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The Science of Immortality: How Genetic Engineering Is Going to Change Everything with Jamie Metzl

Lace Gilger
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In this episode, we explore the mind-bending science of genetic engineering and why it’s going to change everything in our lives, whether we want it to or not. We share crazy stories and examples from the cutting edge of science, look at shocking examples around the world of what is going on with human genetic science and explore the science of immortality with a few simple life hacks can you implement right now to extend your life and help you live past 100, with our guest Jamie Metzl.

Jamie Metzl is a Senior Fellow of the Atlantic Council. In February 2019, he was appointed to the World Health Organization expert advisory committee on developing global standards for the governance and oversight of human genome editing. He is the author of five books, including the non-fiction work, Hacking Darwin: Genetic Engineering and the Future of Humanity. Jamie previously served in the U.S. National Security Council, State Department, Senate Foreign Relations Committee and as a Human Rights Officer for the United Nations in Cambodia.

  • The future is already here, it’s just not evenly distributed yet

  • Open your eyes a little bit wider and see the radical technological developments that will fundamentally transform your life are on the short term horizon

  • Genetic technologies are, in very short order, going to fundamentally transform our societies

  • The genetics revolution is inevitable and it’s already here. Countries like China are already massively pushing the limits on genetic science, well beyond what we may even feel comfortable with in the US today

  • China is extremely wealthy, extremely powerful, and has a “Wild West” culture around genetic engineering, designer babies, and human genome editing

  • “The Arms Race of the Human Race” - what happens in a world where the US restricts or prevents genetic engineering but another country, for example, China, substantially embraces them?

  • Slippery slope and how this radically starts to change our world pretty incredibly - most people would probably want to know if their child had a higher risk of a certain disease, so they could prevent it… what happens when we make that shift from a child to a human embryo?

  • “The End of Sex” - “Old Fashioned Sex” will soon be viewed as reckless and dangerous.

  • “Would you play Russian roulette with your child’s future health by NOT affirmatively selecting health?"

  • Would you wish polio on a child because it’s natural? What about a genetic disease that could be prevented?

  • It’s not a question of wonderful nature vs scary science. Nature is pretty scary. People die of horrible genetic disorders today.

  • Why Jamie considers anti-vaccine “monstrous"

  • "In vitro gametogenesis” - what happens if you could make 100,000 potential embryos and pick the healthiest ones?

  • What is a synthetic womb and why is it something that is so crazy it might make total sense in 30-50 years?

  • Why Jamie’s goal is to live to 150, and what he’s doing to get there.

  • Simple life hacks can you implement to extend your life as much as possible?

  • Do everything that people who live in the blue zones are doing.

  • Homework: Get yourself educated on genetic science.

  • Homework: If you’re planning on having children, freeze your eggs and freeze your sperm today. Freeze them when you’re twenty. It gives you the option of using healthy and vibrant genetic material in the future.

  • Homework: For longevity: Exercise 45 minutes a day. Eat healthy food.

  • Homework: Do your own homework and empower yourself about precision medicine. Medical knowledge is decentralizing. You are the primary agent of change in your life.

Thank you so much for listening!

Please SUBSCRIBE and LEAVE US A REVIEW on iTunes! (Click here for instructions on how to do that).

This week's episode of The Science of Success is presented by Dr. Aziz Gazipura's Confidence University!

You can learn to confidently connect with others, be bold, feel proud of who you are, and create the life you truly deserve!

What Would Your Life Look Like If You Have Double The Confidence?

Don't Wait and Wonder! Find Out Today!

Want To Dig In More?! - Here’s The Show Notes, Links, & Research

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Episode Transcript

[00:00:04.4] ANNOUNCER: Welcome to The Science of Success. Introducing your host, Matt Bodnar.

[0:00:11.8] MB: Welcome to the Science of Success; the number one evidence-based growth podcast on the internet with more than four million downloads and listeners in over a hundred countries.

In this episode, we explore the mind-bending science of genetic engineering and why it's going to change everything in our lives, whether we want it to or not. We share crazy stories and examples from the cutting-edge of science, look at shocking examples from around the world of what is going on with human genetic science and explore the science of immortality with a few simple light facts that you can start implementing right away to extend your life and help you live past 100 with our guest, Jamie Metzl.

I’m going to tell you why you’ve been missing out on some incredibly cool stuff if you haven’t signed up for our e-mail list yet. All you have to do to sign up is to go to successpodcast.com and sign up right on the home page.

On top of tons subscriber-only content, exclusive access and live Q&As with previous guests, monthly giveaways and much more, I also created an epic free video course just for you. It's called How to Create Time for What Matters Most Even When You're Really Busy. E-mail subscribers have been raving about this guide.

You can get all of that and much more by going to successpodcast.com and signing up right on the home page, or by texting the word smarter to the number 44-222 on your phone. If you like what I do on Science of Success, my e-mail list is the number one way to engage with me and go deeper on what I discuss on the show, including free guides, actionable takeaways, exclusive content and much, much more.

