How Personalized Medicine Works

Hippocrates realized that it is even more important to understand the patient than to understand the disease and now, 2000 years later, we are coming back to that way of thinking with personalized medicine. ?

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Episode Transcript

Speaker 1 (00:00):
All right, josh. So the first part of our winter
tour is over a lot of fun. But we are
going back out this weekend next to Atlanta. While we're
not going anywhere, well, we're going down the road ten
minutes from my house. Sure, Atlanta, Birmingham. We would still
love to see you, and you can still get great seats. Yeah,
and this is a brand new show. Unless you were

(00:22):
in San Francisco, San Diego, Austin, or Dallas, you ain't
seen the show. And it is bringing down the house
all over the country eventually probably all over the world. Yes,
and you can get tickets. You can just go to
s y s K live dot com. It's our square
space powered site and they were powering our tour and
they were they're powering me on a daily basis. So

(00:43):
we will see you guys very soon. Welcome to Stuff
you should Know from House Stuff Works dot com. Hey,
and welcome to the podcast. I'm Joshua m clark. There's
Charles w Wayne, Chucker's Chuck Tran Bryant Chuck Trand I

(01:07):
remember that and then that one never even made sense. No,
who said that me? Yeah, I don't get it. It
doesn't mean anything. That's why I never made sens. And
then there's Jerry Chairs, Jerome Rolling, Jair Tran, and Josh Tran. Yeah,
the trans I'm excited to record this and then leave
because I just quickly on my phone saw that Billy

(01:30):
Joel did Ado performance in the commercial break of IT
talk show and the video was up. Oh yeah, so
I got things to do. Okay, well, let's go personalized medicine. Chuck, huh,
So let's take it back. Let's take away back. Okay,
let's talk about medicine in general. Right, are we way
back machining it or no? No, no, no, all right.
So there's this idea that um two best understand how

(01:57):
to treat a person, you should understand. Critique said, it's
far more important to know what person the disease has
than what disease the person has. Boy, that is smart
for back then it is you know, and I think
that this was the original idea behind medicine, that we
we can understand a disease, but when you apply it
to a person, it's going to be different than when

(02:19):
you apply it to another person. And that is the
heart of personalized medicine, is that understanding. Unfortunately, for many
hundreds of years. Well actually for a shorter time than that.
But in Western medicine, the idea has been that if
it works for most people, it will probably work for you,

(02:40):
or that's good enough for us. Yeah, it's called a
trial and error approach, and that should scare you to death.
Well I get it, because until we until the Human
Genome Project, we didn't have a lot of choices as
a society other than to do our best for the majority.

(03:00):
You know. Well, yeah, like that changed everything. It did,
but even before that, it was it was like, that
was what two thousand, two thousand one, something like that,
the Human Genome Project. Yeah, I mean before that, there
were some precursors to personalized medicine, like let's look at
family histories and stuff like that. Yeah, but even like
it's that's not that old. It wasn't until World War
Two that people started noticing huh. You know, different people

(03:25):
have different reactions to different kinds of medicine. There's actually
an anti malarial drug that was given to troops in
World War two, American troops, and um, if you're an
African American, there's a high likelihood that you might develop
anemia after you were given this anti malarial drug. But
that wasn't that didn't show among um. White troops and

(03:46):
doctors thought, what's behind this? And they went and looked
and saw that genetically speaking African Americans were less likely
to have a gene active that produces a protective enzyme
that keeps you from developing anemia when you're giving this
particular anti malarial drug. And that in the middle of
the twentieth century, it was the first time we really

(04:06):
started in the Western medicine tradition thinking that no, people
have different reactions to different types of treatments and can
have different experiences with different types of disease. Did they
do something about it in that case? I don't know.
I was curious. It depends on the time period in
this country. Shamefully, they might have said, like, yeah, but

(04:27):
who cares. Yeah. At the same time, the Tuskegee Um, yeah, exactly, Yeah,
the Tuskegee experiments were going on. We're also infecting people
in Guatemala with syphilis. Crazy crazy stuff. Um. So you
mentioned Hippocrates, um, more than two thousand years ago. He

