SCIENCE FOR PEOPLE WHO GIVE A SHIT
Oct. 30, 2018

#41: Outsmarting Cholera

#41: Outsmarting Cholera

Our guest is Dr. Minmin Yen, the CEO and co-founder of medical startup PhagePro, where she and her team are developing viruses specifically designed to kill bacteria and prevent bacterial infections.

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Transcript

Quinn: Welcome to Important, Not Important. My name is Quinn Emmett.

Brian: And I'm Brian Colbert Kennedy.

Quinn: And there's Teddy.

Brian: Hey Ted! Aw.

Quinn: Hey pal! Look at that smash face. You've been napping. Hey, today's topic, Brian, outsmarting cholera.

Brian: Yep.

Quinn: Yep. Here's the thing: cholera's still around.

Brian: Oh, I thought it was dead.

Quinn: Yep. And still really sucks.

Brian: Yep, yep.

Quinn: But there's hope on the treatment side, at least, and what's that hope's name, Brian?

Brian: That hope's name is Dr. Minmin Yen.

Quinn: Yeah, that's right. Dr. Yen is the CEO of her medical start-up PhagePro, where she's developed viruses to target cholera bacteria because antibiotics, surprise, are fighting a losing battle.

Brian: Huh.

Quinn: She's got a PhD in molecular microbiology from Tufts University and she started her own lab because bang, that's how she rolls.

Brian: Why wait around for stuff when you can do it yourself?

Quinn: This is another one of those really fun ones where I feel like we should develop a small segment in the middle of the podcast where we just say, "Hey Brian, how would you develop a virus to target?"

Brian: Yeah, that's what we should do.

Quinn: Literally, what is the first step?

Brian: I have no idea.

Quinn: Is it buy a microscope? Is it microscope, right?

Brian: I think first it's don't be me, be a whole different person, step number one.

Quinn: Make so many different choices.

Brian: Make all of the choices different.

Quinn: Oh man.

Brian: Yeah, she's very smart and she's literally just getting started.

Quinn: Yeah, I love talking to these folks who are going to be world changers. Pretty awesome stuff. Awesome, all right.

Brian: Let's get into it.

Quinn: Let's do it.

Brian: Let's talk to Dr. Yen.

Quinn: Rock and roll.

Quinn: Our guest today is Mimi Yen. Together, we're going to talk about outsmarting cholera. Mimi, welcome. 

Dr. Minmin Yen: Thank you. Thank you for the invite. It's a pleasure to be here.

Quinn: Well, you say that now. Give it an hour.

Brian: Just you wait. No, we're very happy to have you. Okay, so Mimi, just tell us real quick who you are and what you do.

Dr. Minmin Yen: Sure. Right now, I am currently the CEO of PhagePro. We're a biotech start-up that uses phages or viruses that specifically target and kill bacteria in order to alleviate the diseases in global health. So specifically, looking at cholera right now.

Brian: Very good. First question. What's a phage?

Quinn: Brian's going to need you to dial it back real quick.

Dr. Minmin Yen: Phages, they have been known about since the 1920s and they are-

Quinn: By you, maybe.

Brian: Yeah.

Dr. Minmin Yen: They're viruses that, just like we have animal viruses that go after our human cells, bacteria also have viruses that specifically target and kill bacteria only.

Brian: Oh.

Dr. Minmin Yen: Those are called bacteriophages or phages for short. They were discovered in the 1920s and looked at for a long time for therapeutic applications, especially for antimicrobial purposes, but then antibiotics came along in 1940s. The US and most of Western Europe really focused all of their attention on antibiotics because it was like this magic bullet.

Quinn: Woops.

Dr. Minmin Yen: Whereas Eastern Europe, interestingly enough, because they're like, "We don't want to be like the West, we're going to not focus on antibiotics and focus on developing these phages further." So actually right now, in the Republic of Georgia, what they have set up is a center that you go in and if you have a bacterial infection, they have this whole library of phages that they screen to tailor the phage therapy for your particular bacterial infection. That's pretty cool.

Brian: Wow.

Quinn: Brian's going to have a lot of questions in this one.

Brian: I'm excited to get the answers to them though.

Quinn: Me too.

Dr. Minmin Yen: I hope I have the answers.

Quinn: Well, that's why you're here, so pull it together.

Brian: All right, we'll get our conversation going here. We are big believers in questions that elicit action answers. We're going to talk about cholera and how you're going to defeat it yourself and what we can do to help you along the way, if that sounds all right.

Dr. Minmin Yen: Yeah, sounds great.

Quinn: All right. Well, she just went along with that.

Brian: Bam. Yeah, that was-

Quinn: All right.

Brian: That's wonderful.

Quinn: So Mimi, we have one important question we like to start with. If you actually did listen to some of the other episodes, you might know what it is. Instead of saying, "Tell us your whole life story," though I am curious how you got to where you are.

Brian: Yeah.

Quinn: We like to ask, Mimi, why are you vital to the survival of the species?

Dr. Minmin Yen: I did hear the question and I was like, "Oh my god."

Quinn: Uh-huh. If it makes you feel any better, I ask Brian every morning when he walks in. He's still not answered me.

Brian: I will get it one day.

Quinn: Mm-hmm (affirmative).

Dr. Minmin Yen: I don't know about me specifically, but I do think that the phage research community as a whole can provide an alternative as we're searching for solutions to the rise of antibiotic resistance around the world. 

Dr. Minmin Yen: The way that I got started with this is that, when I was doing my college undergrad, I was all about global health and engineering solutions, but I really didn't know what direction to take that in, so I decided to go to grad school and did a PhD in microbiology at Tufts University with Andrew Camilli. He's this well-renowned expert internationally in cholera, but he was also getting into the study of phages. He was interested in figuring out whether or not they could be used as an intervention. When I joined his lab, I decided that that was going to be my way of contribution. 

Dr. Minmin Yen: So I actually went to Haiti in 2014 and-

Quinn: That must have been crazy.

Dr. Minmin Yen: It was. It was definitely eye-opening. That was four years already after the earthquake and really, it didn't seem like anything had been fixed or changed. I know there was a lot of aid that went through, and sometimes when that happens, there's redundancies and not everyone's working as efficiently as possible to make the greatest impact, unfortunately. 

Dr. Minmin Yen: I had gone down to Christianville to help train some of the scientists in phage biology, but also just to study the cholera epidemic there. That's what really gave me the motivation as to the role that I wanted to play in global health. I wanted to be not just a scientist at the bench; I wanted to actually make an impact.

