The Promise and Peril of the Genomic Revolution

Get an update from the front lines of the genomic revolution when Neil Tyson interviews Anne Wojcicki, co-founder/CEO of genetic testing company 23andMe. In studio, bioethicist Prof. Robert Klitzman provides perspective. Chuck Nice co-hosts.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Neil deGrasse Tyson?

  Welcome to StarTalk, your place in the universe where science and pop culture collide. StarTalk begins right now.

• 0:16Neil deGrasse Tyson?

  This is StarTalk and I'm your host Neil deGrasse Tyson, your personal astrophysicist. And I'm also the director of New York City's Hayden Planetarium at the American Museum of Natural History. My co-host today, Chuck Nice.

• 0:29Chuck Nice?

  Hey, what's up Neil? Love you man. Love you too man. Love you man. I love you. Good times.

• 0:36Neil deGrasse Tyson?

  Today, we're featuring my interview with Anne Wuchiki, co-founder and CEO of the genetic testing company 23andMe. And we'll be talking about the promises and the perils of the genomic revolution. I can't do that alone because I'm an astrophysicist. What the hell do I know about genes? So, our guest today is Dr. Robert Klitzman, bioethicist and professor of psychiatry at Columbia University. And you co-founded Columbia Center for Bioethics. That's just awesome. Somebody's gotta...

• 1:04Chuck Nice?

  Yes.

• 1:05Neil deGrasse Tyson?

  Somebody's gotta do it.

• 1:06Speaker 02

  I think the world of astrophysicists, so feelings mutual.

• 1:10Neil deGrasse Tyson?

  And you're author of the book, "Am I My Genes?" I like that.

• 1:15Chuck Nice?

  Am I my genes?

• 1:16Neil deGrasse Tyson?

  Or not? Are you something else?

• 1:18Chuck Nice?

  Right. Like my culouts.

• 1:20Neil deGrasse Tyson?

  Okay.

• 1:21Chuck Nice?

  Ah, you see what I did there doc?

• 1:23Speaker 02

  That's right.

• 1:24Neil deGrasse Tyson?

  So, it's confronting fate and family secrets in the age of genetic testing. So, what is 23andMe? It provides direct-to-consumer personal genome tests. So, you get, and they tell you, and then they'll give you the whole genetic profile.

• 1:40Chuck Nice?

  Yeah.

• 1:41Neil deGrasse Tyson?

  Talk about profile.

• 1:42Chuck Nice?

  Yeah, talk about profile. That's funny.

• 1:46Neil deGrasse Tyson?

  Your skin color is, "Yo, you've got a 40% chance of developing whatever in 20 years."

• 1:52Chuck Nice?

  You have a 22% chance of being denied a mortgage.

• 1:56Speaker 02

  But these are issues, actually.

• 1:58Neil deGrasse Tyson?

  Okay.

• 1:59Speaker 02

  These are actual real issues, because there is genetic discrimination that's a major.

• 2:03Neil deGrasse Tyson?

  Well, that's what we're gonna get, we're gonna get there. And so, uh, once they sort of figure you out, alright, once you send in some sample cells, body cells, so they'll provide ancestry info, that'd be as a minimum, for sure. And of course, the next step would be health-related, uh, info. And it was founded in 2006 by Linda Avi, Paul Susizna, and Anne Wachiki. And so, when I sat down with CEO Anne Wachiki of 23andMe, I had to ask her, how do you get in the business of this? I'm always curious. How you, how you get from here to there? Let's find out. When you were in college, did you say to yourself, "I wanna start a company to map people's genes"? That's really creepy. If you had said that.

• 2:46Speaker 03

  Uh, I definitely...

• 2:47Neil deGrasse Tyson?

  I would've said, "Nice to meet you."

• 2:49Speaker 03

  You wanna live in the other dorm.

• 2:50Neil deGrasse Tyson?

  Yeah.

• 2:51Speaker 03

  No. Um, I definitely did not think about that then. When I was in college, I was pretty focused on having fun.

• 2:57Neil deGrasse Tyson?

  And you majored in?

• 2:58Speaker 03

  Biology.

• 2:59Neil deGrasse Tyson?

  But, okay.

• 2:59Speaker 03

  I was majoring in biology, yes.

• 3:01Neil deGrasse Tyson?

  Yeah.

• 3:01Speaker 03

  And I loved genetics. I always loved microbiology. And I always thought about doing something in science. I had dreams of being a MD/PhD. But actually, it was more, my father is a physicist, and my father was part of something called the Superconducting Super Collider, which got shut down in 1990. And it was 10 years of my father's work that I saw him painfully involved, and, but it taught me the importance of being able to communicate complicated ideas to non-scientists. And I think I really took away from that, that if you can't communicate what you're doing, no one's gonna support it. And I think that happened a lot with the physicists. And so, when I got into biology, and I was on Wall Street for a while, and then I saw the human genome sequenced, and I realized, like, this is the next massive era of discovery.

• 3:47Speaker 03

  And that we're just starting to understand the genome. And how cool is it that if you can actually be part of it? And why is it that the layperson can't actually learn about it? But you should be able to follow all this progress with your own genome.

• 3:59Neil deGrasse Tyson?

  Just to be clear, you are reflecting on the failure of your father to make the case for the superconducting supercollider to Congress. So that they would continue to fund it. And you said, "I'm not going to make that mistake."

• 4:12Speaker 03

  Yeah, I think that part of the reason why that failed was because there was not a great understanding of what would actually come out of it. And even today, people understand Higgs. But most people will say, "Well, what do I get out of that?" And I think that's part of what I've tried to say is like, teach everyone about the meaning of science and let people actually explore in their own genome and be part of the process.

• 4:36Neil deGrasse Tyson?

  So, Robert, you know, this word genome is currency today. But we heard of genes, we've heard of DNA, chromosomes. Does genome have a precise definition?

• 4:48Speaker 02

  Yes, it does. So, we each have a molecular blueprint that is half from our mother, half from our father, and makes us and gives us the hair color and eye color that we have and also predispositions to certain diseases. So, some of us are more likely to get one disease or another. And what it is, is in almost every cell in our body, in the nucleus, there are 23 clumps of genetic material, DNA, which is deoxyribonucleic acid, but we'll just call it...

• 5:17Neil deGrasse Tyson?

  Glad you guys abbreviated that one, all nine syllables. Right, okay.

• 5:21Speaker 02

  And so, there are 23 of these clumps from each parent that we get. And each clump consists of information. And the information is in a language that consists of four molecules that we abbreviate A, C, T, and G. And so, these letters laid out, A, C, T, G, laid out 3 billion times, is a very long word. But that is the unique blueprint that makes me. Yours is yours, yours is yours.

• 5:50Neil deGrasse Tyson?

  And those four, those are proteins, is that right? Or amino acids?

• 5:55Speaker 02

  Yeah, exactly right.

• 5:56Neil deGrasse Tyson?

  Okay, so could you list them for us, please?

• 5:57Speaker 02

  So, it's actinine.

• 5:58Neil deGrasse Tyson?

  I'm just testing you, see?

• 6:00Speaker 02

  Pimine, cystine, and guanine.

• 6:02Neil deGrasse Tyson?

  Guanine, excellent. And the movie Gattaca used those four letters to spell its title.

• 6:06Speaker 02

  Exactly right.

• 6:07Neil deGrasse Tyson?

  Yeah.

• 6:07Chuck Nice?

  And the chapel used the cystine as well.

• 6:11Speaker 02

  There you go.

• 6:13Neil deGrasse Tyson?

  He's trying to get in here. Try to get in the conversation. Get in here. Any way he can.

• 6:19Neil deGrasse Tyson?