Sign up for my e-mail list today by going to successpodcast.com and signing up right on the home page, or if you're on the go, if you're on your phone right now, it's even easier. Just text the word “smarter”, that's S-M-A-R-T-E-R to the number 44-222. I can't wait to show you all the exciting things you'll get when you sign up and join the e-mail list.

In previous episode, we talked about one of the most important skills in the modern world, the ability to be indistractable. Are you sick and tired of distraction? Do you feel constantly overwhelmed in a world of notifications, demands, messages and more and more information flying at you? In our previous episode, we discussed exactly how you can battle back from distraction, control your attention and choose the life you want using the power of being indistractable with our previous guest, Nir Eyal. If you want to banish distraction from your life, listen to that episode.

Now for our interview with Jamie.

[0:03:13.6] MB: Today, we have another exciting guest on the show, Jaime Metzl. Jamie is a senior fellow of the Atlantic Council and in February of 2019, he was appointed to the World Health Organization's expert advisory committee on developing global standards for the governance and oversight of human genome editing.

He's the author of five books, including the nonfiction work, Hacking Darwin: Genetic Engineering and the Future of Humanity. Jamie previously served in the US National Security Council, the State Department, Senate Foreign Relations Committee as a human rights officer for the United Nations and much more.

Jamie, welcome to the Science of Success.

[0:03:48.4] JM: Thanks so much, Matt. Thrilled to be here with you.

[0:03:50.8] MB: Well, we're really excited to have you on the show today. It's such a fascinating topic and I can't wait to dig in. I love some of the insights in the book and I can't wait to share some of these anecdotes with our listeners.

To start out, I'd love to open the conversation with one of my all-time favorite quotes, which really resonates with what the book is about, which is this notion that the future is already here, but it's just not evenly distributed yet.

[0:04:14.0] JM: Yup. I totally agree. That's obviously a famous quote from one of our best-known science fiction writers. That's what for me as a futurist, I also write science fiction, that's my mission in life is to get people just to open their eyes a little bit wider and to see these radical, technological developments that are going to fundamentally transform our lives.

If we can just see what's happening and see what's coming with even a little more clarity, we're all going to make better and smarter decisions about our lives, our businesses, that will create better futures not just for us, but for everybody.

[0:04:53.1] MB: One of the most interesting claims that you make in the book and I want to get into all kinds of ideas and thoughts in here, but the book obviously, for listeners who aren't familiar with is about genetic engineering and the future of humanity. You open with the fascinating anecdote. I don’t know if I'm jumping the gun a little bit, but the idea is that there's a lot of controversy around this topic.

The reality is where our hand is going to be forced, because in many ways, this is an inevitable conclusion. It's going to happen one way or another and we really – we’re coming up on a very short timeframe here from a societal standpoint and we need to start making some really important decisions.

[0:05:30.0] JM: That's exactly right. The question is not should we or shouldn't we embrace genetic technologies. We will. Whether people are for it, or against it, genetic technologies are going to in very short order, fundamentally transform our healthcare, the way we make babies and the nature of the babies we make. It's not should we, or shouldn't we on the science. The question is how, because the decisions that we're going to be need to make in very short order are going to be our way of infusing our best values, our ethics into the process of guiding how these incredibly powerful technologies will be deployed.

That's going to be the difference between the positive outcomes that we can all imagine of people living healthier, longer, more robust lives, preventing and eliminating and curing terrible diseases, aging more, healthily and gracefully and living longer and these dystopian outcomes that everybody can imagine. It's not a question of whether the genetics revolution is coming. It obviously is coming and it's already here. The question for us is what role do each and all of us want to play in shaping how these technologies are used, rather than having other people's decision shape us.

[0:06:56.9] MB: Here in the United States, we obviously have a very robust regulatory structure. A lot of this stuff is still very nascent. In the book, you talk about how other countries may not have the same regulatory structure and maybe actually pushing the envelope well beyond what we find either morally, or ethically kosher in today's world.

[0:07:20.1] JM: Yeah. Well man, you and I both have a lot of experience with China. In this world, there are some countries that are really well-regulated. I would say the best regulated country in the world for genetic technologies is the United Kingdom. The US is pretty well regulated. Although our entire healthcare system is a total disaster and a mess, and so that creates a lot of complications, there are some countries that have absolutely nothing. These are countries, they just don't have any regulatory infrastructure and a lot of them have very little capacity, but they can become destinations for medical tourism, or genetic engineering tourism at some point in the not distant future.

Then there are countries in the middle and China is probably the best example of this, countries that are wealthy, that have a lot of scientific capability, that have decent laws on the books, but where there's a Wild West culture and a mentality. Certainly with China, where there is this national and certainly government-led obsession with catching up, with becoming essentially the world's leading country by 2050. The Chinese government has identified Science and Technology leadership as the primary way to get there.

