Author Archives: kyleserikawa

Tall poppies, tall corn and creating the right environment

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All opinions my own and do not necessarily reflect those of Novo Nordisk.

The first time I heard the saying, “Cutting down the tall poppies,” I was in Australia, over 20 years ago, talking to an Professor who was a US expatriate and working at the University of Queensland.  I’ve heard it since in conversations with people from the UK, Denmark and other countries.  The specific connotation in each culture differs somewhat, but the general underlying meaning is that those who rise above the crowd should in some way be brought back down to the level of everyone else. This might be in a physical and material sense, or in an attitudinal way, as in, “don’t think you are better than us just because of your (choose one) wealth, success, position, knowledge, etc.” An egalitarian sentiment, to be sure, but one that sounds odd to someone raised in the US, where individual attainment and excellence are among the key values.

I often contrast that idea to the following story about tall corn.  I first heard it from Professor Michael Freeling when I was a graduate teaching assistant at UC Berkeley, and assigned to TA for his class on Genetics and Society. This was an undergraduate survey class and on the first day, a freshman stood up (aren’t freshmen cute?  Always so earnest and ready to play “stump the Professor.”) and asked Michael where he stood on the question of Nature versus Nurture.

Michael’s answer was to describe his own work in maize genetics. Take a handful of genetically diverse maize kernels, he said, and sow them in a field and see what happens.  You get plants growing to a variety of heights, and each plant will give you different yields. Take another handful of kernels from the same batch and plant them in a greenhouse.  Give them fertilizer, gro-lights, plenty of water, keep out bugs and other pathogens. Then you’ll see the plants growing to more or less the same height, and yielding similarly, every ear on every one.

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One small, wistful story about the shutdown

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Seattle, like San Francisco, like New York City, is a city of water and bridges.  I remember reading Winter’s Tale by Mark Helprin back in college. I think it’s a book that I’d benefit from reading now, again, but one of the concepts that struck me even in my callow youth was his observation about cities that have bridges as part of their fundamental being.  He described how a city, to be magnificent, must “project, extend, fling itself in all directions–over the water, in peninsulas, hills, soaring towers, and islands linked by bridges.”

Seattle is that kind of city.

And it made me sad when I heard that one of our bridges, albeit a small and specialized one, was closing because of the government shutdown. Continue reading →

Biopharma should choose targets using a baseball-style draft

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All opinions my own and do not necessarily reflect those of Novo Nordisk

I was sitting around last evening checking out how the end of my fantasy baseball season is working out (for the record, first out of ten in one league and fourth in the league I wrote about here) and I starting thinking again about the parallels between baseball and drug development (which I previously wrote about here and here for example, and also Stewart Lyman has a nice piece on a similar theme here). And it hit me that there’s another way in which biopharma could take a  page from baseball: fantasy and Major League Baseball both.

Biopharma could institute a draft for drug targets.  And to explore this I’m going to employ the time-honored, not to mention trite and artificial, format of a series of questions and answers.

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Premature testification is not a laughing matter

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All opinions are my own and do not necessarily reflect those of Novo Nordisk.

“These studies, once validated, open an opportunity for creating tests that an expectant mother can take to see if she is producing these autoantibodies. ”

I wrote this statement back in July as part of a post describing the report that maternal autoantibodies to specific neural proteins correlated with the appearance of autism symptoms in the children of those mothers.  Little did I suspect that plans to create a test were already in the works.  Science recently reported (paywall) that researchers behind this study are teaming up with a testing company to develop and market a diagnostic test for maternal autoantibodies.

On the one hand I am much in favor of prognostic tests that will help us anticipate health problems.  I believe in many cases early knowledge and interventions can be helpful, even when there is no “cure.”  One of the hopes for the wave of genomic biomedical research going on now is that it will allow us to better estimate who will and will not come down with specific diseases based on clues in individuals’ DNA.  But on the other hand, it can be problematic when tests are created and released before the underlying biomedical hypothesis has been strongly vetted and supported. Continue reading →

Transparency and the invisible hand in hospital and healthcare costs

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All opinions are my own and do not necessarily reflect those of Novo Nordisk

One of the things that sometimes seems to get lost when people talk about the power of the market to create efficiency is that a free market requires that information be shared and freely available and understandable by everyone.  When information is withheld by one side or the other of a transaction, or when different customers for a service or product are unable to compare prices, the metaphor of the invisible hand breaks down.

You can see, this, interestingly enough, in sports as it relates to both the trading of players under contract and the signing of free agents.  Since I’m a baseball fan, let me link here to a discussion of research that’s been done looking at Major League Baseball.  The studies looked at players traded or signed by a different team as a free agent and how those players performed in subsequent years versus players whose original team re-signed them.  It turns out that players who switched teams did, indeed, perform more poorly relative to projections than players who stayed.  This suggests that the original teams have proprietary information that allows them to make better decisions about which players to retain.  Thus the market for baseball players isn’t quite free and efficient because of information asymmetry.

And unfortunately, information asymmetry is also rampant in other industries such as healthcare. Continue reading →