don't try to understand new things too quickly because you're probably going to be raw and you're probably going to kill some really great ideas in their cradle I think that embryo screening is actually going to be the default way everyone has kids I won this genetic Lottery where I get to see my grandkids
right and then for my mom she lost it right just because of a typo a random you know letter change I don't want my child to suffer from what my mom suffered from I think people who are trying to regulate things like AI things like you're doing out of existence are literally committing suicide at the
national level you get fire Insurance you get earthquake insurance and those incidents are actually much less catastrophic and heart-wrenching than a child with a disease that's incurable now it could be possible for us to use data at the earliest possible stage before you're even pregnant so that a
baby has the maximum chance of being healthy well hello everyone it's Jim o shasy with yet another infinite Loops I was chatting with my guest before we came on and she asked me something no one has ever asked me she said like what are your favorite episodes of this podcast
and I told her that potentially hers was going to end up among them because she fascinates me my guest today is Nora sadiki currently building Orchid a technology company that is trying to focus on genetic screening for embryos for couples and we're going to talk a lot about that because I find it
fascinating you taught at Stanford on reproductive technology and you also have a podcast conceive with no welcome thank you so much for having me Jim and what a very very kind uh introduction I really appreciate it awesome to be on here uh awesome to have you let let's start out with the fellow we were just
chatting about before we uh hit record you got a Peter Theo fellowship and there was it seems from our research that that that rather than it being like whoa that's awesome like look at you you got a lot of push back from people on accepting the fellowship tell me about that oh um actually I'm I'm not sure um
who you're referring to my parents were actually uh really really supportive of it I think they ended up being uh they wanted me to stay in uh Virginia and ended up you know obviously moving out to California to take advantage of uh the whole Fellowship network but um no they were ended up being like
surprisingly supportive of it I applied to the fellowship at the same time I was applying to college and um you know they grew up obviously really really excited about um you know coming to the US to take advantage of the amazing education system here they they actually um
immigrated from Pakistan to uh the us to go to college so um I think given their background they were uh you know shockingly uh supportive of it but um yeah I think at the same time I think it was really more the distance of going from the east coast to the West Coast that that they were uh sad about not as
much you know like the honor and like how cool it is to sort of get the opportunity to um you know meet people who have built um you know the companies that uh you know we all get to um use um I think from from from the perspective of uh you know learning how to build a company like there's no
better person to learn from than you know the people who started with the back of the napkin to you know scaling it out to uh you know millions of people and you know made these companies household names and so the the the primary objection seems to have been you had to go all the way across the country country from
Virginia uh to to California what what was that like uh for you because I'm an East Coast guy um but spend a lot of time in California uh was was it a culture shock uh to go out there or maybe to be able to collaborate with h fellow Geniuses that also uh were uh gaining Fellowship yeah it was a huge culture
shock but I think in the most positive way possible right so so I grew up in Northern Virginia there's like a lot of people who um you know work for the government there a lot of lawyers a lot of Engineers um so that's kind of all that I had saw sort of like doctors lawyers Engineers sort of like you have
three options when you when you grow up what you want to do so um yeah I feel so so lucky that at such a young age so I ended up doing the interviews like around when I was 17 um you know that I got to come out to San Francisco and meet people who um yeah we're just building the most um biz and surprising
things right like everything from um I mean at the time working on um you know curing aging was just totally insane right like no one that wasn't even in the Overton window at all the idea that you you could even attempt to work on um you know curing aging or Fusion I mean now they've gotten much more into the
Zeitgeist over the last 10 years or so but um I think it was just incredibly inspiring for a young person because you know when you're young you you only see what's you know locally around you and and um I felt so lucky to get to meet people who had kind of busted the doors wide open in terms of like this is you
can work on something incredibly ambitious even starting at a super young age and not having you know spent um you know 20 years in the field I think the East Coast Vibe is much more like don't even start working on something even mildly ambitious until you've spent 20 years in the field and I think that um
yeah that kills a lot of great ideas because the problem is that if you have already been working on a problem for 20 years years then you've you know you've you've by definition kind of you know you're not looking at it with fresh eyes you're looking at it from the perspective of you know the other people
in the field and that's obviously really useful you should always have domain experts but um I think the thing that's really unusual and special about the Bay Area is that the attitude is one of like incredible optimism and um incredible excitement and obviously a lot of uh you
know ideas fail but um the fact that there's this tolerance for failure or this tolerance for you know thinking about something um incredibly ambitious also leads to you know really really incredible companies that couldn't have been started elsewhere and um yeah if you just look at the funding environment
like you know the vast majority of like you know the most successful companies get funded here get founded here um pretty much across every category and I think the reason why is it's really special it's really hard to get so many um you know really ambitious Founders
and investors all in the same place and even after they dispersed during Co they kind of all ended up aggregating um you know again here and um yeah I just think that for me particularly I think it totally uh changed my life trajectory because if IID stayed in Virginia and I went to an East Coast school I don't
think I would have gotten that um exposure to basically taking your own Ambitions really seriously right I think that the East Coast can kind of kill a lot of ambition and say sort of like hey you got to work on um you know the the tri through try to do like a minor process optimization rather than like
really there's a lot of encouragement I think here for going for the most um yeah the most ambitious version of your idea rather than like okay the incremental like slight business optimization um verun of businesses which I think is more popular on the East Coast so um yeah I couldn't really
I couldn't recommend the program more highly and I couldn't recommend like at least like a visit to the Bay Area and just like meeting people who are working on startups um you know wherever it is you are more highly because I think it just opens yeah it just opens your eyes just to something that you may have
never even considered as like something that you could pursue I sure you probably experience the same right like before you met someone who's working on um you know investing sort of probably you know seems like a super foreign idea um so yeah I think that the just exposure therapy aspect of it is huge
because it's one thing to like read about something online or see something in a glossy magazine it's totally different to like actually sit down for coffee and talk to that person or like just like be uh you know in an office at a startup it just is like a yeah it's a different it's a different um I think
you can just Envision it a lot more clearly for yourself when you're when you're actually in the environment rather than if you're like looking at someone on the stage doing it yeah it's a schelling point for sure for startups and I love your line uh to take your own ambition seriously did that's something we try to really
encourage at a sh C Ventures and through our fellowship program we we we're really looking in in the tals that's amazing uh and and the and the tales is where all of the interesting stuff uh resides in in our opinion and uh did were you ever encouraged I guess maybe it's an east west coast thing um were
were were you when you were living on the East Coast were were their friends or or uh peers of yours that were like nor you're crazy why why why would you think you could work on that or were they were your contemporaries more supportive and it was we olds who were trying to calm it down a little
bit no I think it's um I think on the on the East Coast it's just not even in the like it's it's not even on the option list right like if you to think like ABCD it's like you go to college you get a job and like the job option like there's like five right that that's what you see everyone doing
