AS184: Jake Farr-Wharton On 23andMe

Transcript

This transcript was generated automatically and may contain errors — the audio is the record.

0:00:32 Thomas: Hello and welcome to Atheistically Speaking with your host Thomas Smith. This is episode 184, and joining me right now is You may be familiar with him on the bonus content, but here he is on the big time. Made it to the show, Jake Farr Wharton.

0:00:48 Jake: I have graduated finally.

0:00:50 Thomas: But that doesn't mean we won't still be producing fine bonus content for you folks for the patrons. Uh, Jake, how are you doing?

0:00:57 Jake: Oh, dude, so good now. But earlier, oh, man, I've been so sick, hey, so sick. I hosted the Australian National Skeptics Convention last weekend, and I had to push through it because I was just so badly under the weather. And to emphasize That, I finished on Sunday night, came home, literally collapsed, and then I spent the next three days in bed with influenza. No.

0:01:14 Thomas: Yeah, and And that Sounds wow.

0:01:27 Thomas: Not affluenza, no.

0:01:30 Jake: Uh, Although I do suffer from that also, yeah.

0:01:30 Thomas: Okay. Yeah, well, that, that is really cool. It sounds like your event was a total success, and listeners, the patrons can hear more about that on the bonus content, content. But today, so congratulations on that, by the way. And I also hear from you that you did a talk that maybe released an audio form on your feed, right? Your regular feed.

0:01:55 Jake: Not, not maybe, it absolutely will Be. I'll I'll put that out hopefully, uh, as soon as the, as soon as it's ready. So there are two talks that I did that, or two sessions that I did that will be released. Um, the first session is, is my talk, uh, which I, I spoke, spoke about fad diets. Um, I started the session off as, um, as, as a character, Dr. Oz, Dr AUS, um, which was cool.

0:01:57 Thomas: Okay, good.

0:02:21 Jake: Got to, got to call everybody fat elephants and told them they all need to lose some weights. Um. Which was, which is real. It was really, obviously, uh, I don't, I didn't think that.

0:02:21 Thomas: It's good. So it was just basically a bunch of Australians laughing at Americans' expense. Is that what I gather?

0:02:34 Jake: Well, there was a lot, there were a lot of Americans in the audience as well. I should say Eugenie Scott, the anthropologist, the physical anthropologist. She was in the front row and she was laughing her dress off. She was just throwing the laughs at me.

0:02:37 Thomas: Oh, okay. Oh, wow. That's awesome. So people can check that out. And just just in case anyone, you know, lives in a cave or something, Jake, of course, hosts Imaginary Friends Show. We've been podcast buddies for quite a while. I love Jake like a brother and someday hope to propose marriage to him. But until that time, we'll just do shows like these. And you can find that talk eventually on his feed over at Imaginary Friend Show. I am definitely going to check that out. Let me know when that comes out. Out. So, but today, we're going to talk about 23andMe. Now, I had seen the headline that they had come back. They started doing business again, and I think you'll be able to talk a bit more about that than I can. Now I, I mean, maybe this is naive of me, but I thought it seemed pretty cool. I mean get your genome tested, find out what's going on. It sounds like you might have a different opinion on that though, so I'm really interested to hear about that.

0:02:50 Jake: Absolutely. Totally. Yeah.

0:03:44 Jake: It's, it's really, uh, an interesting thing. Uh, I'm all for genetic testing, uh, and I need to make that clear. I, so I've worked in a pathology laboratory that has, uh, and, and that is actually one of the world pioneers of a bunch of genetic tests. You know, we pioneered them as clinical trials in our laboratory and we commercialized them and, you know, we offered them to international laboratories, hospitals, et cetera, for the diagnosis of various cancer genes, cancer-related genes, and even susceptibility to various types of of, um, uh, drugs when you have cancer. So some cancers react better to different drugs and, you know, we developed a, uh, a screen that would, a genetic screen that would allow you to see whether you were more susceptible, whether the cancer was more susceptible to certain medications or others.

