WEBVTT - Human Bones, Made In the Lab

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<v Speaker 1>Pushkin. Not long before he died, Steve Jobs made this big, sweeping,

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<v Speaker 1>very Steve Jobs claim. He said, the biggest innovations of

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<v Speaker 1>the twenty first century will be at the intersection of

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<v Speaker 1>biology and technology. A new era is beginning. If Steve

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<v Speaker 1>Jobs was right, if biotech over the next fifty years

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<v Speaker 1>develops like computers did over the past fifty years, then

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<v Speaker 1>we are about to see wave after wave of just

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<v Speaker 1>extraordinary innovations in medicine. Very high on that list of

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<v Speaker 1>innovations human body parts made in the lab. I'm Jacob

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<v Speaker 1>Goldstein and this is What's Your Problem, the show where

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<v Speaker 1>I talk to people who are trying to make technological progress.

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<v Speaker 1>My guest today is Nina Tandon, co founder and CEO

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<v Speaker 1>of EpiBone. Nina's problem is this, how do you grow

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<v Speaker 1>human bone in a lab and do it at a

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<v Speaker 1>price that makes economic sense. In our conversation we talked

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<v Speaker 1>about how EpiBone is growing human bone that's being used

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<v Speaker 1>even now to treat patients, but also we talked more

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<v Speaker 1>broadly about the field that EpiBone is part of. It's

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<v Speaker 1>a field called tissue engineering. Maybe just to start, like,

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<v Speaker 1>what is tissue engineering? Well, tissue engineering is a branch

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<v Speaker 1>of engineering that's devoted to the creation of surrogate body parts. Okay,

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<v Speaker 1>the future, Yeah, one stop body shop for human prepare

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<v Speaker 1>to what extent is tissue engineering the present? What tissue

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<v Speaker 1>engineering is actually happening in mass production, normal medicine. Now,

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<v Speaker 1>that is a good question, and I think you know

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<v Speaker 1>an easy way to think about it is, you know,

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<v Speaker 1>if you and I were to do a thought experiment

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<v Speaker 1>of what would be an easy tissue to grow, what

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<v Speaker 1>might you say? None? I would say it sounds crazy

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<v Speaker 1>hard to grow tissue, all right, right, Well, maybe something flat, okay,

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<v Speaker 1>maybe something with a single cell type. Maybe a tissue

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<v Speaker 1>then regenerates on its own. Skin okay, boom rites a

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<v Speaker 1>skin is a flat tissue, single cell type, and regenerates

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<v Speaker 1>on its own. Okay, has a lot of stem cells

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<v Speaker 1>in it, and so regenerates on its own. Like you

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<v Speaker 1>get a cut, you get a scrape, and magically a

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<v Speaker 1>week later or whatever, you have new skin there. Yeah.

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<v Speaker 1>And so in the early two thousands, we saw two

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<v Speaker 1>products in the late nineties early two thousands be released

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<v Speaker 1>to the market, I believe, for burns and diabetic foot

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<v Speaker 1>ulcers something like that. And so that's the first that's easy.

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<v Speaker 1>So you have this moment twenty years ago, people are

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<v Speaker 1>making skin graphs in the lab and there's sort of

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<v Speaker 1>big dreams. So if we can do skin, maybe we

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<v Speaker 1>can regrow everything in the lab. And so when do

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<v Speaker 1>you get into the field, When do you walk into

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<v Speaker 1>the story. I was an electrical engineer coming out of

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<v Speaker 1>undergrad and I had worked as a software programmer for

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<v Speaker 1>a telecom company. So this was not what I thought

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<v Speaker 1>I was going to be doing with my life. But

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<v Speaker 1>nine to eleven happened. I was living in the suburbs

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<v Speaker 1>for the first time in my life, and I got

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<v Speaker 1>a little bored and started taking classes at the local

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<v Speaker 1>community college in anatomy and physiology. And I think because

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<v Speaker 1>I was so lonely, because I was so kind of

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<v Speaker 1>starved for that type of engagement, I really got into

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<v Speaker 1>this class and I decided I was gonna, you know,

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<v Speaker 1>I had to follow this. So I applied to the

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<v Speaker 1>bioelectrical engineering track at MIT and got in for a

