Forget ageing, let Google manage you!

I can visualize the oodles of intellectual optimism and excitement generated when Bill Maris & Ray Kurzweil sat down for the very first time to envision Calico to ‘Tackle Ageing’ & prolong lives. But despite an equally bold mission statement saying Calico will ‘Devise interventions that enable people to lead longer and healthier lives’, I find it difficult to believe that Larry would’ve agreed to sink millions in this seemingly altruistic goal of creating a clutch of wonder pills that increase human lifespan, in about a decade plus, without fully addressing some key questions, most importantly why Google, why ageing.

Even if in their new-covert enthusiasm (to healthcare), Bill, Larry et al would’ve down-played the primary question of why Google, it’s unlikely a battle-worn pharma baron like Richard Gonzalez would ignore the same. But the fact that Gonzalez is firmly sold on to this idea now indicates that Calico’s actual potential is not definitely limited to mere (& slow) fruition of their stated long-term vision.

Secondly, while it may look like a really compelling cause given the promise of long-life, scientifically I’m still unsure what makes ageing research an attractive business proposition considering Alzheimer’s drug development is struggling with a depressingly high failure rate of 99.6%? Perhaps Google saw some merit is in this very realization that ‘Alzheimer’s Cure’ is pretty much an oxymoron and prevention is where the hope lies. Of course ageing is much more than Alzheimer’s and hopefully the rest of the pathways that arrest degeneration don’t have as many pitfalls and mines as Alzheimer’s does, but how is this untested promise of tackling ageing alluring enough for a healthcare upstart like Google to jump-in with a big-ticket investment?

Through my freestyle inquisitive ramblings below, I have tried to better understand this stealth start-up & see if my above hypothesis makes some sense. Also, despite knowing CALICO is set-up as an independent company, I have dealt with this like Google’s still the boss.

What’s in a name? – Quite a bit actually

Other than the obvious fact that it’s short for ‘California Life Company’, the name surely reminds one of a Calico cat. Art Levinson was apparently okay with the cat connotation in connection with a cat’s nine lives (read: longevity). But looking at all the illustrious names on the team, one'd surely suspect the connotation is far deeper than it looks & there's more to Calico than the cat itself.

After some serious searching, I could make some connection. The biological background to the curious phenomenon called calico cats lies in a spontaneous genetic mechanism called X-inactivation & the effects associated with relative Degree of Skewing (DS) of paternal & maternal X chromosomes among female of the species.The most interesting find in this connection is a study published on NCBI that establishes a link between higher DS & longer lifespan – one of the authors of this paper incidentally is Prof. Kaare Christensen of Danish Ageing Research Centre, University of Southern Denmark.

Great conjectures all, but I’m wondering where does this leave male-longevity? :-)

Let me get this off my list

Is Calico Google Health 2.0? Google Health (GH) was merely a medical data management initiative, a natural offshoot of Google’s cloud aspirations but also Google’s first tentative entry into healthcare. As a “personal health information centralization” service, GH depended on people adapting the same and needed other support organizations to achieve scale. While Google never claimed they did, GH’s monetization was perhaps through positioning healthcare products, solutions to individual users based on the information available against their profiles. Given this background, it doesn't look likely Calico is just rehashed Google Health.

Now the primary reason for closing GH is stated to be ‘the low adoption’ of the platform by users - Really? Did Google really expect to cover the world within one year after it released the finalized version of GH in 2010 before announcing its retirement in 2011? This super-short life-cycle makes me suspect if Google Health was a recce for Calico if not its previous version. If indeed GH was planned as a recce or even if it was coincidental, I guess there would have been some key takeaways; learning from this escapade that went into design of Calico – a few that come to mind are;

• What healthcare data an average individual is comfortable putting up on cloud & what she/ he isn’t
• How easy or tough it is to ensure consistent updating of good quality, verifiable data?
• The minimal data points required to estimate an undisclosed indication(s) (user needs) and have a firm basis for monetizing the venture.-------- E.g.when someone uploads Vitamin-D levels on a quarterly basis, other than the fact that the subject is Vit-D deficient if), estimating the manifesting condition is not still possible unless some other kind of data is uploaded which when read together with the first throws up a tangible story. Now if the same user uploads data on bone-density and say a Vertebral CT Scan, it may be safe to assume the user’s actual condition is that of spondylosis pain & thus attempt reaching out to the user and propose solutions.

