Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.

Emily Silverman  

This episode of The Nocturnists is sponsored by the Bucha Institute for Clinical Excellence at the University of Chicago. The Institute is dedicated to fostering compassionate doctor patient relationships and advancing clinical care each year, the Bucks bomb Siegler Institute recognizes extraordinary healthcare professionals through the National Clinical Excellence Award. To learn more about the award and to nominate a deserving clinician, visit Bucksbaum institute.uchicago.edu, support for The Nocturnists comes from the California Medical Association. Your listening to the nocturnist conversations. I'm Emily Silverman. Humans invent technology. It's just what we do. The agricultural and industrial revolutions were major tipping points in our history, transforming how we live and work, and while they led to incredible improvements in nutrition, living conditions and quality of life overall, they also led to something extraordinary, a population explosion. Think about this. In 1928 there were around 2 billion people on Earth. By 2023 there were 8 billion. If you look at a graph, it's basically a right angle. And while that growth is a testament to human ingenuity, it also brings forward existential challenges. How do we feed and care for everyone while protecting the planet? How do we prevent climate devastation, pandemics, large scale war? Our guest today, Jamie Metzl, has been grappling with these questions for decades. He's a historian and science policy expert who served in the Clinton administration, advised to the US National Security Council in the United Nations and worked with the World Health Organization. He's also the author of multiple books, including the 2019 hacking, Darwin genetic engineering and the future of humanity, and several sci fi novels that use storytelling to make scientific ideas accessible to the public. In his latest book, super convergence, how the genetics, biotech and AI revolutions will transform our lives, work and world. Jamie argues that these technologies, which we normally think of as separate, are starting to converge into a single, intertwined force that, yes, poses threats to humanity, but can also be used to constructively guide us onto a better path in our conversation, we explore Jamie's unconventional career path, the accelerating pace of technological advancement, and his perspective on the origins of COVID 19, including his view that a lab leak is the most plausible explanation, a topic that remains hotly debated, but nonetheless highlights the critical need for safety frameworks in scientific research, we also discuss how innovations like genetically modified food and lab grown meat could help preserve wild land and reduce carbon emissions, and why it's critical to engage everyday people in conversations about humanity's future, instead of leaving those conversations only to experts behind closed doors. This is a conversation that shift in my perspective, it's easy to focus on the risks and dangers of technology, but Jamie makes a case for how, with the right approach, we can turn those same technologies into powerful solutions to protect ourselves and the planet. But before we dive in, take a moment to listen to Jamie reading from his book super convergence.

Jamie Metzl  

Imagine you're a farmer in 18th century England, around the time the first seeds of the Industrial Revolution were being planted, you meet an enthusiastic inventor who describes to you the incredible new technology making it possible to replace some human power with energy derived from steam and coal. What would you think, even if you were a big thinker, would your first thought be? Here comes the International Space Station, CRISPR, babies in generative artificial intelligence, all direct outgrowths of our first steam engines? Or would you be imagining that someday, replacing the cattle and horses pulling your plows with steam driven plows could help you do the same work a little faster for most of us. The second option is how we normally think now, imagine you that same farmer are invited to a global gathering, a prophetic visionary has convened quote our new capabilities to translate steam and coal into power. The host says, will transform all of our lives and how our economies and societies function. They'll drive rapid population growth and urbanization change the nature of the work most of us do and massively increase our. Productivity, although the technologies of industrialization will make our lives easier in countless ways, they'll also make industrial scale war and human induced global warming possible, which could threaten our very existence. But before any of this has played out, I've brought you together to consider what steps we can take now to maximize the benefits and minif the harms associated with this revolution heading our way, trust me, sooner than most of us can imagine. Huh? You might say to yourself, you mean that thing that will help me plow my field faster.

Emily Silverman  

I am sitting here with Jamie Metzl.Jamie, thank you so much for coming on the show.

Jamie Metzl  

My pleasure. Emily, happy to be here.