Dr. Minmin Yen: When Andy and I talked afterwards, we decided to really go for it for my thesis project, do the animal model testing, see if it works, and turns out, it did.

Quinn: Congratulations.

Brian: Boom.

Dr. Minmin Yen: Thank you! So that's what we're trying to bring to market now, which has a whole other set of challenges that we're working through.

Quinn: Oh yeah, we're going to get into that. Thank you for that. Let's establish some context for today's topic, which is defeating cholera.

Brian: And it's definitely not pronounces "co-lair-ah"?

Quinn: Not that ... I could be totally wrong.

Brian: No, I think I'm wrong.

Dr. Minmin Yen: I don't think so.

Brian: Yep, yep.

Quinn: Okay, she's-

Dr. Minmin Yen: At least in the US.

Quinn: She's so kind about it.

Brian: Thank you.

Quinn: To be clear, you should definitely tell both of us whenever we're wrong in the sternest possible tone. Don't dance around it.

Quinn: All right, we just like to get everybody, the two of us, you, though I assume you're using 10% of your brain to talk to us, our amazing listeners at home who are on the subway or driving and texting, wherever they are, on the same page. Brian might have some questions. This won't take that long. Mimi, just tell us, again, everywhere we're wrong.

Quinn: So cholera, it's not pretty. A lot of folks, we have listeners all over the world, but in the US, it's pretty exceptionally rare at this point, so I feel like people might not be as familiar with it as opposed to everywhere else, but it is a bacteria infection of the small intestine. Is that correct?

Dr. Minmin Yen: Yep.

Quinn: And it, most of the time, leads to terrible diarrhea, sometimes within hours, leading to severe dehydration and often death. So three to five million people a year get it.

Brian: Damn.

Quinn: Ranging anywhere – this is a big range, of course, depending on the pandemic outbreaks – 30,000 to 150,000 deaths a year. We've had seven or so pandemics over the last 200 years. Is that about right?

Dr. Minmin Yen: Yep. We're currently on the longest running one, yeah.

Quinn: Oh, that's great news.

Brian: Excellent.

Quinn: Well, I'll add that to my notes. It mostly comes from, as I understand it, unsafe water and sometimes food, like seafood. As far as I understand, only humans are affected by it and it seems like in a lot of the things we talk about, Brian, rising sea levels and flooding should make it even more prevalent, which is great.

Brian: Shocker. Shocker that everything is connected.

Quinn: Yep. We know it goes back as far as the 5th century B.C. Somebody found it written in Sanskrit.

Brian: Whoa.

Quinn: Which is great. Another thing we haven't fixed. And as with everything else, antibiotic resistance is growing. You look at Zimbabwe or Yemen, the disease is very, very real and very dangerous in a lot of places where sanitation is not up to snuff.

Quinn: On that note, Mimi's going to tell us how she's going to fix it. Like so many diseases we're facing or we've talked about, especially bacteria stuff, our best methods seem to be starting to come apart at the seams, starting to fail. As one of our previous episodes, Dr. Gautam Dantas taught us effectively, bacteria's been around a hell of a lot longer than us and is a hell of a lot smarter than us, and anything we've succeeded at seems to be the low-hanging fruit that they've let us succeed at.

Quinn: So Mimi, talk to us again now, what exactly you're working on, where it came from, and how this applies to the current situation.

Dr. Minmin Yen: Sure. Like you said, cholera is transmitted through the water primarily. It's in places that really don't have functioning water and sanitation infrastructure. But what we're increasingly starting to recognize is that 40% of the cases are actually due to household transmission as well. When someone in the house gets cholera, unfortunately because of the disease, it's spread everywhere and the family members are immediately at risk.

Dr. Minmin Yen: Basically, there's this two-day window after the first patient comes down with cholera that the family members actually start to experience cholera symptoms themselves. What we're specifically doing with our intervention is disrupting that transmission cycle. 

Dr. Minmin Yen: What our product does is it's phage-based, so it uses phages that are specifically targeted towards the bacteria that cause cholera and we want family members to take it when the sick person comes down with cholera symptoms so that they could protect themselves within that high-risk window while they're trying to take care of their loved one.

Quinn: I'm sorry, I don't mean to interrupt there. So you're saying the sick person takes it or the family takes it in a preventative measure?

Dr. Minmin Yen: The family takes it as a preventative measure.

Quinn: Okay, interesting.

Dr. Minmin Yen: Yeah, so with any sort of diarrheal disease in global health, really the best solution is the oral rehydration solution. Regardless of what the etiology of that disease is, ORS really is the way to go because it's cheap, it saves a lot of lives, and you don't have to diagnose which bacterium caused it. 

Dr. Minmin Yen: We're not using phages as a therapy for that reason. We don't think it's feasible as a therapy in this particular case, but as an intervention, in the best case scenario, when family members bring in their sick loved one into the clinic, if they can get our product and bring it back to the household so that everyone in that household is protected also during this risk window, it disrupts the household transmission and hopefully disrupt community transmission as well. It's working to protect everyone immediately.

Quinn: I'm going to try to pick some questions out from in there. Trying to imagine this scenario a little bit. Let's say Brian and Teddy and I share a house, a small room like we are right now. Brian gets it-

Brian: Well, maybe you got it.

Quinn: Nope, let's go with you.

Brian: Okay, I got it.

Quinn: First, let's start ... Again, we try to dial it back to like how to make peanut butter and jelly here.

Brian: Yeah.

Quinn: What's Brian's first symptom?

Dr. Minmin Yen: He's going to start – sorry Brian.

Brian: No, it's fine. I'm used to it.

Dr. Minmin Yen: With cholera, what happens is that basically, the bacterium releases a toxin in the small intestine. Flips a switch. All of the body's water's going to start flooding into the small intestine and come out.

Quinn: Wow.

Brian: Wow.

Quinn: Okay, so that's when my clock starts ticking. How long is my window where your treatment is effective? How long do I have to go get that treatment before it doesn't count or is it just a decreasing level of effectiveness? Can you explain that a little bit?

Dr. Minmin Yen: Approximately two days. The studies have shown that-

Quinn: Okay, that's pretty decent.

Brian: Yeah.

Dr. Minmin Yen: It sounds decent to us.

Quinn: You're right. That's very white people troubles.

