From Inside the Cockpit: Navigating the Complexity of Drug Development with AI and Blockchain, by Gunjan Bhardwaj.
This is a book I ghostwrote.
Drug Development Is Broken
Ramaswamy and GSK’s experience is one example of what’s broken in drug discovery and development. Data is hidden away in carefully protected silos, and that secrecy means that important discoveries are not happening at the pace at which they should.
This problem is not limited to big pharmaceutical companies; consider a story I heard from a research scientist at University of Göttingen in Germany who works on the epigenetics of pancreatic cancer—one of the deadliest cancers in the world, a cancer with one of the lowest five-year survival rates, less than 5 percent. Many candidate drugs for treating pancreatic cancer have failed miserably. This scientist described a drug that was in clinical trials, but had been abandoned because it failed to meet the safety and efficacy criteria of the U.S. Food and Drug Administration (FDA). The reality was that this drug actually cured the tumor in a select subset of patients. If one were to look at the epigenetics of the drug’s efficacy and stratify the patient population appropriately, it could be a wonder drug for a smaller segment of patients. But it wasn’t being pursued.
Failed, or apparently failed, drug experiments go to the valley of death. The decision has been made by their creators that they are not worth pursuing, yet valuable data is locked up in those experiments. That data still is useful. Some researcher, somewhere, if he had that data, might see a connection to something that otherwise seems unrelated, and see possibility, just as Vivek Ramaswamy did. Instead, the data about those failed experiments is not published, not searchable and not available—no one can even find out that a researcher conducted an experiment. Researchers only want to publish what seems to work, yet a broader understanding what doesn’t work can also be useful in the search for drugs.
Big Pharma companies might be holding hidden treasures, but they can’t get a real-time look at the entire gamut of drug candidates and the intellectual property (IP) of those candidates. They can’t combine their own research with outside research to come up with drugs that will help patients, which of course is why pharmaceutical companies should exist. The direct advantage of looking at the entire research universe, internal and external, is that researchers can see insights and correlations that they could not previously see when data was trapped in silos. The present system of siloing data and information asymmetry characterizes the life sciences ecosystem and hampers the discovering of potentially life-saving drugs.
The example of SB-742457 illustrates how broken our system of drug discovery and development actually is. Every day, people suffer and die because life sciences and pharmaceutical industries don’t have the technologies and capabilities to bring effective drugs to market more quickly and effectively. The inefficiencies of the system impede better drug discovery and development.
Drug discovery is hampered by a structural system that resembles driving a car by looking in the rearview mirror. Imagine a physician sitting in the cockpit of a racecar. What is flying against his windshield is not wind, but data—the whole life sciences data universe. If the physician wants to drive fast and safely and get where he intends to go, he drives by looking out the windshield. But in life sciences, we drive the car by looking in the rearview mirror—that is, we look at historical data. Worse, we don’t even look at recent historical data; we look at old historical data. It’s as if there’s a time delay for what we’re seeing in our car’s rearview mirror.
Because insights about that data are manually curated and delayed by the process of scientific publication, we are not able to see the data in real time. Peer review of publishable data takes up to 250 days, and the time lag from completion of research to publication can be a year. That’s why GSK sold Axovant a promising Alzheimer’s drug for a pittance; the firm’s researchers were not able to see what the extant, current research on Alzheimer’s looks like.
Ramaswamy and Axovant were able to get a glimpse through the windshield, and that glimpse was worth $2 billion.
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From Love Is Free, Guac Is Extra: How Vulnerability, Empowerment and Curiosity Built and Unstoppable Team, by Monty Moran.
This is a book I book-doctored.
Why People Follow
The only source of a leader’s power is that others choose to follow.
As leaders, we must not believe that we deserve the power bestowed on us. Rather, our power arises only from others’ choice to follow us, and only to the extent that we can harness their energy toward our mission. Put differently, we are at the mercy of those we lead, to the extent that they will follow us only if it appeals to them to be a part of creating the change we are asking for.
We must find in ourselves the wisdom and skill to merit the continued support of our teams. That wisdom, in large part, comes from being in touch with the people we seek to lead. To be in touch with them means to get to know them, trust them, challenge them, believe in them, and to commit to help them be their very best. We need to have full access to our heart, and to offer it to them. We need to become more, not less, human. We need to be in touch with who we are, and share ourselves with them, such that we are worthy of their continued trust and confidence. We must be wise enough to know when we should lead them, or allow them to lead us, because a great leader must at times be a good follower. We need to be aware that, most of the time, the light is more effectively placed on one or more of our team members than ourselves.
Our humility as leaders should arise naturally, because leadership does not reside just in a person, but in a person’s ability to tap into, to be in touch with, a force greater and more significant than any person. It resides in a beautiful and worthy vision. It resides in the intelligence of instinct, and in the wisdom taught by history. It resides in our ability to make complex matters simple, and our ability to see the obvious. To lead effectively, we need to reach further and further levels of humility, even as we may be regaled by titles and positions said to be of high rank, so that we don’t lose sight of what propelled us into a position of leadership in the first place.