Emily Silverman  

So Jamie, as I was saying to you offline, this book kind of blew my mind. And before we dive into the content of which there is much I wanted to hear a bit about your background. You have a PhD in history. You're very well versed in the sciences, but you're self taught in the sciences. Some people call you a futurist, quote, unquote. So tell us about your background and how you came to be doing this work.

Jamie Metzl  

The Genesis was in the 1990s when I was working in the Clinton administration on the National Security Council, and my then boss, Richard Clark and now close friend, he was this really incredible visionary. He actually was kind of the Cassandra of 911 he predicted that future, but wasn't able to address the fears that he had been articulating. And what Dick always used to say is that the secret to efficacy, both in Washington and in life, is to try to solve problems that other people can't see. And so for me, almost three decades ago, I was just looking around at the world, and I really felt that these intersecting revolutions and overlapping revolutions of machine learning, what we became known later as AI and biotech and genetics, and all of these fields that were really much more nascent then than they are now, were going to have profound implications, not just on what it meant to be humans, but on so many of our different systems. And I started just reading everything that I could find to try to understand this theme. And I became really obsessed. I started talking to all kinds of people, interviewing people. And when I was ready, I started writing articles, initially for national security publications, about the national security implications of the genetics revolution. And then I was invited by a member of Congress who'd read my articles, who said, we have to do a congressional hearing on this. I was asked to help organize that hearing and be the lead witness, which I did, and I started writing more, and I was traveling around the country and speaking about these issues, and I could feel that I just wasn't breaking through. And so in order to break through, to try to get a message that people could hear, I decided to do what I had done earlier. My first book was my PhD dissertation was on why the world failed to respond to the Cambodian genocide, and my second book was a novel exploring those same issues in the context of stories, because that's how we learn as humans, through stories. And so this time, I decided, you know, I'm going to write novels about these big issues that we as a species are facing, genetic engineering, life extension, the science of aging. So I wrote my novels, Genesis code and eternal Sonata, which were very successful. And while I was traveling around the country, and I just found myself talking about the human genetics revolution, and say, well, as big of a deal as the human genetics revolution is, it's actually just a little piece of a much bigger story. Is that after nearly 4 billion years of life on Earth, are one species among the billions, or even trillions that have ever lived, suddenly, has the increasing ability to engineer novel intelligence and re engineer life. And the question for us, and maybe for the future of life on Earth, is whether we can learn to use these almost God like superpowers wisely. And if we can, we can do incredible things in healthcare, which is very important to us, but in all sorts of ways, where we humans are interacting with the living world around us, whether it's plant and animal agriculture, industrial materials, energy, computing, data storage, a big story, and I wanted to write a book that could help bring people in to the big story. I know that your podcast is for health professionals, but the reason why healthcare professionals need to understand this bigger story is that this bigger story is the future of healthcare.

Emily Silverman  

I love that you get your message across in non fiction and in fiction. We here at the nocturnist are big believers in the power of storytelling. So I love that you're using both. I want to thank. Back up a bit and talk about these revolutions that you walk us through in the book. So there's the agricultural revolution, the industrial revolution, these digital revolutions, with the internet, biotech revolutions, genetic revolutions, the AI revolutions. But talk to us about the rate of acceleration of this technology and the revolutions. How much time is there usually between revolutions, and how is that changing? Because I really want to drive home the pace of this. 

