Dr. William Newsome, Co-Chair of the BRAIN Intitiative

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Mark Masselli: This is Conversation s on Health Care . I am Mark Masselli .

Margaret Flinter: And I am Margaret Flin t er.

Mark Masselli: Well Margaret , there are some indications that Health Care c osts
are slated to rise in 2015 after several ye ars of slow growth.

Margaret Flinter: Well that’s right , Mark , and it ' s expected that Health Care Costs
will rise roughly 7% next year that's due to a number of factors and certainly the
economic recovery is to blame a bit and the numbers of newly insure d Americans
who will be seeking Health Care maybe with some pent up demand and need.

Mark Masselli: I think you’re right . And this comes on the heels of several years
of slow growth in Health Care.

Margaret Flinter: We’re going to see more cost transp arency moving forward
under the Affordable Care Act. So, I am going to predict maybe more stable,
slower rates of growth in Health Care Cost moving forward.

Mark Masselli: Another thing t he President saw fit to fund in the Health Care
Arena is vital to all of us. The President launched a 100 million dollar initiative to
map the human brain.

Margaret Flinter: Well the head of that program Dr. William Newsome of
Stanford will be joining us to talk about just the enormous scope of that project.

Mark Mas selli: They are calling the BRAIN the last great frontier in medicine. It
should be a fascinating conversation.

Margaret Flinter: And we want to give a moment of honor and pause in memory
of Dr. Arnold Relman, the late editor of the New England Journal of Medicine, a
physician , a scientist.

Mark Masselli: Also L ori Robertson , Managing Editor of Factcheck.org ’s stops by
to correct another misstatement about health policy in the public domain . B ut no
matter what the t opic, you can hear all of our shows by going to CHCRadio. com .

Margaret Flinter: And a s always , if you have comments , please email us at
www.chcradio.com or find us on Facebook or Twitter because we love to hear
from you.
Mark Masselli: But first , here is our producer , Marianne O'Hare with this week’s
Headline News.

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Marianne O'Hare: I am Marianne O'Hare with these Health Care Headlines.
Obamacare and the mid - term elections , t here will be an effect according to a
bankrate.com survey . Am ericans are going to weigh their voting behavior
against the impact of the Affordable Care Act . Independents are trending higher
against the Health Care Law in 2014 with 25% saying they would vote
Republican versus Democratic because of the A CA. The rest of the
Independents pivotal en close races, say they are undecided. And a whole
Americans are less unsatisfied with the Health Care Law. Last time bankrate
pulled Americans at 45% in favor of appeal that number dropping to 30% this
time around and most A mericans favoring fixing rather than appealing the law.
Meanwhile, predictions are pretty consistent on a n expected rise in employ er
Health Care Costs in 2015 , including insurance rates of about 6.8% next year .
A ccording to the survey by Price Waterhouse Health Research Institute, well
insurance rates are expected to accelerate next year up slightly from this years
costs and offset will be realized by slight increases in deductibles. The amount
of money paid out - of - pocket before coverage kicks in.

Ameri ca , land of the free and home of the stressed. A r ecent survey by NPR and
partners of the Harvard School of Health , have found stress at an epidemic level
in this country. According to research, one in four Americans poll reported
currently living with a high degree of stress in the past month s , the unchecked
stress impacts of person’s ability to function. It impacts relationships, family
dynamics, and economic realities as well. The report suggests suicidal
intervention with the stress epidemic. I am Marianne O'Hare with these Health
Care Headlines.

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Mark Masselli: We are speaking today with Dr. William Newsome, Professor of
Neurobiology at Stanford University School of Medicine. Dr. Newsome was just
appointed as director of the newly create d Interdisciplinary Neurosciences
Institute at Stanford University , as well as being named co - director of President
st
Obama’s 21 Century BRAIN Initiative which seeks to develop a framework to
correlate scientific efforts in the quest to map the human brain . He is a winner of
numerous prestigious awards including the distinguished Scientific Contribution
Award for the American Psychological Society. Dr. Newsome, welcome to
Conversations on Health Care.

Dr. Newsome: I am please to be here with you , Mark.

Mark Masselli: Dr. Newsome , congratulations on your selection by President
st
Obama to be co - director of his 100 million dollar 21 Century BRAIN Initiative ,
which is seeking multidisciplinary solutions to unrevealing the mystery of the
BRAIN . The project has been likened in scope to the mapping of the human

gen ome . But currently the nation spends about five billion dollars a year on all
kinds of BRAIN research. Tell us a little more about what sort of discoveries and
payout s you are hoping this project will yield .