0:04:39 Thomas: Can I ask you, Sorry, real quick. That just reminded me, and it's sort of sad in a lot of ways, but I remember Hitch had been working with the guy who believes in Jesus but is still, I think, a Nobel laureate for mapping the genome. You know that guy's name.

0:04:40 Jake: Um, yeah. Oh, yeah, I do know, uh, who you're talking about, That's him. I

0:05:03 Thomas: Francis Collins. Yeah. Hitch had beenworking with him on something that sounds a little bit like this. I don't know if you know anything about that, but is it a similar thing where you're, you have cancer and so, you know, they can test your genome to see specifically what course of treatment might be best or that sort of thing? Do you know anything about, as related to that situation, or is it just a similar?

0:05:25 Jake: Can Definitely Elaborate on type of thing, but the specific one, because he had esophageal Cancer, and That's unfortunately fairly terminal, but So, example, and this isn't the one that my laboratory developed, but it's a great example. Herceptin 2 is a drug, or Herceptin is a drug that is widely used or very effective in destroying certain types of cancer. And I mean that, you know, I use that word very purposefully. It destroys certain types of breast and colon cancers. But you have to have the genetic ability to receive Herceptin. So basically, and also your cancer has to have the susceptibility to Herceptin in order for this to be effective.

So when you have a particular type of breast cancer, you've got this particular diagnosis, Your oncologist or your genetic counselor might ask for Herceptin's susceptibility, um, to be performed on the tissue and, uh, they, on the cancer tissue, on the tumor, or whatever it happens to be. And, um, they will, they will test to see whether it is susceptible to Herceptin and, as a consequence, whether you'll be given Herceptan. So it's not a routine test. It's super expensive because of the staining that they need to use, but it's really, really useful. It can increase the remission rate. It can increase, you know, the survival rate for these types of cancers. And it's been instrumental, it's

0:05:35 Thomas: Right, yeah. Yeah.

0:07:18 Jake: Been really Excellent, Well,

0:07:17 Thomas: Now, maybe, maybe It'll be impossible, but for us dummies, do you, can you say it all, summarize what it is exactly that makes it, makes the cancer itself genetically, you know, um, susceptible to this medication at all? Is there any way you can dumb that down for us? Like, what is it about it that, that makes work for some people, not for others? Oh,

0:07:42 Jake: Okay, so all cancers have, what's not, it's basically, they have immune preference within your body, So, They are your own body cells and, So this immune preference can be switched off in some tumors, you know, eventually, Eventually, and some cancers eventually. Eventually, we will know how to turn them off in all cancers.

0:07:50 Thomas: Okay, Right, Of course, I Was Gonna say I've heard That Is like the, what everybody theorizes, is it'll be the kind of the silver bullet thing. Okay, but is this, so is this treatment you just described, is that this or is that, oh, okay, okay, a

0:08:11 Jake: Yeah. Yeah. Yeah, it turns off the genetic switch that basically gives that cancer immune preference.

0:08:26 Thomas: Free pass in your body.

0:08:28 Jake: Yeah. Well, yeah, it's the right way to put it because it does. It has free range.

0:08:29 Thomas: Okay, yeah. So it's not exactly, and I just want to make sure I have this right, it's not exactly that the medication itself is going and destroying the cancer. It's that it's sort of taking away its camouflage for your body to put it in, of of course, in a very stupid way, but taking away its disguise and then your body takes care of it. That's what happens.

0:08:46 Jake: Pretty much. Pretty much, yeah. That's correct. But without it, that cancer will continue to grow. So, It's it's an interesting, so so on the whole, I I am absolutely for genetic testing. Okay, so just to be super clear, absolutely love genetic testing, think it's amazing, we've taken leaps and bounds in the last few decades, um, and this will really be the future of of all medication, it'll be personalized medication, it's based on um who you are, what your mutations are, and medications in in the future will target the mutations, either to turn them off or to turn them into a gene that is either neutral or positive. So it is really the future of medicine, and I need to be clear, I love genetic medicine, okay? But, and there is a huge but here, if I tell you, Thomas, if I told you right now that you are susceptible to EGFR mutation, what does that mean to you? Well,

0:08:54 Thomas: Okay. Right. Of course. Yeah.