(04:48):
was pretty advanced for thinking that jerkxes needs bleeding, but
uh uh Zeus does not. Zeus never needs a bleeding
by that, But it was lightning bowl at the problem exactly.
But he was way ahead of his time to be
thinking that way back then. Um, some other pioneers since then,

(05:08):
I think we talked about these two, Reuben Otenberg and
Ludvik hick Thorne job. I don't know that was not
good hicktoin uh in nineteen o seven, and I think
in our blood episode we might have talked about this.
That was such a good episode, it was a really
good one. I think, Um, they were the first ones

(05:29):
to say, you know what, people have different blood types
as it works, so that's why people keep dying. Well,
now we're putting this blood into someone that doesn't have
the same blood. So that was land Steiner who came
up with the idea that way. It wasn't blood types.
These two were the ones who first started to match people, like, well,
let's match these people. That's the that's yeah, that's a
pretty good first example of personalizing medicine on the most

(05:53):
basic level, like let's not kill people with blood right uh.
And then like I said, um, family histories and such,
they finally started saying, hey, you know what, maybe we'll
look at your father and your mother and your grandparents,
because if they have this disease, you might have it
as well. But everything changed when the Human Genome Project

(06:13):
came along, and UH, all of a sudden, we found
out we could learn a lot more about our predisposition
for certain diseases. Yeah, because if you think about it,
um are reactions to different diseases, and also the same
medicines that treat different diseases. UH, can be traced down

(06:35):
to the to the genetic level, to the molecular level,
to whether a gene is turned off and expressing a
certain kind of protein or enzyme um or whether our
genes are going to allow for a tumor that expresses
a certain kind of protein that can be tracked. If
you conceivably can look at a person's genome sequence, the

(06:56):
whole thing, analyze it, and then look it what genes
are turned on or off, what proteins are being expressed,
that kind of thing, then you if you also know
that a certain kind of drug attracts a certain kind
of tumor that's associated with that type of genome or
genetic sequence, then you can put patient and drug together

(07:18):
under its ideal form. Dude, we should stop and just
walk away. That's a mic drop statement. I don't think
we need anything else. Okay, I'm gonna go watch Billy
Jolson do up. All right. So, if you think you
go to the doctor and you get personalized medicine, in
a sense, you sort of are. But what we're talking
about is what Josh has said, which is your own

(07:40):
individual biology being the most overriding factor in how you
were treated. Your biology, not just you know, you're a
human being. Yeah, this works on human beings and horses.
And your mom had cancer, your grandma had cancer, so
you might have cancer. No, we're talking about looking inside
of you to find out what your likelihood to get

(08:02):
these things are, and like you said, matching you with
the best treatment plan, right, one of those UM one
of those courses of study. There's a lot of different
things that really kind of fall under personalized medicine UM.
But one of those sub fields is called pharmacogenetics, right.
And that is again, if you can take a person's
genome and then uh analyze it, you can say, well,

(08:25):
I see the sequence right here would react very well
to this particular drug. That's pharmacogenetics matching the drug to
the person, right, yeah, which is the opposite of hey,
it works for eight out of ten people, and if
you're just one of those, the T S T S
and that seriously, that is the basis of western medicine
as it stands right now. It's it called it's a

(08:46):
trial and error approach. And they don't usually stop at ts. No,
they just say like, oh, you survived that round of drugs,
but it didn't Let's try something else. Maybe maybe this
other one that doesn't work for it tends to work
for that might work for you. And then it just
goes on and on and on until they finally hit

(09:06):
upon that drug hopefully that that doesn't work. I say hopefully,
because within that trial and error period a lot of
people die. Sometimes that first time, that first trial results
in a fatal error, and those are called a d
S or adverse drug UM events. There's seven hundred and
seventy thousand people in the US alone they either die

