Ikigami, Ikigai and everything in between

CATHERINE COSTE

Published in

The French Tech Comedy

14 min readMar 14, 2018

This is episode 17 of The French Tech Comedy Season 2.

Episode 16: Baroque Algorithm For Four Hands

Previously in The French Tech Comedy: In Season 2 of The French Tech Comedy, we follow characters like Japanese oncologist and bioinformatics engineer Takafumi Nagato, who is leading the lab of Bioinformatics for personalised CAR-T-therapies in a Tokyo clinic, and his patient, Chinese giant TenBa’s founder Ken Ba, a zillionaire from Shanghai. Yuki, Taka’s sister, is a French-speaking geisha, meaning “artist” in Japanese, in touch with the French Tech. She just got married to a French engineer who was working in Taka’s lab, Nono, and has secretly donated her healthy T-cells to Taka’s patient who, after his second cancer relapse, decided to try an innovative treatment called “liquid biopsy”. Indeed, Ba is becoming an expert in genomic precision medicine. In his case it is a matter of life or death. Among Yuki’s friends in the French Tech branch is Frederic Mougin, a biologist, founder of the startup Gene-i-us:

“We are developing a patient-centric tool for patients to collect, share & monetize their medical, genomics, lifestyle, IoT data with academics & pharma industry.”

Yuki had promised she would introduce Mougin to people working with Facebook Singapore; among them: Nono. What biz plan can Gene-i-usimplement, in order to work with Facebook? Mougin is using a lot of buzz words, but when it turns out Ba’s cancer mutation has entered the stock exchange market, thanks to the efforts of a pharmaceutical company, his oncologist, Taka, fears a Ba Gate. More than ever, the privacy of genetic data is instrumental in the process of developing precision medicine. Singapore is the Chinese Mecca of I.P. and patents. A cryptocurrency, that is seen by financial specialists as a security, is used as a way to reward (healthy and sick) patients in exchange of their DNA data. Yuki is wondering if this kind of money will revolutionise the whole financial and pharmaceutical market as we know it, or will all digital currencies end up behaving like any other tradable financial asset? After all, a security is a tradable financial asset. Ba, Taka’s cancer patient, is trying to gain insight into the situation… While spending a few days in Malaysia both for business and vacation, TenBa’s founder gets to meet with a total stranger who in fact he only knows too well: Simone, Malaysian Chinese actress Michelle Yeoh’s niece. Between Ba and Simone, things are complicated. But it is only the beginning… Simone is trying to make an algorithmic cryptocurrency that could mimmic biological processes within the human body. Meanwhile, Manga artist Koba writes about the blurring frontier between curing and enhancing in the genomic precision medicine era, and the consequences in society. At school, Simone needs to present her Science Fair project alone. Overanxious auntie Michellehad bribed a student from Simone’s class. She wanted her niece’s science fair presentation to be filmed, live. A few days later, she sent a link to a video to a friend of hers, Chinese giant TenBa’s founder Ken Ba, a zillionaire from Shanghai. She’d compiled a 10 minutes extract for him to see, and a question:

“ — What do you think?” Ba said the video was very interesting and offered to have lunch in Ipoh, Michelle’s home town, next weekend, and discuss things. Simone, meanwhile, is stuck in Bangkok, where Ba has sent her a T-shirt as a thank-you gift, she’s not sure why. Also, as a hacker having served time in a Beijing prison, she is suffering from post-traumatic stress. In Singapore, rockstar US physician Tamir Subramanian is a keynote speaker at Facebook’s “The Patient Will See You Now” Breakfast. In the conference room nearby, a Facebook Open Day Q&A session for students from local high schools has just started. Simone is attending, she gets to meet with Nono, who ends up inviting her for lunch at the famous Facebook cafeteria. How to program a digital currency with its own blockchain, taking advantage (or mimicking) the underpinnings of the biological mechanisms of epigenetics? Simone, Nono and Yuki are trying to reflect on this. Yuki and Simone end up talking about reincarnation and video games, while shopping at Daiso, in Suntec City mall, Singapore. Close nearby is South Beach Tower, with the Facebook company at level 22. Rockstar US physician Tamir Subramanian, editor in chief of the Transversal J Med, is interviewing Geronimo Faber PhD, who is spearheading the global crusade to defeat ageing. Nono is watching the one-on-one interview, a video that was just posted on the Transversal Journal of Medicine’s website. The whole thing is boring, and Faber still needs money. Nono revamps the boring video, writing a new episode for the Japanese Manga Saint Oniisan (Saint Young Men), in French: Les Vacances de Jésus et Bouddha (Jesus and Buddha On Vacation). He is almost done, when he gets a call from the Big Boss… Zuck wants his platform to revolutionise healthcare. Koba the manga artist is writing the story of Pierre, an “augmented” patient. The manga book, for US rockstar physician Sub, is called: The Augmented Patient Will See You Now. French actor Jean Reno gets to read François Mueller’s book: The Tsunami of Digital in Medicine. Bad timing, though, as French actor Reno is not happy with medicine and the health care system at the moment… “ — Digital tsunami in medicine, really? I’m waiting???”, he thought. Meanwhile, Simone and Yuki are talking about education and school, and music, discovering the Yin-Yang of friendship. Anti-ageing activist and scientist Geronimo Faber PhD finally gets substantial funding for his labs, but in return he must offer something…

— — — — — — — — — — — — — — — — — — — — — — — —

“ — Finally!”

It’s happening. It’s a thing. Faber now has 10 labs up and running, each equipped with a dozen of hard-working post-doc students and costly material. What an achievement. It took him so long to get there, so many efforts and sacrifices… He is now taking the time to reflect on the achievement, the goal of his life. Getting enough money to do decent research on anti-ageing science. Giving himself credit. Genome engineering using the CRISPR-Cas9 system, gene editing, rewriting the human genome… It’s being done one disease at a time. Big Pharma is turning genomic precision medicine into some kind of ultra-lucrative niche market, which brings us nowhere in terms of drastic progress in anti-ageing medicine. With old age comes blessing, only it appears to be in full-reverse mode: more Alzheimer’s, more cancer, more misery due to poor health … Faber wanted to disrupt this. What if whole groups of diseases, which today we think have nothing in common, could be … erased? Now, he had a say in the story. He was a player, just like any pharmaceutical company. This was a game-changer. For him, for the health care and life science market, for many patients — at least, hopefully.

One of his labs had just published a paper, jointly with Taka’s lab in Tokyo:

“Advancing chimeric antigen receptor T cell therapy with CRISPR/Cas9”

“The clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (CRISPR/Cas9) system, an RNA-guided DNA targeting technology, is triggering a revolution in the field of biology. CRISPR/Cas9 has demonstrated great potential for genetic manipulation. In this review, we discuss the current development of CRISPR/Cas9 technologies for therapeutic applications, especially chimeric antigen receptor (CAR) T cell-based adoptive immunotherapy. Different methods used to facilitate efficient CRISPR delivery and gene editing in T cells are compared. The potential of genetic manipulation using CRISPR/Cas9 system to generate universal CAR T cells and potent T cells that are resistant to exhaustion and inhibition is explored. We also address the safety concerns associated with the use of CRISPR/Cas9 gene editing and provide potential solutions and future directions of CRISPR application in the field of CAR T cell immunotherapy. As an integration-free gene insertion method, CRISPR/Cas9 holds great promise as an efficient gene knock-in platform. Given the tremendous progress that has been made in the past few years, we believe that the CRISPR/Cas9 technology holds immense promise for advancing immunotherapy.” (Source)

Keywords: CRISPR/Cas9, chimeric antigen receptor, T lymphocytes, adoptive immunotherapy, gene therapy