Genetics technologies and biotech more generally are among the most important sciences and technologies that they focusing on. It's not at all surprising that the world's first genetically engineered babies were born in last year and in 2018 in China, because China is really pushing the limits of what is possible, including with human genetic engineering. That is a really, really big deal. I'm on the World Health Organization International Advisory Committee on human genome editing.

I'm actually just going next week to Geneva for our meeting, board meeting repeatedly over the course this year and next, to try to think about and begin to lay out a framework for what a global regulatory infrastructure on human genetic engineering and genome editing might look like. We're a long way from there. In the meantime, there are countries like China that are really pushing the limits in ways that would not be possible here in the United States.

[0:09:42.8] MB: Even before some of the technology was where it is today, in the book you share an anecdote of somebody from China who essentially had 10 children in the US. I don't want to spoil it. Tell me that story. Share that example to listeners. It's so interesting and it shows the mindset too.

[0:10:01.2] JM: Well China, and you know this from your time there, people are very practical in their thinking. What's the best way to do something? Just because it's a society where essentially, the government has gone to war with traditional values, with traditional moral systems, I mean, that's essentially what the Great Leap Forward and the Cultural Revolution were.

It's this country that’s very – it's an extremely wealthy, an extremely powerful country. Individuals are empowered, but unlike other countries, even in that region, like Japan and Korea that still have their traditional value system intact. China, it's like starting over after wiping out its own culture. They don't have these hang-ups of as a largely atheist society of well, God is this genius watchmaker and who are we to mess with God's work?

Then it's practical. All right, and so this example that to China there are some restrictions on surrogacy, which California doesn't have. There was this guy who wanted to have a kid with his wife and they using IVF, they fertilized 10 eggs. Then the plan was to send 10 to 10 different surrogates in California. Then go after these kids are born and look at these kids and pick a couple of them that they wanted to keep and then put the other eight for adoption. I mean, it's so mind-boggling and frightening that people are thinking about life this way.

For me, the takeaway is we are this incredibly diverse species and whatever we think, whatever value we – there's going to be somebody else who just thinks differently and operates by a different value system. That's what we're going to have to navigate and that's why there's some people, the trans-humanists who feel like, “Well, we shouldn't have any regulation. Let people do what they want.” We're talking about the future of life. It had in our decisions, especially using these very powerful technologies have to be guided by an ethical system and the use of these technologies has to be regulated.

[0:12:23.7] MB: This is seriously a global challenge. What happens in a world where for regulatory, moral, political reasons, let's say the United States doesn't really embrace these technologies and a place like China goes all-in on them?

[0:12:39.2] JM: Yeah. Well, I have a chapter in the book called The Arms Race of the Human Race, which explores exactly this. Let's just say that the United States opt out of these technologies. First, it's going to be hard to do, because opting – what opting in means doesn't mean that we're going to – everyone's going to have a designer baby.

It also means that our healthcare is going to be worse. We are transitioning now from a system of generalized healthcare based on population averages, to world of precision medicine and healthcare based on people's individual biologies. What that means is that everyone's going to have their genome sequenced and that's how your doctor is going to in many ways know who you are, so you can get your personalized treatments, actually where you are, Matt, in Nashville, Vanderbilt as a leader in this process.

That means we're going to have many millions and then billions of people who had their genome sequence. We're going to use big data analytics to crack the code of complex biology and genetics. That's going to really open up a lot of possibilities in our healthcare. When we say opting out, first question is opting out of what? We certainly wouldn't want to opt out of the improvements in our own healthcare system.

Then once you do that, then our healthcare system moves from being precision to being predictive, because we'll have a lot of information about people's genetics, that'll tell us something about how their future lives might play out. Then people will be able to use that same understanding of genetics to select embryos when they're using IVF. Then on top of that, we're going to be able to do what has already happened in China, which is use precision gene editing tools to edit the genomes of future babies. Again, all these things are already happening.

Coming back to your question, so what do you do if that as this technology develops, as it whittle that we recognize, as we will, that we're going to be able to have healthier, longer-lived, maybe higher IQ, maybe taller, maybe more athletic, whatever it is that individuals, or even countries want will be doable. What happens if a country like the United States decides to opt out at some point? Well, option one is say, we're opting out, you, whether it's China or somebody else you're opt in, and we'll see how it plays out.

I mean, maybe we'll be better off for opting out, maybe you'll be better off for opting in. In 20, 30 years we'll know the answer to this question, because if you're right, you'll win all the gold medals in the Olympics, you'll get all the Nobel prizes in math and we’ll be the country that said, well, we made an ethical decision, but now there are consequences of that. Or it could be the opposite story.

Or you could say that if you and let's say China, if you, China, genetically alter your people, then what happens if your people procreate with our people? If you wanted to stop that you could say, all right, well we're going to make it illegal for people from our country to procreate with people from your country and you'd have to set up a whole police state system to make sure that you were testing for that, which would be terrible. Or you could say we're going to try to force you, the other country, to stop doing what you're doing of genetically engineering or enhancing your population, but how's the country like United States going to do that against big and powerful and nuclear-armed country like China?