(09:30):
or are injured by an a d E every year
in the US alone, almost a million people, seven hundred
and seventy thousand people every year. You give that person
a drug and they might die. And the one of
the goals of UM of pharmacogenetics is to avoid a
d e s so that you can say, before you

(09:52):
give anybody a drug, like this won't kill you, Yes, exactly,
this won't kill you. We know that because we scanned
your geno. We're not guessing here. We know you genetically
will not die from this drunk. Yeah, I think we
should caveat here when we say things like guessing and
like I don't want to paint the medical industry is
you know, just throwing darts with a blindfold. They've done

(10:16):
They did the best job they could, I think, to
treat massive amounts of people in the most efficient way possible.
But things are getting better now because of the human
biome or the human genome and what we've learned about it.
Like when I look about the future of medicine, it
is like it's super rosy. Yeah, I agree, you know,

(10:37):
like a hundred years from now, it's it's gonna be
amazing what we're gonna be doing, maybe like thirty Like
we're right there on the cusp right now, where we
went through a fairly dark age as far as medicine goes,
where we were taking shots in the dark, figuring things
out as we went along, and now we are right
there at the age where we're about to just take
off like a rocket and really understand health and wellness

(10:59):
and treatment of disease. All right, well, I feel like
we're on the cusp of the message break as well.
I think you're right, So, Chuck, I was talking about

(11:28):
pharmacod genetics, right, there's actually some examples of pharmacogenetics already
taking place. This isn't necessarily in the future, like this
is already starting. Yes, I think it started in the nineties, right, yeah,
And and we'll get to this later. One of the
big reasons that things are cooking now, cooking with gas,

(11:49):
as my dad used to say, is because the massive
drop in cost for mapping your genome. Yeah, like assive.
In fact, i'll go ahead and tease you here and uh,
the first time it was done to James Watson in
two thousand seven, that was two seven, not even the

(12:10):
human genome that was two thousand one. Two thousand seven
was four. A time they mapped the person in full
cost a million dollars. Now you can get it done
a good A good one, not a full You know,
you can't map out the entire genome for this amount
of money. You can, you can you can sequence it.

(12:33):
You can sequence it for that's the caveat less than
two dollars, and pretty soon it's going to be about fifty.
And then from what I saw in that, I think
that was like a Business Insider article, there was a
dude who gave this this really interesting lecture. Um. He
very strongly asserted that they were pretty confident by thanks

(12:58):
to economies of scale, Uh, genome sequencing will cost about
a penny. Yeah, they won't. Won't cost a penny, Like
you won't pay a penny. I guarantee you that. No, No,
but it'll be but it might be like fifty bucks
and someone will be makingfit. No. The I think what
he was saying was if you take all of the

(13:18):
genomes that are sequenced in a year, ultimately that's what
it will have cost. It's about a penny each, right,
But they it's gonna pop up in in different ways
than what you have now. Like this is a pretty
common thought that you will pee into your toilet, and
your toilet will have a genome sequencer attached to it,
and when you pee, your urine will be analyzed for

(13:40):
any changes from that morning or the night before or
anything like that, so that your baseline health is monitored
on a like a several times a day basis. Right,
if my toilet starts telling me to cut down on
my drinking, then I'm gonna start peeing outside. I imagine
that you can probably set it to kind of take
it easy on this area, you know that kind of
And when I say start being outside, I mean full time.

(14:02):
I p outside almost every night, off of my deck.
Sometimes you even stand up. Yeah, that's Raymond mcaulay, by
the way, he's the bio technology and bio and for
Maddox chair Singularity University, what's their mascot, the uh fighting

(14:24):
curs wild. So he's a smart guy, and he's the
one that is saying that this is just getting cheaper
and cheaper. And when you look at the graph in
two thousand seven, it took a nose dive in price,
Yeah it did. He compared it to Moore's law, where
um Moore's law is like the amount of computing power
doubles every eighteen months or something like that, twenty four months.