While 23andMe finally got (long awaited!!) FDA authorisation to market their BRCA1&2 genetic testing for breast cancer on the (worldwide) direct-to-consumer market, Faber was aiming at something even more ambitious! Editing genes was ok, but writing brand-new genes was even better. Rebooting the human operating system (OS) was something maybe more extreme, but it was what made him tick. Thanks to the funding, he was now working with the best scientists in the field! He was so proud of his achievement! In his life, there was simply a before, and an after phase. His whole life was revolving around the two phases, or eras. The Before-era: the base root of all problems used to be money. The After-era: money wasn’t an issue anymore. Then, next thing that popped into his mind:

“ — I want to relax.” God, he needed it so much. His mind and body were both yearning for it. No more worries. Just relax. But there was something. He couldn’t help but think about it. The whole of this event of the past month revived within his mind in 10 seconds:

The funding was great, awesome. But there was something that he had accepted to do in return. On the bright side, it was so nice not to have to drag politicians kicking and screaming to fulfill a promise (of funding) to science. He was now free to do the research he had always wanted to do. But the money came with strings attached, and there were quite many of them.

It was a painful thing to do. Having to go through the rollercoaster once more. That’s what the last month was, right? A rollercoaster. And Faber had a passionate dislike of them.

Ikigami, Ikigai and everything in between (in 10 seconds)

Facebook (with offices in Singapore, California, Seattle and Tokyo), jointly with Tencent (Singapore, Shenzhen, Shanghai and Beijing), was launching a school science education project, including actions such as benchmarking, auditing, and taking corrective action through innovative measures. Faber had accepted to complete a difficult and often thankless task, acting as the scientific coordinator of the Joint Education Program.

Geronimo Faber PhD, a British citizen and scientist who is spearheading the global crusade to defeat ageing

François Mueller, a bioinformatician and mathematician from Switzerland

At first, Faber couldn’t understand why he had been dumped on with this unfortunate project, as teaching and pedagogy were not his strong suit, obviously. But as soon as the auditing progressed, and after a few conversations with Nono, who was currently based in Singapore, still working with Facebook, in the marketing of gaming industry, he was able to hit on the real reason: his unparalleled aptitude to stay in tip-top shape under any condition, even in the eye of the storm. He had kicked off the joint education project with a speech in front of the French Ministry of Education, saying that the teacher should be put at the service of the student, instead of the reverse, which became blatant to him: it was the employer’s liability to find work for armies of teachers, no matter their degree of competitiveness. If students were taught about yesterday’s world, it didn’t matter. Most important thing: give all teachers a job.

“ — French Ministry of Education is like like a feudal lord, offering a sort of serf status to the teachers. Serfs have to grow kids, like they are some oat in fields. But serfs like to think of themselves as white knights who are slaying private companies to protect innocent lives; whereas in reality, they are Don Quixote fighting windmills. They are hating private companies, so much so that, as a consequence, they are fostering long-term unemployed, instead of educated citizens, as they often claim.”

Faber’s little speech was not well received. The teaching profession in France acted as a team and declared in the national press that they repudiated the self-loathing Faber PhD.

Ikigami, a Japanese manga. Pic: http://www.mvm-films.com/AsianCinemaTitle?ID=70

But that was not the end of the story. Faber was now receiving mails and letters, written by armies of French students. He quickly learned that numerous fan clubs in middle and high school had been formed, and a manga series was in the making, where both sides of the story would be told; in any case, this is what the French manga publisher promises. As part of this bold strategic plan, a Japanese anime based on the true story would be airing on NHK, the Japanese national TV, next year. The announcement had just been made by the French manga publisher, who had signed a commercial agreement with the NHK just before the Salon du Livre, the book fair trade in Paris. Speaking of private companies … Faber was not only becoming a popular hero in France; he was also more or less secretly loved by teenage girls, who were sending him a huge quantity of messages. French journalists in “Le Monde” soon published literary musings about sexual relations between adults and children, alluding to Faber and his teenage fan club. In Switzerland, he had no better luck with the auditing project. Francois Mueller, The author “Le Tsunami du numérique dans la santé” — “A Digital Tsunami in Health Care”, assisted him and was of great help. At least, things got a little less extreme, even if they must get to grips with these sobering realities:

"-- For the moment I only had contacts with students and professors in medicine ... and obviously they have no training in Data Sciences or Artificial Intelligence ... there is no teaching in these areas ... Medical schools in Switzerland are lagging behind, students are very disappointed," wrote Mueller.