Jamie Metzl  

It's really an essential point. And because you talk about all these different revolutions, and anybody, any rational person listening to this podcast, say, Well, geez, that's a whole lot of revolutions. How do I think about these revolutions, and that's why the first chapter of my book, it's called the nature of change. Because unless you recognize that the story here is not any one revolution, it's the nature of change. It's the acceleration of technological and even social change itself, then you're going to be starting your process too far downstream, and you'll just be overwhelmed. So the basic story is that we are unleashing what still is the greatest transformative power in our world, which is human imagination at scale. And so a couple ways I like to talk about it. One is 100 years ago only there were 2 billion people on earth with about a 15% literacy rate. Now we have over 8,000,000,085% literacy rate. That means we've gone from around 300 million people able to participate in the world of knowledge shared beyond their immediate communities, to over 7 billion people. We're all connected to each other. So we don't need to invent things that have already been invented somewhere else to discover things that have already been discovered, which is what our ancestors have spent a huge percentage of their time doing, just because they weren't connected to each other. And then we have names for different technological revolutions as just mentioned, but really what we're just seeing is an acceleration of the rate of change, and part of the reason for that is that every technology is embedded, in many ways in every other technology. So a simple way of describing it is about 10 to 12,000 years ago, we had our agricultural revolution, and then as a result of our agricultural surpluses, we were able to organize ourselves into bigger communities, and then those communities had taxation and other things they needed to keep tabs on what was happening, and that helped push forward our development of writing and right now, if we just, if you and I, Emily, just pressed a couple of buttons on our computers and we saw the source code that was feeding into what we were doing. Well, we see we'd see ones and zeros, and maybe we'd see different letters of the computer code. And what are those letters? So the numbers are what we call Arabic, but they're really Hindu numbers, and the letters are what we call Latin, but they're probably better called Phoenician letters, but these are our ancient writing codes that are foundational for our computer codes. And with our computer codes, we can obviously have the computer revolution, the machine learning revolution, the AI revolution, and now with the tools of AI, we're able to interrogate complex living systems, living systems whose complexity goes way beyond our capacity to understand them using our unaided brains, and we're able to understand a much deeper appreciation, for example, of how a plant diffuses proteins through a leaf, and looking at those very efficient evolved natural designs, we're actually able to be inspired To create computer chips based on these natural designs, which speed better machine learning, better AI and more insights. And the basic formula is, the better and higher quality data you have, the stronger your algorithms, and the more computing power you have, the better able you and we are able to understand these very complex patterns, and the more that we understand the existing world around us that we are creating, the better able we're going to be to not just manipulate these systems, but manipulate the world around us. And so those are the drivers of these other changes. And for people in the sciences, just one really easy and very recent example of this, if you look at the Nobel Prizes recently announced in both chemistry and physics, both of them were awarded to computer scientists, not chemists and not physicists. That doesn't mean we had to run up great chemists and physicists. It just means that you don't need to be a chemist or a physicist to revolutionize chemistry and physics, and you don't need to be a physician to revolutionize healthcare. And what we need to do is build these complex ecosystems where humans can do the things that we do best, which is why I love your focus on storytelling, because I think humans this is just. Beginning for us. We have so many opportunities. I don't believe Artificial General Intelligence is even a thing. Actually, I don't even believe artificial intelligence is what we're building. We're creating machine intelligence. Machine may be super intelligent, not artificial humans. It's its own thing, inspired by us. And so these are the changes that are driving everything else, and because these technological innovations are compounding, that's why we're seeing this acceleration. Our ancestors, your plow was kind of like your father's plow, or my father and mother's plow, and your grandparents and great grandparents. And now we're just we're all feeling it in our lives, and it's so deeply ingrained. We don't even notice it like you get a new iPhone, if it's not a significant upgrade from your last iPhone, you're just pissed off and you feel like you've been ripped off for our ancestors just doing the exact same thing as your parents did in most cases, was the norm. It's a real change, but we humans, we adapt to change so quickly that we get bored with it and just assume that this revolutionary change is our new normal.

Emily Silverman  

The accelerating rate of change, in many ways, is exciting, but in some ways is scary and overwhelming. And I want to take a minute to talk about the inevitability of innovation. So we had on an amazing guest, Sarah Walker. She's a theoretical physicist. So Sarah believes that life is information propagating through time, and the purpose of life is to generate novelty, than to maximize the number of things that get to exist. And she sees our technosphere as a natural extension of our biosphere. She believes in a way life is destined to build technology. That is what life does. And so by that logic, you know, everything that's happening, this accelerating rate of change, is very natural and normal. There's also this thought of like, well, maybe we should slow down, or maybe we should stop it. I was reading these emails from 2015 between Sam Altman and Elon Musk that became available to the public because of a lawsuit. And in the email, Sam says, for those who don't know, Sam Altman is the head of open AI, I think we all know who Elon Musk is. Sam wrote to Elon, I've been thinking a lot about whether it's possible to stop humanity from developing AI, I think the answer is almost definitely not, if it's going to happen anyway, dot, dot, dot. And then he goes on to propose a project, and then Elon responds, probably worth a conversation. So I want to talk about this idea of like, can we stop it? Like, clearly people are asking this question, can it be stopped? Is it even worth having that conversation? Or do we just take for granted that this unleashing of imagination, this accelerating technology is going to happen, and then move on to the conversation of, what do we do about it?