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<v Speaker 1>PhD for a PhD program, And so it's at MT

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<v Speaker 1>that you sort of discover this emerging field of tissue engineering. Yeah. Yeah,

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<v Speaker 1>And when you discover it, like, what do you think, oh,

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<v Speaker 1>my gosh, it's so cool this woman, Gordona, who was

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<v Speaker 1>one of the professors, and I just connected with her

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<v Speaker 1>as a person. To discover that one of the nicest

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<v Speaker 1>people that I knew at MIT also happened to be

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<v Speaker 1>experimenting with using electrical signals to grow hearts, and that

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<v Speaker 1>I was like, wow, I need to know if maybe

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<v Speaker 1>she might want to work with someone who's an electrical

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<v Speaker 1>engineer on that, and she did, And that was really

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<v Speaker 1>felt like destiny to me because I thought to myself,

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<v Speaker 1>I mean, I'd already fallen in love with the heart

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<v Speaker 1>at that point through my studies, so it really spoke

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<v Speaker 1>to me. And the idea that we could copy those

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<v Speaker 1>electrical signals to try and coax embryonic stem cells into

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<v Speaker 1>becoming heart cells or you know, to essentially coax the

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<v Speaker 1>tissue to form that to me was intoxicating. So how

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<v Speaker 1>do you get from there? I mean, you fell in

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<v Speaker 1>love with the heart, but you didn't end up starting

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<v Speaker 1>EPI Heart, You started EPI bone, Right, how do you

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<v Speaker 1>get from from there to starting your company? Cardiac tissue

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<v Speaker 1>is on the end of the spectrum in terms of difficulty.

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<v Speaker 1>There's a lot of intermediate hard end of growing tissues

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<v Speaker 1>mechanically at most metabolically active tissue in the body, multiple

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<v Speaker 1>cell types arranged in a very specific manner. So really

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<v Speaker 1>the most difficult you could possibly imagine, and bone is

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<v Speaker 1>in the middle. It's a complex shape, but we could

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<v Speaker 1>solve that using digital fabrication, and we could use a

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<v Speaker 1>single cell type to engineer a pretty high quality bone.

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<v Speaker 1>So it was clear to me that if I wanted

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<v Speaker 1>to be involved in translating that's the word we use

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<v Speaker 1>in the field, translating science towards the clinic in my lifetime,

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<v Speaker 1>I should probably you work on a tissue that's closer

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<v Speaker 1>to the skin side of the spectrum than cardiac. Right,

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<v Speaker 1>so you start epic bone, you decide to work on bone.

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<v Speaker 1>That's like almost ten years ago now, and today you

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<v Speaker 1>do have this engineered bone. You're doing a clinical trial

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<v Speaker 1>and as I understand it, right, this is bone that

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<v Speaker 1>is going into people's jaws, where typically a surgeon would

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<v Speaker 1>cut a piece of a patient's own bone out of

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<v Speaker 1>some other part of their body. But you're growing the

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<v Speaker 1>bone in a lab basically from scratch. So tell me

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<v Speaker 1>about the clinical trial that's going on right now. Okay,

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<v Speaker 1>so patient I think I'm allowed to say this. Patient

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<v Speaker 1>one suffered a traumatic injury due to a car accident,

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<v Speaker 1>and so we provided bone to help reconstruct the jaw.

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<v Speaker 1>Patient two had suffered from a degenerating jaw resulting in

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<v Speaker 1>airway obstruction, so we provided bone to help elongate the

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<v Speaker 1>jaw and relieve that airway obstruction. Patient three, he was

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<v Speaker 1>born with facial asymmetry that would only be correctable by

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<v Speaker 1>taking bones out of some other part of his body

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<v Speaker 1>to reposition his jaw, and we were just able to

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<v Speaker 1>grow bones for him using a small sample of his

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<v Speaker 1>fat tissue. So you know, whether it's for cancer, trauma,

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<v Speaker 1>or congenital defects, people need bone. It's bone is the

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<v Speaker 1>most transplanted team in material after blood. And so he

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<v Speaker 1>is three. The number of patients in the trial, that's

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<v Speaker 1>the we've done six. Oh, he's done six, Okay, yeah,

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<v Speaker 1>And what is the total number of patients you plan

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<v Speaker 1>to enroll? That's the fully enrolled. So that was our

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<v Speaker 1>phase one too. That was our phase one two, first

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<v Speaker 1>in human, first in class. Basically safety and a little

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<v Speaker 1>bit of efficacy. That's what phase one two, that's right, Yeah, yeah,

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<v Speaker 1>in a little bit of efficacy, and hopefully we'll move

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<v Speaker 1>forward with a phase three in the not too distant

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<v Speaker 1>future where we'll be able to help a few more patients.

