much for being here. despite what is an unusually rainy miami november evening, we at the university of miami are extraordinarily privileged to sponsor tonight's event. we are fans of the author and also of the interviewer, and it is my privilege to introduce them both to you. so mikhail securus, who i consider one of my besties, is a professor of medicine and, the chief of division of hematology at the sylvester comprehensive cancer center at the university of miami miller school medicine. he has a medical degree and a master's degree in clinical epidemiol from the university of pennsylvania school of medicine and completed post-graduate training at harvard university. mikhail is also the coauthor or author of more than 400 scientific manuscripts cancer. he is on the editorial board of several journals, has 60 essays for the new york times and authored eight books, including when blood down life lessons from leukemia. the food and drug administration has been frequently in the headlines recently, but few of us know much about how the agency works. drugs, the fda safety, efficacy and the public's trust tells story of how the fda became the most trusted regulatory agency the world before it existed. drug makers could hawk any potion claim treatment for any ailment and make any promise on a label. but a series of tragedies, health crises and patient advocacy forced the government to take responsible for the efficacy and safety, drugs and medical devices. in 2011, the avastin hearings, a century of the fda's evolution demonstrating how its of checks and balances works or doesn't. now on to siddhartha mukherjee who is the author of the new york times best seller gene an intimate history the emperor of all maladies, a biography of cancer, which the 2011 pulitzer prize in general nonfiction and the laws of medicine. he also happens to be an associate professor of medicine at columbia university and a cancer and researcher. the song of the cell an exploration medicine in the new human begins in the late 1600s, when english polymath robert hooke and an eccentric dutch cloth merchant, anthony van lavan, hooke looked through their handmade microscopes. what they saw introduced a radical concept that swept through biology and medicine, complex living organism are assemblages tiny, self-contained, self-regulating units. our organs are physiology. ourselves are built from these which hooke named cells reframing human body as a cellular ecosystem marked the birth of a new kind of medicine based on manipulating cells. and here, mukherjee tells the story of how scientists discovered began understanding them and now are using that knowledge to create new humans. it is my great pleasure to introduce dr. saka, harris and mukherjee the stage. thank you. for. said. it's so nice to see you. same here. mikhail said, and i have a bit of a history now. not bad history in the way people sometimes say we have a history, but the two of us first met when sid was a medical student at harvard and i was a resident at mass general. and so i think we're separated training by about three to 2 to 4 years, something like something like that. and then you followed through mass general and then at the dana-farber cancer institute. and here we are today. i'm going where you are. well, i hope our rain didn't deter you today. it's delightful to have you here. my pleasure for making the trip. i wonder if i could start off. i wanted to read a little bit, just a brief section from your book, because loved this part and it's what draws a lot of us into science. in the introduction, sid writes i have spent a lifetime cells. every time i see a cell under a microscope with fulgent glimmering. i relive thrill of seeing my first cell on a friday afternoon in the fall of 1993, about a week after i had arrived as a graduate student in allentown science lab at the university of oxford to study immunology. i had ground up a mouse spleen. yes, we actually do things like that and plated the blood tinged soup in a petri dish with facteur to stimulate t cells. the weekend passed and on monday morning i switched on the microscope. the room was so dimly lit that it was not even necessary to pull the curtains. the city of oxford, always dimly lit, if cloudless. italy was a land made for telescopes. then foggy, dark. england seemed custom made for microscopes. and i put the plate under scope, waiting beneath a tissue culture medium where masses of translucent, kidney shaped t cells that possess what i can describe only as an inner glow and a luminous fullness. the science of healthy active cells like eyes looking back at me, i whispered to myself and then to astonishment, the t-cell moved deliberately, purposefully seeking out an infected cell that it might purge and kill. it was alive. it's a beautiful segment. and i think that. thank you. one of the reasons you're so popular here with your writing said you make science approachable and you make science come alive. i understand. rumor has it we may have some liberal arts majors in the audience. can i ask you for a brief biology refresher? what is a cell? how does it divide and form organs? so thank you. mcgill, first of all, and thank you for coming wading through the rain. a cell is the smallest autonomous unit of life. it's it's very important to recognize the idea that it in fact the smallest autonomous unit of life, we're built out of them. but write down to any living creature, single celled living are still cells. one of the things that a years ago i was working i had a book opening in brazil and i was walking outside