Dr. Minmin Yen: In places where it's hard to get to healthcare clinics, we have to think of a different model in order to reach those people. But in the best case scenario where this is an infrastructure for diarrheal diseases like in Bangladesh, for instance, there's this whole center. They've really done a good job in trying to reduce the number of diarrheal disease deaths there. 

Dr. Minmin Yen: You would go into the clinic with the person who's sick, and then ideally, we would give the product so that, during that two-day window that you came in, you would be protected before experiencing the symptoms yourself.

Quinn: Interesting.

Brian: Sorry to back up real quick. You just said 40% of people who get cholera get it from a family member or somebody close them?

Dr. Minmin Yen: Yeah, that's approximately what it is.

Brian: Yeah, that's a lot.

Dr. Minmin Yen: Yeah, it's a lot. It's something that was as recognized before. Even that 40%, everyone in the global health field understands that surveillance is lacking and data is lacking, so take that 40% with a grain of salt.

Brian: Sure, sure.

Dr. Minmin Yen: But it's still a huge percentage and if we could really disrupt that transmission, we could probably make a huge impact on the disease burden then.

Brian: How does it get transferred between people? Just in the air?

Dr. Minmin Yen: No, it's oral fecal route.

Brian: Oh.

Quinn: Don't be bashful here. You're on here for a reason.

Dr. Minmin Yen: Unfortunately, with cholera, because of the rapid nature of the disease, your fluids are just going to come rapidly out of your body, so there's a lot in that household that's being spread around. Usually, children are really affected by it, so if you ever tried taking care of a sick child who had diarrhea, it's not going to be sanitary of course. Unfortunately, that's how the family members are going to be exposed it, just by the sheer amount that's around.

Brian: Man.

Quinn: Okay, I just want to, again, dial it back a little bit and build to something eventually here. So there's no vaccine for cholera, right? The prevention is sanitation, safe drinking water. Is that right?

Dr. Minmin Yen: There is a vaccine. There's an oral cholera vaccine that's been developed and it actually is recommended by the WHO. That side of things has been interesting in terms of the way that it's developed, but in any case, the oral cholera vaccine requires two doses administered by a healthcare worker. You take the first dose, and then a week later, you take the second dose, and a week later after that, that's when the earliest onset of protection really is.

Dr. Minmin Yen: There are some studies that are trying to show the efficacy of just that single dose at the beginning, but in any case, because vaccines depend on the immune system in order to mount protection, that protection's not going to be fast enough within those two days when these family members are really at risk. That's the niche that we're trying to protect. If, best case scenario, you have a sick family member, you get the vaccine the first dose on day zero, you still have to wait and by that time, it's too late, in my opinion.

Brian: Right. Is that oral vaccine out there? Is that available or distributed?

Dr. Minmin Yen: It is distributed, so [crosstalk 00:17:43]-

Quinn: You said it's interesting, what was going on with that. I'm curious what that means.

Dr. Minmin Yen: Yeah. I think in a lot of cases, we aren't proactive enough in global health. The one scenario that I could think of in recent years where the cholera vaccine has really been given proactively is when the Rohingya refugees went into Bangladesh to the Cox's Bazar. The diarrheal center that I mentioned previously in Dhaka, Bangladesh, the people there really had a lot of foresight in that they went to the WHO, asked for the number of doses to prevent cholera in this refugee population to prevent a cholera outbreak from starting there.

Dr. Minmin Yen: That, I think, is an outlier in terms of how we're usually responding to humanitarian crises like these. If you look at Yemen, there's been a million cases of cholera there already, and that was just in the last year or so. That's far surpassed the number of cases that happened in Haiti in seven years or eight years since the cholera epidemic broke out. 

Dr. Minmin Yen: Even though the oral cholera vaccine is out there, there's still a lot of logistical issues, there's still supply and demand issues that need to be addressed. Of course, we're thinking about those for our product as well. How do we go about bypassing them or what can we do at the beginning stage, since we're fortunate enough to learn from the lessons from before, how can we make our product more easily distributed and more stable? How can we really get it to the populations that need it the most without running into all of these complications?

Brian: What form does your treatment take? It sounds like "Ghostbusters."

Quinn: It sounds like "Ghostbusters." Choose the destroyer.

Dr. Minmin Yen: Yeah.

Quinn: Yeah, I'm sorry. Again, we're just trying to pain a picture. Is it a pill? Is it a shot? Is it a patch?

Dr. Minmin Yen: Sure. The animal models, we did it as a liquid formulation, but that is subject to a lot of stability issues. There's a lot of countries that have cholera that are hot and humid climates, and then the [inaudible 00:20:07] is not particularly functional in these countries. Ideally, we're working right now on making it into a tablet formulation so that it doesn't have to be stored at four degrees Celsius, so that if it gets left somewhere outside for a week, it's still stable, the family members can still take it. But that's something we're working on right now.

Brian: Does your treatment have a shelf life? Can people just buy it ahead of time like the EpiPen and not have to worry about that window? If you get sick, you just open the medicine cabinet, take the treatment, and you're good, no clinic?

Dr. Minmin Yen: Yeah, ideally. There's a couple of issues with that. With the oral cholera vaccine, the shelf life for that, I forgot how many. It's on the [inaudible 00:20:54] years. It has to be a four degrees Celsius and the WHO stockpiles 2 million doses per year, which is not a lot.

Dr. Minmin Yen: In order to even be a product to be distributed in that type of infrastructure, we have to have a shelf life of three years at least at four degrees celsius.

Quinn: Oh, shit.

Brian: Wow.

Quinn: What if you can get it to be the pill?

Dr. Minmin Yen: I think we could go for much longer at a hot and humid 40 degrees Celsius type of weather. 

Dr. Minmin Yen: What's interesting then with your question of whether you can buy it before, then it goes into how are pharmaceuticals moved around in global health? In a lot of countries, the informal healthcare system is what people turn to. They don't go to the clinic, they go to someone local or they go to someone who has a lot of medicines that are available that are normally highly regulated in the US. Antibiotics happens to be one of those things that is kind of just given out sometimes without any sort of prescription.

Dr. Minmin Yen: For us, we're still trying to figure out how we can use that to our advantage. Is it that we start off with this phage product and really start building this phage manufacturing distribution actual community and ecosystem where phages can be distributed like antibiotics so that, if we have a stable phage tablet, it can be given over the counter? That's something we're trying to work out and figure out what is the best way to actually get into the hands of the people in a safe manner.

Quinn: What are, geopolitically, the biggest problem areas right now?

Dr. Minmin Yen: Where to start?