  Okay. Okay, Chuck. Well, go on, Chuck. We'll carry you for this one, Chuck.

• 6:25Speaker 02

  That was quick. I like that. So these, to give you an example, what that means is, so this is three billion letters. If, if this was, behind you was a wall of books, that would be three billion letters. And so if it's eight, our alphabet is 26 letters, but if you just had four letters and you wrote A C T G G three billion times, A C T G G, A C T C C, whatever, uh, we're 99.9% the same and we're .1% different, which means if I-

• 6:55Neil deGrasse Tyson?

  From one another.

• 6:56Speaker 02

  From one another. So if I pull out one book, uh, that's on the, that shelf, that's the amount by which each of us differs. And what we can now do is, we can tell someone what those three billion letters are for themselves, uh, and, uh-

• 7:10Neil deGrasse Tyson?

  So, so the, the whole sequencing, the genome is getting the sequence of letters?

• 7:14Speaker 02

  Exactly right.

• 7:15Neil deGrasse Tyson?

  So genotyping is the act of-

• 7:17Speaker 02

  It's a process, right?

• 7:18Neil deGrasse Tyson?

  The act of doing so.

• 7:19Speaker 02

  Right, right.

• 7:19Neil deGrasse Tyson?

  Okay. That's pretty cool.

• 7:21Speaker 02

  It's very cool stuff. And I should say that this, the first time this was done was 15 years ago.

• 7:27Neil deGrasse Tyson?

  2000.

• 7:28Speaker 02

  2000.

• 7:29Neil deGrasse Tyson?

  Right. Okay, so hence the, the banner headline that the human genome has been solved. In fact, we, we interviewed President Clinton on StarTalk. Yes. That's what I was gonna say. I don't mean to boast or anything. President Clinton, I just, just, I don't mean to boast.

• 7:47Neil deGrasse Tyson?

  It was good for me too. It was good for me too. He was proud that that happened under his watch.

• 7:55Speaker 02

  As he should be.

• 7:56Neil deGrasse Tyson?

  That's all I'm saying. So, so getting back to my interview, uh, with, with Ann, I wanted to find out, uh, what's the mission?

• 8:02Speaker 02

  Yes.

• 8:03Neil deGrasse Tyson?

  You know, you can genotype somebody, but now what are you gonna do with it? Let's find out where we're going.

• 8:08Speaker 03

  We are about individuals accessing, understanding, and benefiting from the human genome. The genome, I think, has a massive potential in transforming healthcare. And what we did is we got a million people genotyped last year. And so, people are now, a million people, running around, going to their doctors and talking about genetics, I think, starts to become disruptive.

• 8:30Neil deGrasse Tyson?

  Do this, fix that.

• 8:31Speaker 03

  Well, you can't necessarily do this and fix that, at this point, but you can come in and say, "Hey, I'm a carrier for cystic fibrosis. I should be aware of that." So, part of what we've had, as a mission of the company, we are very much about enabling access. And so, in order for you to actually access it, it has to be affordable.

• 8:48Neil deGrasse Tyson?

  And right now, what's it cost?

• 8:49Speaker 03

  We're at $199, $199. Doesn't require any insurance, anything. It's online. It is...

• 8:56Neil deGrasse Tyson?

  And what, you send in some spit, or something?

• 8:57Speaker 03

  Yes, so we give you a little tube, you spit in the tube.

• 8:59Neil deGrasse Tyson?

  I just made that up, it's really true.

• 9:00Speaker 03

  It's really true. It's really true. It is really true. It is a saliva-based test. We just send you, we send you a little box, you spit in the tube. We can give you one, you spit in the tube, and then, it's easy to understand. So, when we've worked with the FDA, we have over 90% comprehension. I mean, that people from all over the country get this, they don't know anything about genetics, they're understanding it. And the long-term, the research that we're doing, is all about people benefiting from the human genome.

• 9:26Neil deGrasse Tyson?

  They're trying to do good with this, but there's always the bad side, the dark side, if you will. And, it's information. Information is power. Information is control.

• 9:39Speaker 02

  Yes.

• 9:40Neil deGrasse Tyson?

  So, what are the anxieties that we should have? And what are the future anxieties we don't know we actually should have yet?

• 9:47Speaker 02

  Right, right. The unknown unknown.

• 9:49Neil deGrasse Tyson?

  Yes, yes. Mr. Bioethicist, you should have, you would have thought about this way more than any of us.

• 9:55Speaker 02

  Yes. Well, there's a few concerns. So, one is there's still genetic discrimination, which is that there is the Genetic Information Nondiscrimination Act that was passed by Congress that applies to health insurance. But, life insurance...

• 10:07Neil deGrasse Tyson?

  In other words, if they find something else, something out about you from your genetic profile... You are predisposed to cancer, we are not going to cover you.

• 10:13Speaker 02

  Exactly right. So, that they can't do. But, life insurance companies can discriminate. Disability insurance companies can discriminate.

• 10:22Neil deGrasse Tyson?

  Those sons of bitches.

• 10:23Speaker 02

  Sons of bitches. Long-term care insurance companies can... Discriminate. So if I apply for life insurance today, they could say, well, have you ever had genetic testing done? Let's see the results. Oh, you have this gene that gives you an increased rate of cancer. I'm sorry, we're not gonna cover you, or we'll triple your rate, etc. So-

• 10:40Neil deGrasse Tyson?

  So you've been failing at your job as bioethicist?

• 10:48Speaker 02

  If you could convince Congress to change all this, I'm with you.

• 10:51Neil deGrasse Tyson?

  I'm just saying. Yeah, I'm just saying. We brought you on here as a bio- I thought you were fixing the world, but now, okay. So what you're saying is that law that was passed doesn't cover all aspects of the human, of, of health, the health industry?

• 11:05Speaker 02

  It just covers health insurance, not life insurance, disability insurance, long-term care insurance.

• 11:10Chuck Nice?

  And it only covers health insurance because that damn Obama and his stupid Obamacare made it so that we can't be, uh, uh, prejudged and, and, and discriminated against. Thanks, Obama.

• 11:23Speaker 02

  Obama's done another good thing, by the way, which I hope we get to, which is he announced that, last year, that we're gonna sequence 1 million Americans. Uh, we'll, we'll come back, because I think that's a terrific thing.

• 11:32Neil deGrasse Tyson?

  Get back to that.

• 11:33Speaker 02

  Yeah, yeah.

• 11:33Neil deGrasse Tyson?

  Let, let's get back to that. So-

• 11:35Speaker 02

  So one concern is discrimination. The other concern is subtle discrimination. So one woman I interviewed, for instance, told me, uh, you know, I-

• 11:43Neil deGrasse Tyson?

  You don't have to tell us about subtle-

• 11:44Chuck Nice?

  Yeah, believe me, we know.

• 11:45Neil deGrasse Tyson?

  We just, we just skip that and go on.

• 11:49Chuck Nice?

  Subtle discrimination, um, could you park my car? I don't work here.

• 11:54Chuck Nice?

  I do not work here, thank you.

• 11:55Neil deGrasse Tyson?

  No, go on. Sorry.

• 11:56Speaker 02

  This is the issue, so, a- as you know, so, um, uh, one woman I interviewed, for instance, said, you know, I tested for that breast cancer gene test, and I mentioned this to a coworker, someone I share my cubicle with, and the next thing I know, everyone in the office was coming up to me saying, "How are you?" The next thing I knew, uh, when the boss was gonna retire, everyone assumed that I would be promoted to fill his spot. The boss was retired and I was not promoted. I wasn't fired, but I wasn't promoted. Uh, and there's sort of a glass ceiling for me now. Sound familiar? And so there's that kind of subtle discrimination that goes on as well. So people may say, well, let's see, we're gonna promote someone. Well, you know, we just found out that she has an increased risk of cancer. You know what? Let's see, maybe we shouldn't go there.

