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In the inaugural episode of So Curious, our hosts Angelica and Bey talk with neurologist Dr. Erin Conrad about cognitive enhancements. Later in the episode we also sit down with Franklin Institute’s chief bioscientist, Dr. Jayatri Das, to chat more about public perceptions of cognitive enhancers.

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Transcript
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Hello, world, and welcome to So Curious, presented by the Franklin Institute.

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In this season, Human 2.0, we will be talking to scientists and non-scientists

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alike about technology and innovations surrounding the human experience.

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We're your hosts.

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I'm Angelica Pasquini.

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And I'm the Bul Bey.

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But you could just call me Bey.

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All right, here we are.

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First episode. This is it.

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This is it. How are you feeling?

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I'm good. I'm excited.

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I'm excited to learn, get learnt. Yeah.

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I feel like one of those kids at the

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beginning of that Magic School Bus episode.

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You know, something is about to happen. It's about to go down.

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Absolutely.

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This is essentially the Magic School Bus podcast.

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Who's the Lizard?

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You know what, I didn't watch the show that much. But I know I am Miss Frizell.

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That's kind of like without any pushback. You got that.

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Yes. I'm really excited to talk to scientists

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and people that are really talented in their field.

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I mean, there's nothing I like more than

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listening to someone who knows what they're talking about.

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And it's not something that I need to necessarily know anything about.

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Isn't that kind of nice in this day and age when everyone has to have an opinion

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on everything and know everything about everything?

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Experts are becoming a part of the conversation.

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I think conversations are becoming democratized, which is cool.

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But experts should always be experts and stand out and always be that source of

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facts, studies, figures, measurements, documented things.

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And we're going to be talking to all of

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those different people in those different fields and they're on bleeding-edge

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technology stuff, cognitive enhancements and biohacking.

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I would talk to anyone who is an expert in anything.

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In fact, that's like taking a vacation.

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You can just listen to someone talking about it.

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I like anything Renaissance Faire,

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anything. I will listen to someone talk about it.

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All right.

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So I was thinking about starting this podcast off without introducing ourselves

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at all and just jumping into the topics and being different.

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But no, let's introduce ourselves.

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And my name is the Bul Bey.

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But you could just call me Bey.

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I'm a Philadelphia-based rapper, creative collaborator.

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And who are you? Hello, world.

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My name is Angelica Pasquini.

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I'm a comedian, writer, musician.

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I like to think about the intrusive nature of technology and societal standards

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around modern living, really casual stuff like that.

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Yeah. This is episode one.

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Today we're going to be talking about cognitive enhancements.

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Yeah. Enhancing the mind.

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Yeah, I know how to enhance a room vibes, candles, incense, furnishing, textures.

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I love all that. I mean, in terms of cognitive

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enhancements, memory, pattern recognition, so many different things.

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But focus is something that we all deal with a little bit.

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My focus kind of trails off. What about you?

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Are you someone that locks in on something

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and knows exactly what's going on and all the details and all the patterns?

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If it was up to me, I would love to have

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the ability to focus on what I want to focus on and tune out the rest.

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Like sounds and noise and people, literally that.

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But also the cool thing about cognitive

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enhancements is the idea of eliminating what's not necessary, you know what I'm

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saying? So I love the idea of being able to pay attention to what I need to do, and

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then that alleviating, like, tons of time-wasting looking all around.

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Right.

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I'm not sure if this is a superpower in a good way or if I'm a villain, but I have

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an uncanny ability to just block people out when they talk to me.

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Wow.

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So if I'm having a conversation with someone and I don't know if I'm just more

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focused or interested in something else in other detail, my mind will drift.

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I'm not sure if that's actually like a

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superpower or like a step back, a disadvantage or something.

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Yeah.

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I think that in some situations that could probably be really helpful.

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I block people out all the time, but that seems rude.

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So cognitive enhancements, a lot of the drama around this that people have and

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culture would be what is considered fair and unfair.

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Right.

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So I think, like any kind of enhancement, what does that mean?

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You take something and it needs to be better.

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The idea of it needing to be better at all

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is very philosophical, especially when it comes to the mind.

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This is where people get really tripped up because it's like, of course we all would

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like to be enhanced, but what is the limit?

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And what are the parameters around that?

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And what is considered fair or unfair advantage.

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What I'm excited to do is just get to a baseline, a standard, a default.

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I think the word enhancement is a loaded term.

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People come to the conversation with so

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many different stories connected to it, narratives.