Brian: Great.

Dr. Minmin Yen: I know, sorry. The places where it will be hardest to do cholera prevention are places that have war. I mentioned Yemen, but the Democratic Republic of Congo actually has just a steady state of high cholera cases because of what's going on there. When people are dying, it's really hard to say, "No, you can't use antibiotics." It doesn't matter to them, the global trend of antibiotic resistance, right? It's hard to say to them, "No, I know you have the medicine in your hand that you believe that is going to work, but I don't want you to take it," or, "I don't want the government to distribute it."

Dr. Minmin Yen: In terms of navigating that, how do we tell ministries of health, for instance, "You need to start looking for alternatives" or, "You need to start distributing this other alternative that we think is going to be successful, but there's no test case for it right now"? Navigating that and getting people to adopt to that, I think, is going to be quite difficult, especially in the face of civil war and refugee camps when there is so much need.

Quinn: Sure. And I recognize you guys are just so far from this, you're just coming out of animal trials right now, which is great, but existing things like the vaccine and such or just oral treatments, looking at countries like Yemen, which are just destroyed in so many ways, how do they break down their efforts as opposed to maybe just trying to help somewhere that's a little bit easier first? How do they approach a situation like that? How is that being handled?

Dr. Minmin Yen: I've been talking to a few people about this. For the oral cholera vaccine, the way that it's distributed, it's really dependent on the people on the ground, the organizations working on the ground, so MSF, any local organizations that really know the area and the culture. You have to depend on them and trust your local partners to distribute and understand all of the complications that would come with that in that setting.

Dr. Minmin Yen: I would say that we're still figuring it out. The global health community is still figuring that out, obviously, since cholera is still around and it's been around, like you said, since the ... What did you say?

Quinn: Long time.

Dr. Minmin Yen: Yeah.

Brian: Long time B.C. or something.

Dr. Minmin Yen: The best case is really doing a whole infrastructure overhaul, but a lot of the governments simply don't have the money. If you look at Haiti for instance, the UN, when they finally admitted, "Oh, our bad. Sorry about the cholera outbreak."

Quinn: Oh god.

Brian: Jeez.

Quinn: That just did not get ... I know it was a couple of years ago now, but oh my god.

Dr. Minmin Yen: Yeah. Also, it astounds me, the number of people that I talk to about this years later and they don't know anything about it.

Quinn: Why don't you recap that for us super quick for us and tell everybody what actually happened?

Brian: Yeah, like you said, it not being as big an issue here, I think a lot of people just have no idea.

Dr. Minmin Yen: Yeah. So a earthquake struck Haiti in 2010, devastated the whole area, and then that meant a lot of service people were coming into help out. That's great, but as part of it, when the UN workers from Nepal came in, unfortunately, there wasn't enough screening, there wasn't enough training as to how human waste should be handled while they're in the country. Someone had cholera and it went into the water. The water, because of the flooding in the area, it just spread throughout the country so quickly.

Dr. Minmin Yen: Right now, it's kind of sad. The cholera epidemic is slowing down in Haiti, not because there's been really any changes to the infrastructure or the prevention, but in part because so many people in Haiti have gotten cholera and survived it that they're immune to it.

Quinn: Wow.

Dr. Minmin Yen: One of the factors in the epidemic slowing down is that previous exposure.

Quinn: That's so interesting because it is, in effect, an island and it's so curious what's that going to do to the survival rate there.

Dr. Minmin Yen: Yeah. Now, cholera's stuck there. It's in the water and unless there's sanitation infrastructure that gets put in place for it, the people are going to continue to get cholera over the next few generations if they haven't had previous exposure it.

Dr. Minmin Yen: The UN finally owned up to the part that they played in it. It's hard. We do get angry, but we also have to understand that the global health community as a whole, we have to make sure that we don't get into our silos, that we're not fighting each other because we all want the same thing. So understandably, the UN, there was a lot going on. I've never been in a situation where an earthquake just happened and you have to be on the ground. I'm sure there's a lot of issues that come along.

Quinn: Of course.

Dr. Minmin Yen: But they really did fuck up.

Brian: Yeah.

Dr. Minmin Yen: They admitted to it being their fault and they committed money to helping with the infrastructure, but I really haven't seen much come out of that. 

Brian: Oh really?

Dr. Minmin Yen: And of course, overhauling an infrastructure takes time and it takes a lot of money and it takes a lot of political will and stuff like that. That's what happened, unfortunately. It's still going on. If you go down there, there's still cholera epidemic still breaking out.

Brian: Yeah, and it's been eight years.

Dr. Minmin Yen: It's just not in our news cycle.

Brian: Yeah.

Quinn: Of course it's not in our news cycle, but that's the entire point of what we're trying to do here.

Brian: Right, right.

Dr. Minmin Yen: Yeah, exactly.

Quinn: I should note, as a brief intermission, to our majority American listeners, again, we don't really have cholera here. I'm sure there's cases here and there, but we are not perfect. You might be pretty happy with your sanitation systems and your Brita filters, but have a look at Flint, Michigan, look at our flooding, our sea level rise. That's just starting. It just takes a case or two to come over here on a plane and we're dealing with this too. 

Quinn: I don't want to be a scaremonger, I never try to be, but both in thinking about how you – and we're going to work towards this – how you take action to help these folks' infrastructure and war-wise and how you vote and where you donate your money, remember, these things can come home and we're facing a whole of interconnected threats that can bring these things to our doorstep pretty quickly. Just don't tune out on this one.

Quinn: All right. So you're moving past animal trials, that's very exciting, congratulations.

Brian: Very. 

Dr. Minmin Yen: Thank you!

Quinn: Now on the flip side of that, what sort of obstacles are you running into?

Dr. Minmin Yen: Funding.

Brian: How come? That's always the answer, isn't it?

Quinn: That's so weird.

Brian: Number one answer.

Dr. Minmin Yen: So weird that that's always what people think of!

Quinn: How have you been funded to date? How did this whole shebang start?

Dr. Minmin Yen: Yeah. Andy is at Tufts University and he's a tenured professor, so he has NIH grants. He also was a Howard Hughes Medical Institute Investigator.

Quinn: Okay, what the hell does that mean?

Brian: What?

Dr. Minmin Yen: That's a really prestigious appointment where Howard Hughes Medical Institution is a nonprofit that will select certain professors that are really making advances in science for humanity and they'll give them millions of dollars.

Brian: Wow.