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<v Speaker 1>And so how does the process work. So we take

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<v Speaker 1>two things from the patient. One, we take an image

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<v Speaker 1>a CT scan, which is like a three dimensional X ray,

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<v Speaker 1>so we can extract three dimensional data out of that

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<v Speaker 1>and design a perfect puzzle piece shaped biomaterial that will

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<v Speaker 1>be the eventual shape of the bone. We also take

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<v Speaker 1>a small sample of fat tissue from the patient so

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<v Speaker 1>we can extract the stem cells out of it, so

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<v Speaker 1>those cells can attach to the scaffold, proliferate, lay down

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<v Speaker 1>new matrix, and essentially turn that biomaterial into living bone.

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<v Speaker 1>It takes about three weeks for bone. So you take

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<v Speaker 1>a CT scan to get the image of the shape

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<v Speaker 1>of the bone you need, and then from that you

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<v Speaker 1>make when you say a puzzle piece, you make basically

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<v Speaker 1>something that is the shape of the bone you need

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<v Speaker 1>made of stick or something. What is it made of?

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<v Speaker 1>So we take a cowbone, strip all the cellular material

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<v Speaker 1>out of it, so we're left with essentially protein and

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<v Speaker 1>mineral and it's a very porous material. It looks like

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<v Speaker 1>pumice stone and you can infuse cells onto that and

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<v Speaker 1>the cells kind of recognize that matrix as being a

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<v Speaker 1>place that gives them a cue towards differentiating them towards bone.

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<v Speaker 1>It feels bony enough to these cells that they say, okay,

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<v Speaker 1>let's let's make the rest of this bone. So right,

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<v Speaker 1>so you have this puzzle piece made of cowbone essentially, right,

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<v Speaker 1>that's in the right shape. So that's kind of one

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<v Speaker 1>one track. And then on the other track, you're taking

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<v Speaker 1>fat from the patient. You're getting the stem cells out

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<v Speaker 1>of that fat, and stem cells are cells that can

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<v Speaker 1>become any kind of cell. Right, So, yeah, we've got

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<v Speaker 1>the cowbone puzzle piece, we've got the stem cells from

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<v Speaker 1>the patient. What exactly how happens next? Well, this is

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<v Speaker 1>our secret sauce. The bioreactor. So a bioreactor is just

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<v Speaker 1>a fancy word for a cell culture system, like a

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<v Speaker 1>place where you can culture cells in and so we

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<v Speaker 1>get those cells to turn to grow up and turn

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<v Speaker 1>into bone. So so just to be able to see it, like,

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<v Speaker 1>is the bioreactor a metal box? What actually does it

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<v Speaker 1>look like? You know, you imagine a little bone and

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<v Speaker 1>then you imagine the reverse image of that bone. So

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<v Speaker 1>a little gasket that like covers that bone perfectly, and

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<v Speaker 1>that gasket has holes in it so I can perfuse

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<v Speaker 1>liquid food through it as it grows. And that gaskets

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<v Speaker 1>contained in kind of like another canister where we can

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<v Speaker 1>have fluid that comes in and fluid that comes out.