Then we get to this where we started, which is well, if we don't want those kinds of outcomes, how far can we go in building some global regulatory infrastructure that would have to be very permissive, but that could at least try to build some guardrails, so that the terrible Nuremberg style abuses of humans doesn't happen? That's what we're working on in Geneva, but it's a really hard task.

[0:16:59.6] MB: Such an interesting problem. I want to explore – we've talked already about the inevitability of this and because of the global nature of the phenomenon and the science. I want to start digging into some of the crazy stories, ideas, happenings, things that are taking place both now and are possible in a world where this science becomes more ubiquitous.

Maybe as a starting point, let's dig into a little bit more on a topic you already touched on, which is healthcare. Let's assume we can put aside the geopolitical and ethical questions for a minute. We may come back to them. I want to explore, what does the world look like in a world with precision medicine, or even predictive medicine that's enabled via some of this genetic science?

[0:17:43.2] JM: Yeah. Well it's great, because every time when we go to a doctor, for most of the conditions that we have, we'll get a symptom and we'll go to our doctor. The doctor will treat us based on our being a human. For an average human, if you have a headache, a Tylenol for example, will make you feel better. In this world of generalized medicine based on population averages, the way you find out that if you're one in, whatever the number, a 100,000 people who will die from taking that Tylenol is by taking the Tylenol. That's how we've have treated cancers and still treat most cancers. If you have as one cancer, whatever we have treatments for those big categories of things.

In the world of precision healthcare, your doctor is going to know a lot more about who you are based on your personal history, family history, biometric information, various tests. The most important piece of information is going to be your sequence genome, which will be the foundation of your electronic health record and that's how when you go for a treatment, your doctor is going to give you something that's tailored for you, or if in case, the cancer we're going to sequence, which is starting to happen, about 12% of cases. Now sequencing your tumor cells, so that we can target an approach based on exactly the type of cancer that you have. That's precision medicine.

When we have, as I mentioned before, these billions of people and we have their genetic, their genotypic information and their phenotypic information, which means how those genes are expressed over the course of their lives in massive data pools, then we're going to crack the code of complex genetics and we're going to have a lot of probabilistic, predictive information about how from birth, essentially, about how your life may play out. Part of that will be about risk factors. If you know you have an increased risk for developing type 2 diabetes, for example within from early childhood, your parents should be helping you to have habits of exercise and healthy eating and self-monitoring.

If you know that you have an increase – your daughter, for example has an increased risk of breast cancer genetically, so you'll want to start breast cancer screenings maybe when she's 20, rather than when she's 40, which is the norm. That's going to be right now, a lot of that information, predictive information is it's scary to people, because nobody wants to be at the hospital taking home their newborn and told that their newborn has a 50% greater than average chance of developing early onset Alzheimer's 40 years from now. I mean, right now that scares people.

The medical community is afraid that people are going to freak out, because doctors tend to believe now that people can't handle raw information about their futures, which is something I very much disagree with, but that's a prevailing view in the medical community. Our genome isn't just a healthcare, or a disease genome. It's a human genome. As we uncode, decipher these secrets, we're going to know a lot more about ourselves that has nothing to do with healthcare, about our potentials for things like IQ, personality style, being great at specific narrowly defined functions, like sprinting, or abstract math. That's going to force us to think differently, not just about healthcare, but about parenting and about life.

[0:21:27.5] MB: It's so funny, because it starts out as such a slippery slope and it really quickly develops into a place where people could be making decisions that are almost today, seem ridiculous, or out of control.

You have the example of, I think most people listening to this show right now would say if they could figure out that for example, the example used that their daughter had an increased risk of breast cancer, they would want to know that, because then they can take steps early in life to prevent that and hopefully ensure that it doesn't happen, or that it's mitigated. What happens when, and this is a very quick and easy and subtle shift. What happens when that genetic information moves from let's say, a newborn child to an embryo?

[0:22:11.6] JM: Well, it depends. I mean, people are going to have a lot of information about their unimplanted, pre-implanted embryo. The reason why I've been writing and speaking for many years about the end of procreative sex is that we know how the traditional model of sex and procreation works. If any of your listeners aren't familiar with that, you can consult the internet. There are lots of pictures and videos. We are moving from that world of it seems simple, just because it's so built into our biology of procreation through sex, to procreation through science.

The way that we're going to do procreation through science is by taking conception outside of the human body and we're going to use the tools of in vitro fertilization, IVF. Women will have their eggs extracted, which it happens all the time now. It will be much more common. Those eggs will be fertilized by the mid of the father's sperm in the lab. Then you'll have a certain –based on the number of eggs and the fertilization process, you'll have a certain number of pre-implanted, early stage embryos. Let's just say that it's 10.

