Last week I heard a great talk by the president of Arizona State University about research progress being made at the University and by its partner, the Translational Genomics Institute, in personalized medicine.

Yesterday I saw an article in the Wall Street Journal about what would happen as Boomers turn 60, asking for those personalized solutions to the health problems of aging.

But only this morning did I get my first taste of personalized medicine (albeit on a limited scale) and what the real implications and ramifications are for the future. My taste is only an hors d'oeuvre, believe me, compared to what's coming.

My foray into personalized medicine came on www.drweil.com, the new site Dr. Andrew Weil has created to sell his line of supplements. I've followed Andrew Weil's work for many years, always with great respect. I know he's not a charlatan, and I know he is a pioneer. I also know that, as a university-based physician, he hasn't entered the field of vitamin supplements to build a multi-leval marketing empire. So when I saw him on the Today show, I decided to see whether he had anything to offer me as I wage my personal war against the ravages of aging.

Dr. Weil has a feature on his site called the Vitamin Advisor. If you are willing to fill out a fairly detailed questionnaire about your health concerns and the advice your primary care physician has given you, and if you know a little bit about your own health, you can come out with a program adapted to your individual needs. The software takes your answers and figures out that someone my age who drinks alcohol but doesn't smoke, exercises and sleeps well but has arthritis, should take certain supplements -- everything from calcium to milk thistle.

After I filled everything out, I was asked to rank my concerns. Is it more important for me to increase my energy than to preserve my memory, for example. I care a great deal about optimal health, so I ranked all the concerns either high or moderate.

The software then kicked out a supplement program for me. 33 pills a day. The cost per pill, in each case, was pretty low--maybe $.64 for calcium. The supplements come in individual packets, so you can carry them with you, and so you won't forget what to take when. The order is shipped to your home.

But then came the check out piece. The software asked me: Do you want a 30 days supply? Or 90 days so you can save on shipping? I calculated the cost of my supplements both ways, and found out that for 90 days, the cost of the program for me would be a whopping $663.00. Not to mention the cost of my time as I try to swallow those 33 pills. Or the opportunity costs of what I COULD have done with that $663.00.

I finally decided to go one month at a time. I also eliminated a few concerns. If I run out of energy, I'll take a nap. I got it down to 26 daily pills and $183.00 per month, but I couldn't go any further without compromising what I consider my quest for optimal health.

So I got out the trusty credit card that gives me frequent flier miles, and I hit send.

What have I bought? An elegant personal solution to my supplement "problem", combining technology and medicine. Supplements made by a man I trust, in dosages I believe are correct for me. Something I think might help me live better, if not longer. A different program than what I had been on, which consisted of large bottles purchased at Costco. What had I been thinking, trying to save money on my health? Who knows what's in those Kirkland vitamins? I got my first wakeup call when I looked at the Vitamin E I've been taking and found out it was made from d-alpha tocopherol, which Dr. Weil says doesn't do anything for you. (You have to have mixed tocopherols in your Vitamin E.)

Fortunately, I have the wherewithall to pay close to $200 a month for vitamins. Now think of the Baby Boomers coming right behind me. Think about how close we are coming to a two-tiered health care system: concierge medicine and Andrew Weil supplements for those of us with the money to spend and the willingness to spend it on ourselves; Wal-Mart supplements for the others. Or even more complex, a health care system in which all things are possible, but few of them are affordable.Is it our genetics that will determine how long we will live, or our finances?

I rarely think anyone has anything better to say than I do, :-) but this morning I came across an article that I think is so important that rather than paraphrase it, I'm just sending it to you. The scary thing about this article is that it was written by a person substantially younger than I am, but the engineering program he describes is exactly the same as the one I observed while I was an English major at Cornell, my version of Smartypants U. I offer this in respectful memory of Lew Platt, who graduated from that program in my year, and then went on to run Hewlett Packard where I met him again while I was at Intel. If he were still alive, I would love to share this with him, and see what he thinks. What do I think? Nothing has changed, and that's pathetic. The author of this is Doug Kern:


I am an engineering washout. I left a chemical engineering major in
shame and disgust to pursue the softer pleasures of a liberal arts
education�hear my story, and learn why the United
States lacks engineers.