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<v Speaker 1>It's about the size of a coke can, and the

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<v Speaker 1>fluid input and output are attached to a pump, so

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<v Speaker 1>it's constantly pumping. And that whole contraption, which we've made

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<v Speaker 1>quite efficient in terms of sizes about a shoe box

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<v Speaker 1>in terms of size, and we can stack them up

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<v Speaker 1>so that we can grow many at a time. Great,

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<v Speaker 1>So you take the cowbone puzzle piece, how do you

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<v Speaker 1>get the stem cells to like go on to the

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<v Speaker 1>puzzle piece and grow. Yeah, we perfuse them very slowly

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<v Speaker 1>and the cells attach. And that's part of why the

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<v Speaker 1>biomaterial is so important, because you know, a piece of

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<v Speaker 1>decellularized bone has a lot of these nanostructure attachment sites

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<v Speaker 1>that cells recognize and glom onto, and so there's a

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<v Speaker 1>period of time where the cells attach. Most cells in

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<v Speaker 1>our body are attached to some sort of three dimensional

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<v Speaker 1>matrix and then they start to proliferate. And lay down

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<v Speaker 1>even more matrix. So they proliferate around sevenfold and they

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<v Speaker 1>fill up that porous structure. So even though it was

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<v Speaker 1>porous at the beginning, it looks like bone at the

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<v Speaker 1>end of huh. So you take the puzzle piece, you

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<v Speaker 1>put the puzzle piece into the reactor, and then you

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<v Speaker 1>send the patient stem cells into the reactor and they

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<v Speaker 1>attached to and grow over the puzzle piece in within

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<v Speaker 1>as well, they're filling up the three dimensional YEA, yeah,

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<v Speaker 1>it's not a pancake. It's not a pancake. It's it

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<v Speaker 1>it's like a honeycomb or something. It's really important to

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<v Speaker 1>get the cells in three D. You know, a lot

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<v Speaker 1>of people can grow cells on a Petrie dish, but

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<v Speaker 1>grow cells in three D is a that's a big challenge.

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<v Speaker 1>But we've seen that the bones perform their mechanical duties

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<v Speaker 1>on day one. You know, patients are able to eat, speak, drink,

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<v Speaker 1>all the things that you'd want to do after the break.

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<v Speaker 1>The problems Nina and her teams still have to solve

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<v Speaker 1>to get lab grown bone approved and into widespread use. Also,

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<v Speaker 1>how should we think about the pace of progress in

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<v Speaker 1>tissue engineering and in biotech More broadly. Now back to

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<v Speaker 1>the show. So I want to talk about sort of

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<v Speaker 1>the future and what you're working on next in a minute.

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<v Speaker 1>But before we do that, I mean, you've been in

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<v Speaker 1>the field now for twenty years. Your company has been

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<v Speaker 1>around for nine years, and so tell me about the

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<v Speaker 1>progress of the field in the time you've been in it.

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<v Speaker 1>Tell me about the progress of the field in the

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<v Speaker 1>twenty years. What has what has happened faster than you

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<v Speaker 1>might have expected, what has happened slower? And like where

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<v Speaker 1>are we now? What is happening in tissue engineering right now?

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<v Speaker 1>There was a technology developed for cartilage, cartilage in a

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<v Speaker 1>couple of generations of cartilage, so that's been established as

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<v Speaker 1>like another tissue that can be engineered. There's another company

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<v Speaker 1>called hum Site which makes tissue engineered vasculator. They are

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<v Speaker 1>very close to getting in approved for commercial use. They

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<v Speaker 1>are hope within about a year or so. They're a

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<v Speaker 1>publicly traded company. So so vasculature, Just to be clear,

0:14:13.396 --> 0:14:16.596
<v Speaker 1>like blood vessels, they're making blood vessels. Blood vessels. That

0:14:16.796 --> 0:14:19.996
<v Speaker 1>seems hard. It's hard. Yeah, it's hard. It seems hard.

0:14:20.236 --> 0:14:21.876
<v Speaker 1>You gotta get the tube. It's a tube. I don't

0:14:21.876 --> 0:14:23.996
<v Speaker 1>know why that seems harder to Me's a that. Yeah,

0:14:24.036 --> 0:14:26.796
<v Speaker 1>hollow organs are a step above flat tissue for sure.

0:14:27.316 --> 0:14:30.436
<v Speaker 1>And UM and there's their founder, Laura Nicholson. What she

0:14:30.676 --> 0:14:35.116
<v Speaker 1>learned in growing vasculature was that cells needed flow, not

0:14:35.236 --> 0:14:40.276
<v Speaker 1>just flow of liquid, but pulsatile flow. Be interesting, you're

0:14:40.356 --> 0:14:43.276
<v Speaker 1>moving like pulsatile, like like the way the heart beats.