Right now what happens when you're selecting which of those 10 to implant in the mother, generally it's an embryologist looks at the embryo and just visually say, which one looks healthy, and that's an imprecise art maybe, as much as it is a science. There is a process of pre-implantation genetic testing where you extract a few cells that would have gone into the placenta and you sequence them and you can tell a lot of information about mostly single-gene mutation disorders, things Tay-Sachs and sickle-cell disease and Huntington's disease. Then there's something – you get some information about chromosomal abnormalities, like down syndrome and that can be done in various ways and just a few other minor things.

We're moving very, very quickly into a world where we're going to have lots and lots of information that goes well beyond these relatively simple areas that we can understand now and that's connected to describe a moment ago about our great understanding of the genome. Now you are prospective parents and you have these 10 embryos and you have to pick which one gets implanted.

One of the options is to say, “I don't want to know. I'm going to put it, you could say in God's hands.” God's hands is an embryologist and a fertility doctor. Somebody is choosing based on some criteria. Maybe it's just random chance. Maybe people will say, “I want one that I know isn't going to die young of a terrible deadly genetic disease,” and that seems like a reasonable thing for people to do.

Already when you're doing that, I mean, that is in many ways, it's a form of eugenics, because we are making the decision about which of these 10 embryos will have the potential to become a baby. There's a lot of values that go into that decision. We could choose issues related to health, related to longevity. Then beyond that, the sky's the limit. Any genetic trait, any trait that's even partly genetic, we will be able to predict not entirely, but increasingly the genetic component of that trait and then use that in making decisions.

The science is pretty much already there to rank 10 embryos from likely tallest to likely shortest. Maybe we're a decade away from being able to rank them from likely highest genetic component of IQ to likely lowest. Likely most outgoing to least outgoing. You see where this is heading, that all of these attributes that we see as the magic of life are going to be things that we’ll never understand completely, but we'll understand more. That's why I always say this isn't a conversation about science. Science brings us to the conversation. This is a conversation about ethics.

[0:26:33.8] MB: You had a great line in the book where you talk about whether or not people in the future, or even, and really the immediate term will be asking themselves whether or not you would play Russian roulette with your child's future by not affirmatively selecting for healthy embryos.

[0:26:53.0] JM: Right now, if you or your listeners, if you're on the street and you see a little kid and the kid is walking in a way that makes you – makes it look pretty likely that kid has polio, or had polio, what do you think? You don't think, “Wow, that's terrible. Fate has been so unkind to this kid.” You think somebody screwed up, because polio has been eradicated, or mostly eradicated and that's great. I mean, that's what we would want. Nobody would wish polio on somebody else, because, “Oh, no. That's nature. That's God's will. “God's will that your kid should have polio.” Those are fighting words.

We are going to have this ability to make these kinds of decisions, but it's very sensitive. I was on a panel in Berkeley a few months ago and with this wonderful poet, whose daughter has down syndrome and daughters is just this wonderful person. She has opened up his life and it's been – he says and obviously, the greatest gift of his life. It was hard for me to say that what I believe that in 20 years seeing a kid with down syndrome is going to be about as rare as seeing a little kid with polio, because it is just going to be not something that kids are born with and that's already happening in Northern Europe, where non-invasive prenatal screening is required and covered by national health plans.

There are almost no very, very few kids being born with down syndrome in Scandinavia and Northern Europe. All this stuff is really sensitive. How are people going to feel when they see that kid 20 years from now that wanted a whatever kid, who has down syndrome. Are they going to say, “Wow, that's so great that that child's parents embraced nature so much.” Let's say, let's make it even more complicated. Let's not call it down syndrome, let's call it sickle-cell disease, or Tay-Sachs, or Huntington's, or some of these very, very dangerous, painful and even deadly diseases, those are going to be seen increasingly lifestyle choices by the parents.

The parents decided they wanted to do this “natural thing,” even though nothing about our lives isn't really natural when baselined against how our ancestors live. I think that that's going to feel, it's not just going to be wonderful nature versus scary science. I mean, nature is actually pretty scary. People who are having these kids who die of terrible genetic disorders, that's actually pretty scary. If parents can eliminate, or reduce the risk of these deadly, painful genetic disorders for their kids, parents are going to do it.

[0:30:01.6] MB: As you point out in the book, that decision-making process gets us in pretty short order to a place where it could even be considered reckless, or dangerous to have children the old-fashioned way.

[0:30:14.8] JM: Yeah. Right now when most of us, certainly I meet someone who hasn't vaccinated their kids, I don't think, “Oh, that's so wonderful that you're not vaccinating your kids, because if “God had wanted us to be vaccinated, we would have been born vaccinated.”” What I think is you anti-vaxxer, you are a monster.

Because when you look at the number of humans who have died from infectious diseases over the years, I mean, it is in the many hundreds of millions, possibly billions. It's only because we've been so successful in fighting back, that people – and that other people are vaccinating their kids, that people can feel that they don't have to do it.

