:45.280,0:01:52.400
bespoke CRISPR therapies for patients in real 
time. I think this is such an interesting moment

0:01:52.400,0:01:58.000
we're in right now. We've seen the example with 
baby KJ. We talk about that right here today.

0:01:58.000,0:02:03.520
And there are so many things going on here at 
Stanford and in the Bay Area and of course much

0:02:03.520,0:02:09.040
more broadly across the country and elsewhere 
that make us think that, you know, there really

0:02:09.040,0:02:15.520
is an opportunity right now to seize the moment, 
figure out how we can find those patients that

0:02:15.520,0:02:22.960
can benefit from CRISPR and create the pathway 
to helping them in real time and doing it in

0:02:22.960,0:02:27.840
a cost-effective way. That's what I'm scaling 
— the thing really interested in doing. Yeah.

0:02:27.840,0:02:31.520
Well, we'll get to a little bit more 
detail on the baby KJ story shortly,

0:02:31.520,0:02:36.320
but you lead an institute with I think one of the 
coolest names of any institute, the Innovative

0:02:36.320,0:02:42.560
Genomics Institute. As a genomics nerd, that 
sounds like the perfect place for me to visit

0:02:42.560,0:02:46.720
or work. I think who wouldn't want to work there? 
But tell me a little bit about the institute first

0:02:46.720,0:02:51.440
and the work that you're doing there. And then 
we'd love to dive into some specific examples.

0:02:51.440,0:02:58.720
Well, this institute started just over 10 years 
ago in Berkeley and in San Francisco. We were a

0:02:58.720,0:03:06.400
joint institute from the very beginning linking 
UCSF and UC Berkeley and UC San Francisco with

0:03:06.400,0:03:12.480
the idea that we could bring genome editing 
to bear on health and climate challenges in

0:03:12.480,0:03:16.480
ways that would have real world impact.
How do we do that? You know, it sounds

0:03:16.480,0:03:21.120
like a broad grand goal, but you know, how do 
you actually get there? And what I'm excited

0:03:21.120,0:03:27.360
about is that over the 10 years of our existence, 
we've raised a lot of money. We've also invited a

0:03:27.360,0:03:34.400
lot of partners in. We've just recently signed an 
agreement with our third campus partner, UC Davis,

0:03:34.400,0:03:40.160
has become a formal partner of the IGI. 
And we love the idea that we can leverage

0:03:40.160,0:03:46.480
expertise that exists on different campuses 
to focus on big projects and problems that

0:03:46.480,0:03:52.640
none of us individually would be able to 
work on or really tackle meaningfully.

0:03:52.640,0:03:58.320
And what's amazing is that we're really focused 
now on building collaborative teams, especially

0:03:58.320,0:04:04.000
with younger scientists who are just starting 
their careers and with companies that can bring

0:04:04.000,0:04:10.320
their expertise to bear on these projects and 
problems and inviting people that are very excited

0:04:10.320,0:04:16.560
about science but maybe are not scientists. 
Philanthropy comes to mind. Yeah. That can

0:04:16.560,0:04:24.880
meaningfully gather their different capabilities. 
Yeah. To do things that otherwise wouldn't happen.

0:04:24.880,0:04:29.040
So, you view the institute partly as a sort 
of gathering place. Bring the smartest people,

0:04:29.040,0:04:33.840
the most energetic people, the most innovative 
people together and help them do cool — I mean,

0:04:33.840,0:04:38.400
that's what we do here in California, right? 
That's what we do. The new frontier. Yeah. I

0:04:38.400,0:04:42.000
think that's right. Perfect place 
to do it. And we're excited to be

0:04:42.000,0:04:46.480
able to collaborate on a few of these things.
Absolutely. I love many things, but what I love

0:04:46.480,0:04:52.000
about it most is these ambitions are not small. 
Human health and disease and planetary health are

0:04:52.000,0:04:57.760
pretty big topics. I don't think anyone would 
doubt that you could make an impact in those.

0:04:57.760,0:05:03.520
Why don't we start maybe with this amazing story 
that hit the headlines in this last year with the

0:05:03.520,0:05:10.000
collaboration that you helped put together and the 
teams that came together for baby KJ. How did that

0:05:10.000,0:05:15.760
come about? And tell us how things are going.
It's an incredible story, isn't it? It's so

0:05:15.760,0:05:23.280
inspiring to see the example of a child who 
was affected by a metabolic disease diagnosed

0:05:23.280,0:05:31.680
in real time and treated with a therapy that 
was created for him, for his disease. Yeah. And

0:05:31.680,0:05:38.800
tested first in animals and in collaboration with 
appropriate regulatory guidelines and his clinical

0:05:38.800,0:05:44.320
team at the Children's Hospital of Philadelphia 
figuring out how to actually treat this patient

0:05:44.320,0:05:51.680
and ensure that he would have a safe path to what 
we hope will be a permanent cure for the disease.

