连接患者与平台 - 谷歌

大家好，欢迎回到《医疗创新播客》。我们是主持人Brennav和Arvind。今天非常高兴能邀请到谷歌的临床专家Justin Chen医生。Justin，能否先请您简单分享一下您的职业历程，您是如何从临床医学转到谷歌从事科技工作的？

Hey, everyone. Welcome back to the Medical Innovation Podcast. We are your hosts, Brennav and Arvind. Today, we're really excited to be speaking to doctor Justin Chen, a clinical specialist at Google. Justin, how about we start off by you telling us a little bit about your career journey and how you went from clinical medicine to working in tech at Google?

我最初是一名工程师。本科读的是生物医学工程，所以创新一直是我非常感兴趣的领域。在这个过程中，我意识到自己最终想更贴近患者，于是去了医学院，完成了内科住院医师培训。很长一段时间里，我对细分专业方向都很迷茫，最终选择肿瘤内科主要有两个原因。

I I started off as an engineer. I was biomedical engineering in undergrad, so some of the innovation was always pretty close to my heart for interest. I, through the process, realized I wanted to be closer to patients eventually, and so I went off to med school, did internal medicine residency. Didn't really know what I wanted to do for a long time subspecialty wise. I was pretty undifferentiated, and I ultimately landed on medical oncology for a couple reasons.

一是觉得这门科学非常迷人，能够如此密切地接触重症患者让我充满使命感并渴望深入学习。二是当时肿瘤内科领域在药物和诊断方面正涌现大量创新，有很多令人兴奋的进展。记得我刚开始住院医师培训时，免疫疗法和靶向治疗刚刚兴起，如今这些技术已经彻底改变了患者的生活——这正是我想参与的领域。

One was I just thought the science was really fascinating, being that closely involved with patients with such serious illnesses was something I really felt compelled to to do and learn more about. And then the second piece was also I just felt like a lot of innovation from drugs and diagnostics were happening in medical oncology. There are so much interesting stuff being pushed through. You know, when I started with residency, immunotherapy targeted therapies were just starting to come around, and they've made such a big change now in people's lives. So that was something that I wanted to be a part of.

在做肿瘤专科培训时，我深深爱上了临床和科研的双重工作。当时我思考如何将两者结合，原本计划成为临床研究员——在学术界工作，研究试验产品，开展临床试验并发布成果。我尝试了很多机会，偶然通过美国癌症研究协会（AACR）的新人计划，被引荐到阿斯利康参与传统医学角色的临床试验工作，这段经历让我受益匪浅。

When I did medical oncology fellowship, I I really kinda fell in love with the clinical side of it, as well as scientific side and was just thinking, like, how do I bring all of this stuff together? And I was really on track to be a clinical trialist, like, to work in academia, look at investigational products, work on clinical trials, report those results out, push the science that way. So I knocked on a lot of different doors just to see what would open, and I somehow got connected with, someone who's actually at UNC now who's a medical oncologist, and he connected me to, this newer opportunity that was being offered through the AACR, which is the American Association of Cancer Research. And they were trying to build better bridges between academia trainees and industry. So I ended up spending time at AstraZeneca working on essentially clinical trials in sort of a traditional medical role, and I really, really enjoyed it.

这段成长经历让我深入理解了临床开发的意义，以及从产业角度开发药物的过程。之后我又开始探索新方向，最终进入了一个更关注临床试验数据流程的岗位，这结合了我受训期间和产业界的多重经验。

And that was a a great formative experience for me to sink my teeth into what clinical development means and how you develop drugs from an industry perspective. I then was like, alright. Where do I go from here? And kinda same thing. I just sort of started knocking around on doors, see what would open, ended up going into a role that focused more on how data flows through the clinical trial process, through a culmination of various things I did through training and in industry.

我获得了临床信息学认证，担任过不同职务，最终来到谷歌担任临床专家，负责多个产品领域的对接工作，搭建技术团队与临床团队之间的桥梁。希望这个曲折的职业路径能给您们提供概览，当然也乐意探讨任何具体细节。

I got boarded for clinical informatics, took on a couple different roles, but eventually landed myself at Google where I'm in this role of a clinical specialist where I help interface with a lot of the different product areas and try to build bridges between technical teams and clinical teams. So I hope that gives, like, a decent overview for sort of a windy path that I've taken, and, of course, happy to dive into any specific details that you may want to.

我想接着聊聊。作为即将完成第四学年、正在考虑内科和肿瘤科方向的学生，听到您既深耕临床又探索创新的经历很有共鸣——特别是您最初选择肿瘤科的动机。这个领域与产业界的紧密联系确实很特别。

I'll take that. I feel like per personally, like, as a right now, I'm about to go into my taking a year off before I finish off my fourth year, and I'm thinking internal medicine and probably medical oncology too. So it's it's cool to hear that you've done that, but then also been able to explore the innovation side and, like, really resonate with a lot of the things you were talking about in the clinic like, why you're interested in medical oncology in the first place. So I it it's it's interesting to see too. It's feel like it's such a special field where you have such a clear connect with industry.

我是说，你们使用的所有药物都非常新颖且近期研发的，尤其是免疫疗法更是如此。所以，是的，我认为这也是我正在考虑的一个领域。那么你现在是否仍在担任肿瘤科医生，同时也在为谷歌提供咨询？或者说，你的工作是如何分配的？

I mean, all the drugs that you're using are so novel and recent, and the immunotherapy is especially is is so recent. And so, yeah, I I think that's that's a field that I'm thinking about as well in that space. Are you so are you currently working still as a medical oncologist and, like, consulting with Google as well, or is it like, how is your work kinda split out?

这是个很好的问题。很多进入行业的人，与学术职位或临床实践都有不同程度的联系，你会看到各种不同的情况。比如有些人会完全投身于行业，有些人会保留部分临床实践工作，有时可能还会附带一个志愿性质的学术职位。

Yeah. That's a great question. A lot of people that go into industry, have various degrees of connections to either an academic position or a clinical practice, and you'll see kind of things across the board. Like, some people will go completely into industry. Some people will hold part time roles in practice, and sometimes that might also come with a more, volunteer academic position.

就我个人而言，我在谷歌全职工作，但同时我也志愿参与肿瘤医学实践，并在斯坦福大学担任兼职副教授职位。

So for myself, I'm full time at Google, but I do volunteer my time as well, for a medical oncology practice, and also hold a, part time adjunct position at Stanford.