Not long ago, I showed up for my first year at Smartypants U., fresh
from a high school career full of awards and honors and gold stars�
I was determined to spend my college days learning something
useful. With my strong science grades and excellent standardized test
scores, I felt certain that I could handle whatever engineering
challenges Smartypants U. had to offer. Remember: Kern = real good at
math and science. You will have cause to forget that fact very soon.

I had three options for a chemistry class: the intro course, the
accelerated course, and the genius course. My high school chemistry
background made me a good fit for the accelerated course, but my
academic advisor warned me not to take it. The course instructor was
a legendarily incompetent teacher, even by the dubious standards of
Smartypants U's engineering department. He was so incoherent and
capricious that academic advisors were warned to steer students away
from his courses. So why was he kept on staff? His research was
outstanding. My tuition dollars at work.

Being too arrogant to waste my gifts in some kiddie intro course, I
enrolled in the genius course. Memo to freshmen, wherever you are:
unless you are a certified, card-carrying prodigy with a four-digit
IQ, do not EVER EVER EVER sign up for a chemistry class whose
informal nickname contains the word "Turbo." "What happened?" said
the comment on my second test. I wish I knew.

In high school I had grown accustomed to math classes that featured
clear, helpful instruction from teachers who liked to teach and
excelled at teaching. At Smartypants U, the jewel in the crown of
American academia, my math instructor was a twenty-something teaching
assistant whose classroom style never deviated from the following
pattern:

1) Greet class.

2) Ask if there were any questions about the previous evening's
problem set.

3) If so, work out the problem in question on the chalkboard,
without further explanation.

4) Repeat step 3) as needed.

5) Announce the pages in the textbook from which the next
problem set would be derived.

6) Perform a sample problem from the new problem set.

7) Ask if anyone has any questions.

8) Give the problem set assignment.

9) Dismiss the class.

Total elapsed time: never more than 25 minutes.

Clutching the shredded tatters of my pride and dignity, I trudged to
the office hours of my math instructor every week, seeking an
explanation for the increasingly mysterious problems in the textbook.
My instructor welcomed my presence as she would welcome the Angel of
Death. Irritated? She was terrified. Explain�the problems? Articulate�
the steps? Relate�the concepts? I would ask questions, and she would
respond by completing yet another sample problem as fast as she
possibly could, blushing nervously. I felt like I was on a Star Trek
episode. "Captain, I think I understand�the creature communicates
through multivariable calculus problems!"

I know what you're thinking, and you're wrong. She was as American as
I am. Spoke perfect colloquial English.

The social-life-killing workload was the stuff of gallows humor among
the three or four upper-class engineers who could still laugh. "Sleep
is for the weak!" they bellowed, when gathering at the listless
engineering parties. "Your underwear has two sides," they whispered,
pressing their furry acne-ridden faces into the ears of bewildered
freshmen. "Use them."

Compose in your mind a montage of quizzes covered in red
ink, classes wasted in the stupor of incomprehension, and frowning
instructors muttering strange incantations in their eerie scientific
argot. And of the hands-on laboratory portion of the chemistry class,
I will say only that I still hold the record at Smartypants U. for
most failed attempts at that hateful titration experiment. ("No - not
dark pink! You filthy godless soul-eating beaker! Damn you to hell!")
They assigned grad students to watch me after failure number six. And
I still screwed it up.

Meanwhile, my friends majoring in the liberal arts pulled dandy
grades while studying little. "You just wait," I thought, gazing upon
them like the ant regarding the grasshopper in the summer. "You party
and blow off homework now, but in ten years, you'll be making merely
wonderful money as investment bankers and consultants, while I'll be
getting laid off from a great job at General Electric."

My first-semester GPA was the engineering major average: 2.7. But to
a former academic superstar, a 2.7 GPA was akin to a public flogging.

I nearly fainted when I learned that I received a 43% on the Physics
final. I nearly fainted again when I learned that the class average
was 38%. A sub-50% grade on a science test is a curious creature, as
much the product of grader whim as academic achievement.