0:05:51.680,0:05:57.920
It's really really exciting. You know, it's worth 
pointing out that this is probably not a one-off

0:05:57.920,0:06:06.720
case. This is an example of what is now possible 
to do and it's partly inspiring to see a patient

0:06:06.720,0:06:15.120
and his family of course treated effectively but 
what's even bigger and inspiring to all of us is

0:06:15.120,0:06:20.240
the opportunity to do that for so many more.
And the key features of that — this was CPS1

0:06:20.240,0:06:26.800
deficiency, so this was a metabolic disease that 
causes hyperammonemia and that can cause severe

0:06:26.800,0:06:32.160
brain damage and would even be associated 
with a 30 to 50% risk of death. So this

0:06:32.160,0:06:38.080
is not a trivial condition and one that was 
diagnosed pretty early in life — like two or

0:06:38.080,0:06:42.480
three months when he was first diagnosed.
Yeah. I think even earlier. Yeah. Yeah.

0:06:42.480,0:06:48.080
And then so many remarkable things about it. I 
mean maybe in your world the least remarkable

0:06:48.080,0:06:55.280
thing is that you can edit the genome to the 
better copy. But being able to take that case

0:06:55.280,0:07:01.760
and with the joint work with the group at CHOP 
and at Penn to be able to develop this, test it,

0:07:01.760,0:07:09.040
go through the regulatory agencies and within 
— I think was it 7 months? — and then have

0:07:09.040,0:07:13.760
an N-of-one therapy that was essentially 
curative. I understand there were two or

0:07:13.760,0:07:16.640
three doses that were given.
That's right, three. Yeah.

0:07:16.640,0:07:20.560
But this is the ultimate in many ways. I 
think that's one of the reasons it caught

0:07:20.560,0:07:26.160
people's imagination in precision medicine. 
Here is a precision surgery for the genome

0:07:26.160,0:07:31.120
that is essentially curative of a disease 
that would otherwise be fatal. I mean,

0:07:31.120,0:07:35.760
that's incredible. It's incredible.
Yeah, it's really very exciting. And

0:07:35.760,0:07:41.760
as you're saying, I think the inspiration 
is part the effect on this individual,

0:07:41.760,0:07:48.880
but it's also the idea that we could do this 
for many others and we now have a pathway. We

0:07:48.880,0:07:55.280
can see all of the steps that can happen and how 
to do them in a period of time that's meaningful

0:07:55.280,0:07:59.520
for the patient. It doesn't take years and 
years — this was done in a matter of months.

0:07:59.520,0:08:02.400
Right. Right.
And wouldn't that be great to do for more? I mean,

0:08:02.400,0:08:08.000
there are thousands of these babies born every 
day. And I think being able then to scale — and

0:08:08.000,0:08:14.880
so you can see a path toward not N-of-one 
just but N-of-10, N-of-100, N-of-1000. Yeah.

0:08:14.880,0:08:19.680
And I think one of the challenges has been that 
technology often moves so much faster than our

0:08:19.680,0:08:24.160
regulatory agencies are able to. I mean, they 
have a very important job — safety is incredibly

0:08:24.160,0:08:29.120
important. It's hard when there's so few people 
in the world who truly understand new technology,

0:08:29.120,0:08:34.800
but it seems like there was a very collaborative 
relationship with the FDA over this and that they

0:08:34.800,0:08:39.040
are very open to the idea of scaling.
That's what we're seeing. It's really

0:08:39.040,0:08:45.520
interesting to see this and I think it's partly 
again that you know the FDA after all is human

0:08:45.520,0:08:50.000
beings and they can see the potential, 
they can see the opportunity. I think

0:08:50.800,0:08:56.800
Fyodor Urnov at the IGI deserves a lot of 
credit for his role in helping to educate

0:08:56.800,0:09:01.280
regulators about the science. As you said, it's 
often hard for them to keep up. There's so many

0:09:01.280,0:09:06.000
things happening. How do they become experts in 
every new technology? They really can't. Yeah.

0:09:06.000,0:09:10.400
And so it does require scientists to go in and 
say, “Look, you know, we'd like you to understand

0:09:10.400,0:09:14.560
what we're doing. We want to work with you. We 
want to partner with you. We want to do this

0:09:14.560,0:09:18.400
in a way that makes sense for everybody. 
And of course, safety has to come first.”

0:09:18.400,0:09:22.560
Yeah, it's great that it's a conversation 
because I think once you're conversing,

0:09:22.560,0:09:28.800
it's possible to have those explanatory moments.
And I think so there was an industry partner as

0:09:28.800,0:09:32.400
well. I think this was in this 
large group that were involved.

0:09:32.400,0:09:36.480
Yeah, it's very interesting because that 
partnership existed already — you know,

0:09:36.480,0:09:42.800
was kind of pre-existing to the diagnosis of 
KJ. This is a partnership with a company called

0:09:42.800,0:09:48.160
Danaher that makes molecules among other 
things. And they are very good at it. They

0:09:48.160,0:09:53.520
know how to make molecules that are prepared 
in a way that can be delivered clinically.

0:09:53.520,0:09:59.600
And so when the baby KJ case came along, they 
stepped up and said, “Yes, we're willing to

0:09:59.600,0:10:07.120
provide the molecules needed for this treatment 
and we'll do it at our expense.” Yeah. Amazing.

