Hey everyone, welcome to the PiaRitiya drive. I'm your host, Peter Atia. The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obsessions along the way. I've spent the last several years working with some of the most successful top performing individuals in the world, and this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life.
If you enjoyed this podcast, you can find more information on today's episode and other topics at piamd.com. I'm just podcast, I'll be speaking with my good friend, DA Wallach. I've known DA for maybe five years now, maybe four I can't recall, but he is truly a Renaissance man. I have been accused of being a Renaissance man on occasion, but I'm not.
DA, however, is. And if you look up Renaissance Man in the dictionary, I think you'll just see his picture with his curly hair sitting there. He is a recording artist, a songwriter, an investor, an essayist. He was discovered while on undergrad at Harvard by Pharrell, among others who signed him to a deal.
He went on to become one half of the band Chester French. They released three full-length albums, and he also has a solo album called Time Machine, which was released in 2016. We'll link to all of that stuff. All with Chester French, they toured with a number of legendary bands and artists such as Lady Gaga Weiser and perhaps my favorite of them all, Link 182.
Beyond music, however, DA is sort of in a class of his own in terms of his intellectual curiosity and his ability to assimilate information that seems so far outside of his area of expertise. In fact, some of the most interesting discussions I remember having with DA is sort of what prompted this podcast. I remember one day he came over, he was passing through San Diego on his way down from LA, came by, and we were sitting out at a park on the swings having a discussion about liquid biopsies. And I was thinking to myself, how is it that I'm sitting here with this guy, my buddy, who's a musician and a very good investor, having this discussion about liquid biopsies at a level of detail that I don't get to have with pretty much anybody else outside of people who are knee deep in this field.
And that was sort of when it clicked in my mind. I was like, you know, DA would be a great guy to have on the podcast. He's advised a number of companies, including SpaceX, Dr. Undemand, Ripple, Amulete, and of course he was an artist in residence for Spotify.
And we talked actually quite a bit about Spotify on this episode, for anyone who's kind of interested in how it came to be. The other things that we talk about, of course, is his background in music and his start. My daughter is a great drummer for a little kid, and I've always been interested in how one can continue to encourage kids to be involved in music. And we talk about some fun times that we've had when he's been over and jammed with her.
We talk a lot about cancer screening, which anybody who's kind of ever heard me talk about this stuff privately, I really think that when it comes to the major metabolic diseases, cardiovascular disease and the other atherosclerotic diseases, cancer and neurodegenerative diseases, the big tool that is really missing is these liquid biopsies. By the time cancer becomes visible on an imaging study, you can make the case you've lost the war. I don't know if that's true, but I do believe that if we can catch these things when they are not yet fully determined to be cancers, based on either looking at DNA signature or any signature, even protein signature, that we might have a shot. We also get into some really nerdy stuff that I think is very important for anybody thinking about screening such as positive predictive value, negative predictive value, sensitivity and specificity.
And we'll link to some information here that we use internally in our practice to help patients navigate that. So if you're interested in music, if you're interested in liquid biopsies, cancer prevention, general cancer screening, and just interested in listening to a really smart dude who seems to know a lot about a lot of things and can speak very articulio about them, I think you'll really enjoy this podcast. So find the show notes for this at pteratiamd.com forward slash podcast, and we'll link to a lot of the stuff that we talk about that will hopefully allow those of you who are interested to follow up and learn a little bit more. So without further delay, here's my conversation with the amazing D.A.
Walla. D.A. Peter, thanks for having me over to your lovely place. You're welcome.
You're welcome here anytime. I like how you saw that I was in the driveway before I got here and I was kind of just hanging out. Well, we have this thing called the doorbird, which is kind of the evolved version of a ring. And you, you, since you're interested in all esoteric technical things would be interested to know that this is the only web enabled cloud recording doorbell system that can hook into a electric strike, a strike being the thing that opens a gate remotely.
And so I'm able to see who rings the doorbell. And then if I want to let them impress a button from the same app that opens the gate. Remarkable technology. Yes.
Technology as allergy would say. Yes. So we have known each other. I don't even remember how we met.
I think we met through Gary Tobs. We met through Gary Tobs and I met Gary Tobs because I cold emailed him, which is how most things started my life. Yes. I cold emailed him because I became sort of obsessed with obesity and nutrition research.
This was maybe six years ago or they're about six, seven years ago. And then I had gotten coffee with Gary up in Berkeley and he thought it would be worth our meeting. And now I talk to you more than I talk to Gary. Yeah.
No, it became a, it was a love at first sight actually. And you know, one thing that's really funny, we're going to talk so much about sort of your musical career and things like that. But I will forever be grateful to that one night that you and Adam were over for dinner. This was just after my daughter, Olivia started to play the drums and you guys got up, Adams played the piano, you played the drums, Olivia then played the drums.
And it was really exciting to see, she got to see an action, what improvised music can look like. And I really think that that's part of the reason she still loves the drums. Well, that's good. I mean, part of the drums that's fun is that you don't necessarily need to know the musical material as well as other instrumentalists do in order to play along with people.
You don't need to sort of learn the song. You can kind of, as long as you can learn the beat of the song or figure it out quickly, you can play, which is as someone who doesn't necessarily love practicing something that's always drawn me to drums. And I remember her teacher when she was five and I started saying, you know, it's really really really hard because the music's really hard to read. So the only shot she'll have it starting this young is if she sort of has an intuitive feel for the music, in which case she can get by on that until she learns to actually figure out that, you know, two six e-ins is actually an eight and that kind of stuff.
Right. Well, that's a good point. And I think the best way to learn instruments or to learn music in general is kind of to start without any framework, play around and explore yourself and then learn a little theory because what you don't want to do is become imprisoned by theory. But it does answer some important questions that you'll arrive at if you allow yourself to get lost in the first place.
And so I've always said that, you know, when we have kids, my vision for piano training would be you just have to sit there for half an hour every day and you can do whatever you want. You don't have to touch the piano if you don't want. But of course, anyone sitting at a piano for 30 minutes will and you can figure out how it works. And then theory, if you have spent, you know, tens of hours messing around is like an amazing gift because it goes, oh, okay, well, that makes sense.
That's how it works. It's just like if you were trying to reinvent mathematics with no orientation. Like Ramanujan. Yes, like Ramanujan, which, you know, I'm not.
You're almost Ramanujan of music. I wish. So speaking of which, how did you get started in music? Were you always musicals a child?
Were you playing instruments when you were young? I don't think I was particularly musical. I always liked listening to music. And my dad would take me to jazz shows occasionally when I was young, which sort of infected me with an interest in jazz.
The first instrument I tried playing was the saxophone because I thought it looked cool. And I remember we rented one. This was in the middle school band. So it might have been fifth grade.
This would have been alto sax or a tenor. I don't even remember. I mean, any of that we rented, I brought it home and I tried to learn how to just make a sound with it, which is not trivial because with a read, you have to purse your lips in a particular way and all this. And I was so frustrated in the first hour of trying to play the saxophone that I gave up and became a drummer.