0:14:43.316 --> 0:14:47.356
<v Speaker 1>And it's not like a river. It's like, yeah, exactly,

0:14:47.476 --> 0:14:50.476
<v Speaker 1>it's not a river. And so that's that was her

0:14:50.516 --> 0:14:54.076
<v Speaker 1>genius discovery. And they are you know, they've treated UM

0:14:54.276 --> 0:14:57.236
<v Speaker 1>soldiers and civilians in the Ukraine who need who need

0:14:57.276 --> 0:15:00.836
<v Speaker 1>blood vessels. UM. They are close to commercials. Has the

0:15:00.916 --> 0:15:03.556
<v Speaker 1>progress of tissue engineering been slower than you would have

0:15:03.556 --> 0:15:06.756
<v Speaker 1>thought twenty years ago? Yeah, I think my notion of

0:15:06.836 --> 0:15:10.396
<v Speaker 1>time was very different following years ago. You know. Now

0:15:10.436 --> 0:15:13.676
<v Speaker 1>I'm like, oh, twenty years okay, that's nothing. A human lifetime,

0:15:13.676 --> 0:15:16.076
<v Speaker 1>that's nothing. You know, what can be done in a

0:15:16.116 --> 0:15:18.836
<v Speaker 1>human lifetime? Not much? You know, that's like more my

0:15:18.996 --> 0:15:23.076
<v Speaker 1>kind of gallows humor. Now, things move slowly, slash wisdom,

0:15:23.236 --> 0:15:28.756
<v Speaker 1>slash wisdom. Yeah, sure, but like yeah, things it's a

0:15:28.796 --> 0:15:31.076
<v Speaker 1>glacial I like to tell people this is like a

0:15:31.116 --> 0:15:34.316
<v Speaker 1>slow motion marathon in a way like this past twenty

0:15:34.356 --> 0:15:36.796
<v Speaker 1>years have you know, blinked and been gone in a heartbeat.

0:15:37.196 --> 0:15:40.476
<v Speaker 1>But yeah, it takes a long time to do things.

0:15:40.516 --> 0:15:44.516
<v Speaker 1>I think I've gotten better at being more honest or

0:15:44.636 --> 0:15:47.756
<v Speaker 1>realistic in terms of estimating how long something's going to take,

0:15:47.916 --> 0:15:52.636
<v Speaker 1>because you can't rush the science. And it's really, you know, interesting,

0:15:52.676 --> 0:15:54.596
<v Speaker 1>you say, oh, it sounds so futuristic. I think a

0:15:54.596 --> 0:15:58.396
<v Speaker 1>lot of people believe that this should happen, and there's

0:15:58.516 --> 0:16:00.796
<v Speaker 1>very few people that have the skill set to make

0:16:00.796 --> 0:16:03.476
<v Speaker 1>it happen. You know, because if you watch science fiction,

0:16:03.636 --> 0:16:05.556
<v Speaker 1>and or if you watch I don't know, even Star

0:16:05.596 --> 0:16:09.396
<v Speaker 1>Wars or the Marvel movies, there's always examples of people

0:16:09.556 --> 0:16:14.116
<v Speaker 1>getting healed with technologies like tissue engineering, so people assume

0:16:14.596 --> 0:16:17.676
<v Speaker 1>that that's going to happen. Like Luke Skywalker got a

0:16:17.716 --> 0:16:21.276
<v Speaker 1>new hand, So why can't I get a new hand totally? Totally?

0:16:21.356 --> 0:16:24.876
<v Speaker 1>Or in Waconda, you know, they just regenerated, or you know,

0:16:25.236 --> 0:16:28.836
<v Speaker 1>there's all these technologies in pop culture. Even in Grey's

0:16:28.836 --> 0:16:34.436
<v Speaker 1>Anatomy they had episodes of tissue engineering. And yet it's

0:16:34.756 --> 0:16:39.676
<v Speaker 1>very hard and it takes a long time. And so

0:16:39.756 --> 0:16:42.156
<v Speaker 1>I'm glad that I've been working on this particular tissue

0:16:42.196 --> 0:16:45.996
<v Speaker 1>because you know, it's been ten years as a company

0:16:46.036 --> 0:16:48.636
<v Speaker 1>and we've brought it to where it's never been before.