0:10:07.120,0:10:10.720
And then this was a base editor 
delivered in a lipid nanoparticle.

0:10:11.360,0:10:12.400
Right.
So it

0:10:12.400,0:10:16.560
goes to the liver pretty naturally 
which is exactly where you need the—

0:10:17.200,0:10:22.560
Well you're touching on an important point that 
I think is really good to just state here very

0:10:22.560,0:10:29.680
clearly and that is that one of the reasons that 
the baby KJ case could proceed the way it did

0:10:29.680,0:10:37.280
was that the affected tissue — the liver — is one 
that we know how to deliver molecules to. We used

0:10:37.920,0:10:43.920
existing technologies with both CRISPR and 
the delivery vehicle, the lipid nanoparticle,

0:10:43.920,0:10:50.560
that were also pre-existing, that had been 
clearly validated clinically. And so there

0:10:50.560,0:10:55.360
was no new technology that needed to be 
created. We simply had to refashion it

0:10:55.360,0:11:02.000
for this particular case, but we know how to 
do that after 10 years plus of doing this.

0:11:02.000,0:11:08.000
And so I think that, you know, right there tells 
you that when you have technology that's reached a

0:11:08.000,0:11:17.440
place where you have off-the-shelf capabilities, 
we need to get better at quickly pointing that

0:11:17.440,0:11:25.200
to the problems where it can really be used in 
real time. And that's what was so exciting here.

0:11:25.200,0:11:26.800
Yeah.
And it sounds

0:11:26.800,0:11:32.320
like there's openness on behalf of the regulatory 
bodies to see that many of those elements can be

0:11:32.320,0:11:38.480
repeated and maybe just the guide RNA can be 
changed and you have a new therapy for a new

0:11:38.480,0:11:44.960
creation — and this is game-changing, isn't it?
I mean, you know better than any of us — thinking

0:11:44.960,0:11:51.360
about when you have rare genetic diseases, this 
is something that you know in the past we would

0:11:51.360,0:11:56.000
have said, well, you know, we can diagnose 
it. Okay, we can maybe give palliative care,

0:11:56.000,0:12:03.040
but we really don't have anything that's going to 
provide a long-term or even potentially a cure.

0:12:03.040,0:12:07.760
If the best outcome is a liver transplant, 
then hopefully we can do better than that.

0:12:07.760,0:12:14.560
Exactly. And this is what CRISPR has offered from 
the very beginning, right? — this opportunity to

0:12:14.560,0:12:21.120
create a targeted approach for each individual 
mutation. It's just that, you know, if you have a

0:12:21.120,0:12:27.040
rare disease where for each disease that you're 
treating, you have to go through a full-blown

0:12:27.040,0:12:31.680
three-phase clinical trial, it's not realistic, 
right? I mean you don't even have the patients

0:12:31.680,0:12:37.760
to do it even if you wanted to, and the expense 
would be prohibitive. But here, I think the FDA

0:12:37.760,0:12:43.680
is saying, “Look, let's take a new lens to this. 
Let's recognize that this is really a different

0:12:43.680,0:12:48.880
kind of technology. And we're really talking 
about a different kind of therapy, aren't we?”

0:12:48.880,0:12:54.000
This is not something that you're going to be 
injecting someone with every day or a month.

0:12:54.000,0:12:56.640
Hopefully, it's a one-and-done.
One and done. Yeah.

0:12:56.640,0:13:02.000
Remarkable. Really it's the sort of ultimate 
for precision therapy and amazing that we're

0:13:03.040,0:13:08.160
able to talk about that now. We move science to 
cure. Now we just need to think about scaling.

0:13:08.160,0:13:10.560
Exactly.
So yeah, well talking about scaling — you know,

0:13:10.560,0:13:15.680
that's talking about an N-of-one therapy, but you 
also have these ideas to potentially impact the

0:13:15.680,0:13:22.480
entire population or thinking about the planet 
by editing the microbiome. And I realize that

0:13:22.480,0:13:27.760
you recently got a big grant with Jill Banfield 
to think about microbiome editing. I spent a lot

0:13:27.760,0:13:33.200
of time thinking about genetics, genomics, and 
also gene editing. I hadn't spent a lot of time

0:13:33.200,0:13:38.800
today thinking about microbiome editing. So tell 
me what's in scope for that. Essentially exciting.

0:13:38.800,0:13:43.280
Well, what's fun about microbiome editing 
is it takes CRISPR back to its source.

0:13:43.280,0:13:48.960
Yeah. Right. So maybe a lot of people know 
this, but maybe they don't. CRISPR comes from

0:13:48.960,0:13:54.320
bacteria. It comes from an immune system 
that bacteria evolved to fight viruses.