• 12:41Chuck Nice?

  So it's more of a, it's more of stimulating a implicit bias towards someone.

• 12:47Speaker 02

  Exactly right.

• 12:47Chuck Nice?

  Than outright discrimination.

• 12:49Speaker 02

  Yes, correct.

• 12:50Chuck Nice?

  I got you.

• 12:51Speaker 02

  So that's one concern. Uh, another is that what 23andMe is doing, as I said, there are three billion letters. 23andMe is not looking at all three billion letters. They're looking at one out of every several hundred thousand letters. They're looking at what are called SNPs, which are single nucleide polymorphisms. And I should say the ACTG, by the way, actually are nucleotides rather than proteins. They form proteins. That's okay. So, um, uh, so what they're doing, imagine this wall of books again. What, what 23andMe is doing is it's saying, well, take one book. We're gonna give you the first letter on every three pages. So the first letter of the book's A, three pages letter of the first book's a C, three pages letter of the first letters a T. Well, you don't know if you're reading the phone book or the dictionary or the Bible or anything else.

• 13:34Speaker 02

  So what 23andMe is now doing is just giving you one one hundred thousandth of the information, uh, that's there. So there are gonna be false positives, as are orange and X anyway, there are gonna be false negatives, uh, and there are gonna be lots of other problems understanding it.

• 13:49Chuck Nice?

  So what, what, what hot water did 23andMe get into a few years ago?

• 13:53Speaker 02

  So several years ago, 23andMe said, we're gonna give you, um, medically useful health behavior, he- health information.

• 14:00Chuck Nice?

  Mm-hmm.

• 14:00Speaker 02

  And, um,

• 14:01Chuck Nice?

  From your spit.

• 14:02Speaker 02

  From your spit. And what happened, a lot of it, there were false positives, there were false negatives. A lot of it is increased prob- it, it, it didn't give you-

• 14:11Chuck Nice?

  To be clear, a false positive is-

• 14:13Neil deGrasse Tyson?

  Is the test shows that you have something, but in fact you don't have it.

• 14:17Speaker 02

  Correct.

• 14:17Neil deGrasse Tyson?

  Yes, and a false negative is a test shows you don't have something, but in fact you do.

• 14:21Speaker 02

  Yeah, like the test says, you don't worry about cancer, and in fact, I should be worrying about cancer because I do have that gene.

• 14:26Chuck Nice?

  Yeah, I don't know what that tumor is on my neck then, right, that type of deal.

• 14:31Speaker 02

  Yes, right, right. So, um, the other part, but what they said is that this is going to be medically useful information, in fact, for the vast majority of people, it wasn't.

• 14:39Neil deGrasse Tyson?

  Okay.

• 14:40Speaker 02

  What 20, what the FDA said is, you know, you're, you're advertising this as medically useful information, show that it's medically useful over several years and they couldn't do it. Imagine if your doctor said, uh, you know, I'm going to give you a bunch of information, but it's not really right.

• 14:56Neil deGrasse Tyson?

  But, okay, but, but genetics is complicated business.

• 15:01Neil deGrasse Tyson?

  Genetics is complicated, it's a complicated business. And, but you would hope the people who are charging you for it understand those complications. Let's get Anne Sensen, how complicated it really is, check it out.

• 15:14Neil deGrasse Tyson?

  Of all the properties we think of, of being human, what percentage of those are cleanly identified in a genetic sequence? What percent are a tangle of cross-influenced forces?

• 15:27Speaker 03

  I would say the majority of us is a tangle of cross.

• 15:31Neil deGrasse Tyson?

  A tangle.

• 15:31Speaker 03

  So, we've done research, we've done the largest research study out there, for instance, on things like handedness, left-handed, right-handed, and it is remarkable how complicated that is.

• 15:43Neil deGrasse Tyson?

  And is it complicated just because you haven't really figured it out yet?

• 15:49Neil deGrasse Tyson?

  I mean, the movement of the planets in the night sky was complicated until we figured it out. It took the genius of Isaac Newton.

• 15:57Speaker 03

  Sure.

• 15:57Neil deGrasse Tyson?

  To show how simple it is.

• 15:58Speaker 03

  Well, I think that we have to establish, at some point, there will be a world where there's just laws and principles, and it becomes very clear and simple how everything works, but at this point in time is incredibly complicated.

• 16:08Neil deGrasse Tyson?

  So handedness is complicated?

• 16:10Speaker 03

  Everything is complicated.

• 16:11Neil deGrasse Tyson?

  How about height?

• 16:12Speaker 03

  It is very complicated.

• 16:13Neil deGrasse Tyson?

  Really?

• 16:14Speaker 03

  Yes. The thing that's interesting here is all these things are, we're just scratching the surface of our understanding, and the job I feel like I have to my consumers is conveying the fact that we really don't know a lot yet.

• 16:29Neil deGrasse Tyson?

  So we're just scratching the surface of this. Is it premature for anybody to promise anything to anybody?

• 16:34Speaker 02

  So it turns out that there are around 50 genetic tests for about 50 diseases that if you have it, it's pretty predictive and we can do something about it.

• 16:45Neil deGrasse Tyson?

  That's a start.

• 16:45Speaker 02

  That's a start.

• 16:46Neil deGrasse Tyson?

  Okay.

• 16:46Speaker 02

  And that, those affect about 1%, 2%, 3% of Americans. Then there are, so some people, but for 90-something percent of people, we're not going to find things that are very predictive that you can do something about.

• 16:59Neil deGrasse Tyson?

  Well, not yet.

• 17:00Speaker 02

  Not yet.

• 17:00Neil deGrasse Tyson?

  In principle, okay. So, so the interesting test as we go forward will be, and we'll discuss this as we come back from the commercial. Once you are armed with this information.

• 17:11Speaker 02

  Yes.

• 17:12Neil deGrasse Tyson?

  Then what are you going to do with it?

• 17:14Speaker 02

  Hmm.

• 17:15Neil deGrasse Tyson?

  Okay, what will people, how will people behave in the face of that information, knowing their genome perfectly, when StarTalk returns?

• 17:37Neil deGrasse Tyson?

  Welcome back to StarTalk. I'm with my co-host Chuck Nice.

• 17:41Speaker 02

  Yes, sir.

• 17:41Neil deGrasse Tyson?

  And our guest bioethicist, coolest title ever, Dr. Robert Klitzman of Columbia University. And we're featuring my interview with Ann Wuchiki, co-founder and CEO of the personal genetic testing company 23andMe. Not 23andU, 23andMe. And one of the most famous sort of genetic testing cases typically has to happen to a celebrity to achieve consciousness in society. And it was with regard to Angelina Jolie. She had the breast cancer gene. In fact, had her kids and then went in preemptively with a double mastectomy. And so I was just curious about the case of Angelina Jolie, what role that played in her field and her, in her industry.

• 18:24Speaker 02

  Right.

• 18:24Neil deGrasse Tyson?

  And what, what impact it might have had on the, on the rest of us. So let's just, let's, let's open this segment with what, what Ann says about Angelina Jolie.

• 18:34Neil deGrasse Tyson?

  Perhaps the most famous person with the breast cancer gene has been Angelina Jolie. Do you foresee the day where women, they get their own information, say, "I'm gonna go get the double mastectomy"?

• 18:45Speaker 03

  Yes, for sure.

• 18:46Neil deGrasse Tyson?

  This will just be a thing?

• 18:47Speaker 03

  For sure. Right now, it's lots of people who have the BRC mutation and end up dying, in my opinion, unnecessarily at an early age.