Jamie Metzl  

So I don't know whether the universe has a stated purpose or an unstated purpose, or an implicit purpose or an unimplicity purpose, but there certainly are forces, whether it's the law of physics. I'm a big fan of Sarah's work, and where Sarah describes maybe everything that we're doing is just the universe trying to understand itself. So as individualized as we believe we are, we are just little pieces. If you look down at us from some other civilization, we would all just look like a bunch of ants. But when you look at these ants. You know, there are choices. Am I going to carry this leaf, or am I going to carry that leaf? Or am I going to go here or going to go there? Even though, if you just look at ant colonies, they seem to do a lot of the same things in these different contexts, the only way that we're going to stop this technology, which is a real possibility, is if we use it to create so much destruction that that creates a break in and of itself. But frankly, even that, there are people who say, well, we should have a turn off. But what do we turn off? I mean, this is a system of systems with no central node, with complete decentralization. So I definitely think that technological advancement over time is inevitable, and when you if you just look backwards in time for humanity, even if at the worst times, either they were spurring technological innovation in the moment, like World War Two, which was one of the biggest catalysts for innovation. But I think every one of these wars or they were laying the foundation for further innovations, like the black plague in the 14th century, which nobody at the time would have said, Oh, this is going to really spur innovation. But it turned out that having so many people die from the Black Plague ended up forcing levels of innovation in the second half of the 14th century and beyond. So for me, the question is not, is technological advancement inevitable? I believe it is. For me, as I said at the start, the question is, what can we do to increase the odds? That we will use these technologies and these capabilities wisely. And in my mind, that is the game, the press the off button people are going to lose. And there's no one specific answer, but I have a pyramid of layers, and at the bottom layer is the individual, individual education, engagement and empowerment. And then there's communal, there's corporate, and the other smaller communities that we are, whether hospitals or healthcare systems, in the case of healthcare, but lots of other things in other sectors, there's national regulation, sharing best practices across countries, certainly in health and agriculture and everything else. Some countries are better regulated than others. We can share ideas. There's International and certainly there are lots of international agreements in the United Nations, and there's global. And I think right now, one of the big challenges that we face is the mismatch between the nature of the greatest challenges we face, which are global and common, and the absence of a framework for addressing that entire category of problems. And so that's why I and others founded the global interdependence movement, one shared world. Because if we don't recognize that we're all sharing the benefits and sharing the risks, we'll live in a zero sum race to the bottom world. And so we really need to think more about how do we build a world that just better incorporates the mutual responsibilities of our complex, global interdependence?

Emily Silverman  

I want to talk about that framework in a bit, but let's first start with some of the more medical aspects of the problem. You actually give the COVID pandemic as an example of a case study of a way that things can go wrong. Talk a bit about the COVID story, you know, origins, prevention, containment, that whole story. How is that an example of technology backfiring on us and wreaking havoc on humanity?