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It has some negatives attached to it, enhanced.

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Have you been specially enhanced in all these different ways?

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But it's not something to be scared of or

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frightened or something to explore and ask questions about.

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Or at least that's more or less my take on it.

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Yeah. I think for me, we all have such different

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minds and we all have such different gifts, and it's cool to give people the

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opportunity to see where they have natural gifts.

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And maybe sometimes we feel like we have to enhance ourselves

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to be able to do certain things that maybe we don't necessarily need to be doing.

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I don't know. The SATS, for example.

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This is one way to measure knowledge. Right?

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There are so many different types of knowledge.

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There's so many different types of people that are so uniquely gifted.

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I think sometimes, cognitive enhancements,

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people might think about having to apply themselves in a way that might not come

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naturally to them, and they have every right to do that.

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But it's also cool to look at what is

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coming natural and sort of like lean into that as well.

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And I think you're entirely right.

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I love what you just brought up.

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All right, so let's transition into our first guest because I think she has a

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better understanding of all the cognitive enhancements.

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Our first guest today is Dr.

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Erin Conrad.

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Erin Conrad works in the Neurology

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Department of the University of Pennsylvania, where she specializes in

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epilepsy seizures and deep brain stimulation.

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Before coming to Philadelphia, she earned

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her MD from the University of Michigan in 2015.

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Her article, "Attitudes Towards Cognitive Enhancement, the role of the metaphor and

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context," was a vital addition to cognitive enhancement research.

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The piece assesses people's views on cognitive enhancement and how we might

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help destigmatize and educate about its use.

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Welcome, Erin.

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Could you introduce yourself?

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I'm Erin Conrad. I'm a doctor.

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I'm a neurologist specifically, and my specialty is in epilepsy.

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My research is a combination of more quantitative EEG analysis, trying to help

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improve outcomes in epilepsy, and then also a little bit of ethics as well.

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And this is how I forayed into cognitive enhancement.

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I got really interested in neuroethics.

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You kind of lit up around cognitive

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enhancement. Where did that spark come from?

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I did a lot of work with Anjan Chatterjee, who's at Penn as well, and he was starting

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to do some work in cognitive enhancements, so he got me interested in it.

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From a research standpoint.

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Can you define what cognitive enhancements are?

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It's where healthy people enhance their cognition.

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So this is very different from enhancing

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cognition for the purpose of treating a disease.

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So as a neurologist, for instance, I prescribe medications like cholinergics to

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help treat Alzheimer's disease and improve thinking in that disease.

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And then psychiatrists might prescribe

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stimulants to people with ADHD or similar diseases.

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Increasingly, healthy people have started

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to use these same sorts of medications to enhance their own thinking.

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Why do you think people are making that decision?

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I think there are a lot of motivations.

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I'm most familiar with seeing this among students who are studying for an exam or

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something like that and might take stimulants to kind of help with their

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attention and their focus while they're studying.

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We also see a similar class of sorts of

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medications in athletes who are kind of taking performance-enhancing drugs.

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We're also increasingly seeing this in the workplace.

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People who aren't students aren't athletes

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but are just taking it to perform better at their jobs.

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Are energy drinks cognitive enhancers?

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I mean, they could potentially, you could say a cup of coffee, you could say is a

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cognitive enhancer, like anything that is enhancing your thinking or mood or

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anything could be argued to be a cognitive enhancer.

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Can you talk about some of the language in

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a conversation going on about healthy people using cognitive enhancements?

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I think the pro arguments are some of the more obvious ones.

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First, as an individual, you can improve your thinking, your mood.

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It sounds great.

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Also, there are potential benefits to society.

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So, for instance, some people work in jobs where their reasoning ability, their

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focus, their reaction time are critical to helping, protecting the public.

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So you can think of pilots or maybe doctors, for instance, firefighters.

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I'm a doctor.

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And so medical residents who are young doctors in training.

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They routinely work 30 hours shifts without sleep.

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Which is wild, which is crazy.

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That's a whole other conversation.

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That's a problem in itself.

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That's the other thing about this stuff is sometimes it's like there's a solution

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here, but the problem is sometimes a societal one.

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You think the best solution to the 30 hours shift thing is not stimulants.

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It would be like fixing the doctor shortage or something like that. But

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that's going to be hard to fix. So in the absence of that, if you're a patient and

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you know your doctor is going to be sleep-deprived, would you rather have a

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sleep-deprived doctor or a sleep-deprived doctor on stimulants?