• 18:54Neil deGrasse Tyson?

  Okay, so it's an interesting...

• 18:55Speaker 03

  Because they didn't know this.

• 18:56Neil deGrasse Tyson?

  An interesting point here, of course, is that gene mutation that gives breast cancer is the very small percent of all breast cancer.

• 19:02Speaker 03

  Sure.

• 19:03Neil deGrasse Tyson?

  So while it's a start, it still doesn't really make a dent in the breast cancer knowledge.

• 19:08Speaker 03

  100%.

• 19:09Neil deGrasse Tyson?

  Genetic knowledge.

• 19:10Speaker 03

  But that's where genetics is complicated. We know what some part, like breast cancer, in 10 years, it will not be seen as, "Oh, there's breast cancer." But you're gonna say, "You have a cancerous mutation, it's based on these things, it's manifesting in the breast, it could manifest in the uterus, it could manifest other places in your body, but this is the source of the mutations and this is how it's evolved." And it's gonna be a different sort of treatment. And you're already starting to see that with personalized medicine, where breast cancer tumors that have the Herceptin mutation, the HER2 mutation, get the drug Herceptin, and it ends up working incredibly well because it's targeted towards them.

• 19:41Neil deGrasse Tyson?

  Okay, so...

• 19:42Speaker 03

  And I think that's a lot of the promise for genetics and personalized medicine.

• 19:45Neil deGrasse Tyson?

  So that's the tuning of the attention given to the one case versus another?

• 19:48Speaker 03

  Correct. But it has not trickled into the broad public, and I think that's part of the mission of 23Me, is get the genetic information out there.

• 19:57Neil deGrasse Tyson?

  So we get the information out there, will people do right by it, do you think?

• 20:01Speaker 02

  Well, the problem is, a lot of people may not understand the information, so you hope that someone could sit down with them and go over it. So with breast cancer...

• 20:08Neil deGrasse Tyson?

  Someone like...

• 20:13Speaker 02

  Well, I hope they read the book.

• 20:14Neil deGrasse Tyson?

  Someone, someone, someone, somewhere, I don't know.

• 20:18Speaker 02

  Someone who listens to this and is interested, and I think we need to increase public understanding of these issues. But breast cancer, for instance, as you've said, is about, of all breast cancer, about 10% is the genetic kind, the familial kind. And if you have the breast cancer mutation, there's about a 50% chance you may or may not get breast cancer. So you could not have the mutation and get it, or you can have the mutation and not get it. So let's say I find out that...

• 20:45Neil deGrasse Tyson?

  By the way, can I be obnoxious in this moment?

• 20:48Speaker 02

  Yes.

• 20:49Neil deGrasse Tyson?

  Anytime there's a medical result that says you have a 50% chance of one thing or another, it means you have no freaking clue. Because if you had a clue, it would be a zero percent, percent chance or a hundred percent chance.

• 20:58Speaker 02

  Yes.

• 20:58Neil deGrasse Tyson?

  If you had a clue.

• 20:59Speaker 02

  Uh.

• 20:59Neil deGrasse Tyson?

  I just want to make that clear.

• 21:00Chuck Nice?

  Now, is that, is that?

• 21:02Neil deGrasse Tyson?

  Okay. It's like the, the weather person said, 50% chance of rain tomorrow.

• 21:05Speaker 02

  Right.

• 21:05Neil deGrasse Tyson?

  You have no idea.

• 21:07Speaker 02

  Right.

• 21:07Neil deGrasse Tyson?

  All right.

• 21:07Speaker 02

  Right.

• 21:07Neil deGrasse Tyson?

  Because in the future, perfect weather forecasting would be, it will rain or it will not rain.

• 21:12Speaker 02

  Right.

• 21:12Neil deGrasse Tyson?

  And you wouldn't be giving probabilities, that's, you give probabilities when you don't actually have predictive value.

• 21:17Speaker 02

  So that's the issue, and that's a problem with a lot of, most diseases in 23andMe and other genetic testing, is that we don't have predictive value yet for most people, for most major diseases.

• 21:27Neil deGrasse Tyson?

  Actionable predictive value. Right. Because you want to be able to make a decision.

• 21:29Speaker 02

  Right, correct. I should say, by the way, as mentioned there, that the, the future and the hope, and why 23andMe's doing this in part is to sell these results for millions of dollars to drug companies. We're trying to figure, to target drugs, to know based on your genes, you should get this drug for a disease, whereas for the same disease, maybe I should get a different drug. And that, it's thought that that's going to be a patentable kind of information.

• 21:52Neil deGrasse Tyson?

  Okay, so, on the subject of, am I my genes, or am I my environment?

• 21:55Speaker 02

  Yes.

• 21:56Neil deGrasse Tyson?

  Then, tell me how, about how environment plays out. Because I, I, I used to host a, a TV program called Nova Science Now. We did a segment on the, on epigenetics.

• 22:05Speaker 02

  Yes, correct.

• 22:06Neil deGrasse Tyson?

  And, and even though I did the segment, and I narrated in it, and I spoke with the people active in it, it's still magic to me that this can happen. So can you just tell us what this is?

• 22:14Speaker 02

  So it used to be thought, and I should say, we're learning more about genetics every day. So this is a rapidly evolving field. But it was, used to be thought that-

• 22:21Neil deGrasse Tyson?

  No pun intended. Yeah, ha, ha.

• 22:22Speaker 02

  That's right. That's right. I like that. So, um, uh, uh, it, it used to be thought that there would be a cancer gene, a fat gene, an alcohol gene, the gay gene, the whatever gene, uh, and we now know that it's much more complicated, that there are many, many, many genes involved with any kind of complex behavior or common disease like that. Uh, and so-

• 22:46Neil deGrasse Tyson?

  And the environment is in, in that equation.

• 22:47Speaker 02

  Environment's in that equation. So- I can give you many examples, but what happens is that genes give you a predilection. And it's like the weather, how often we know that there's a 50% chance or 30% chance it may rain, but there could be other stuff that goes on. The wind can blow one way or the other, and we don't quite know.

• 23:07Neil deGrasse Tyson?

  There's that butterfly who could be.

• 23:09Speaker 02

  There's that butterfly.

• 23:10Chuck Nice?

  Over in Japan, they actually created this hurricane over here. My god.

• 23:13Speaker 02

  That's right, blame the butterfly.

• 23:15Chuck Nice?

  Damn you butterfly.

• 23:17Neil deGrasse Tyson?

  There's, I, there was an article in, in the Journal of Irreproducible Results where the, this is the, the fun journal where it's not real science, but it sounds like it's real science. So, someone captured the butterfly. Started, that was responsible for Hurricane Andrew back in 1990.

• 23:35Speaker 02

  That's pretty funny.

• 23:36Neil deGrasse Tyson?

  But I interrupt, go on.

• 23:37Speaker 02

  Oh, so, um, what we know is that somehow the environment affects which genes get turned on, when they get turned on, how long they get turned on, things like that. So, uh, as well as whether or not a disease will manifest itself.

• 23:51Neil deGrasse Tyson?

  So, so epigenetics is the study of how environment can help, or, or for good or for worse, alter those genes?

• 23:59Speaker 02

  Exactly. Turning on genes, turning off genes, could be what you eat, what other things, the environment, and also-

• 24:03Neil deGrasse Tyson?

  The epicenter in a, in an earthquake is the center on the part, it's on the ground above where the earthquake took place. So epigenetics would be something above the genes?

• 24:13Speaker 02

  Exactly right.

• 24:13Neil deGrasse Tyson?

  Okay.

• 24:14Speaker 02

  So, and because we have the genes that are forming proteins-

• 24:16Neil deGrasse Tyson?