(14:46):
They can't remember, um. And it was pointed out that
genome sequencing was actually moving in a rate of five
to ten times the rate of Moore's law. That's awesome.
That is awesome as far as genome sequencing concerned. The
problem is computing powers still following Moore's law. And here's
the big problem. This is why we're not all getting

(15:07):
our genome sequenced right now. Because it might be very
cheap to sequence human genome, it's still very expensive because
it requires a lot of computing power to analyze that genome. Yeah,
that's the main stumbling block is you can't sequence your genome,
stick it in a machine and have it say you'll
get cancer. Yet. That's the future, but not too far off. No,

(15:32):
that's like Gattica. Yeah, but the I mean this guy
Macaulay was saying, probably in about ten years they will
have machines like that. Yeah, which is what we need.
That's the main stumbling block right now is there's so
much data that computers can't even keep up. So right
now you could conceivably get a decent genome sequenced and
analyzed for like fifteen grand, which is not I mean,

(15:56):
that's not all the realm of it's not the reach
of everybody. You have to be people that, Um, the
the the big change will come when all of us
get our genome sequence basically for free. And the holy
grail in the not too distant future is to not

(16:16):
only have a genome sequencer and analyzer in your toilet,
but also you'll be wearing like a wearable or have
an implanable something, yeah, but or maybe something that's under
the skin that is like fitbit, but that's analyzing everything, um,
including your hormone levels things like that. So you're not

(16:37):
only analyzing your p you're also analyzing your body in
a moment to moment basis. And all this stuff is
run through an app you have on your phone that
is tied in to your health records and other kinds
of medical data um that you control and you share
with your healthcare provider rather than the opposite. That's another

(16:58):
big change coming that we talk sucked about in Will
Computers Replace My Doctor episode, that that medical information about
the person is going to be wrestled away from healthcare
and healthcare providers and insurance companies and placed in the
hands of the individual. And that's going to be a
huge change that will probably come from this personalized medicine
exactly one of the positive changes. All right. So there

(17:21):
have been some early stories that have given us all
hope for the future when it comes to looking at
these biomarkers UM for potential of disease, and one of them,
there was a drug called U k A l y
d e c O kellidico kalitico I think so UH
in two thousand twelve to treat a rare form of

(17:42):
cystic fibrosis UM, which is a deadly lung condition. And
the FDA here in the U S approved this drug
UM basically because they found out certain people have genetic markers,
these biomarkers that they wouldn't respond to other drugs treating
UH cystic fibrosis. So they said, this is a new
drug that will work for you. Success story boom, and

(18:04):
this like this is the future of personalized medicine all
over the place. Right. It covers about four percent of
cystic fibrosis patients. So in the US, it's people that
the drug was targeted for, right, because you would think
I'm just cynical, but you would think that's so few
people that somebody be like, a why bother, I'll bet
it costs a bunch of money for the drug, But yes,

(18:25):
you're right, UM. And then secondly, it also kind of
shows how personalized medicine shifts our understanding of disease to right,
the reason these people with cystic fibrosis didn't respond to
regular medicine is because their cystic fibrosis was developed because
their genes didn't that regulated salt and water movement across
the surface of their lungs were mutated and not functioning properly.

(18:49):
So this specific drug that targets these four percent of
cystic fibrosis patients goes in and messages with that gene. Well,
if you do the other ninetent of cystic fibrosis patient,
their salt and water um movement is just fine. That's
not why they have cystic fibrosis. So it changes your
understanding of cystic fibrosis. It's not like you have cystic fibrosis.

(19:12):
This is why you have it. This is how your
body is showing that you have cystic fibrosis. You have
cystic fibrosis, and you can have all these you can
have it under these different mechanisms. That's what personalized medicine
is changing too. It's changing our understanding of disease itself.
Same with cancer, right, certain tumors express certain proteins and

(19:32):
although yes, you have an out of control growth that
makes a cancer. It really doesn't bear that much of
a resemblance to this other kind of cancer. And the
more we dig into how people respond differently to cancer
treatments and how they can host different kinds of tumors
is changing our understanding of cancer. And a lot of
people are like, cancer is too big of an umbrella.