• Did the solutions advised/ advertised, push-notification made to the users translate to any tangible change in their choices (of where/ what to spend) & what percentage of users were inclined to take endorsements as ‘real’ health solutions?

It’d be reasonable to assume that Google Health conceived in 2008 was piggy backing on the quantified-self trends that incidentally are still strong and was essentially designed to accept, process data fed manually either by user or by supporting stakeholder organizations. However given the proliferation of the wearable digital health feedback systems in past 2 years & given the inherent limitations of the GH platform to integrate internet of things may have prompted Google to discontinue GH and think of a completely new to way pursue its Health ambitions.

Why is Google thinking health?

Calico in its stated vision is unabashedly a healthcare company & nowhere hints at anything even remotely Googlish (sic). So what prompted Google to enter a domain that’s clearly & completely unconnected to its core-competencies. If I let alone the self-actualization needs of Larry & Sergei and Google’s avowed itch for innovation & paradigm-setting, what unstated and unassailable advantages Google already has/ will have over other Pharma biggies who've been there and done but yet can’t confidently talk of prolonging lifespan?

Of course Sky Nash on LBB earlier did say ‘Utilizing the world’s leading minds and Google’s raw computational power, Calico promises to lift, correct and protect humans from aging’. Computational power is fine, but Google neither owns nor has even an indirect stake in any of the invaluable clinical data generated by pharmaceutical innovator organizations over thousands of clinical failures and some successes. So what other kind of data can potentially help them do a better job of putting out drugs and those that tackle ageing at that? – could it be;

• Not to the same level of detail as FB has and not as structured, but Google has user information that could be put to use in wellness business.
• Google’s probable access to the data of online sequencing companies like 23andMe & DNANexus (GV invested into these companies).

If user data is at the base of this opportunity, how is Google data better than FB's which is far better differentiated & spread across billions of users? - I guess the crux lies in the data semantics. The semantics of a structured data query peppered with specifics generated from mapping user preferences through “Likes” (as for FB) V/s of an unstructured, spontaneous search history based data (as for Google) can be greatly different.

However given that Google search is more personal & private than activity on FB account (contestable, as the lines are blurring ever since smart phones with ‘location-on’ took over) people are likely less inhibited in what they search for & this inherently makes their profiling based on search history a lot more accurate and actionable at a one-one level. Whereas on FB, the likes by the individual’s at best indicate a broad interest rather than an individual trait and importantly don’t necessarily indicate what the user is looking for – Let me just say that the data Google has access to & generates every second is more valuable than what FB would have when it comes to identifying a heath consumer's need!

Example: consider & compare the following Google search keyword composition, as recorded from a single advanced search or from a search history over a period of time…

• 40ys+heart disease+arrhythmia+female+supplements?+self-diagnosis+vitamins+non-surgical treatment+jogging+yoga+meditation+fenofibrate+non-surgical+hereditary?+childhood eosinophilia+zinc+PCOS+India+traction safety+physiotherapy

With the following FB profile+activity

• 40yrs+female+1500 friends across 20 countries+Likes “Yoga”; “Herbalife”; “working women” “Titanic the Movie”; “Savage Garden” “feel” worried, bored, depressed variably across a month & with status-updates that dealt with topics & images that demonstrate ‘feeling generally great”; “euphoria”; “health problems”; “heartbreak’; “depression” et al

When it comes to how much one can profile the user based on the above input, I feel Google search history wins hand down on the degree of specificity of data & for the sheer number of conjectures and probabilities possible. FB data on the other hand is specific on non-health aspects & even if an effort is made to interpret the semantics, it’s likely to end up with ‘probably-true-observations’ but not much actionable observations on aspects related to health. So as long as health info is considered ‘stealth info’ by users, Google is where people are going to end-up.