botox clinic there everywhere. by the way, in brazil, i was not getting botox. what happens in brazil stays in. yeah, exactly. but anyway, it was called a life clinic and was this picture of dna outside? it and dna, of course, is the molecule that carries genetic information and it has become. it's an iconic molecule, a double helix. everyone knows it. you walk outside if there's a life clinic here, it'll have a picture of dna on it. what's amazing, that dna itself, the genes is are lifeless. the molecule is lifeless. it has no life. you could swallow it and eat it and would just go right through you. it's the cell that brings dna to life and it i often make the analogy that you can imagine your genetic information, your genome as a musical score, but a musical score is a piece of writing. it has no music. it's the cell that that music to life. hence the word. hence the song of the cell in the title. but but it's very important to realize that that that it's if you want to think about life and you want to think about medicine, you have to of course, genes are incredibly important, but you have to think about the cell. and as i said, going back, you know, what is a cell? the cell is the the smallest autonomous unit of life that we know. and everything goes back to the cell. i'm going to finish by saying, you know this goes takes us back history to the book in the late 1800s rudolf rudolf virchow who will come to was a young pathologist who made two very, very radical statements. his first statement was that all normal physiology is the consequence of cellular physiology. so essentially he was saying, is that everything that we do, every activity, every function, every this conversation, the fact that, you know, the temperature has fallen 20 degrees, what bodies have managed to regulate it and our temperatures haven't 20 degrees. everything is about life is a consequence of cellular function. so that was statement one. and then he made the the obverse of that statement, which actually extraordinarily important in medicine. and he he posited. and now we know it's increasing be true. he posited that all disease is cellular dysfunction. so if you want to track down any disease, any source of any disease, it might originate in the environment it might originate in some behavior. it might originate in a situation occupational hazard, a diet, whatever it might be. but ultimately, it has to impinge on ourselves and all illness is cellular dysfunction. and so that's just too highlight the importance of of why we need to understand cells and why why even wrote this book. i love how you positioned that of the cell and the cell and the functions of the cell as, basically carrying out the instructions of the genetics. we but i don't know if anyone knows this. sid and i both specialize in cancers at the bone marrow, particularly leukemia and leukemia like conditions. and when we talk to patients, we go we talk about the cell. i mean we jump right to it. there aren't i don't think there are a lot of diagnoses where understanding the cell those genetics are so critical to understanding the treatments that we're offering why why those treatments work and ultimately what we follow over time in people to hopefully show that their leukemia is in remission or even cured or unfortunately, sometimes when it comes back, you harkens back to a past age. prior to the 20th century. could you talk a little bit about what people really understood about the cell from the time of robert hooke to rudolf virchow, louis pasteur and and walter fleming? yeah. so robert hooke was the first person to look at cells and there's a there's a picture of, of, of his first, his own first picture of cells. actually, he saw he didn't see cells. he the outlines of cells in plants. hooke was an amazing, amazing. he was an incredible. he was an indigent young student at oxford wadham college and sort of a strange world. when i first went to oxford, my my rooms were across from hooke's rooms in a bizarre way. now, are those those have become a national monument. and they're preserved. but anyway, there was hooke and he i describe him as someone who had a his there's intelligence was phosphorescent and elastic like a rubber band that stretches as it glows or glows as it stretches. there's a pun in there because. he he all he discovered the laws of elasticity. so hooke's one of his major contributions is that he actually figured out how rubber bands work and the physics of how bands work. but nonetheless he was an incredible polymath he was an architect. he was a scientist he was a microscopist he was a telescope. he did telescopes. and at one point in time, he into a nasty argument with newton and said that he'd even invented or discovered the laws of gravitation which he hadn't. and and the great irony of this was and this an apocryphal story that apparently that president of the of the royal society and the the great story runs that when the royal moved its offices newton was so about about hooke that he refused or or neglected to take the single portrait of robert hooke that exists in in the in the history of the world. and he apparently left it behind in the old the royal society. and so there is the man who really the basis optics there's no picture of him. we don't know he looked like anyway so back to hooke so hooke finds these but hooke has no idea why important and he doesn't even know whether they're general whether he discovered something some universal principle or whether he's just found, you know, something unusual or interesting in his under his