EVERY SPOKEN WORD
35 min read · 6,503 words- 0:00 – 1:40
Cold Open Trailer
- MHMax Hodak
The brain very literally, very clearly, plainly is a computer. You can solve computational problems by arranging matter in a certain way and then, like, taking your hands off and pressing go. We talk about being a brain in a vat. That's what the skull is. Like, the brain is connected to the environment through a small number of wires, the cranial and spinal nerves. These little cables that carry your interaction with the world. If you can get the visual signal, auditory signal, balance, motor in and out of the brain, that is an end in itself. That is the central object. The retinal prosthesis right now I think is a great proof of concept that we're on the right track. Nobody had previously ever been able to restore a form vision image in the mind's eye of a, of a blind patient in this way. We need to add depth of grayscale. We think we can see a path to get at least red and green. And so there's ways that we can compound upon this path through an engineering process to make a product that's better and better.
- SPSpeaker
[upbeat music] Hi, listeners. Welcome back to No Priors. Today, I'm here with Max Hodak, the founder and CEO of Science, formerly of Neuralink. We talk about PRIMA, the implant that helps people who have gone blind see again, which just got regulatory approval in Europe, their quest to sustain the human experience, and substrate independence for the brain. We also talk about alignable representations between AI models and the future of neuroscience. Welcome, Max. Max, thanks so much for doing this.
- MHMax Hodak
Thanks for having me.
- SPSpeaker
So for anyone who is not familiar with Science, can you just describe a little bit about, uh, you know, why you started the company, leaving Neuralink, what the mission is?
- MHMax Hodak
Fundamentally, we're a medical device company. Um, but I think if,
- 1:40 – 2:00
Max Hodak Introduction
- MHMax Hodak
like, the mission of lowercase S science is to use a differentiated understanding of the universe to improve the human condition, I mean, that's, that's the mission of uppercase S Science. That's what we do. We use, uh, specifically an understanding of how to work with the brain to get big effect sizes that you don't get in medicine often. Um, our main product is a retinal prosthesis. You can think of it like a cochlear
- 2:00 – 2:53
Science Corporation Overview and Origin
- MHMax Hodak
implant for the eye. Um, cochlear implants are some of the biggest impacts in, in all of medicine. I mean, you can-- If you've ever seen a video of a newborn turning on, uh, turning it on for the first time, it's striking. And our goal is to, to build things like that, including our PRIMA retinal prosthesis.
- SPSpeaker
And for people who are not familiar with that, it's a chip-
- MHMax Hodak
Yeah, so-
- SPSpeaker
... that's inserted with glasses.
- MHMax Hodak
It- so it's a tiny chip that's implanted under the retina in the back of the eye for patients that have gone blind due to loss of the light-sensitive cells in the eye. Um, so specifically, this is diseases like macular degeneration, which our clinical trial was done in, and we're about to do studies in retinitis pigmentosa and Stargardt's and a couple other diseases. So it is a chip that sits under the retina and then converts. It's-- The patient wears glasses that have a laser projector that projects an image onto the implant that then stimulates the retina to bypass the dead ro- rods and cones and stimulate the retina directly to get a visual signal back into the brain.
- 2:53 – 6:32
A Revolutionary Solve for Blindness
- SPSpeaker
How did you go from, uh, we should have, like, a nick invasively in the brain to this particular form factor as the first premise?