  Proud of me for knowing that.

• 24:17Speaker 02

  Yeah.

• 24:18Chuck Nice?

  You should be, that's right, that's right. Yeah, but you're you and you know that.

• 24:23Neil deGrasse Tyson?

  No, no.

• 24:24Chuck Nice?

  Like, no, no, no one's gonna be impressed. You, and you know that.

• 24:27Speaker 02

  I'll give you an example. So, when, for the book, when I did these interviews for the book, Am I My Genes? The first woman I interviewed with breast cancer said, you know, I always knew I shouldn't have stayed in that awful relationship all those years. I said, why is that? She said, well, that's why I have breast cancer. I said, but you have the mutation. She said, ah, yes, but what triggered it was the stress of that awful relationship. And she may be right.

• 24:47Neil deGrasse Tyson?

  Okay.

• 24:48Speaker 02

  So you have phenomena like that. The problem is it's often hard to measure that stress. This is why we don't quite know. But even things like depression, for instance, are 50% genetic, 50% other. So, you can get depressed, you, in other words, a bad thing could happen to all of us, and the person who has genes predisposing for depression could really get depressed.

• 25:07Neil deGrasse Tyson?

  You're just completely susceptible to, so, so part of, part of genetic counseling is environmental counseling.

• 25:14Chuck Nice?

  Yes, so- Like if you have a predilection to being depressed and you are a drinker, you are exacerbating the fact that you are going to be depressed. Right. Got you. And genetic counseling also looks at, uh, I think we're about to stop a sec, but other issues of what would you do with the information? Are you gonna have your breasts removed? Are you gonna tell your sister you can't stand? Are you gonna tell your seventeen-year-old daughter that she may have this? There are a lot of decisions.

• 25:38Neil deGrasse Tyson?

  So, uh, let's find out what Anne says about what the role of changing your environment plays in this. Check it out.

• 25:45Speaker 03

  What's inspiring is that you get the opportunity to actually alter your environment. You can't alter your genome-

• 25:51Neil deGrasse Tyson?

  Right.

• 25:52Speaker 03

  But you have the ability to alter your environment. So the people who are smoking, not all of them go on to develop lung cancer.

• 25:57Neil deGrasse Tyson?

  Correct.

• 25:58Speaker 03

  So is there a genetic reason potentially why some do and some do not? Part of what we're hoping to do, so for instance, there was a story that came out about Target, where they said they predicted-

• 26:08Neil deGrasse Tyson?

  Target-

• 26:09Speaker 03

  Target the store.

• 26:09Neil deGrasse Tyson?

  The store.

• 26:10Speaker 03

  The store. And so there is a scandal that they predicted a sixteen-year-old was pregnant before her father or before she knew. And that was in part because Target had so much information about her shopping patterns, they were actually able to predict. And so what I think about-

• 26:25Neil deGrasse Tyson?

  They think that was out her genome.

• 26:26Speaker 03

  Correct, correct. So, but part of what I think about in healthcare, which I feel like is a tragedy, is I would love to walk into my doctor and say, "Hey Anne, based on all the different behaviors you have, and your genome, your environment, what you eat, how you exercise, you are five years away from having this kind of condition." Then I could actually-

• 26:45Neil deGrasse Tyson?

  That would be awesome.

• 26:46Speaker 03

  That would be awesome. So that's what we're building towards.

• 26:50Neil deGrasse Tyson?

  Yeah, so, so, so tell me about that. Is there a, um, apparently Target was able to disentangle shopping habits and come up with a-

• 27:00Chuck Nice?

  Right.

• 27:01Neil deGrasse Tyson?

  An accurate conclusion of the health and state of this, of this girl.

• 27:05Chuck Nice?

  It's on the, but that, that, based on the girl's online presence. They took everything she did online- Right, well she probably was buying pregnancy tests.

• 27:11Neil deGrasse Tyson?

  Right, right.

• 27:13Chuck Nice?

  Yeah.

• 27:14Neil deGrasse Tyson?

  Okay.

• 27:14Chuck Nice?

  But one week she's buying pregnancy tests, the next week she's looking at the prices of diapers.

• 27:18Neil deGrasse Tyson?

  No.

• 27:19Chuck Nice?

  Right? How much is formula? It's like, "Hey." The problem is that-

• 27:24Speaker 02

  Um, we all know that he, we in America.

• 27:26Neil deGrasse Tyson?

  Well, I think she had a three hour phone call with her boyfriend right after she took the pregnancy.

• 27:30Speaker 02

  Right.

• 27:30Chuck Nice?

  Yes. And then he actually went online and looked up suicide prevention.

• 27:35Neil deGrasse Tyson?

  That's right there, it is.

• 27:36Chuck Nice?

  Put it all together.

• 27:37Speaker 02

  But we know that two thirds of Americans are overweight or obese, for instance. So if we want to improve our healthcare, we don't need genetic testing to tell most of us we need to watch our, our, what we're eating, to exercise more. Those are basic things we all need to do. And the problem is that a lot of the environmental influences that affect our genes are things we can't control. For instance, we know with, uh, there are certain markers that have been associated with mental illness, which become active if you've been abused.

• 28:05Chuck Nice?

  Oh.

• 28:05Speaker 02

  Growing up. Well, you can't affect, you, you, if you're being abused, you should change your environment anyway, regardless of the fact that it may affect genes.

• 28:12Chuck Nice?

  Now you tell me.

• 28:13Speaker 02

  Right. Or it may be that, uh, you know, the diet of your parent, your, your mother when she was pregnant. Again, so some of those are things we can't control.

• 28:24Neil deGrasse Tyson?

  Which was like alcohol for all the rest of, all of us born in the fifties.

• 28:27Chuck Nice?

  Right, alcohol, right, exactly. Or lead.

• 28:30Neil deGrasse Tyson?

  Lead, yeah, lead.

• 28:31Chuck Nice?

  Which is now a big thing now with Flint, Michigan.

• 28:33Speaker 02

  Absolutely, yeah.

• 28:34Neil deGrasse Tyson?

  Yeah, yeah. So, uh, let me find out something. The, the, the disentanglement of these, um, because it's not the gene for this and the gene for that.

• 28:44Speaker 02

  Yes, correct.

• 28:44Neil deGrasse Tyson?

  It's way more complicated.

• 28:45Speaker 02

  Yes.

• 28:46Neil deGrasse Tyson?

  How much more data do we need to disentangle it?

• 28:48Speaker 02

  Right.

• 28:49Neil deGrasse Tyson?

  So that we can improve these predictions.

• 28:50Speaker 02

  The analogy I use is if someone had asked Christopher Columbus in fifteen hundred, what'd you find? He would have said, I found some islands off the coast of India. And it took hundreds of years, three hundred years later plus, Lewis and Clark are still traipsing around, figuring out what's in the middle of the country. So we're at the beginning of what will be a long adventure. Uh, we're learning a lot, but when you think fifteen years ago, we didn't know anything about these three billion letters. And we did not know what they were, or how many, or how they operated. And so in fifteen years, we've learned an enormous amount. In the next fifteen years.

• 29:24Neil deGrasse Tyson?

  Yet we're still in our infancy.

• 29:25Speaker 02

  We're still in our infancy.

• 29:26Chuck Nice?

  Yeah, like born a couple of days.

• 29:28Neil deGrasse Tyson?

  Right, a couple of days ago, right, in the big picture. So you have hope then that the future will bring improved. Predictions.

• 29:36Speaker 02

  Yes.

• 29:37Neil deGrasse Tyson?

  So that you're not a 50% this or that, it's 100% this, 0% that.

