“But daddy how are babies made?”
Last Friday, during Shabbat, our daughter, Mia, popped the question: “How are babies made?” Nina, my wife, is 24 weeks pregnant, and Mia, who is only 5, really wanted to know how babies were made.
You would think that question is hard to answer to such young a child. Uncomfortable. My first attempt was to try to simplify things. I went for the famous seed story.
“You know how at school you have been growing plants? You plant a seed, and then a few days later you see a sprout coming from under the dirt? Well, I planted a seed and mom has a baby in her belly,” I said.
“But how. daddy, how did you plant the seed?”
“Well, that,” I said, “You will find out when you are older.”
“You mean when I am 10?”
“Yes, Mia, when you are 10.”
So, by now you are probably thinking that by the time she is ten we will have the “sex talk.” But no, we won’t. When she is ten, we will have the “lab talk,” because Mia, like 5 million other children in the world so far, was made from Nina´s eggs and my sperm at an in vitro fertilization lab. My seed was “planted” in a petri dish.
Mia’s question was not only timely because of Nina´s pregnancy, but because today we are launching Prelude, the company that will help thousands of people have healthy babies when they are ready (a feature in Forbes about Prelude, authored by Miguel Helft, is here). And as a result of Prelude´s strategy, we will transform the infertility industry into the fertility industry, and in coming years, many more parents will have the “lab talk” with their kids.
Why would Prelude encourage the “lab talk” and not the “sex talk”? Because sex fails too frequently for it to be the only means of procreation. In the 60s, with the invention of the pill, the sexual revolution was launched—a revolution that decoupled sex from procreation. In the 2010s, thanks to the invention of vitrification (mostly developed at Prelude labs) and genetic sequencing of embryos, we are launching the second sexual revolution and decoupling procreation from sex.
When women under 30 are asked how many children they would like, the most common answer is three. But by the time they are 45, which is the natural end of fertility, 19% had no children, 22% had one, 30% had two, and only 29% had three or more children. Moreover, of those who had children, around 3% of babies were born with a congenital illness, and to get there, 20% of known pregnancies ended up in miscarriage. And to add to the risk of starting a family, every year there are tens of thousands of clinical abortions on pregnant women whose amnios or NIPT results lead them to decide to abort. So if having babies by having sex produces these results, should we continue to trust sex as the only means of procreation? We don’t think so. At Prelude, we think sex is great, sex is fun, but it is just too unreliable as the sole way to have babies during our 30s and 40s.
Prelude is a complementary strategy to starting a family having sex; an alternative that only occasionally would be necessary if millennials had their children at the same age as baby boomers had theirs. By stretching youth into our 40s, we’ve squeezed maternity out of the equation. A large segment of women is ending up with no children, or just one or two, when they wanted more. Or, because of advanced maternal and paternal age, they are having babies with significant health problems.
So, how do we fix this?
It’s why we developed The Prelude Method! The Prelude Method consists of freezing sperm and eggs when you are fertile, making embryos when you are ready, genetically sequencing parent’s and embryos to reduce the frequency of congenital illness, and transferring one at a time to reduce multiple pregnancies.
So. while all Prelude babies develop in their mother´s wombs, Prelude babies, like Mia, are not made having sex. And as opposed to people who solely rely on sex to make babies, people who rely on both sex and Prelude have a much greater chance of achieving their parental goals of having healthy babies when they are ready. Prelude uses the technology available to infertile people, on fertile people. At Prelude we believe that something as important as having a baby, and equally important, a healthy baby, should not be left to chance.
Today is a big day for us. Today, as Prelude, we announced that:
- We raised $200 million mainly from a phenomenal group of investment professionals known as Lee Equity including Barry Baker, Yoo Jin Kim, and Collins Ward.
- We have acquired the largest egg bank in North America, My Egg Bank, started by the scientist who perfected the vitrification technique in the U.S., Dr. Peter Nagy; and Dr. Daniel Shapiro, one of the nation’s leading reproductive endocrinologists who developed the most reliable technique to avoid hyperstimulation and obtain many eggs from fertile patients.
- We have acquired Atlanta-based RBA, one of the nation’s best fertility clinics, whose CEO, Dr. Andrew Toledo, and COO, Ron Davidson, are also a stellar part of our team.
- We have recruited a remarkable top manager, Tia Newcomer, as Chief Revenue Officer, former Vice President, Marketing & Commercial Operations at CBR, who convinced hundreds of thousands of new parents to preserve their baby’s stem cells.
- Allison Johnson, who worked for Steve Jobs and launched the iPhone and every other i-product from Apple during Steve’s time, is helping us communicate Prelude to the world.
- Joanna Rees, a well-known venture capitalist from San Francisco, and Dr. Mehmet Oz, America´s doctor, have joined our board as independent board members and are investors in Prelude.