0:13:54.320,0:14:01.200
So we think it's very interesting to now take that 
technology and turn it back to those very microbes

0:14:01.200,0:14:08.560
and use it in a way that allows targeted changes 
to be made to particular microbes in the context

0:14:08.560,0:14:16.160
of a multi-species community — which is what a 
microbiome really is — right? And doing that in

0:14:16.160,0:14:22.720
a way that could impact health and could impact — 
well let's say just health writ large — you know,

0:14:22.720,0:14:28.240
health of humans, health of the planet, right?
And so that was the vision for the program that

0:14:28.240,0:14:34.480
we call BIOM, which is our TED Audacious 
Fund project with Jill Banfield. And the

0:14:34.480,0:14:40.080
idea there was to create the kinds of 
targeted tools that will allow CRISPR to

0:14:40.080,0:14:45.600
work in the microbiome whether we're talking 
about the human microbiome or the cow rumen.

0:14:45.600,0:14:47.600
Yeah.
What sort of

0:14:47.600,0:14:53.600
examples when you were working could you get? So 
potential climate change is on the agenda here.

0:14:53.600,0:15:00.640
It's on the agenda because — and this involves 
our wonderful colleagues up at UC Davis who have

0:15:00.640,0:15:06.720
for a long time been aware that the microbiome in 
the cow rumen — which is where, you know, they're

0:15:06.720,0:15:12.880
digesting grass in multiple stomachs and got a 
lot of microbes that are busily doing that kind

0:15:12.880,0:15:18.160
of metabolism — the problem is that some of those 
bugs are also making a lot of methane. Yeah. And

0:15:18.160,0:15:23.040
that's one of the most powerful greenhouse gases 
and it's like a third or something human-produced.

0:15:23.040,0:15:29.920
Shocking, right? I was astounded to learn that 
agriculture and in particular cattle farming

0:15:29.920,0:15:36.320
accounts for almost a third of the methane 
emitted annually that's human-caused. So,

0:15:36.320,0:15:41.680
what can we do about that? I don't think it's 
realistic to ask everybody to stop cattle farming.

0:15:41.680,0:15:47.920
Yeah. Right. That's just not going to happen.
And so better would be to find a way to actually

0:15:47.920,0:15:53.600
just reduce the methane emissions at the source. 
And so this is where we think CRISPR comes in

0:15:53.600,0:16:00.000
because we know we can manipulate genes in these 
microbes. Increasingly, we know the genetics of

0:16:00.000,0:16:05.360
methane production in the cow rumen. And so 
again, it's sort of an analogy to the baby KJ

0:16:05.360,0:16:09.600
case where we've got all the pieces, right? 
We've just got to put them together to make

0:16:09.600,0:16:13.120
something that's going to have real impact.
And that's what we're doing with our BIOM

0:16:13.120,0:16:18.960
program. So we have a whole team of young 
investigators. Jill Banfield is the leader,

0:16:18.960,0:16:25.200
but we've got a lot of scientists now who are 
really focused on this kind of challenge working

0:16:25.200,0:16:30.480
both at the Berkeley site of IGI, but also 
working up at UC Davis where they actually

0:16:30.480,0:16:36.720
are birthing calves and starting to test.
So it's great. The idea is that we would treat

0:16:36.720,0:16:43.920
individual cows. And again, the idea would be a 
one-and-done kind of treatment that would then be

0:16:43.920,0:16:51.680
maintained through adjustments that wouldn't be 
prohibitively expensive in the diet and would be

0:16:51.680,0:16:56.160
possible to distribute around the world.
I see. Really interesting. And then I'm

0:16:56.160,0:16:59.040
guessing — I'm just thinking this through 
now as you're explaining it — but I suppose

0:16:59.040,0:17:04.640
offspring often don't inherit the microbiome, 
but they are gifted much of their microbiome

0:17:04.640,0:17:09.520
from their parents at the time they're born — 
mother predominantly at the time they're born.

0:17:09.520,0:17:16.000
But then the — I assume in an animal population 
that there may be some chance that some treatment

0:17:16.000,0:17:20.160
of the mother might even impact…
It's an interesting question,

0:17:20.160,0:17:23.280
right? I mean that's one of the things we're 
researching right now is to what extent you

0:17:23.840,0:17:30.960
get that kind of population change.
Yeah, that's really fascinating and

0:17:30.960,0:17:36.640
really CRISPR writ large indeed. This 
is literally a climate-level question.

0:17:36.640,0:17:40.880
There's some human health elements to that 
too. Did I see asthma maybe as one disease—

0:17:41.520,0:17:48.000
Sorry — Susan Lynch up at UCSF, you may know her 
— she has had a longstanding clinical research

0:17:48.000,0:17:53.760
program on the connection between the human 
microbiome and asthma. Yeah. And so we would

0:17:53.760,0:18:00.000
love to be able to also manipulate the human 
microbiome to reduce asthma susceptibility.

0:18:00.000,0:18:05.600
Sounds a bit wild. I thought it was kind of a — 
it sounded a bit like a long shot when we first

0:18:05.600,0:18:12.320
discussed it, but I think again the pieces are 
coming together. We understand the genetics of

0:18:12.320,0:18:19.120
production of molecules in the human gut that 
can induce asthma susceptibility. And now again

0:18:19.120,0:18:23.520
we have the tools to manipulate it. So you 
can start to see the pieces coming together.