Jamie Metzl  

I was actually sitting in this exact chair at this exact table where I am right now in late January of 2020, and I was telling my partner, I said, you know, it's funny. I'm looking at these news reports on COVID origins, which are saying it comes from this market in Wuhan, and I'm looking at the available evidence. And I'm seeing two different stories, because on january 24, of 2020, there was a paper in the Lancet showing that about 40% of the earliest cases of COVID 19 were people who had no exposure to the market. And I had recently been in Wuhan, so I knew Wuhan is not a place like where I used to live in Cambodia, we have these crazy wild animal markets. Would you think, Well, if there's going to be a pandemic, it's going to start here. People in Wuhan are highly educated, highly sophisticated, wealthy. They look down on the southern Chinese and Southeast Asians who have those kinds of dietary habits. So it didn't really make sense to me that you would have this kind of outbreak in a place like Wuhan, but I also knew that Wuhan had China's first and largest level four virology Institute with the world's largest collection of captive coronaviruses, and immediately learned about the research that they were doing their highly risky research, not just making chimeric viruses, but using the backbone of SARS coronaviruses and specifically attaching spike proteins and receptor binding domains to attach to humans at the point of our ACE two receptors, and then infecting humanized mice, Ace two humanized mice, with those viruses. And then we learned a little bit later that in 2018 an organization called Eco Health Alliance, along with the Wuhan Institute of virology and the University of North Carolina and others, had actually applied for $14 million of funding to DARPA to create these kinds of very specific chimeric mice that would be the exact, not approximate, exact blueprint for what would become a SARS cov two. And it turned out that in the notes on their application, the American guy, Peter Dak, was saying, Oh, we're going to put that this is going to happen at level three biosecurity, but actually, in China, we can just do it at level two bio security. And so it just seemed, then to me, and it seems to me now, that the overwhelming, beyond overwhelming hypothesis, is that COVID 19 stems from a research related incident, an accident in Wuhan where these scientists probably well intentioned had been young people trying to create a pan Coronavirus vaccine. Something had gone wrong. They were all young sure they didn't detect it for a while, and then the pathologies of the Chinese authoritarian state kicked in. And the reason why I say all this, and reason why I've been active on both sides of this story for all of this time is. So the COVID vaccines have saved 10s of millions of lives, and COVID, 19, by recent estimates, has cost about 28 million lives. And so these technologies don't come with their own value system. If someone said, Well, should we shut down virology and epidemiology? Well, the answer, obviously is no but do we need regulations? Do we need to really think deeply and systemically about how do we optimize benefits and minimize harms? The answer to that question is obviously yes. 

Emily Silverman  

Tell us about how some of the very technology that helped create the population boom, and you know, the climate crisis could be harnessed to, if not solve, at least mitigate some of the harms of climate change. And I'll just tack on one more question to that, which is I was speaking to a palliative care doctor recently who talked about using a lens of palliative care to address things like climate anxiety and climate grief. The idea of being doc, like, how long do I have? Is it curable? Is it reversible? And if not, what can we do to extend my life a bit or help with quality of life a bit? So I guess two questions is one, like, talk about how we got ourselves into this, how technology might help get us out, and then whether that frame of palliative care resonates for you, or maybe that's too pessimistic for you, because I do love your optimism.