so I don't think it's it's it's two things right it's it's um the set of options is I think fewer that people even consider and then the idea if if you propose the idea of to do something outside of the cookie cutter I think that is because it's not even on the option list it's sort of like people
don't have a response to it it's s of like oh that's bizarre and strange and I haven't really heard of anyone doing it versus I think on the West Coast it's totally opposite I would say like the default is work on something um you know really incredibly ambitious for as long as you want on a Sho string budget and
then if for some reason you know none of those things end up handing out then okay all this other stuff that on the east coast is the default those are your backup options and um I really liked that uh that reorientation because um yeah I mean those are yeah work working on something that could help a lot of
people that um you know might not exist otherwise is you know always the kind of thing that um I found most exciting and the yeah the idea of being around a group of people where that's actually um celebrated rather than met with a lot of skepticism is um I think really really
special right because when I when an idea is Young it's um you know it's frail and it's fragile right and you could you could either you know uh yeah have an environment that supports it to grow into that massive Oak these like really incredible you know companies like you know Apple and Google that were
sted garages on Sho spring budges or they can get killed right I think unfortunately the I think the environment on the east coast is is more likely for them to U you know Bally that seedling never to even you know make it out because it's it just remains in someone's idea just remains an idea um
because yeah folks around would basically if you if you brought it up they would immediately say oh that sounds odd or that's weird rather than the default in the west coast is oh yeah go do it like try it out yeah I always try to find things to root for as opposed to against because
rooting against things just seems so painfully obvious to me I mean like that's easy you really need to spend a lot more time looking at ideas looking at people and saying wow that is really super cool which kind of leads me to what you're doing right now yeah I think I think what you're doing right now is super
cool so so tell us the story about what led you to found the company and and uh actually go for making the next generation's Health span I guess that's a Peter AA line right he didn't he write a book about that I think uh better than previous previous generations yeah yeah
yeah yeah cool um so yeah I guess the story of orchid starts pretty young so my mom has this condition called uh retinitis Pigmentosa so uh what that means is that she started progressively going blind in her 30s so what happens is you start by losing your night vision then you lose your peripheral vision and
then slowly as your retina degrades you lose um you know the vast majority of your central vision as well so that diagnosis took um actually many years to to get to uh she kind of went around to a ton of different Specialists talked to them about her symptoms and you know eventually this diagnosis ended up um
they they all sort of converged on it and um it was a really really hard diagnosis to receive because obviously if you grow up and live your life as a exited person um the idea of your vision and all of the Independence that comes with having Vision getting ripped away from you is um incredibly frightening
right and then there's also this this denial or this hope that you know maybe it's not as bad as the doctors are saying right maybe the vision won't degrade um as fast or as severely as the doctors were saying right and unfortunately they were correct and um you know she did end up losing her
vision and um uh it was really hard I think for everyone in her family to see her life get hijacked and um I think you know in that period the very long period where you know that diagnosis was getting um converged on there was also this fear of you know is this going to affect her siblings like my aunts and
uncles is it going to affect us her kids and then um you know just that that that fear and uncertainty of like you know something that I think we all take for granted which is like you know being able to wake up and see uh the Sun every morning um or seeing your grandkids um isn't going to be something that you're
going to be able to do and um I think kind of what struck with me during that whole time was just this um unfairness right it's just I I won this genetic Lottery where I get to see my grandkids right and then for my mom she lost it right just because of a typo a random you know letter change that she
you know when she was born and was being formed she ended up having um you know just totally changed the trajectory of her life and it wasn't my you know my grandparents her parents fault like she didn't inherited from them it just spontaneously randomly by just sheer horrible luck happened to her and um I
think that just struck me as like this is a huge um unfairness in the world and um obviously at the time we done teenager you know Elementary School you know when all this stuff started um yeah I think that just struck struck me for a really like kind of uh like burn burned a you know hole in my heart for a while
and then when I was at um Stanford I was studying uh computer science and I was working in a lot of different Labs on um different types of computer vision or deep learning applications um you know predicting transcription Factor binding or predicting you know melanoma versus
carcinoma and um yeah just by chance I ended up coming across these really large data sets um where you have um hundreds of thousands or of people with their sequence data their DNA sequence paired with their um medical record so okay what's LDL level what's your blood pressure you know did you get diagnosed
with schizophrenia and um it was just really cool to see because you know you know rewind you know a decade um earlier those data sets didn't exist right like sequencing was way too expensive it wasn't um dominant enough for those data sets to exist and um it was the promise of you know the Human Genome Project
that cost you know um you over a billion dollars to get the first human genome sequenced and now finally sequencing it gotten cheap enough you know organizations had um aggregated all of this data and um you know for me as a computer scientist I was like this is cool like now genetics is a
computational science now uh we can actually be useful we can build these models we can quantify risk for genetic diseases in ways that weren't um possible before and you know for me as I was getting older I was you know you know getting engaged and things like that like the the application that
jumped out to me as the most obvious and uh like the most massive like like human history projector and altering impact was being able to use this data in the context of um pregnancy and having babies where you know I don't want my child to suffer from what my mom suffered from but not only that we have
data now on thousands of genetic diseases and I don't have to take that risk for my child they can just avoid all of these diseases that would result in you know a baby in the NICU um you know a baby that has like a horrible birth defect that has um you know developmental delay there's so many
diseases that we now know about that we don't have to roll the dice and um you know leave to chance now it could be possible for us to use data at the earliest possible stage before you're even pregnant so that um you can identify an embryo that is um you know free of these you know pathogenic or you
know disease causing uh mutations so that um you know a baby has the maximum chance of of being healthy so that was the application that was obviously like the most uh exciting for me you know given my you know life experience and my family history and um you know as I was thinking about you know do I want to um
like what what do I want to work on what kind of my life's work with the hill that I want to die on this one was like a clear what I sort of like um yeah basically help helping everyone have a healthy baby helping families um who've suffered tremendously from um you know a disease either you know they themselves
the parents are affected or the child um is affected it was just so obviously something that you know I'd be willing to yeah it was just a hill that I was obviously willing to die on and um you know having done the teal fellowship and seeing how incredibly hard startups are
even for something that you know I think people think you know something like you know Pinterest oh you're just like putting you know images online it's like it's an incredibly hard process to build a company from nothing there's just so many challenges along the way so I wanted to make sure that whatever I
worked on was something that yeah was at least you know you know uh for for some number of years previously and what I can envision myself for at least a decade into the Future something that um would continue to motivate for me and that I think had a shot at being my life's work and um yeah basically being
able to help families have Healthy Babies was something that um yeah that that that definitely check the boxes there so um yeah so what the company um actually does is that we've built the world's first whole genome sequencing report for embryos so what happens during IVF is that you have um multiple