0:18:23.520,0:18:31.280
I think in many ways the microbiome has been 
really ignored by human physicians and by the

0:18:31.280,0:18:36.000
health care system to date partly because we 
haven't been able to manipulate it very well.

0:18:36.000,0:18:41.600
Obviously C. diff diarrhea has been one area of 
great success. But overall, I think we've found

0:18:41.600,0:18:45.680
it fascinating from a scientific standpoint as 
we learn more and more ways that the microbiome

0:18:45.680,0:18:53.040
interacts with the human part of the dual organism 
and vice versa. Obviously a lot of diet-nutrition

0:18:53.040,0:18:58.960
work and our GI colleagues have been to the fore.
But some of the remarkable impacts that are seen

0:18:58.960,0:19:05.280
even on psychological conditions and psychiatric 
conditions, on anxiety from the microbiome — it's

0:19:05.280,0:19:09.920
just remarkable. And I do think that we're 
ready for another revolution there where we

0:19:09.920,0:19:14.080
understand that we can actually manipulate 
the microbiome in a much more precise way to

0:19:14.080,0:19:18.480
help with these diseases where it's clearly 
fundamental. Even responses to chemotherapy

0:19:18.480,0:19:22.320
and other trials that we've seen — the 
microbiome could make a significant...

0:19:22.320,0:19:26.960
I think this science looks so interesting. 
It's not my area of expertise at all,

0:19:26.960,0:19:31.440
but I'm fascinated by the increasing, 
as you said, connections with different

0:19:31.440,0:19:35.200
human disease conditions. There's a lot 
of fundamental science still to be done.

0:19:35.200,0:19:39.520
Yeah. But now we have the tools to do it.
We have a lot of people — you're here talking

0:19:39.520,0:19:45.840
to our trainees and many others here at Stanford 
— and we have many who have thought, including

0:19:45.840,0:19:52.640
in our faculty, about moving into industry. Some 
actually — this being West Coast — come back from

0:19:52.640,0:19:57.760
industry back to academia. We have pretty free 
flow and we have many who start companies as well.

0:19:57.760,0:20:02.560
But I wondered since we have you here — you're 
both somebody who spent a short time, I believe,

0:20:02.560,0:20:08.960
in industry — but also very important. And maybe 
not everyone knows that story; if you want to

0:20:08.960,0:20:13.440
share, I'd love to hear that. But also you've 
started companies obviously and moved technology

0:20:13.440,0:20:17.360
really into the real world. Do you have advice 
for people that are thinking about that or who

0:20:17.360,0:20:25.440
are struggling with that element of what the next…
Well, it's a great question because I consider

0:20:25.440,0:20:34.880
myself the most naive person probably out there 
when it comes to thinking about how to sort of

0:20:34.880,0:20:41.520
commercialize scientific discoveries. I certainly 
didn't — that was not on my radar when I started

0:20:41.520,0:20:47.840
my career and even when we started working on 
CRISPR it wasn't the thing that was on my mind

0:20:47.840,0:20:55.040
at all. And I had to learn about it because 
I realized fairly quickly once we had done

0:20:55.040,0:21:01.520
the initial work on CRISPR that when you have 
a technology that's cross-cutting like this

0:21:01.520,0:21:07.920
and you see opportunities for it to have real 
impact, some of that can get done in academia.

0:21:07.920,0:21:12.800
But frankly, you're probably going 
to need the teams and the financing

0:21:12.800,0:21:17.280
to do it much more broadly than would be 
possible in a typical academic laboratory.

0:21:17.280,0:21:23.760
And so how to do that became top of mind for me at 
that point. And I was fortunate to have a lot of

0:21:23.760,0:21:29.680
people, including a number of folks at Stanford 
— I consider, by the way, I've long considered

0:21:29.680,0:21:35.120
Stanford a real leader in this. Stanford has 
had a culture for a long time about how to make

0:21:35.120,0:21:41.040
that smooth transition between fundamental 
discoveries and scaling that happens with

0:21:41.040,0:21:46.320
commercialization and how to do that effectively.
It's been a great journey. I can just give a

0:21:46.320,0:21:54.080
30-second summary because you alluded to my little 
foray into the business world and this happened in

0:21:54.080,0:22:01.120
2009. So I had a really exciting opportunity to 
move to Genentech and I decided to do it because

0:22:01.120,0:22:08.240
I felt that I was sort of mid-career at that point 
and I'd been at Yale for several years before I

0:22:08.240,0:22:13.920
moved to UC Berkeley. So I'd been at two wonderful 
universities. I was starting to worry a little bit

0:22:13.920,0:22:23.520
that my work although exciting on one hand was 
not going to have the kind of impact — especially

0:22:23.520,0:22:27.200
in health — that I would always write about 
in my NIH grants, you know? And I thought,

0:22:27.200,0:22:35.440
you know, am I really talking about that? But 
yes — well — this is part of the story, right?