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I'd rather them be well rested! Is one of

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the reasons the cognitive enhancers are such an exciting topic for you and many

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other people in the field, is it because you're pioneering? Is this all new?

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A lot of neurology and psychiatry are

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undergoing, an explosion now in terms of our understanding.

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The brain is so poorly understood, and

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it's one of the last organs of the body that we don't understand very well.

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And then with cognitive enhancement, that's really in its infancy, I think.

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But there are a lot of doctors and scientists that think that there's

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potential that the future incarnations of these could actually be really powerful.

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And so it's exciting to think about it

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from an ethical standpoint while it's still in its infancy.

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I would love to talk a little bit about

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your findings and your paper and talking about the framing and the language that we

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use around cognitive enhancement in society.

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The project that we did in 2019, it was a

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study of basically public opinion on cognitive enhancement.

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Most of the studies that had been done so far were asking about the use of

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cognitive enhancement in students, but we were interested in looking at it more

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broadly because we're seeing increasingly people who aren't students, who are just

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taking it for work or for personal use, was increasing.

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And so we wanted to see what people thought about that.

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So we did a survey of 3700 people.

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We gave participants one of three different scenarios.

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We asked them to imagine a student using

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cognitive enhancement pills to help study or an athlete using them to help train or

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an employee using them to help in the workplace.

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And we asked them, what do you think about this?

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Do you think this is okay to use cognitive enhancement in this situation?

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And would you do it yourself if you were in this situation?

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The first thing we found is that people were much more likely to say it was okay

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to use it than to say that they would use it themselves.

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We also found that people were more accepting of cognitive enhancement in the

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workplace than in either school or athletics.

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And that was a little interesting and unexpected.

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We had expected that people wouldn't really like the use of cognitive

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enhancement in sports, and we weren't expecting necessarily to see this

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difference where people thought it was more acceptable to use cognitive

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enhancement in the workplace than in school.

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So it wasn't totally clear why people

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thought it was more okay to use it in the workplace than in school.

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I have a wild guess, only because we see work as a lifeline.

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This is how you make a living.

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If you are not able to work and you can't make a living and take care of yourself

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and the loved ones around you, so on and so forth.

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So we might have a softer attitude towards

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someone being stimulated so they can stay up for 30 hours.

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That's my guess.

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And I will have to follow up with another survey.

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Yeah, right. So you think the benefits to

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the individual are higher in the workplace?

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That's fair.

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Erin, do you think that cognitive enhancements are cheating?

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This is a cheating answer, but I think

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that cheating is defined based on the rules of the game.

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And if you set the rules of the game very

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clearly to say don't use these drugs, then it is cheating.

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And then in school, I think that gets more complicated because then

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for instance, if you're taking a pill that enhances your performance right before you

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go into the SATs, that feels like "not fair." What about, though, if you're

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taking that same pill to help you study for the SATs two weeks before, that is

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also maybe a little less unfair, but still doesn't seem great.

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But then let's say, what if you took this pill ten years earlier and it actually

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made you smarter, able to learn more information down the line, and then maybe

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go on to do more good things with that? That seems more fair. It seems like it's a

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continuum depending on the context in which you're using it.

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I love that answer. The one thing that popped into my mind and when you said that

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is, who's making these rules and how are we navigating these questions based on

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these assumptions, based on these standards and these rules?

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I have a question, too, about transparency around these things.

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So everyone has the right to be private about what they want to be private about.

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But when it comes to hero-worship and

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putting people on a pedestal, do you think that people being transparent about some

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of the enhancements they use would be beneficial to our society?

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That's a good question.

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So I think in the context of school, for instance, being able to say, oh, I was

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successful in part because I was taking a stimulant.

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I think that could be helpful to inform

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other people's choices, potentially in a positive way.

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Like, if more people were using stimulants

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and that was helpful to them, then maybe that could be a good thing.

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We don't fully know the potential of these

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medications, both from a positive and a negative.

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So I think for now, understanding what

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people are doing would be more helpful in terms of the pros, benefits to the

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individual, benefits to society, and then in terms of the downsides.

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People talk about the medical risks, the psychiatric risks of addiction.

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Some people are concerned about this

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concept of fundamentally altering who we are.

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Other people are really worried about this coercion idea.

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Like, so for instance, you catch someone

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who's taking performance-enhancing drugs in sports, and they say, I didn't want to

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take it, but I had to because everyone is taking it.