0:09:57 Thomas: I'll pretend that it's good. I don't know. I have no idea. It sounds bad. It's probably bad.

0:10:04 Jake: And and so so what if what if I tell you that um three generations ago you had a BRCA mutation, what would you do with that information?

0:10:14 Thomas: I knew it. I could smell it on me. No, No, I don't know.

0:10:20 Jake: Well, Yeah, you can smell that, no you can't.

0:10:23 Thomas: That would have been very fortunate if I, I would have gone with that. If it turned out that was some like stink gland thing, I would have definitely claimed that I knew exactly what you're talking about, but darn it. I was close. No, it probably wasn't close.

0:10:38 Jake: So so this this is the thing, and this is this is why I have such an issue with these consumer-based genetic information and genome screen medical, you know, quasi-medical screens. It's because unless you sit down with a genetic counselor to fully understand the implications of every single one of the mutations that come back as positive or susceptible, then then that information is either harmless and too much and, you know, just ultimately pointless. You know, you get nothing out of it. Or B, it can actually be really harmful and can create a tremendous level of stress.

0:11:25 Jake: Or, you now, or worse still, let's propose a third option. It actually picks up a horrible mutation or a very high susceptibility to a particular type of cancer or something like that, and that information does not make its way through to a medical professional who can properly interpret that and counsel you on that because this institution is not a medical institution, and there is no genetic counselor provided to you. So in my state of Queensland, and this is replicated throughout Australia and certainly throughout the developed world, anytime you require some sort of genetic screen, whether it be for a singular mutation or for multiple mutations, or whether it's because your great-grandma or your grandmother's had a breast cancer and it turns out that that breast cancer gene is one of the dominant ones and there is a possibility that you have it and you need to be screened for it. And I am sorry for those who understand genetic mutations and I'm only talking about cancer, so I apologize for that, but it's an easily relatable one.

But, you know, that's one of those scenarios that your grandmother has this particular type of cancer. It's quite a dominant one. And the doctor tells your grandmother, hey, you need to get all of your family members in to be screened for this because it means that they're at a greater susceptibility for this genetic disease or this illness.

0:13:04 Jake: So the my great issue with 23andMe and other organizations like them is that they don't do the due diligence with the counseling, with the genetic counseling, they don't do the due diligence with somebody who fully understands the implications of every one of those mutations in the same way that say we do in Queensland or we do throughout the developed world. That that is generally what will happen. You'll get a referral from a GP or from another specialist to go and see a genetic counselor. That genetic counselor will say, hey, I need to warn you, we're doing a genetic screen for this sort of stuff. When you come back, we'll analyze your results and we'll discuss the implications.

0:13:52 Jake: So you get the screen back and they talk you through every one of the mutations, your your susceptibility, your likelihood of getting various diseases. And at the end of that conversation, you have a plan of action for, in some cases, the rest of your life.

0:14:11 Thomas: You know, that's definitely never happened to me. I don't know how much that occurs in the US versus, uh, where you are, I've never heard anything about anyone I know being genetically tested for anything. I'm not sure if that's just our healthcare system or what, but what in your mind, now I don't want to, could one allege first off that, you know, they're just competition for you, so you're a little, so your sour on them, but also what in your mind is different between, let's say something like 23andMe and something like, like, I don't know, what's one of those stupid, well, maybe not stupid, but one of those websites where you just type in your symptoms and every single time it says you have a massive brain tumor that, and they go like, to me, those are just as bad.

0:15:04 Thomas: I mean, every time I've typed in a symptom I've had into, why am I blanking on that? I'm sorry, I'm terrible with names. The name of the website. Yeah, well if you, right, it's just one of of those basic health websites. And every time it's like, well, you could be nothing or you could be already dead as you're reading this. It seems profoundly unhelpful. And you could make the same argument, couldn't you? That, well you have this data you're typing in. I mean, the difference I guess would just be the data you'RE typing in, here's what my symptoms are. And they're telling you, well it's either allergies or you're missing half of your skull and your brain needs, you know, So, what in your mind is the difference between that, which I don't think the FDA has had any problem with that I know of, and 23andMe or other genetic testing services?