Also, with the big pharma companies increasingly open about sharing their clinical data (Ref: JnJ tying up with Yale university) with an intention to maximizing the data’s monetization potential, Google may find willing partners in them and thus access to clinical data may not remain a weakness anymore for Calico.

Does Google Ventures hold a clue to Google’s health ambitions?

Yes, it appears. Google Ventures (GV) portfolio does look representative of the arguments put forth earlier on why Google is into Health? The life science portfolio is populated with companies that have a definite personalized medicine/ health focus --à 23andMe (personal genetics); one medical group (personal medicine); foundation medicine (cancer diagnostics, genomics analysis); DNANexus (cloud based DNA sequencing); Flatiron health (Onco data platform); Predilytics (advanced healthcare analytics); Transcriptic (next generation lab automation); SynapDX (blood diagnostics); Rani Therapeutics (oral large molecule biotherapeutics); Doctors on Demand; AdiMAb (Yeast based antibody discovery platform). Other than life Sciences, GVs investment into upstart companies leveraging Hadoop for healthcare data management also is relevant to the personalized medicine, E.g. Cloudera; Clearstorydata etc.

As the trends indicate, it is imminent Google Ventures will start investing into companies working on wearable/ injectable health devices, such as the one by Proteus and obtain a stake in the high value vital body data domain? But once cannot ignore the fact that GV is absent from most of the big wearable start-up funding deals in 2014 namely, NanoHealth ($135 million), Alignment Healthcare ($125 million), Proteus ($120 million), MedHOK ($78 million), Lumeris ($71 million), Zenefits ($67 million), and Doximity ($54 million)) – This reluctance is surprising considering Google otherwise appears bullish on health.

Update 15 Sep 2014: Though it isn't linked to Google Ventures, I did miss out including Google's smart contact project for which they have tied-up with Novartis - While at this stage it isn't clear the lens can send up the date to the mobile phone, assuming its on the cards, this could be a cutting edge usage of internet of things in medical devices. Similarly the recent Google acquisition of Lift technologies: while Lift spoon is indeed a amazingly simplistic and utilitarian device that improves basic quality of living for those effected by Parkinson's, I guess the Lift Pulse & Lift Stride technologies are what are going to help Google integrate this company into its digi-health future.

Data + User engagement + Alliances + Tailored drugs = Longevity

From the above hypothesis & conjectures, it's safe to infer that Calico would pursue its vision of tackling ageing through its mission to engineer a large-scale, data driven personalized medicine revolution.

The various nuts and bolts that’ll naturally be part of this greater mission could include aspects like; Enabling users to get into the quantified-self mode & leverage this conversion to create a data-set that could be utilized for genetic profiling & drug discovery. Using the personal charisma of its start-studded team to cobble together alliances with other major pharmaceutical innovator organizations like Abbvie, get access to their idle clinical data & maximize the utility of the same by enabling open sourced research & thus create an ecosystem of mutually dependent pharmaceutical innovation clusters.

The leadership at Calico looks well suited for the purpose and their individual strengths in sync with the above vision & mission – Below is a quick peep into what individual value-add they’ll potentially get to the table.