(19:54):
These are really almost different diseases. Yeah, And I think
the Macaulay guys said the hope one day is to
stop cancer before it even starts at such a small
molecular level with these advanced Uh. I guess like a
blood test. Yeah, basically the blood test will be so
advanced that let's say, you know you're going to develop

(20:16):
cancer in five years, Like we can tell that already,
So let's just stop it now before there's a yeah,
or before it gets big enough that it's a problem. Yeah, exactly. Uh.
If you have type one diabetes, I think it is
um good news. There is a new system. It's a
basically an artificial pancreas device and they are wearable and

(20:41):
the clinical developed by u v A and Harvard Go
Cavaliers and Crimson, the Crimson Smarties. That's Harvard. Right, they're
not the Crimson Tide too, are they? No, not the Tide,
They're just Crimson's the Crimson. I think you guys left
part off their Harvard. Well, they do have a mascot,

(21:02):
I think, like John Harvard, but it's not like it's
just a square of Crimson. I don't know. I think
so maybe they're above it. They don't need a Crimson
Knights Crimson Knights. No, is that Rutgers. That's Scarlet Knights. Anyway,
uv A and Harvard developed this thing together. Uh. And
it starts clinical trials in like the next month or two.

(21:24):
Uh and for six months, two forty people are gonna
wear this thing, this artificial pancreas to tell your body, uh,
exactly when you need the optimal level of insulin in
your body at all times. Well, and introduces that optimal level.
Oh does it? Uh? Huh? How so? So it's like

(21:44):
it's monitoring your blood glucost level. Yeah. And you you know,
if you have diabetes you have to inject insuline. Yeah,
this stuff, say, is connected to report in your chest. Oh.
I don't think this one particularly is this is just
a wearable monitor. But I think eventually they're gonna have
what you're talking about. I guess I'm just getting ahead
of the ahead of myself. That's that's actually regulates, not

(22:09):
monitors in the future, I think is what you're talking about,
or injects like an optimal dose regulating your glucose so
you don't have to do it. I think this is
just a wearable monitor so you could just like press
and say, okay, what kind of how much insulin do
I need right now? And it tells you the exact
like milligrams, so you still have to like a dope,

(22:29):
go and inject it yourself, right, I think so. I
don't see how it could be wearable on your arm
and also be attached to your body like the insides
of your body through like a an ivy. Yeah, I
don't think that's what this is. All sounds like there's
two different things, but it's still monitoring exactly what your

(22:51):
blood glucoast level is. Absolutely and it's your blood loose
coast level ergo, it's personalized medicine, that's right. If you
have tendus like our buddy Aaron Cooper. Aaron Cooper, he
probably didn't hear that. I'll heard it was a ringing.
He just hurts. UM. They're working on customizable devices that

(23:12):
adjust the audio signal that's unique to your own ear.
In other words, hey just put this hearing aid in
there that may or may not work for you, right
from what I understand it actually so, UM, you know
noise canceling headphones, Well, it kind of works like those.
I guess it figures out what pitch you're hearing that
tonight is that, and it just gets rid of it.

(23:34):
I think that's neat. I do too, UM and then check.
There's another early example of a good a big win. UM.
There's something called herceptin, and the FDA said, yes, go
ahead with this. UM. They figured out that this particular
drug worked for a specific group of people UM whose

(23:56):
tumors expressed a specific protein, and it was a breast
cancer UM tumor targeting drug. But like again, it wasn't like, oh,
you have breast cancer, here, try um her septin, it'll
work for you. It's we we we believe that you
have this kind of tumor because it's expressing this kind

(24:17):
of protein. So her septin is going to treat this
orray for her septin. Yeah, Well, let's take another break
and we'll get back and finish up with some of
the obstacles in the future. All right, So this all