0:15:11 Jake: Dr. Google, I know what you mean.

0:15:55 Jake: Yeah. I mean, just to clarify from my own ramblings, if 23andMe were to invest in genetic counselors for people. Obviously, their price would go up significantly, but that would reduce the impact of, you know, that would completely alleviate all of my issues with it. So if that was done, I wouldn't have an issue with it, but they don't.

0:16:16 Thomas: So, maybe if every result came with a, what, a phone call or something where they could really discuss, it might be, it would probably be impossible for them to have actual physical offices, but

0:16:28 Jake: There's zero way for them to do it because of the number of, of, um, you Know, clients that they have.

0:16:32 Thomas: Requests, yeah. Yeah.

0:16:34 Jake: I'm not going to call them patients because they don't, you know, they aren't, they don't have that, that doctor-client relationship. But the nature of their business is you can get everything. You can get your likelihood that you'll go bald by the time you're 30 from that. And some of the information they give to you is funny. Some of it really is funny, but some of it is also potentially, potentially, um, life-changing and there's nobody there to counsel them through it. So if they, if they were to do due diligence and say, if they picked up a mutation, um, on say the BRCA one and two genes that relate to, to, um, uh, severe types of cancer, breast cancer and and colon cancer, if they were to pick up, um, things like Huntington's disease and other mitochondrial diseases and, and, you know, in cases when they did pick that up, they did their due diligence, then that would be perfect. You know, and I would cease criticizing them. I would, I would seize my, you know, my hesitance to say, wow, that's really cool. But they don't, you Now, that is just not

0:17:00 Thomas: Like

0:17:47 Jake: What they do. But so you asked me, you Know, what is the difference between this and, you know, Dr. Google and their various applications.

0:17:52 Thomas: WebMD, I think is what I was trying to think of. WebMD, you know, it's always the classic joke that you type in whatever it is and, you Know, it could be a brain tumor every time.

0:17:57 Jake: WebMD, yeah. Well, it is true. True. In any, in any case, it could be a brain tumor. Um, and

0:18:09 Thomas: Okay. I got to go to the doctor. Sorry.

0:18:11 Jake: Shit.

0:18:11 Thomas: See ya. Cancel the show. I

0:18:15 Jake: Well, this, you know, the, the, the thing is, is, um, symptoms are, uh, uh quite like, there's no way to tell from a single symptom what you, what you have, you know, in many ways, uh diagnostician, you know, as much as GPs are often maligned because, you know, you go into six minutes and then they kick you out with antibiotics, there's, you know, they are detectives in a number of ways. They are there to sort of say, here are your symptoms. What's the most likely outcome from those lists of symptoms? And, you Know, they are doing internally a WebMD search, you Know, and coming out with an answer.

0:18:58 Thomas: Was going to say, I mean, do you see the future? Maybe this is a little unrelated, but But do you see the future of that being just computer? Because that sounds an awful lot like what a computer could do really well. Here, let's narrow it. Let's give you a list, an exhaustive list of your symptoms, and let's query the database and find out, you know, what are all the things that could be. I don't know. I mean, do you think eventually that will be where medicine goes? Or is there just a necessary, for now at least, maybe until, you know, some new technology comes along. But is there just a necessary human component that, that is required for that sort of thing?

0:19:35 Jake: Well, the human component is, in the GP example, once you reach the end of your symptoms and they say, well, here are a couple of differential diagnoses, they give you a point of action. Some of it might be some medication or another, but the rest of it will be referral to another practice or maybe come back in two weeks if nothing's changed, and that might change the opinion of the differential diagnosis. So, you know, the future, I think, I'm sorry, I missed you.

0:20:05 Thomas: I could probably program that. I could probably programthat into a computer.

0:20:12 Jake: Come back in two weeks, tell me whether it's gotten better.

0:20:13 Thomas: Yeah, that seems pretty easy. Yeah. No, it doesn't seem that hard.