Dr. Minmin Yen: Andy was one of those professors. I was coming in during his – it's a five-year appointment – so I was coming in during his second five-year appointment, as a grad student. A lot of the money, including a fellowship that I got from that same institution, actually funded my Haiti trip and funded a lot of my supplies and stuff. That's the academic funding.

Dr. Minmin Yen: And then right now, we're looking to move out of Tufts University so we can have our own space. We're just starting to do a fundraising push now, so we have to be quite diverse in our portfolio, as opposed to a lot of other biotech start-ups that are money making ventures. We're not going to VCs or angels really because I can't promise them a 10x return on something or really, how much is human life in terms of-

Quinn: Right. That just comes back to the fact that Silicon Valley is focusing on all the wrong fucking things.

Dr. Minmin Yen: Yeah, exactly. We applied to a grant from the NIH, which is specifically for small businesses. We're looking at the Welcome Trust. Hopefully there's grant money there.

Quinn: What's the Welcome Trust?

Dr. Minmin Yen: Similar to Gates Foundation in terms of the amount of help it gives global health. It's out in the UK. It funds a lot of basic science research, it funds post-docs, professors, it funds global collaborations. There's a whole bunch of stuff in its portfolio, but it's one of the biggest contributors to basic science research in the Western world, at least.

Quinn: That's interesting though. The funding and what you're able to offer in return, which sounds insane, because what you're offering is to fix one of the world's oldest bacteria-focused diseases and that's what they're getting in return, which is-

Brian: Yeah, come on! It's a pretty big return.

Quinn: I get it. I understand. You guys aren't a nonprofit, right? So people can't ... These institutional investors or angel investors or VCs or whatever, this is not a charitable cause, right?

Dr. Minmin Yen: Right. What we've decided recently is we were incorporated as a traditional C-corp; we're looking at converting into a public benefits corporation. That means that our shareholders, if we don't choose the more commercial path to go down for our company, we can't be held liable for that. We have a social mission, it's built in to our charter. That's what we're looking to convert to.

Dr. Minmin Yen: The reason that we chose a for-profit is because of this small business grant, of the funds that can go to small businesses. We wanted to take advantage of a lot of the funding available for biotech start-ups because ultimately, we still are a biotech start-up, just with a prioritization in global health. 

Dr. Minmin Yen: We're trying to ride both worlds, basically, and it's been interesting because I'm at an intersection of not only biology, global health, but business as well, which is not usual, I feel like. I'm trying to balance all of those communities and figure out the best way forward for our organization as to how to take advantage of all the resources.

Quinn: It sounds like there's a lot of calculations there. There's definitely trade-offs one way or another, like you can't be a nonprofit or else you can't apply for the small business grants because a nonprofit is not a small business. And yet, at the same time, you can't promise 10x returns to somebody because etc. etc.

Dr. Minmin Yen: Yeah.

Quinn: Because this is not a drug or a treatment that should be this immensely profitable thing.

Dr. Minmin Yen: Right. Then we have to start being creative and there's been a lot of time spent on, "Okay, maybe we should reach out to family offices," so high-net worth individuals usually have someone manage their money. Maybe reach out to them. We can reach out foundations that give grants. 

Dr. Minmin Yen: I was thinking – I don't have the network for this, but if you guys do, that'd be great – reaching out to people who are rich in the countries that have cholera because basically the US, like you said, not many people know about it or if they do, it's thought of as a disease that has already been eliminated in a lot of the world. Let's say someone who grew up in India, someone who grew up in Nepal, they grow up knowing about cholera and if they have the funds for it, I wonder if they would be philanthropic about it and contribute as well. That was one of my strategies. It hasn't really panned out yet.

Quinn: Look, clearly, you gotta be pretty wide-ranging and flexible. Good news is apparently a lot of parts of America have stopped vaccinating their children, so all of these diseases that Americans are like, "Oh, that's dead," they're coming back and we're being made more aware of them because these fucking idiots think they're smarter than their doctors.

Dr. Minmin Yen: Oh yeah, that's great news.

Brian: Really good news. Maybe a big cholera outbreak will happen here and then some rich people from here will help out.

Quinn: Perfect! Great, great. We got you all set up. Hey, I want to pause before we get to our action steps here and get emotional for a second. 

Quinn: Do you feel like now you're on the right path, personally? You mentioned you didn't know exactly how to apply yourself in this specific capacity. Looking at where you are now, trying to decide how to focus your company legally, funding-wise, how to move into human trials, the impact you can have and the difficulties, the wide-ranging and incredibly complex difficulties of distribution and war, do you feel like you're going in the right direction, Mimi?

Dr. Minmin Yen: Yeah. I could say for the first time since I started the company, I feel like everything's pulling together. I incorporated with Andy and another co-founder then in 2016 in October. It was right on the cusp of me finishing my PhD. I actually started a part-time Masters in Public Health degree program as well at Boston University at the same time. 

Brian: Part-time, part-time Masters degree. No big.

Quinn: Yeah, I also want to pause. Did you say you finished your PhD?

Dr. Minmin Yen: Yeah, two years ago.

Quinn: Oh!

Dr. Minmin Yen: I defended my PhD thesis and then incorporated in the same week.

Quinn: And we have failed to address you as "Doctor" this whole time, which is great. 

Brian: Yep, that's not good.

Dr. Minmin Yen: Oh, no, no!

Quinn: Start over Brian.

Brian: Very sorry about that.

Quinn: Start the whole fucking thing over. Goddamn it!

Dr. Minmin Yen: Oh no, being called doctor is a little weird for me.

Quinn: No, I get it, but you know what? Maybe you don't feel this way, but I've got some incredibly smart and hardworking lady doctorates in my family and I think it's so important for young people, men and women, to know about young women such as yourself that have gone through it and succeeded and hear the word "doctor" and have that respect.

Brian: It's a big deal!

Quinn: I think it's important.

Dr. Minmin Yen: Thank you.

Quinn: Anyways, sorry.

Dr. Minmin Yen: No, no worries. I feel like I could talk all day about woman representation and woman of color representation, but in any case, that's a whole other-

Quinn: We're happy to run it back it and do that one next time.

Brian: Yeah.

Quinn: Anyways, you were saying that now you feel like ... Please, keep going.

Dr. Minmin Yen: Yeah, it was a lot of hats to wear two years ago and I kind of felt like I drowning in all of it because I didn't know anything about business. I was trying to finish my degree. It, ultimately, is incredibly helpful, especially in my line of work. But it was December, last year, where I've gotten so many "Noes" from people that I was like, "All right. I have one year before my student loans kick in. I have to either get enough traction that I think it's worth it or I'm just going to have to put it aside for now and think of something else."