• Art Levinson: Innovator, administrator par excellence with a jaw dropping professional pedigree – Unquestionably most useful in getting alliance partners from pharma & technology domains.
• Hal V Barron: Knows how stuff works or not in clinic, what pitfalls exist in clinical trial & just how much of it can be predicted genetically – Deep domain knowledge of another lifespan linked disease domain of Cardio Vascular therapeutics.
• David Botstein: The one who’ll know what to do with big data on genetic ancestries from the likes of 23andMe - Can help put out diagnostic tools (mobility driven; home-use; Molecular diagnostics? Companion diagnostics for personalized medicine)
• Cynthia Kenyon: Ageing expert, figuratively speaking the one who can map out a calico cat - The quintessential tea-taster, the screener of potential drugs that act on individual ageing triggers.
• Robert Cohen: The one who understands the opposite of longevity, programmed cell death nee apoptosis, the devil’s advocate to Cynthia - Understands cancer triggers, and blocks & individual variances in each genetic make-up

Is Calico’s “challenge to ageing” the new drug-discovery paradigm?

Or is it just a play of words & a smart pitch to the healthcare consumer who hitherto had to make do with rather promise-less solicitations & six-month increases in survival after a year-long therapy?

Whatever may be intention & the outcome, Calico is sure to change the way healthcare is viewed, pursued henceforth and the health consumers are in for an entirely new & enticing solicitation.

Exciting times indeed!

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Image courtesy (partly modified) - Wikipedia

Please forgive me my friend!

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Looking at the omnipresent, persistent conflict all around the world and realizing how mostly banal the typically offered justifications are, I am starting to wonder if we (the 'Humanity', if one can still call us that...) are increasingly driven solely by our rights; our entitlements; our privileges; our contributions; our generosity; our (perceived?) sacrifices; our value-addition etc and have all but eliminated through disuse, the need to stop once in a while and mull over our not-so-positive impact on others around us & do a little something about it.

Even as I am ashamed that I haven't ever heard of this till today, I am also happy that I have finally stumbled upon this symbolic yet undeniably noble concept of Micchami Dukkadam, the annual ritual of seeking forgiveness followed by the Jain community.

We perhaps went through a better part of the year mouthing the mandatory go-to-hell's, damn-you's, F/S-you's & an occasional thank you - For a day let's set aside our ego & entitlement and say;

MICCHAMI DUKKADAM - If ever I have offended you in thought, word or deed, even if unknowingly, I seek your forgiveness today

Missiles are the new Mines

Even as speculation is ripe on the WWW on whether it is the pro-Russian separatists BUK anti-aircraft missile OR the Ukrainian Air force air-to-air missile that felled it, it can't be denied for a fact that the actual on-the-ground MH17 crash investigation is getting inexplicably slower & rather covert lately.

Either which way, one has to but agree with Dr. Brahma Chellaney when he says in his recent article "To prevent another MH17, examine root causes" that the most critical aspect to be addressed in light of this tragedy is effectively barring/ preventing countries from transferring SAMs to non-state actors.

While inter-state relations, arms-control isn't generally what I write on, a specific aspect in the above article prompted me to share my opinion. It's about the US administration apparently considering building-in a remote kill-switch in the sophisticated TOW anti-tank missiles being provided to the 'moderate jihadists' in Syria with a noble intention of ensuring these missiles aren't usable in any other hands &/or for any other sinister purpose (i.e. other than fighting the Assad regime!) - this stuck me as throwing-in yet another deadly uncertainty into the already impossibly volatile cocktail of missile proliferation among non-state groups;

Below is the comment I posted against the above article;

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Great insight as always Dr. Chellaney! Even if supplier states indeed wish to NOT let non-state/rogue-states use their SAMs for any deviant purpose (if there’s any other kind), the plan of ‘building obsolescence’ into missiles, while sounds sci-fi, comes across as an ill-conceived strategy since this’d create a supplier base that differentiates its offering by way of NOT building in obsolescence into its ware – any incremental risk-mitigation from the innovation would thus be negated by this newly introduced uncertainty. The trading states probably would be better off exercising precaution through consensus trade regulation than resorting to doomsday preparedness features as these.