0:20:17 Jake: Well, there you go. You should be making WebMD 2 or 2.0.

0:20:19 Thomas: Okay. But I'm, I'm pretty limited in my programming. So it would be like an Excel version of web. Dr.

0:20:26 Jake: Hey, that's okay.

0:20:27 Thomas: Excel.

0:20:28 Jake: That's awesome. I love it.

0:20:29 Thomas: Yeah. Well.

0:20:31 Jake: Yeah, so I mean that's sort of the difference there between a GP and WebMd is WebMд can't prescribe you a medication. WebMD can't refer you to a specialist.

0:20:39 Thomas: Not Now Not Yet.

0:20:41 Jake: Not now, that's right. Yeah, maybe next year.

0:20:42 Thomas: Yeah. But I, I Mean, it could it get to the point where it's at that level? I wonder, but it's okay, I mean that's obviously not, probably not your area of expertise, so I don't want to, it was just a question I was thinking about, uh.

0:20:54 Jake: Well, let me tell you what I think the future of medicine is. It's either going to be one or the other of these two or maybe a combination of both. I think there is going to a tricorder-type scanner like they had on Star Trek.

0:20:55 Thomas: Sure. Star Trek. 3D.

0:21:13 Jake: That is a mixture between a pathogen scanner, a temperature scanner, um, and probably also like a an MRI scanner, something to that, or maybe even a PET scanner as well, you know, like something combined that can scan you for, for the presence of pathogens, viruses, um, and in these, uh, that can, you know, can pinpoint an illness and a treatment, you know, once you've pinpointed an illness all it needs to do is tell you what, what the treatment is, is going to come from that.

0:21:48 Thomas: 3D Print you a, a treatment.

0:21:51 Jake: Well, you know, you joke, but that is, that is going be the future of medication.

0:21:53 Thomas: No, I'm not really joking, actually.

0:21:57 Jake: I know. Absolutely. It's, it's like when you think of, of pharmaceuticals, of,of drugs, you Know, all of these drugs, they're all molecules suspended in, in a tablet, you Now, so if you can print a, a molecule, if you print a molecule or if you you can print with a certain type of thing to be technical, then – but

0:22:08 Thomas: Yeah.

0:22:20 Thomas: Enough with this jargon. Jeez. No idea what you're talking about. Okay. Yeah, that

0:22:26 Jake: You could. Technically, you could print a medication or you could print a stent that instructs you then, a DIY heart valve ballooning. How cool would that be? I just sit there, shove something in my femoral artery, and then the nanobots go do their work.

0:22:31 Thomas: Would be cool.

0:22:46 Thomas: Yeah?

0:22:47 Jake: But no, I think the other side of this is there probably will be computer-based blood analysis tools where it pricks your finger and it does a full antibody screen looking for acute infections and also pathogens. So, it'll either be a quick blood scan of every known pathogen at the same time. It looks at your blood count, what's your blood looking like, too many leukocytes means an infection.

0:22:48 Thomas: I

0:23:26 Jake: What's your hemoglobin looking like? Do you need more iron? Doing a quick mineral screen as well, B vitamins, too much zinc, whatever it happens to be. And then also doing a full electrolyte and liver function test panel, testing your thyroid function. All of these things can be done, I think, in the future with a drop of blood where now they require a vial. You know, we're getting smarter and smarter. Our equipment is getting better and better.

0:23:50 Thomas: Was gonna say, why doesn't this exist already? I mean, I feel like I've been hearing about this for a while, but it just, Just there must be some incentives that aren't lining up or something. Or is it, hmm,

0:23:59 Jake: It's not incentives. It's just the quality of the equipment as it stands right now. Now, you know, we're learning better ways to do the same things that we've done in the past with, you know, with a greater, like with a lower requirement now. So, you know, a hundred years ago, the way that you could tell whether somebody had lupus was you get a vial of their blood, a big vial of their blood and you put a paper clip in there.