Jamie Metzl  

I mean, we have to do better. When we had industrialization, what labor did fossil fuels replace? It wasn't like we lived in Utopia and then industrialization ruined Utopia before industrialization humans and animals did all of the work. So it is not at all coincidental that mega scale human slavery ended as industrialization began, because somebody or some machine actually needed to do the work. And although there are uninformed people who, when they think of slavery, think, Oh, I know what slavery is. Slavery is American slavery. Everybody was doing slavery. There was massive scale slavery in Africa itself. The Arab slave trade was bigger than all of the Atlantic slave trade. That is the history of humanity. It's not like we should go back to this kind of golden age. But as I said before, the reason why we have increased the reason why we can have problems of climate change and land stress from growing populations, is that we've solved past problems so well that now we have all of these capabilities to grow our human populations, and that's everybody, every generation. We're always the old lady who swallowed the fly. And so now the question is, well, how do we solve this problem? We have to look at, well, what are these different sectors, and how do we want to do it in agriculture. Agricultural productivity has increased by about three times, so 300% over the last 70 years or so. And that's why we can have all of these people. But if we just go from our current 8 billion to 10 billion people over the next few decades or so, these are people who are whose parents are currently poorer, but who will all become wealthier? They're going to want to eat like us. If we just scale up our current forms of agriculture as is, which is already a pretty revolutionary way of doing agriculture relative to previous times, we're going to have to wipe out all the wild spaces on Earth in order to do that. So the question is, how do we increase agricultural productivity with fewer inputs of land, water, fertilizer and energy and other things, and so part of that answer has to be agriculture itself is a form of radical biotechnology. So it's not like we're using technology on some kind of natural ecosystem. We're using technology to just amend other radical technology. And so part of that will be that we're going to need to continue to do things like modify seeds, which is whether it's transgenic modifications, what people call GMOs, or using tools like CRISPR to edit the genomes inside of plants to make them either more agriculturally productive, better able to withstand hotter temperatures, salination or other things thinking differently about fertilizer, moving from synthetic fertilizers that have been so transformative over the last 100 years to manipulations of the microbiomes. That line the roots of plants or in soils to do more naturally what our fertilizers are doing. And the big win is to think differently about animal agriculture. I mean, the right answer, of course, is for everyone to become a vegetarian. But in every society, including America and Europe, in spite of all of the veganism and increased awareness per capita consumption of animal products is going up. So the question is, well, can we get the animal products that we want and do so with a lesser footprint, and we'll see about issues of cost and scale, but in principle, the answer is yes. We can extract stem cells from the healthiest living animals, grow them in labs, expand them in industrial bio reactors, and have molecularly identical milks and meats. And maybe even better, maybe even with better taste profiles, better health profiles. And if we can do that at scale, and it doesn't mean eliminate all of our consumption of animal products, maybe we can make a big dent in that. And so it's, as I said at the outset, the big story is our increasing ability to re engineer life. It's showing up in healthcare. But it's not coincidental that many of the founders who are having the greatest impact in cell culture and also cultivated meat. Companies are all regenerative medicine doctors. We're saying, Well, we're in the business of generating tissues, and so we're generating tissues of living beings, in this case, humans. But what if we just applied these exact same technologies in other in other contexts. And so because the macro story is humans understanding and increasingly being able to manipulate living systems, that's why I've written super Converse. It's all one story. Human Health is critically important and critically important to us, but that's just one piece of this bigger story.

Emily Silverman  

So you talk in the book about how getting together and figuring out, how do we maximize the chances that things go well and minimize the chances that things go wrong? How that's a really important thing to do. And obviously the way to begin is to get people in a room and get them talking. And so you talk in the book about how in 1975 I think there was the Asilomar process, where a bunch of smart people got in a room to hash out some suggested rules. Later, there was a similar conference in Napa Valley. Later, you talk about yourself being part of a who committee after the CRISPR baby in China occurred, trying to lay out like, how do we think about this. But you also said, in your case, after the report came out from the WHO committee, that, quote, releasing our report felt kind of like marching to the edge of a cliff and flinging papers into the swirling air while shouting into the wind. And you talk later in the book about how keeping the conversations among experts in these closed rooms and cutting off ordinary people from the conversation, that that can backfire, and one example of this is the activists against GMOs. For example, GMOs got a really bad rap, and one reason that that might have occurred is people just weren't kept in the loop and educated about what a GMO is and how dangerous is it, or how safe is it. So talk a bit about as we're putting together these guard rails. How do we broaden the conversation to include more than just top level scientists.