(24:51):
sounds rosy, but there are some obstacles we already talked about.
One the previous biggest one was cost. This article itself
is m way out of date because it said seventeen
thousand dollars a person, and now it's already like two
hundred bucks. I think that might be though with the
with analysis. Oh really, yeah, I think that's what they're saying. Okay,

(25:16):
oh yeah, follow up on the data. Yeah, all right's
announced down to fifteen grand, So it's up by two
thousand dollars. So it was written a week ago, all right,
But the cost of the genome was a previous hurdle.
Now that's coming down. Another hurdle is that we mentioned
was just processing the data. And then another hurdle is
just overstating the impact of this of the findings. Um,

(25:41):
just because and it's a slippery slope, Just because you
are susceptible to something doesn't mean you're gonna get it. No,
And that's actually there's something called the Jolie effect, that
Angelina Jolie effect. Oh boy, I've got eight thousand jokes.
Have you heard about that now? So do you remember
when she did genetic testing and found that, um, she

(26:04):
was there was a likelihood that she would develop breast cancer.
I think perhaps like her mother may have had breast cancer.
I'm not sure, but she was convinced that there was
a good chance she's going to get breast cancer. So
she went ahead and had a double mestectomy without breast cancer,
no tumors, no nothing. She just preventatively had mossectomies. Angelina

(26:26):
Jolie did yes, and it created what's called this Angelina
Jolie effect. And Christina applegated something like that too. Well,
she had breast cancer. Angelina Jolie didn't have breast cancer,
believed that she would conceivably get breast cancer, so it
just had her breasts removed and the right um and
it created what's called this Angelina Jolie effect, which is

(26:48):
this idea that UM, the more we know about our bodies,
the more UM focused on all the things that could
conceivably go wrong, hype pathetically could go wrong, that we
may take radical steps like like prophylactic surgery. Basically, you know,
to prevent something that may or may not even happen.

(27:10):
And this is a big concern among bioethicists about this
kind of understanding that will come from personalized medicine is
are we gonna all become obsessed with our health? Well?
I think people that already are. This will just be
the next step of that. Yeah, But I could see
if it could bring more people into the full I'm
sure there's a lot of people who don't think about
their health just because they don't have that kind of awareness.

(27:33):
But if it was in their face, like, hey, buddy,
here's your genome, Look at this crazy stuff that could
happen to you. Do you may start thinking about it
even if you weren't predisposed to it before. But you
would have to go get that done to begin with.
Well that's another question too. So right now, if getting
your genome done costs seventeen grand right, um, should that

(27:56):
be just the providence of the rich or that a
human right to know what your genome says? If anybody
can know what their genome says, should everybody? I predict
that the answer will ultimately be yes to that, then
there's a right, and the government will probably fund a
program for every American get to get their genome sequence years.

(28:21):
Another big problem is the f d A is just overtaxed,
you know, it's it's a rapidly moving field and they
just can't keep up at this point, which you know,
because there are a lot of new things that come
along with new drugs, new devices that the FDA has
a test. Well, not just that the understanding of it
as well, Like they used to have this open database

(28:43):
from the Human Genome Project to where all of these
anonymous subjects, genes or genomes were just sitting out there
for anybody to go and data mine, right, and then
somebody proved that you can actually find you can d
anonymize these people because again this is their genome and
figure out whose genome you're looking at specifically, And the

(29:06):
FDA had to shut it down, but they shut it
down after somebody proved that this could already be done.
So they're they're having to react rather than being able
to keep up with the changes in the field. And
that's one of the other huge slippery slopes in the
future is um Well, a couple of things. How insurance
companies deal with this um A. Can they deny someone

(29:28):
based on a biomarker um right, now there's legislation that
has been signed into law that says no, you cannot.
It's called biological discrimination, which is profoundly insightful or foresightful
for the government. Sure, I'm really surprised by that one. Uh.
And you know what, Canada is the only G seven