0:24:28 Thomas: You had to drink it. Yeah,

0:24:31 Jake: Now, that was the way to tell whether you were a vampire or not. It works in 100% of cases. Now, you put a paperclip in the vial of blood and depending on how the blood hemolyzes, you can tell which is hemolysed just means that basically the blood cells perforate themselves and you end up getting this really gross mixture. Anyway, but yeah, so you put it in the blood vial and eventually you get this particular pattern that corresponds to lupus. Whereas now, you do a quick lupus anticoagulant screen on a tiny, really small amount of blood. Six years ago, you had to do a full culture, microscopy culture and sensitivity for things like, let's say, mycobacterium, for things like multi-resistant organism screens.

0:24:34 Thomas: Yeah, yeah.

0:25:30 Jake: Now you put them under a chrome agar plate and it grows in a couple of, in like 30 minutes, uh, you know, whereas you used to have to wait days to to grow a MRO, so we are getting better. Um, we are getting smarter and and these things are getting quicker and smaller, and you will be able to, you know, plug in a USB blood screen, blood screener in the future, but

0:25:55 Thomas: That would be pretty cool because I feel maybe I'm just too healthy. I don't think of myself as very healthy. But my experience with the doctor is usually I hurt something in hockey and then he goes, I don't know. And then he's like, well, you can go like scan it or x-ray it. And then it's like oh, okay. And then I do that and then He's like yeah, I don't know. There's, okay, so you got that scan? Yeah, it looks like it's hurt, so just stay off it.

0:25:55 Jake: Um.

0:26:21 Thomas: That's pretty much my medical experience. No, that's interesting, but, okay. I want to get back to it, though, because I really am wondering. I'm not sure I see that meaningful a distinction between 23andMe and WebMD, you know? I mean, it's just, it'S slightly more precise data, sure, or maybe significantly more precise data, but you still could say, okay, when you type in these symptoms to WebMD, it'll always tell you, look, just go see a doctor. We can't really, we're not a doctor, I assume, and maybe this is an incorrect assumption, because I haven't used WebMD, 23andMe, but I would assume 23andMe gives you a similar thing of you definitely should see someone if you're concerned about these things, because it's a very easy thing to do.

0:26:20 Jake: Just Stay off it. Well,

0:27:08 Thomas: So if If they're not doing that, that's another story. But what's the difference? What do you see is the major difference there?

0:27:14 Jake: One is symptoms and the other is hard data. Well, The issue with symptoms is that they are so vague in general. They're not specific to your genome, whereas 23andMe is specific to to your genome. You know, 23andMe produces a report that says, you know, you have a 40% likelihood of developing balding before you turn 40, whatever, you know, and there's hundreds of these or thousands of these lines of things, again, to be technical, that, you know, that suggest your susceptibility or your likelihood of this thing or that thing. Um, and from that, absolutely, I have no doubt that they say if you're concerned about this, uh, go and see a doctor.

Again, my criticism isn't that they have a line saying, you know, indemnifying themselves, it's it's more that they don't do the due diligence for calling through major issues with mutations, but I think the, I think the major difference between say WebMD and 23andMe, and I'm I'm grasping at straws here because I don't really see a huge difference either myself, is that, you know, one is symptom-based, you know your own symptoms, how you can describe your own symptoms, which is always going to be limited unless you are a doctor yourself, versus hard data on your actual genome and the implications implications of various mutations in your genome.

0:29:00 Thomas: Yeah, I guess it's a little different. I don't know. Maybe I wouldn't be as harsh as you are, but I think you definitely have more expertise on it. So perhaps that's just my naive assumption on it, but. I don't know. I think they could. Well, I'm glad they're working with the FDA. I think I know they've gone back and forth. I don't know currently exactly, you know, what I know they were still doing like a genetics test or rather, sorry, ancestry test. And that seems like pretty harmless information.

0:29:32 Thomas: I mean, so, so hopefully they just continue to work with the FDA to do what they need to do, but, uh, I'm glad they're doing that.