0:22:35.440,0:22:40.480
Because I went — I accepted the position at 
Genentech and it was a bit of a tumultuous

0:22:40.480,0:22:44.560
time there. They were being purchased by Roche 
at the time. And so there were lots of changes

0:22:44.560,0:22:52.240
happening. And I just realized within a few weeks 
that it was, you know, a little bit like putting a

0:22:52.240,0:22:56.560
square peg in a round hole or something. You 
know, I do love the academic setting in the

0:22:56.560,0:23:03.280
sense that I love the lab. I love working with 
my students. I really enjoy that interchange.

0:23:03.280,0:23:08.880
So I ended up going back to Berkeley. I had taken 
a leave — thankfully they took me back. Okay.

0:23:09.600,0:23:13.440
But you know an interesting thing happened 
because when I went back, I had cleared my

0:23:13.440,0:23:17.600
calendar completely as you can imagine. I didn't 
have any travel. I wasn't going to be there and I

0:23:17.600,0:23:21.280
didn't have any teaching, you know. And so I had — 
I suddenly had — you know, I looked at my calendar

0:23:21.280,0:23:25.680
and I had like these blank days of just being 
able to hang out in my lab, talk to my students,

0:23:25.680,0:23:30.400
think about things, work on things that I just 
found interesting. One of them was CRISPR.

0:23:30.400,0:23:32.080
Yeah.
Because this was something

0:23:32.080,0:23:38.800
we were playing around with due to Jill Banfield 
— right? Her ideas around what it might be doing.

0:23:38.800,0:23:44.720
And because of that, in part, you know, I think it 
really gave us the freedom to explore some ideas

0:23:44.720,0:23:51.920
that might or might not have happened otherwise.
And so I really taught myself something

0:23:51.920,0:23:55.840
interesting in that whole process. And that 
is that, you know, I think it is important

0:23:55.840,0:24:02.960
to pursue your scientific interests. I think 
it's good to keep an eye toward applications

0:24:02.960,0:24:09.760
and thinking about where could this discovery 
have impact. But I do think it's important to

0:24:09.760,0:24:14.640
be true to what you really love to do. And that's 
kind of what I taught myself in that experience.

0:24:14.640,0:24:21.440
That's remarkable actually — the journey, the 
path not traveled, you know. Yeah. But I think

0:24:21.440,0:24:26.480
this idea that you need space to be able to 
think and explore and how important it is to

0:24:26.480,0:24:32.080
explore without understanding exactly where the 
destination will be is really valuable. And it's

0:24:32.080,0:24:36.560
something we all love in our academic lives.
Maybe I should clear my calendar

0:24:36.560,0:24:42.720
for the next weeks. You've inspired me.
Well, talking about inspiration, I know that some

0:24:42.720,0:24:49.200
of your early inspiration toward science came from 
reading books and that was certainly true for me.

0:24:49.200,0:24:55.120
Many people I think have very inspiring teachers 
in school. That probably wasn't the case for me

0:24:55.120,0:24:59.520
in science, but one of my teachers did give me a 
book, The Selfish Gene by Richard Dawkins, that

0:24:59.520,0:25:05.440
really — I mean — just his writing was so clear 
and it just — the passion for the subject just

0:25:05.440,0:25:11.520
came across and it really lit the flame for me.
But you're really, I think, viewed of course as

0:25:11.520,0:25:16.720
one of the leading science communicators in the 
world. And we're in a moment — kind of interesting

0:25:16.720,0:25:22.000
moment — where science is really under attack in 
many ways and certainly science communication is

0:25:22.000,0:25:28.240
more important than ever. And I just wondered if 
you had some thoughts to share about this moment

0:25:28.240,0:25:34.560
we're in, how important it is for scientists 
like ourselves to be out there talking to the

0:25:34.560,0:25:39.040
real people in the world, not just the folks 
in our lab but the folks at our conferences.

0:25:39.600,0:25:45.760
As scientists somewhat under attack — and it is a 
fascinating moment because on the one hand we've

0:25:45.760,0:25:51.840
got more tools than ever for communication, right? 
We got all kinds of social media. We've got many

0:25:51.840,0:25:58.240
people who have stepped forward as spokespeople 
for science which is great. And a lot of those

0:25:58.240,0:26:04.480
folks have many followers, right? And they've 
attracted a lot of attention and a big audience

0:26:04.480,0:26:10.480
on the one hand. And then on the other hand 
there's a lot of frankly just false information

0:26:10.480,0:26:17.440
and disinformation that goes around. Vaccines come 
to mind for example where unfortunately it does

0:26:17.440,0:26:23.040
a tremendous disservice to the science and also 
to people that could otherwise benefit from it.

0:26:23.040,0:26:29.280
So what do we do? You know, and I think that it's 
a tough challenge that I'm not sure there's an

0:26:29.280,0:26:36.320
easy answer to. I do think that scientists need 
to be better about communicating about their

0:26:36.320,0:26:42.480
work. I don't mean that all of us need to become 
national or international lecturers on the topic.