embryos so you I guess to back up a little bit what happens to the to the woman is that you take um injections for about medication for about 10 days to mature your ovaries so your ovaries um during a natural uh menstrual cycle they release one egg but actually dozens to hundreds of eggs are actually lost every
month so what the medications do is they mature all of those eggs that would have otherwise been lost that month um so that you can um grab them and save them in the freezer so after you do that retrieval so basically grabbing those eggs after about um you know 10 to 14 days you can fertilize them with your
partner sperm and you create embryos so you have about anywhere from five to 20 embryos during an IVF cycle and then where Orchid comes in is that the edge of that embryo is sampled by the embryologist so about five cells from that day five embryo that's about 125 cells get sent to orchid's lab and then
you know what we're able to do is that we're able to get a 100 times the data on that embryo compared to Legacy technology so we can get 99.6% of the embryo's genome and um what we can do with that with that 100x data is we can report on conditions that previously were undetectable or would
have been missed by the by the older technology so we can tell parents about each embryo's risk for Pediatric cancer adult onset cancer heart defects skeletal defects um a whole range of genetic growth defects neurodevelopmental disorders intellectual disability autism there's
just an incredible number of single Gene diseases as well as polygenic diseases so polygenic diseases are the ones where it's not just one gene but it's the cumul effect of millions of variants that are driv risk so examples of that would be something like um schizophrenia or heart disease or bipolar disease
where um you we're basically quantifying the genetic predisposition to disease it's not a yes or no this this embryo have this specific genic variant that's linked to autism or linked to retino blastoma type of pediatric cancer so we give parents this um massive 100x upgrade on the amount of genetic
information they can have on their embryos and then they use that information to transfer the embryo that is um healthiest so that the um parents have the maximum chance of having uh a healthy baby and um yeah what's really cool is that um you know this has been kind of like the the holy grail for you
know 40 years right since IVF was invented people have wanted to have this level of information on uh their embryos and we've been the first company to be able to introduce it and um yeah the product is now live uh Nationwide all across the US um babies have been born uh dozens of pregnancies are in process
so it really feels um I know it's particularly like rewarding moment for me because at the very beginning um you know people thought what we were trying to build was uh impossible right it was sort of just a a dream to be able to to do it and now I've got kind of G full circle to you know have brought it have
published the papers to actually um you know have have happy moms with happy babies it's just um really cool really it's really awesome to be able to serve um you know so many people who are in um the situation where um yeah they could they could potentially benefit from having this um upgraded information on
on their embryos so I I think uh genetics is fascinating it's always been fascinating to me I did the rabbit hole jump on you know identical twins separated at Birth um and in fact there was a huge study done at my Alma moer of the University of Minnesota on uh twins that uh were
identical and the the Striking similarities between them even though they'd never met each other in many regards but it's also which I find somewhat odd genetics seems to also be like a really hot button issue yeah a lot of people that I've talked with who I would normally think of as you know
open-minded sort of progressive mindset people like when the subject of either uh you know the implications of genetics or things like this come up well you can't play God and you can't do this and I'm like I don't get that at all I I mean I understand the the point where some people would want to ask a lot of
questions sure but it seems to me that if you have the ability to uh make sure that your child is going to have the greatest chance at a successful physical at least life and mental from what you've said it seems like a a a a universal good have have you heard from from people who like are are on the other
side of this issue and if you have like how do how do you address them yeah I mean I think that it's um for some reason I would say that this this type these types of objections are like uh magnetized for anything around reproductive technology so there's like a really really interesting history of
um yeah of reproductive technology so something as like simple and standard as um birth control so literally just you know contraception condoms were banned in the US so there was these laws called the comto or obscenity laws where even the mention of birth control like literally just Contra like um condoms
was considered obscene and people were jailed for putting that in a newspaper selling anything like it was just considered um yeah it was just it was people were allergic to the idea that um people should be able to control when they have kids right so it took um Decades of fighting there was a Supreme Court case
just to get married women the ability to purchase condoms right and in order for them to do that they had to get approval from their husbands and that was like a massive like I think 30 40 plus year fight to get that right and then um you know I think an additional decade or two
for the right for unmarried women to have access to contraception um and then there was another like massive uh debate and fight over uh the introduction of the epidural so basically pain relief during pregnancy so pain relief was offered in every other part of medicine from Dentistry to um you know different
types of surgeries but the idea of using an epidural during pregnancy was sort of like this massive debate around oh like well shouldn't women suffer for during pregnancy because you know Eve efforted or something I don't even know the whole debate or reasoning why but um yeah there's this I think there
is this special I mean I think everyone knows that there's this like specialness to um giving new life I mean it's clearly a miracle it's like just a massive beautiful thing that happens so I think that the correct orientation is to have more um scrutiny over that area and more protection for you know the
vulnerable you know pregnant mom and baby um but to me you know the transition from you know home birth to hospital birth did that right and it was me lot of skepticism of oh why are you medicalizing um you know the process of giving birth but you know it like massively reduced fetal and maternal
mortality by you know having access to everything you have in a hospital during you know during during the delivery process and similarly IVF is also met with a massive amount of you know pitchforks and uh you know concern was and um you know 12 million people wouldn't exist today if um IVF wasn't um
invented so I think people discount future people too much right like those 12 million people that wouldn't exist and then at the time you know people were were so against the idea of IVF so I think people you know when thinking about this technology really need to consider future people right the idea
that you know now we could slash incidence rates for every major disease because instead of again rolling the dice and randomly getting random outcome you can um avoid these um these horrible diseases that unfortunately we don't have cures for and that are much more common than people realize so just for
this that category of single Gene genetic diseases there's actually um you know 30 million Americans in the US that have rare disease so 10% of the population even though each individual rare disease terrible naving uh under 200,000 people are affected if you aggregate or add up all of the thousands
of diseases it ends up being this massive number 10% of Americans 30 million people right and for most of those people 95% don't have any treatment option so it's sort of like okay you're kind of stuck in the situation where um drug companies don't want to develop um treatments because
the market sizes are too small so it's like this huge failure of our system to be able to um help these people and we have this opportunity now for at a really the fraction of the cost of even the best treatment so in the case of my my mom for retinal P Pigmentosa the first gene therapy was actually
developed for her condition it was called luxtera it is was approved I think in 2017 or 2018 and it costs $800,000 per eye and it doesn't reverse the blindness it just prevents it from progressing and then again only a really small fraction less than 5% of people with uh retinitis Pigmentosa are legible
because they have the specific variant RP 65 that looks turn to treat so the vast majority of um these diseases unfortunately there's so many different typos that the gene therapies can't even you know help everyone they can only help the fraction that have the specific typo that the gene therapy targets so um
cures and treatments are incredibly hard and expensive to come by they typically cost you know a billion dollars plus to bring to Market once they are in Market they're incredibly expensive they do have side effects versus this alternative is like a vaccine for every known disease um you know before you're