From the outset, Prelude will have a sizable acquisition war chest [or bankroll] to partner with and acquire more fertility clinics around the country and to build a phenomenal embryo testing lab and cryogenic facilities.
In the years to come, many more parents like Nina and I will have the “lab talk” with Mia, our son David, and our baby on the way. And maybe you will too, because those who do will be much more likely to have healthy babies when they are ready than those who rely on sex alone for reproduction. With Prelude, our biology will finally come to terms with our psychology.
As depressing as Trump counter factual populism is, there is something even more worrying: the conditions that made Trump happen are not going away. These are elite education and a deteriorating job market.
As Trump says he loves the uneducated. And by tying lower education to residence and higher education to income, our society can’t stop producing his type of voters. The best universities in the USA can only accept about 3% of those who turn 18 every year. So a country that provides elite education for only 3% of its population shouldn’t be surprised, that a candidate who preys on the rest with reality TV appeal and groundless proposals, can get elected.
And then there’s deteriorating job quality. Yes we still have jobs, like we still have car owners. But the trend towards massive automation is about to take a few more exponential steps. And as cars will be mostly pooled and driverless, many of today’s jobs will also go the way of AI. First will be transportation, then hospitality, then health care.
The next Trump will not speak about Mexicans stealing our jobs and be wrong about them, he will speak about AI stealing our jobs and be right about it. So either we find a way to educate more people and provide occupations and basic income to all, or we will have Trump after Trump. And one day democracy will be a distant memory.
Last night I had dinner in San Francisco with an illustrious group of people. Some of them would arguably be perceived as the smartest people around. Yet their worldview was very biased by their life in Silicon Valley.
A lot of the conversation on inequality centered around how zoning laws are pricing a new generation out of the housing market. True here. Not true in Atlanta, Berlin, Miami. Are restrictive zoning laws a problem? Yes, but are they the reason why there is inequality? Only partly, and depends where. I have another explanation for inequality and that is: inheritances, elite education, uneven distribution of talent.
Another Bay Area centric explanation was that pervasive technology is causing violence. Do we believe that Syrians or Libyans are killing each other because they have Facebook or Twitter? Not really. Hutus and Tutsis killed each other without smartphones and with machetes. I see the violence in the Middle East as a resurgence of tribalism, fake us vs them. Religion being used for tribal purposes.
Then there was the belief that education is not what is needed to solve inequality, because many people with college degrees end up serving coffee. Yes this may be true here. But in most of the world access to education is indeed a ticket to the middle class. And less education will give us more Trumpism. As he said it he loves the uneducated. Moreover education is about being part of a culture, not only a way to get what job.
Lastly a very radical view, was that robots and AI are taking over the world, and hence, an experiment in basic income was started in Oakland to simulate a world in which nobody has a job. Could AI and robots leave many without work? Yes. But so did mechanized agriculture.
In short all the problems were real. But the intensity attributed to each one of them and the proposed solutions were very Northern California.
Today Leo (9) and I were on Messenger, using video, he in Madrid and me in Miami. We were having a long conversation as he walked around Madrid doing different things and I was doing my work. So we were virtually together for quite a while, happy the other person was there, sometimes silently. At some point Leo said to me. Dad, aren’t you glad we live in the future and you and I can do this? My reply was that for a long time I had beeen dissapointed about the future. Fabrice Grinda and I debated this point around 5 years ago and he was the first person who alerted me that the future was finally arriving. He knows I felt that when I was at university in the 80s we believed that by the year 2000 so much would be different, and it wasn´t. But over the last 4 years, I realized, that the future that we were promised in the 80s indeed has arrived. Prelude, my new company that is focused on having babies with fewer illnesses and whenever people are ready, involves two technologies, vitrification and genetic sequencing of embryos that were not available a few years back. Fon and others have blanketed the world with WiFi making it easier and cheaper for hundreds of millions to connect. Tablets and smartphones have reached the masses. Driverless cars are already going around the streets and while they may not fly as we thought, they are radical. CRISPR has given us a real chance to gain control of evolution and my belief is that we will use this tool wisely as we now use genetically modified food. Living in a connected world is enabling us to stay in touch emotionally and intellectually with the rest of the planet. The app economy has given us knowledge and comfort in the palm of our hands, almost as a second arm and a second brain, always with us. Hyperloop is doing away with the connection between speed and the sound barrier getting rid of the atmosphere at sea level. So yes, I am very glad Leo that we live in the future. And while nothing will replace the hug I would love to give you, following you around Madrid today, made me feel very close to you.