0:26:42.480,0:26:50.720
It's just that I think all of us need to figure 
out where can we have an impact. It's as simple

0:26:50.720,0:26:57.200
as having a one or two sentence non-jargony 
explanation of what we're doing so that when

0:26:57.200,0:27:02.480
you sit down on a plane and you're chatting with 
your seatmate about what you do, you can roll that

0:27:02.480,0:27:08.000
out. Get in an elevator — you can tell somebody 
quickly what you're doing and why it matters.

0:27:08.000,0:27:15.440
Unfortunately, because scientists haven't been 
effectively doing that over the last few decades,

0:27:15.440,0:27:20.720
there's been a bit of an erosion of 
the appreciation of science across our

0:27:20.720,0:27:27.520
country. And I think some taxpayers at least 
wonder, “Yeah, why are we shelling out money

0:27:27.520,0:27:32.720
for projects on things like bacterial immune 
systems? And why does that matter?” Right? And

0:27:32.720,0:27:38.240
so I think it is very important to do this.
So this is what I tell my students. I say,

0:27:38.240,0:27:44.400
“You know, figure out where you're comfortable. 
You don’t have to be an author. You don’t have to

0:27:44.400,0:27:51.280
be a lecturer necessarily if you want to do that. 
But just being able to tell your grandmother what

0:27:51.280,0:27:56.480
you're doing and why it matters is really key.”
I think that's something we talk about a lot

0:27:56.480,0:28:00.320
here actually. And I think an example we 
often use is like your Uber driver when

0:28:00.320,0:28:04.000
you're around the country giving a talk or 
something and you're often talking to your—

0:28:04.560,0:28:09.600
Exactly. It's those conversations I think can 
really have an impact on people. And like you say,

0:28:09.600,0:28:13.760
just being able to understand — I often say this 
to my students and trainees when they're giving

0:28:13.760,0:28:18.160
a scientific presentation — you actually want to 
think about it as if you're explaining it to your

0:28:18.160,0:28:22.880
grandmother or explaining it to a family member 
because that will force you into a narrative

0:28:22.880,0:28:25.920
format to sort of tell a story.
Exactly. Yeah.

0:28:25.920,0:28:29.280
And even scientists like to hear 
stories. They do. They want to see

0:28:29.280,0:28:33.600
your data but they love to hear stories.
That's right. And I think that we could

0:28:33.600,0:28:38.560
all be better at that. And I think that in order 
to gain a little bit of the public's trust — and

0:28:38.560,0:28:45.120
we have collectively lost some of that, whether 
it's because of folks who are treating science

0:28:45.120,0:28:50.640
as something other than the rigorous approach 
to truth that we know it to be or whether it's

0:28:50.640,0:28:54.720
because we're less good at communication — we 
definitely have lost a step. And so either way,

0:28:54.720,0:28:58.720
I think we all do need to step up a little bit.
Agreed. Yeah.

0:28:59.280,0:29:03.200
I wanted — while I had you captive here — 
to ask a specific question that there aren't

0:29:03.200,0:29:09.360
many people I could ask this to, but I was at 
this — just in — some listeners may not know,

0:29:09.360,0:29:16.640
but you did your PhD with Jack Szostak at Harvard 
focused on ribozymes, catalytic RNAs and studying

0:29:16.640,0:29:22.080
essentially the origins of life. And I happened 
to be at a conference recently and Dante Lauretta

0:29:22.080,0:29:25.440
from Arizona was there and he had run this 
mission — the OSIRIS-REx mission — where

0:29:25.440,0:29:32.400
they sent a capsule to Bennu, which is this 
4½-billion-year-old asteroid, in order to capture

0:29:32.400,0:29:40.640
essentially space dust that was unimpacted, 
non-contaminated by humans. It just kind of blew

0:29:40.640,0:29:48.320
my mind that they found on this asteroid that's 
4½ billion years old all the nucleases and 14 of

0:29:48.320,0:29:56.560
the prebiotic amino acids and many of the things 
that would be required for the origin of life. And

0:29:56.560,0:30:02.480
this is something that — where you started your 
career. And I sort of have a hobby interest in

0:30:02.480,0:30:09.840
it just to read about that. But the RNA world idea 
is one of the ones I think in many ways what drew

0:30:09.840,0:30:15.280
you into RNA. I wonder what you thought to that.
They just have been publishing in the last few

0:30:15.280,0:30:23.520
months these papers with this incredible prebiotic 
chemistry analysis. And you must be an RNA world

0:30:23.520,0:30:29.680
person, right? Do you believe that?
Right. Yes.

0:30:29.680,0:30:33.680
It just seems like — I mean, that's one of — 
I mean, we've talked about individual humans,

0:30:33.680,0:30:39.920
we've talked about planets. This is almost like, 
you know, planetary-scale ideas — like thinking

0:30:39.920,0:30:44.960
about how life could actually have started.
It's such a fascinating question. Yeah. Right.