even pregnant so I'm just super super excited to give this um opportunity to parents and um I agree that obviously pregnancy is this like magical beautiful incredibly special moment so I think every company in technology that's operating in that space um you know needs to be operating at an incredibly
high standard and to um demonstrate the effectiveness of that technology and that's why we've been really um slow and methodical and careful about um you know all the studies that we've put together before we started offering it and um yeah just feel really proud to be at a place to be able to give parents so much
more information for this um incredibly uh important decision and moment in their yeah and uh bringing up the uh almost religious fervor that people get whipped up around this stuff brings to mind the fact that you know I'm so I'm 64 I just turned 64 and in my own lifetime the change thank thank you in my in my own
lifetime the changes particularly in the United States would be mindboggling to people if they actually looked at the progress that's been made in 1971 as you mentioned uh women women could not get credit cards without their husband's permission how up is that and like like when you go back and
see I think that in in most cases it hasn't all been changed for the positive but the vast majority of changes and what is now accepted like would have been incon aable to somebody looking at this from 1971 and and that's why I think context is so important if you don't have
context you you you you might have some sort of immediate or emotional reaction to a position that you know maybe isn't warranted and and like I look at things like this I'm like are you kidding me where where how can I sign up a dozen people for this a hundred a thousand because what you're what you're doing is
not really when I've had conversations with people specifically about things like crisper and gene therapy that's where I find a ton of people with a real like hot button have you ever seen the movie gataka you know I'm like yes I've seen mie gataa and and it seems that another part of all of this I don't know
I'm a huge fan of David deuts in his book The Beginning of infinity in which he AR in which he argues that essentially the precautionary principle leads usually if taken to excessive lengths leads to stasis which in my opinion is death right it's brain death if you're in a stasis situation uh
that's not a good look what what are the most common findings and like I'm also really interested like how do the parent the potential parents re act when when they get the the full report uh from the embryo project yeah yeah yeah I think it may it might help me to kind of just
give you some vignettes of some of the like types of patients who kind of come to us and then yeah I can get I can get into that so um yeah so there's there's one of our patients where they had a child with a denova or spontaneous mutation in a gene called kcnq2 so unfortunately that leads to very very
severe um devel mental delay um the child not being able to talk not being able to walk like just very uh severe um uh symptoms and they came to us because they wanted to um screen for this in their subsequent embryo so they had a chance to have a healthy baby so sometimes people come to us because
they've had a first child with a very severe disease and they want to um mitigate the chance that that affects uh their their next child another example um is a uh is a condition called um uh smooth brain disease so unfortunately it's again it's a mutation in a gene that causes the brain to um form in uh
incorrectly and not grow at the normal rate unfortunately it's terminal um those children need to don't end up really um being able to um the vast majority don't end up being able to you know Reach Elementary School age so that family is actually one of our um philanthropic cases where uh we're
actually trying to cover the vast majority of the um screening cost so that that family has a chance to have a healthy baby um we also have um families where they have a one of the parents has a history of a complex a brother has schizophrenia oh good the other situation was um yeah parents who are suffering from a
condition uh themselves so we had um you know individuals who had a family history like a brother or a aunt or Uncle with schizophrenia or with bipolar disease and they want to um you know minimize the chance that that affects their future child so for those conditions what they get is a percentile
so is this every 99th percentile of schizophrenia or are they in closer to the 50th percentile and the higher the percentile the higher the base rate of the disease so in those higher percentiles you might have a 3X or 5x chance of developing the disease compared to the B line average so they
kind of get a lifetime absolute risk as well as a percentile for each embryo and they can try to transfer the embryo that has a minimum uh genetic low genetic risk for that specific disease um and then the other thing that I found really really interesting is that we've started having cases where we actually uh
diagnose parents from the embryos so they'll come to us maybe the one of the examples that I'm thinking of is um you know the father is older so we call that advanced paternally age and older fathers contribute more paternal mutations so unfortunately sperm just like eggs accumulates genetic mutations
and those can lead to much higher rates of neurod Developmental disorders like um autism intellectual other types of things so sometimes when we have older fathers we you know that's an indication for want to use uh sort of more advanced whole G from embryo screening so they came for that and then what they ended
up finding out is that you know half the embryos have this um single Gene form of diabetes called Modi and Mom and Grandma were already being treated for that condition but they didn't know that it was genetic they had they were doing all the treatments but they didn't know what
the actual genetic cause was so from the embryos even though we were looking for neurodevelopmental disorders we ended up finding out okay half the embryos have this single Gene genetic form of um U of diabetes called Modi and then we also were able to tell U Mom and Grandma that you know that was the cause of their
condition um we also uh you I think found a case where um you know some of the embryos had a something called a micro deltion that ended up in that causes seizures it was also it's something called xlink so females are XX and males are XY so females have a less severe manifestation of the disease
because they have two xes so one X can kind of compensate if it's a functional copy plus a broken copy and if you're a male you have X Y so you only have one functional copy so that if that copy is broken then you have no functional copy so the males are more severely affected
and um yeah so we you know it wasn't told reported to us that Mom was having some seizures but you know she actually was and that was actually that mutation was present in some of the ambras but not all of them um so we were constantly really shocked and impressed by that because um it kind of goes to show that
you know whole genum screening isn't the default uh for people today and even though people are doing this because they want to prevent diseases in their embryos and their future kids they're actually getting some answers about you know these symptoms that doctors are just treating the symptoms of but not
identifying root cause of um in the themselves and I also find that um really interesting and really compelling because once they find out the real genetic reason then that can actually guide treatment and again obvious has awesome implications for the Next Generation where um if it's a milder
disorder then you know they they they can prepare for early if it's something that's more severe that you know they they really hate having to deal with they can um uh usually identify that's unaffected from that specific disease and just avoid it entirely for for their kiddos amazing because the ibf obviously
is how you're able to do it for embryos but you also have a saliva test that people who are just not using ibf uh can take what can that tell them about about their own predispositions and and what they could do when they have that knowledge yeah yeah yeah it's kind of like what your what I was just saying
earlier about sometimes we're uh diagnosing parents from their embryos right so the benefit of doing the saliva testing is that you can find out about the information about yourself so um yeah we have whole genome reports for parents that they can just submit via a spit test and the difference again here
is it's a lot more data so something like 23 and me their testing is um you know very affordable but it is only looking at a very very small fraction of the genome so um yeah the downside of looking at a small fraction of the genome is that you can kind of think of it as um you know are you doing spell
check on a single page in your in in your textbook or you doing spell check on the entire book so if you're only looking at a small section of the genome you're only able to to look at risks for that one page or you know really small segment versus we want to be as comprehensive as possible because this
is a super important step which is um you know having kiddos so what the advantage of is of the saliva testing is that parents understand their own risks and we actually stimulate embryos so when you have um a baby you know you get uh you know half the DNA from Mom and half the DNA from Dad but they can