It's really difficult, because this idea of what is natural is shifting. It shifts within the context of our culture's. Something that feels natural to people and even traditional sexual conception may come to be seen as something that's really dangerous. That's I feel this shift that is happening, beginning to happen now but is increasingly going to happen over the coming years.

[0:31:40.6] MB: Hey, I'm here real quick with confidence expert Dr. Aziz Gazipura to share a lightning round insight with you. Dr. Aziz, how do you become more confident and what do people get wrong about confidence?

[0:31:54.8] AG: I love this question. My life mission is to inform people this one thing, that you can learn confidence. Because the biggest thing that people don't realize is that confidence is a skill. They think confidence is something that you're just born with, that the people that look confident just somehow have some ability that you don't have and that's what I thought for many years, until I discovered that actually, this is something we can learn.

What most people get wrong about this, other than thinking that they can't, so they don't even try, is they think it's going to be this huge undertaking and it's scary and they try to just push through and do this thing that I hate the phrase, but it's so common, which is fake it till you make it.

What they don't realize is that there's a much easier way, a simpler way and ultimately a faster way and a gentler way. That is to treat it like any other skill, like the guitar. You want to learn how to play the guitar, you want to break it down into its individual elements, like notes, chords, progression, scales. If you learn each individual thing, all of a sudden, you could play a beautiful song. Confidence is absolutely no different than that.

You can break confidence down into its little individual elements, like body language, starting a conversation, how to be assertive, all these things can be broken down in sub-skills. If you just learn those sub-skills one after another, take action on what you learn and practice it just like an instrument, all of a sudden in a period of months – you could be stuck for decades, but in a period of months, you can have more confidence than you've ever had in your entire life. That's what I'm dedicated to doing. That's what I teach. That's what I create all my programs around and that's really the message that I want to get out there to everyone listening and everyone in the world.

[0:33:31.5] MB: Do you want to be more confident and stop suffering from social anxiety and self-doubt? Check out successpodcast.com/confidence to hear more about Dr. Aziz and his work and become more confident.

[0:33:48.0] MB: I want to just dip our toe into a couple other themes, or topics that you write about talking about reproduction and some of the crazy things that might be coming down the pike. Tell me a little bit about the process of creating, or synthesizing eggs and I might be misphrasing the science here. Tell me a little bit about that.

[0:34:06.1] JM: Yeah, yeah, yeah. The technical term, which shouldn't scare anybody, is called in-vitro gametogenesis. Basically, with just a little bit of background, everybody knows what a stem cell is. When your father's sperm fertilizes your mother's egg, how does that one little – your first cell become you and that that cell has the potential to become everything. As our cells grow over time, they become differentiated and that's why there's a difference we could see in our bodies, we could see in a skin cell and a blood cell and a heart sell, etc.

There's a technology for whom this great Japanese scientist won the 2012 Nobel Prize, Shinya Yamanaka called essentially induced stem cells. What this does is it allows us to take any adult cell and take it backward in time. You take a cell that's differentiated, like a skin cell and then you take it back in time, so that the skin cell becomes a stem cell.

The reason this is important, it connects to what I was saying a little while ago about the number of eggs that a human woman can create. Male sperm, average male ejaculation has about a billion sperm cells. Average woman having her eggs extracted in IVF has about 15 eggs extracted. That's a limiting factor, especially if we're doing embryo selection. Obviously, if you have a bigger number of embryos, you have a greater range of choice.

Using this induced stem cell technology, the approach is already works in animals, not yet applied to humans, but it will be. You take a skin graft, which is easy to do, that has many millions of skin cells, you induce those skin cells into stem cells using these for what are called Yamanaka factors, named after this scientist. Then you induce those stem cells into egg precursor cells and egg precursor cells into eggs. Now you have – you started with a billion sperm cells. Now you have, let's just call it a million eggs.

You fertilize a million eggs with a billion sperm cells. Now humans, so you have a billion options, or a million options, I'm sorry. Let's say you sort them with a machine and you get down to a 100,000 based on whatever criteria. You extract a few using an automated process, extract a few cells from each of those 100,000 early stage embryos, sequence them. Again, the cost of sequencing has gone down from about a billion dollars in 2003 to about $600 now. It's going down towards essential negligibility. Then the process of having a baby is where the mother has her – the father gives a sperm sample the old-fashioned way, the mother has her skin graft taken. Then a couple weeks later, you go to the fertility clinic and you say, “Here are our priorities. We want a kid,” and where this is legal and based on your own values and the regulatory environment around you say, “We want a kid that we want to optimize for health, for longevity, for whatever.”

It's not like build-a-bear, because I mean, you have to work with the biology that exists, but there's going to be tremendous optionality. We are going to be able to push theoretically for now, but actually in the not distant future, we're going to be able to push changes across our population in ways that really would have just been absolutely unimaginable, not just to our parents and grandparents, but to most people today.

[0:38:08.8] MB: So interesting. We're jumping around a little bit, but another topic that I found fascinating and it's almost something that sounds so ridiculous that it's going to make complete sense in 15, 20, 30 years whenever it happens. Tell me a little bit about synthetic wombs.