- MHMax Hodak
Well, so when we started the company, we had a couple ideas. Um, the f- one of the ideas was this, uh, was the biohybrid neural interface, um, direction, where instead of placing m- metal wires into the brain or genetically modifying the brain, what we do is we graft in living neurons that grow in and form new c- biological connections. That's a big research project. It's very exciting research, but also, um, needed to be paired with another nearer-term business. And we asked ourselves, like, what was the most valuable thing we could do? And we thought that we could restore vision to the blind with the resources available to us and, and where the state of the field was in early 2021. And it-- so if you want to do that, we have to start from this understanding of, like, how does the brain get vision? What is vision in the brain? And you, you could look at the retina, which is obviously how vision gets into the brain, the f- the first place it's created. The, the first stop of the optic nerve into the brain is a structure called the, the lateral geniculate nucleus in the thalamus, so that you could think, "Oh, we'll stimulate the LGN." And then the connection from there is visual cortex. And like, it's a half a billion cells up at the back of the brain. And so if you want to restore vision, you can think, I can go in through the retina, I can go in through the, the thalamus, or I can go in through V1. There's a bunch of scientific technical reasons that lead you to think if you have an optic nerve, you want to be in the retina. And from there, you have a choice of do you stimulate-- There's two types of cells, and there's a couple different ways you could stimulate them. And so we explored kind of all variants of that early on. We developed an in-house gene therapy that affected the retina in one direction. We did a survey of electrical stimulators. We looked at ultrasound. And what we ended up doing is we developed, indigenously, a state-of-the-art gene therapy, which is probably going into humans next year, as well as we, we found the state of the art out there in the world of people electrically stimulating the retina. And there was a company in France called Pixium that back in late 2022, um, had by far the state-of-the-art work. It was originally developed by an inventor at Stanford and then licensed to this small French company, and they were in the middle of clinical trials. And we got to know them over a course of a couple years, and then were in a position to acquire them when we saw something that I think kind of nobody else really saw at the time, and that, I mean, we-- that deal has turned out to be great.
- SPSpeaker
Can you talk about the recent, um, CE designation regulatory approval you got?
- MHMax Hodak
Yeah. So it took us about two years for post-acquisition to get it to the place where this was, was possible, but we just in July got marketing approval in Europe for PRIMA to start commercially selling it there. Um, and so that's a major milestone. That means it's, it's really commercially available. The first sales will happen in the coming weeks. Um-
- SPSpeaker
That's amazing. I think most people think of anything in the BCI field as, you know, a, a moonshot project that may or may not pan out ten years from now.
- MHMax Hodak
Well, I mean, people forget that the moonshot worked. Like, we went, we left, like, boot prints on the moon. And so this comparison, I mean, I think that there's It has gotten used in Silicon Valley to mean these things that have extremely long odds and are unlikely to work, and therefore we can vaporize a bunch of investor money just fine. It's like, you know, when we went to the moon, we did it. And so historically, the success rate of moonshots is higher than I think people give them credit for. The mo- one of the most important things is having a real business here, and this is the start of that.
- SPSpeaker
Can I ask how you, um, when you were exploring both, uh, different signaling pathways and form factors and just conditions to go attack, um, or, uh,
- 6:32 – 9:10
Scope of Timeline and Engineer Cost
- SPSpeaker
how you thought about scope of timeline and engineering cost and risk? Were you, were you just looking for, like, the, um, like, big enough to be useful and feasible in some period of time, or how did you think about funding the project and how long it could take?
- MHMax Hodak
So there's three elements to our pipeline. The first is our working vision, second is our bio hybrid neural interfaces, and the third is, are working a different area of, of medicine, um, perfusion, a, a program called Vessel. These three things together form kind of the minimum set of things that I think if they're successful in the timescale of 10 to 15 years could really drive a, a sig- I think, a significant revolution in medicine broadly. People have spent huge amounts of time and money looking for drugs to restore vision or to restore hearing or to stop Parkinson's or to, to help paralyzed people move again. Understanding th- the, like, the biology and the molecular detail required to make a drug has been very difficult. Humanity just isn't that good at that, to be totally honest. On the other hand, the brain is a computer, and when you deal with the brain as a computer, you get these, these things to work very, like, it's just again there, you don't see demonstration. You don't see things in medicine like a cochlear implant being turned on or a deep, deep brain stimulator being turned on or, I mean, you can implant a, a quadriplegic patient motor cortex and, and have them playing video games in, like, an hour. Like, this just, you just don't really see things like this in medi- in most drugs. Um, and so there's this-
- SPSpeaker
In sm- i- you know, in small molecule random walk, you know [laughs] sifting in, in nature.