microscope. about ten years after him. there's character who plays a big role in this book named anthony van leeuwenhoek. he's a dutch clothes salesman, so he's a cloth salesman. and he also invents a microscope, a very different kind of microscope. and his original idea that he wants to look at that, the quality thread, because he lives in delft, there's a big booming trade of of cloth. and so he to look but then he becomes obsessed with his microscope. now this louis hooke is completely the opposite of hooke. he is. he's never been trained in science. he has no scientific background. but then he begins to discover in droplets of water and everywhere he looks, he begins to discover what he calls animal quills. but those are, of course, cells. and if you've ever seen that beautiful microscopes, you ever have a chance to go there. there's a couple of them in the united states where many and in in in the netherlands, the one in the university of cambridge. they're they're beautiful there. but this big. and you hold them up to the sun, you almost think it wouldn't work. but anyway, so hook and lou and hawks sort of discover that there are cells, but none. and neither of them realizes how important they are. this is a time when people are still unclear about how we're made, how bodies are made, and they're to in mass questions that are sweeping through biology. one question is how our bodies made, what are we made of? and for the longest time, people believed that we're slabs of meat. and how do those slabs of meat around or you know what? there's a theory that there's some vital satirical vitalism. there's some vital fluid. and that's how cells are born. they're born out of a process analogous to crystallization. so when you put salt in water in a bath and evaporate some of the water out, it spontaneously forms crystals. and so lots of people believe that that's how cells rise. they you know come into life like crystals come into. so so there's this theory that's sweeping through biology and then there's the other theory which is goes back the same kind of question. well, if we how do we go from a tiny embryo to being a large, you know, animal? and again, there's no there's no understanding of cells and people that there's a very popular theory called formation in which people think that we're sort of we we are fully formed when we're born like a little mikhail's and and we get sort of blown up like like those macy's thanksgiving balloons and we become and bigger and bigger. and ultimately we become fully sized. and that's that those are the reigning theories. cells come out of spontaneous generation and we as creatures also arise out of spontaneous generation. and the book begins at a moment when these two scientists in germany begin to realize that both those theories are unlikely to be true. sladen and schwann. the book begins with an evening with them, and all of a sudden realize that that when they're looking down their microscopes, they begin to in animals and in plants. one is a botanist, one's a zoologist. they realize that, in fact, we're made of cells and, that's the beginning of cell theory. so now this brings us up to the 1800s. then there's there's a long what i call a valley in which people begin to explore. well, if you're made out of cells, how do cells arise? how do they come, come, come around? how do you how are they born? and how do we develop as humans. and that leads us into the early or late 18, 19th century, early century, when scientists like rudolf virchow make the argument that, first of all, that all cells come from cells, and he actually picks up that line from an earlier investigator. but it's a it's a very audacious line because. there's no spontaneous, not like crystals you don't form it. you know, you don't form out of water. all cells come from other. and and then i told you the other two that normal function is cellular function and all illness is cellular dysfunction. incredibly ideas for their time of course later, all proven to be true. now if you follow that line of thought, lots of things begin to fall out of it. first of all, if you say all cells come from cells, it might seem like a very bland statement, but incredibly important things fall out of that. one thing that falls out of that is if all cells come from cells, then the way you can explain, the development of a of a human being with several trillion. right, is that they must have come from the division of the first cell, which is the union of the -- and the egg by the way, the smaller in the body and the largest cell in the body. so that's one thing that comes out of it. and then the other thing that comes around much, much later in the 1950s is a theory of cancer. so if all cells come from cells, then a cancer cell must have come from a normal cell. there's that's the only way that it could have come. and if that's true, then something must have happened to a cancer cell to make it a cancer cell from a normal cell. and that's the genetic basis of cancer. so you begin to see the roots of these ideas becoming enormous, full of disciplines, the whole discipline of pathology, the whole discipline, embryology, the whole discipline, you know, the study of humans, the study of bacteria, everything comes back to. this this moment of time when cellular theory is established in the late 19th century and, you know, you make it so clear how it was that one critical theory that led to this explosion and probably reason we have such an incredible understanding of the science in the past 100 years as opposed to what had occurred hundreds of