Exposing ourselves so deeply can cause a bit of anxiety: “Will people think I am weak? Am I good enough?” I have often worried that what I had to give wasn’t enough, and that people deserved more. It takes courage to share our authentic self with others. But this vulnerability allows us to establish a connection with people necessary to lead effectively. We have to trust that we will survive sharing ourselves in this way. (We will, by the way. Actually, it will be incredibly invigorating.) When we feel our own authenticity flowing from our heart, those we lead will feel drawn to this and they will trust us to take them to a better place.
Love and Leadership
I believe that the growth, development, and unfolding of our soul is the purpose for our life on Earth. The magical power that most powerfully promotes our development is love, a universally present force that arises in our hearts when we are able to be fully present and quiet the distracting din of our mind and its many judgments.
This discussion of love is central to discussing leadership, because leadership is about helping people grow and blossom toward becoming the best version of themselves: leaders help others on their journey.
Love is what remains when one releases judgment. The absence of judgment allows true understanding, which gives rise to forgiveness, acceptance, compassion, and thus love. To love someone is to feel their truth, feel their essence—the reality of their being beyond personality or ego. When you know a person’s truth and are completely present such that you can feel their essential nature, a feeling of love naturally emerges.
The words "I love you" imply a closeness, a depth, understanding, and a camaraderie of souls. By saying you love someone, you are saying, “I see you, know you, understand you, appreciate you, accept you, and I feel a kinship, a closeness to you arising from that association.” There is an awareness that the two of you share a sacred connection: a familiarity, and oneness with a universally available consciousness.
While love is magical and wonderful, it is not rare. Love is free! It is what is left over when one removes everything else. In my view, it is synonymous with truth and god.
When I say “god,” I am not referring the god of any specific religion. Instead, when I use the word “god” I am referring to a powerful force that is greater than us, that is beautiful, forgiving, and all knowing: the purest embodiment of love and goodness.
It’s very hard not to love someone whom you deeply understand. I love some strange and difficult people, many of whom are quite unpleasant outwardly. If you’re willing and able to set aside your judgments in favor of curiosity and understanding for someone’s situation, and take time to know them deeply, then it is inevitable: a deep affection, love, will naturally arise. A connection born out of fellowship and understanding. Experiencing this may lead you to an awareness, even if fleeting, that we are all offspring of the same wondrous, mysterious universe. When we let our guard down, and make room for curiosity and the desire to know and understand others, we start to feel a lot more love. Even for people who are famously “difficult.”
We are all in this together. We are not truly separate, even if we are from different countries. What creates the feeling of separateness is our fear: fear of someone misunderstanding us, not valuing us, judging us, or taking advantage of us. To prevent this, we erect barriers that prevent a connection. Especially in cities, where the overwhelming number of people makes it hard, even risky, to be completely open to a connection with everyone. But it is this connection, when nurtured by compassion and understanding and complete acceptance (which implies no judgment), that grows naturally into love. If our heart is open to it, we can find this connection with almost anyone, almost anywhere, as long as they too are open to it. Remembering this concept is critical to leadership, because excellent leadership requires that we overcome our fear, and establish this deep connection.
Nearly all of us share in common a desire to be seen, understood, and accepted for who we are. We want to feel we are somehow remarkable and special. The reality is, we are. Unfortunately, we often don’t see this, because we believe that we are special only when we compare positively with others. This is ego-based thinking, and the ego has the mistaken view that our value lies in our separateness, when the exact opposite is true. What makes us special is what we have in common: that we are all part of a wonderful and infinite consciousness. There is room for all of us to be special (no one has to be un-special) since the universe does not grade on a curve!
The Christian way of looking at this is that God loves all of us, without regard for our good deeds, so long as we recognize Jesus Christ as our savior, ask for forgiveness of our sins, and accept God into our heart. It is a beautiful concept, really. Christians say that we cannot earn God’s love. Instead, it is a gift from God. It is an act of providence. It is free, if we merely have faith and believe. It is the gift of Jesus, who died for our sins.
The Buddhists say that all suffering arises from desire. There is a term, Dukkha, which refers to the constant dissatisfaction of our existence caused by not having what we want, or having what we do not want, or being separated from what we want. The way to eliminate suffering is essentially through the elimination of ignorance, which is wisdom. Wisdom is achieved by coming to know things as they really are, which takes practice. The Buddhists have various methods by which to do this.