0:30:44.960,0:30:49.040
I mean it's just so interesting. When I got to 
graduate school, I really didn't know what I

0:30:49.040,0:30:57.040
wanted to work on. And my adviser Jack Szostak 
was brilliant at taking a huge question like

0:30:57.040,0:31:03.440
that and boiling it down to experiments that we 
students could actually do in the lab. You know,

0:31:03.440,0:31:08.320
it was really interesting to me to see how you 
do that, how you think about — and we try to

0:31:08.320,0:31:12.720
do this of course in our own research, right? 
— as we have big questions we want to answer,

0:31:12.720,0:31:17.920
but you've got to somehow figure out how to 
turn it into, you know, an experiment that

0:31:17.920,0:31:25.520
somebody can actually do in a two… you know.
And so that was my first real exposure to that

0:31:25.520,0:31:33.920
type of science. And I've never lost that 
sense of wonder at, you know, the kinds of

0:31:33.920,0:31:39.360
capabilities that scientists have when they 
really put themselves to a task like that.

0:31:39.360,0:31:45.360
And, you know, in the case of the RNA world — 
yeah, I think it's still a really interesting

0:31:45.360,0:31:52.960
question that's not fully answered. I think we 
have a good sense of the kinds of molecules that

0:31:52.960,0:32:00.000
clearly had to be around in the prebiotic Earth. 
Where they came from is a question. I think this

0:32:00.000,0:32:06.240
asteroid data is fascinating, right? Because it 
does kind of support the idea that Francis Crick,

0:32:06.240,0:32:12.560
I think, first proposed, which is that life 
probably came from elsewhere — or at least the

0:32:12.560,0:32:17.520
components came from elsewhere — because maybe 
there wasn't actually time for those molecules

0:32:17.520,0:32:25.040
to evolve here on the planet. Or to emerge, you 
know, on the planet — not really known. But I

0:32:25.040,0:32:33.760
think this new evidence is certainly interesting 
in terms of thinking about the origins of life.

0:32:34.720,0:32:41.680
Maybe the components arrived here and were 
easy fodder for evolution to begin working on.

0:32:41.680,0:32:44.880
Maybe. Yeah. Yeah.
Just remarkable. And this idea — and

0:32:44.880,0:32:48.640
then thinking about your own journey there, 
like from the prebiotic sort of chemical chaos

0:32:48.640,0:32:55.840
that was your PhD to this highly precision-based 
editing and curing of individual diseases — just,

0:32:55.840,0:33:00.880
you know, it's been a remarkable journey.
It's been fun. I mean I can't imagine

0:33:00.880,0:33:07.360
having done anything else, in a way, because 
it's been just such a wonderful career to be

0:33:07.360,0:33:12.080
involved in the process of discovery.
The next five or 10 years — what do you

0:33:12.080,0:33:16.400
think? Will we have — we'll have a toolbox 
to use? We'll go recurrently to those?

0:33:17.440,0:33:23.120
Yeah. No, the toolbox will continue to expand. 
That's for sure. You know, the capabilities will

0:33:23.120,0:33:31.520
continue to evolve. That's also for sure. I think 
it's really a question of how to turn this kind of

0:33:31.520,0:33:39.120
technology now into a turnkey approach to disease. 
Yeah. You know, whether we're talking about

0:33:39.120,0:33:46.080
planetary disease or human disease, it's really 
about doing that in a way that becomes scalable.

0:33:46.080,0:33:52.800
And I still think there's a really important role 
for academics and for nonprofits here because I

0:33:52.800,0:33:59.280
think it's pretty clear that — again, I defer to 
your expertise here on the clinical side — but

0:33:59.280,0:34:02.480
humans are complicated.
Yeah, definitely agreed.

0:34:02.480,0:34:06.160
Right. And, you know, this is why — you know, 
people always wonder why do so many drugs fail

0:34:06.160,0:34:12.640
in clinical trials? It's just — it's brutally 
hard. And I admire people that have devoted their

0:34:12.640,0:34:18.000
careers to drug discovery because it's a really 
hard problem. It's harder than anything I do,

0:34:18.000,0:34:23.200
I think. You know, right? It's — you know — our 
work is the first step, but then you've got to

0:34:23.200,0:34:28.240
actually show that it works in an actual disease 
situation and is safe for people to use. And,

0:34:28.240,0:34:33.200
you know, that's a whole different ballgame. 
So I do think it's going to require continued

0:34:34.880,0:34:41.280
technological and scientific discovery to get 
us at least closer to that goal of being able

0:34:41.280,0:34:45.920
to quickly come up with therapies that are 
effective for different types of disease.

0:34:45.920,0:34:50.880
I know for you drug discoverers, you might argue 
that what you do is like easier than what they do.

0:34:50.880,0:34:53.680
We're so happy to have you here. Thank 
you so much for spending some time with

0:34:53.680,0:34:57.280
us. I can't think of few people who 
have impacted the world currently and

0:34:57.280,0:35:00.400
more than you have in this room. It's 
a pleasure to have the chance to chat.

0:35:00.400,0:35:04.800
Great to be here. Thanks again so much.
The preceding program is copyrighted by

0:35:04.800,0:35:13.200
the Board of Trustees of the Leland Stanford Jr. 
University. Please visit us at med.stanford.edu.