And then played drums throughout middle school and high school. And I had sort of bands with high school friends and that sort of thing. And then in college became a singer, which was something I'd never done. Oh, so I didn't realize that you had never sung until you got to college?
I had never sung and I met some cool guys in the dining room at my college. And then they said, do you want to try out for this band we're thinking about starting? And I said, sure. And I tried out as the drummer, but I got beaten by my friend Damien, who then became our drummer.
And as a consolation prize, they asked me if I wanted to be the singer. And I said, well, I've never sung before, but I'll try. And I've been trying ever since. So I didn't realize that.
So you went into what became Chester French as the drummer? Trying to be the drummer and then Damien, who became the drummer, later quit and became a filmmaker and is now one, like 10 Academy Awards. He did Whiplash and then he did La La Land, which I have a small cameo in. But Whiplash, if you've seen it as about a drummer and it's somewhat autobiographical about Damien.
Oh, I didn't realize. I mean, Whiplash is, there's only probably five movies I have stored on my iPad. It's just, they take up a lot of room, right? So, but the five that I have are like, if I'm on an airplane and everything goes to hell and a handbag's getting on the Wi-Fi is broken and I don't feel like doing work, and Whiplash is one of those five.
Which means it's a movie I've seen more times than I can count, but I especially like a last scene. Well, it's a high-octane movie. I mean, it's about human performance, basically. So I know why you like it.
It is unbelievable. Yeah. But I had no idea about this notion that it was not just purely fictional and that there was some autobiographical component to it. A little bit.
I mean, I don't think there was anyone as sinister in Damien's life as the teacher in the movie. And both as a drummer and now as a filmmaker is incredibly self-critical and hardworking and perfectionistic. And so I think those elements are definitely a reflection of his personality. I'm always amazed when you look back at sort of the Anil's A Rock and Roll, how many musicians didn't come into it as singer?
So for example, I remember hearing about Bob Dylan and Jimmy Hendricks and people who really never thought of it as their voice was what was going to do things. And yet we still think of them as completely iconic. Can anybody learn to sing? I don't know if anyone can learn to sing.
I mean, you need a certain amount of physical instrumentation that you just can't escape. I mean, so there's things I wish I could do with my voice that I'll never be able to do, just like I wish I could dunk a basketball. That being said, I think there's probably an enormous range of refinement that can be pursued because I started as a pretty bad singer and I think it would become an okay singer. And a lot of that, just like any physical activity, is about learning how to mentally control a part of your body to get it to do what you want it to do.
It's just controlling your vocal folds and the way that you express air is a relatively fine-tuned set of physical processes. And so the sort of detailed control that you need to physically command over your anatomy is kind of difficult to obtain. But I became a much, much better singer. I think the thing that is probably more natural that you either have or you don't have is an ability to know when you're making a noise whether it is on pitch.
And some people clearly don't have this, but I think most people have a decent sense of pitch and if they didn't, then they wouldn't be pleased by harmonious music. I mean, we have a natural ability to hear whether someone's hitting a sour note in a chord or something or whether someone's singing off tune. That bothers most of us. So if you can be bothered by that, then chances are you can hear the difference between that and the right thing.
And that's what a lot of it comes down to. When you're singing, it's very important that you hear yourself because that's the feedback loop. Yeah. So do you remember the first time you sang on stage in front of people besides your band mates?
Well, it would have been freshman year in college and we began by doing sort of weekly performances in the student commons at Harvard and the audience was 20 or 30 of our friends. And the band always had a sense of humor to the music. Although that trailed off in our final album, which was not really funny, but earlier we had always kind of been humorous at some level. And I think that masked how poor my musicianship was for a long time because we could kind of play it off as a bit of a joke band.
So sort of like bare naked ladies? Like what was it? Not that they were a joke band, but you know, they were always having fun. They were silly.
We were irreverent and somewhat subversive in the notion that what we did was meant to almost be ironic. So we would do songs about medieval knights. We would do totally absurdist music. And I think totally possible to hear it and either think that it was self-consciously funny or to think that it was totally clueless.
And so that made it easier to sort of cut the tension a little bit and break the eyes or so. You know, that it wasn't like you were scared to death getting up there. For me, like if you said to me, Peter, you have to either go and climb Mount Everest or K2 and there's like a 30% chance you're going to die or you have to sing in front of a thousand people. I'm trekking.
Like I'm going to the mountain. I'm actually singing in front of any human being. Like including people like my kids. Like there's no way I'm singing.
Yeah, I don't know why there is some sense of shame that attends singing. I mean, I know what you're saying. I don't feel it, but I know what you're saying. I wish I could.
I mean, like part of it is I think realizing that singing is just musical speaking. So we're really singing all the time when we're talking. We're just not using tonality in as deliberate a way. I mean, there's a pitch to every time you speak.
So singing is just controlling that pitch, which is actually a helpful thing that I learned from vocal coaches who when I went to go touring, I went to see literally because it became more of a sport for me. It was now something that I was going to have to do for an hour or two every day. And I didn't have a physical endurance and the muscle control to endure that without hurting myself. So I would go to some coaches to sort of get ready to tour and they would make this point that singing is just musical speaking.
And it really changed the way I thought about singing and made it quite a bit easier. So let's talk to the transition. So you guys start this. Tell me about the name Chester French.
Where did it come from? Chester French was the name of a sculptor Daniel Chester French who did the Lincoln Memorial and then he also did the John Harvard statue which is in the center of Harvard's main quad. And we didn't know that when we chose the name, but we had a dining hall there that all freshman eight and that sort of looks like the Hogwarts dining hall in Harry Potter, big wood paneled room with soaring ceilings and busts all around the walls. So we were going into lunch and we saw one of these busts and it had a little plaque under it that was we thought the name of the person who had been sculpted.
And so he said, Chester French, that's kind of a cool name. And we picked it then and there. And then we later of course learned that that was the sculptor of not only that bust but also these other great American sculptures. So when did you guys start to get some traction?
And I mean, because most college bands don't end up going on tours. So what was that transition like? We basically got no traction doing what we initially set out to do which was to build a live performance following. So the conventional wisdom if you started a band on the East Coast in college, which a lot of people did actually, they were musicians, was start playing on your campus, start playing at surrounding campus parties and sorority keggers and whatever and then ultimately get a van and start driving around the East Coast and going to other colleges and you can build a following among college students.
And we tried to do this but we just totally ate shit. I mean, we could barely get people to come to our shows on campus. And then I remember booked a gig at a club called Great Scott in Boston, which was kind of the Harper's Ferry was the specific one that I'm thinking of here. Great Scott was another club.
We booked a show at this Harper's Ferry and we both tried to recruit our friends from campus to make a 10 minute journey to this club. I think three of them came. And then we also for the three nights prior to the show went and stood on the street in front of the club, figuring that people who lived in the area probably walked by the club or people who went to the club might come and see multiple shows, handing out flyers trying to promote ourselves. And when we got there to do the gig on a Thursday night or something, I think there was an audience of like five or seven people.