Like many Americans, I was exposed to the Christian outlook as a child, since I went to a variety of Christian churches. I appreciate many things about Christianity, and I believe the truth of Jesus’ words. But my understanding of truth, my philosophy, is informed by many learnings and experiences, and isn’t completely tied to any one religion. I see elements of truth appearing in the wisdom of Judaism, Hindu, Islam, Buddhism, Zen, Christianity, and many other religions. What I have learned reading about and speaking to religious people from all over the world is that the fundamental message underlying these “different” religions is quite similar. Namely, that there is something out there much greater than us, and it is beautiful, forgiving, and all knowing, and the best way to live is to partake of it as fully as we can! Throughout this book, I sometimes refer to this as the Universal Consciousness. But in my mind, I’ve come to believe that this Universal Consciousness is essentially synonymous with love. Or truth. Or god.
No matter how you choose to go about it, to look for the love I’m describing is a beautiful practice. Our failure to see it notwithstanding, it’s all over the place. Closing the blinds doesn’t mean the sun’s not shining. If we can cultivate an openness, and calm our rejection of our current situation, we’ll see and experience more and more of it, for the simple reason that it is everywhere.
So … what? Should we just love everyone? Well, sure! But it’s not that simple. As often as not, one or both of any two people will erect barriers to complete openness, which inhibits the connection I’m talking about. Great leaders find a way to make this connection safe, such that a close connection and trust emerge.
I believe love is all around us. I believe love is infinite. I believe that love has no opposite, and that it is available for everyone and everything at all times. The fact that we do not always feel the warmth of love around us is a result of our own limitations, such as our limited senses, our dysfunction, our effort to build ourselves up as something greater than those around us, and our limited understanding of reality. If we call this reality the truth, then we could say that the truth exists independent of our ability to fully comprehend it. But if we could somehow fully understand the truth, we would see that the truth of the universe is good, is love, is god.
When I say love has no opposite, I mean the existence of love needn’t imply the simultaneous existence of a cosmically powerful evil force or being. Nor does it imply the existence of a physical place called “hell.” If there is a hell, I believe hell is a psychological state wherein we are greatly separated from the truth: from love, and from god. It is hell to be in that mental state, where our misunderstanding, dysfunction, or mindset limits us from participating as fully as possible in the warm glow of love. Heaven, by the same reasoning, describes not a physical location, but a complete unity with god, truth and love. I believe this union is possible, and this state of consciousness could be called heaven, or many other familiar names, such as awakening, enlightenment, moksha, or self-realization. Ultimately, I believe it is our destiny to find this connection with Universal Consciousness, and that our life on Earth is a part of this journey. But this journey is not linear: it has many twists and turns.
Leaders help others on their journey. Love is the mechanism that allows them to do that.
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From America 3:16: Family, Faith, Freedom … Forever, by Graham Allen.
This is a book I ghostwrote.
The Homeschool Years
Have you ever felt like you couldn’t do anything right? Well, that was my daily burden as I tried to understand why my parents were always upset about everything I did. I either wasn’t smart enough or “Christian” enough to gain their approval. My stepdad was never happy about anything—in fact, he was always one step away from being furious about everything.
One Christmas, he let me know how much he hated the Post Office. Workers at the local post office would write back to kids who had sent letters to Santa. He was angry because he knew the Post Office (as Santa) would tell me I was a good boy when obviously I was terrible and deserved nothing for Christmas. This is also how I found out that Santa wasn’t real—because he was attempting to prove to me how bad I was.
The worst part of this is, I was not a bad kid. You may be thinking, “Sure, that’s what all bad kids say,” but when I look back now I see that I was actually a pretty good kid. Was I perfect? Absolutely not! However, I tried hard, but I never seemed to be good enough—so I thought I was the worst kid in the world, because that’s what I heard every day. That’s all I heard every single day.
Up through fifth grade, I went to a Christian school. Obviously, when you have the most “Christian” parents on the planet you go to a Christian school. I met a girl there named Ellisa. (Spoiler alert: Many years later I am blessed enough to call her my wife, but that comes later in the story. I told you God was constantly working in my life.) My mother was an academic, and she decided that any grade less than an A was unacceptable—and “unacceptable” equaled punishment. My teachers were under strict orders to contact my parents if I didn’t perform to my mother’s standards. It’s one thing to know you have let your parents down and there will be consequences. It’s another to know there is no way to win, and that no matter what you do, you are doomed. That’s how my life felt.
By sixth grade, both Mom and my stepdad were at home 24/7. That’s when they decided to focus their full attention on me. They concluded that my school just was not making me a good enough person. They wanted to ensure that the only voices I heard were the ones they wanted me to hear—theirs. And so the homeschooling era began. In this arrangement, my mom was the teacher and my stepdad was the enforcer. Lord knows they had their share of demons, and they took them out on me whenever they had the chance.
I hated every second of it.
Nowadays, homeschooled kids are encouraged to go through the academic curriculum and also to engage in social activity with other kids. My experience was the opposite.