Jamie Metzl  

Asilomar in 1975 if you go to really any science group, they all say, oh, we need to do an Asilomar for AI and Asilomar for whatever, because it's considered the gold standard of responsible science. Because these scientists who got together in 1975 in California, where you are, they did a great job of saying, hey, this thing is coming. It'll have huge implications. We want to recommend a safe way forward. And their recommendations became enshrined in law. I think it's had a very positive impact on how these, these developments, it was then called recombinant DNA, have played out over time. But the reason why in the book, I say it was not the success it's been advertised as is because public engagement, Inclusion and Engagement just wasn't enough. It was hard to do in those days. It was pre internet. It was hard to do, but it just wasn't enough. And so that's why, when I'm a deep critic, not of everybody who has concerns about GMOs, but most people are victims of massive, knowing, highly cynical, active misinformation campaigns organized by organizations like Greenpeace that are actually, in my view, doing very, very real harm. It doesn't mean there aren't issues with GMO crops, issues of mono culture, issues of corporate control, and we need to address all of those. And so we do need higher levels of engagement. And one thing that I've been deeply involved in is, well. What are the right levels of engagement on issues of COVID 19 and so we're at the age of these radical revolutions. It's not possible to consult everybody, but we need to recognize that regulation is just one piece of this broader category of governance, government regulations will fail unless we have some type of all of society consensus about the directions in which we should move. So based on some of the nominations that President elect Trump has made, all kinds of people who are raising questions about vaccination, maybe some legitimate, certainly some of them less than legitimate. And so if this happens, if we have this national anti Vax movement, and there's another pandemic, which there almost certainly will be, it's my view that many, many people will die, and that's really unfortunate. So what's the takeaway from all this? Is that public education, engagement, empowerment, as difficult as it is, and it's even more difficult in the middle of crisis like COVID 19, when we're trying to move quickly, it's more important than ever before there's a level of humility that's really difficult, that is required among all experts in our society, not because we don't need experts, we absolutely do, but just because our information systems are distributed, and when people don't feel heard rightly or wrongly, people start to have distrust. And that's what's happening in not just our society. When you look at what's happening really across the world, Romania, Georgia, France, South Korea, almost every democracy is having breakdown of trust and mutual trust, and lots of them are being manipulated by hostile outside actors. So I'm not saying that this is easy, but the answer, the alternative to public engagement and consensus building, either it's the nanny state, which may be places like United Arab Emirates and a few other places can pull off or it's well functioning democracies, and that's even more difficult to do. But in the healthcare field, we can look at places like Estonia or Finland, where democracies are actually working, where they're actually building pretty solid healthcare systems that are incorporating new ideas and bringing people along and growing in our bigger and more diverse societies. It's more difficult, but it's no less important.

Emily Silverman  

The title of the book is Superconvergence. And so the idea is that all of these revolutions are starting to converge and kind of become one thing, in a way, and you write in the book, if we solve for pandemics, but not climate change, we lose. If we solve for pandemics and climate change, but not nuclear weapons, we lose. If we solve for pandemics, climate change and nuclear weapons, but not for runaway AI and synthetic biology, we lose seeing each of these issues separately is kind of like seeking to create a new vaccine for each flu virus we encounter. And you go on to say that it's great to have an AI committee and a nuclear weapons committee and a climate change committee, but that all of these issues share a common root, and that we need to address that common route. And you use the term, which I thought is really interesting, we need to, quote, update our global operating system and quote, to address this one convergent issue. So I was wondering if you could talk about that, and what does that look like? 