combine in a lot of different ways so we simulate um you know a thousand embryos that could emerge from uh mom and dad and then we show the risk distribution so you just show you know how much risk for a specific disease would you be able to mitigate for the ones that are polygenic or the ones that involve um
you know um anywhere from dozens to millions of variants that are kind of included in a risk score so for the polygenic risks you kind of see okay um how much could we mitigate risk so how much could we reduce the risk by identifying embryo um that's the lowest risk of the batch that you know you know
you and your partner would create and then for those monogenic ones you find out okay do does mom or dad have the disease at all and then you have to do the actual embryo testing to look for spontaneous or novel mutations right so for the condition that affected my mom if you screamed at my grandparents they
wouldn't have it but um unfortunately it spontaneously happened in in her so the advantage of doing the embryo testing is that you can look for both um inherited and non-inherited genetic changes so inherited meaning comes from Mom and Dad and non-inherited meaning um new or
novel mutations that happen uh in in every embryo and in each one of us when we're formed um so the advantage of the saliva testing is that you can get more information about yourself and get kind of a uh in expectation result for the for for the embryos or or kids that you would have and then um that can help
make the decision about you know does IVF make sense for your family or you know uh does um you know the the at home process make sense for your family because you know you're you're so low risk for you know every disease you you two already won the genetic lottery so there's no U of screening that's
necessary but um yeah I think maybe one of my um you know spicier opinions is that I think that um embryo screaming is actually going to be the default way everyone has kids I think that sex is going to be for you know connection and for fun with your partner and for something really important like having
kids um uh everyone is going to choose to do embryo screening because it's sort of like you know you get um you know fire Insurance you get earthquake insurance and those incidents are actually much less catastrophic and heart-wrenching than um you know a child with a disease that's uh incurable right
sort of like if your house burns down it sucks you take a you know big economic hit but um you know you kind of you buy a new house you kind of move on and um you know if a if if one of your children has a condition it's sort of you know it's it's much more painful right it's it's more painful than if you yourself
have the condition and um yeah the fact that now it's not up to chance now it's you know for the for for so many conditions we already know what um Gene is linked to that disease I think that parents are going to choose that hey for something this important I want to um you know I want to screen my
embryos identify the risks beforehand and then transfer an an embryo that's free of as many as as many risks that you know science knows about um today um because yeah unfortunately it's kind of the humbler uh position is that it's it's easier to identify a risk before the symptoms emerge than to actually be
m to develop uh treatments and cures because unfortunately those are really really few and far between in our um in our medical system today the uh use case for the saliva test seems like it could also extend to just people who want to know about their own potential risks since you're looking
at a much larger section of their genetic uh makeup than others but then as I listen and you bring up insurance like what about the idea that once the insurance companies get their hands on this like there they're they're gonna simply deny anyone with pre-existing conditions yeah that be a really good point um
fortunately in the US there's a law called Gina so the genetic information non-discrimination act so health insurance companies are um banned from denying you coverage based on your genetics so that's amazing but um so yes so for health insurance you know it's illegal to discriminate based on uh
genetics but actually for life insurance it's not so that's something to flag is that you know you may want to get a life insurance policy set up prior to getting genetic testing because um they are able to uh request genetic information for your for your life insurance policy but
um yeah I think that um yeah it would be really cool that there could be like an entire generation of um kids that have lower life insurance premiums because they they've already been free screened for uh you know some the worst diseases the other thing that's crazy is that um like what percentage of people would you
guess who are in the um er so basically people in the ER but you restrict to people who are in the ER who um are not there for an acute injury so not like bullet wounds or car accidents um eight like adults so like 18 to like 45 years old or so how many of those people in ER do you think would have like a genetic
reason why they're there oh wow um my guess would be that most people would say that the figure was low so I'm gonna go high yeah I'm gonna say thatth maybe a third of them yeah yeah yeah that's really close it's actually 25% so it's just massive you know a quarter of young you know young
adults who are in the ER you know there's a genetic reason why they're there and I just find that so astonishing that you know maybe if they had known about that um typo or condition earlier they could have had you know treatments options to avoid it and um yeah I guess what would be what
would be your guess for um you know babies that are in the NICU so the neonatal intensive carry in it like what fraction of babies do you think would uh are there for genetic reasons I'd go even higher there I'd say maybe 50% yeah yeah yeah you're really close it's 40% so yeah it's just massive the numbers
are so massive and it's um yeah it's time to put all this like genetic data to use right I mean we've been collecting it for you know two decades and um yeah just like you're saying it's really valuable to have it on yourself because then you know it's not medicine one- siiz fits-all where um you know you
just start screening at an average time it's like no some people are at above average risk they should probably start screening you know 10 years earlier and start proactively managing it 10 years earlier and other people are low risk and it probably doesn't make sense for them to you know maybe do screening at
the same time maybe they can push it off a couple of years um so yeah I think that the data is really valuable on ourselves but the thing is about ourselves is that for now our genetics are fixed versus you know for our kids um you know they're they're not you can actually totally avoid um a a condition
so uh it's just a really you know exciting moment in history right where you know it used to be the case for you know all of time previously that it it was a lottery and you have you had to just hope for good luck um so it's really cool to kind of have this transition point where um yeah now
parents get to get to make their own luck and mitigate risk for for these diseases I'm very much on the the side of uh this is what a what a fabulous time to be alive yeah because of all of the discoveries that we're making but what about let me play Devil's Advocate and and Advance uh the thing that I hear
a lot which is oh well once we let that happen then parents are going to engineer their children to be a certain height to be have certain color eyes to have all of these things H how do you respond to those types of arguments yeah I think that it's a well so I guess to be very clear like we don't do that
we're a health focused company so we're looking at things like oh and I I I didn't mean to imply that you do that that but that's a common Mis that's a common misunderstanding when people start talking about the ability to um you know pick and shoes they they are many a a non uh trivial number of people
immediately kind of like knee-jerk reaction is but you know and as I said you know wait then everyone's gonna be picking hi eye color and all I know that isn't what you do but I I'd be interested in in your response yeah I think it's sort of a um you know societal conversation right like we're
gonna have to decide what information as a society do we want parents to have when they're making this decision about which embryo to transfer and um it's really interesting the diversity of um regulation on genetic testing across the world so in China and India for example you cannot report on the sex of an
embryo and um in the US uh you can and I think the other one that I think is really funny is that um in France uh paternity testing is uh is not accessible it's illegal you have to get a court order in order to get a paternity test and I'm not going to comment on you why that would be so
disruptive to French society but um I find that also hilarious right it's like something that's you know you can just go online and buy that here in the US but you need a court order to get that in in France M the potential for uh advancement here just seems so huge to me you mentioned that you're
able to do a A variation of in silico various tests on here's what the great number of Ember that from the saliva test right yeah what are you most excited about in terms of things that you feel are tangibly near say in the next five years in in this field yeah I think that um again because all this