“ — Pour l’instant je n’ai eu que des contacts avec des étudiants et des professeurs en médecine… et évidemment ils n’ont pas de formation en Data Sciences ni en Intelligence Artificielle… il n’y a aucun enseignement dans ces domaines… ils sont très déçus par le retard pris par les facultés de médecine….en Suisse.”

Faber pondered whether he wanted another fan club of young girls in love with him, this time in Switzerland. He was in no hurry. Next thing he knew, he was in Beijing, attending another feedback on an auditing of some school system in yet another part of the world. China. At some point, Chinese President Xi Jinping sent a video message to the small gathering of scientists and engineers.

“ — I want an A.I. in each classroom.”

And he didn’t look like he wanted to put these issues up for debate. He wanted to get things done. Soon after the meeting, directives were given. A.I. programs would be great at accompanying, coaching students, individually. They could also help in teaching literature, languages, interact with very young children, teach science, biology, offer individualised coaching programs for MOOC students, etc. Faber thought of Yuki, Taka’s, sister, again. She had a popular show on YouTube, called “A Geisha Lost Between Two Worlds”, where she was discussing a motley collection of topics, including ageing, genomics, the latest in genomic precision medicine in cancer, baroque flute, makeup, dieting, cooking, beauty and wedding tutorials, yoga, ballet and preventative medicine, organic fashion and food, daily life in Japan compared to daily life in France, etc. — with equal dedication and commitment.

As far as he knew, the girl looked like a stunningly beautiful geisha, she was also a ballerina. More importantly, she had given some of her healthy T-cells to her brother Taka, an oncologist working in cutting-edge therapies. Taka had re-engineered the T-cells and hybridised them with T-cells and such coming from his cancer patient, Chinese zillionaire Ba, in the hope to cure him. Also, a few months ago, Faber had been attending Yuki’s wedding with French engineer Nono in Paris. He had been invited to the wedding by Taka and Ba. Obviously, Taka’s love for his sister was very strong, and Yuki seemed to worship her brother like he was some kind of Lord Buddha walking the earth.

But the reason why Faber thought of Yuki was very specific and had nothing to do with Taka or her YouTube channel. If anyone was lost between two worlds right now, it was him; not the Japanese girl. Nono had engineered an A.I. program that had helped Yuki through a series of scientific MOOCs, difficult online courses for specialists taught by the NY Institute of Tech on EdX, a platform that was making those courses available to anyone. That’s how she had learned about microbiology, genomics, the basic of chemistry, computer programming and bioengineering. Faber had even interviewed Yuki about these MOOCs. This is what they needed in China. Nono’s AI program. The one he had written for Yuki. He had to talk to Nono, and to Yuki. But in his experience, not everybody was happily bridging the gap between two opposite worlds, China and Japan. Nono was overcoming this challenge with brio, but how about Yuki?

On more than a couple of occasions, Faber found himself lost in translation when discussing with the Japanese geisha (see episode 23 and episode 24 of Season 1). When back in London, Faber checked out Yuki’s Facebook timeline, and her YouTube channel. The Japanese ballerina was also a talented musician, and her latest concert in Singapore, as a flute soloist in the philharmonic orchestra, had been celebrated. There was an article about the concert, called “The Fusion Musique Project”, in The Straight Times, and the journalist was singing praise for both soloists, showing in an entertaining piece of art how China and the Western world could make art by bridging gaps.

“ — If they can make art, they can also make science,” thought Faber.

He clicked on the link to the video…