And that's particularly depressing when you've spent two and a half hours setting up and sound checking and hauling all your gear. So anyways, that strategy failed. I'm not sure why. Maybe we just weren't good live or something.
But we took a turn at the end of sophomore year in strategy and our focus became just making recordings and the thought was ultimately the product is a recorded music product. That's what we're really making. We're songwriters and producers. And so our focus shifted to essentially just living in the recording studio, making stuff.
And the idea became let's try and make an album that we think is a great complete representation of our musical ideas. And if we do that and it's really good, it will speak for itself. And no one in the record industry will care whether we have this big live following or not. Luckily, that turned out to work.
I mean, it was not certain by any means, but we made this record over the subsequent two and a half years. And then in the middle of senior year started sending out that album to as many people as we could send it out to. And ultimately, it got to Kanye West who gave us our big break and flew us out to Los Angeles and offered us a record deal. And then that spurred a number of other people attempting to sign us to record deals.
We ultimately chose to work with Pharrell and did a deal with him and a guy named Jimmy Iaveen who ran Interscope Records. And as soon as we graduated, we moved out to LA and that became our career. I mean, just put that in context for a moment. That strikes me as like a fairy tale, right?
I mean, what's the probability that Kanye West, I mean, how many times is he getting something pitched and having to pick a neat lot of a haystack? Is that how that works? I think it was a little atypical that other artists supported us. And now that I'm sort of not doing music full time in retrospect, when I look at the band's career, it's kind of clear to me that we were an artist's artist.
In other words, our fans tended to be people who were quite musical, whether they were famous musicians or whether they were just random people who played guitar at home. But we were making a style of music that I think spoke to musicians specifically. Part of that was the result of trying to make music that we wanted to listen to. And so we were our own customer in a kind of weird way.
So it certainly wasn't typical that other artists would be the ones to jump start our career. On the other hand, it was at a time when the music industry was changing. And so all of the paradigms by which artists got discovered were being destabilized. There used to be these armies of A&R people who worked at record companies and they went to concerts and scouted.
And what was changing when we came on to the scene was that the internet was becoming the primary distribution channel for music and also the primary place where people discovered new artists. This is what like 2003, 2007. Okay. And so, you know, Facebook was a couple years old.
MySpace was kind of at its height. And we were one of the first artists to primarily build our audience online. So that was unique. And was Facebook a better channel for that than, say, having your own site that you're hosting?
Like, how were you? Facebook was and remains a bad channel for that. But MySpace was an amazing channel for that. And MySpace had all of these features that allowed culture to kind of virally permeate civilizations.
So tell me what MySpace did better than Facebook with respect to that or what are they enabled? Well, there were, let's say, two or three distinctive things about it. The first was that it essentially was a place where spam was totally legal and standardized. And so it was kind of like MySpace felt almost like Times Square in the 80s or something.
You know, it was like a little unsavory. There were all these weird people on there. People had avatars. So you didn't know if it was really them or not.
Identity had not been formalized in the way that Facebook ultimately made it. So on the one hand, you could spam people. So for us, we could go on there and just randomly send our music to random people who we thought might like it. That was highly useful.
The second thing was that they had this thing, Top 8. So on everyone's MySpace page, you could pick your Top 8 friends. And that became kind of like a prize to be one of the Top 8 of a famous person or one of the Top 8 of a famous band or something. And so you could kind of go on MySpace and try and find artists who you thought would share an audience or whose audience you wanted to steal essentially.
It's not stealing because it's not a zero-something. People can like a lot of artists. But we would identify these artists who we wanted to steal the fans of and then we'd try and get our music to them to get in their Top 8 because then tons of people would discover you. And then the third thing was that MySpace allowed each user an incredible amount of freedom in designing their page.
So you could go in and change the HTML or the CSS on your MySpace page. And this from a user experience standpoint made it a very difficult place to navigate. But I think what it brought out was that everybody when you give them a creative canvas likes to paint on it. And what you saw was that ordinary people who were just MySpace users, consumers of content, themselves would really wear their identity on their page.
And so you could kind of navigate this universe of MySpace and understand the cultural orientation of every person on it. And it made it really easy to figure out who were your people. I mean, if you were like a goth band or something or a metal band, it was very clear who the metal people were. And so for us, we could really take advantage of this and kind of hack the system to find our people quickly.
I don't want to go too down the rabbit hole in this, but it's so interesting because I haven't thought about MySpace in probably 10 years or something like that. When the history book's written and it can probably be written now, I'm assuming, why did Facebook win MySpace lose at the risk of oversimplifying things? I think there are a few reasons I perceive and there are probably many I have no idea about like what you just strike me as having a better sense than the average person based on a pretty robust understanding of how both of them worked. MySpace was even if they maybe thought they were being scientific, it was not a sort of science project.
In other words, the people building it were in LA. They were kind of more inclined to understanding culture and thinking about personal freedom and expression. Whereas what Facebook was built around was the idea that if you created an accurate map of people's real world relationships, then the behaviors that they exhibit in the real world would end up mirrored in this digital environment. Social values like trust were going to be essential in the Facebook universe.
Whereas in MySpace, like I said, it was a time square in the 80s. It was like there were CD people on there. You didn't know if people were who they said they were. It was a fake place.
The early internet was much more like that. Everyone was in chat rooms with aliases and stuff. You never really knew who was who. Facebook became a digital version of the real world.
It was more valuable from the outset because things that you only previously could do in reality, like talk to someone or share with them photos or something, became something that you could do in a highly managed way through Facebook. That's really interesting. I would have assumed just as a guy who knows nothing that Facebook won because they figured out how to monetize this stuff better than MySpace. It sounds like there's much more cultural, emotional, philosophical differences that may have decided which direction was going to have greater mass appeal.
I think that's right. You see this resuscitated in the rise of Snapchat because Snapchat is also back to that LA mindset. It's much more expressive and irreverent and culturally contextualized. It's got a lot of character and personality.
It's logo is a funny ghost drawing and this sort of thing. I wouldn't give up yet on the idea that the future of the internet may allow people to be much more expressive than you see them being on Facebook. Facebook is a little totalitarian, not necessarily in a bad way. That's a word that is pretty much loaded.
I'm looking for an aniseptic or anodyne or I don't know what the right word is, but it doesn't have a lot of flavor. It's a reflection of the engineering mindset behind it, which itself is really ingenious, but it as a digital place lacks culture. Mark Zuckerberg, who I think very highly of and who's a friend, is a genius business person and technologist, but he's never, I don't think, been a specially interested in culture. When he talks about Facebook being a community and a global community, I think, I think he is potentially always, I don't want to put words in his mouth, but I think he's maybe always thought that Facebook shouldn't have too much of a culture that it imposes.