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And then there's also a concern of exacerbating inequalities, because

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imagine, these pills are probably not going to be free.

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So if they're available only to those who

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can afford them, then it's going to be exacerbating preexisting inequalities.

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And then you imagine, taking SAT prep

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classes or things like that -- it's just another way for people who are already

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rich and successful to get more rich and successful.

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And also it is an answer to a societal pressure. Is there ever a time where it's

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like, all right, enough, you're good enough as you are?

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I think one way in which cognitive enhancement is different from, say, SAT

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prep classes is the idea of it being a zero-sum game or not.

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So if it's something like the SATs, I feel like that is a zero-sum game.

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You're measuring your ability relative to other people's.

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But you can imagine if people are taking cognitive-enhancing pills for their job,

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then depending on what that is, everyone could potentially benefit.

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I think the classic historical example I can think of is Paul Erdos.

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He was a mathematician, and one of the most prolific mathematicians in history.

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He authored over 1000 mathematics papers,

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and was doing this heavily aided by stimulants.

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And one of his friends was kind of worried about him, and he actually made him a bet

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that he couldn't go off of stimulants for a month.

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And Erdos took the bet and he did it.

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He didn't use any stimulants for a month.

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He was not able to write anything.

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He couldn't come up with any discoveries.

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And he told his friend, you just set mathematics back a month.

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And you can imagine the flip side of, w

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ell, maybe if you have people, scientists, whatever, who are taking these, can they

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accelerate their discoveries and enhance social progress?

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That's the big potential benefit of cognitive enhancement.

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That's exciting.

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But against all of those potential negatives.

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Something that jumps out to me as well as

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far as the workday and how many hours we should be working.

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Me, as a young person, and I know a lot of

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other young people, have an assumption that people are grinding nonstop.

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But a lot of the CEOs that we look up to

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of these big corporations work like 2 hours a day.

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And so I like using cognitive enhancements as a tool to at least kind of deconstruct

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and ask these really important questions about work, who we are.

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What are some of the next steps in cognitive enhancements?

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So first, from a public policy and public

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opinion standpoint, understanding how people feel about these different things

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depending on the situation they're in. In terms of the actual research, before we

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even get to cognitive enhancements helping healthy people,

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improving these medications that we have available to people with disease, and then

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find a way to translate that to healthy people.

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What do you think the future is of cognitive enhancement?

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The future.

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First, I think most universities ban

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the use of these stimulants for nonmedical reasons.

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And also just the fact that so many people

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are using this, out of proportion to how many people are prescribed it.

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When it comes to prescription stimulants,

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for instance, that makes me think that banning cognitive enhancement probably

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isn't going to actually stop people from using it.

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So I think it is to some degree inevitable.

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So then it's more about, well, how do we

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then respond to it, given that people are going to use it?

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And I think part of that is involving the public in the debate to understand how

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people feel about it, whether they would use it, in what context?

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So that it's not just a bunch of ethicists and scientists talking in isolation.

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But then also I think that it's so hard to

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talk about it now because it's still in its infancy.

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The pills, as they exist right now, aren't that effective.

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And I think that as we develop

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future versions of these that are potentially more effective and have their

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own concrete risks and benefits, then I think it will evolve from a conversation

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that's more abstract thinking about potential benefit, potential harms into a

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real conversation about these are the benefits, these are the harms.

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And then I think it will become clearer what we're talking about.

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Erin, thank you so much for joining us and having this conversation.

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Yeah, you're welcome. Thanks for inviting me.

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Yes, thank you.

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That was awesome. Yeah.

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I always find it so interesting that the context plays into people's opinions.

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Right? Yeah.

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Well, I guess some people don't feel that way.

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Right?

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Like some people are a little bit on the fence about that.

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Yeah.

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I love how she was so open about talking about the differences that people have in

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perception around this and that she empathized with that.

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And even though it's her specialty, I think that she had a very zoomed-out

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point of view, and she was able to see everyone's point of view.

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I also love that she accepted us, saying, hey, we put people on a pedestal, that's

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superhuman, and maybe we should take it easy around that.

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So how do you think the attitudes towards

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cognitive enhancement might push us to, I don't know, being better, faster,

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stronger, smarter, quicker and all that stuff?

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I think it's all about people understanding what's good for them.

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And I think the best version of Human 2.0 is an integrated version of yourself where

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you're like, all right, what do I need and what does that look like?