Cloudsciencing [sic]

A potential game-changer in contract research services domain & I’m talking about the latest concept that calls “Putting Science in the Cloud” in its intro of Emerald Cloud Laboratory, essentially what looks like an idle infrastructure monetization initiative of the 'stealth start-up', Emerald Therapeutics.

Pun apart, if indeed this turns out like it’s promised, a scientist in any part of the world will be able to simultaneously prescribe & iterate-on (with the robotic handlers) the experiments that she/he outsourced. This in turn will make it easy for more drug discovery start-ups to emerge (including some garage innovators too..) & pursue their dreams in a quicker, cheaper & more efficient way (~ the likes of DNAnexus claim that as scale emerges, it’s possible that a whole human genome can be sequenced for a mere $1000!)

The above scenario also implies that scale is a possibility & efficiency at scale an absolute need for any player in this emerging domain.

With only JIT availability of both laboratory & equipment consumables as a probable potential 'scale-limiting' bottleneck, I won't be surprised if the domain of cloud contract laboratory services (I wouldn’t yet call this research..) is quickly populated & dominated by the likes of Life Technologies, a process likely starting with acquisition of buyer organizations by these technology platform & consumable behemoths.

An exciting prospect surely for a scientist currently hyperventilating while awaiting the outcome of an outsourced experiment.

Take me in, dammit! - a gripe & a request

For the lack of any better term, I christen myself an inafluxer, to mean a nouveau Linkedin author who’s dying to be an influencer but loathe to admit it! (or not..)

Right from the day I have been given the privilege of publishing on LI (no email, just stumbled upon it..) & I grabbed it greedily, I’ve been trying to make sense of what exactly it takes to get the inafluxer articles ‘featured’ on relevant channels.

While I couldn't identify any rationale yet, I observed a probable trend wherein LI;

• Identifies profiles that could be potential churners of reasonable quality posts on largely generic/ popular issues & ones that could beget a loyal following
• Invites them to publish on LI with a personalized email; ensure their initial posts get huge viewership, build a quick following & thus compel the new writers to get regular with posts – a clever no-cost approach to develop quality content by utilizing the inherent need of smart, opinionated & communicative individuals to be heard and importantly, to be recognized.
• Essentially, this appears to me as an "Influencer Seeding Program", assuming that a lot of the current stock of Influencers will soon encounter a writer’s block if not a cramp.

I could be dead-wrong in my hypothesis, but a chap who writes on pharma venture capital, while not even being a VC, doesn't fit the bill perhaps.

bummer...

PS: yelling apart, I am all willing to be used free & fair - Try me LI, I don't tire easy :-)

Disclaimer: The inafluxer logo is of course fake & has been put together with a harmless & sole intention of enabling this funny (hopefully) rejoinder grab some eyeballs

Read this article (& comments) also on Linkedin

The next Facebook may not be found online after all

It’s not very often one comes across an article, a cover story at that, in Newsweek on the start-up scene & VCs – So there was no which way I could have let-up an opportunity to read through, read in between the lines, postulate, extrapolate and generally make my own merry conclusions on stuff the article never intended to dwell on - Call me extreme, that’s okay – like the partners at Greylock, I don’t back down easily either :-)

It isn’t perhaps about trying to find/ fund the next Facebook at Greylock

While the title has enough oomph to grab eye-balls, it could be fundamentally misleading. A quick look at the recent investments (mentioned within the article) of Greylock partners shows it is bullish on startups that are waltzing back into the realm of real-life albeit through cyber gateways – i.e. ones that have built revenue models on O2O commerce platforms;  think Airbnb; Coupons; OneKingsLane; Shopkick (all Reid Hoffman investments..); Sprig; (Simon Rothman) – Though it’s just one subset of investments primarily by one partner, the sheer millions pumped in indicate there’s a lot of enthusiasm at Greylock on O2O commerce.

Just may be David Sze should display a real apple (besides Apple Newton & Apple iPhone) in his timeline collection of technologies – a sweet reminder that any technology’s ultimate potential lies offline

Incubate a potential acquisition? – Sounds like a nice strategy or is it?