• 29:40Speaker 02

  Well, but some, you know, there's gonna be a lot of uncertainty, even the weather. You'd think that whatever the weather is in New York, they'd be able to know because it was that, whatever is whatever the weather was in Philadelphia yesterday, and yet, and sometimes they're accurate, but sometimes they're not. They say 30% chance of rain. So there's gonna be chaos theory implications of uncertainty and, you know, butterfly wings and you ate, happened to be living near, you can't one day near that place where there was lead in the water. Who knows?

• 30:08Chuck Nice?

  May I ask you this though?

• 30:09Speaker 02

  Yes.

• 30:10Chuck Nice?

  Because it sounds to me like the, it's, this is a big data problem.

• 30:16Speaker 02

  Yep.

• 30:16Chuck Nice?

  Because the way you're saying it is, well, with what we know, we have this mass of information, but what we have to be able to do is sift through it, almost like you guys or the geneticists have to become like Target. You actually have to switch places with Target so that you can know exactly what's going on on, on our individual basis.

• 30:35Speaker 02

  That's right. So this is why President Obama announced that he wants to do the full sequencing, not the SNPs, but the whole 3 billion for 1 million Americans.

• 30:45Neil deGrasse Tyson?

  Okay.

• 30:45Speaker 02

  And if we start.

• 30:46Neil deGrasse Tyson?

  That would benchmark some data set.

• 30:47Speaker 02

  Exactly right. And that's the kind of research that we need to really understand all the variation.

• 30:53Chuck Nice?

  And if only he hadn't have said it, because now half the country doesn't want to do it.

• 30:58Neil deGrasse Tyson?

  So I asked Ann, is there anything we can do to improve the future predictions? Because she's in the business of this, and let's find out where she's taking it.

• 31:07Neil deGrasse Tyson?

  Is there some machine that you think should be invented that can help you do your work?

• 31:12Speaker 03

  I'm a big fan of the tricorder. I mean, if I could.

• 31:14Neil deGrasse Tyson?

  For non-Star Trek fans, this is the.

• 31:17Speaker 03

  Well, so I want some kind of device where.

• 31:19Neil deGrasse Tyson?

  That makes a sound and a light flashes.

• 31:21Speaker 03

  And then it tells.

• 31:22Neil deGrasse Tyson?

  Completely diagnoses the entire condition of the body.

• 31:24Speaker 03

  So I want some way of continuously monitoring what's going on in my body. Some way you can see exactly, like I eat a candy bar, exactly what happens in your body. And so I think with that kind of information, people will be able to change their behaviors. And I think with Fitbit and whatnot, we are just at the beginning of being able to monitor individuals. The tech revolution is changing the landscape of consumer healthcare and actually bringing consumers to the forefront of healthcare and letting them knowing about their body. I think the reality that I realize, like, people go to the doctor, let's say, once a year. If you're healthy, you go once a year, you have your checkup. But you do things that impact your health every single day. If it's smoking, or walking, or eating, etc. All those things impact you.

• 32:07Neil deGrasse Tyson?

  Impact it plus or minus.

• 32:08Speaker 03

  Exactly. So part of it is actually helping people track all that and realizing that your health is not about the episodic visit to your doctor, but it's about what you do every single day.

• 32:18Speaker 04

  So, Robert, do you think doctors will become obsolete in the limit of this technology? No, because there is a lot of complicated data, and it helps to have someone objectively look at it. So patients- He works in a hospital that hires doctors, just to make that clear. This disclaimer here.

• 32:37Chuck Nice?

  Tell you there might be some bias.

• 32:38Speaker 04

  Well, I think, you know, consumer-driven healthcare is extremely important, but patients often say to docs who now say, "Well, I'm not going to decide for you, decide." Patients say, "Well, what would you do if you were me, doc? I don't know what to do with this information. What do we do if there is a 30% chances of this versus a 70% chance of that? Should I have my breast- Like prostate cancer involves so many of these kinds of- Exactly right. You don't know what the goods and the bads of one decision versus another. Right. I mean, so there are people who could fix their own computers, God bless them. You know, some of us need to go to the Apple store and say- Did you say Jobs bless them, or God bless them? I didn't hear you right. I thought they're the same thing, or some people think they're the same thing. Jobs bless you.

• 33:22Speaker 02

  So, so many of us could technically fix our computers, but it helps if someone who knows what they're doing, look at the information, particularly when there's conflicting information out there. The other problem is, a lot of the data on diseases and treatments is based on people who have no other medical problems. They only have diabetes versus they have diabetes and weren't alcoholic and they're depressed and they have cancer and so you need judgment.

• 33:47Neil deGrasse Tyson?

  So, when we come back with my interview with Ann, we're gonna find out what fears we should all have about genetic testing in the future. It's StarTalk. Welcome back to StarTalk. I'm with my co-host, Jelena Hayes. And our guest, bioethicist Dr. Robert Klitzman of Columbia University, author of Am I My Genes? Levi's? Stupid joke and you probably get it all the time. We're featuring my interview with Ann Wachitsky. And I asked her, just to benchmark this segment, I asked her, what are some of the

• 34:29Neil deGrasse Tyson?

  most common fears and concerns that people have with genetic testing? Let's find out.

• 34:35Speaker 03

  People usually come and they say two things. One, I don't want to know the day I'm gonna die. And I'll say, we don't do that. And then second...

• 34:43Neil deGrasse Tyson?

  They really say that?

• 34:44Speaker 03

  Yeah, really say that.

• 34:45Neil deGrasse Tyson?

  I still want to know the day I die because I don't know how to live the day before. Was it Frank Sinatra who said, "Live every day like it's your last?" Because one day you'll be correct.

• 34:54Speaker 03

  It's a good say. The second thing that people fear is the insurance questions. And that's actually been rectified in large part with the Genetic Information Non-Discrimination Act, known as GINA. So you cannot be discriminated against for your, knowing your genetic information by your employer or by insurance companies.

• 35:12Neil deGrasse Tyson?

  But they already discriminate based on other information?

• 35:14Speaker 03

  Yes, but they cannot discriminate based on your genome. So if you walked in and said, "I have the BRCA variants for breast cancer," they cannot discriminate based on that information.

• 35:25Neil deGrasse Tyson?

  So, yeah, it's one thing to be discriminated against by some institution, but how about people just not wanting to know? And I don't understand that. I want to know everything I can possibly know so I can make an informed decision. But you're an ethicist. You must remember the day, we're kind of the same age here. Remember the day when doctors, it was in their code of interaction with patients to not tell you if they opened you up and found out you were terminally ill?

• 35:49Speaker 02

  And that's still the case in many countries, in Japan, in Spain, in Italy.

• 35:53Neil deGrasse Tyson?

  If that happened to me, I would punch the doctor in the face.

• 35:55Speaker 02

  Exactly.

• 35:56Neil deGrasse Tyson?

  From the casket. So, other countries, they still don't do that?

• 36:00Speaker 02

  That's right. But, but take an example with genetics like Huntington's disease, which is a deadly disease that Woody Guthrie, the famous singer-songwriter, had. If I have this mutation, there's a 50% chance that each of my kids will have it. And if you have it, you will die of it. And there's no treatment. So, people like Arlo Guthrie, damn, not a good thing.

• 36:18Neil deGrasse Tyson?

  Right, right, right.

• 36:19Speaker 02

  So, have to decide, do I want to know that I'm going to die of this thing? And I'm going to die at about the age my parent died, so usually in your 40s or 50s. And there's nothing you can do about it. Now, some people say, well, I can still, one person I interviewed said, you know, even though there's nothing I can do about it medically, if I find I have this, I'm not going to raise four kids in suburbia and have a boring job as an accountant, I'm going to move to Tahiti and be an artist. So, there are personal decisions.