- MHMax Hodak
Yeah. I mean, small molecules especially are super hard. I mean, even, I mean, you can do some super highly engineered patient-specific CAR T and instead you get, like, an auto- like, giant immuno reaction. It's like if I put electrodes in M1, you will probably be using a computer in an hour. Um, and so it's just, it's easier. It's more amenable to biology in many ways. You can do drug discovery for a decade, run a clinical trial. You're gonna turn over a card. The answer might be no, and then, like, what, like, you, everybody goes home. Whereas here, we have a clear sense of how to make the thing better. Um, the retinal prosthesis right now, I think, is a great proof of concept that we're on the right track. Nobody had previously ever been able to restore a form vision image in the mind's eye of a, of a blind patient in this way. But at the same time, it's, it's a small field of view. It's like looking through a straw. It's only black and white. Um, we need to add depth of gray scale. We think we see a path to get at least red and green. Blue is a little bit trickier. And so there's ways that we can compound upon this path through an engineering process to make a product that's better and better.
- SPSpeaker
Can you talk a little
- 9:10 – 9:45
Clinic Trial Process
- SPSpeaker
bit about what you saw in the clinical trial in terms of variation between patients or what the ceiling was so far?
- MHMax Hodak
Yeah. I mean, in the clinical trial, I mean, the main thing was just the existence proof of, like, that success-
- SPSpeaker
People could see. Yeah
- MHMax Hodak
... was a possible outcome, right?
- SPSpeaker
Yeah.
- MHMax Hodak
Like, the, we had patients filling in Sudoku, um, puzzles or, or crossword puzzles. Um, there were patients that were reading books, and so I saw some of these pat- some of these videos, um, met with one of the patients, talked to the surgeons. We, um, I mean, this is one of those things that seems too good to be true. It's-
- SPSpeaker
How do clinicians react to all of this? Like, do, would, would the people that you
- 9:45 – 12:21
The Response from Clinicians
- SPSpeaker
work with say at the beginning like, "Yes. Max is right. Like, the brain is a computer. This should definitely work. It should work at a higher likelihood and better rate of progression than our random walk and biological understanding"?
- MHMax Hodak
Well, if you wanna make people angry, you should tell the internet-
- SPSpeaker
[laughs]
- MHMax Hodak
... that the brain is a computer.
- SPSpeaker
Okay.
- MHMax Hodak
Um, that-
- SPSpeaker
We're gonna start by doing that.
- MHMax Hodak
Yeah [laughs] .
- SPSpeaker
All right. Yeah.
- MHMax Hodak
Yeah. Um, that kind of starts you off in a, in a, um, a, like, a defensive place.
- SPSpeaker
Why don't people like that?
- MHMax Hodak
I don't know. This is one of those things, this just feels like bike shedding to me. I mean, to me, I don't mean that metaphorically. Like, the brain very literally, very clearly, plainly is a computer in, in my understanding of the world. I also view the universe generally as a computer. Like, we can solve pro- like, you can solve computational problems by arranging matter in a certain way and then, like, taking your hands off and letting and pressing go. And so the fact that, like, that, that, that, that unfolds in time to solve some computational problem, I think of that as a computer. The brain's the same thing. Um, and that I don't think there's necessarily a deeper-
- SPSpeaker
That's a broader definition of computer than I had before
- MHMax Hodak
... a deeper point there.
- SPSpeaker
Yeah.
- MHMax Hodak
Yeah. I mean, there's nothing special about transistors. I mean, we understand computers in this idealized way as the, as, like, a Turing machine. That's an abstract computer. Um, it's just you're going from state to state in ways that are subject to laws that mean that the transformations are interesting and meaningful. But no, I think this was fairly contrarian, um, the, both in the sense that BCI has this broader interpretation than motor decoding, um, as well as, like, like, is a retinal prosthesis a BCI? Uh, that's also kind of a, this minor definitional question. But if you think that it is, then that o- that kind of opens up this interpretation of, of a lot of areas of medicine that could be accessible to it that other, that people weren't really thinking about. I mean, clearly there was interest in look, like, looking into this. Like, it wasn't that contrarian. It's a different approach, and I think we come from a different culture than a lot of the conventional biotech industry. Um, there's always been kind of an East Coast-West Coast divide in biotech, especially. Um, and we are more of a tech company than a conventional biotech company.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
And our device view of a lot of historical biology problems makes us, like, even more of a tech company by biotech standards. So we mostly raised from, from tech investors, not that much from biotech investors. In fact, there's only one VC that I sought out at all at the Series A that I went to go pitch, which was Bob Nelson, who's a biotech investor.