It should basically be a blank canvas for all of the diversity that is in the world. When you allow people to express themselves more, it's unclear whether what you're doing is loading a place with some cultural precepts of your own, even by the way that you design what those expressive tools are, or if you're actually giving people more freedom. I think Facebook has always taken the approach of limiting people's expressive capacity, forcing them to make comments or post things in these very structured, linear formats, where some of these other tools have been a lot more liberal in the attitude that they take to personal expression. When you went to college, what, what, I mean what you studied?
I did African American studies, and I have a minor in Kikuyu, which is a Kenyan language that I no longer speak. Were you thinking about going to grad school after? I mean, were you just pursuing your bliss? What were you thinking you would end up doing before you ended up in LA, of course?
I wasn't thinking much about it at all. I mean, I think I'd been very interested in public policy, and so politics interested me, and I think academia may be interested in me. The arts certainly did, and I think halfway through my freshman year, I decided that the goal I wanted to shoot for was becoming a musician. But part of that was a response to finding when I got to college that Harvard was essentially vocational school for investment banking and management consulting.
I never, I didn't know that those were jobs in the world. I'd never heard of either of those professions. And when it became clear to me that 40 or 50% of my classmates would end up in those jobs, I was kind of horrified. And I thought, oh my gosh, is that the adult life that awaits me?
And maybe as a bit of a rebellion against that, I went full bore into I want to be a musician. That is hilarious. The vocational school for investment banking and management consulting. I didn't realize it was a high school.
I don't know. But whatever, even a third of people end up as investment bankers and management consultants, that's pretty interesting. I don't think anything wrong. I mean, I know you were a management consultant at one point, but there was a sense in which I felt that my college and elite universities in general, I've mentioned it in the university, I've mentioned it a couple times, but I'm not someone who's a big booster.
I'm not involved in alumni stuff. I don't take a lot of pride particularly in having gone to Harvard or anything. And part of why is because I'm very suspicious of these institutions, both because they essentially serve a function in the society of reproducing inequality and social hierarchy. And they've been doing that for hundreds of years.
And second, because they homogenize all of these talented young people. So they do an extraordinarily good job of finding interesting, unique people in high school and then turning them into boring, high achieving technocrats. And that's kind of a tragedy for the world. Because it's a waste of the formidable resources that those universities do have that what they choose to do with it is essentially pump out functionaries in the financial services.
But somewhere along the way, you learned to think, and is it safe to then assume that you learned that before college and that college, if anything, didn't diminish that ability rather than augmented it? I'll tell you where I'm going with this. And we're going to talk a lot about biology and our mutual interest in hacking and lifespan and all that sort of stuff. But I remember after even the first day we met, maybe it was like after our second meeting or some time, I remember thinking, how does this guy know so much about this stuff?
You had more than just a superficial understanding of stuff that suggested you'd read a couple of things about it, which obviously just suggested to me that you learned how to learn. And as a result of that, when you decided, hey, I really want to understand this area and I want to understand the science of this stuff, you at least had a toolkit that you could use to do that. Where do you think you got that? I think I've maybe just always been curious.
And that is a personality trait or disposition. Just wanting to understand things has always driven me to some degree. When I went to college, I was interested in race and the history of race in America and how this set of ideas about who we are influences what the world is and who we become as people. And I was essentially interested primarily in these very complicated phenomena in the social world.
So I wanted to, I remember the first time I read Marx and whatever, it was so engaging to discover a set of these totalizing ideas about how history works or something, whether I agree with them or not it's a separate issue. But the idea that one could theoretically describe reality was always compelling to me. And what has happened intellectually, as I've gotten older, is that I've realized that science is essentially the best methodology that we have for describing reality. And I've realized that I think the things that most interested me, social phenomena, government, public policy, history are very difficult to address with the science currently at our disposal.
So ultimately, I believe we will be able to have an empirical understanding of some of these sorts of things. But I was going after them back then, naively thinking that we already had those tools at our disposal or that I could by reading a lot about history develop a accurate picture of how it works. And one, learning how to think is about understanding the limitations of our own biology or our own cognition. But then it's also about figuring out what's knowable and how you can understand things and what processes you can use to understand things.
And so when I encounter a subject, I'm instantly tracking on what's the theoretical framework behind it. The details don't really interest me. It's what's the skeleton behind it? What's the structure of it?
And for that reason, I don't think I've never been good at facts. I'm not good at dates. I'm not good at memorizing names of biomolecules. But what sticks in my brain are these kind of theoretical constructs.
Yeah, somebody asked me on Twitter a while ago and I decided it would be a good question for an AMA at some point, which was if you could change something about the medical school curriculum, what would it be? And I wouldn't describe it probably as eloquently as you. But it's basically, I remember the first day of medical school, they said, the average college graduate has a vocabulary of X words. And I don't actually remember what X is, but I feel like it was about 10,000 or something like that.
And they said, in the next two years, which is before you go into the clinical stuff, you're going to learn. So if it was 10,000 with the college grad, they said, like, you'll learn 12,000 new words. And obviously you do need to learn a new vocabulary in medicine. But when I look back at medical school, rather, I think the biggest deficit was no attention paid deliberately towards how do you think?
And that, of course, becomes relevant because, you know, all facts have a half life. And some facts like anatomical facts have very long half lives. So in an area like that, it's probably reasonable to know stuff. But in other things, like the time you're done medical school, the information is wrong or irrelevant.
And yet nothing's really put in place to teach that skill of how do you go about you're now out there in the real world, you're taking care of patients and yet maybe what you learned about cholesterol or maybe what you learned about subject XYZ is kind of not right, or at least should be revisited or the probability of it being correct is lower. So do you and Liz think you'll have kids? Yeah. And so how do you now I'm asking this as a curious parent, but how do you think about creating an environment to produce that type of curiosity and that skill set?
What do you think a parent can do deliberately? I'm asking this based on you having been the kid, not the parent so far. Well, you certainly have more experience with this because you've got kids. What I've heard people say and what I sense may be real is that you actually don't need to teach kids this.
They're born with a lot of it and what the world tends to do is squeeze it out of them. And so I guess I would invert the question and frame it as how do you not kill a child's curiosity and how do you feed it? Certainly one of the things I think my parents did was not sanction in a negative way asking questions or asking why questions. And by contrast, you can inculcate a child in religious ideologies or strictures about how to live that are so imprisoning that becomes a fundamental part of their brain.
And so I think just not making those mistakes is probably the most important thing. I like the example you gave earlier of your piano lesson is 30 minutes of sitting in front of a piano for some period of time. Before you start to read sheet music and start doing drills and things like that, I like that idea. Absolutely.
I mean, look, there's a balance between the sort of wrote discipline that is required in anything and then the creative and exploratory potential within that area. In my mind, I tend to wait the latter. And so what's difficult for me is the brutal, repetitive skill building. And I've had to figure out ways in life of not making my success depend on that aptitude and figure that's stuff that I look to other people to help me with.