stuff is driven by data and more and more people are getting sequenced um the number of diseases that we're going to be able to te detect is only going to grow right so for example for autism you know they've sequenced Simon Foundation has sequenced I think over 100,000 individuals and families who are
affected by the disease and they've identified I think um I think in the range of 100 to 200 genes that are linked to some of the most severe forms of autism so these are individuals who are unfortunately um non-verbal um you know very severely affected by um by autism and you know sometimes a lot of
other symptoms are associated with it so as more individuals are sequenced the number of um genes and the fraction of autism um that we're going to be able to detect is only going to grow right similarly for Pediatric cancer for these heart defects for these skeletal defects for the single genin conditions that's
going to grow and then also for the polygenic conditions it's going to grow so I think um you know right now we're looking at um you know a ton of different diseases and there's I think more that are on the horizon that I think parents are very interested in so things like um propensity for um
substance abuse um there's just so many um Behavioral uh conditions from addiction to you know suicide attempt that are um you know that are linked to your genetics and to the extent that we can get more information and build models that more accurately um you know and precisely
quantify risk for those conditions I think that that's going to be um really powerful and is on the horizon soon and the other thing is that the data sets that we have right now are uh quite biased toward um Europeans and there's been growing effort to get more and more data for different ancestries so South
Asians for example we get heart attacks um 10 years earlier than any other ancestry and we're twice as likely to die from those heart attacks so for example in my embryos I'm trying to minimize risk for for heart attacks and so there's certain diseases that affect um certain ancestries more often and
that often has a genetic link and um I think that's also really powerful is that you know okay get more data on on all the ancestries and then also be able to help specific ancestries that have higher rates of certain diseases to um mitigate that um in their families so uh I think more data is going to mean
better models more models more diseases and um more like fine brain um analysis right so whenever you're building these models you need to have really good um labels right so for something like uh LDL levels like there's lots of different labels that you can use to define a disease like heart disease or
or um you know substance abuse or depression right so as the data the data we have gets um set this data sets get larger hopefully the data sets will also get richer right so we're going to have more and more fine grained measurements on um each of those uh genomes and that's also going to result in uh better
models getting built and um yeah better better results now uh do you have plans uh as you move forward with the company to follow the children that were born uh under your protocol yeah so we've um started sequencing the babies that are born and um yeah it's really cool to be able to
see that that um sequence that we got from the um embrio so before the pregnancy even began um and then the S the sequence data matches the um the baby so that's some uh really cool early results that we have and um yeah I mean obviously we're super confident in the results so I think eventually it'll be
really cool to be able to show on you know thousands of of babies that the rates of those really awful outcomes like you know babies and the NICU with these really severe conditions um can go down right because that's the whole goal is that at a you know society-wide level what if we could just have way less
suffering what if we could just have way less um diseases whether that affects babies or children or adults um yeah so I think it it'll be fun to you know continue to enroll those families and to yeah be continuing to um publish on the results there you mentioned that much of the data like most long-term health
studies are done pretty much well for the most part were done on men not on women so the Farmingham study for example uh was mostly men and then they discovered oh women might be very very different and then also uh what you mentioned that most of the data is on westerners uh do do you
have any protocols to guard against algorithmic bias uh within your own protocols oh what do you mean by that well I mean by that in data you know this is my old day job I was a Quant in uh Financial investing right so if if you get what looks like a self- selected sample right where where the people are
op in it may or may not be reflective of a larger random sample right and if your algorithms are trained on self well you mentioned earlier right the people who are coming and are finding your service particularly useful are people who have a suspicion or a certainty that they have some genetic anomaly in their
family history right and so I'm just curious as to that self- selected sample might lead to algorithmic solutions that or Andor permutations in the modeling that one that was done on a broadly based random sample would lead to a different algorithmic protocol saying yeah yeah yeah so we've
calibrated all of our models so that um regardless of your ancestry it's giving sort of the most accurate um risk estimate for your embryos and um we kind of we we basically explained that hey okay the error bars are going to be higher if you're if the data that's in the training set doesn't represent as
closely um your genetic so we kind of quantify all of that stuff and do some really careful counseling on um you know exactly what um the differences are in the risk estimates uh depending on uh sex and depending on Ancestry and those types of things um but yeah that's a really interesting and um important
Point um so yeah I would say it's really interesting I would say it's super diverse the set of people who come to us right it's um single mothers by choice it's um gay parents it's parents who have a genetic disease either themselves or in their family who've had a first child with a gentic disease but I would
say we also have a ton of people who are you know just you know fully healthy but you know they're planning on having kids you know in a few years right so they want to freeze their embryos and um basically maximize the chance that their child is healthy because you know I
thing that's so funny is like you know the healthiest time for you know a woman to have a child is still like you know 19 or 20 years old right but you know we're still in college then and it's not a convenient time to have kids in modern society um you know and it's it's really funny you know on the coast like San
Francisco in New York like the average age of a first-time mother is you know 33 bumping up to 34 and you know a geriatric quote unquote pre pregnancy is 35 so if you want to have multiple kids you're kind of almost guaranteed if you're on the you know um you know career track to to to be in that window
so um I think it's really cool that there's this trend that's kind of emerging where you know women are sharing information saying hey you know don't try and you know freeze your eggs and embryos at 39 or 40 you know that's kind of too late go ahead and do it younger when you're in your 20s and um
it's really cool to be seeing those couples i' wouldd say like a you know double digit fraction of our customers or our folks who have um you know no genetic diseases no plans to have kids um immediately but they're just proactively freezing getting all this data on their embryos so that um you
know in a couple years when they want to have kids um you know they they have the uh you know the healthiest gametes and embryos that that they can possibly have how long does a frozen embryo last yeah I think indefinitely so the the oldest embryo that was frozen that was born I think was about 30 years um
that that happened pretty recently and I think that that's super sci-fi and funny because um you know feasibly those parents could have be you know 26 27 so their embryo in some way can be older than than them obviously you know it's a newborn baby but um I don't know it's it's very I don't know for some reason I
find that very astonishing the idea that you know a human could be in suspended animation for for that long and um yeah I mean the freezing technology has has come a long way so you know 40 years ago um you know when ibf just started the embryo survival rate was much lower it
was closer to like you know 50% you know when you from freezing to unfreezing now it's incredibly high it's like 99% so the vitrification or new freezing technology is really really good and um yeah it's just amazing you know what I mean it's sort of like for for orchid for our embryo reports to be useful it
required um you know massive advancements and investment from so many different fields right it you know was a billion dollar investment to get you know the first you know human reference genome built it was 40 Years of innovation in IVF for it to be such a safe convenient um you know successful
process like it is today um you know required you know machine learning and gpus to get so much cheaper and you know more widespread of those phal techniques to get developed so um yeah it's just it's kind of amazing like the convergence of all these Technologies so that um yeah so that so that this has