[0:38:24.7] JM: Yes. It's funny, I talk a lot about synthetic wombs. My friends attack me for it, because – so just back, so synthetic wombs, so the womb exists in the woman's body, it's basically the environment, the little micro-environment inside a pregnant woman in which the embryo grows. There's a lot of work being done now for creating and creating synthetic wombs, which are essentially plastic bags. The nutrients that an embryo needs are being passed through in and out of these synthetic wombs.

Already, it's starting to be applied experimentally in animal models. There are some people who are asking whether humans will have babies with synthetic wombs. If we were to go there, it would really open up this process, it would industrialize the process of human reproduction. When we think about some of the topics people are exploring now, like colonizing Mars and we may just be in very different environments that we made to reproduce, just in different ways than we do now. A lot of work is happening in synthetic wombs.

For now, I'm a little cautious about the possibility of having human babies born in synthetic wombs, just because I think that there is such a complex interaction between the mother, even if it's a surrogate, or the egg mother, the genetic mother, but certainly between whoever is carrying this embryo inside of their body, there's a lot of interaction that it's not just chemicals, it’s sounds, it's emotions. I think that is probably for a while going to be very difficult to replicate. I'm sure it would be possible to have it functionally work and have kids be born this way, but I would be really cautious about damage that might be done to these kids by being raised in an environment with just a lot less stimulus then human kids are used to.

[0:40:45.4] MB: Fascinating. I never considered that perspective. Just thinking about from a safety standpoint alone, it seems like something that could end up being in 50 or a 100 years, it could be considered reckless if you don't have synthetic wombs, why would you jeopardize getting sick, or being in an accident, or whatever when you could grow somebody in a safe and scientifically secure environment?

[0:41:06.3] JM: I mean, that's one possibility. I'm not closed to it. There's a lot in all of biology, including human biology that we don't fully understand. That's why for me when I think about interventions, something like embryo selection where you have to pick one, they're all your natural embryos, and let's just use predictive analytics to try to make our best guess. That I'm more comfortable doing, than something where we are just completely and aggressively transforming a full and complex environment that we don't fully understand. That's why with artificial wombs, I'm more cautious than other people.

Even with genome editing, gene editing, pre-implanted embryos, like was done in China for the first time last year. There are some people who are saying we're going to be making a 1,000, 10,000 gene edits to pre-implanted human embryos. I'm much more cautious. I'm certain we're going to be making edits, but I don't think we're going to be making many thousands just because, again, these are very complex dynamic environments.

If we know that there's a single gene that either is creating an outsized harm and it could be changed, or if changed could create an outsized benefit, I think that will be attractive. Changing the whole environment, that's a bigger deal. Maybe we'll get there, but that's not a 20-year thing in my mind. That's a 100-year thing.

[0:42:44.1] MB: Fascinating. I want to keep digging. There's so many interesting anecdotes and stories and themes throughout the book. Tell me a little bit about what does the science say, or where do you think things are going to be heading for people like us that are already alive? Let's talk a little bit about immortality. Is it possible for us to genetically change our age, or extend our lifespans? What do we do for the people who are already alive and how is the science going to impact us?

[0:43:11.4] JM: Yeah, yeah. I'm very focused on this, because I've already staked my claim that we want to live to a 150. I love life. I think everyone should love life. If we have more healthy life, that's great. Our parents, our grandparents and if we can extend their healthy lifespans, so rather they're going to get dementia happen at 95, rather than 90, imagine all of the wonders. I mean, just what a wonderful contribution to life, to all of us to have more love, more innovation, more ideas, more wisdom. All those things are great. I think we can and we should aspire to them.

A few things we can do; one is we need to get a little bit selfless in the sense that if we want to live longer, we should assume that everybody should have that same right. There are places here in the United States – I mean, I'm in New York City, just a mile away from me, there is a 25-year different average lifespan. It's based on education level and poverty. Certainly globally, there are countries in the developed world where we have 80-year lifespans in their places in Africa where it's in the late 40s and 50s.

If we want this for ourselves, we should recognize that we should want it for everybody. We already easily have the technology to help people in poorer parts of our country, disadvantaged parts of our country, and the world live longer. I think that we should really as our first step, try to do that.

In addition though, if we believe in what we're doing, we should ourselves also live longer, healthier lives. We're not helping anybody by dying younger than we can. There's a there's a few different things that we can do. Now the obvious ones that all your listeners will know is we should just do all the things that people in the blue zones do, which are the places where people on average live longer. That is, I don't even need to repeat it, but it's exercise, diet, community, reason for being, all those kinds of things that everybody knows.

Everybody, if you're not exercising at least 45 minutes a day, you are just taking from the account of your healthy future and life. If you're eating crap, you are taking from your future life. Everybody gets that. Then one of the things that we can do beyond that, so certainly I'm a big believer in intermittent fasting and the basic philosophy behind that is that our ancestors have survived, that's why we're here, these very narrow funnels where most other humans died out. The most recent one was about 75,000 years ago. There were just maybe a thousand homo sapiens left on the very southern tip of Africa.