My elevator talks to me. But doesn’t listen. It says “8th floor” when we get there. But I can’t just say “8th floor” to go up, I have to press a button. And my elevator doesn’t recognize me, nor my voice. So anyone else who is not authorized can go to the 8th floor. I think it’s time that what Nest did to thermostats, somebody does to elevators. Have elevators respond to voice commands and only take authorized users to their floors. And how about having elevators tell you if your little kids get in by mistake. Or they notice that you walked in and tell your Uber or Lyft “Martin is arriving in 1m”. Or have sensors in the front door that call the elevator down before you get to it. Or use AI to learn building traffic patterns along the day and save energy and time for building occupants. There’s lots of cool things that a smart lift could do.
Unfortunately yesterday while on a road bike ride in Miami, I crashed. It wasn’t awful. I will be fine soon. But today I have pain in different parts of my body and stayed in bed. The last time I fell off my bike was in 1997. Back then all I could do while in bed was to read a book, speak on the phone and watch TV. 19 years later, in bed, I realize that a tremendous amount of technological effort has been invested in building what could be called the “life in bed” economy. And recovering from a bike accident is a world of choice.
-want to eat in bed? Seamless, GrubHub, Uber eats, and many others will make sure your recently cooked and warm food is home delivered.
-want to socialize in bed? Facebook, Instagram, Whatsapp, Messenger, Twitter, Skype, LinkedIn and many others will make that very easy.
-want to be entertained in bed? Netflix, Amazon Prime, Youtube, Showtime, HBO and many other digital services will give you all the movies and tv shows ever made on your iPad.
-want to shop in bed? there are so many services that will get you whatever you want while in bed! the most obvious ones Amazon, eBay, Apple.
-want to study in bed? Udacity and many other purely online or also online universities will help you get your in bed degree.
-want to read in bed? Kindle and the Kindle app will make that easy.
-want people to come home and give you a massage, manicure, or any other services while at home? TaskRabbit ThumbTack and all their competitors will basically get you any kind of service at home you can dream of.
-want to listen to music? no need to reach out for a CD anymore, Spotify, Soundcloud and others will give you all the music ever made at the touch of your smartphone.
As I recover I wonder if this life in bed economy is actually good for us. Not convinced. Certainly not good for social, for being fit, for socializing in the real world. Can’t wait to get out in the real world again.
Here’s an idea I had to stop rising sea level. This plan assumes that we will fail at stopping emissions and that rising sea level will be a reality. It is estimated that sea level has already risen 15cm from 100 years ago and that currently sea level is rising around 1cm every 4 years. So the question here is what could make sea level fall 1cm every 4 years and my idea is to use nuclear power to pump water on to the Antartic continent and accumulate it there to compensate for the 25mm or so that sea level is rising every year. Now in order to calculate if this is feasible first we need to know what is the sea level surface around the world and that is 510 million km2. Then we need to calculate the area of Antartica that is above 500m, as you know for every 500m you go up temperature drops 3C and so far global warming has been .85C in the last 100 years. The area of Antartica is around 14 million Km2. This means that the ratio of oceans to Antartica is around 30 to 1. That means that for every cm we take out of the ocean we need to accumulate 30cm in Antartica. Sounds doable. So if we pumped water above 500m that is the same of 500 years of global warming at current rates and it is safe to say that way before then will have stopped burning fossil fuels so it is very unlikely that the earth will warm more than 3C. So any ice that is now ice at whatever altitude it is it will be ice at 500m higher. But it turns out that Antartica is surprisingly a very high continent. The average height of Antartica is 2500m which means that the average Antartic temperature is 9C lower than at sea level so it is extremely likely that any water pumped over Antartica will freeze there for millions of years.
So now that we know all these the next thing we have to calculate is how much water is there in 25 mm multiplied by 510 million km2 because that is the amount of water than the ice melting is currently pouring in the oceans. And the plan here is that whatever water we are losing at sea level we pump to an altitude where it will stay frozen forever somewhere in Antartica. After that we need to calculate the energy we need to pump that water 500m up. And then we need to build a number of power stations which in my view should be molten salt nuclear reactors because they are much cheaper to build and also use very commonly available fuel. This video shows what China is doing with them and explains there advantages.
So using Wolfram Alpha I came up that there is around 1250km3 of water melting from the ice cap per year in the world. This doesn’t seem to be an impossible volume of water to pump up in Antartica to a level where it will stay frozen forever. If you´d like to please help me complete this calculation, I need to find out the energy that is needed to pump this amount of water up 500m over one year.