这确实令人印象深刻。我确信同时兼顾临床事业和谷歌的工作并不容易，这非常非常了不起。我们很想进一步了解你在谷歌的具体角色。显然，谷歌作为世界上最大的公司之一，正试图在医疗保健领域产生影响。他们有许多面向消费者的举措，比如2021年收购了Fitbit。

That is really impressive. I'm sure it's not easy to juggle both your clinical career and your work at Google, so that's very, very impressive. We'd love to go more into what does your role at Google look like. Obviously, Google is one of the biggest companies in the world that's trying to make an impact in health care. There's lots of different initiatives from more consumer facing, like Google bought Fitbit in 2021.

谷歌正在开发并已经开发了从最初的MedPalm模型到最近的MedGemma模型等一系列AI模型。鉴于谷歌有这么多不同的举措和尝试在医疗保健领域产生影响的地方，我很想听听你具体参与了哪些项目，有机会参与过哪些类型的工作，以及你的日常时间是如何安排的？

Google is developing and has developed models on the AI side from the original MedPalm models to the more recent MedGemma models. So given that there's all these different initiatives and all these different places that Google is trying to make an impact in health care, I would love to hear more about what are you involved in specifically, what type of projects have you had the chance to work on, and how does your time how does your day to day play out?

这是个很好的问题。在行业里，特别是在谷歌、微软这类所谓的超大规模公司里，情况确实非常不同。最近你也听过微软相关人士的分享。我认为挑战在于，对我个人和谷歌的临床团队来说，我们规模相对较小，但医疗涉及很多不同领域。当然，我们有搜索引擎业务。

Yeah. It's a great question, and it's, something that is very different in industry and very different at these, like, quote, unquote, hyperscalers like Google, like Microsoft. And, you know, you've heard from people at Microsoft as well recently. I think the challenge is, you know, for myself, for a and for a clinical team at Google, we're relatively small force, but health touches a lot of different things. So, of course, we have search.

我们有Gemini、大语言模型、YouTube、Fitbit以及健康领域相关业务。随着领域发展，要跟上步伐确实很困难：一是从肿瘤医学角度，二是从当前AI和大语言模型的发展现状，三是在谷歌内部，要完全理解这个庞大组织的所有业务也很困难。

We have Gemini. We have the large language models. We have YouTube, Fitbit, the the wellness sphere of things as well. And it's really hard to follow the field as it evolves, one, from a medical oncology perspective, two, from sort of where we are today with AI and large language models. And then three, like, even within Google, it's hard to fully understand, like, this vast organization and all of the different things that they do.

就我个人而言，我更关注我们的云组织如何与企业对接，以助力实现他们的愿景和使命。同时我也会涉及更多研究层面的工作，为各类事务提供顾问意见。谷歌之所以有趣，是因为在Alphabet旗下有众多不同品牌，而谷歌内部又存在诸多不同的产品领域，其中一些我们刚才已经提到过。

And so for for myself, I focus a little bit more on how our cloud organization can interface with enterprises to help empower what their vision and mission is. And then I do touch a little bit as well on more of the research side and providing sort of an advisory voice to various ongoings there. And Google is is kind of interesting because there are so many different, brands under the alphabet umbrella. And then within Google, there are all these other different product areas as well, some of which we've already mentioned.

同样有趣的是，至少对我而言今年在Doximity担任医学研究员期间，这个角色与医学培训截然不同。特别是作为医学生时，我总觉得自己处于临床医学认知的最底层，而现在我有时竟是团队中唯一具备医学背景的人。即便作为医学生，我也能理解自己的见解对团队开发产品的独特价值。我特别好奇，当你说自己在谷歌的角色相当于肿瘤内科医生级别时，这段研究员培训经历如何转化应用？不仅是肿瘤学知识，还包括对医学体系结构的理解，这些如何作用于你的工作？

And, what's interesting too is, I think, at least for me in this this year, I've been working at, Doximity as, like, a medical fellow, and it's been a very different role than being in medical training, particularly because I feel like, at least as a medical student, a lot of the knowledge that I thought I I was surrounded by like, I feel like I was kind of on the bottom of, like, the understanding that people had about, you know, clinical medicine. But now I'm in an environment where I'm the only person sometimes on the team that has any kind of understanding. And and even as a medical student, can understand, like, how my insight is really valuable towards the team in ways that they wouldn't otherwise be able to build products. I I'm curious, especially for you, when you're talking about your role at Google being at the level of medical oncologist, having this fellowship training, how does that translate in the sense of using your clinical training and understanding of not just oncology, but maybe even I'm and whether it's the the the medicine itself or just the understanding of, like, the structural parts of medicine?

这些专业背景如何具体应用到你在谷歌的工作和贡献中？

How does that go about being applied to your job and what you're able to contribute at Google?

这是个很好的问题。其实不总是关乎医学培训或亚专业。我从你的播客和其他嘉宾的分享中经常听到，灵活性和知识广度是个反复出现的主题。当然有些时候我必须深度调用肿瘤内科的专业背景。

That's a great question. It's not always about the medical training or the subspecialty. And I think I've I've heard that through, like, your podcast and some of the other guests that have come up. Like, flexibility, breadth comes up as a theme that's recurring. There are times where I definitely do need to lean deeply into, like, that medical oncology training and the background.

但即便如此，肿瘤内科也已高度专科化了。比如有乳腺肿瘤专家、肺部肿瘤专家等等。所以有些领域我能侃侃而谈，比如肿瘤内科中的肺癌方向，但有些领域就需要请教他人或查阅资料。关键是要清楚自己的舒适区边界。

But even then, medical oncology has become so self specialized. Right? And so you have your breast oncologist and your lung oncologist and etcetera. And so there are certainly things that I'm very comfortable speaking about, you know, medical oncology, lung cancer, and there are things that I'm I'm not as comfortable. So it's it's about, like, understanding where your own comfort zone is and where you need to ask for help or go read.

很多时候甚至完全与医学无关。很多工作本质上是模式识别。比如药物研发的难点在哪里？其实很大程度上在于如何严谨地进行科学研究并合理评估成果。

And there are a lot of times where it's actually not related to medicine at all in some ways. A lot of it is just pattern recognition. Right? Like, what is so hard about doing, for example, drug development? Well, a lot of it actually just comes down to, like, how you rigorously do the science and measure success appropriately.