0:16:49.196 --> 0:16:52.556
<v Speaker 1>And now the challenges a lot more with a lot

0:16:52.596 --> 0:16:55.996
<v Speaker 1>of that technical de risking behind us. The challenges are

0:16:56.076 --> 0:16:58.276
<v Speaker 1>more or less of will this work in a living

0:16:58.316 --> 0:17:01.716
<v Speaker 1>system and more towards will this work in a clinical setting?

0:17:01.836 --> 0:17:05.356
<v Speaker 1>Will this work in the economy? And I find that

0:17:05.396 --> 0:17:08.276
<v Speaker 1>to be extremely exciting when you say will this work

0:17:08.276 --> 0:17:11.236
<v Speaker 1>in the economy, that's a big interesting question that we

0:17:11.276 --> 0:17:13.956
<v Speaker 1>really haven't talked about yet. So so how do you

0:17:13.996 --> 0:17:16.316
<v Speaker 1>think about that? How how are you approaching that? You know,

0:17:16.436 --> 0:17:19.236
<v Speaker 1>unit cost economics need to work. That's where the biomanufacturing

0:17:19.236 --> 0:17:22.436
<v Speaker 1>comes in. Automation of cell culture is a big driver.

0:17:22.716 --> 0:17:25.596
<v Speaker 1>It's a very artisanal process, you know, using our hand

0:17:25.636 --> 0:17:30.356
<v Speaker 1>pipets and expensive, right, artisanal and hand this that that

0:17:30.356 --> 0:17:33.236
<v Speaker 1>that is expensive, right. I don't want an artisical bone.

0:17:33.276 --> 0:17:36.676
<v Speaker 1>I want to mass producing bone, right yeah, right. Creating

0:17:36.716 --> 0:17:40.356
<v Speaker 1>the infrastructure that allows for automated biomanufacturing is a big

0:17:40.356 --> 0:17:42.036
<v Speaker 1>piece of it. We're not the only ones that need

0:17:42.076 --> 0:17:45.156
<v Speaker 1>to be working on that um But then also I

0:17:45.196 --> 0:17:48.996
<v Speaker 1>think scientifically and clinically being very clever in terms of

0:17:49.036 --> 0:17:51.316
<v Speaker 1>the end points you're measuring in your clinical trials so

0:17:51.356 --> 0:17:54.436
<v Speaker 1>that you can make the economic case. For Look, if

0:17:54.436 --> 0:17:57.156
<v Speaker 1>we're going to give you this piece of tissue, it's

0:17:57.196 --> 0:18:00.556
<v Speaker 1>going to save you surgeries down the line. That is

0:18:00.676 --> 0:18:04.276
<v Speaker 1>very interesting, And like, tell me specifically what that means

0:18:04.356 --> 0:18:08.716
<v Speaker 1>in the case of the of the jawbone easy economic

0:18:08.756 --> 0:18:13.516
<v Speaker 1>cost of avoided. What is the economic cost avoided for evybone? Well,

0:18:13.556 --> 0:18:15.316
<v Speaker 1>if you had evybone, you don't have to do an

0:18:15.356 --> 0:18:18.196
<v Speaker 1>extra hour or half hour of surgical time, you don't

0:18:18.276 --> 0:18:20.236
<v Speaker 1>have to put the patient in the ICU for as

0:18:20.316 --> 0:18:23.476
<v Speaker 1>much time for recovery. What those all are very easily

0:18:23.556 --> 0:18:28.596
<v Speaker 1>calculatable costs. So so that economic case is as important

0:18:28.716 --> 0:18:33.116
<v Speaker 1>to me as as the clinical case. So if things

0:18:33.156 --> 0:18:36.796
<v Speaker 1>go well, when do you think you might actually be

0:18:36.916 --> 0:18:42.396
<v Speaker 1>approved and out in the world twenty six, twenty seven? Okay, yeah,

0:18:42.476 --> 0:18:43.956
<v Speaker 1>not crazy if you had at maut a future but

0:18:43.996 --> 0:18:46.716
<v Speaker 1>a while yet. So for some people that's forever. For

0:18:46.756 --> 0:18:49.596
<v Speaker 1>some people they're like, oh, that's pretty soon. I wonder