become something that's you know no longer uh sci-fi but something that is is you know parents are using today do do you have any plans to like uh address there's a lot of talk right now about the emerging digital divide right where well and and I have very distinct views
on this I think people who are trying to regulate things like AI things like you're doing out of existence are are literally committing suicide at the national level because there are going to be other countries that embrace it and and I think that that's going to cause a huge digital divide what about
the Divide here of like affordability right are are are there any plans for like this is giving me an idea like there should be a foundation where people who don't have the means uh to to get this done who can apply for a grant or anything have have you looked into that at all yeah yeah yeah so we
actually have a philanthropic program so for folks who can't afford it um we're really happy to have this um you you know this set of folks review the applications and we want to accept as many as possible because I totally agree it's like this is something that um you know is uh you know a bit expensive
today but we want it to be something that's affordable and accessible to everyone and um already in the US we're living in this really unfair status where you know some families can who have infertility can afford IVF and you know they either pay out of pocket or they're at like a really cushy company
like Google who will cover it for them there's other families with infertility who aren't able to have a baby right like the most fundamental thing just because of a cost barrier and I think that that's insane I think that every insurance company and every company should be covering IVF plus genetic
screening because it's something that um I think is really critical for families right so currently the way their Healthcare System is set up is that we're spending the vast majority of money like you know millions of dollars to extend your life by two weeks at the very end of it right and it's like I
don't think anyone wants to spend you know their their last days um you know hooked up to to life support I think they' way rather have that money um and those resources spent during this really you know pivotal you know time in their life where they're um forming and growing their families um so yeah I mean
in terms of the costs we really hope to make it more affordable both from like just the natural scaling and um automation stuff that that companies um like us are going to be able to do we're also hoping for you know really widespread um employer sponsored health plans and uh Insurance support because
again it's something that's so critical I would say from like a you know National like competitiveness perspective right I mean think about it right like the the children are the future right it's like it's it's a platitude for a reason and um if you have an entire population an entire
generation where the odds are stacked for them rather than against them where you know they're not you know having their life hijacked by these horrible genetic diseases whether it's earlier in life or later in life I mean that's a massive benefit right we're spending trillions of dollars managing the
symptoms rather than root causes of these diseases and if you know if we're able to apply this on a national scale I mean it's a huge Advantage right all those trillions of dollars you know that are locked up in um you know ineffective treatments can go to you know cures and to go to curing so many of these other
diseases and other problems can go toward educ I mean we can divert the money to you know whatever you know Society thinks is most useful um but I I totally agree with you I think from like a competitiveness um standpoint it would be a massive Advantage for uh a country to adopt and we've already been seeing
um you know some some of those Forward Thinking countries in Asia and the UA reach out to us and say hey this is like a huge problem and a huge National priority for us like you know how do we get this technology over here and obviously I'm an American so I want to see the the greatest adoption um here
but um yeah I mean it all depends on what we choose as a society right I mean if if uh these other governments you know make it um super affordable that obviously there's there's going to be higher uptake um over there so uh yeah I hope this is something that um you know we as a society choose to make a
priority because it can have you know massive um benefits for individual families and that accurs you know to us um as a society as well have you been able to discover new and novel uh genetic anomalies from the data of the people that you've screened and if so what what have you
discovered yeah um I would say the new discoveries and stuff that we've done are more on um the chemistry and computational side right so the U IP of the company is sort of a new chemistry or new protocol or or a new way to be able to get whole genome data off of embryos um so that's kind of the novel
step that uh orchid has developed but in terms of the genetics um that's really more uh uh standing on the shoulders of giants of the entire you know Global genetics Community right so there's these groups of independent academic geneticists and they meet uh annually or by anually to kind of look through all
the papers that have been published all around the world and they develop these databases where they say okay this variant this Gene is linked to this disease and they kind of develop these operating procedures where they figure out okay here's the criteria to to decide whether this Gene is definitively
linked to disease or whether it's um you know disputed or you only moderately linked and we get to leverage that um to be able to build these really powerful reports for parents so what we really try to do is take um what's already happening in either the Pediatric or adult setting and we just try to move
that data up to embryos um and then we're kind of innovating I would say more more on the polygenic side so for the single Gene side we take what the whole Community has already agreed is uh working and super valuable and then on the polyenic side where we're quantifying predispositions that's where
we get to kind of add some more of that um computational spice and Secret Sauce to kind of get the most accurate possible results um for specific families depending on their specific ancestry composition or their own family history so we can tell people based on their own family history like let's say
you have one mom that has a you know breast cancer rather than you know a mom and her sister of breast cancer right so we have advanced modeling that shows for your specific family um based on who is affected and unaffected by certain diseases we can quantify the risk um you know most precisely for for your um
embryos um and I think that that's also super powerful because um you know it's kind of like smoking right where smoking is this massive lifestyle intervention where it makes you much more likely to develop lung cancer it's not a guarantee that you get lung cancer but it does make you much
more likely and these genetic um predispositions are similar where you know unfortunately if you are South Asian like me and you have a propensity toward heart disease yes you can exercise and yes you can uh you know take um you know medication but unfortunately your PR your natural
Baseline risk is just still higher than other ancestries um so again being able to democratize or um you know reduce that genetic privilege that um some people have is is really amazing the idea that everyone can have um you know a fair shot at a healthy life is something that um yeah it's just like
super cool to be able to offer to parents well I think what you're doing is is absolutely fascinating I think that as I said earlier I'm just so lucky to be alive at this part of the timeline yeah because uh seeing all of the Innovations uh here and elsewhere like what a great time to be alive
honestly um and and so I'm very impressed by what you uh are doing I I I have two more questions one is a bit of a diversion from what been talking about and I I noticed that two of your favorite essays were what you can't say by Paul Graham yeah and secrets by Peter theal just tell me I I'm fascinated by
people's favorites in in this regard and so why why are these two among your favorites huh that's a good question well I think in terms of writing what I really enjoy the most in writing is when someone is able to um articulate an idea or a concept that you may have this sort of like vague feeling about or intuition
about in your mind but you but you haven't really made really sharpened into something concrete and precise and I think that um everyone sort of feels that you know that feeling of oh that's something that I you know can't quite talk about because you know you'll face um you know skepticism or you or you'll
be ostracized and um sometimes there's a lot of things that are worth um discussing there and basically the taboo around it is um yeah can be suffocating and basically prevents really understanding well you know what's really going on here and I think that um I think I think it can
just be incredibly powerful right so I think in the context of what we're doing again there's this incredible amount of taboo around reproductive technology of hey don't touch this this is sacred this is something that you know science engineering shouldn't touch and I feel the exact opposite it's like because it