这种核心方法论在临床试验、药物研发、质量改进乃至其他高度监管的领域（如汽车或电信行业）都是相通的。关键在于如何识别这些模式并建立类比，让各方都能理解。我在工作中经常运用这种思维来弥合差距，协调不同团队达成目标共识。

And that is something that is thematically the same whether you're in clinical trials and drug development or in QI perhaps or maybe even in other fields that are highly regulated, right, like automobiles or or telecom industries. And so how do you recognize these different patterns and make analogies so that everyone can sort of understand these things? And I I think I I've leaned on that a lot in my role to try to build bridges, to narrow the gaps, and to bring all these different teams together so that we're aligned in whatever it is that we're trying to build.

没错。你还受益于拥有多样化的经历，从临床医学实践到在大学医疗系统担任兼职教授，再到与初创公司合作，甚至在阿斯利康这样的大型制药公司工作。我相信这种丰富的经历和能从不同独特视角看待行业的能力，使你能为谷歌内部从事健康项目的不同团队提供有价值的见解和建议。

Right. And you also benefit from having had a wide variety of experiences from practicing clinical medicine and acting as an adjunct professor at a university health system to working with startups and working even in big pharma at AstraZeneca. So I'm sure that wide variety of experiences and being able to see the industry from such different and unique perspectives allows you to chime in and have well formed opinions and advice to different teams working on health initiatives within Google.

是的，完全正确。这很大程度上是关于情境转换，这可能是当你离开医学培训或临床实践后最困难的事情之一，因为那条路非常明确，通常要求你在某一领域非常专精，尤其是在学术界，对吧？在那里，如果你专精于某一领域，就要发表大量论文。这与被拉进像你提到的Doximity这样的环境截然不同，在那里你的专长现在变得不同，你需要为许多不同的事务发声。

Yeah. Spot on it. It's a lot about context switching, and that's maybe one of the hardest things when you come out of, like, the medical training or clinical practice where the road is pretty clear, and that road typically says you need to be very specialized in one thing, especially in academia, right, where you're, if you're specialized in one thing, publish a lot of papers. It's kinda different than getting pulled into, Arvind, like you mentioned, Doximity, where your expertise is is different now and you have to speak for a lot of different things.

百分百同意。就拿我个人过去几年的经历来说，我有机会从事医疗保健和生命科学咨询、早期风险投资、产品开发和初创公司工作。你必须做的工作类型、必须持有的视角，与临床医学实践完全不同。拥有临床视角能让你参与讨论并将事物直接与患者护理联系起来。但除此之外，你必须愿意从不同角度看问题，必须从更宏观的视角出发，特别是考虑到像肿瘤学这样非常细分和专业的领域。

100%. Even speaking from personal experience over the past few years, I've had the opportunity to work on health care and life science consulting, to work in early stage venture capital, to work on product development and start ups. And the type of work you have to do, the perspective you have to have is very different from that of clinical medicine course practicing medicine, having that clinical perspective allows you to chime in and relate things back directly to patient care. But beyond that, you have to be willing to see things from different perspectives. You have to look from a big bigger picture point of view, especially considering a field like, for example, medical oncology where things are very, very niche and specific.

你服务的只是人群中的一小部分。所以从那个领域转到谷歌健康，我相信需要一定程度的适应和视角转变。

You're caring for a subset of a subset of a population. So going from that to Google Health, I'm sure, was a little bit of a adjustment and shift in perspective.

没错，视角确实非常重要。对吧？比如要理解你的听众是谁，你在与谁共事，他们来自什么背景，

Right. The perspective is really important. Right? Like, understanding who your audience is, who you're working with, where are they coming from,

然后

and to

试着在中间找到某个平衡点，希望如此。

try somewhere in the middle, hopefully.

确实。不过我很好奇。你在谷歌工作已经十个月了，有机会参与许多不同的项目，见识了谷歌正在推进的各种计划。正如你提到的，这其中有很多变化。

Exactly. I am curious, though. You've been at Google for about ten months now. You've had the opportunity to dive into a lot of different projects and seen sort of the variety of initiatives that Google is working on. And as you mentioned, there's a lot of variation.

要知道，在Alphabet这个大伞下，有谷歌、YouTube、Verily等子公司的项目。单就谷歌自身而言，就有众多不同领域的计划在推进——比如我看到过关于乳腺癌研究的文章，还有更通用的Medgema和早期的MedPalm模型。整个谷歌乃至Alphabet在医疗健康领域有大量不同方向的计划。从你的观察来看，哪些因素促使谷歌对特定垂直领域或项目产生兴趣？

You know, within the alpha umbrella, there's projects under Google, under YouTube, under Verily. And even just within Google itself, there's so many different initiatives going on from you know, I've seen articles about breast cancer work. There's a more general Medgema and older MedPalm models. So there's a lot of different initiatives going on about health care within Google and Alphabet as a whole. From your perspective, from what you've seen, what factors drive Google to take interest in a specific vertical or in a specific project?

显然在医疗健康与科技交叉领域有成千上万的项目可做，但谷歌选择了非常具体的项目来推进。我很好奇是什么驱动着这些决策？是什么激励谷歌关注某些特定方向？

There's obviously thousands or millions of different projects that could be done within the intersection of health care and technology, but Google chooses very specific projects to work on. And I'm curious what drives that decision making? What incentivizes Google to pay attention somewhere?

这是个好问题。我认为归根结底，谷歌被视为一家非常面向消费者的公司，比如搜索、YouTube等业务。而健康对每个人、每个地方都至关重要。因此我们的使命是帮助全球各地的人们延长寿命、提升生命质量，因为这最终会触及我们的所有用户——无论是患者、搜索用户，还是合作伙伴体系中的重要组成部分。

Yeah. It's a good question. I I think, ultimately, Google has been seen as a very consumer facing company, right, with things like search and YouTube and and all those. And health is important no matter who you are, where you are. So what we're committed to do is to help everyone and everywhere to live a longer, healthier life because it, at the end of the day, also touches our users, whether you're a patient or someone on search and consumer or a part an important component of of the partner system.