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And I think that some of these cognitive enhancements give people the opportunity

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to assess what they really need and even have a team around them and have

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accessibility to it and even have the opportunity to say, hey, guess what?

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Actually, no, it's not what I need.

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So as this research happens, I think the

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discourse is going to change around the content.

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Absolutely. Some of the framing of the questions might

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evolve so continuously we'll gain enlightenment but be confused.

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Yeah, those are both always happening at the same time.

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It's kind of a beautiful thing.

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There's someone who can certainly shed more light on cognitive enhancement.

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We're referring to, of course, Franklin

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Institute chief bioscientist Dr. Jayatri Das.

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Let's welcome, Jayatri now for a recurring

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segment, Body of Knowledge with Jayatri Das.

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On this segment, we will discuss our episode topics in a more open formu.

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We're going to throw around some questions and talk about ideas.

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Welcome, Dr. Jayatri Das.

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Welcome, Jayatri. So what comes to mind

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for you first when you hear cognitive enhancements?

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Right.

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So I think about how do I make myself smarter, right.

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Very simple level.

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I need to be better.

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I need to do better on something.

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I just need my brain to work better. Right.

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That's the assumption in a cognitive

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enhancement is that we need to fix something.

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Right. I think what surprised me when I first

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started learning about this was how many people are already doing it.

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I read a statistic that in a survey of college students in the US, about 17% of

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students are already taking some kind of pharmaceutical cognitive enhancer.

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Wow.

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So a little troubling, but I mean, maybe that's just that.

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So let's unpack that! Yes, exactly.

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I'd love to.

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Right, so when we think about different types of cognitive enhancers, we can think

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about things like caffeine and nicotine, which are legal.

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And I think most people would think it's ethical because it's legal.

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That's kind of an interesting connection between ethics and the law.

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But I drink caffeine to get some energy or

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wake up in the morning or focus before I'm getting ready to do something.

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So we're all pretty comfortable with caffeine.

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But then when you think about attention,

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drugs, like Ritalin or Adderall, or drugs that help you stayP awake, like Provigil.

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These are drugs that people are now using not to treat a particular diagnosis, but

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to do better on a test or to stay awake and study longer.

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Things like that. Totally.

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I think too about celebrity culture and how a lot of celebrities are taking things

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to stay awake and taking things to then rest and they're traveling around the

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world and they're creating all this work that people look up to.

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But the transparency around cognitive

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enhancements is important to me because I think that if that kind of thing is talked

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about, then maybe more people would understand.

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Like you can totally accomplish these

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things, but please understand that there were enhancements and that there was

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help. I don't know. That's an interesting question.

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And I really appreciate that insight because people act human as if they're

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doing everything without any level of assistance.

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But there's a lot going on when you kind of pull back the layers.

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Yes. I mean, what you guys are touching on

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really gets at some of these ethical questions that social scientists have

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talked about when it comes to cognitive enhancement.

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So even getting beyond, just the medical

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risks of taking it when it's not prescribed to you, the authenticity of it,

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this boundary between treatment versus enhancement and who defines what's healthy

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and what's enhanced talking about inequality.

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There are people who have access to these drugs and others who don't.

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And what does that mean in terms of who can get it and who can benefit from it?

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And then that idea of just unfairness, right?

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Thinking back to doping in sports and things like that.

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So for this part of Body of Knowledge, we're taking to the Internet.

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Ever heard of that?

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To see what people are curious about when it comes to cognitive enhancement.

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Cognitive enhancements, to me are like the

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real Housewives of science because there's so much drama around it.

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Everyone has an opinion.

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People think it's fair, and some people think it's not fair.

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Some people think it's none of your business.

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Our team Google search cognitive

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enhancement and we're going to read off some of the search results.

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Yeah. And really quickly, we ask the Internet,

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of course, what do they think about cognitive enhancements?

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So we have some auto-fill questions here.

And at the top of the list:

"is cognitive enhancement for studying?"

And at the top of the list:

There you go.

And at the top of the list:

Probably about 17% of people Googling where to get those drugs.

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"is cognitive enhancement for depression?"

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That's such a complex one to unpack because there's so much that we don't know

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about what happens in the brain because of depression.

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People's ability to think and process is...They just can't do it.

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But we don't understand enough about why they can't do it to be able to reverse it.

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Within the realm of science and research, how is depression framed? How are

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scientists looking at depression? You talked about some of the complexities

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around it and not being able to pin it down.