0:18:49.676 --> 0:18:54.836
<v Speaker 1>if the sort of absurd rate of development of basically

0:18:54.876 --> 0:18:58.716
<v Speaker 1>semiconductors right, basically if Moore's law, and the development of

0:18:58.716 --> 0:19:02.236
<v Speaker 1>computer technology has messed up our sense of the rate

0:19:02.276 --> 0:19:04.956
<v Speaker 1>of technological development. Like if we have come to expect

0:19:04.996 --> 0:19:07.396
<v Speaker 1>so funny that you brought up law, Well, you were

0:19:07.436 --> 0:19:10.036
<v Speaker 1>an electrical engineer, so you know than I do. Yes.

0:19:10.756 --> 0:19:16.116
<v Speaker 1>So in biotech there's a joke called e Room's law,

0:19:16.756 --> 0:19:20.716
<v Speaker 1>which is if you spell more backwards, what do you get?

0:19:20.756 --> 0:19:24.716
<v Speaker 1>Because we're sort of the opposite of that, it gets

0:19:24.756 --> 0:19:28.996
<v Speaker 1>twice as expensive and twice as slow every year. Yeah,

0:19:28.996 --> 0:19:32.436
<v Speaker 1>and the FDA is backlogged and there's just been so

0:19:32.716 --> 0:19:37.476
<v Speaker 1>few approvals over time, it's really gone down. So I

0:19:37.516 --> 0:19:42.276
<v Speaker 1>think everyone understands that no one wants to hurt people

0:19:42.756 --> 0:19:44.916
<v Speaker 1>from a regulatory standpoint, no one. They don't want to

0:19:44.956 --> 0:19:48.156
<v Speaker 1>hurt people. Entrepreneurs and companies, we don't want to hurt people.

0:19:48.596 --> 0:19:51.236
<v Speaker 1>But there's a risk benefit to you know, if you

0:19:51.276 --> 0:19:54.636
<v Speaker 1>if you hold back innovation, sure fewer people will get hurt,

0:19:54.676 --> 0:19:57.436
<v Speaker 1>but also a fewer people will will get these breakthrough treatments.

0:19:57.636 --> 0:20:00.516
<v Speaker 1>There's regulation, and that's clearly important, but I feel like

0:20:00.556 --> 0:20:03.996
<v Speaker 1>also the body is just super complicated. Like I feel like,

0:20:04.076 --> 0:20:09.436
<v Speaker 1>even independent of regulatory bottlenecks, it's just very hard problems

0:20:09.996 --> 0:20:12.436
<v Speaker 1>it's hard, but it does feel like, well, I'm climbing

0:20:12.436 --> 0:20:15.276
<v Speaker 1>a mountain that's worth climbing, and you know we'll get there.

0:20:18.676 --> 0:20:20.396
<v Speaker 1>We'll be back in a minute with the lightning round,

0:20:20.836 --> 0:20:33.596
<v Speaker 1>including a very compelling argument that ourselves are intelligent. Okay,

0:20:33.636 --> 0:20:35.676
<v Speaker 1>that's the end of the ads. Now it's done for

0:20:35.676 --> 0:20:38.556
<v Speaker 1>the Lightning round. What's one tip for finding a mentor?

0:20:39.756 --> 0:20:44.956
<v Speaker 1>M who's your professional crush finding? I'm run, sure, yeah,

0:20:44.996 --> 0:20:48.836
<v Speaker 1>you're professional crush. That's that's how that's Identifying a mentor

0:20:48.916 --> 0:20:50.996
<v Speaker 1>is like, who do you have a crush? How do

0:20:51.036 --> 0:20:53.316
<v Speaker 1>you find a mentor? How do you find a mentor?

0:20:53.636 --> 0:20:55.756
<v Speaker 1>Here's my answer. Good people lead you to good people.

0:20:56.556 --> 0:21:00.716
<v Speaker 1>I like all of those answers. As a former McKinsey consultant,

0:21:00.796 --> 0:21:06.556
<v Speaker 1>do you think McKinsey is overrated or underrated? I think

0:21:07.716 --> 0:21:13.276
<v Speaker 1>I think neither appropriately rated. They're appropriately powerful. I mean,

0:21:13.316 --> 0:21:17.076
<v Speaker 1>they do good work and they're full of very earnest people,

0:21:17.596 --> 0:21:19.596
<v Speaker 1>and my goodness, do they know how to make a

0:21:19.596 --> 0:21:24.316
<v Speaker 1>two by two matrix out of any problem? Um? Good?

