[Script Info] Title: [Events] Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,I want to talk to you\Nabout the future of medicine, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,but before I do that, I want to talk\Na little bit about the past. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now, throughout much\Nof the recent history of medicine, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,we've thought about illness and treatment Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,in terms of a profoundly simple model. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In fact, the model is so simple Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that you could summarize it in six words: Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,have disease, take pill, kill something. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now, the reason for\Nthe dominance of this model Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is of course the antibiotic revolution. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Many of you might not know this,\Nbut we happen to be celebrating Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,the hundredth year of the introduction\Nof antibiotics into the United States, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,but what you do know Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is that that introduction\Nwas nothing short of transformative. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Here you had a chemical,\Neither from the natural world Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,or artificially synthesized\Nin the laboratory, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and it would course through your body, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,it would find its target, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,lock into its target -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,a microbe or some part of a microbe -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and then turn off a lock and a key Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,with exquisite deftness,\Nexquisite specificity, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and you would end up taking\Na previously fatal, lethal disease, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,a pneumonia, syphilis, tuberculosis, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and transforming that into a curable,\Nor treatable illness. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,You have a pneumonia,\Nyou take penicillin, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,you kill the microbe, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and you cure the disease. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So seductive was this idea, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,so potent the metaphor of lock and key Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and killing something, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that it really swept through biology. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,It was a transformation like no other, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and we've really spent the last 100 years Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,trying to replicate that model\Nover and over again Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,in noninfectious diseases, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,in chronic diseases like diabetes\Nand hypertension and heart disease. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And it's worked,\Nbut it's only worked partly. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Let me show you. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,You know, if you take the entire universe Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,of all chemical reactions\Nin the human body, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,every chemical reaction\Nthat your body gets, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,most people think that that number\Nis on the order of a million. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Let's call it a million. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And now you ask the question, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,what number or fraction of reactions Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,can actually be targeted Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,by the entire pharmacopia,\Nall of medicinal chemistry? Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,That number is 250. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The rest is chemical darkness. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In other words, 0.025 percent\Nof all chemical reactions in your body Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,are actually targetable\Nby this lock and key mechanism. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,You know, if you think about\Nhuman physiology Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,as a vast global telephone network Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,with interacting nodes\Nand interacting pieces, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,then all of our medicinal chemistry Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is all operating on one tiny corner Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,at the edge, the outer edge,\Nof that network. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,It's like all of our\Npharmaceutical chemistry Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is a pole operator in Wichita, Kansas Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,who is tinkering with\Nabout 10 or 15 telephone lines. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So what do about this idea? Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,What if we reorganized this approach? Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In fact, it turns out\Nthat the natural world Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,gives us a sense of how one\Nmight think about illness Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,in a radically different way, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,rather than disease, medicine, target. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In fact, the natural world\Nis organized hierarchically upwards, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,not downwards, but upwards, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and we begin with a self-regulating,\Nsemi-autonomous unit called a cell. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,These self-regulating,\Nsemi-autonomous units Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,give rise to self-regulating,\Nsemi-autonomous units called organs, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and these organs coalesce\Nto form things called humans, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and these organisms ultimately live\Nin environments, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,which are partly self-regulating\Nand partly semi-autonomous. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,What's nice about this scheme,\Nthis hierarchical scheme Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,building upwards rather than downwards Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is that it allows us to think\Nabout illness as well Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,in a somewhat different way. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Take a disease like cancer. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Since the 1950s, we've tried\Nrather desperately to apply Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,this lock and key model to cancer. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We've tried to kill cells using a variety\Nof chemotherapies or targeted therapies, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and as most of us know, that's worked. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,It's worked for diseases like leukemia. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,It's worked for some forms\Nof breast cancer, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,but eventually you run\Nto the ceiling of that approach, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and it's only in the last 10 years or so Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that we've begun to think\Nabout using the immune system, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,remembering that in fact the cancer cell\Ndoesn't grow in a vacuum. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,It actually grows in a human organism, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and could you use the organismal capacity, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,the fact that human beings\Nhave an immune system, to attack cancer? Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In fact, it's led to the some of the most\Nspectacular new medicines in cancer. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And finally, I mean, there's the level\Nof the environment, isn't there. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,You know, we don't think of cancer\Nas altering the environment. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Let me give you an example\Nof a profoundly carcinogenic environment. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,It's called a prison. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,You take loneliness, you take depression,\Nyou take confinement, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and you add to that, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,rolled up in a little white\Nsheet of paper, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,one of the most potent neurostimulants\Nthat we know, called nicotine, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and you add to that one of the most potent\Naddictive substances that you know, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and you have a pro-carcinogenic\Nenvironment. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,But you can have anti-carcinogenic\Nenvironments too. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,There are attempts to create milieus, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,change the hormonal milieu\Nfor breast cancer, for instance. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We're trying to change the metabolic\Nmilieu for other forms of cancer. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Or take another disease, like depression. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Again, working others, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,since the 1960s and 1970s,\Nwe've tried, again, desperately Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,to turn off molecules that operate\Nbetween nerve cells -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,serotonin, dopamine -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and tried to cure depression that way,\Nand that's worked, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,but then that leads to the limit. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And we now know that what you\Nreally probably need to do Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is to change the physiology\Nof the organ, the brain, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,rewire it, remodel it, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and that of course, we know\Nstudy upon study has shown Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that talk therapy does exactly that, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and study upon study has shown\Nthat talk therapy combined Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,with medicines, pills, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,really is much more effective\Nthan either one alone. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Can we imagine a more immersive\Nenvironment that will change depression? Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Can you lock out the signals\Nthat elicit depression? Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Again, moving upwards along this\Nhierarchical chain of organization. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,What's really at stake perhaps here Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is not the medicine itself but a metaphor. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Rather than killing something, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,in the case of the great\Nchronic degenerative diseases -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,kidney failure, diabetes,\Nhypertension, osteoarthritis -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,maybe what we really need to do is change\Nthe metaphor to growing something. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And that's the key, perhaps, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,to reframing our thinking about medicine. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now, this idea of changing, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,of creating a perceptual shift,\Nas it were, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,came home to me to roost in a very,\Nvery personal matter about 10 years ago. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,About 10 years ago --\NI've been a runner most of my life -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,I went for a run, a Saturday morning run, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,I came back and woke up\Nand I basically couldn't move. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,My right knee was swollen up, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and you could hear that ominous crunch\Nof bone against bone. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And one of the perks of being a physician\Nis that you get to order your own MRIs. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And I had an MRI the next week,\Nand it looked like that. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Essentially, the meniscus of cartilage\Nthat is between bone Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,had been completely torn\Nand the bone itself had been shattered. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now, if you're looking at me\Nand feeling sorry, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,let me tell you a few facts. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,If I was to take an MRI\Nof every person in this audience, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,60 percent of you would show signs Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,of bone degeneration\Nand cartilage degeneration like this; Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,85 percent of all women by the age of 70 Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,would show moderate to severe\Ncartilage degeneration; Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,50 to 60 percent of the men in\Nthis audience would also have such signs. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So this is a very common disease. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Well, the second perk of being a physician Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is that you can get to experiment\Non your own ailments. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So about 10 years ago we began, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,we brought this process\Ninto the laboratory, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and we began to do simple experiments, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,mechanically trying\Nto fix this degeneration. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We tried to inject chemicals\Ninto the knee spaces of animals Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,to try to reverse cartilage degeneration, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and to put a short summary\Non a very long and painful process, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,essentially it came to naught. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Nothing happened. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And then about seven years ago,\Nwe had a research student from Australia. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now, the nice thing about Australians\Nis that they're habitually used Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,to looking at the world upside down,\Nand so -- (Laughter) -- Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Dan suggested to me, "You know,\Nmaybe it isn't a mechanical problem. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Maybe it isn't a chemical problem.\NMaybe it's a stem cell problem." Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In other words, he had two hypotheses. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Number one, there is such a thing\Nas a skeletal stem cell Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that builds up the entire\Nvertebrate skeleton: Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,bone, cartilage,\Nand the fibrous elements of skeleton, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,just like there's a stem cell in blood, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,just like there's a stem cell\Nin the nervous system, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and two, that maybe that, the degeneration\Nor dysfunction of this stem cell Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that is causing osteochondral arthritis,\Na very common ailment. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So really the question was,\Nwere we looking for a pill Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,when we should have really\Nbeen looking for a cell. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So we switched our models, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and now we began to look\Nfor skeletal stem cells, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and to cut again a long story short, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,about five years ago,\Nwe found these cells. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,They live inside the skeleton. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Here's a schematic and then\Na real photograph of one of them. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The white stuff is bone, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and these red columns that you see\Nand the yellow cells Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,are cells that have arisen\Nfrom one single skeleton stem cell, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,columns of cartilage, columns of bone\Ncoming out a single cell. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,These cells are fascinating.\NThey have four properties. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Number one is that they live\Nwhere they're expected to live. Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,They live just underneath\Nthe surface of the bone, Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,underneath cartilage.