Having allegedly mastered 43% of the course
material, I was now deemed fit to take even harder Physics classes. I
wondered: at the highest levels of physics, could you get a passing
grade with a 5% score on a test? A 3% score? A zero? Could drinking
from a fire hose actually slake your thirst?

Exhausted and demoralized, I stumbled into my next semester of
engineering. My new math T.A. had all of my old T.A.'s inability to
teach, but half of her mastery of English. One day in class I heard
myself saying: "If I understood what I didn't understand about the
problem, I would understand the problem, and therefore I wouldn't be
asking a question." The T.A. stared at me across a void that seemed
increasingly unbridgeable.

The course was called "Discrete Mathematics." Many people thought
that the course was called "Discreet Mathematics." Wrong. To clarify:
"Discrete Mathematics" is "the mathematics in which Kern was getting
a D at midterm." "Discreet Mathematics" is "how Kern dropped that
class along with the rest of his engineering course load and signed
into liberal arts classes, all on the last day he was eligible to do
so, because he couldn't stand the stress, abuse, and lack of
comprehension anymore." No one waved goodbye to me at the engineering
door.

The United States contains a finite number of smart people, most of
whom have options in life besides engineering. You will not produce
thronging bevies of pocket-protector-wearing number-jockeys simply by
handing out spiffy Space Shuttle patches at the local Science Fair.
If you want more engineers in the United States, you must find a way
for America's engineering programs to retain students like, well, me:
people smart enough to do the math and motivated enough to at least
take a bite at the engineering apple, but turned off by the
overwhelming coursework, low grades, and abysmal teaching. Find a way
to teach engineering to verbally oriented students who can't learn
math by sense of smell. Demand from (and give to) students an actual
mastery of the material, rather than relying on bogus on-the-curve
pseudo-grades that hinge upon the amount of partial credit that bored
T.A.s choose to dole out. Write textbooks that are more than just
glorified problem set manuals. Give grades that will make engineering
majors competitive in a grade-inflated environment. Don't let T.A.s
teach unless they can actually teach.

None of these things will happen, of course. Engineering professors
are perfectly happy weeding out undesirables with absurd boot-camp
courses that conceal the inability of said professors to communicate
with words. Fewer students will pursue science and engineering
majors, and the United States will grow ever more reliant upon
foreign brainpower to design its scientific and manufacturing
endeavors. I did my part to fight this problem, and for my trouble I
got four months of humiliation and a semester's worth of shabby
grades that I had to explain to law schools and employers for years.
Thousands of college students will have a similar experience this fall.

So engineering is suffering in this country? It deserves no better.

The good news? There's a lot of innovation in Arizona, and many companies that have struggled to get started are now getting traction. A suprising number have made it through the lack of seed capital, the dot-com bust, and the vicissitudes of starting a business, and have brought their products to market.

The bad news? No one has taught them how to make a decent investor presentation, so that even when presented with an audience of angels and other potentially helpful people, they persist in mumbling into their beards like auctioneers. This is a common problem of entrepreneurs, who usually lack the relevant experience (as TV personalities, standup comics, or drama students) necessary to make good presentations.

I offer my advice after attending the annual TIE-AZ Angel event, "DeMystifying Angel Investing." TIE is a wonderful group that started in Silicon Valley in 1992, when a group of entrepreneurs from the Indian subcontinent decided to help their fellow entrepreneurs by educating and mentoring them. TIE expanded to Arizona about five years ago, and has an equally good track record of convening the best and the brightest, being relevant, and -- more important -- being actually helpful.

Last month, TIE-Az gave entrepreneurs the opportunity to apply for a spot in the "Rapid Fire Presentations," section of the program. These presentations, because of the number of companies chosen, were held to one minute and were aimed at a panel of angels. There were, I think, about twenty presenters, many of whom I knew. Before the presentations, the entrepreneurs listened to the angels talk about how they choose investments and what they look for, as well as answer questions from the audience.

Arriving fashionably late as usual, I saw that the room was already packed. In fact, it was so crowded that even the technology reporter for the Arizona Republic, usually a guest with a reserved seat, was sitting in the very back against a wall in a hastily procured chair.

Apparently, TIE-AZ had twice as many attendees as they expected. There was a heightened level of interest on the part of the community, probably because there were four REAL angels on the panel, including an investor from the Mars family (Snickers)who said he has already made five investments in Arizona companies and thinks we have better companies than his native Orange County.