The war on terror has been brutal, inhumane, extremely costly and ineffective. But as opposed to what many argue, it is not Western brutality that gave rise to ISIS. European democracies are the kindest social systems around the world. With free health care and education for all, EU nations are more caring than US. And in terms of military interventions in the Middle East US has led in presence and arguably in inhumanity. Yet an estimated 4000 ISIS terrorists were raised in this kind Europe and went to the Middle East to behead Christians, Gays, to enslave women, to destroy history, to kill Shias, to send thousands of families to their death and millions into exile. Some of these terrorists are going back to Europe to bring their terror. We saw that twice in the horrible attacks in Paris, in Brussels, Copenhagen, Toulouse. Am I in favor of Western responses like Guantanamo or drone attacks? No. But not because closing Guantanamo or stopping drone attacks would end terrorism, but because becoming terrorists ourselves is not who we are nor what we stand for. But the brand of terrorism we are experiencing now is growing, not because of what we do, but because of its appeal to many. Jihadism has an evil logic of its own that is unrelated to our actions. Because of our colonial past we tend to believe that everything that happens around the world is because of our policies. But those days are over. ISIS is a movement similar to Nazism, an incredibly powerful ideology that draws people to it for its simple logic, clear explanations, black and white world, quick answers for everything. I would also love to think that if we were only nicer so would be ISIS. But I don’t think we have evidence that that is the case. ISIS hates us not for what we do, but for who we are. Because in Western democracies we promote the very uncertainties that they think they have eliminated. They don’t hate our actions, they hate our presence. Germany has been the kindest country in the world to Muslim refugees. I think we can all agree that there is no guarantee ISIS won’t attack there. No, we did not create ISIS.
Here is a list that explains how technology is disrupting my life.
-newspapers: Twitter,Facebook,newspaper online apps, news apps.
-magazines:Medium, Tumblr, magazine apps.
-my car: Uber, Lyft
-my desk: iPad lying in the couch.
-cable TV: fiber optic internet.
-linear TV: Netflix, Amazon Video, Hulu.
-fix line telephones: smartphones.
-CD holders: Spotify
-movie theaters: large TV displays with video on demand.
-hard drives: cloud
-paper agendas and calendars: apps
-intercoms: whatsapp from downstairs.
-shopping malls: Amazon
-credit cards: Apple pay, CC inside smartphone
-printed photography: looking at photographs on iPad
-travel guides: Yelp, Google, Tripadvisor.
-pens, pencils, markers, handwriting: glass keyboards.
-printers: iPad, QR codes.
-alarm clocks: clock app.
-dumb watches: smart watches
-maps and asking for directions: google maps.
-phone calls and texting: whatsapp, viber, Messenger.
-GPS devices like Garmin: google maps, sports apps.
-Microsoft Office: Google docs.
-reading on airplanes: WiFi on airplanes.
-travel agents: travel app.
-in person learning: online tutorials, Youtube, Udacity.
-taxis: Uber, Lyft
I am a father to three girls and three boys. But this post is only about the father son relationship. More precisely it is about father son communication, or lack of it. First my experience: as a dad it is easy to speak with boys until they are around 8, then there’s a ten year silence and communications restarts after they are 18. From 8 to 18 it is extremely hard for dads to have normal conversations with their boys, or at least that’s been my experience. With Tom, I am still getting over the car rides we took alone on skiing trips when he was 13, we would say one sentence every 100km. Now I am spending a weekend in Menorca alone with Leo (9) and getting a conversation out of him, getting him out of his books, his games, his movies is like getting a splinter out from his foot. And while I hope it’s not the case, I fear the same will be true of Davidi when he turns 8. Now at 2 he does talk a lot to me, in broken English, German or Spanish but because of what I lived through with the older boys he must think it weird when I hug him with gratitude. He doesn’t know what I know, that this hug is a slow good bye to the time in which I will be unable to get him to look up from his iPad. These days I thank him for whatever broken language I get. Davidi go dad pool? Yes Davidi, go pool!! Let`s go swimming. With Mia (4) instead I don’t worry. I know ours will be an uninterrupted conversation.
Women, and by that I mean sisters and moms, do find ways to talk to boys. Like Nina Varsavsky does get Leo to speak. And she was able to get Tom to speak when he went through his 10 year silence. Women know how to play men along, somehow be interested in their obsession of the week. But dads, we just don’t know what to say to them. Men you know, we are not great conversationistas. And when a game obsessed boy meets a work obsessed dad conversation is not easy. Because as a dad to start a conversation with your 12 year old, either you totally get into whatever weird game he´s into at the moment, or whatever book that has 350 characters in 150 moods each (a book that your dad brain would never be able to keep up with but he knows all possible combinations)….or well, they just won’t talk. As opposed to girls don’t expect them to start a conversation. So you stay quiet and they go back to their book, iPad, or as in the case of Leo, Kindle book in the iPad.
I understand girls who are 14 and fall in love with a 14 year old boy only to cry over the fact that they just won’t talk to them. Hey girls, you are not alone. That boy can’t talk to his own father! But there is hope. Now Tom and I meet and have the most awesome conversations, yes he´s 21 but dads, be patient. The silence cracks, it just takes a decade