• 36:42Neil deGrasse Tyson?

  Just a discount.

• 36:43Chuck Nice?

  I was going to say, one man's Tahiti is another man's accountant.

• 36:45Neil deGrasse Tyson?

  Okay, go on.

• 36:46Speaker 02

  This is a quote. So, you know, there are, some people want to know Alzheimer's disease, for instance, we have very good tests that show you have maybe three times the risk of getting Alzheimer's disease. Some people say, well, I want to know, but there's nothing we can do about it. Other people say, no way, I want to just live each day as if it's my last, which is by Seneca, actually, who said, I want to...

• 37:11Neil deGrasse Tyson?

  Seneca, oh, man, I wanted Frank to have that one, Frank Sinatra.

• 37:15Chuck Nice?

  Okay. Live each day as if it's your last, because you never know when you're going to write.

• 37:18Speaker 02

  Yes, yes, right.

• 37:19Neil deGrasse Tyson?

  Okay. Sorry, Frank.

• 37:22Speaker 02

  So, he was then assassinated, I believe, Seneca.

• 37:25Chuck Nice?

  My Frank Sinatra.

• 37:31Chuck Nice?

  Chairman of the Bob.

• 37:33Speaker 02

  They didn't do it his way.

• 37:34Chuck Nice?

  That's right, you crazy.

• 37:35Neil deGrasse Tyson?

  It was not my way.

• 37:36Chuck Nice?

  It's all my fault. Yeah, moke.

• 37:39Speaker 02

  Okay, go ahead. Anyway, so these are decisions and the point is that, uh, one wants to sit down with a genetic counselor and figure out what information do you want? Do you want to know about the stuff we can't do something about? Do you want to know everything? Do you just want to know the things that are actionable, uh, et cetera?

• 37:55Neil deGrasse Tyson?

  Are people plugged in enough to even answer those questions in an informed way?

• 38:02Speaker 02

  We need to give people more education. We need to

• 38:04Neil deGrasse Tyson?

  I don't see that happen.

• 38:05Chuck Nice?

  I was gonna say, well, now the whole thing's crap.

• 38:10Chuck Nice?

  Talking about educating the masses, okay.

• 38:12Speaker 02

  I would say that in

• 38:14Neil deGrasse Tyson?

  That means it'll never happen.

• 38:14Chuck Nice?

  That's exactly.

• 38:16Speaker 02

  But I would say that in 10, 15 years, when you go to your doctor, he or she will have on the computer your complete genome and can press a button, say, "Do you want to know if you have the Alzheimer's gene? I can press this button. Do you want to know if you have the breast cancer gene? I can press that button." But it's important, and hopefully they'll talk to you and say, you'll say, or they'll say, "This means X or Y."

• 38:36Neil deGrasse Tyson?

  You know what I want? I don't want you to tell me with precision what I'm gonna die from because you know my genome. I want you to know my genome and fix the genome so I don't die of it.

• 38:48Speaker 02

  Exactly.

• 38:48Neil deGrasse Tyson?

  All right? So, so

• 38:50Speaker 02

  Therein lies the real thing.

• 38:51Neil deGrasse Tyson?

  Is that so wrong to now require that of you? Now, in my, in my interview with Ann, I, I asked about, uh, there's something about genetic, uh, what is it?

• 39:01Speaker 02

  Spercast 9.

• 39:02Neil deGrasse Tyson?

  Uh, what is it? You can, uh, a technology to edit your genes.

• 39:09Speaker 02

  The genes of embryos.

• 39:10Neil deGrasse Tyson?

  Edit them.

• 39:11Speaker 02

  Mm-hmm.

• 39:12Neil deGrasse Tyson?

  There's something wrong, fix it.

• 39:13Speaker 02

  Fix it.

• 39:14Neil deGrasse Tyson?

  Come out, you got the perfect gene, let's find out where

• 39:16Chuck Nice?

  How those two black people end up with a white baby?

• 39:20Speaker 02

  They fixed it.

• 39:23Neil deGrasse Tyson?

  Let's find out where Ann takes us on that topic.

• 39:28Speaker 03

  So there's a new technology out called CRISPR-Cas9. It is a very easy gene editing technology.

• 39:34Neil deGrasse Tyson?

  It's a tool.

• 39:36Speaker 03

  It's a tool. And so what happened is the first time there was the recombinant DNA, there was a meeting, a famous meeting about the ethics.

• 39:43Neil deGrasse Tyson?

  Back in the like the 70s or something.

• 39:44Speaker 03

  Yes, called the Silmar meeting. And there's a new one that's being formed based on this new gene editing technology, and there has to be discussion. So in China, there was, you know, the first embryo that was gene edited. And so people are already starting to do those types of things, but as we understand the genome better, and you can edit better, you have to understand where does society draw the lines?

• 40:06Neil deGrasse Tyson?

  Mr. Bioethicist, where does society draw the lines?

• 40:09Speaker 02

  I think we need to be very careful, because the problem is, we're editing the genes of embryos.

• 40:14Neil deGrasse Tyson?

  We could have said that. I need to get better information. Be careful. Thank you, Herr Dr. Professor of Bioethics.

• 40:22Speaker 02

  I'm just impressed how right you are. So we can take an embryo, and we could say it has the breast cancer gene, this is hopefully in a few years, or this is what people are thinking, we can make sure it doesn't have the breast cancer gene, we want it to have blond hair, blue eyes, we can put in blond hair, blue eyes, etc. The problem is, one, who will have access to this? So with a lot of reproductive IVF kind of technology...

• 40:46Neil deGrasse Tyson?

  Just to be clear, if you can get in the embryo to remove the breast cancer gene, do you do that there and then because there are fewer genes that you have to do that to?

• 40:56Speaker 02

  So, right, so for instance, rather than...

• 40:58Neil deGrasse Tyson?

  Because every one of my cells has that information.

• 41:00Speaker 02

  Exactly right. So any one of your cells could, you know, get too much UV light or something in an airplane or something, too much radiation, start to go berserk, and that's what can't...

• 41:10Neil deGrasse Tyson?

  Less likely for Chuck and me, but go on.

• 41:13Speaker 02

  Okay.

• 41:14Chuck Nice?

  Little bit of a sunshade happening.

• 41:15Speaker 02

  Right, okay, right.

• 41:16Chuck Nice?

  UV filter.

• 41:18Neil deGrasse Tyson?

  We got genetic UV filtering.

• 41:20Speaker 02

  There you go, right.

• 41:21Neil deGrasse Tyson?

  But go on.

• 41:22Speaker 02

  I'm envious. So, when the embryo, though, there is just one big cell at a certain point, right?

• 41:30Neil deGrasse Tyson?

  So there you go.

• 41:31Speaker 02

  Before we go into two cells, four cells, so by changing the one original cell that makes us, when the egg and sperm combine, you can then affect all the genes. The problem is, what if we make a mistake? We find that a gene actually does two things. So that gene may lead to some cancer, but it also gives you, helps with intelligence.

• 41:49Chuck Nice?

  Right.

• 41:50Speaker 02

  Or that gene may give you blond hair, but it also lowers your something else that you need.

• 41:57Chuck Nice?

  Or you take it out and you're born with nipples for eyes.

• 42:00Speaker 02

  Well, but again, we

• 42:01Chuck Nice?

  Chuck, what? I don't know, Chuck. This is where my mind goes.

• 42:08Speaker 02

  I know, right, right.

• 42:09Chuck Nice?

  Sorry.

• 42:10Speaker 02

  Well, but, but the idea is that we don't know what we're playing with here, and that's what the danger is, is one. And the second is, down the line, who will have access to this? So, right now, it costs a lot of money and people pay out of pocket for, right now, we can screen embryos for different diseases. And wealthy people can now say, "I want to screen the breast cancer genes for my embryos so my kids don't get it."