- SPSpeaker
When you, um, describe different types of BCI products and missions, uh, I think you have a really good way of explaining it that is, you know, on a spectrum. Can you, can you talk about
- 12:21 – 14:59
Broader Biotech Landscape
- SPSpeaker
just the landscape of what devices and approaches people are, are working on in BCI today?
- MHMax Hodak
Yeah, I mean, I think BCI is a category kind of like how pharma's a category. I think sometimes you- I, I'll talk to VCs, and they're like, "Oh, we have a BCI bet." I'm like, "Do you have a drug bet? You made one bet on a drugs?" Like, that's that, how you think about the category.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
Everything from-
- SPSpeaker
Versus thinking about it, like, in, you know, neurodegen and Parkinson's or s- a specific condition.
- MHMax Hodak
Yeah, or maybe even different bets within neurodegenerative.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
You've got a degrader, and maybe you've got a gene therapy, and maybe you've got something else. Like, because they're, um-
- SPSpeaker
Different hypotheses.
- MHMax Hodak
Yeah.
- SPSpeaker
Yeah.
- MHMax Hodak
And similarly, I think on, like, like one end of the spectrum, you've got silent speech devices that may be BCI in a greater or lesser degree. Like, maybe they're recording a neural signal like EEG. Maybe they're using something just like radar through the face, which I know. Like, I know is an idea out there. Um, but these are all basically hand substitutes. And on the one hand, hands are great.
- SPSpeaker
[laughs]
- MHMax Hodak
Two... On the two hands, hands are great. The, they work really well. You don't need to think... Like, uh, I'll talk to teams that say, like, "Oh, well, it'd be really nice if to go to your next thing, you didn't have to, like, open the Uber app and, like, call an Uber. You just, like, thought of it and it was there." I'm like, you probably wanna communicate really unambiguously with the Uber app. It'd be pretty annoying if they just start, like, spontaneously sh- you're getting notifications during meetings that, like, oh, it thought that you were thinking about an Uber, therefore it decided to summon, summon two for you. And so you'll probably want these to be pretty explicit. And to the degree that that is a volitional intent, like, you already don't need to do a lot to get your hands to do things. Um, now, could you have extra hands? Extra hands famously useful. Um, and so having some easier way to communicate, um, might, uh, might be useful. That is kind of outside of the scope of things I spend a lot of time thinking about. Because if you can, if you get vision, hearing, balance, and a kilobit per second of motor control, you're halfway to the matrix. And this takes you into some, like, really trippy interpret- reinterpretations of medicine, and that's the stuff that we work on. I think other people will do things like speech-to-text and, and, uh, AI communication. There is a distinction. So there's, there's a... Let me come back to your broader question a second. But there's some point where you go from communicating with a thing to ex- redrawing the border around your brain. And we don't have a great sense of exactly where that transition is yet, but there's a sense that there is one. Like, y- you, the way that you use the two hemispheres of your brain as one integrated bound thing is different than the way that you talk to another person. And it's not just that there's correlation, 'cause, like, all communication
- 14:59 – 17:35
Brain’s Relationship to Senses
- MHMax Hodak
is about creating correlations between brains when we speak. There's big correlations that are being driven between our brains because there's, uh... I mean, all, all communication is, is, like, premised on that. If we didn't pre-share a language or some common education, like some sense of math, then we wouldn't be able to communicate those concepts. Because there's some, uh, there's some thing that's lit up in my brain, I can serialize that to language, can send that to you. That lights up the same pre-shared concept spaces. And so there's one mode where you're, you've pre-shared some structure between the two brains, whether this is an AI model or a biological brain, and then you're communicating over that channel. The other is you've added some new structural capability. I think figuring out where that transition happens is a really int- like, a really compelling area of research for us.