对吧？如果我们投资于那些以患者为核心的组织机构，就是希望能助力你们实现使命——让患者群体活得更健康、更长久。我们的目标是在所有业务领域形成某种统一的方法论。或许可以通过我们在做什么，以及如何从主题上分解这些问题来回答。当然，如你所知，我们在AI领域处于前沿地位，这已是共识——就像你提到的Gemini和Gemma模型。

Right? So if if we have an investment in working with organizations where patients are front and center, like, we want to be empowering you to accomplish your mission of your patient base living healthier, and longer lives. And the goal is really to have some sort of unified approach across all of our our different areas. I think one thing that is maybe a good way of answering this question is, like, what are we sort of doing, and how do we, like, how do we thematically break some of this down? And, of course, you know, we are a front center for for AI, so that's kind of a given, right, with all of the things like you've mentioned and with our Gemini and Gemma models.

我们还致力于'因地制宜'——这个理念可以有很多层含义。可能意味着某个组织刚踏上技术转型之路，我们愿意从他们现有阶段提供帮助；也可能指地理意义上的适应——作为具有全球影响力的公司，我们深知不同地区对医疗实践有不同限制。

We are also really committed to meeting people where they are, and that can mean very different things. It could mean that you're an organization that is nascent in this sort of technology journey, and we wanna meet you there and help, you know, get you, to where you wanna be. But it could mean geographically. Right? Like, we're a company that has global reach, and we wanna recognize that different geographies have different restrictions on different practices.

因此理解这些人群的背景及其日常生活现状非常重要。第三点是我们非常关注助力医疗机构转型——这种转型可能以研究为导向，也可能是B2B模式等各种形式。

So understanding, like, where these people are coming from and where they are in their current day to day is is really important. I think the third thing is we are very interested in helping organizations transform, and these are organizations working in health care. That transformation can take the shape of many different ways. It could be a research way. It could be sort of a business to business perspective, or what have you.

我认为第四点是，我们正努力认识到医疗保健是一个生态系统。那么，我们如何在全球范围内支持一个能助力每个人健康旅程的生态系统？就像水涨船高，这正是第四支柱的意义所在。团队最近的工作之一就是开发类似Medgema这样的模型。

And then I think the fourth one is we're really trying to recognize that health care is an ecosystem play. So how do we support an ecosystem globally that can help everyone along their health journey? Right? Like, a a rising tide lifts all boats, then that's sort of what that that fourth pillar is about. One of the things that the teams have done very recently is to work on models like like Medgema.

你提到了MedPalm和Medgema，Medgema是基于Gemma构建的开放模型，其核心理念是如何创建开发者社区可用的工具。他们可以基于某种基础模型，针对特定任务进行微调，按照路线图推进，甚至可能开发出自己的医疗设备，而无需过多担心许可和知识产权问题。这些都是谷歌尝试解决健康问题的不同方式。当然还有更多举措，我们本可以花几个小时讨论所有不同的计划，但这些是首先要强调的。

So you mentioned MedPalm, Medgema, and I Medgema is an open way model built on Gemma, and the idea is how do you create tools that the developer community can use. They can take some sort of foundation model, fine tune it for specific tasks, have a road map to do so, and be able to even potentially take it as far as creating, like, their own medical device where they don't have to worry as much about licensing and and IP issues. So these are some of the different, ways that Google has tried to, address health. And there's, like, a whole other slew of things. We could spend, you know, hours talking about all of the different initiatives, but those are just some of the things to to highlight first off.

你知道的，听到像谷歌这样的大公司既进行医疗产品的内部开发，又开展开源项目让其他组织能通过不同方式使用技术，总是令人兴奋。这就像拥有一个提升全球医疗科技的总体目标，而不必局限于谷歌内部构建的内容。我个人特别喜欢听到MedJemma这类能让其他团体也能使用的倡议。在谷歌工作期间，有没有哪个项目让你觉得特别有趣或激动？

You know, it's always exciting hearing big companies like Google doing both the internal development of medical products, but then also the open source development that allows for a compounding effect for other organizations and other groups to use that technology and use it in their own ways. And it's like those two like, you have an overall goal of just improving health tech for the world, not necessarily just having to be through whatever Google internally builds. So I I always I always like when I hear, like, MedJemma coming out and initiatives that enable other, groups to also use it. In in terms of during your time at Google, has there been, any particular project that you found particularly interesting or exciting that you worked on?

是的，我认为NetJumbo可能是当前一个很好的例子。它最近才发布，如果大家还没看过，网上有一些很酷的演示展示了它的潜在应用场景。我特别期待它如何能交到医疗保健领域从事各种工作的人们手中。

Yeah. I think, like, NetJumbo is probably a good one right now. That was released relatively recently. If people haven't checked it out, like, there are some really cool demos out there about what you could potentially be thinking about, and how this could work. I'm really excited about how that can get into the hands of people, doing all sorts of different tasks within health care.

我觉得这个项目很棒。作为谷歌整体，我们还开发了许多其他类型的解决方案。比如有个叫'AI协科学家'的项目，核心是如何提升研究人员和科学家解决复杂问题的能力，如何帮助他们激发创新想法，进一步推动创新边界。

So I think that one's awesome. We've also worked on a lot of different other types of solution as as the broader Google. And, you know, one of the things that's out there is something called, like, the AI co scientist. Like, how do you really uplevel researchers and scientists to tackle challenging problems? How do you start helping to brainstorm new ideas that are exciting and further pushing that innovation boundary more.

对我而言，关键是如何以可扩展的方式将这些内容有机连接起来。本质上，这就是从研究到产品化（可能是某种企业级解决方案）的挑战所在。临床医学也存在类似情况——比如如何将实验室验证的成果（比如某种能杀死癌细胞的分子）推进到一期临床试验、三期临床试验，最终上市并观察实际效果，然后通过识别新出现的治疗缺口和适应症演变，将这些反馈纳入生命周期管理，开发新资产或新策略来应对不断变化的疾病模式。

I think for me, a lot of it is how do you connect all of these together in a way that works and can be scaled? Fundamentally, I think that's, like, the challenge with going from research to not so much research, maybe a product, maybe some sort of enterprise offering, and it's there's there's parallels in clinical medicine too. Right? Like, how do you go from something that you can prove in a in a bench top? Right?