Dr. Newsome: We 're at a really unique time in the history of neuroscience.
Those of us who have been in the field for a few decades really sense that rate of
change has been accelerating enormously in the last five years and we are -- it is
only the beginning of this acceleration . And the real difference maker here is the
invention of new technologies that fundamentally allow neuroscience to ask
questions that we have only been able to wonder about and reflect about in the
past , very new tha t are happening. There is change of foot is making many of us
who are experimental have to rethink what it means to be an experimental
neuroscientist and I think that what we are shooting for here is really nothing less
than a revolutionary kind of unders tanding about how all of this electrical activity
in our brains makes it possible, the mental lives that we all have , o ur thoughts,
our aspirations, our goals, our memories, and our ability to learn. We really want
to understand the biological mechanisms that make these things possible and
these new fundamental technologies are going to be a quantum leap along the
way here . And a charge from President Obama is really to try to understand the
BRAIN at this very basic level. I am sure that these are going to have positive
outcomes for our understanding of disease as well.

Margaret Flinter: Dr. Newsome , yo u have been, I think, quoted saying that
complete mapping of the human brain won’t take years like the Human Genome
Project did and it might take decades , which is why t he President referred to this
st
as 21 Initiative and I think you ’ve also referred to the Brain as a three pound
mass of glue between the years but at the same time as the most complex
known entity in the universe. So what are the challenge s? Why it is so hard?

Dr. Newsome: Ye a h. When you said the keyword Margaret, there was keyword
there is complexity. So this three pounds of glue inside our head, and I will refer
to it as glue because that literally is the consistency. If neurosurgeo ns know that
you know, it’s about the consistency of jell - o or toothpaste. But inside that three
pounds that you say is the most complex entity in the universe that we know
about. So, in each one of our heads, that three pounds contains 100 billion
neuro ns okay. So, these are nerve cells that communicate with each other
electrically and it ' s that electrical communication and that circuit activity that
somehow underlies our mental lives. So, you have 100 billion nerve cells and
then each of those nerve c ells is making 1 , 000 somatic connections. Little
chemical connections with other cells and these somatic connections are sort of
the points of information transferring. So, you have got 100 billion neurons each
with a 1 , 000 somatic connections that means you have a 100 trillion of these
somatic connections. And just to map that kind of complexly interconnected
network is incredibly bonding, and we have done calculations that say in a
human brain you know, if we really map these connections carefully and
thoroughly we would fill up many terabytes worth of disks with information just for

one brain and we don’t know how to even handle datasets that large at, okay?
This is right out at the hairy edge of what computer science is able to handle at
this point. And then if you could imagin e techniques that allow you to do that just
the massive amount of data and how we would handle it and how we would
analyze it and how we would mine it is self daunting. So, I think, you know, when
you look at those three thing s chained together, you can start seeing why we say
this is not something that’s going to be done in a year or two years or even ten
st
years but this really is a grand challenge for the 21 Century .

Mark Masselli: You know, Dr. Newsome, you say this is a spectacularly good
time to embark on the quest of mapping the human brain and because of the
recent technological breakthroughs is the technology on the mapping capability
or is also on the neuroscience side?

Dr. Newsome: The t echnology is on all these f ronts. I mean that ' s one reason I
say it is the spectacularly appropriate time for this. I mean the Obama
Administration they got this one right , okay? This really is the right time , it's t he
right topic at the right time and the technologies really do create the potential for
revolution over the next couple of decades. I kind of like in this to trying to
understand traffic patterns around New York City and information flow around
New York City, so we could take out a road map and we could look and we c ould
see all the connections of the roads and exactly where each road runs. We need
that in the human brain. And that sort of what I call neuroanatomy . Just knowing
where the cells are, where they make their somatic connections to other cells so
that yo u have the static road map. But that road map if you look at it of New York
Area, it doesn’t tell you what traffic is flowing on each road at any moment of the
day, right ? That’s a dynamic property. That is information flow within that
network of roads and it is the same way in the brain. Just knowing the map
doesn’t tell you what sorts of information is flowing in different circuits at different
time. So there no one answer to this question about activity and dynamic activity
it depends on what you ar e doing. So we need the new technologies, but we
also are developing new technologies unprecedented new technologies to get
that dynamic activity to measure the traffic in the neurons. And so now we have
statisticians, and physicist, and mathematicians c oming in to help us develop
theories about these new datasets that we are acquiring and once you develop ed
a theory, you really want to be able to protrude the system. You know, you say
aha, I have a theory on how this thing works now. I want to go in an d I want to
change the traffic on this one road and see if I can predict the changes that will
happen on the other roads and we are developing new technologies for
protruding the activity on the nervous system.