Our ancestors were the ones who could survive scarcity. The way that they did it is that our cells shifted from growth mode to repair mode, like on your computer shifting to screensaver mode. We have that. When we use calorie restriction, an intermittent fasting in my mind is the best way to do it, our cells shift to repair mode. They go to screensaver mode and that is just by definition, it works to extend our health span.

Then there are a lot of drugs and small molecules that have been shown to have health span extending effects in animals and human studies are just beginning. Some of them include a metformin, which is a type 2 diabetes drug. In different names, humans have been using it since the Middle Ages. There's rapamycin, which is an immunosuppressant, which has extended animal lives by 25% to 30%. There are the various NAD+ boosters, so that maybe some of your people have heard of NMN, or NR. These are basically your body has a cellular repair mechanism, but it gets worse as you get older. This is essentially what these molecules are trying to do is just boost your repair, near natural repair method.

There's the whole set of drugs that people are using. I'm very confident within a decade, many of us will be taking personalized anti-aging drugs, and that's great. Then there's a whole thing of the different – there's pruning senescence cells and there's a whole industry. Jeff Bezos is investing in that. There's parabiosis, where in animal models when they cut open and stitch together an old mouse and a young mouse in many ways, the old mouse gets younger, the young man gets older, and so there's something about blood serum. It is conferring those youth factors. Different companies, like Alkahest are identifying what those are. That's another promising area.

Then finally, with everyone getting sequenced, we are beginning to identify what are the genetic patterns that help super agers, people who live past a 100 to help them live that long and then identifying well, what are those genes doing? We can either say, well, what are those genes doing?

Genes instruct cells to make proteins. We could just short-circuit the process saying, Well, what are those proteins being made and how can we mimic those proteins, perhaps with some pill. Or going back to what we talked about a moment ago, now that we know these genetic patterns that increase the person's chances of being able to live a long and healthy life, how can we select embryos after IVF, that are more likely than the others to live that long and healthy life? This whole field is just exploding and there's a lot of room for progress. I'm pretty confident that we're going to keep pushing the edges of possibility.

[0:49:32.2] MB: There's so many different topics and areas and themes I want to keep exploring, but I know we're short on time. For listeners who want to concretely implement, or start one of the steps, or one of the themes, or the things that you've talked about today, what would be a piece of homework that you would give them, whether it's around immortality, life extension, or even understanding the science better?

[0:49:53.4] JM: Yup. I'll be very specific. Number one, get yourself educated. If you want to read my book, I would love for you to read it. It's written. It's a one-stop shop to tell you what you need to know to make smarter decisions. It doesn't have to be my book. There's lots of great information out there, so you have to get yourself educated. If you are planning on having a baby at some point in your future life, I encourage everybody to freeze your eggs and freeze your sperm, because we're going to make babies in a different way.

In my view, everybody should just freeze when you're 20, because when you're 30, or when you're 35, or when you're 40, you want to at least have the option of using your own sperm, or egg cells that are frozen. It's easier for men to do than for women, but I certainly encourage everybody to do that.

In terms of longevity, absolutely. As I said before, if you aren't exercising 45 minutes a day, if you aren't eating healthy food and not eating crap and processed junk, you're not helping yourself. Nobody should be smoking, because we are – this is about building our future possibility. Then finally, what I would say is for their age of in just in terms of healthcare and personal management, the science is moving so quickly that very, very few of the doctors understand the newest technology.

I mean, doctors are wonderful and wise and conservative in a positive way. Most of them don't know anything about genetics. Most of them are not part of this whole – I mean, they're not trained in what's coming in personalized, or precision medicine. You really have to empower yourself through your own knowledge. We all have to recognize that the world is decentralizing and each individual, we are the agents, the primary agents of change in our lives. To play that role, we really have to hold ourselves more accountable than at an earlier time.

[0:52:14.4] MB: Jamie, for listeners that want to dig in, that want to find you and the book and your work online, what is the best place for them to do that?

[0:52:21.7] JM: Yeah, two websites. One is my personal website, jamiemetzl.com. J-A-M-I-E-M-E-T-Z-L.com. Then the book website, which is hackingdarwin.com. On the hackingdarwin.com, there's a whole discussion forum where people can share their thoughts, they can debate with each other. What I'm really trying to do is to spark a national and global conversation about the future of human genetic engineering. Because this is about our future as individuals and as a species, we all need to be part of the conversation about where we'd like to go and how we get there.

[0:53:02.6] MB: Well Jamie, thank you so much for coming on the show, for sharing all these fascinating and sometimes shocking anecdotes and stories. The book is packed full of really insightful and interesting information. Thank you so much for sharing it and coming on the show and sharing all this with our listeners.

[0:53:19.3] JM: My great pleasure, Matt.

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