- SPSpeaker
What are you most personally interested in in terms of exploring that boundary yourself?
- MHMax Hodak
Yeah. Well, I mean, that is a, like, what is you is a really central question here. Um, like, if the end of the artificial intelligence quest is-
- SPSpeaker
I don't really care. What if I just want my brain to be a better computer or a richer one-
- MHMax Hodak
Well, I think-
- SPSpeaker
... in terms of understanding other people's experiences?
- MHMax Hodak
I mean, I think that you still... There is an important question here. So if I just, like, scanned your brain into a computer, and there was a s- software simulation of you-
- SPSpeaker
Mm-hmm
- MHMax Hodak
... is that, does that count as you? Like, would that make you feel better about dying of cancer? Like, if you were diagnosed with lung cancer, and so you said, "Okay, well, we'll scan you into a computer." So, so imagine that we did it, like, non-in- non-destructively. So you're s- you'll s- you are still there.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
But then you're talking to the software replica of you.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
And then you're like, "Okay, I'm gonna go to hospice, but this thing will keep doing my venture investing job."
- SPSpeaker
Mm-hmm.
- MHMax Hodak
Like, does that make you feel better that much?
- SPSpeaker
Well, I, I think on this question, uh, I'm... Have you ever been under general anesthesia?
- MHMax Hodak
Yeah.
- SPSpeaker
Yeah. Well, I-
- MHMax Hodak
And that produces a break there, and that's, uh, this is the type of thing that you have to explain about why does that feel different.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
Because I think it does feel different. I think that people are reticent to undergo general anesthesia, but they do it and they survive, and they realize it's fine. And then there's if I could make a copy of you, and you can talk to that copy, and you're like, "Okay, I will go away now." I just don't think that many people are gonna be like, "This is it." Um, and so you have to answer why it's different. There's an asymmetry in the, uh, so in-
- SPSpeaker
Oh
- MHMax Hodak
... you've got, like, some of the operators that actually change things in physics are like a creation or an annihilation operator, and we get these in life, right?
- SPSpeaker
Mm-hmm.
- MHMax Hodak
You can create a new life or a new mind or a new soul, and then there are times when they can be annihilated. They can get destroyed. And then there's ways that they kind of change while intact.
- SPSpeaker
Do you study consciousness,
- 17:35 – 19:50
The Study of Consciousness
- SPSpeaker
um, at Science in a, like, a sequential way or, uh, directly, explicitly today when you talk about the operators that are part of it, let's say?
- MHMax Hodak
Y- so your conscious moment is a, you're experiencing a bunch of things in parallel. So you, you're seeing things, and you're hearing things, and you're feeling things, and you're smelling things, and these things happen just simultaneously together. But they are ki- they're kind of different elements of the experience, and we wanna understand how does the brain construct each of those, and how does it cause them to be perceived together to the exclusion of other things. Like, you have your vision and your hearing. You never get my vision and your hearing. Um, and I, like you kind of have this, like you might think like that sounds like really obvious, like it's in my brain, it's not in your brain. But we need some more fundamental explanation for really how that partitioning happens.
- SPSpeaker
Okay, so you think that's a, a foundational component? Yeah.
- MHMax Hodak
And so, and yeah, so I'm in the camp that like f- continuity is greatly important. And so, people will accept significant drift in their identity over time as long as they have continuity.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
But if you preserve the sense of identity, like you have a software simulation that answers exactly like you would now, but it's not phenomenally continuous-
- SPSpeaker
Mm-hmm
- MHMax Hodak
... that is less satisfying.
- SPSpeaker
Yeah, that's an interesting trade. I think I would take dramatic morph, but con- continuous experience.
- MHMax Hodak
Yeah.
- SPSpeaker
I don't know if I'd take like significantly degraded IQ.