My band as an example, my partner Max is, I mean, he's good at everything. He's a musically brilliant person at a compositional level too. And he can write great music and he's very theoretical. But he also has that OCD capacity to sit there and practice guitar for 10 hours.
And that's really fun. That's his happy place. I go crazy doing that. And so I think to come back to your question about children, I think the struggle for me will be figuring out how to impart to them a greater capacity to do the part that I don't like doing because if you can really have both, that's the superpower.
But it sounds like to me at least maybe part of the secret is knowing how much emphasis to put on each of those two. Again, they're not mutually exclusive, but you understand that this is a kid that if pushed too hard on the wrote stuff will actually dampen the creativity versus sounds like in Max's case, that's not the case. He can live in both of those worlds and be quite successful. I think that's right.
One metaphor I used to think about this because a debate that comes up in all contemporary art, be it painting or writing or music, is essentially whether amateur work can be just as valid as quote unquote professional work. So if you think about punk rock, the whole idea is screw learning these instruments, I'm just going to pick up the guitar and express myself. And so of course, there's a level of vitality that can be produced through that type of artwork. Both the absence of formal rules gives birth to a lot of expressive freedom.
And you can get a kind of visceral version of someone, but there are only so many ways to smash a guitar on stage. And so if a hundred and none of them are as good as Jimmy Hendrix at Monterey, and Jimmy Hendrix can, he can still smash a guitar on stage, but he can also do a thousand other things that the Ramones can't do. And so the metaphor that I've been thinking of lately is almost like granularity or resolution. So if you imagine a photograph of something in low resolution versus high resolution, it's the same thing that's being expressed, but the greater the resolution, the more detailed there is.
And when someone is making music or singing or writing a poem or doing anything, what you're essentially, they're communicating. And what you're getting is you're getting sort of a photo of their brain. And the more technical skill they have in this metaphor, the greater the resolution of that picture they can produce. And so I once remember being in the studio with Pharrell and Herbie Hancock came by.
And Pharrell is a kind of folk musician. I mean, he's incredibly successful and he's very, very talented, but he's not a trained, he didn't go to music conservatory. He can't play you a boxanada. He can write amazing stuff.
He's a theoretical musician, right? He's a great songwriter and he's got great taste. And Herbie Hancock came and he was showing us a bunch of piano exercises that he and his friends used to do in Chicago in the 60s. And Pharrell kind of expressed that he was scared to learn that stuff because he was worried it would eat into his roughness or his authentic expression.
And I remember Herbie Hancock saying, it's just going to give you more colors to paint with. It doesn't cost you anything. There's more things that you can say with those ideas you've got. And I thought that was a great argument.
I think it was convincing to Pharrell too. When you were in high school, who do you in retrospect look back at and say, yeah, those were really, those musicians shaped my, either my taste or my philosophy or my way of writing or performing like who, just broadly speaking, who were your influences in that regard? They're a little bit mundane, but they're sort of the obvious suspects, the Beatles, Bob Marley, Curtis Mayfield. Those are the big ones.
Stevie Wonder, maybe those four. Motown, all the Holland Doge or Holland were the three great songwriters. You did a lot of the Motown stuff, a lot of the four top songs, a lot of the temptation songs. See James Brown?
Yeah, I like James Brown. But I would put, I'm more of a songwriter. And James Brown, I think, is most important as both a performer and as a groove guy. So different music is good at different things.
And there's a tradition in black American music that I think ultimately begins in Africa and in the African diaspora of music that is not really linear. It's not about a narrative story being told through something like a song. It's much more about setting a musical mood and almost being a place that you hang out. Indian music is also like this.
If you think about Indian Raga's, for example, it's sort of a tonal place. And the piece of music, maybe half an hour long, maybe two hours long, but you kind of go there and you're just hanging out there in that vibe. Whereas the sort of music that influenced me much more that I've sort of working in is more about, again, it's kind of more theoretical. It's more about a story.
It's a linear story. It's a three minute song. There's a beginning and middle and end. It has some conventions about the way that it moves through those places.
And people I cited I think are emblematic of that style. Now you're a drummer. So what drummer would you have identified with most? I'm starting now going to double back on what I just said because the key function of the drums is most highly expressed in those types of music that are essentially groove musics.
So Clyde Stubblefield, who played with James Brown, is one of my favorite drummers of all time. That style of music that James Brown made is all about the drummer. Give the drummer some. And other people who are giants of that format are Bernard Purdy, who's just, he's still around.
He's incredible. I think he claims he's the most recorded drummer of all time or maybe played on the most hits of any drummer of all time. And then there are great rock drummers like Keith Moon or John Bonham. In jazz, the drums are much more of an instrument.
You can sing through the drums in jazz music because the drummer is not just hitting hard and fast and loud. The drummer has an incredible dynamic range of tonalities and expressive options. So in jazz drumming, you know, Elvin Jones is probably my favorite. He played a lot with John Coltrane, but there are an almost unlimited number of incredible jazz drummers who I look up to.
I think in the show notes for this podcast, we should link to some performances that you find particularly notable. That'd be cool. I remember once you gave me a nice list of stuff for Olivia, which was like, here's some great Michael Jackson songs, here's some great James Brown songs, here's some great movement. This is a great way for a kid to start thinking about music.
And I thought that's a, it's such a helpful thing to provide. So, okay, let's go back to LA. So you get the LA, you're living the dream, right? Like it's, you hit a home run here.
It's hard to imagine given what the denominator is on the number of people they're trying to accomplish what you guys have accomplished. And are you primarily now still a studio band or are you once you've got this break, are you becoming kind of more performance based as well? Well, by that time, the band was just me and my bandmate Max. So it was a duo, really.
And we, as we made music, were a studio thing still, but we quickly realized you were playing what? So you were doing vocals, you were doing drums and were you keyboard as well? You know, I was primarily writing the songs with Max and singing them. And Max in the band was the primary instrumentalist.
He can play pretty much everything and he can learn new instruments in a week. So Max on the recordings was playing almost all the instruments occasionally. We'd have studio musicians come in and do stuff that he couldn't do. You know, if we needed a viola player or something.
But my function of the band was largely to write the songs with him. I was writing all the lyrics. I was typically writing the vocal melodies of the songs and then singing them. So how did Spotify come into the picture?
Was that true, true and unrelated? Was that just a did Sean start that or how did that? No, so let's fast forward a few years. So we basically, because there's not a lot, I think that is super interesting about this period in my life, although you may disagree.
I don't know a period of your life. Well, it's not interesting. So it's 2007, we get a record deal, we move out here and then we spent three years making records and touring. And a lot of stuff happened.
And you're doing it at one point, right? We toured with all sorts of people. Lady Gaga, Blink 182, Weezer, huge number, really cool artists. And then I concluded that I didn't like touring.
And it was around that time that I discovered Spotify. I think at the time I already had an interest in investing, but I didn't really know which direction to go. I had met Ashton Kutcher, who became a really good friend. And he and I got along, I think right away because we were both from the Midwest.