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It's one of the biggest mysteries

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in neuroscience right now is trying to figure out what is the brain chemistry of

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depression, what causes it, and how do you change it.

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And even when you think about antidepressants,

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we kind of know what they do, but we don't really know why they work and why they

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work for some people and don't work for other people.

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I think where we're seeing this

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relationship with cognitive enhancement is this general cry for help, is like, "I

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know that I'm not working the way to be who I want to be and how do I help that?"

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And then, of course, taking into

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consideration the natural ebb and flow of moods.

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Right.

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And the manic and then the depressed waves that many people go through before

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accomplishing anything or truly even getting out of bed,

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almost depressed enough to become manic enough to do something with the day.

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That is often what I think about and that

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I see around me, especially obviously with artists.

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But then you get to talk to people that aren't artists.

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If you open up your world a little (I'm

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speaking to myself) and you see that everyone feels this way.

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Everyone.

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So there's this other thing with modern

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society and depression, which is, i nstead of something being wrong with you,

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maybe something is right with you because look around if you're not depressed at

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all, we got a big problem going on with you.

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But of course, there needs to be solutions

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when it's getting in the way of being able to live a life.

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But there are thresholds there that are interesting.

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Right. Again, who defines what's healthy

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and what's clinically depressed? And what is that gradient?

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"cognitive enhancement in the elderly....?"

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Man, this is one of the questions that I

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get asked the most, like how do I keep my brain healthy as I get old? Becausee part

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of normal healthy aging is some cognitive decline.

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I walk in rooms constantly and I'm like,

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why did I come in here? What was I going to do?

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And you're not even that elderly, right?

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We're all here living our lives along a spectrum.

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Right.

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Time is a construct, Bey.

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It's fine.

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People are asking that a lot for sure.

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And again, it's just like

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what is sort of quote-unquote "normal aging?" And what kind of cognitive decline

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can we all expect versus when is it a symptom of something more serious?

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The next one on the list is, "are cognitive enhancers worth it?"

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That's a value question.

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Yes, it is, "worth." What are you trading and what are you gaining?

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Right.

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You brought up something a couple of moments ago about, I know I can do this.

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So it's that perception of who you are and your ego.

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And like, I know I can do this.

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And so maybe I don't know the pursuit of that you think anything's worth it?

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You'll lay it out all on the line to

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perform the way that you feel like you could or should.

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Right. But if you think of cognitive

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enhancer as like a shortcut to an achievement, does it still mean as much?

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Wow. Well, that's a great question.

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I think the last one, which I absolutely loved was Adderall, is life changing.

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I love that that's a commercial.

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I mean, it can be life changing for

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somebody who suffers from attention disorder.

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This type of medicine can really make a huge difference in someone's life.

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Right.

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And the question is, okay, but for that purpose, that's great.

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But what about repurposing it for somebody who just wants to do better on a test?

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Right.

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Well, that's all the time we have for today.

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Thank you so much to Jayatri and Aaron Conrad.

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This concludes our first episode of So Curious.

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I'm excited.

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Hi, this is Angelica Pettini from So Curious.

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You know what?

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We love making this shop okay, but sometimes they are great bits.

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We just can't fit them into the episode.

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So we put together a bunch of great bonus content and you can find that available at

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beyond fi.edu. Thanks so much for listening to our premiere episode of So

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Curious presented by The Franklin Institute.

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We're excited for the season ahead.

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We've got a lot of amazing science and guests in store for you.

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Subscribe to this podcast wherever you're

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listening and Mark your calendar for new episodes every Monday.

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This podcast is part of The Franklin Institute.

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The Franklin Institute is a science Museum located in Philadelphia.

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The Franklin Institute's mission is to

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inspire a passion for learning about science and technology.

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For more information on everything about

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The Franklin Institute, visit fi.edu. This podcast is produced by Radio Kismet.

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Radio Kismet is Philadelphia's premiere

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podcast network for businesses looking to develop their own branded podcast content.

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Check them out@radiokismet.com.

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There's a lot of people who make this podcast happen.

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Thanks to the producers Joy Montefusco and

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Jayatri Das, our managing producer, Emily Cherish, our operations head, Christopher

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Plant, our associate producer, Liliana Green, our audio team, Christian Cedar,

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Lund, Goldie Bangley, Lauren DeLuca, and Brad Florence.

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Our developer footman producer, Opiola

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Bocola, our science writer Kira Vayette, and our graphic designer, Emma Sagar.

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See you next week. Bye.

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