- MHMax Hodak
Well-
- SPSpeaker
Laura Deming asked me this. Yeah
- MHMax Hodak
It's like life with provable characteristics is a thing we've never seen before, and it might be, might be transient. Like you'd probably accept degraded IQ for some period of time if it then got back filled some number of weeks later and then you got some ex- I mean, at that point where you achieve substrate independence, you can really, you can take that almost anywhere you want.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
Which is why that's really, really interesting. One of the big missing pieces here is connectomics. Um, that is getting to the, that is getting pretty close, I think, d- in terms of to the point where the project could be done. Um, we're still relatively far from a human connectome, but I think we're not that far from a mouse connectome. That would be enormously useful for, for like facilitating this research and understanding about how all this works. We need to understand like even really basic questions like what is the overall architecture of the brain. We have some answer for, but I don't know that it's like a really, really detailed one at this point.
- SPSpeaker
You are
- 19:50 – 22:10
Investments in Brain Computer Interface
- SPSpeaker
of the view that it makes sense that there is this increased like, uh, interest, this surge of investor interest and founder and engineer interest in BCI as a field given the progress of AI model research because, uh, the representations actually should be shared, or they, they empirically seem to be.
- MHMax Hodak
Yeah, I mean, this is, this is the idea called the re- uh, platonic representation hypothesis, and this is really interesting. It's, it is controversial in the community, but I mean, from where I sit, there's clearly something real happening. So when you look inside these big AI models, the mathematical objects that you see look a lot like the things that you see in neuroscience. So if you look at how do, how do these AI models represent, um, just like represent concepts, and you look at the parts of the brain that represent concepts, you see these, you see very similar geometry. That to me was one of the first clues, like when I really saw that, and we, we use that practically. Like we use that constructively at Science. Like that, we know that that is, that is true because we can get alignments between animal brain neural recordings and AI model internal representations. That was a big clue to me that the AI, AI was on the right track, and this was like not a gimmick and not hitting a wall. There was like something deeper, deeper that's true here. Um, there's some fact about the universe where these things as they're learning are grabbing onto some true underlying data manifold. I mean, it feels like a law of physics. Like if you apply enough compute to matter, you get this thing that looks like intelligence.
- SPSpeaker
Why do you think that's controversial or wh- why is it in the field?
- MHMax Hodak
There's some faction of people that kind of don't want this to be true for reasons that are not totally clear to me. Um, it is also not clear, we don't comple- we don't really under- fully understand the whatever phenomenon is happening here. It's unclear if the structure is global or if it's local in some sense. The, in the, like there's, you can recover relational structures between ideas, but it might be that this, this works locally. It doesn't, like the, where disconnected things might be placed might, like this, this gets fairly deta- like tech- technical quickly, but there's a bunch of stuff that we just don't know, and I think this causes, um, creates space for people to wonder, is this as giving us as fundamental of like a hint as it might seem? I think that it is.
- SPSpeaker
What do you think are the most fertile ways to study neuroscience today if m- if your set of beliefs is true?
- MHMax Hodak
Yeah. Well, I mean, ironically
- 22:10 – 24:46
Fertile Ways to Study Neuroscience
- MHMax Hodak
it's probably working on AI.
- SPSpeaker
Yeah. [laughs]
- MHMax Hodak
Yeah, I have some, I have a couple neuroscience friends at, at OpenAI and Anthropic who it's like we joke, it's like, "Oh, you left neuroscience." Like, "No, no, no. It is just way easier to do neuroscience on the models." Um, but to the de- the degree to which it is neuroscience is fascinating.
- SPSpeaker
I want to talk a little bit about the future and, um, the, maybe the very short and then the medium timescale for, for science short of, you know, changing the boundary of who, who we are. So, um, what does it, what does it look like to commercialize, um, the, uh, first program for you? You said that there need to be $100 million run rate businesses in this field. How do you get there?
- MHMax Hodak
Yeah. Well, I mean, becoming profitable or at least have like, having the ability to do this forever is a super high priority. Restoring vision to the blind is pretty good business if you can actually do that.