Margaret Flinter: Well, Dr. Newsome , you’ve got now an interdisciplinary
neuroscience institute that you that you are directing at Stanford, which is going
to help provide a framework for the national BRAIN Initiative and tells what the
new research paradigm looks like and tell specifically about t he institute.

Dr. Newsome: Well the institute here at Stanford is a new attempt to integrate
brain research across the entire campus, and we have a lot of traditional
neuroscience research here in the School of Medicine at Stanford and in the
Department of Biology and to some extent and in the Department of Psychology .
But we all realized and we are fortunate that our President and Provost here at
Stanford realized that the brain is no longer just a problem in biology. Today , we
realized you know that t hese new technologies that are transforming , our
understanding are coming from all different directions.

So the latest technologies that give us the best mapping are new clarity
technique t hat is fundamentally coming from chemists. It is coming from
chem ical treatments of the brain that render an animal brain for example
transplant so that so that we can look all the way through it and trace these fiber
pathways all the way through it. So chemistry is playing a big part in terms of the
large scale activi ty recording optics and physics are playing a large part. We are
actually now monitoring the activity of tens of thousands of neurons at a time
through optical means , and new microscopes that have been invented by
physicists and engineers. The ability to perturbed results from genetic
manipulation of certain cells and putting in sensors in a certain cells that allows
us to shine light on those cells and that technique was just invented seven or
eight years ago here at Stanford, it called Ontogenetic , but that is coming from
genetics and molecular biology.

The electrical engineers help us make better electrical measurements , and then
the electrical engineers and the computer scientists are teaching us about
algorithms. So we are trying to raise philanthro pic funds that will incent our
faculty to get out of these disciplinary silos as you say. We want to create a new
culture of brain science whereby electrical engineers and molecular biologist and
then traditional neuroscientist are working together in an iterative loops , and have
these iterative loops going back and forth between the physical scientist and the
engineers and the experimental neuroscientists. So no matter how interested
they are if there is not some money to fuel the process it is not going to go
forward. And that instantly plays right into the national Obama BRAIN Initiative
right. This is the kind of thing that the BRAIN Initiative should do nationally.

Mark Masselli: We are speaking today with Dr. William Newsome, professor of
Neurobi ology at Stanford University School of Medicine. Dr. Newsome was just
appointed as Director of the Interdisciplinary Neurosciences Institute at Stanford
and also named co - directive of President Obama’s BRAIN Initiative which seeks
to develop a framework t o correlate scientific efforts to map the human brain
considered the last frontier of modern science. Dr. Newsome , I would like to talk
about the President’s BRAIN Initiative. You talked earlier about putting together
the best and the brightest and you a re co - director in this project as Dr. Cori
Bargmann, noted Neuroscientist from Rockefeller University and t he President
referred to the two of you as a Dream Team and as you have said it daunting

even monumental tasks so tell us if you would, how your team is planning to
undertake the challenges and where are you in the process at this moment?

Dr. Newsome: Well Cori and I and are chairs of the committee, a planning
committee for the NIH . It’s our task s to sort of survey (inaudible 13:46) now,
w here the b ig opportunities lie. Where are the new technologies are are creating
opportunities that absolutely have to be exploited and make recommendations to
the US Government Agencies about how to exploit this and where to go. We
have a great committee of 12 peo ple in addition to ourselves representing all
areas in neuroscience and this is what Collins referred to as the Dream Team. It
is an outstanding team, so one of the main things that we have done is realized,
we don’t have all the answers and we are openin g this up to an outside process.
So we are holding a series of workshops over the summer where we are inviting
a dozen or so experts in each of four individual fields and thoughts with us. So
these experts give us thoughts about what they think their par t of the field is and
where we should go and then we have two or three hours of afternoon
discussion, where we really sort of get into it and debate it , what are the merits of
this approach versus the other approach.