years prior to that. yeah. and again, you know, we had to wait. i mean cell biology had to wait for its its moment and its moment was to some extent it was microscopy. subsequently, of course, it became much more complex and more developed. it had to wait for that for, that moment and microscopy was that was that moment. yeah. so let's move on to the 20th and 21st centuries. if okay. one important medical innovation that occurred, the transfer of cells from one human being to another. i never thought about it that way until i read it in your book. but that's what's happening. a straightforward example, of course, are blood transfusions, right? we're bringing cells from one body into another body early, experiments for which range from the macabre to the mad. those are your words actually love that phrase. so how has the transfer of been used to treat disease as has been the case with bone marrow and even create new life, as was the case for louise brown in england. so cell transplantation has had has a very strange birth. so again going back to the 19th century, you have the first blood transfusions. and initially people thought, well, blood is blood. why don't we put sheep's blood into a human? and that didn't go very well, not only for the sheep, but for the human being. and so so but the interesting thing that which actually goes back to the subtitle of this book is that people also thought scientists even thought that when you transferred blood from animal to another or one human to the other, you would that new human being, you would that the that that the psychic elements, personalities, memories would also be transferred from one human to another. and so there was a real sense when you came out of this blood transfusion that you would be altered, you'd be changed. and, of course, to some extent that's true. but by the 1920s and 1930s, blood transfusion had become much, much more a science than this mad sort of let's put sheep's blood into human being and see what happens. it had become a science, in part because of magic. so people, scientists like carl lance understood that blood had to be matched before it can be transplanted. so you can only transplant blood groups between blood groups aside from you know the universal donors, the oaths. and if i could jump in there for a second, when you say matching so that everyone understands what exactly are we matching? so we're matching. so blood cells on this surface, like all cells carry on their surface. but series of molecules and what we are matching is the these series of molecules broadly. but we can go into much greater detail on this. but we're matching these molecules such that your blood and my blood have the same molecules so that it's so that my immune system doesn't recognize your blood is foreign because these two molecules are matched against each other. and that's why we have blood. ab oh, and. ab right. and so that's the and blood transfusion has an incredible history. then it becomes it really changes the, the medical of the war because as you can imagine, the transfusion of blood is absolutely crucial in on the battlefield when you lose blood, the only way replace blood is using either plasma or blood. and and that really changes history. so that's the first thing to be transfused or transferred and then the 1950s we come across bone marrow transplantation, which is very familiar for you and me. but again, a complete shock to the entire world. so i tell the story of the first transplant where successful transplantation. between two twins and now again, when you do a bone marrow transplant. you need to be matched because otherwise immune system will recognize the foreign bone marrow as, foreign and and reject it or the bone marrow will find your body is foreign and reject you, which is even stranger. but so we go to seattle, we move to seattle and the first bone marrow transplants are being performed, transferring bone marrow so that now the twin basically a chimera. so she carries the bone marrow of her. and since then the field has moved on. you don't need twins anymore. you can perform very clever matches, very cautious matches and transfer marrow one person to another person without the requirement for for them to be twins. and we've moved on since then. right. so then we on to the birth of ivf. um, so that ivf is also a form, of, uh, transplantation, a strange form of transportation. you harvest eggs from someone's body, um, you fertilize them with --. the, with --, and then you grow it in the petri dish until a little bit, um, you know, eight cells or, uh, a little bit bigger, and then you transfer it back into a woman's womb. so that it can know that, that, that the, the, the embryo now, now grow, um, and now we have, we moved on since then, and i'm pushing along into the 21st century. there are attempts to now transplant, um, type islet cells in the pancreas so that you can cure type one diabetes. these are very very novel efforts the efforts to create artificial, artificial organs of various kinds artificial bio artificial livers. and so this whole field of transplantation from the early mad experiments to now very sophisticated experiments has really begun to boom. finally and has led to lots incredible cures of diseases. um, you know, in, in my first book, when blood breaks down, i write a little bit abo >> in my first book, i write about thomas who was the first person this initiated bone marrow transplantation and his initial experiments were on little beagle dogs. he and his wife made a deal if they would work out the mechanism of