Dr. Minmin Yen: In January of this year, I started pushing hard on all fronts to really get the name out there. It's overwhelming to go from two years of noes to finally some person being like, "Oh, I can help you out." 

Quinn: Oh my god.

Dr. Minmin Yen: That's how I found my other co-founder in April. That felt awesome, just having someone else to bounce ideas off of, and then finally signing Matt on as Head of Business Development and Marketing. I was like, "Oh my god, I have a team. Someone believes in me." 

Dr. Minmin Yen: And then since then, we just went through a summer program at MassBio, which is this nonprofit in the Boston area that connects a lot of academics with the business side of things to help them through because a lot of us don't really know how to exactly take something from the lab to the market. Getting into that program, having 12 mentors sit down, focus on me for an hour each week, that was, yeah, something that I never imagined that I would ever have the privilege of doing.

Dr. Minmin Yen: It's been amazing and a little scary, I gotta say.

Quinn: You were like, "Oh, nobody will help me," and then you're like, "Wait, why am I sitting in the middle of these 12 people?" It's quite the switch.

Dr. Minmin Yen: Yeah, exactly. And then the MIT Tech Review, I thought I was dreaming when I got on the list. For my part, I'm very optimistic about how we're moving forward. There's a lot of generous people out there that are willing to give expertise, they're willing to provide time. 

Dr. Minmin Yen: I think, for my part, I need to do a good job with aligning all of those resources so that they can be used most effectively and efficiently to move forward. That's been a hard lesson since I've always been all over the place, but learning to manage, learning to actually have workflow processes, all the project manager skills and stuff that I never thought I would need are really being put to the test right now, so I am very excited going forward.

Quinn: That's awesome. That is a hell of an answer and a candid one at that. Well, Brian is opening up, is that your wallet?

Brian: Yes.

Dr. Minmin Yen: Are you considering donating to my cause?

Brian: It's very possible.

Quinn: You know what? I gotta tell you though Mimi, he offered to buy my avocado toast like an hour and a half ago, that didn't happen either, so don't fucking hold your breath.

Dr. Minmin Yen: Oh no!

Brian: Quinn is so generous that any time I even try or anything, reach for my wallet, offer anything, he always says, "No." It's not my fault I didn't do it.

Quinn: Oh, okay. We'll see.

Brian: You refuse. But this is a good segue. All right, so we've mentioned before, obviously, cholera isn't super prominent in the US anymore, but obviously it is a hellish nightmare in so many other places.

Quinn: Mm-hmm (affirmative). That's the technical term.

Brian: Still. Yeah, I know. I'm technical.

Quinn: Yep.

Brian: Yeah, so from medicine to sanitation to [inaudible 00:42:30] to war, it's a huge issue. What can our listeners do? How can our listeners support both your research and cholera prevention efforts around the world? Obviously money. Money helps.

Quinn: Yeah, but let's get specific. Where should they be applying themselves? Let's start with, yeah, individual actions.

Dr. Minmin Yen: If we wanted to talk about donating, it's really the organizations that are doing a lot on the ground in terms of distribution. That would be organizations like Doctors Without Borders, it would be UNICEF. There's Gavi, which is the Vaccine Alliance. I would say Partners in Health does a lot of community health worker work that is absolutely amazing and they reach places that a lot of the clinics don't reach. 

Dr. Minmin Yen: So people who are helping refugees, who are helping the populations that don't normally have access even to primary healthcare, those are the places you want to donate to because those are the ones who will be involved in the actual distribution of it, whether it be hand washing services or vaccines, they're going to have the logistics and the infrastructure to set that up.

Dr. Minmin Yen: And then for funding basic research, there's a lot of nonprofits on the West Coast, actually, in Seattle, my dream city. The Infectious Diseases-

Brian: It's so pretty up there.

Dr. Minmin Yen: I've never been, but I feel like I would love it.

Brian: You've gotta go. It's so green. It's beautiful.

Quinn: It's pretty great.

Dr. Minmin Yen: I feel like it'd be my soul city. There is the Infectious Diseases Research Institute, that's the main one that you want to look into donating. They do a lot of, they're a nonprofit, but they're a research institute that's looking to take translational drugs for TB, malaria, all of the big hitters out there.

Quinn: What do you feel like are the big actionable questions we should be asking of our representatives? We've gone from clicks you can take with a mouse, but when someone uses a tool like 5calls.org or something or writes a letter, however that works, I guess with a pen and a paper or something of that nature.

Brian: What?

Dr. Minmin Yen: Handwritten, very intimate.

Quinn: You know? And is actually speaking to their representative or they're at a town hall, again, it's a particularly, not difficult, but almost out of left field one, which it shouldn't be but it's because it's not here. What should they be talking to their representatives about?

Dr. Minmin Yen: Sure. That's something that I struggle with as well because I am very cholera-focused, but with my global health training now, it really is strengthening infrastructure, it's looking at primary healthcare systems and building that up, it's building up distribution and stuff. Instead of just talking about cholera specifically, I would say there are policies that the US takes that affect global health on a wide scale. 

Dr. Minmin Yen: US government is one of the biggest funders of global health services and the biggest Executive Order that has made a huge impact since it was signed is the Global Gag Order. I'm not sure if you guys have heard about it. It was signed in January 2017, I believe. It's also called the Mexico City Policy, I think. But basically, they say it's protecting life in global health. Any healthcare center that is funded by US money that gives access to contraception and abortion services, they can't do that anymore.

Dr. Minmin Yen: That from, not only a maternal and child health view, is terrible, but also these healthcare clinics, they're not always specifically providing, but they're helping with HIV, they're helping with ORS and helping with diarrheal diseases. They can lose half of their funding and try to do operations that way and try to do everything that they can to treat all the other diseases with half of their operational funding, or they can reduce their abortion services and contraceptive services. It really has made a huge impact globally, this particular gag order.

Dr. Minmin Yen: When people talk to their representatives about, more people need to actually know that it happened, first of all, and fight back against it.

Quinn: That's-

Brian: Insane.

Quinn: Yeah, that's pretty concise. That is the exact type of thing I don't think anybody has heard about, and if they did, they've probably fucking forgotten because as they look out the window, there's just flames everywhere.

Brian: Ugh!

Quinn: Anyways.

