Q&A: The self-experimenter who intends to change medicine

SmartPlanet speaks with Larry Smarr who has embarked on a computer-aided study of his own body, which may lead to profound changes in the way we practice medicine.

Larry Smarr knows himself. Probably a lot more than you know yourself. Smarr systematically monitors his body using sensors that track his skin temperature, a headband that analyzes his sleep patterns, as well as with blood work performed and stool samples studied nearly every month. You might consider him one of the prime examples of the "data-driven self" movement—a rapidly growing trend where people are self-tracking every data point they can about themselves in order to alter behavior and health. But not many are doing it on the scale that Smarr is. Already he has successfully self-diagnosed serious health issues months before they landed on his physician's radar.

Smarr is an astrophysicist-turned-computer scientist and one of the original founders of the Internet. He runs the California Institute for Telecommunications and Information Technology (Calit2) where he is working on a "computational model of the human body".

SmartPlanet caught up with Smarr in La Jolla, California to talk about his research and why he believes this sort of self-study will dramatically dismantle the medical system as we know it.

SmartPlanet: You talk about something called the "computational model of the human body." What exactly is that?

Larry Smarr: Well let's start by understanding that we get about a factor of a thousand-fold increase in computer power for the same money every decade. This is known as Moore’s Law. As far as we can see this will continue. If you go back to just where we were in 2000, there wasn’t Google, there wasn’t Amazon, web services, the cloud really wasn’t an idea.

And now there are millions of processors in the various clouds that are out there. Project forward ten years and we’ll have the so-called excess scale computer, which is one million teraflops. So one million trillion computations a second. And it will be composed of about a billion processors of say the strength and the fastness that we have today. I don’t think it’s crazy that the cloud, instead of millions will be billions of processors.

SP: OK, that's an almost unimaginable amount of computational power and speed. But what about the biological body connection?

LS: So last month, in July, the first scientific paper came out on a complete computational model of a single cell including all the metabolism and DNA replication. This is a quest that people have now been on for twenty years.

But it’s finally possible. If the fastest computer today has several hundred thousand processors and in ten years that computer will have a billion, I think we’re going to have pretty accurate models of entire human bodies.

SP: What will that mean for us?

LS: Well at the same time anyone who goes to the doctor will be able to get a patient's full genome done for a few hundred dollars, about the same cost as a medical exam. And we’ll have that across hundreds of millions of people. It’s hard to understand how data rich the world we will be in ten years from now is compared to how data poor it was ten years ago.

SP: It's difficult for people to get their heads around what teraflop is. And the power of such machines.

LS: To give you an example. My team is analyzing the sequencing of my gut microbes, of which there are several hundred species. And Craig Venter’s institute in Maryland sequenced and sent back to me twenty-five billion [DNA] bases. And we use a single processor from a super computer for half a year to analyze that data and turn it into what are the different species. Well in ten years, with Moore’s Law, that will be four hours.

SP: Wow.

LS: It means that everybody will be able to do this, literally on a daily basis.

SP: You think everyone will want to sequence their stool?

LS: Well by sequencing their stool they'll get their gut microbiome, which is so critical for your health, for obesity. Everything is dependent on the ecological distribution in your gut microbiome.

SP: I suspect the general population is not thinking about the importance of the microbes within our bodies.

LS: Our human cells are only one tenth of our cells. Ninety percent are the microbe, which we basically ignore. And yet your immune system has been created between the human DNA and the microbial DNA. Obese people have a different microbiome than lean people. A lot of autoimmune diseases are kicked off by problems with the microbial distribution. It’s going to revolutionize medicine to understand the world of the microbes inside of all of us.

SP: In your own study of your body, one could say you’ve become a poster man for the so-called data-driven self or quantified-self movement. Can you describe this trend?

LS: It’s very odd to me that people are such a complex biochemical machines and yet we go into the doctor’s office and the thing he’ll ask you is, "How you’re feeling?" That’s a pretty crude estimate of the state of your body.

Today people are wearing Fitbits to measure how many steps they’re doing, they’re wearing chest straps to get the second-by-second heart rate linked to their exercise machines. They’re wearing Zeo headbands at night to measure every thirty seconds the state of their sleep.