(29:48):
country that doesn't have this protection biological discrimination, and it's
a big deal. There's a lot of people that are
going like, why are we the only one where Canada? Uh?
Predict Trudeau will change that. Well, there's a big push
to for UM. And it's funny when they voted in

(30:08):
the what was the act called uh them Genetic Information
Non Discrimination Act of two right um. It passed by
a vote of to nothing in the Senate and four
fourteen to one in the House. Who is the one?
It was Ron Paul of all people. Huh. I'd be

(30:32):
interested to know what his his thinking was. I've got
it because I was I thought the same thing. Here's
his thinking, because it doesn't make sense that he's because
he's pretty obsessed with the government staying out of your bills.
He said, uniform federal mandates are a clumsy and ineffective
way to deal with problems such as employers, and one
of the rubs is either you'll be denied insurance or
maybe you won't get hired for a job or promoted

(30:53):
if they know that you might, you know, keep the
buckets soon. That guy can't push a broom. He's got
a defect on his G four eight gene. But it
says right here in his experience, and he can push
your broom genetics. He said, uniform federal mandates are clumsy
and ineffective way to deal with problems such as employers
making hiring decisions on the basis of the potential employees

(31:13):
genetic profile. Imposing federal mandates on private businesses merely raises
the cost of doing business and thus reduces the overall
employment opportunities for all citizens. Huh. Yeah, I see what
he's saying, but I don't know. It's kind of surprised.
It seems like something you'd want to protect, um, but
it passed by the widest of margins regardless. Yeah, that

(31:34):
might be a record. No, I'm sure there's been unanimals
one of the I would like to know what those were,
you know, like honoring girl Scouts on Patriot Day or something. Now,
there was one person's like no, No, that was Bernie Sanders.
I choked on a on a tagalong once, never buying
them again. Um, there's another obstacle, Chuck, and it is

(31:55):
gathering the information, like yeah, to get this understanding of
you know, what kind of genes lead to certain kinds
of diseases so that we can treat people in an
individual basis when we stumble across that same genome and
a person later, you have to under you have to
have a big database of genes. So where do you

(32:15):
get it? Twenty three and me, that's apparently where you
go get it. It sounds like forever twenty one, like
a mall store and me. Uh yeah. They are a
company now and the leading company I think for the
personal genome test market, and how they're making their money
now is not by selling these test kits which is

(32:36):
ninety nine bucks, which supposedly they were selling at a loss, right,
so they could eventually have this database that they could
then sell to whoever, not whoever, but namely like form
of companies and people doing research. So the twenty three
and me amassed a database if I think about eight
hundred thousand people, six hundred thousand people who took the

(32:58):
twenty three and me test and paid ninety nine looks
for it, agreed to donate their DNA, their gene, their
genome research to research. Right. So twenty three and Me said,
thanks a lot, guys. Now we have six hundred thousand
individuals genomes just sitting there waiting to be analyzed. And
very recently they closed to deal with a company called
gene Tech. Gene Tech paid twenty three and Me sixty

(33:21):
million dollars just to analyze three thousand people with Parkinson's genomes.
That's why they were selling the kids at a loss, Yes,
because they knew the big payoff was in something else entirely. Yeah,
and um, they're they're from what I read in the
UM A M I T. Technology Review article. Um, the

(33:42):
twenty three and me. You shouldn't paint them, And I
don't mean to paint them as nefarious or anything like that.
But there's a guy named um Charles Seife who writes
for Scientific American. In two thousand thirteen, he called the
idea of a private company amassing a private database of
human genomes yeah terrifying. Yeah, I mean it definitely is

(34:03):
like the stuff of science fiction movies. I couldn't decide
whether or not it was bad or not. I think
what people are most concerned about is like, well, what
happens in the future, or what if it becomes just
like Facebook, where they have the rights to sell your
personal information to whoever wants. It's exactly what it is.
So Facebook data minds your behavior that you get to