Jamie Metzl  

All of these issues are coming together, and just like with the flu example. That's why a universal flu vaccine is so important. You say, Well, what is the common element of all of these flus? And so ideally, rather than having a bespoke flu vaccine every year, we can say, well, all of the flus have these common elements or these common vulnerabilities, and we can address those. So right now, as I said before, the common vulnerability is that we, collectively as humans, have developed these world changing superpowers, but we don't have a way of solving common global problems. And so if that's the case, you have all the energy in the world, and it almost seems impossible to solve climate change, but let's say you do it, but don't solve these other things, you don't win. So the way to win is to think about this global OS upgrade, and that also just seems impossible, until you realize that the world which we occupy now is not an inevitable one. We live in these nation states, which are primary organizational principles for the world. But the modern nation state was really fully codified only in the middle of the 17th century, after the 30 Years War, through the treaties the Peace of Westphalia, and then after two world wars, we realized we needed some kind of international process to bring countries together, and that was the UN and the Bretton Woods. And now across the board, we're seeing the total failure of the United Nations, which is really not playing a significant role in any major global problem. And in some cases, with UNRWA in the Middle East, it's actually causing harm. And the Secretary of the General of the United Nations, whenever he meets with people, he says, Oh, I have no power. All I can do is get in the press. And so he just makes statements, trying to make each statement stronger and stronger about any issue. So the UN system has totally failed. The problem is we need it. We need the UN more than ever before. So those of us who are critics of the UN, I'm not a critic of the UN because I want to abolish it. I want a better UN, and I do a lot of work with the who these hard working people, the WHO incredible people would be the first to say, you are expecting us to solve these global problems, but we don't have a mandate to do it. When China was blocking the WHO from from going to Wuhan in early 2020 and lying to the WHO about human to human transmission, the who didn't have that many tools. They couldn't say, you know, we're going to go to Wuhan anyway. Their entire budget is smaller than the budget of an average US teaching hospital, and they only control 20% of their own budget. So it's one thing to say, Oh, the who isn't doing its job, but the harder question is, well, why isn't it? And the reason it's not is because of us, and if we want that to be different, we need to say our what's it going to take for that to be different? And then in the book, I say, but even that is not enough, because our problems aren't just International. Our problems are increasingly global. And so just like our brains are kind of like, you know, one ice cream scoop with our neocortex is the latest scoop, we need another scoop on top of this system of the nation state, which was helpful but also harmful. Now we need another scoop. That's the global OS upgrade that I talk about, and that is we need to build a new layer in our world based around the mutual responsibilities of our complex global interdependence. And I'm 100% certain we're going to do it. We're gonna do it in one of two ways, 99% chance we're not gonna do enough now and then there's gonna be some huge crisis, whether it's a synthetic bio pandemic, much, much, much worse than COVID, or some kind of global nuclear war or an ecosystem collapse that forces us to realize that even if, like me, you're living in this big city of New York City, we're totally reliant on these living ecosystems around us for our food, for our air and all those kinds of things. So if there is that kind of crisis, we're going to crawl out of our holes afterwards and say, you know, we better organize ourselves so this doesn't happen again. It's kind of the equivalent of a Martian attack, or there's a 1% chance. And that's me being an optimist, that in a spirit of love and our shared not just humanity, but are you sharing this planet with all living beings, we can articulate what needs to be done and start working in that direction. In 1795 was when Immanuel Kant articulated his idea for of a league for peace, because he saw these competitive nations are going to kill each other. And it was 150 years and the failure of the League of Nations finally later in 1945 was when the San Francisco treaty was signed establishing the United Nations. We need that, and that's the real challenge. Is that we live in a world where we're increasingly divided. We are already in a new Cold War between, certainly the United States, China, Russia, Iran and North Korea. So we're moving in the opposite direction in really dangerous ways, and nothing is going to stop us, but if we continue on this path, we're going to have some kind of other crisis. I mean, where our world feels today, to me, at least, kind of like the 1930s where all these trend lines and everything's moving in a dangerous direction. And there are lots of people who are saying, hey, wait a second, this doesn't sound good. So if we do nothing, we're going to have a bad outcome. But I am an eternal optimist, in spite of everything I've just said, and I think that responding to what Sarah said, I think technological advancement of some sort is inevitable, but we have a lot to say. A about how it happens, how we're organized, how we collaborate with one another, how we use these incredible technologies to do what every healthcare professional is doing. How do we treat people better, to have better outcomes? Because healthcare outcomes aren't just about health or healthcare, they're about human potential. Every the opportunity to love to write poems, to spend time with people, to think of new ideas. So that's what, really what this is all about. 

Emily Silverman  

Wonderful. I think that's a great place to end on that little note of optimism on top of a heap of dread, in a way, but, but I think it's so important to have voices like yours in the mix, and books like this. The book is called super convergence, how the genetics, biotech and AI revolutions will transform our lives, work and world. Thank you so much, Jamie, for all the work you're doing to guide us toward a better world, and for your eternal optimism. I'm going to be hanging on to that for sure. Awesome.

Jamie Metzl  

Well, thank you so much, Emily. It's my great pleasure, and it's, it's like this whole thing, we all just have to keep trying. And little by little, if we all push in the same direction, maybe we'll, we'll make some progress. So thank you.