My transition to homeschooling led to total isolation from the outside world. Here’s one example of what that meant: A church sat across the road from our house in Caledonia. It had a basketball court, which I could see from my room. I remember watching kids play basketball every day. My town only had 1,100 people, yet I didn’t know a single one of those kids! I so badly wanted to go play with them, but I wasn’t allowed to. I was so alone. I was a middle school kid who was literally under house arrest.
I don’t remember much from that year, except that it seemed to be one, gigantic “lesson.” I do remember being up at 2 a.m. trying to pass a math test my stepdad had given me. When I gave it to him he would work the problems, tell me it wasn’t right, and hand the test back—but not actually teach me anything. I would go back to my desk and do them all again. This happened again and again, until I passed most nights around midnight. I began to grow nauseous over taking tests.
Because my parents were always sick, or seemed to be, I spent a lot of time alone. Like most kids that are alone the only friends I had were imaginary ones.
In sixth grade, I began to struggle with depression. I developed anxiety related to hypochondria. As I watched my mom getting sicker and sicker, I thought it was only a matter of time before the same thing happened to me. I would feel the different parts of my body, looking for indications that I was ill. If I found something suspicious I would tell myself, “You’ve got cancer, you’re going to die.”
The isolation of homeschool created a lifestyle of indoctrination. In my life, we accepted the Bible and religion without question, and our particular Biblical system was all about punishment. For example, I once ate a candy bar I wasn’t supposed to. When my mom and stepdad asked me, I lied and denied it. I knew that lying was wrong, but I did it anyway. That incident led to three months of no privileges. I wasn’t allowed anything: no TV or music. No leaving the house. No friend time, even though I didn’t have any to begin with. I wouldn’t see the light of day for months.
My grandparents’ house was my safe haven during this time; they lived two miles down the road, and I could walk there. When I lost my privileges, I wasn’t even allowed to visit them. I had no escape! You won’t be surprised to learn that I became depressed and started acting out. I wasn’t doing drugs or cussing my parents. But, as any young teenager would, I began to fight back. I began to question, and I found out very quickly that questions would not be tolerated either.
Physical and emotional discipline played a big role at home. After I had been found guilty of something, I had to go outside. There, my stepdad read the Bible to me. There was always a bible verse that explained why I was such a terrible person. Then, I put both hands on the wall and he administered a spanking with a board he kept for the very purpose of purging my sins. Or at least that is what it appeared to be. He was, he said, “administering religious medicine.” Afterwards I was forced to watch Joyce Meyer videos with my stepdad and my mom.
The only videos we watched were the ones that could be twisted to fit their agenda that something was wrong with me. It was the only television they allowed me to watch during my times of imprisonment.
I look back now and see that these were extreme punishments. You, reading this, might be thinking the same thing. At the time, I did not. I didn’t think it was unusual to be asked to lean against a wall while my stepfather applied “religious medicine” to me with a board. I thought everyone had the Bible read to them as part of their punishment. I thought it was normal to be grounded for months for eating a Hershey bar. I just didn’t know any different.
Religion became a real nuisance. Everything in my life centered around religion and how I was clearly failing at it. No matter what I did, I could never seem to get anything right. My entire life felt like a bootcamp, where you can never get anything right, even when it actually is right (because that’s part of the bootcamp plan). Bootcamp breaks you down, and then very meticulously builds you back up with a specific purpose.
I am still not sure what my parents purpose was. It wasn’t to make me a better person. In the end, the only conclusion I have is that they wanted me to feel one thing: fear. I would ask, “God, why is everything so hectic for me all the time? I never get it right.”
Homeschooling under my parents completely isolated me for a year and a half. (Funnily enough, my wife also was homeschooled. When our kids were born, she suggested homeschooling. Does it surprise you that I said, “I’d rather die”?)
I don’t believe my parents are, or were, abusive people or parents. Extreme in every sense of the word? Absolutely. Yet it is not lost on me that so many people had it so much worse. Instead, my parents thought they were saving my soul. Still to this day, I believe that about the both of them. That is the scary thing about an ideal: right or wrong, people believe it until the end. According to them, I was the worst person in the world. No matter what they tried, it was clear that I was going to Hell.
As I said, I actually was a pretty good kid. I never drank a beer until I was 18 and in the military. I never smoked or even had a girlfriend until my junior year of high school. I was smart, too, getting As and Bs in class. I didn’t see that in myself at the time, because all I was told was how bad I was. I was never good enough. Now, in my thirties, with three kids of my own, I look back and can see how messed up my home life was. I know now that God is a God of love and mercy, yet when I was a child the Bible was turned against me time and again as a tool to prove how “bad” I was.
At that time, the only God I knew was a bully.
You might assume I’d be against religion forever. Yet I’m a Christian today. I just have a very, very different idea from my stepdad and my mom of what that actually means.
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