So we are getting this input from a la rge community. We have also got our blog
site setup where we can get information from individual s later during the coming
year we will be getting input from potential foundation and company, partners,
private company partners, that’s one part of our charg e . So we will be looking
carefully at that. We will be hearing from the patient advocate groups because I
think that’s a very important perspective to get, you know, it really holds our feet
to the fire about disease and you know, for a lot of patients a nd a lot of your
listeners on this radio station. This is not abstract. This is not kind of game.
This is real life. I was kind of skeptical about this, but I was inspired by Cori to
actually be a part of this.

Cori finally said she just did look that this is what President Obama’s time and he
thinks it is worth his time to push this thing then we simply have an obligation to
go along and produce the very best plan that we can do. I said Cori you run. We
have got to do this thing together. So she is about the best co - chair I can
imagine working with. We have a fantastic committee and I can assure you we
are all working very hard this summer toward our preliminary report that is due in
September.

Margaret Flinter: As you have spoken it sound like t he charge is really more of
the hundred thousand foot level if you will of understanding what ' s normal before
one dives into what doesn’t work and what’s not normal. Is that safe to say?

Dr. Newsome: All right, that is our charge . And our charge is mo r e specific than
that, actually . I mean one misconception out there is that somehow, we are
doing some master plan for all of neuroscience and that is not true. Our charge
specifically talks about the dynamics of brain activity. All this sort of firestor m of

electrical activity that 's going on in your brain right now and going in Mark’s brain
and going on in my brain and those of all your listeners, I mean there will be
millions of neuron inspiring of these millions of action potentials and our charge is
really to understand how the dynamics are merging out of that densely
connected network. It gives rise to that mental life. Okay, that’s what the NIH
charge and that’s publically available on the NIH website.

Now , of course, much psychiatric disease is related to experience , r ight ? That’s
the way we feel it. That’s why people come into the clinic because they have
altered experiences, whether we are talking about depression, whether we are
talking about schizophrenia, people altered experience and we n eed to
understand how the nervous system gives rise to experience in the first place
then how dis orders the nervous system give rise to these disorders of
experience.

Now my gut feeling is that the answers to some neurologic diseases that we all
care abou t, my gut feeling is that the answers to those diseases are going to
come at the molecular and cellular level. And it may be that the global brain
activity is not highly relevant. Alzheimer’s and Parkinson’s, I don’t know. But
there are other diseases l ike the Autism Spectrum Disorders and like
Schizophrenia that are probably my hunch es, they are going to come down to
disorders and connections between the neurons, right ? So I think that the brain
activity map that we are sort of (inaudible 17:41) here t his dynamical activity will
be highly relevant to some of the diseases and might be less relevant to others.
But we are not going to know and we are not going to really be able to make that
call until we start making progress on this with the new tools at our disposal. For
much psychiatric and neurological disease right now we are just stumbling
around in the dark. And my father died about 10 years ago of Alzheimer’s and I
know we are a largely stumbling around in the dark . And Cori says our job, the
jo b of this BRAIN Initiative is to turn on some lights, okay ? So when we start
turning the lights some of this darkness, hopefully will be dispelled.

Mark Masselli: Well and there are a number of people who are trying to that and
says similar as a site mo re of a key question but there is a lot happening with 3D
Imaging at the brain and DAC and a time where this is going to play a role in
terms of trying to print out elements of the brain that you have bee n able to map
through imaging.

Dr. Newsome: There are these packets of really bright people out there who are
taking neurons nerve cells that are grown in tissue culture and they are trying to
assemble them into actual functional circuits inside of you know, Petri dishes so
it’s kind of like printing a pr inted circuit board accept we are actually using live
cells and trying to get them hooked up and ways that might do elementary
computations. And you know, the long - term implications of that research is to be
able to recreate circuits inside natural brain so when some group of cells decide
up and die, maybe it is not enough just to put stem cells into that place. Maybe

those stem cells actually have to have instructions. Molecular and chemical
instructions about how to wire up together and if we can under stand what those
molecular and chemical instructions are in the lab than that will obviously help us
create those structures and networks inside the brain. When you think about that
kind of research 10 or 20 years down the roads , it is about getting cells ultimately
into real brains and helping them hook up with their proper partners to actually
recreate circuits. It would be like you know, your computer is broken and if the
repairman came out and just took the top of your computer and he took a bunch
of transistors and just sprinkle them in there randomly and closed the computer
and say well let’s see if that fixes the problem, you would think he was an idiot,
right ? So it’s kind of like that. We can’t just take a disease of brain and sprinkle
cells in there randomly and say lets see if it fixes itself. We actually have to know
how to get those cells integrated into the circuit and a way that will make the
thing work. So that’s the long - term goal of that kind of research.