transplanting from one beagle to another and that beagle would survive, they'd adopt the beagle. they did that and it worked a second time and they did that and looked up and had this yard full of beagles and he realized he really had something going and that was the time he started to move to humans. >> right. you must have met him at least once? >> i did. >> i did too. he won the nobel prize from his work and passed away 10 or 15 years ago. >> right, at the beginning of our career is when he was in his line of work. >> right. when i went to seattle, it was one of the most moving parts of the book, i assembled all the nurses who had been in that first trial. i found out all their phone numbers and i asked at the center all the nurses in the original wards, transplant wards andl they'd all been hand traid by donald thomas and there's a very, i think a very moving segment in which they all file into this room and they all hug each other and remember those first days because if the record is correct, the first 70 patients died, the first 70 patients died and you have to think to yourself, what kind of human do you have to be or what kind of human being can you be when 70 patients die and you're going to say i'm going to try the 71st? 71st. and the kind of incredible resilience of all that and these nurses had these unbelievable stories of the first children who they staid up all -- stayed up all night holding their hands, telling them stories and watching one after the other experimental trials fail until finally they started succeeding and now we have hundreds of thousands of p patients if not billions of patients that have undergone bone marrow transplants. >> yeah, you know, it always makes my stomach turn a little bit because i've heard that story as well; right, of so many people going flu transplants and dying and same with organ transplants to lead to what we have today, which is honestly a scientific miracle. >> right. >> it is a miracle. but to think of the ethics of what those folks went through as well. i just simply don't think we'd have anymore, i think for good reasons. >> yeah, for good reasons, absolutely, we have put up strong and important guardrails around human experimentation and so forth. but there was something and this is not to say that, you know, they were the pioneers of transplantation, they went through every committee and doing nothing unethical and the first child born through ivf, was approved by every single committee, but what's important is i make a very important distinction in this book, and you talk about ethics, between disease and desire. between disease and desire. we understandd disease and desie is linked to enhancement or augmentation. cell therapy enables both. cell therapy and gene therapy enable both. for the -- that's easy -- to some extent those are bright lines. that's been a bright line for most of medicine. looking at history, that bright line when in the moment is often not that bright. when the picketer arkansas first patients -- when louis brown, the first ivf baby, when luis brown was born, there were lots of doctors and said human beings have delivered infertile seizure disorders since the birth of humanity. why is that a disease? but others argued, including edwards that would argue leading up to brown's birth, but for some people there's an aching suffering, form of suffering that hasff to do with their infertility it did indeed qualify that there was suffering and disease involved. what's interesting is that in retrospect, all of the things have become creeker. when you're. living in the moment, it's often very fuzzy territory and treating patients in a trial and 70 have died and are you going to perform the 71st? in retrospect, there's a triumphant narrative that one can have of the success of medicine. when you live through it, it's very, very difficult, it's very fuzzy, and i know you've written about this in your own books as well. it's verywe complicated to live through it in real life. >> acutea. limb plastic leukemi. >> acute lymphoblastic leukemia was a great cancer story. we're approaching a 90% curate in kids who have this form of leukemia. but unfortunately when it's bad, it's very, very bad and that's -- >> that's the 10%.ha >> yeah, that's the 10% so emily was in the 10% and when you remove her t-cells, these are taking some of her immune system and the sames cells you saw whn you were first looking at cells and that you saw movement. these t-cells were removed from the body. we change how they -- what their focus is so whatin they're going to kill and focusing it on her own leukemia and re-infusing these navy seals versions of the immune system back in. n >> that's right. and emily's case is particularly important because what we -- what scientists didn't know then was that the navy seals can go rogue in defense that once these t-cells begin to eat up their cancer, they can become -- they can cause an incredible inflammatory condition so deeply inflammatory that your whole body goes into a kind of shut down and go into an organ letdown and just by chance, it happened that emily's doctors found a mechanism to dent it down and we use that today. and that was what really led to her coming alive as it were. she was taken for dead. >> we talk y about this all the time and the extensive prayer unit andth making it through the rnnight and had a child who hada juvenile form of rheumatoid arthritis and was on medicine for that. >> the story goes she was taken to the icu desperately ill not because of o her leukemia and we would later find out that her