The winning applicants were told they could have only one slide, in addition to the limitation of speaking for only a minute.

What would you have done?

I'll tell you what the presenters did. Almost to a person (one woman presented), they threw up a single Powerpoint slide with almost an entire business plan inscribed on it in agate type. From the rear of the room, where I was sitting, no one could read a thing.

They then began to read the slide, or some variant of it, aloud as quickly as possible, in a nerve-wracking race against the bell signalling the end of a minute. Most of them didn't finish. Many of them spoke to the screen, or to the microphone in their shirts, instead of to the audience. I don't think I saw a single person address the panel of potential investors.

Not one of them took into account what had been said for the past hour by the panel of angels, nor could I see evidence that anyone's pitch had been influenced by what he had heard.

Now, given that same set of parameters, what COULD they have done?

First, faced the investors and spoken to them. Let the audience, largely non-investors, be an audience. Take advantage of the opportunity to get feedback from people who actually put money into companies.

Second, used a slide with very few words on it that functioned as a billboard, with a call to action: to find out more about our company, visit www.newco.com. Made the type on that slide large enough to be read by everyone, and read at a glance. Why make the audience read your slide while they are trying to listen to your presentation?

Third, given an elevator pitch that focussed on three things: 1)the benefits of the technology to its market 2)the expected ROI to the investor and 3)the current status of the company (how many customers, how much current revenue).

And now here's MY pitch: this is the kind of training we give our own clients and the participants in our Fasttrac programs. Juding from the TIE meeting, I think there's still a need for our services.

Bummer. It�s over � my summer in Silicon Valley. This is the third year I�ve gone up there to help bring the word from the desert to the Valley, and vice versa.

However, this year there�s not as much news to bring back. The desert knows as much as Silicon Valley does, especially since the hurricane season has devastated half the country and created unforeseen opportunity for the other half. Disaster recovery, environmental cleanup, construction, communications infrastructure, engineering, concrete and asphalt, building materials � things Arizona is at least as good at as California. The government money is all going to be directed to finance the rebuilding of the Gulf Coast. The opportunities will be huge. For the next few months, indeed years, it will be all about reconstruction.

(Social work and psychology will also flourish as �industries,� because you can be certain all this relocation and loss have caused an outbreak of post-traumatic stress disorder. Dr. Phil is already on the scene. )

But why just reconstruct? Why not take this opportunity to reinvent? Although the venture funds are out there making investments, there isn�t anything exciting for them to invest in right now. They are all trying to learn about biotech, and the industries that support it. But the time horizons are long for those investments, and the IPO window for them is narrow, the stock market having also bounced around on the winds of Hurricane Katrina.

In the interim, they�re also giving small amounts of follow-on capital to companies in the RFID, network security, and distributed application space.

So I have a suggestion: as long as there is all of this money looking for something to do, why not use the innovation skills of Silicon Valley to find better ways to do things that have suddenly revealed themselves as desperately needed and are accomplishable in the short term?

Let�s start with remaking America�s aging physical infrastructure: the way water is purified, carried, or conserved. The way electricity is produced and transmitted. The way cities are planned and built.

I�ve never been able to attract venture capital to, let�s say, construction methods that cut the cost or the time to build a house, such as prefabricated wall panels, or insulation materials. Nor have I seen much attention given to non-toxic paints, or new pipeline materials, innovative ways to place utilities underground so they won�t be interrupted by hurricanes, or ways to remove contaminants from water. The only company even remotely connected to construction that we saw funded was a new way to apply termite protection � and that one was funded by an SBIR grant, not a private fund.

But these are the kinds of innovations we need immediately, and because we have ignored them in favor of more �sexy� investments, we have situations like the one in New Orleans, which is as much a manmade disaster as a natural disaster. There�s common agreement that only 20% of the damage to New Orleans was caused by the hurricane, while the other 80% has been caused by the consequences of the levees� failure. And for the evacuees, who have been asked to leave their homes (if they still have them) for thirty to eighty days, the damage is incalculable. We�re going to need to generate jobs in Memphis, Houston, San Francisco, Phoenix � every place the Red Cross is sending evacuees.