- SPSpeaker
Especially since almost everyone has the problem as an age-related problem.
- MHMax Hodak
Yeah, so AMD, it's like one in two have some early stage by 80. Um, the, it's like one in 10, 85, um, that actually have it. The, it is definitely a major issue and, and not just vision, but the, these topics in general affect everybody. We don't have firm pricing yet. This is a thing that we are being a little cautious about how we talk about publicly 'cause we aren't to- like totally sure yet. But the precedents for vision are all, I mean, I think we could say they're expensive. I mean, Second Sight 10 years ago, they-- So there was a company, uh, about a decade ago that had a retinal prosthesis that works differently than ours does. It did not get the type of performance that PRIMA does, but was briefly approved because, again, there's really nothing for these patients. There's always been a lot of enthusiasm for anything that could possibly help them. And they didn't get what we call form, form vision. They didn't get like a coherent like face or like, like paragraph that, that your eyes could scan over. They got these flashes of light that patients could look at and kind of think about assembling into what they meant. Um, they got paid about $150,000 per patient, um, in the mid 2010s. There's a gene therapy that works, that is only relevant in the first place for about 5% of patients in one narrow indication. Um, and it really doesn't work that well. It gets an 0.1 lines of improvement. It kind of slows the rate of de- degeneration for some patients. That reimburses at almost half a million dollars per eye. And so there's... I mean, some of this is a function of just how expensive it is to develop these therapies and how high the failure rate has been historically. Um, and then, um,
- 24:46 – 27:50
Biotech Expansion for Science Corporation
- MHMax Hodak
some of it is that there's just... It is... I mean, vision's a very dominant sense for us. If you l- if you lose that, that's totally debilitating, and restoring it is, is very important, even just, uh, like minimal vision. So the, the TAM will grow over time. For this first version, it's on the scale of, like, hundreds of thousands of patients-
- SPSpeaker
Mm-hmm
- MHMax Hodak
... in the US and Europe. So for the, the current version of PRIMA, it's probably hundreds of thousands of patients. And then the next version, which is going into animal studies now, will be in humans hopefully next year, um, should expand that to millions.
- SPSpeaker
You said something that surprised me as a intermediate point between, um, vision and, you know, fully understanding consciousness. Um, how does oncology or other... Like, how do other indications fit into the picture in terms of what you might work on?
- MHMax Hodak
I mean, the thing that makes you, you-- the only organ that you can't even in principle transplant is the brain. The, uh, like, the heart, the pancreas, the liver, the lungs, as far as I'm concerned, they're really support characters.
- SPSpeaker
Mm-hmm.
- MHMax Hodak
They're there to keep the brain activity interesting and, and going. And I think we're gonna get to a point where because the biology is so difficult, I mean, you've got this, like, alien nanotechnology that is around us that we are c- like, completely surrounding us, that we are completely dependent on, that we understand still very poorly. Instead of needing to solve that, are there ways where we can accomplish the same fundamental goals, you know, like, using a toolbox that humanity is much more advanced in? And so I'm gonna be ultimately fairly disappointed if I'm murdered by my pancreas. And that, I think that's, that's the worldview, is that the thing that matters is the brain. The brain is the computer that gives us this. You could not... Y- We talk about being a brain in a vat or ha- like, these upload, uh, thought experiments, but you already-- that's what the skull is. Like, the brain is connected to the environment through a small number of wires, the cranial and spinal nerves. The optic nerve is nerve two. The vestibulocochlear nerve that carries hearing and balance is nerve eight. You've got these, these little cables that carry your interaction with the world. That world is, is generated by the brain. And so if you can get visual s- the visual signal, auditory signal, balance, motor, like s- somatosensory motor in and out of the brain, that is, that is an end in itself. That is the central object.
- SPSpeaker
Okay.
- MHMax Hodak
And through a, a mix of the BCIs that allow you to kind of change the s- the s- the thing that it's interacting with and our profusion medicine program, um, we think that there's ways to significantly ex- i- improve, um, not just lifespan, but health span and, and kind of create a better, a better quality of life for many patients in ways that I think will feel kind of like a lateral move, rather than just solving many of the things that people have seen on the horizon.