We were both artists and we both had an interest in business and technology. But he was a decade ahead of me in terms of being a famous entertainer. And he was three or four years ahead of me in terms of thinking that Silicon Valley venture capital could be an interesting canvas for his artwork. And so he gave me a little bit of a template for an artist who was going to get into the technology business.
And the question became for me, you know, how do I go from being a musician who neither has capital nor investing experience and become a professional investor? And Spotify ended up being in retrospect of the pivot that allowed me to do that. You know, historically, the music industry has not birthed many good businesses. And so it was a pretty happy accident that right at this time that I wanted to make this transition, this company that would become now a $28 billion public market behemoth was starting to become ubiquitous in Sweden.
And I had friends who knew about it. And when they told me about it, the appeal of that product, this idea that you could install a thing on your computer and have all of the world's songs ever at your instant recall was an incredibly cool thing to me. And I was just thinking of it as the customer, basically, you know, I was someone who collected tons of music, had hard drives full of it, was always struggling to manage the data. You know, I get a new computer and I have to copy all the songs and I have to put them in folders.
And it was such a pain in the ass that when someone showed me this, I thought, whoa, this is what I've always wanted. And was Pandora on the scene at that time? Pandora was really popular. And it was just streaming.
Pandora was streaming, but it was streaming algorithmic radio. Right. In other words, you couldn't choose the song. What was so cool about Spotify was that it recreated the experience of having bought every song ever.
You had MP3s that you buy through the iTunes store, for example, maybe on your computer, but maybe you'd bought 200 of them. That was your library of music. Whereas when I first saw Spotify, I thought, wow, for $10 a month, it's as if I bought everything ever. I mean, that was such a shocking value proposition to me that I thought this is almost certainly what everyone should have if the powers that be allow it.
And the business question, which was much more difficult than the product design question was, can this company get everyone who owns music to be a part of delivering this experience to the consumer? And so was the hardest sell with the artists or with the studios? Everything was a hard sell. Spotify was, I'm not going to take much credit for it because there were thousands of people working on this from the beginning almost, but everything about building that business was difficult.
The first thing that was difficult was that record companies and music publishing companies own the rights to the music. And they had seen their business destroyed in the 90s. The record industry went to a quarter of its former size in the 90s because of piracy. And so you'll remember the record labels were suing.
Is that because CDs had become so ubiquitous that it was easier to copy a CD than say a vinyl or a cassette? I mean, not that it's not hard to copy cassette, but the quality is not as good. What was coincidental with CD rhymes? So two things happened.
One, sites like Napster arose that allowed people to trade music freely without paying for it. And then what they did with that music after they traded it on the internet, which was so difficult to control or put a lid on was then they would burn CDs and copy the CDs and whatever. So not only did the format of CDs get unlocked with the ability to write CDs, I mean, you remember getting your first CDR. That was really cool.
But also you had this unfettered digital environment in which people could share music without anyone getting paid for it. What preceded this in the 80s and 90s, really in the 90s, was the CD revolution. And so not only was piracy painful in its own right, it succeeded a decade during which the music companies resold the entire history of music in a 10 year period. In other words, they not only sold in the 90s on CDs, the new music that was being made in the 80s, but everything that had been made today.
So they sold you an entire library of the world's history of music in a 10 year period. They were rolling in cash. And when they made new music, they would sign an artist, they'd make one hit song that they play on the radio. And then you had to go buy an 1899 album with 14 other songs you didn't want just to get the one you liked.
So they were raking in the cash by completely controlling the consumer's experience. Piracy blew the lid off that and the consumers rebelled and everyone stopped paying for music. And so the industry that Spotify came into was one that had been eviscerated by piracy. And then to add insult to injury, the legal paid download model that Steve Jobs pioneered with iTunes unilaterally recaptured the distribution system of what before then had been fragmented.
So the record labels used to in the good old days of the 90s, both control the radio station so they could make things get popular. But then they had a variety of physical retailers, Sam Goody, Virgin Megastore, all these different CD retailers that they could play off each other. They had all the leverage. They could make the thing big and then they could tell you at the record store that you had to give them this promotion or else your artist wasn't going to show up there and do a CD signing.
Well, when Steve Jobs invented the iTunes store, he became the only retailer that mattered. And so the record labels had this one to punch they've been subjected to of the industry disappearing and going to a quarter of its size. And then this one guy who didn't need them, Steve Jobs, who made all his money selling hardware, gaining total unilateral control over them because he became the only place they could sell music. And so they were desperate never to let either of these sorts of things happen to them again.
They were incredibly paranoid about a new model that they viewed as threatening the paid download business. So Spotify was showing up telling consumers for 10 bucks a month, you get all the music ever. The labels at that point were still embedded in a model where what you did was you sold people downloads for a dollar a piece. They were used to selling you 10 songs a month for $10.
And Spotify came along and said, let's give them 22 million songs for $10. So selling the record labels was incredibly difficult. And then the artists were ardently against this as well because for them, their lifeblood was selling downloads. They too were in an environment that was severely nutrition restricted from the past decade.
And they were struggling to make money. Most of them were only making money touring and recovering a little bit of income, selling their recordings. Spotify came along and what we said was, we're going to fix this problem. We're going to convince most people in the world that they should pay for music.
And the way we're going to do it is we're going to give them an experience that is every bit as good as the free illegal experience. And we're going to get them hooked on it and then we're going to charge them 10 bucks a month. And if we can get a huge percentage of them paying 10 bucks a month, that is far more than the average consumer at that time was currently spending on music. I still don't understand the economics of Spotify.
So if you're spending that time and by the way, I couldn't just sign up for 10 bucks a month today. Could I? Aren't those two? Ten bucks a month.
I thought that was like a student deal or some. You can sign up for $3 a month for the first three months today and then it'll go to $10 a month. I'm ashamed to say I still don't use Spotify. I still wed to iTunes.
You got to get on it. And I don't know if it's just like the hurdle rate of switching out of iTunes. But it strikes me as ridiculous because I pay a buck 29 per song. I probably buy an average of 10 to 20 songs a month.
So I'm obviously spending more money than I would. But let's just talk about the remuneration for the artists. So when I spend a buck 29 on iTunes, where does the rent go? 30% goes to Apple.
70% goes to the record label. The record label pays out roughly 10% of their 70%. So 7% to the music publisher, which owns the song note that the song, which is called publishing is different from the recording of the song. So if you and I write Happy Birthday and people sing it all over the world, we own the song no matter who's singing it.
But if Tony Braxton records a version of Happy Birthday, she owns the recording. The song owner gets about 10% of the 70% and the artist will typically get somewhere between 15% and 20% of what's left after their 15 or 20% cut has fully paid back the record label for all the money that label has spent promoting them. So Apple's getting a straight 30. That's pretty straightforward of the 70.
The label is getting the majority of it. The label is getting the majority of it. And the artist is getting anywhere from zero to maybe 10%. 50% something like that.