0:29:18 Jake: Totally. Oh, totally. You know, that's fun. Well, I personally hope that the FDA imposes something like what I've suggested on them, uh, because, you know, otherwise they are creating anxiety in, in people or alternative, again, the, you Know, the other, the another scenario is that they find something significant and the the patient isn't told. And with so many of these things, if you take action early before, while you're asymptomatic, before you become symptomatic of whatever disease or malady is in there, if you take action before that thing starts to affect you, then you have a greater chance of overcoming the effects of that illness.

0:29:43 Thomas: Hmm. Okay.

0:30:21 Thomas: Well, but then it seems like 23andMe can only help you. I mean it seems it's without it. I mean, you're relying on a system that, like I said, I mean I've never heard in my normal doctor experience of oh, maybe we should test your genome for something, like it just doesn't come up, and, right, yeah

0:30:38 Jake: Yeah, yeah. No, I'm The same as well. Don't get get me wrong. You know, I've, I've never had the risk of a genetic disease, um, put, put up against me, but I can tell you I have friends who have had to go in to have Huntington disease, um, checked, you know, and

0:30:52 Thomas: Yeah, I know there's a lot, that's the one where, I think that's the one, I remember hearing, I think an NPR story on it where it's, you really, you try to decide if you want to know or not and if, if you have it, you're, I mean, there's just nothing you can do. And it's, it's I remember a story about, uh, people who, I think it was a family who knew they were genetically predisposed to it. And, uh. It was a big choice among all the siblings. Like, do you want to find out, you know? And it, it, It's a really interesting thing. Um, right.

0:30:53 Jake: Yeah.

0:31:05 Jake: Well, And it's the sort of thing that you wouldn't, you know, um, not to, uh, put too much into sort of what happened, um, on that show, but, you know, if you decided that you were, were going to have kids and you carried that gene, There are other options such as mitochondrial transplants or even nuclear transplants. You can take the nucleus of somebody else's or the mitochondria of another woman's egg if you're a woman or same for the sperm and have that transplant take place. So it's still, it's still that sperm and the egg, um, still carry your genetic material, but they remove the gene. They remove the, the, the gene that will pass on Huntington's.

0:31:42 Thomas: Oh, wow. Yeah.

0:32:16 Jake: So it's, it's so, it's so very important. But again, you know, if 23andMe patient, um, they have no obligation to tell you, uh, you know, to go and to go and seek counseling about this, you know, so it's that, it's that sort of thing, and that's my criticism, you

0:32:33 Thomas: Well, I don't. And, and, uh, I do know that there's, there's definitely currently a couple of lawsuits they're going through. Um, but I, I feel partially like I, I feel a little bad for them. Like they're just trying to provide information and information. I don't know. My philosophy is I see what you see, your concerns for sure. And I understand. And I think the ideal world would be you could consult someone for it and talk to someone for it. But in a world where that's not already currently happening, but now you're armed with this additional information that you can choose to take into a doctor or do what you can. I don't know. I might come down, apologies, but I might comes down a little more on the pro-23andMe side, but, but I definitely appreciate the case you're making for it.

0:33:22 Thomas: And I do hope they find a way to kind of bridge the gap for that, you know, so hopefully that happens.

0:33:26 Jake: Know I Would even think, um, I would think that they have an opportunity here to to to, you know, to really make medical history. There are only so many genetic counselors out in in the world, um, it's not, a it'snot a, a huge profession, profession, pardon me. So, you know, if they linked in with genetic counselors for, you know, to basically refer them cases when they found results that, you know, that the patient had no ability to interpret, you know, in cases where they did find a mutation or a disease, then you would want that passed on to somebody who not only could interpret it, but also better inform the patient.

0:34:15 Jake: So it doesn't even have to be a tremendous amount of, you, you know, impact from 23andMe, just, you know, the forwarding of that information onto a genetic counselor, and maybe that ends up being just a tick box that you tick as you're filling out your initial form, you know, in the case of a major abnormality, do you give us permission to send this to a genetic counselor in your area?

0:34:32 Thomas: Yeah. Hmm.

0:34:41 Jake: Yeah, something like that.

0:34:41 Thomas: Yeah, no, that could work. Yeah.