I�m not asking venture capitalists to donate their funds to the Red Cross. I�m asking them to consider opportunities they don�t ordinarily consider, such as alternative energy sources and construction techniques, conservation technologies or water purification --, and band together to fund those.

I will bet their return on investment will be just as high � after all, Arizonans have grown rich building infrastructure and housing for the past fifty years. While these industry segments are often scorned by economic developers who look past them to more exciting technologies, at times like these they are the industries with the biggest markets. You can bet all the homebuilders will find their way to New Orleans in the very near future, along with the Home Depots or the world.

But why go back to the old stuff? Wouldn�t it be cool to use this time to try new and perhaps improved technologies and techniques? I bet there are entrepreneurs out there with solutions to most of New Orleans� problems, if they could just find some funding to help them get their products to market. It�s time for all of us to begin thinking outside the box.

I'm so furious at our federal government and our country that I can hardly stand it. I don't know who is worse, the government or the citizens who elected it.

I've spent the week staring at the enormous disconnect between raging flood waters, crushed houses, dead bodies, and men in suits and pancake makeup saying help is on the way. That's crap. The people who could help are in Iraq. They are our soldiers and National Guard.

But the people who need the help are not much better. Right now, I'm watching New Orleanians try to evacuate patients from the Charity Hospital amidst looting and sniper fire. Last night, there was full scale looting, as people tried to take food and water from each other. No sense of common humanity, and no social contract.

And no police, no military. No help. No food, no water. Not much different from Indonesia or Sri Lanka. Or Baghdad. But we're the nation that tells everyone else how to live.

CNN seems to be the star of this show, using its technology to locate missing relatives and inform the nation that the disaster is much worse than anyone can imagine. Two days ago, someone got the bright idea to bus 25,000 people from the SuperDome, where the roof had collapsed, to the AstroDome in Houston, where the City's mayor had promised help. But someone shot at the busses, slowing the process. And now New Orleans officials realize there are many more people in the city who need to get out, and nowhere for them to go.

People are getting on busses to go to a strange city where they know no one and have no idea when they can come back. But this is the BEST alternative.

To get help for his stranded citizens, homeless and milling around the Convention Center, the Mayor of New Orleans has to call on CNN to issue a desperate SOS. The only lines of communication that are open seem to be through the media. In the mean time, Presidents 41, 42 and 43 are working out a "strategy" to raise money. By the time they get it done, all the poor black people they're trying to help will be dead. George W. has gone home to his daddy.


Nothing has illustrated the difference between the rich and the poor in America than this tragedy. There may be 500,000 people, or more, who are now refugees from New Orleans and the Gulf Coast. And this is no short term deal: New Orleans must be evacuated completely and people can't come back for months, until they drain it. How could it have been worse in Bandh Ache?`

Thousands have already died. They were either too poor to evacuate, had nowhere to go, or ignored the early warnings and thought they'd tough it out. I'm sure all the rich got out, as all the hotel rooms in Texas and Tennessee are booked. Although the TV anchors don�t mention it, just about every refugee they are interviewing is black, while every government official is white.

How did this happen? How did we become a nation in which, even in an emergency, people cannot meaningfully respond? In developing countries, people help each other in a tragedy. In New Orleans, people are robbing each other and shooting at teach other. Many times this week, I've heard the word anarchy used.

So where is the government, the entities we pay our taxes to so they will protect us in times like these?

The state government takes some blame, because although the governor of Louisiana told everyone to evacuate last Sunday morning, she didn't say how you were supposed to do that if you didn't have money, a car, or relatives in another state. The local government is useless, most of its employees without cars, phones, computers, or homes themselves.

The federal government wasn't even thinking FEMA was important enough to re-fund during the summer recess. As I write, there's still debate over whether Congress should come back into session early to give FEMA its $10 billion budget.

The Department of Homeland Security: where was it? On Thursday, it is just beginning to stir itself to deploy troops and funds.

This is a mind-chilling display of ineptitude, and of the fraying of the social contract. I like to think some good can come out of it -- like a re-thinking of our own political processes, or a withdrawal from Iraq.