leukemia had been wiped out but the t-cells we infused had a message and we had likened them to rogue t-cells and inflammatory chemical pamphlets and they make going on a kill and attract more t-cells and they create this unbelievable rampant. we've seen immune rampants in covid. not the same but immune ram panelings. rampants. >> in history, >> when they tried gene therapy on a young man a decade and a heave earlier on a young man. there was incredible sensitivity not only because i got this beautiful goal with this terrible cancer was about to die but the institution had a reputation for doing these kind of crazy novel therapies that could potentially kill people. >> and thes universe is a bizae place. just by coincidence, the doctor treating emily happened to have a child who happens to have a form of immune arthritis who happened to be on a medicine that could dampen down theso immune system so she had autoimmune disease. she had -- this kid was on drugs and getting to the hospital laboratories and the laboratory people work overnight and found she had had sky high levels of these levels that t-cells make and this drug like i said happens to be a drug that's elected againstst that particulr chemical. it was sort of the doctors that use the word boom. and all of a sudden she came alive and her leukemia went into remission and we got to know that and she's now 17 and applying to college. and leukemia free. she was almost -- she had 100% remission. >> a variety of conditions and curing people and i think i'm getting it to be organized and monopolizing all the questions and not getting all the w questions and a opportunity t ask. >> ir want to thank you and k talk -- for talking about your fabulous book. >> i'm one of those miracles. i was diagnosed with acute lymphatic leukemia ten years ago and that saved my life. i was treated with core blood stem cells so i want to ask you your opinion about that. is that becoming more mainstream now than bone marrow transplantation? >> it is awa form of bone marrow transplantation and absolutely it's becoming more and more mainstream in the sense it is aa form of transplantation and instead of bone marrow, you get blood drawn from the umm bell the umm bellcal cord of a fetus. that would be effective in the sense that you need to work. >> so all three of my kids, weon donated the cord blood for use for people like you. >> we donated both our children's blood from the cord. >> final time, the person that collected it was one of my former leukemia patients who was cured. it came fulll circle. >> yes, i collected my child's cord blood and i was making such a fust that the gynecologists wanted me to get out. >> good evening and thank you for coming to talk to us. what inspired you to become an author and write about these topics?yo >> why did i decide to become an author and -- >> write about these topics. >> i this been the first book, it came out of my time as a fellow and i write books to bring people into my world and partly it's because people are fundamentally curious about their world but when you encounter medicine and really allow people to understand what the history of those things are. and as i write, i developed a kind of writing with the mix of the parts of the book are memoir, some parts of the book are deep histories and some part of the book are things that i did. why do a book, i just have indian curry and so that's sort of a way of writing these books. >> we have time for just a couple questions. five minutes. >> i'm curious. what's the evolutionary reason for only four blood types. why aren't there 27 blood types? >> it's a very good question. there's a short answer but i have to give you anti-seek stories. first of all, often in evolution, things don't happen. we can tell you how they happened. the blood types are actually defined by not just on the surface of cells there are molecules, typically proteins and bloodty types are defined by sugars that are attached to the proteins. they have these proteins have functions, they carry out other functions in the cells and it turns out that some of these proteins are shared between us and bacteria. there's an immune response generated across the proteins and i can recognize your blood type not because i've been transfused with your blood before, but because i have an immune response to your blood based on the fact it's shared between that protein and other proteins.s. >> they carry out remote function when human beings were evolving and happen to be four type os it's noted as if one is especially good as doing what it's doing and therefore they've been carried along evidence of acrosshistory and some blood tye more prevalent in populations and some are less prevalent in some populations and some are more rare than others. but otherwise they're neutral. >> the evolutionary history of it. >> following up on the question earlier, obviously there must be a market for i'll say late medical information otherwise i guess more people on the scene because they're curious or throughout the ages people are curious about the hidden history of medicine? >> i think people have been always been curious. the genere of writing medical nonfiction goes back a long way. you could say in some ways, the first philosophers were national scientists partly because they william c. rogers engaging in national science and people writing a cells book. the way to first describe the cells. it was a popular book for just popular consumption with micro-graphia and about seeing tiny things in the universe. there's been a long history and the internet