Brian: Anyways! We have kept you for a little bit here. We can not thank you enough for coming on today.

Quinn: Yeah, for sure.

Dr. Minmin Yen: Oh, it was my pleasure.

Brian: Thanks for letting us be your first.

Quinn: Yeah, to be clear, you're not out of here yet. Don't pack up and run.

Dr. Minmin Yen: Oh! Just kidding.

Brian: Yeah, hold on. 

Dr. Minmin Yen: Okay.

Quinn: Easy.

Brian: I'm just thanking you.

Quinn: Easy.

Brian: Who else should we talk to, Dr. Yen? Other world changers out there like you that we could sit down and chat with? It doesn't have to be people specifically in your field of work, but somebody who's kicking ass on cancer or trying to save the world from climate change or trying to send us to space, anything.

Quinn: You can always just email these to us later, but I think people like to hear names as well, but any ideas would be awesome.

Dr. Minmin Yen: Well, from a science perspective, I would say the scientist who recently just won the Nobel Prize for her directed evolution of the enzymes, that's super cool from a pharmaceutical and trying to make a greener industry. That's Dr. Francis Arnold. If you can get her, that would be really awesome for you guys, I think.

Brian: I would like the Nobel Prize winner, that'd be great.

Quinn: Yeah sure, that sounds easy.

Brian: No big deal.

Dr. Minmin Yen: Oh yeah, that's totally fine. Well, you reach for the stars, see what you come up with.

Quinn: Yeah, perfect. Thanks for making it easy, jerk.

Brian: No, that's great. Seriously, thank you. If you do think of any more, we'll take any recs.

Dr. Minmin Yen: Yeah, I will definitely email.

Brian: Truly, thank you. All right, we have a little lightning round of questions for you.

Quinn: Yep. First one.

Brian: Not a lightning round question, but here we go.

Quinn: Shut up, Brian. Hey Mimi, when was the first time in your life when you realized you had the power of change or the power to do something meaningful?

Dr. Minmin Yen: Oh.

Brian: Oh!

Dr. Minmin Yen: This year.

Quinn: Good first reaction.

Brian: Did you say, "this year"?

Dr. Minmin Yen: Yeah!

Brian: Cool!

Quinn: Okay, let's hear it.

Dr. Minmin Yen: I called myself Chief Scientific Officer for a very long time. I didn't think I had the expertise or the experience to be CEO of a biotech start-up, a global health start-up, whatever. Then I went to the MIT Women's unConference or I got selected to be among the people who could pitch there, and that's when I was like, "Oh, I'm actually doing something"-

Brian: A badass.

Dr. Minmin Yen: "That people recognize as good work." And I promoted myself.

Brian: Good.

Dr. Minmin Yen: Yeah.

Quinn: Fucking awesome, man.

Brian: Well-deserved.

Dr. Minmin Yen: Yeah, that was really the first time when I believed in myself really because I just thought I was a bench scientist. I just thought I would science the shit out of it and then other people would take it and run and actually do some good with it, but this year is when I decided I would be the person to do something with it.

Quinn: Fuck yeah, man.

Brian: That's so important.

Quinn: I love that.

Brian: Keep the confidence strong and alive.

Quinn: Yeah, we literally need it. Hey Mimi, who is someone in your life that has positively impacted your work in the past six months? It cannot be Brian.

Dr. Minmin Yen: Oh god, that was my first answer!

Brian: We know, we know, and it's much appreciated.

Dr. Minmin Yen: I would have to say Andrew Camilli who is my PI Advisor and now my co-founder. I think it's very rare for a professor, a tenured professor especially, to be so generous with his time, his work, really giving credit and career support to the people in his lab instead of just using them as minions. Without his support, I would definitely not be here today.

Quinn: Awesome.

Brian: That's awesome.

Quinn: That's nice.

Brian: What do you do when you feel overwhelmed with all this work?

Quinn: Specifically. What's your self-care?

Dr. Minmin Yen: Oh my god. Flaming Hot Cheetos.

Brian: Are you kidding me? Amazing!

Dr. Minmin Yen: All of my friends know that once I go into a dark place, I need, there's so many in this line, by the way, there's not-

Quinn: Speaking of things that can cause cholera.

Brian: Yeah. I have to say my girlfriend is a huge fan of Flaming Hot Cheetos. That is her one thing also and just to punch myself up a little bit here, for her birthday, I got her a cake that was shaped like a bag of them.

Dr. Minmin Yen: Oh hey! Look at you!

Brian: Pretty, pretty good. Thankfully, they didn't taste like them because I think they're horrendous, but if that's your thing, get it girl.

Dr. Minmin Yen: You know, I'm actually in LA right now. 

Brian: Oh great.

Dr. Minmin Yen: On the West Coast, you guys have Extra Flaming Hot Cheetos and that has been magical.

Quinn: You know what?

Brian: What is that?

Quinn: If necessary, not so much.

Brian: Extra Flaming Hot? Are they just jet black?

Quinn: Can you imagine sitting in that conference room? "Hey, I got the idea. I got it. I know what we're going to do. Extra. Should we just call it Extra? Yeah, just Extra."

Dr. Minmin Yen: It's twice as hot. I call them my Black Label Cheetos because they're that good.

Brian: I'm going to have to find these. We're in LA too. They must be at my local 7/11 or whatever.

Dr. Minmin Yen: Exactly.

Brian: All right, I'm going to get them. Thank you for that. My girlfriend's going to be very happy.

Quinn: Oh, Jesus. All right Brian, bring it home here. I've had enough.

Brian: Here we go. How do you consume the news, Dr. Yen?

Dr. Minmin Yen: That's changed over the past year. As I'm sure everyone is trying to struggle with how do you make sure you're not pulled into this deep pit of despair when you read the news recently?

Brian: Mm-hmm (affirmative).

Quinn: Mm-hmm (affirmative).

Dr. Minmin Yen: I try to stay informed, but briefly. So "The New York Times" morning and evening briefing, the Daily Scan, short things and headlines. Then when I really want to dig into something, I actually do my research and I go on Google and try to look for more articles, opinions about it. I do try to make sure I'm getting all perspectives. 

Dr. Minmin Yen: As angry as we are, I am in the camp that we need to understand where everyone's coming from in order to actually solve the root of a problem. When you go into a negotiation, you think, "Okay, what is the other person wanting? What are their motivations for feeling the way they do, wanting the things that they want?" Perhaps that's not the solution that most people come with, but for me, that's the perspective I need so that we can all come to the same page. So I try to make sure that, now that I know the echo chamber exists on social media, that at least during my readings of the news, I make sure to look at other perspectives as well. 

