How to Succeed at Failing, Part 4: Extreme Resiliency (Update)
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What is the deadliest infectious disease and why is it overlooked?
Actually, TB, for the last 20, 30 years, has been the number one infectious disease killer in the world. Babak Javid is a physician scientist who studies tuberculosis, or TB.
You may think of TB as a 19th century disease when it was called consumption. It killed John Keats, Anton Chekhov, and at least two of the Bronte sisters. It killed the heroines of both La Boheme and La Traviata. And today, it still kills more than a million people each year, most of them in the developing world.
How does tuberculosis relate to poverty?
TB is a disease of poverty It's really a major problem in India, China, Indonesia, Pakistan, South Africa, Nigeria TB is a bacterial infection There is a vaccine for it, but it's not always effective
It can be treated with antibiotics, but it's a long and fairly complicated course of treatment. And as deadly as TB is, it doesn't draw the attention or the funding that flow to other diseases.
There is no Hollywood star that gets TB that puts it in the public mind and everyday people's thoughts. One of the reasons I was attracted to this field is I felt that infectious diseases in general, and TB in particular, is... you know, one of the mechanisms of injustice in our world. And I really wanted to tackle that.
Javed runs a tuberculosis research lab at the University of California, San Francisco. He has also worked at labs in Beijing and at Harvard. His kind of research comes with a lot of failure.
I remember in my graduate school, I went over a year and a half without a single experiment working. And it's very hard to get up in the morning and go back and expect to fail again.
The first drug that was found to successfully fight TB is called streptomycin. It was discovered in 1943. It won a Nobel Prize for Selman Waxman, the main scientist behind it.
And the way that streptomycin works is that it does two things. It inhibits the process of making new proteins. It's called a protein synthesis inhibitor. But that in itself doesn't kill the bug. What kills the bug is that in addition to that inhibitory action, it actually causes the bug to make mistakes when it makes these proteins.
What interested Javid was this second function, the drug causing the bacteria to make mistakes as they are creating the proteins that produce the symptoms of TB. So he went looking for other ways to trigger those mistakes, and he found some, but it turned out this wasn't enough to...
to thwart the bacteria. What was really shocking and surprising to me is the bug didn't seem to mind. It just carried on regardless. So I cranked up the error rate and I kept pushing and pushing and really the bugs were kind of fine with it until eventually when I had really cranked up the error rate an awful lot, then the bugs died. It takes a lot of error to kill these bugs. I was reflecting on my results and I was thinking, this just doesn't make any sense to me. The prevailing dogma at the time is that with a small amount of error, you induce what's called error catastrophe, where the errors in the new proteins make faulty proteins. machinery in the cell that then makes more errors and it just feeds on itself. And these bugs were extremely resilient.
And that made me take a step back and I thought, what if actually these errors aren't detrimental after all, at least in a moderate amount? And That was my, I guess, aha moment. I have to be honest, at the beginning, I had no idea why this was. We were coming up with lots of different ideas just to explain it.
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Chapters
8 chapters
1
What is the deadliest infectious disease and why is it overlooked?
0:52–1:25
2
How does tuberculosis relate to poverty?
1:25–6:30
3
What is the significance of adaptive mistranslation in bacteria?
6:30–12:36
4
How can a premortem improve decision-making?
12:36–13:21
5
What lessons did Theresa MacPhail learn from the COVID pandemic?
13:21–15:41
6
How does the Museum of Failure help us learn from mistakes?
15:41–28:49
7
What challenges do startups face in the rideshare market?
28:49
8
How can organizations encourage candid feedback?
21:52–52:38
Speakers
8 identifiedMore from Freakonomics Radio
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