0:21:26.636 --> 0:21:31.156
<v Speaker 1>I like broken down to do a two by matrix? Um.

0:21:31.676 --> 0:21:34.836
<v Speaker 1>What's been the most surprising thing about running a company?

0:21:35.596 --> 0:21:41.396
<v Speaker 1>I think, how much your psychology gets amplified. You know,

0:21:41.556 --> 0:21:44.436
<v Speaker 1>just think how much of the company is a mirror,

0:21:45.036 --> 0:21:48.116
<v Speaker 1>and if I'm having a bad day, it amplifies to

0:21:48.196 --> 0:21:50.676
<v Speaker 1>the team. It just makes me have to just really

0:21:50.676 --> 0:21:55.716
<v Speaker 1>take my own mental health and really seriously. Downward dog

0:21:55.796 --> 0:22:00.876
<v Speaker 1>or Warrior one, Oh, down dog? I think I love them? Well, yeah,

0:22:00.876 --> 0:22:05.956
<v Speaker 1>Warrior one, I'd say Warrior two. Okay, good, I love yoga.

0:22:05.956 --> 0:22:07.996
<v Speaker 1>I could talk about that for a long time. What

0:22:08.116 --> 0:22:10.956
<v Speaker 1>do you understand about human body that most people don't

0:22:12.236 --> 0:22:17.116
<v Speaker 1>That sells are intelligent all of our selves. Intelligence isn't

0:22:17.196 --> 0:22:20.036
<v Speaker 1>only in the brain. Intelligence is everywhere in the body,

0:22:20.236 --> 0:22:24.556
<v Speaker 1>at the cellular level. What do you mean by that, Well,

0:22:24.596 --> 0:22:27.476
<v Speaker 1>we tend to think of intelligence as being in our brain,

0:22:27.956 --> 0:22:30.756
<v Speaker 1>and that places like our heart are dumb. It's a

0:22:30.836 --> 0:22:33.596
<v Speaker 1>dumb pump that listens to the brain. But the heart

0:22:33.636 --> 0:22:35.956
<v Speaker 1>is thinking on its own. It's making a lot of

0:22:35.996 --> 0:22:39.676
<v Speaker 1>decisions about how much blood to pump and send signals

0:22:39.756 --> 0:22:42.156
<v Speaker 1>up to the brain, but also does plenty of thinking

0:22:42.156 --> 0:22:45.756
<v Speaker 1>on its own. The eye isn't just a camera. The

0:22:45.916 --> 0:22:51.436
<v Speaker 1>eye contains a lot of decision making processes about what

0:22:51.476 --> 0:22:54.236
<v Speaker 1>we're seeing before even sending the image up to the brain.

0:22:54.476 --> 0:22:58.956
<v Speaker 1>The optic nerve is the largest amount of data compression

0:22:59.076 --> 0:23:03.436
<v Speaker 1>known in biology. So intelligence is distributed throughout the body.

0:23:03.436 --> 0:23:05.116
<v Speaker 1>And I don't think a lot of people think that,

0:23:05.236 --> 0:23:09.396
<v Speaker 1>but I know that, and I love that about the body.

0:23:09.436 --> 0:23:11.516
<v Speaker 1>It makes me, It makes living in a body fun

0:23:11.676 --> 0:23:20.516
<v Speaker 1>for me. Nina Tandon is the co founder and CEO

0:23:20.716 --> 0:23:25.356
<v Speaker 1>of EPIBOE. Today's show was produced by Edith Russolo, edited

0:23:25.396 --> 0:23:29.556
<v Speaker 1>by Sarah Knicks, and engineered by Amanda kay Wong. I'm

0:23:29.636 --> 0:23:32.876
<v Speaker 1>Jacob Boldstein and just one last quick note. We're going

0:23:32.916 --> 0:23:35.036
<v Speaker 1>to be off for the next couple of weeks and

0:23:35.156 --> 0:23:38.916
<v Speaker 1>we'll be back with a new episode on Thursday, April twentieth,