More and more we’re able to use blood tests, or stool tests, or saliva tests to get DNA, to get your cholesterol variables, and depending on what they are, modify you behavior to get them to better numbers.

Think of what we do with our cars: We have little chips in our cars that measure second-by-second how well our spark plugs are working, how well our breaks are working, our fuel injection. If you go in at twenty thousand miles, thirty thousand, forty thousand miles, they read out the values of your numbers and compare them to the population of cars of your make and year, and if there’s something that’s beginning to go wrong, they just take out a module or put in a module and put it back on normal. That’s what I’m doing with my body.

SP: What was your motivation to study your body like this?

LS:  I had come to La Jolla in 2000 from the Midwest where I’d spent twenty years. I was overweight. I hadn’t been exercising. And I looked around and saw how wonderfully fit all these people were, slim, trim.  I figured if I didn’t get with the program, they’d sent me back to the Midwest. So I got a trainer and I started reading about food. And I understood that my body was a biochemical machine and I needed to provide it with the right raw materials. I drastically changed my diet to much more healthy types of food. And in particular, I was looking at reducing the inflammation that our food causes be we in America we have about twenty times as much omega-6 essential fatty acids as omega-3. Omega-6 oils drive inflammation, whereas omega-3 drive anti-inflammation. I wanted to see how I was doing by actually measuring the ratio of omega-3’s to omega-6’s in my blood.

SP: So you went to the doctor?

LS: Yes, and the doctor said the insurance companies won’t pay for that test because it’s preventative. I thought this is nuts. They won’t pay for a test now to keep me from getting a costly chronic disease later?

SP: You decided to take it into your own hands?

LS: Right. I found on the web you could order a little kit and have Quest Diagnostics take your blood professionally and send you back the data on the web site.

I realized that I didn’t need a doctor’s permission to measure something about the state about my own body. I mean, what a crazy idea that you need anybody’s permission to know about the state of your own body?

SP: The thinking that we need to see a doctor is quite strongly embedded in our American culture.

LS: It was so liberating. I thought gee this is fun. I’m a scientist. I sort of geeked out on the realization that I could actually begin to measure all these different subsystems. I could look at the state of my liver, I could see how well my kidneys are doing. Before long, I was tracking over a hundred different variables.

SP: And this is when you found something a bit odd with your body.

LS: I discovered that there was one thing that was completely off scale in terms of its numbers, which was the inflammation in my blood measured by what’s called a complex reactive protein. I was five times the upper limit, and then over the next two years, to my horror, I was ten times, and then fifteen times the upper limit.

To put that in perspective: Four times the upper limit is enough to quintuple your chance of future heart attack. And I’m up to fifteen! And I said, oh my god, what’s wrong with me? And I went in and showed this to my doctor and he said, well how do you feel? I said what difference does it make how I feel, I’ve got data.

And he said, well do you have a symptom? And I said now I feel great, but there’s something terrible that’s going to happen to me. And he said, well when you have a symptom come back, and we’ll talk about it.

SP: Sort of a wait and watch this potential play out?

LS: This is when I realized that people weren’t taking a preventative point of view and a predictive point of view. And that’s when I found other people taking part in this quantified-self movement, which is now all over the world. And I began to then meet with a lot of people that were at the frontier of this much different approach to the state of the body.

SP: What about the dangers of too much information?

LS: To answer that question I like to look at other things. iTunes, for instance, handles the fact that there are now many thousands of songs more than you would have had ten years ago. That hasn’t freaked people out, because iTunes makes it easy to find things. It isn’t that the individual has to deal with the information. The institutions make it their job to take all that information and to provide the citizen with an easy to use, easy to understand interface.

SP: I think that is going to be most important innovation for the quantified self movement: How easy that interface can be, and how accessible it can be.

LS: If on your smart phone you are able to get a kind of personal, day-by-day, coaching. I think that we will be able to handle this information, and we will end up having much better bodies.

I don’t care whether it’s the republicans or the democrats or anybody else, there is not going to be enough money generated by this country to take care of a set of citizens who don’t take personal responsibility for keeping themselves healthy.

This post was originally published on Smartplanet.com

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