doesn't tell stories. but medicine is about telling stories. >> i've always looked out for medical professionals being an english major f. you can't tell a good story, you can't be a good doctor. it used to be you didn't have a shot of getting into medical school if you had a liberals arts background and i made a joke about the liberal arts major and carrying a liberal arts card as well. >> every story has an ending an. >> yeah, go ahead. >> really quick. along with the theme, i'm actually a history major and also an obgyn physician and i read all your books and think they're fantastic. your theme is similar to what the other audience members have asked over the last few years what we've seen with the pandemic and p with a lot of different things is there's a huge mistrust the book had in science and medical knowledge. as someone that's just such a wonderful communicator, how do you think weth can all better communicate with the public and better kind of bridge that gap? >> well, very short answer because we're running low on time but it's a very important question, how do we communicate? i think we communicate with honesty. you'll find -- you can take my books as a history of failure andce history of success. history of accomplishments and history ofat terrible things tht science and medicine have done. on the other hand if we only communicate with authority and command, people with be nor nervous. when facts change, i change my mind whether you do. so communicating some of that is communicating for good medical communication. thank you very much. >> thank you. [ applause ]. >> they document america's story and on sundays, book tv brings you the latest nonfiction books. funding for cspan brings you funding for these shows and more. >> now more than ever, it all starts with great internet. >> democrat wes moore was the democrats first black governor. he appeared to talk about his books. >> it's not just about how do we, how do we, you know, add on clauses to things like the law enforcement order -- law enforcement officers bill of rights or qualified immunity. it's not stopping there. the demands we're seeing are dealing with structural racism. and how exactly can we deal with all of these various issues in a way where there's very real offenses and sin sayrety and a real sense of -- >> he appeared on book tv recently and america a reception story. -- >> are we going together or not and the answer is do we go together or not at all. i think it's interesting and frankly helpful for us to go through this tribal conversation to see how hard it is to try and figure it out and it's the republican tribe or democrat tribe or black one or white one will produce and has more respective appreciation for the necessity of pursuing the american dream and more in south dakota. >> where we're going and not being opposed to the country and i do think we also have to be pretty clear on what we're for and be ready to take action should we have the opportunity to get congressional act to get them to the president's desk. >> before his election to the senate of ohio, republican jd vance was well known as best selling author of hill billy elegy and we have a significant problem with the effected of going and getting a 4-year college education and it's not surprising when those are the only two pathways that you see people going in those two directions. but also think that we have to think a bit more constructively about regional economic development and the way it's gone for the past 10 or 20 years is that i'm a local municipality and i offer somebody a tax credit to set up a restaurant in my hometown. that's great. new restaurants are fantastic but that's not the sort of longtime term economic redevelopment that has to happen in some of the areas and it's something that basically all levels of policymaker haves to be thinking differently than they are right now. >> democrat cory bush was reelected in her st. louis district and appeared on book tv to talk about her book the forerunner. >> the sexual assault i experienced before most of my time and trying to find myself and i blamed myself. i went through the next 20 years blipping myself every single time that -- blaming myself every single time it happened. oh, it was because my shirt was cut short and my shorts were really, really short. it was because i was out walking with friends when i met them and, you know, i was dressed a particular way so that's why it happened. >> tune in to watch all your favorite authors. former fox news political editor argue that had the media puts profits over good journalism. here's a portion of that interview. >> i as a journalist do not have much interest in media criticism. i joke about it and it's like asbestos abatement and it's hazardous and you need specialized equipment and best left to the professionals. there's lots of good media criticism. i think most media chris schism is trash and most media criticism is indicative of the problem i'm trying to talk about in this book, which is that it's a refuge for partisans. we don't want to talk about what our side did so let's talk about the coverage of what our side did. i had a weird experience professionally or we're all having a weird experience as citizens which is the stuff is -- the changes that have gone through our industry? the past 20 years, you know, it's been a lot. there's been a lot going on and we're in a time where people are really hungry for us to -- for the learning curve to steepen and for us t get better fasr. >> watch the full program any time online book tv.org. just search chris