Margaret Flinter: We have be en speaking today with Dr. William Newsome,
Professor of Neurobiology at the Stanford University School of Medicine and co -
st
director of President’s Obama’s 21 Century BRAIN Initiative . You can learn
more about Dr. Newsome’s ground breaking work by going to
monkeybiz.stanford.edu. Dr. Newsome, thank you so much for joining us o n
Conversations on Health Care today.

Margaret Flinter: You were rocking Marg a ret and Mark .

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Mark Masselli: C onversation s on Health Care. We want our audience to be tru ly
and to know when it comes to the facts about Health Care reform and policy, L ori
Robertson is an award winning journalist and managing editor of Factcheck.org ,
a non partisan, non profit consumer advocate for voters that aim to reduce the
level of decep tion in US politics. Lori , what have you got for us this week ?

L ori Robertson : We often find politician eng ag e in what we call Mediscare ,
distorting an opponent’s position on Medicare to scare seniors. The latest
example comes from a West Virginia Heal th Grades in which the incumbent
uses his opponent words on Medicaid to create Mediscare. And on from
Democratic Representative Nick R a hall says that his Republican opponent Evan
Jenkins has “billionaire financial backers ” in reference to the Koch Brother s who
want to turn Medicare into a voucher plan that would raise d seniors out - of - pocket
cost by $6 , 000. That’s an outdated reference to a 2011 House Republican
Budget Plan, a Representative Ry a n who has significantly revised this plan
since. It may or ma y not increase seniors cost. But then the add says Jenkins is
comfortable with raising seniors out - of - pocket cost saying, “he said senior should
have some financial skin in the game and think harder about going to the doctor.”
He was talking about the Me dicaid extension under the Affordable Care Act and

West Virginia’s move to charge Medicaid recipients a nominal copay to prevent
the overuse of Health Care Services.

Medicaid is a joint Federal State Insurance Program for the low income.
Medicare is for seniors age 65 and over. The new copays allowed by the Obama
Administration in 2013 are eight dollars for the non - emergency visit to an
emergency room and doctor visit co - pays ranging from zero to four dollars
depending on income levels. West Virginia ' s rule exempt individual s in nursing
homes or hospice from any Medicaid co - pay s . I am L ori Robertson , Managing
Editor of Factcheck.org .

Margaret Flinter: FactCheck.org is committed to factual accuracy from the
country’s major political players and is a pr oject of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you would like
checked, email us at chcradio.com, we will have FactCheck.org’s Lori Robertson
check it out for you here on Conversations on Health Care.

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Margaret Flinter: Each week, C onversations highlights a bright idea about how
to make wellness a part of our communities and to everyday lives . Of the
roughly 2.3 million American soldiers who have returned from multiple tours in
Iraq and Afgh anistan as many as 20% have returned with so called invisible
wounds, post - traumatic stress disorder, traumatic brain injury, anxiety,
depression, and stress. While the Federal Government has been shining a
spotlight on the problem there simply aren’t eno ugh soldiers getting the treatment
they need and their families and loved ones suffer alongside them. Dr. Barbara
Vanderlin is a licensed clinical psychologist who saw the need growing and
decided to something about it. In 2005 she and a handful of colle agues launched
an organization dedicated to creating a network of volunteer of coun se lors and
therapists who would devote their time to treating soldiers and their family
members. It is called Give n Hour. She has created a network of 6 , 500 licensed
thera pist in all 50 State and they have provided thousands of hours of free
therapy to all veterans who reach ed out to them , and they are also working with
the Federal Government’s initiative to train the next generation of doctors and
mental health professiona ls to recognize the unique characteristics of PTS D and
related conditions. Given Hour , creating a network of volunteer therapists who
are helping soldiers and their families who suffer from the impact of their service
using that network to better train fu ture clinicians to treat these disorders , n ow
that’s a bright idea.

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Margaret Flinter: This is Conversations on Health Care , I am Margaret Flinter.

Mark Masselli: And I am Mark Masselli . Peace and health.

Conversations on Health Care, broadca st from the campus of WESU at
Wesleyan University. Streaming live at www.wesufm.org and brought to you by
the Community Health Centre.