0:34:42 Jake: I mean, all of these things could be, all of my criticisms can be mitigated by just such such a small amount of due diligence on their part. And frankly, like they've done huge amounts of good in the way, you know, they've made genetic screening so much cheaper. You know, they've mapped the genome. They have turned the mapped genome into something that is consumable. But the issue is with so much information, you have zero chance of being able to walk away with that information, understand it and take any actions necessary in cases where action is necessary. So, yeah, I mean, huge opportunity for them to to break ground. They've already made this screening so freaking cheap, you know, and so comprehensive

0:35:25 Thomas: But yeah, I was going to say, I mean, I do remember a time when I think it took a million dollars to map someone's genome, but now it's amazing how far it's come. So I guess that is definitely real progress. Okay, well, thank you so much for coming on and discussing your concerns. And that's really cool. It sounds like it's something you know a lot about and you've worked with. So I think, uh, definitely, um, I, I can understand the argument and I really hope they, they make some sort of move to amend that kind of stuff or, or to fix it. But, all right, well, thanks Jake so much. And of course, as usual, you can find Jake on the Imaginary Friends show, dotcom podcast. You can find him

0:35:33 Jake: Yes. Indeed. Although

0:36:11 Thomas: Pretty much every week.

0:36:12 Jake: Although we will be changing the name, um, fairly soon of the of the podcast.

0:36:13 Thomas: Oh, okay. I wasn't sure if that was public info yet. Awesome. Well, there's going, oh, okay, nice.

0:36:17 Jake: Oh, no, it's definitely public info. In fact, um, the majority of the suggestions that we've had for, um, the podcast new name have come from the listeners. So, um, we've heard tremendous number of really good ones.

0:36:28 Thomas: Nice. Oh, that's good. So it will be a name change. But but for now, for the time being, you can find it imaginary friend show. And that's what's your main Twitter again? Is it Jake Farr Wharton? Or is it imaginary? Okay, Jake, at Jake Farr Wharton. So thanks so much for coming on. Really appreciate it. And listeners, patrons can find us on a bonus content near you. So, thanks for coming on.

0:36:30 Jake: Yeah, at Jake Farr Wharton.

0:36:53 Jake: Awesome. Cheers.

0:37:10 Thomas: All right. Well, that's our show and that's our week with a new format. I loved it. I got a lot of good feedback on it. And it'll just get better. Don't worry. It'll get better every week. Most of the feedback I got on the long interview question was that I should just post a really long episode. And that's funny because I had gotten the impression from much earlier on when I asked you guys something like this before that too long of an episode was a big turnoff. So that's why why I haven't done that. And then also I actually will run into a limit eventually on what I can actually upload. So, I don't like, I mean, I can always upload bigger things with worse audio quality, but I don't really like. Anyway, so, I'll compromise. I'll definitely have longer episodes and if the interview is long, I'm not going to cut it off super early, but, I also will make an effort to not quite have it be as long because I do know there are a lot of people I've talked to who don't like really long episodes.

0:38:09 Thomas: They lose interest. So, I'll try to bridge that gap, but all in all, lots of good feedback. Thank you guys so much. That's what I love about this show. People give me the feedback I asked for rather not the the exact type of feedback but they give me feedback when I ask for it so that's good I'd like to thank my new patrons Jeff Shaffer, Kelly Spears, and dave newman. Thank you so much for pledging, you guys. I really appreciate that. That is, it's very kind of you. Of course, you can pledge at patreon.com/atheist and then you can, we can comment there. You can message me on Patreon if you like anything from my patrons. And I want to thank my top guys, Zimu Zinu, Adrian Borschoff, Michael, Jonathan Moyet, Jay Aldenwalt, Bangs, Nuttybits, Peter Skelton, Brian Gareford, Dale, Matt Garrett, and Samantha with the honorable mention there.

0:38:57 Thomas: Thank Thank you so, so kindly, my supporters. I love you guys. You make the show go round. And with that said, I have so much to talk about next week. Probably too much. I'll have to whittle it down. And I'm really excited for this new format going forward. So thanks for joining me. I'll see you next week!