- SPSpeaker
For people who are, um, interested in working at or investing in science, if you are successful, you know, w- what will be the change to human experience 20 years from now, besides you not worrying about your pancreas as much?
- MHMax Hodak
Yeah, I mean, that's it. Like, that's the...
- 27:50 – 29:06
What Success Looks Like in Neuroscience and Tech
- MHMax Hodak
There's the... There's a s- like, a fragility that we all live... Like, there's this jeopardy that we all live under as part of the human condition, and I think that if we're successful, what will happen is that sense of jeopardy will fade. Like, we will be- we will just become much less fragile. Um, we will have the ability to upgrade and replace parts of ourselves. So neurodegeneration, we don't know about. That one still seems-- That's still difficult. That still needs, like, real investment. Um, the two leading causes of death, though, are cardiovascular disease and cancer that metastasizes to the brain, and I think both of those are gonna be really attackable through this type of work. Um, the other extreme is if we are serious about exploring the universe and going to the stars, we are gonna have to adapt ourselves to that environment. We're not gonna export Earth with us everywhere we go. And these bodies are great, but they're designed for this planet, and it is gonna be... A- adapting ourselves to the hard vacuum of space is definitely going to be, um, I think the thing that we wanna do in the long run. And ultimately, those are the same pro- those are the same project.
- SPSpeaker
Being able to preserve yourself and being able to adapt yourself-
- MHMax Hodak
Swap-able parts-
- SPSpeaker
Or update
- MHMax Hodak
... and substrate independence. Yeah.
- SPSpeaker
Yeah. Substrate independence. I'll use that phrase. The, the simplest premise for a
- 29:06 – 30:25
Goals Within Human Preservation vs. Adaptation
- SPSpeaker
company in the BCI domain today is, like, you can, in some way, invasively, noninvasively talk to an AI model, um, in, like, a high bandwidth way. That is not your focus of interest. Why?
- MHMax Hodak
Yeah. Well, I mean, first of all, I think that talking or writing is thinking. I think this idea that there's the stuff that's just, just kind of preformed in your brain, that if you could ac- access it through BCI, it would be faster, is probably not, not the case.
- SPSpeaker
You don't think there's some special latent state that's not language?
- MHMax Hodak
No, I think that... But the... Like, it feels like it, you'll have, you'll, it'll feel like it's fully formed, but until you really sit down and try to write it out, it is, it isn't really, and I think that feeling is misleading. And so there's this, there's this, like, 10 bit per second kind of famous, like, cognitive bottleneck. There's this observation that the brain seems to process information, like if... There's a bunch of ways you can triangulate this. You can put somebody with a perfect memory on a helicopter ride over Manhattan and ask them to draw what they saw, and then you look at all the details. It works to about 10 bits per second over the course of an hour or two. There's, like, a, a bunch of different independent lines of evidence for this. So there's some deeply evolved cognitive bottleneck at a- about that, and I think that this kind of rolls up through language. But even so, but even if you, if you take that, it probably... I mean, it probably would be nice to be able to walk down the street with, like, a cap on and, like, ask questions to my
- 30:25 – 31:38
Conclusion
- MHMax Hodak
AI through monologue. Like, that might be possible. There's probably some combination of EEG and MEG that might be capable of this. Um, that is still just, like, a different type of product. That is not the thing we are trying. Like, brain keyboard is, I'm not, it might be valuable. It might turn out to be like AR len- AR glasses, where it's just that we were, our attention was already fully 100% occupied, and putting it on the face didn't really change that. We were already consuming all of you all the time. But the, at the other end of that spectrum are things like generating vision or generating hearing or, um, achieving substrate independence. Those are the things that we are focused on, not brain keyboard. Um, both of these are potentially BCI pro- um, problems or products, but very different type of companies that will build them, just as I think you have a huge range of, of drug companies.
- SPSpeaker
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Episode duration: 31:38
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Transcript of episode 7HXqMepjvy8