这些经验同样适用于技术领域。我认为当前AI和大语言模型正处于'验证阶段'——就像药物研发中需要证明分子有效性的实验室阶段，之后还要经历复杂的转化过程。我们需要理解技术在实际应用中的表现，并根据反馈不断迭代，形成应对快速演变需求的策略闭环。

Like, how do you find a molecule that can kill these cancer cells? And you can prove it on the lab side, but then you gotta take it into phase one trials, then you gotta take it into phase three trials, and you gotta take it in the market and then see what actually happens. And then you iterate on that by understanding where new care gaps come in, where the indication and treatments are evolving, and how do you feed that back into your life cycle management to create new assets or new strategies to tackle an ever evolving sort of disease paradigm. So I think a lot of that holds true as well for for technology. I feel like with AI and the large language models, we're sort of in this prove it phase.

不知道你们最近有没有看到，应该就是今天，《纽约时报》有篇文章讲人们对AI的怀疑态度，还提到了'幻灭低谷'这个词。对吧？所以现在就是要证明实力的时候了。

I don't know if you guys saw recently. I think it was just today. The New York Times had an article about, like, skepticism with AI, and the the word trough of disillusionment was was mentioned. Right? So it's like, prove it now.

我觉得医疗领域也是如此。有了令人兴奋的新资产，就必须证明它的价值。必须确保它能带来可衡量的实际效益。

And I think that's true in medicine too. Right? You have new exciting assets. You gotta prove it. You gotta make sure that it actually has tangible benefits that you can measure.

所以我非常期待看到这一切如何协同作用，来解决我们面临的各种问题。

And so I am very interested in seeing how all of this kinda comes together to tackle all these different problems that we have.

这很有道理。开发一个程序、软件或新工具是一回事——无论是通用技术还是更具体的医疗技术。但真正证明其价值，将模型转化为临床价值，则完全是另一回事。从模型最初开发到实际应用，中间有很多步骤，人们往往意识不到这过程中有多少障碍。

That makes a lot of sense. Building a program or software or having a new tool out there is one thing, whether you're talking about just technology or more specifically health care technology. But actually being able to prove the value of it, translating the model into clinical value is a completely different thing. So there's a lot of steps from when the model is first developed to when it's actually used in practice, and people don't often realize how much how many hurdles there are along the way.

没错。我们希望能用现有的各种工具构建这种连接组织，让人们可以以此为支架，尽情发挥创造力。

Yeah. Exactly. And we wanna be able to build that connective tissue with all the different toolings that we have so that people can use that as a scaffold and build to their heart's content, basically.

确实。谷歌可以做很多出色的工作，开发非常惊人的模型。但通过向公众发布、开源，人们可以在此基础上构建，影响力能增长十万倍。即使这些模型越来越先进，想到它们在未来几个月或几年内能提供的价值和影响力会增长到什么程度，还是很不可思议。不过我好奇模型发布后会发生什么。

Right. I mean, Google can do a lot of great work and develop really amazing models. But by releasing it to the public, by making them open source, people can build off of them and the impact can grow a 100,000 fold. And even as these models get more and more advanced, these capabilities, it's crazy to think about how much they'll grow and how much more impact, how much more value these models will be able to provide in just a few months or a few years. But I am curious what happens after the model is made.

比如说Medgema的下一个版本发布后，谷歌如何改进它、为公开发布做准备？有哪些质量检查措施？当它准备就绪后，如何交到合适的人手中，让他们提供正确反馈，使模型能持续改进并越来越融入医疗生态系统？

Let's say, you know, Medgema, the next iteration comes out. How does Google work on improving it, getting it ready for public release? What quality checks are there in place? And once it's sort of ready to go, how do you get it in the hands of the right people so that they can provide the right feedback and the model can continue to improve and become more and more integrated into the health care ecosystem?

是的。这实际上是一个有趣的挑战：当你构建这些工具时，如何让人们来使用它们？比如，如何对外推广、宣传，找到合适的合作伙伴，找到合适的研究人员获取反馈？这确实是一个既具挑战性又充满趣味的领域。我认为很大程度上在于让医生和医疗创新者参与进来，真正理解当前存在的临床问题，了解这些不同产品的用户群体，然后与技术专家和工程师合作提出可解决的方案。

Yeah. That's actually one of the interesting challenges is when you build these tools, how do you get people to come and use them? Like, how do you externalize, publicize, find the right partners, find the right researchers to gain feedback from? It's actually a really challenging and and interesting space. I I think a lot of it is where people, like, you know, physicians and physician innovators can come in and so, like, really understand sort of the clinical problems that exist currently today, understand the users of these different products, and then work with the technologists and the engineers to come up with ideas that can be tackled.

这些想法可大可小，有些可能是极具野心的突破性构想。我认为我们的核心价值就在于成为连接当下日常临床实践与未来技术应用场景的桥梁。我们有多种渠道将这些工具交到合适的人手中，无论是通过领英等社交媒体、博客文章，还是激发他人使用热情——无论对象是大型机构、公共实体，还是独立开发者或初创企业创始人。关键在于：我们如何赋能他们？因为某个小小的初创想法可能会带来颠覆性变革。

And and these ideas can be small, or they can be, you know, huge and and moonshots worth of ideas. That's where I think a lot of our value is is to be that transition layer between the day to day clinical practice as we know it today versus where we could see it in the future with these tools. And there's all sorts of different avenues to, like, go about and get these tools into the right hands of of people, whether it's through things like LinkedIn and social media posts, blog posts, or getting other people really excited about using this, whether those are large organizations or public entities or just, like, you know, even the individual developer or someone that has a great idea for a start up. Like, how do we empower this? Because that one little start up or idea could be huge and game changing.

听到你们在这方面的差异很有意思。你既有临床背景，现在又在谷歌任职，同时还与斯坦福保持联系——虽然我们通常认为斯坦福更偏向学术机构，但说到创新前沿，它绝对是首屈一指的。我好奇的是，你在谷歌的工作是否与斯坦福教职身份有关联？你是否能弥合传统学术研究与谷歌快节奏研究之间的鸿沟？这两个角色之间存在怎样的联系？

And, it's it's interesting to hear the the differences you have with that. And I think that having a clinical background that you do and then also being your current role at Google, but also being connected to Stanford, which is, you know, what we think about more of, like, an academic institution. Although, you know, when you think about Stanford, you think about it as the most innovation forward, institution. But, I'm curious how your work at Google, if at all, is connected to being faculty at Stanford and if you're able to bridge the gaps between maybe that more traditional academic research side with more fast paced research that's at Google and just what kind of connection there might be between those two roles that you have.