• 42:30Chuck Nice?

  And while you're there.

• 42:31Speaker 02

  And while you're there. Poor people can't get this. So, in the future, it may be that certain diseases become more diseases of poor people than of wealthy people who could afford to screen it out.

• 42:40Chuck Nice?

  That's kind of already the case still, when you think about it.

• 42:42Neil deGrasse Tyson?

  Healthcare in general.

• 42:43Chuck Nice?

  From healthcare in general.

• 42:44Speaker 02

  But the question is, do we want to make it worse?

• 42:46Chuck Nice?

  Okay, fair enough.

• 42:47Speaker 02

  Anyway, so, and the other problem is, even now, we're trying to develop stem cells from skin cells. They make a lot of cancers. We make mistakes for figuring it out.

• 42:56Neil deGrasse Tyson?

  But all of that is to cure something that, where there was a problem.

• 42:59Speaker 02

  Yes, correct.

• 43:00Neil deGrasse Tyson?

  Clearly, if you can cure something that was a problem, you can take something that's not a problem and make it better, right? You can improve something that might have just been average.

• 43:09Speaker 02

  We could try.

• 43:10Neil deGrasse Tyson?

  Okay, is that, is that, is that on the docket?

• 43:12Speaker 02

  So, the Chinese are very interested in looking for genes for intelligence.

• 43:15Chuck Nice?

  Oh, brother.

• 43:16Speaker 02

  If we find a gene for intelligence, let's stick it in every embryo we got.

• 43:19Neil deGrasse Tyson?

  Yeah.

• 43:20Chuck Nice?

  Plus all.

• 43:21Speaker 02

  The problem is, there have been millions of dollars spent looking for genes for intelligence. They found one that's the most powerfully predictive one. If you have this gene, you get one extra point on your IQ test. That's it.

• 43:31Chuck Nice?

  That's it.

• 43:32Neil deGrasse Tyson?

  Really?

• 43:33Speaker 02

  So, there's a lot of stuff we don't understand.

• 43:35Neil deGrasse Tyson?

  And it turns you into a jerk. You're a smart jerk that no one

• 43:39Chuck Nice?

  It may.

• 43:42Neil deGrasse Tyson?

  No one will have babies with you.

• 43:44Chuck Nice?

  Big nasty a-hole.

• 43:46Neil deGrasse Tyson?

  That's right.

• 43:47Chuck Nice?

  Right?

• 43:48Neil deGrasse Tyson?

  So, because that's what, that was the theme in the film, Gattaca.

• 43:52Speaker 02

  Yes.

• 43:53Neil deGrasse Tyson?

  Gattaca wasn't inventing new humans. It was using your entire genome and saying, "Let's get the best that is within you, match it with the best of who is with your mate."

• 44:05Speaker 02

  Right.

• 44:06Neil deGrasse Tyson?

  And I had to ask Ann, what was her take on the movie Gattaca? And let's find out.

• 44:11Speaker 03

  Gattaca is actually, in a large part, a movie about inspiration of what's possible. Because they essentially took this individual and said, "This is your genome. You can't do these things." And he kind of said, "Screw you, I'm gonna do it anyways." And he showed that there is a balance between genome and environment. And that as much as people can have a genetic predisposition for something, there's potentially things in your environment that you can do to overcome it. And to me, that is why I started this company and why I do this. Because I want to know what I can change.

• 44:37Neil deGrasse Tyson?

  So the part about designing babies, that was not a thing to you. But the fact that the guy in the end, who wasn't genetically, that he swam farther, that that was the cool part. By that was a cool part, but they created their own baby. And there was the piano concerto with, and the person finishes and he has six fingers on each hand? That's why the music had, there was more notes getting played.

• 44:57Speaker 03

  There is...

• 44:58Neil deGrasse Tyson?

  So that didn't disturb you?

• 44:59Speaker 03

  I actually, I tend, I am a half, you know, a glass half-full kind of person. So I tend to focus on the positives here. And I think there's a massive positive for the potential of genetics.

• 45:11Neil deGrasse Tyson?

  Okay, yeah, just in case people didn't see the movie Gattaca. There was, people were being genetically engineered. And one person played the piano and it was beautiful. And he shows up later and he's got six fingers.

• 45:21Speaker 02

  Six fingers. Only he can play the particular piece that's being played.

• 45:24Neil deGrasse Tyson?

  Exactly. And so it was an intriguing experiment in what the potentials are of the human genome. And there was one guy who was not so born, not born with such intervention. And...

• 45:37Speaker 02

  They're called invalids.

• 45:38Neil deGrasse Tyson?

  Oh, that one, I forgot that. That's why they're invalids, invalids. And at the end, he was able to not be constrained by the expectations of his genotype. And he did things that actually surprised other people. And so she focused on that. But to me, the rest of the movie was still kind of weird.

• 45:57Speaker 02

  Well, there's two, a few problems. One is, I'll say, the hubris of prediction. In other words, a notion at birth, "Oh, this child has a 70% chance of this, a 60% chance of that." That kind of predictiveness, we don't yet have. The notion that there is this gene, that that gene, that's 100% predictive. Every medieval fairy tale has a soothsayer or the crystal ball that can tell us our future. Wouldn't it be great to have? We don't have that. We need a lot more information. Even there, there'll be, for good or bad, some of us think for good, a lot of variability. The other thing is, it's a discriminatory society where even that little bit of genetic difference could make-

• 46:34Neil deGrasse Tyson?

  We're tribal.

• 46:35Speaker 02

  We're tribal. The problem is with genetics, you can imagine a school saying, "We want the kids who don't have that gene that gives them a little predilection for autism." And Johnny has that-

• 46:46Neil deGrasse Tyson?

  Gene bullies.

• 46:47Speaker 02

  There you go.

• 46:49Chuck Nice?

  Oh, I love it. Oh, I am gonna write a whole animated series called Gene Bullies.

• 46:55Speaker 02

  My most recent book actually is called The Ethics Police.

• 46:58Neil deGrasse Tyson?

  Ethics Police, okay. Is it out yet?

• 47:01Speaker 02

  It came out a few months ago.

• 47:02Neil deGrasse Tyson?

  A few months, I'll look for that. Why didn't you bring that one? I would have held that up.

• 47:05Chuck Nice?

  The arch enemy of the gene bullies.

• 47:06Neil deGrasse Tyson?

  We get the whole superhero scene, the scenario already figured out. Yeah, so I think, like any great discovery, scientific or exploratory, there's always dangers. There's dangers that can kill us, dangers that can... But with wise governance, leadership, guidance, such as what your job is, I don't see why we can't take this as far as we can into the future and improve the species, not in a Nazi eugenics way, but in a sensible way. Get rid of the diseases, improve the quality of people's lives, and I think we're good to go.

• 47:44Speaker 02

  So, these absolutely should be goals. It's important that we have equal access, so it's not just gonna be the super wealthy people who get this, but everyone has access. And I think absolutely there are diseases we can get rid of with genetics, there are treatments that we could use that are better, will help us better than the current way we give out drugs, etc. So I think there's a lot of terrific possibilities, and this is a great opening field.

• 48:11Neil deGrasse Tyson?

  And I'm glad we solved all those problems in this episode. Start talking. Thank you, Robert Klitzman. Your book- Am I my genes? It should be on everybody's shelf. Chuck. Always a pleasure. Always good to have. It should be everyone's lap as they read it. That's how weird this should be. Chuck, always good to have you here. Always good. I've been your host, your personal astrophysicist Neil deGrasse Tyson, bidding you as always to keep looking up.