Now, that sounds grossly unfair. What makes it less obviously unfair is that the record label is the one taking all of the financial risk in financing the music and very often paying for the artist's life. So in this economy, they are still the only companies that take a financial risk making original artwork and they certainly deserve to be paid for taking that risk. So how does it work at Spotify?
So now you paid your 10 bucks a month. How is that rent spread out? Sure. So what happens is you listen to music all month at the end of the month, Spotify looks at the amount of time that you spent listening to each of those songs and your $10 gets split.
Pro-rata to the originators of that music in roughly the same distribution as the 70% out of iTunes got split. Yes. How much does Spotify get to keep up the 10 bucks? OK, so Spotify keeps 30 and the other 70 goes the same way, but now it's pro-rata.
Yeah, that's correct. And so for a consumer like you who maybe before Spotify was spending more than $10 a month, it results in less financial benefit than it might have before. On the other hand, it depends how much you listen to those songs. So if on Spotify, you know, if you buy the song on iTunes and you listen to it one time, you're paying $1.29 for one listen.
But a lot of people when they fall in love with a song, listen to it thousands of times and they listen to it for years. And if you take $1.29 and split it among thousands, effectively they're paying very little each listen. So the paradigm shift is towards a pay for listen model. It's a consumption based payment.
Now back before any of this stuff came along, if you had a radio station and you played a song, not satellite radio, just right FM radio, for example. Did you have to pay a royalty for that? The radio station had an agreement with an organization called Performing Rights Society. These are societies that manage a particular type of write in music.
So if you and I write a song, we and record it, we've just generated a whole basket of different types of legal rights, all of which we begin by owning. And then we can sell those rights off to different third parties that will help us collect the income that attaches to the exploitation of those rights. In the case of songs that get played on the radio or performed at a basketball game or these sorts of things, that right is called a public performance right. And the radio stations do deals with these rights societies in the US.
The two most prominent ones are called Ascap and BMI. And those organizations are responsible for monetizing that right on behalf of artists. So the radio station at the end of the year will give us half a million dollars and then as cap will do something like Spotify does, which is tabulate what that million dollars corresponded to and they'll pay out the royalties to artists pro rat in accordance with that. And Sean Parker was involved with Spotify and with Napster, right?
That's right. He had kind of a this was this was the evolution of what he and Sean and done. It was they had intended Napster to become a legal service and what they wanted, you know, 20 years ago was to go do deals with the record labels to legalize it, but the industry was so defensive towards them and so aggressive that it couldn't happen. It took 20 years and it took the industry being decimated for everybody to be desperate enough that they were willing to entertain solutions to the internet.
And that's what Spotify was. You know, it's interesting when you look at all of the businesses that have been disrupted by the internet and contrast it with those that have not, right? So you've just given us a very eloquent description of how the music industry was disrupted, but you also pointed out something interesting, which is it wasn't just the internet that disrupted. It was the desperation that followed the decimation that permitted the restructuring.
Of course, then you can write off all the glib and obvious examples, right? What Amazon has done to retail, what Netflix has done to, you know, blockbuster and stores on the side of the street, what Uber has done to taxis, what, you know, all of the travel sites have done to travel agents. I mean, it's been incredibly disruptive. And yet when I think about medicine, it's like one of the least disrupted industries by technology and you know, you basically still have hospitals, eat all the rent, payers, although most people generally perceive them as bad guys generally don't get paid that much.
Providers get less and less on a per encounter basis. And it's, you know, overall a pretty much similar system to what it was 20 years ago. And that's, I don't know, I mean, I have to think about it, but I can't think of too many industries that are unchanged in the presence of this revolution as healthcare. No, I think you're right.
The appeal of investing in healthcare is exactly what you just expressed. And that's what drew me into it several years ago. And what I've learned since then has been slightly disillusioned in, but I'll give you my take on it. The first thing I would say is that healthcare is still an industry that largely gets paid through labor.
So most of the money ultimately goes to labor, goes to doctors, it goes to the healthcare personnel. The hospitals don't make that much money. They're not that great a business. You know, if you look at Kaiser, for example, which is an integrated payer provider, you know, in California, I think they have a 3 or 4% gross margin.
It's not a phenomenal business. The payers to your point have very low margins. They in fact have legally imposed limits on the amount of gross margin that they can generate, which, you know, you can argue about the ethics. The pharmaceutical companies, who everyone hates, seemingly extract enormous profits.
On the other hand, it's a very competitive industry. And apart from the legalized monopoly given to them via patents on new drugs, they are the only companies, sort of as I said about record labels. They're the only ones who are out here designing new solutions. And taking an enormous risk.
And taking an enormous risk. And their shareholders are taking that risk. Now, whether they're being overpaid or underpaid to take that risk is totally debatable. The other thing is that it's unclear where technology can deliver dividends in terms of human health.
And so we're thinking about medicine at a moment in which we as a species have already made enormous progress. I mean, whatever, we've doubled or tripled lifespan. And, you know, these numbers better than I do. But even if you get rid of the infant mortality factor and these other things that distort the numbers, people are living quite a bit longer on average than they were even seemingly 30 years ago.
And that's especially true of affluent societies until they get afflicted by the diseases of affluence. So where can we get more life from or where can we reduce suffering and disease by way of technology is a little unclear. There are all sorts of things that we could of course do to make hospitals more efficient and to spend less than we do on things like end of life care that maybe aren't a good use of capital. But there's not so obviously a Spotify of health care waiting to happen.
It's more like there are a million little IT operating efficiencies that McKinsey consultants will over the next several decades implement in large health organizations. And then the big promise is around new types of medicine that I think will arise in the biotechnology industry. And that's where I'm now spending a lot of my time and attention. Yeah, it's sort of interesting because I think one of the challenges of health care and I think this was most evident during the debates many years ago, not many, but what I call it, ten years ago around the ACA and around revisiting a restructuring of health care.
And one of the things I found a little painful in listening to politicians talk about health care was they spoke about it like there was just one problem to be solved. But the way I sort of think about it is there are at least three completely separate but highly related problems, which is quality of care. And that can be broken down into two levels. You can sort of have it as just keeping people from dying versus generating alpha.
So really improving quality. There's cost, which is just a cost to the system. And about 90% of the dollars are basically spent by three entities, the government, the employer, and the payer, depending on who's at risk. The consumer is on the hook for about 10% of that cost.
So how could you reduce the cost? And then the third leg of that stool is access. How do you ensure access? And so when we talk about technology disrupting health care, it's like where do you start, right?
Because for me, I can see things where technology can be quite helpful on quality of care. Not entirely obvious to me how to leverage technology at lower cost. People much smarter than me, I'm sure think about that. And not entirely clear, at least at a practical level, how it can drive access.
Although in theory, that should be the first place you want to go after leveraging technology. But I think I'm trying to think about what you said about how Spotify went about it and trying to see is there a parallel there. Because the thing with Spotify that was hard was you had multiple constituents, right? You have artists, you have labels, you have consumers.