确实。就我个人而言，在研究方面不太常跨越这道桥梁。更多时候是在指导学员时，或是与你这样探讨非传统职业路径的人交流时才会涉及。这正是我非常热衷的事情，也是我参与这次对话的重要原因——因为这条道路确实充满挑战。

Yeah. So personally, for myself, I don't cross that bridge a lot when it comes to research. Where I do cross that bridge a little bit more is when it comes to supervising trainees and talking to folks like yourself about what a path could look like that is, you know, off the beaten path for, physicians. And that is something that, you know, I am very fond of. And, you know, a big reason why I wanted to join you both on this is that that is really hard.

现在路径越来越清晰了。比如肿瘤医学领域就很明确：完成专科培训后，可以选择临床实践一段时间，或者进入行业从事药物研发、医学事务等工作。如今更多新兴岗位向医生开放，比如创新型初创企业或科技公司。我特别乐于帮助学员和其他人理解我们能在医疗技术演进中发挥作用的领域。当然，每个人的情况都不尽相同。

It it's getting more clear. It's definitely been more clear for medical oncology where the path has been, you know, you go into oncology, you graduate fellowship, and you can either practice for a little bit, or you can go into industry and do drug development or medical affairs or what have you. I think these roles now are opening up more where physicians are going more innovative start up y roles or coming into tech. And that's where I just really love helping, like, the trainees and others understand sort of where we can play and have a voice in the evolution of health technology. And I think it's different for other people.

对吧？有些人可能担任着连接学术界与产业界的研究角色。但归根结底，这取决于你如何定位自己。部分因素也取决于合同条款——哪些能做，哪些不能做？

Right? Like, other people might have research roles that are bridged between academia and and in an industry or whatever their role is. But, you know, it all comes down to kind of where you wanna position yourself. Some of it comes down to just, like, what does your contract look like? What are the things that you can or can't do?

还有利益冲突问题。所以基本上，各人有各人的选择。

What are the conflicts of interest as well? So to each their own, basically.

这个观点非常好。我认为医疗保健和医疗行业越来越意识到，成为医生后还有非传统的发展路径。你可以进入科技行业、初创公司、咨询或风险投资领域。越来越多的医学生、住院医生和早期职业医生正在探索这些机会，了解外面的世界。

That is a really good point. I think it's becoming more known in the health care and the medical industry that there are paths you can take after becoming a physician. That are not, quote, unquote, traditional. You can go into tech or startups or consulting or venture capital. I think more and more medical students, residents, and early career physicians are exploring those opportunities and learning about what's out there.

但与此同时，由于需求增加而供应相对稳定，争取这些机会也变得越来越有竞争性。因此我认为，任何能提高透明度、让更多人了解这些机会的事情都值得我们去做。不过回到你的职业路径，我知道在加入谷歌之前，你曾在几家初创公司工作过，比如Grail和北京的公司。

But at the same time, because of the higher demand and about, you know, steady supply, it's becoming more and more competitive to seek out these opportunities as well. So I think anything we can do to increase clarity to make the opportunities that are out there more known is something we should definitely do. But going back to your path, I know you've before Google, you worked at a couple of start ups. You worked at Grail. You worked at Beijing.

初创公司的环境在资源、权限、职能和团队动态方面显然与谷歌这样的大型科技公司截然不同。我很想听听是什么促使你从初创公司转向谷歌的？是因为工作内容？团队氛围？还是发展机会？

The start up environment is obviously very different in terms of resources, access, the functionality, the team dynamics compared to a big tech company like Google. So I'd love to hear more about what prompted you to go from the start up space to pivot into Google. What was it about the was it the work? Was it the team dynamics? Was it the opportunity?

是什么促使你做出这个改变？在这两类公司中，你在工作内容和经历方面注意到的最显著差异是什么？

What prompted you to make that change? And what are the biggest difference you've noticed in terms of the work and the types of experiences you've had at both types of companies?

是的，我会从几个不同角度来回答。我之前的工作很大程度上仍聚焦于科学和临床发展。比如我们如何运作科学机制，向患者推出值得信赖的新成果？

Yeah. And I'll answer that a couple different ways. So a lot of what I did in my previous roles was still focused on essentially science, and clinical developments. Right? Like, how are we running the scientific machinery to push new things out to patients that we can trust?

这个主题在谷歌依然成立——我们如何将值得信赖的产品交到用户或开发者手中。实际上，拥有不同岗位经历对我很有帮助，让我能理解初创公司与大型企业各自面临的挑战。在大型组织里，'治理'这个词经常被提及，有时人们会本能地反感它，但有时这种决策架构确实有助于做出关键决定。

That theme is still true at Google. How do we get things out into the hands of users or developers that are trustworthy. I think, actually, having had different roles was really helpful so that I can sort of understand the challenges that existed in a start up versus a really big company. This word governance is thrown around all the time in these big organizations. And, you know, I think for for good reasons, sometimes people have a gut reaction to it.

理解这种机制何时能提供帮助、何时可能成为阻碍，以及如何应对各种不确定性，对我来说非常有益。另外我也想特别指出，谷歌在医疗保健领域的角色有些独特——为什么谷歌会雇佣医生呢？

But sometimes it's actually good to have that infrastructure and that decision making organization to to help make really critical decisions. And understanding, like, where that can be helpful, where it could be potentially a hindrance, and how to navigate through a lot of different uncertainty that can come up has really been helpful for me. And so I I do also wanna recognize, like, Google, you know, is is a little bit unique, especially for a role in health care. Right? Like, why does Google have doctors?

确实存在一些模糊地带，比如我们具体做什么以及如何最好地帮助组织，这个领域发展太快了。我从创业世界学到很重要的一点就是：如何适应变化？如何在保持自身和目标灵活性的同时，还能达成想要的结果？说到底，我们都得对自己想从事情中获得什么保持一点自私。

And there's certainly ambiguity with, like, what we do and how we can best help organizations, and it's such a fast moving field. And so I think one thing from the startup world that I really took was, like, how how do you adapt to change? How do you be flexible with yourself and with your goals but still accomplish what you want to accomplish? Right? Like, at the end of day, we all have to be a little bit selfish with what we're looking to get out of things.