is sacred because it is special because it is so important science and engineering should make it as safe for moms and their babies as possible and I think that in examining that that um Taboo it's sort of like well it's not really well founded right and we kind of talked about you know contraception we
talked about epidural we talked about IVF and these were incredibly positive technologies that we all take for granted today we all think that you know it's obvious that a woman should choose when she gets pregnant who she marries um you know that she should have the opportunity to choose IVF if that's
right for her family you know infertility doesn't have to be something that you know God wanted you to be infertile no we don't accept that anymore now it's if you're infertile you have opportunities to do IVF and to do procedures so that you can have a baby right and I think um yeah in in the
future it'll become obvious that you know you should H you should have the ability to have as much information as possible about your embryos to mitigate the chance that they have all of these diseases and today you know there is a little bit of um yeah I would say uh uh I would say fear around it and I think
that that's going to go away just like it went away for these other Technologies and um yeah it's really cool to be able to you know be be building something in that space and I think there's a legacy of you know great Technologies not just in the reproductive technology space but in
others that that kind of took advantage of that same secret that they recognize right I mean people used to think that oh my God how could you possibly get into someone else's car like that's terrifying like they could kidnap you and yes that does happen sometimes with Uber but for the vast majority of people
they rely on Uber to be able to get around right and you know self-driving cars ended up you know resolving that problem around you know you know Rogue folks uh in the future and for now you know people are doing background checks to resolve that problem and it's a you know it's a trusted service and you know
same for airb be there was this immense fear of oh my God A stranger's home like I would never stay in a stranger's home and again you know just totally um you know blasted open the capacity for um you know vacation stays and so many different geographies there's a whole set of entrepreneurs who make their
living um you know with Airbnb homes and um yeah I just think it's very true I mean I think some of the greatest ideas are hiding in plain sight in a sense that hey there's these blinders on people where they say they won't look they refuse to look in this one area because you know Society is pushing them
away from looking there and um it can end up being like a gold mine for ideas because so few people have the courage to actually think for themselves and look at well what do they actually think about that thing themselves rather than what is everyone telling them to think about that thing um and um yeah I just
love I think both of them are just such incredible writers and they um yeah they basically describe you know this this concept in a in a really um articulate and beautiful way yeah and and uh as you were talking about the the fear you know I think human operating system is Guided
by emotions mostly and the the dominant emotion that rules most of the others is fear and when you look at how humans have responded to Innovation and uh progress in the past it's it's it's virtually the same picture right you go all the way back to novels and everyone was losing their about oh my God
this this is going to corrupt the youth and whatnot and and I think that the disconnect is that we also have this weird uh idea that we know what the future is going to be yeah we have this idea that that we already know everything that's going to happen and of course we know nothing well we know some
things right directionally but the idea you know again to quote David Deutsch you know what were people thinking about quantum physics and the internet in the year 1900 well they weren't because nobody had ever heard of or even conceived of those things and that's why I'm I'm so much more on the side of
don't try to understand new things too quickly because you're probably going to be wrong and you're probably going to kill some really great ideas in their cradle rather rather rather than letting them flourish and and I think what you're doing is a great idea and it's no longer an idea now it is a reality which
I think is super cool well our final question on the podcast is uh we're going to wave a w and we're going to make you the Empress of the world now you can't put anyone in a re-education camp and you can't kill anybody but what you can do is we're gonna hand you a magical microphone and you can say two
things into it and the entire population of Earth is going to wake up whenever their morning is the next day and they're going to think to themselves I've just had two of the greatest ideas and unlike all the other times I'm gonna actually act on these two ideas what what two things are you going to incept
in the world's population okay so what what are the two ideas that I broadcast and then everyone actually does it yeah oh okay cool um I think one of them would definitely be um you know inspiration perishable so act now I think that's a really really big one um I think Moment of clarity and
that moment of hey there's something that I'm excited about are just so so precious and I think that um we're always you know too quick to um you know delay starting And Delay working on them and then kind of that that beautiful moment uh you know can expire and then you know it went from being like Oh the
words were just you know flowing so easily on the page to you're you're stuck with the with the blank page I think that would be um you know the first one and I think the um the second one would be um you know just be be okay with um you know shipping or sharing that rough draft I think that it's you
know really really I think people have really high standards for themselves and they want they have this vision of I want this thing to be so perfect and beautiful and like you know the the thing about an expert or or someone who's really excellent is that they have failed you know hundreds of times more
than the novice has even tried right and if you just kind of accept that hey this is a learning process and you're a little bit more generous with yourself you know like when a baby is learning to walk everyone's kind of celebrating every single um stumble every single you know minor you know success and I think
that um adults should kind of treat themselves with that same uh generosity and love of like hey I want to like keep learning and keep building things and keep um you know learning throughout life and the way to do that is kind of be more gentle with yourself and say hey look
this is my first version I'm pointing it out I'm starting to talk about it and then um I think that leads to again like make that that really amazing thing it's like the other thing about so you know to kind of draw this back to companies is like so many of the most incredible companies today started out as something
you know totally different and um trying to think like you know PayPal started out like you know beaming stuff between Palm Pilots right I mean and then it turned into like this Global you know amazing payments thing and I think Facebook started out as like you know like a hotter not website and then now
you know it's billions of users um trying to think there's obviously even more crazy P pivots I think another really famous pivot is obviously you know slack I think slack started out as like you know video game company and then kind of you know been became like the most you know most popular you know
corporate messaging thing right oh actually no my favorite example is Netflix right Netflix started out mailing DV DS to people's homes and now is like replacing Hollywood I mean what an insane pivot you could never predict when you're mailing DVDs to people's homes that you're actually going to
become a company that not only kills Blockbuster which everyone was super skeptical of at the time um but you know you're actually going to be producing your own streaming service you know you're going to be producing you're not gonna you're going to Stop Licensing from Hollywood and you're actually going
to start producing your own film so I just think that um you know that first step is often so much hard than harder than just continuing on and you know taking all those subsequent steps to becoming you know this giant and Amazon started just mailing books and is now
you know there so much revenue is coming from you know AWS and their um compute service so it's like you don't know where that step is going to take you and just taking that first one is um yeah can sometimes be the hardest so yeah just get started do that get that rough draft out there I love both of those
those are really really great share with our audience where they can find you and your compass yeah I'm on Twitter at uh nor sidiki and uh the company is called Orchid our website is Orchid health.com and uh thank you so much for having me this was such an amazingly well researched and uh
thoughtful uh interview and podcast so just such an honor to be on and such an honor to get a chance to uh chat with you and your uh your amazing audience wow the honor is mine it was really great having you on and I wish you all the great success I thank you you're going to earn oh thank you so much so so cool to be here