And they all kind of want something a little different. And that speaks of an optimization problem, which is clearly what health care is. But going on what you said a moment ago, it sounds like today you're a little less encouraged than you would have been four years ago when you're thinking on this problem. Well, let me try and recapitulate your three legs of the stool in one simple framework, which is something that we should all be aiming for is to generate universal access to the current best available health care that anyone in the world receives.
You know, one of my favorite quotes, I always forget who's quoted is, but venture capitalists talk about a lot, which is that the future is already here. It's just not evenly distributed. And I think that's almost always true. Look at what rich people are doing and assume that in 20 or 30 years, everybody will have that.
And so what are rich people doing right now? Well, they're paying doctors like you a lot of money to do very bespoke types of medicine that leverage all sorts of deep biometric analyses of their bodies, a lot of thinking by you and your team. And a lot of spend on the usage of what are currently expensive machines, MRI machines to do preventative screening for tumors every year, things like this that if you're really rich, you know, you might as well go get an MRI every day. You're a good full body MRI every year.
I mean, just see if there's anything going on. Why not? And so what stands between today and orphans and Somalia receiving that level of care and what stands in the way I think is to some degree a level of technological leverage. What is happening in your head when you look at a patient's blood tests and try to gel that with your biophysiological mental models is something that I believe computers will be able to do in the future.
And so right now we use physicians for thinking and for bedside manner and for guidance. And then we use some physicians like surgeons for physical procedures that they're essentially athletes at. You know, you want high performing athletes who don't mess up who are very precise, who've done it a million times. Well, the roboticization of physical medicine like surgery is something that I believe will just continue to get better and better.
It may take longer. It may not be replaceable immediately. But that will, you know, we will be primarily doing robotic surgeries a hundred years from now. The cognitive work that physicians do will, I believe, largely be replaced by computational systems that can leverage the same types of theoretical frameworks that our minds are utilizing to make good decisions.
And what you're left with is all the touchy, feely personal stuff that you as a physician and any other physician knows really matters. It's not superficial. The ability to help someone make good decisions about their own health, to make someone care about their physical health, to help them navigate difficult decisions that aren't straightforward. That aren't straightforward that involve trade-offs are the sort of things that physicians right now don't have the time to do that they did when they were taking their medicine bag around to people's houses and hanging out for a couple hours.
And so in a certain way, we may go back to an older style of medicine, but the people who do that may look more like highly skilled nurses than like physicians. So I believe that what you'll see is globally a lot more technology involved in the deployment of medicine and a shift in the composition of the labor market around medicine towards something that looks more like a large population of highly skilled nurses, fewer overpaid or appropriately. But maybe overtrained physicians that right now are very scarce that only rich people can access. And then most excitingly, you're going to see a lot of new medicine.
That's the stuff I'm focused on now as an investor. And that's the stuff that I think is going to be the most game-changing. That's the stuff that's going to buy us years of additional life. So when did you make that transition where you sort of your big foray into this was obviously Spotify as far as like transition one, so DA 2.0 to DA 3.0, and then DA 4.0 doing the investing.
So the biotech stuff specifically, when did you make that transition? Well, I'm still making it because it's a hard transition to make. And there's been so much that I've already had to learn and so much more that I have yet to learn. I think the starting point was this realization that what mattered most in healthcare as a capital allocator, meaning the most useful place that I could help direct money was to what goes through the pipes of the healthcare system as opposed to the healthcare system itself.
The healthcare system in America for the reasons we've just discussed is a creaky old infrastructure. And it's important to fix it, just like it's important to fix the government or the broken bridges that we have all over the country. But it's not the most interesting thing to do. And it also doesn't have a global impact because fixing the US healthcare system doesn't do a lot for folks in Sudan or in Saudi Arabia or in Japan or anywhere else.
You're just dealing with a human system where what's broken are the human structures that we've constructed to deliver the thing. So that was my starting point was realizing that the medicine itself was the thing that mattered more. And ultimately, despite all of the valuable things that physicians do, the biggest game changers in human health in the past 50 years have been pills. They've been pills that very brilliant people invent and that we can give to people through any number of channels and that actually fix the problem sometimes.
And we're moving into an era of medicine that people call preventative medicine or precision medicine or whatever you want that really boils down to addressing illness at the level of mechanism. Understanding that diseases have a functional concrete explanation and that we can develop interventions that actually fix what's broken in a very precise way and without a lot of collateral damage. And our ability to do that better and better is what's going to give people much more health in the future. And we're in in two or one of that journey.
So as an investor, there couldn't be a more exciting place to hang out. And the advances that we're making on a monthly or yearly basis are staggering. So when I noticed that that was happening in the world, it just became clear to me that this was not only an exciting and interesting place to be, but also one that could be enormously profitable, both financially and in terms of the benefit to humanity that delivered. What about you interested in the problem of living longer, personally?
Well, I guess I am not primarily preoccupied with living longer or with longevity as I am with the reduction of suffering that already exists. And so people who are really obsessed with longevity, maybe you are one of them, will make the argument that death is the great tragedy of human life and that we basically don't realize it's so bad because we take it for granted and can't see any alternative. That may be right, but I also think there's a lot of evidence in nature that death and the turnover of populations has some utility. Steve Jobs talked about famously that this is nature's way of clearing out the old ideas and bringing in new ones and creating urgency and create an urgency.
But I don't want to downplay the credibility of the argument for longevity. I just think that there are enough people dying obviously prematurely from things that should be preventable, and there are lots of people dying in the second half of their life or suffering from things that should be preventable that we should start by focusing on those things. Now, it may be the case that longevity is the skeleton key to all of those problems, that the number one risk factor for all diseases is age, and that if we could just figure out what's happening with age, we could just figure out what's happening with age. Then we could get out in front of all these other diseases as opposed to playing whack-a-mole with all of them.
That may be the case, and I think it's a legitimate hypothesis to explore, but it's not the one that I'm starting from or else all of my investing would be in longevity, whereas most of my investing at this point is preoccupied with individual diseases and whether we can arrest them and detect them earlier. So what are you most passionate about right now? Not necessarily from the investment thesis perspective, but from the technology or promise that the idea holds? Well, the holy grail for me is approaching what I think of as a singularity-like moment in biomedicine.
People throw around the term singularity, I mean, all sorts of things, but I actually believe it's a whole other thing. Who coined it? It may have been Kurzweil, or Ray Kurzweil, or I'm not sure, or it may have been some of those old cybernetics dudes. I first heard it from Ray's work, I don't know enough.
Why don't you explain briefly what, how he's referring to it? Well, I think Ray Kurzweil is referring to the singularity as this moment when human minds merge with machines. And so we, for example, download our brains into computers and then are effectively immortalized because our consciousness exists now in a digital format. That's not the singularity I'm talking about, but the concept of a singularity is that this is a moment at which sort of everything changes, and there's an almost infinite acceleration in our capacity to do something.