对我而言，重点始终在于：哪里能学到最多？哪里能让我真正深入钻研、撸起袖子实干、全身心投入，真正理解我被聘用要做的工作？只要这个条件满足，其他外界杂音我都能接受。我认为这个标准对很多人都适用，而这也帮助我走过了整个历程。

For myself, it's always been about where can I learn a lot? Where can I really sink my teeth into, roll up my sleeves, get dirty, and just, like, really understand the job that I was hired to do? And if that, for me, was there, then, you know, I was, like, I was fine. And whatever was happening, like, outside noise wise, like, that's okay. So I I think that that test will hold true for for a lot of different people, but that helped me throughout the journey.

确实，在谷歌的经历对我也是如此——我仍在不断学习，这里有太多出色的同事，无论是临床、非临床还是技术岗位等等。这是一段绝佳的学习经历。

And certainly, it's true here at Google for myself where I'm still learning from a ton, and we have amazing individuals here whether they're clinical, nonclinical, technical, etcetera. It's been a wonderful learning experience.

是的，我觉得这对你来说很独特。我还想谈谈你之前提到的关于为对临床外活动感兴趣者提供指导的事，因为在临床工作之外，我们确实很缺乏这类引导。我敢说Pranav也会同意——在学术环境中提出这些话题，某种程度上甚至让人觉得是禁忌。就像我现在这个职位，申请住院医师时都得字斟句酌。像你这样有经验的前辈作为导师非常重要，否则我们就会因为害怕表达而找不到引路人。

Yeah. And I think it's so unique for for yourself. And I also wanted to touch on on what you had said earlier about being a mentor for those that have interests in extraclinical activities, I guess, you know, on top of things that are clinical because I think we really lack that. And it's it's often I'm sure Pranav can agree with this too is bringing those things up, especially in the academic setting, almost felt like taboo in a way where I felt like, especially this you know, even this role that I'm in right now, I have to word it really carefully when I, like, apply to residency and all that. And, you know, people like you that have that experience, it's super meaningful to have mentors like that because otherwise, you kinda just get you're just kinda scared to word it and don't really know anyone that's already actually walked that path.

真的很感谢这一点。我还想探讨的是，拥有临床背景确实能带来独特的视角。传统观念里——就像我医学院早期认为的——你选了什么专科就注定要从事那个领域，要么走学术路线要么私人执业。但现在完全不同了。

So do appreciate do appreciate that. But one thing I I wanted to touch on too was, I think, especially having a clinical background, it's it's a really unique exposure to have because traditionally, like, probably in the earlier part of medical school, I was always like, oh, you know, you get your specialty. You're gonna work in that specialty, you know, you you can go academic or private. Those are, like, your career paths. And now it's like, no.

你可以先接受临床培训，从事临床工作，然后决定暂时不想做临床，转去非临床岗位。你依然保留着临床培训背景，随时可以回归。这就像根据人生不同阶段来平衡选择。我很好奇你如何看待自己的临床培训与谷歌角色的关系——既对创新充满热情，又保持着对临床医学的兴趣？你如何考虑在不同时期侧重不同领域，并平衡这两者？

You could go in, get your clinical training, work clinically, decide, I don't really wanna do clinical stuff right now, take a role somewhere else that's nonclinical. You still have the clinical training, can go back and and do that more time, and it's almost this this balance of doing what you feel like given the seasons of your life. I'm curious how you look about look at, you know, your clinical training and your role at Google, kind of this interest in innovation, but also this interest in clinical medicine, and how you look about, you know, thinking about when you might wanna do more of one or more of another, and how you think about striking that balance between between the two sides.

是的，我想回应当你提到的第一点——关于寻找非全职临床医生的导师关系。我完全理解并感同身受，那段经历至今记忆犹新。就我个人而言，很幸运一路上都有导师提携。

Yeah. I wanna comment on the first point you made about sort of the the mentorship and finding connection outside of people that are still practicing medicine full time. I certainly sympathize and empathize with that. I remember that journey very, very clearly. I think for myself, I was really, lucky in that I had mentors that were able to foster me along the way.

我认为他们意识到当时正发生一种范式转变，我们需要能够相对轻松跨越不同领域、进行这种情境转换的人才。所以我全力投入其中——当我找到擅长这方面的导师时，我就紧紧跟随他们。他们从临床、科研乃至创新层面都给予我极大培养。当我能够将自己的想法和发展方向表达得越来越具体时，我惊讶地发现获得了项目组（特别是我的研究员项目）如此多的支持。他们甚至允许我在原有研究员项目之外，额外参与这个完全不同的特殊项目，这让我非常兴奋。

And I think they recognized that there was this paradigm shift sort of happening where we did need people that could cross different zones relatively easy and and do the that sort of context switching. And so I really leaned into that. Like, when I found mentors that, like, were were good with that, I, you know, latched on, and they really fostered me from clinical, from a scientific, and even from an innovation perspective. And I actually found that, you know, when I was able to get more and more concrete about some of my ideas and where I wanted to go, like, I was surprised the amount of support I ended up having from my program, especially my fellowship program. And, you know, they even allowed me to go off and, like, do this, like, totally weird different fellowship on top of my fellowship, which was which was really exciting for me.

关于你第二个问题——如何平衡临床实践与产业界工作？我认为这是个动态演变的过程，取决于个人具体情况。最大的挑战往往出现在医学院毕业时：你接下来要何去何从？

And to your second question about, like, how do you balance it, and where do you see kind of the clinical practice versus working in more of, like, the industry side? I think that's ever evolving, and that changes depending on your personal circumstance. And the biggest challenge that tends to come up is when you finish medical school. Like, what are you gonna do from from there? Right?

有些人会选择不做住院医师培训，直接进入咨询或其他领域。之后的问题就是：完成培训后怎么办？住院医师结束后要不要做研究员？研究员项目结束后又该何去何从？

Like, some people will opt not to do residency and go into consulting or something else. Then it's about, like, after you finish your training. Right? After you finish residency, are you gonna do fellowship? And after your fellowship, like, what's next on the horizon?

所有这些选择都会因你人生阶段的不同而有所差异。就我而言，我妻子是儿科医生（上帝保佑她陪伴我走过这段旅程），她有着稳定的事业。我们曾坦诚讨论过：我的职业发展方向是什么？如果家庭中有人提供稳定收入来源，我是否可以承担更多风险？

And all of those might reflect differently depending on what stage in life you are in as well. And so for myself, my wife is a pediatrician, and, you know, god bless her because she's seen me through this journey. She's had a stable career, and we had blunt discussions, right, about, like, where is this going? Like, where is my career going? Am I okay to take on a little bit more risk if someone else in the family is doing something that's more stable in this steady stream of income.