Dr. Minmin Yen: And not only US, also how internationally, how people write about issues in the US as well because I think there's a lot to learn from other governments and other people out there.

Quinn: Why is she so rationale?

Brian: I know, what?

Quinn: What are you talking about? No, that's amazing. I'm so thankful for people like you that are out there world changing have that perspective and make those efforts because it really is absolutely necessary.

Brian: Yeah, imagine our world if there was a whole bunch of people that thought like you. Everything would be so much better.

Dr. Minmin Yen: I mean, I'm a slow burner, so I will probably get angry two years down the line.

Brian: Sure, sure.

Quinn: Right.

Dr. Minmin Yen: About something that someone said previously, but I try to be rationale in the moment so that it's not escalating things beyond our control in response.

Brian: Right.

Quinn: Are you like that with jokes as well? Are you the person who gets in the elevator and a minute later is like, "Fuck! I had a great joke!"

Dr. Minmin Yen: No, no. I'm pretty good on my jokes.

Quinn: All right, all right.

Brian: No problems with the jokes.

Quinn: No problem with jokes.

Dr. Minmin Yen: Never, no.

Brian: Also you know, when you do get angry in two years for whatever thing, you could just sit back, relax, and cool down with a nice bag of Extra Hot Flaming Cheetos.

Quinn: Yeah, right?

Dr. Minmin Yen: Exactly, exactly.

Quinn: Enjoy your gastrointestinal distress.

Dr. Minmin Yen: Oh yeah, I just really like to feel superior to people. You know?

Brian: I got one more – well, not one more, but here's the next question. We haven't even talked about this gentleman today, which is fantastic.

Quinn: Thank god.

Brian: But if you could Amazon Prime one book to Donald Trump, what would that book be?

Dr. Minmin Yen: I'm sure some people have said this. "Mountains Beyond Mountains."

Brian: Oh yeah?

Quinn: Yeah.

Brian: We may have just gotten that like maybe not the last one, right, but the previous one.

Quinn: I think pretty recently, yeah.

Brian: Oh, that's great.

Dr. Minmin Yen: Yeah, it's the 15th anniversary of the book coming out, so it's probably on people's minds.

Brian: Oh yeah, okay.

Dr. Minmin Yen: Yeah, "Mountains Beyond Mountains" would be a fantastic one, I think.

Brian: Excellent.

Quinn: What do you feel like he could get from that most specifically?

Dr. Minmin Yen: Perspective. I think privilege is not a bad thing. A lot of us have privilege. I have privilege. It's understanding what to do with it and how to use it to really advocate for people who don't have it. "Mountains Beyond Mountains," you have this white doctor going in and you can argue that he might have a god complex or he might have the white savior complex, and those are issues that we definitely have to make sure that we're aware of and cognizant of when we go and help developing countries, but at least he's still helping.

Quinn: Sure.

Dr. Minmin Yen: And doing so in a way that's empowering the local community and really relying on people to build themselves up in those communities as well. He's using his privilege to help others and that's an important lesson for us all, I think, not just Trump, but a lot of people in the US.

Quinn: Sure.

Brian: Dr. Yen, where can our listeners follow you on the internet?

Dr. Minmin Yen: I don't do social media very often.

Brian: Oh, okay.

Dr. Minmin Yen: I like to lurk and follow other people.

Brian: Sure.

Quinn: Oh good, she's a stalker. Perfect, perfect.

Brian: Where can they maybe follow your work or anything like that?

Dr. Minmin Yen: We do have a website. It's poorly done. I had to do it in a pinch.

Quinn: Perfect. 

Brian: Excellent.

Quinn: Welcome, ours too.

Dr. Minmin Yen: That is www.phageproinc.com. I'll post press releases once in a blue moon about stuff that we do. I need to hire a social media intern or something, but you could follow me through there.

Brian: I'm available.

Quinn: Are you? Wait a minute, what?

Brian: We'll talk privately.

Dr. Minmin Yen: Is this an empty promise again?

Quinn: Good, good, good.

Brian: Again?! Ugh.

Quinn: This has been great. Dr. Yen, Mimi for short, we can't thank you enough for all that you're doing, for all that you're going to do. Brian and I were talking before he didn't buy me avocado toast about how much we enjoy bringing-

Brian: I mean, now every fucking day I'm going to buy it for you.

Quinn: I'm trying to say something. How much we enjoy bringing on folks who are on the cusp of doing something really fantastical and world-beating, mostly so we can say we go there first, but also because it's so exciting and there's so much hope in your eyes still.

Dr. Minmin Yen: You know, the light hasn't gone out yet.

Brian: Keep it, keep it.

Quinn: It will.

Brian: No!

Quinn: But we're excited and we just want to say thanks for taking the time to come on.

Dr. Minmin Yen: Thank you so much. It's been a pleasure talking to you guys. Really fun too for my first podcast.

Brian: Cool! 

Quinn: It's all downhill from here. Awesome. All right, well Dr. Yen, thank you so much. We will talk to you again soon for sure.

Dr. Minmin Yen: All right, sounds good. Have a good one guys.

Brian: Thank you, you too.

Quinn: All right thanks.

Brian: Ciao.

Quinn: Take care, bye.

Dr. Minmin Yen: Bye.

Quinn: Thanks to our incredible guest today and thanks to all of you for tuning in. We hope this episode has made your commute or awesome workout or dish washing or fucking dog walking late at night that much more pleasant. As a reminder, please subscribe to our free email newsletter at importantnotimportant.com. It is all the news most vital to our survival as a species.

Brian: And you can follow us all over the internet. You can find us on Twitter @ImportantNotImp.

Quinn: Ugh, just.

Brian: So weird. Also on Facebook and Instagram @ImportantNotImportant. Pinterest and Tumblr, the same thing. So check us out, follow us, share us, like us, you know the deal. 

Brian: Please subscribe to our show wherever you listen to things like this and if you're really fucking awesome, rate us on Apple Podcasts. Keep the lights on. Thanks.

Quinn: Please.

Brian: You can find the show notes from today right in your little podcast player and at our website importantnotimportant.com.

Quinn: Thanks to the very awesome Tim Blane for our jamming music, to all of you for listening, and finally, most importantly, to our moms for making us. Have a great day.

Brian: Thanks guys!