(34:23):
use their application for free. Twenty three and Me analyzed
your d n A and sent you some stuff back
for bucks, and their data mining your genes. It's the
same thing as Facebook. It's just instead of behavior, they're
analyzing genes, their data mining or amassing a database of
it for sale. But right now they're saying, but yeah,

(34:43):
we're selling it to researchers who are out to make
medicines to make people better. Yeah, and that's you can't
really argue with that. It's just the potential for it.
Can you can understand how somebody could make it. It
could could be made very uncomfortable by that. Yeah. The
evil overlord, son of the current head of twenty three
and me is one will do it well. The founders.
The founder used to be married to Sergey Brynn of

(35:04):
um of Google. Yeah. I think they since split up,
but she still is the founder, and I believe the
person who's running twenty three and me hopefully she subscribes
to that Don't Be Evil thing too. Seriously, if you
want to know more about personalized medicine, we should probably
revisit this every six months, I think, Chuck. Um, you

(35:25):
can type those words into the search bar at how
stuff works dot com. You should also check out these
um awesome episodes. Your limbs torn off? Now, what can
can your grandfather's diet shorten your own life? Um? And yeah, blood,
that was a good one. And then, um, will computers
replace my doctor? If this episode floated your boat, you

(35:46):
will love this too. And I said float your boat,
which means it's time for listener mail. That means it's
almost time for Billy Joel doo wop. I'm gonna call
this Satanic Panic Movies. Hey, guys, my wife Jody and
I just listened to the episode on Satanic Panic and
we loved it and reminisced about our childhoods. We were
both children of the eighties and uh, she remembers all

(36:08):
the daytime talk shows about Satanic panic. We both had
no idea it was taken so seriously by so many people.
For me, I always assumed that stuff was just legend.
Although there was a Devil's Drive Street in my own
town growing up that kept all its ten year old
spooked into our teenage years. Uh and it was a
rite of passage when you finally got your license to
drive down that street. Mostly, I remember Satanism through movies

(36:30):
and pop culture, though given your pinchamp for cinema were
cinema tangents, we were both expecting to hear more on
that topic in this episode. Agreed. Here's my top ten
list of mainstream eighties satanic Bannock movies. Number ten, drag Net,
number nine, The Golden Child. He said this one does

(36:50):
not hold up well. I'm supposed to hear that they
didn't hold up well. Number eight Children in the Corn uh. Seven,
Witches of Eastwick, Eastwick six, Every popular horror movie in
the eighties right thirteenth Night around Elm Street elloween. I
take issue with that Man's not samar in Elm Street
by the third enth is certainly not see pans are
just creepy killer guys. Slash your boots come one. Number five,

(37:13):
The Burbs, Yeah, number four, The Evil Dead Series, No.
Number three, Indiana Jones and the Temple of Doom ritual sacrifice.
Not give him that. Yeah, I'm not satanas. I think
he's just broadened Number two, Poultergeist. No, no, not even close.
Number one. I don't think he asked which ones are

(37:33):
you gonna say? Don't belong Number one young Sherlock Holmes.
I love that movie, but I don't remember much about it.
Oh yeah, there was a whole It was very It
was more like Indiana Jones and the templeo Toom was
like a ancient egypt worshiping Victorian cult. That was cool.
I saw it like in the last year or so. Really,

(37:54):
I remember enjoying it when I was red. Where did
that guy go? No idea, I was wondering that myself. Uh.
Thanks for an amazingly delightful and consistently entertaining podcast. Guys.
We came out to your Boston show and absolutely loved it.
Happy New Year. That is from Brian Gladstein of Framing
m Massachusetts. Thanks Brian, thank you for half of that
list you send as well. We appreciate it. If you

(38:16):
want to get in touch with us, send us a
list that we may or may not trash. You can
tweet to us at s Y s K podcast. You
can join us on Facebook dot com slash stuff you
Should Know. You can send us an email to Stuff
Podcast to how stuff Works dot com and has always
joined us at our home on the web, Stuff you
Should Know dot com. For more on this and thousands

(38:39):
of other topics, is it how stuff Works dot com