It is perhaps a strategy/ wish to utilize the (insider) knowledge of a current investee companies that are avid deal-hunters themselves by way of incubating a few custom designed startups & facilitating (evetually) their acquisitions by the aforesaid companies – Consider the investments in Nextdoor, Path, Jelly, Medium, Pandora (all David Sze investments..) & the likelihood of these companies getting acquired by either Facebook or Linkedin at some point of time.

Startup scene in USA is raining Asoks* – and they’ve been raking in some moolah, finally

The article starts with Gagan Biyani (Sprig), dwells on Aneel Bhusri (Greylock) and mentions the likes of Nirav Tolia (Nextdoor) – not an inconsequential acknowledgement of the increasing presence of Indians in the American entrepreneurial scene.  

*’Asok’ is used in the context of any techie of Indian origin rather than just the IITians.

A final dig I can’t help – The article by Katrina Brooker is far superior to anything related I’ve come across in HBR magazine till date.

What if one happens to be possessed of a heart that can't be trusted? - a book review that isn't one

Just finished reading “The Goldfinch”, a book by Donna Tartt that recently won the Pulitzer prize in fiction for 2014. While I enjoyed my journey through the at-times-agonizingly-long story, what's lingering on in my mind at the end of it all is a fascination for the painting itself, that little masterpiece by Fabritius, the theme of & inspiration behind the book.

The painting’s composition as intended by Carel Fabritius and/ or as inferred by the viewer seemingly evoked emotions of varied hues within the author and articulated through the protagonist, emotions ranging from feeling of angst, identifying with the chained but resolute bird; an overwhelming urge to free the creature from its misery and thus a symbolic effort at deliverance of a shackled self and finally a submission to the status quo, a realization that you cannot choose the being you want to be…. More than anywhere else where there's a more direct reference to the painting, I feel the text quoted below is where the author most eloquently delves into the existential angst as represented by the chained bird;

"A great sorrow, and one that I am only beginning to understand: we don't get to choose our own hearts. We can't make ourselves want what's good for us or what's good for other people. We don't get to choose the people we are.

Because--isn't it drilled into us constantly, from childhood on, an unquestioned platitude in the culture--? From William Blake to Lady Gaga, from Rousseau to Rumi to Tosca to Mister Rogers, it's a curiously uniform message, accepted from high to low: when in doubt, what to do? How do we know what's right for us? Every shrink, every career counselor, every Disney princess knows the answer: "Be yourself." "Follow your heart."

Only here's what I really, really want someone to explain to me. What if one happens to be possessed of a heart that can't be trusted--? What if the heart, for its own unfathomable reasons, leads one willfully and in a cloud of unspeakable radiance away from health, domesticity, civic responsibility and strong social connections and all the blandly-held common virtues and instead straight toward a beautiful flare of ruin, self-immolation, disaster?...If your deepest self is singing and coaxing you straight toward the bonfire, is it better to turn away? Stop your ears with wax? Ignore all the perverse glory your heart is screaming at you? Set yourself on the course that will lead you dutifully towards the norm, reasonable hours and regular medical check-ups, stable relationships and steady career advancement the New York Times and brunch on Sunday, all with the promise of being somehow a better person? Or...is it better to throw yourself head first and laughing into the holy rage calling your name?” 

When I look at the painting, my first impulse is to agonize over its chained status, it's limited boundaries & it's still stoical disposition in such a dismal state. The subsequent thought is if whether the bird even if unchained would challenge its boundaries, having never ever experienced a free life & but then a sliver of hope emerges that a free-will can never be chained. Do I associate myself with any, all of these… probably yes, probably no… I guess the given context; the prevailing mental-state determines the feelings and association with self.

Look long & hard enough; this living bird could enliven your brain.

And yes, get the book! It’s for keeps.