Keynote Address: 'Entering the World of Big'

Eric Topol, professor of genomics at TSRI, chief academic officer for Scripps Health and director of the Scripps Translational Science Institute (STSI), was commencement speaker and honorary degree recipient at The Scripps Research Institute (TSRI) 2015 commencement ceremonies.

Voted number one “Most Influential Physician Executive in the United States” in a national poll conducted by Modern Healthcare, Topol works on genomic and wireless digital innovative technologies to reshape the future of medicine. One of the top-10 most cited researchers in medicine and a practicing cardiologist, Topol has published 1,100 peer-reviewed articles, with more than 165,000 citations. He has been elected to the Institute of Medicine of the National Academy of Sciences and named in GQ Magazine as one of the “Rock Stars of Science.” He is also editor-in-chief of Medscape. His bestseller book The Creative Destruction of Medicine (Basic Books) was published in 2012 and The Patient Will See You Now was released in January 2015.

Following are his commencement remarks.

President Paulson, Dean Williamson, Faculty, Proud Families, Friends and Especially the Honored Graduates:

Today is a very big, special milestone day for all of you, and I’m thrilled to have the chance to share this celebration with you. It's hard to put into words so a bit of this song from Pharrell Williams will help us.

[HAPPY Song verse]

I’m really happy for you. Not just because you’ve graduated today. But because you’re doing so at the most exciting time in the history of biomedicine.

When I graduated over 35 years ago, everything was relatively tiny and primitive. If you wanted to communicate with someone, you would call them on a telephone or type a letter on a typewriter. Now your telephone has been upgraded to be your prosthetic brain; you don’t usually want to talk to anyone—you just text them—sending an email is like waiting forever. What the hell is a typewriter? Type? We couldn’t even do a genotype, no less sequence the DNA of a bacterium. I had to go the library each day to look at hard copies of journals to know what was going on in the field. What’s a library? You instantly download PDFs.

So the world has now irrevocably changed—bringing along unprecedented opportunities and challenges. It’s the latter that I want to get into with you this morning. But first, let’s set the landscape.

There’s the proverbial, already becoming hackneyed term big data. We’re in the zettabyte era now, generating 3 quintillion bytes—that’s 3 exabytes—of data every day at terahertz speeds. Supercomputing power is approaching exaflop-processing speed. It would take nearly 5 million years for you to watch all the video being put on the Internet each month. It’s gotten so big that people don’t even know what it means anymore. Maybe big data was best summed up by Dan Ariely, the behavioral economist at Duke, when he compared it to teenage sex: “Everyone talks about it, nobody really knows how to do it, everyone thinks everyone else is doing it, so everyone claims they are doing it.”

And there’s big science—our increased reliance on very large-scale, national or global research teams like the Human Genome, Proteome and Epigenome Projects, The Cancer Genome Atlas and the BRAIN Initiative. Harry Truman once said, “It is amazing what you can accomplish if you do not care who gets the credit.” Well, that doesn’t exactly work in academic circles. At a time with diminished governmental funding and little recognition of “little” science, how do you succeed in advancing life science?

Of course you want to publish highly reproducible, fully validated results and engage as many worthy collaborators as possible. With well over 1.5 million peer-reviewed scientific articles published each year, more than 90% are never cited and half are never read besides the authors, reviewers and editors. An average academic journal article is read in its entirety by about 10 people—that is, besides your mother and father. These numbers are getting even worse with more journals and more publications each year. You don’t want to do all that work and not have it appreciated, not have it impactful. Or worse, to have it regarded as a “contaminant to the literature,” a term Eric Lander once used with me on a discovery of sequence variants linked to heart attack that we had collaborated on.

So what can you do? How do you thrive in a world of big data and big science? You can ante up with your own bigness.

That’s why you need, now more than ever before—to have big ideas. They may not be as big as Elon Musk, who has already—at the young age of 43—upended the transportation, aerospace and energy industries. But you, too, are incredibly bright and resourceful and chock-full of great ideas.

In my years as a mentor, I’ve had the privilege of working with so many extraordinary young scientists—who cumulatively have taught me far more than I have imparted to them. The single most important characteristic that separates the ones who have had major success was that they really believed in themselves. It’s that confidence to deal with the inevitable ups and way downs. To never accept pre-existing dogma. And to take risks. The biggest risk is not taking a risk.

Ernest Hemingway wrote: “The best people possess a feeling for beauty, the courage to take risks, the discipline to tell the truth, the capacity for sacrifice. Ironically, their virtues make them vulnerable; they are often wounded, sometimes destroyed.”

In biomedical research, these risks are for things that will have big impact. I liken these impactful, hot biomedical findings to the Scolville Heat Units scale used for rating hot food, which ranges from low—score of 100—pimento—to high—chocolate habanero peppers—over 500,000 heat units. Those off-the-scale Heat units are for discoveries that are immediately lifesaving and life-changing. But even Tabasco ones at 50,000 units are transformative, changing medicine. You have the power—the intellectual capacity, the terrific TSRI training and all the right stuff—to make such high impact, hot, big discoveries.

And, as we all know, some luck along the way is important. But luck frequently doesn’t just happen. It’s usually not an accident; it’s not stochastic. You know the Daft Punk Get Lucky song, featuring Pharrell, about a guy who stays up all night to get lucky. Well, you’ve been up all night doing experiments many times. It’s all that hard work and tenacity that helps give rise to big bouts of luck.

Besides big ideas and luck, you need to be able to tell your science story extremely well. Be a big communicator. It’s now well beyond what Einstein said: “You do not really understand something unless you can explain it to your grandmother.” Share your work, what you read and think on Twitter—if we all did that, we’d all get smarter faster. Whether it’s a blog, Twitter or a presentation to people without a science background—storytelling and communication in simple terms with passion and enthusiasm is critical to cultivate. In fact, much of Elon Musk’s success is not so much attributed to innovation, but to dogged perseverance and a masterful ability to communicate.

Finally, it’s about being a big person. Many of you have given back to your community through ScrippsAssists and other initiatives. And many have been in the Society of Fellows career development programs. These are a start, but it’s time to design your life. You’re not merely players as in Shakespeare’s description “All the universe is a stage and all the men and women are merely players.” You don’t want to get the Duck syndrome of floating on the surface even though you’re paddling furiously underneath. Or be a permadoc, in the post-doc pile-up.

Well beyond computer science, Stanford University’s most popular course is called Designing Your Life—“forming you into the person that will go out into the world, effect change and be a leader”—teaching you to live life with an intentionality. As an example, I recently saw a post-doc describe himself on his Twitter site as “determined to be a leading authority on pain receptors.” And the intentionality is not just about your own mission. Part of the Stanford class is devoted to “building your life around somebody else, and orienting around love as part of one’s career.”

That’s what is really big. Your family. Your kids and your grandchildren won’t care how many pages are in your CV, if your h-index is 190 or that your articles have more than 150,000 citations. They will care about your love for them, how you show it, and your important, lasting contributions to biomedical research—especially if you can explain them well.

It’s not too early to think of the legacy you want to leave the world. And to go for it. This Average White Band verse captures YOU right now well. In case you missed it: You’ve got it. You can have it. 'Cause it is waiting for you.

Be Muskian. You probably won't remember a word I've said. But I hope you'll remember just four words:

“Think Big, Act Bigger”

Thank you and congratulations for your milestone achievement.

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