这种权衡在我做决定时至关重要。当时我们刚开始组建家庭，灵活性对我同样关键。这促使我选择留在产业界，但又不愿放弃临床实践。我至今仍热爱面对患者的工作，虽然是以志愿者身份无偿进行。

And so that calculus was really important, at the time when I was deciding. We also were, you know, starting to build a family, and so that flexibility was really front and center for myself too. And so that factored into my decision to stay on the industry side, but I didn't wanna let go of clinical practice. Like, I I still really love being in front of the patients, and I I did it, like, as a volunteer basis. Like, I you know, I don't get paid for it.

这纯粹是出于我对患者的关注，以及处理复杂肿瘤病例的兴趣。我持续这么做的原因一是仍然乐在其中，二是考虑到未来可能出现的转变——毕竟产业界存在更多不确定性，你无法预知初创公司是否会失败。

This is just purely out of my interest to be with patients and working through tough oncology cases sometimes. And I think why I continue doing is there's one, I I still enjoy it. The second piece is, you know, at some point, like, this might switch. Right? Like, reality with industry is it's a little bit of a riskier endeavor because you don't know if that startup you're in gonna fail.

你无法预测是否会有大规模裁员，宏观经济会如何变化，所以必须有所准备。对于仍保持临床医术或相关技能的人而言，这就像一份保障。也有人通过兼职值班赚取额外收入，这个选择始终存在。

You don't know if there's gonna be big layoffs. You don't know what's gonna happen with the, you know, macroeconomics of everything, and so you have to be a little bit prepared. And, you know, I think for people that still practice clinical medicine or have that skill set, it's something to fall back on as well. And there's always people out there too that, you know, wanna pull in a little bit extra money, do some moonlighting shifts, and that option is open too.

你说要有点自私，但同时却在免费做肿瘤医生，这确实有点讽刺。我也不知道。

It's a little bit ironic that you say you have to be a little bit selfish, but at the same time, you are working as a medical oncologist for free. So it's a little bit ironic. I don't know.

是啊。我觉得这概括了很多医学工作者的状态。比如经历医学院、住院医师培训，奉献多年光阴，长时间工作，本质上就是为了完善医学的艺术与科学。

Yeah. I think that's, a lot of medicine in a in a nutshell too. Right? Like, going through med school, residency, giving years of your life, working really long hours to essentially, you know, perfect the the art and the science of medicine.

但我100%同意你说的。没有绝对正确或错误的道路，一切都取决于你的人生阶段、当前兴趣、可用机会，以及你对未来一年、五年、十年的规划。但也要为观点转变或中途转向的可能性做准备。这些都是需要考虑的，做这些决定从来都不容易。想想我自己的人生，就有太多一年前根本意想不到的机遇和经历。

But I 100% agree with everything you said. There is no one right or wrong path you can take. It all depends on where you're at in your life, what interests you at the time, what opportunities are available to you, where do you think you'll be a year from now, five years from now, ten years from now, but also get a plan for what if your point of view changes or what if you decide you want to pivot at some point. So it's all things you need to consider, and and there's no easy way to make those decisions. Even just thinking about my own life, there's so many opportunities or things that I've done that I never would have expected to do just a year prior.

一切都取决于当我主动探索时，哪些机会之门会为我敞开。

It just all depended on what opportunities, what doors opened themselves when I took initiative in trying to explore what was out there.

没错。而且我要说，你得到的任何工作都不会是最后一份。趁职业生涯早期多去探索。

Yeah. And I will say any job that you get will not be your last job. Right? Like, explore. You know, the earlier career is the time to to do it and to explore.

我从未想过会进入谷歌工作。如果在医学院或进修期间问我，我绝对想不到会有今天。部分源于际遇，部分源于我自己的选择，但更多是机缘巧合。

Never would I have thought I would be at Google. Like, if you asked me in in med school or in fellowship or along the way at all, I never would have envisioned that this would be my job today. Some of it is out of circumstance. Some of that circumstance was influenced by myself along the way, but a lot of it was was not. Some of it is just timing related.

对我个人而言，有句话特别共鸣：有人告诉我他们只是敲门看看哪些门会开，如果听起来有趣就直接进去看看门后有什么。我一直遵循这个信条，并相信自己的直觉。

And just for for myself, something that really resonated with me was someone told me that they just knocked on doors, saw what opened. If it sounded cool, they would just go right through and then see what was on the other side. And and I've kind of followed that mantra and trusted my gut along the way.

这种生活态度很棒。我是说，你永远不知道一次对话或偶遇会带来什么，永远不知道它会打开哪些门。我一直相信，交谈总不会有坏处。至少，你会学到新东西，获得新知识或新视角。

That is a great way to approach life. I mean, you never know where a conversation or a random meeting may lead to. You never know what doors it may open. And that's something I've always believed is that it can never hurt to have a conversation. At the very least, you'll learn something new and walk away with some new knowledge or some new perspectives.

这也是我们创办这个播客的原因之一——希望能与像你这样出色且充满启发性的人进行有趣的对话。

So that's one of one of the reasons we started this podcast to have interesting conversations with really amazing and inspiring people like yourself.

是啊。说实话你们两位都远远走在我当年的阶段前面。我在医学院承受沉重学业负担时，根本没有像你们这样参与外部活动，还同时开展这么多酷项目。

Yeah. Yeah. And the both of you are, like, you know, way ahead of, like, where where I certainly was at this stage. Like, I was not engaging externally and having all these really cool projects in addition to the big academic burden that you're taking on with medical school.

我们真的很感激你这么说。这段旅程至今很精彩。不过我很好奇，回到你在谷歌的时光，你日常的工作状态是怎样的？是经常深入技术细节直接与工程师编程人员协作，还是更多从宏观层面参与谷歌健康项目的整体方向和战略制定？

We definitely appreciate that. It's been a great journey so far. I am curious, though, going back to your time at Google, your work at Google, what does the average day or average week look like for you? Are you typically getting granular, getting your hands dirty working with engineers and programmers directly? Are you more at a high level working on overall direction and strategy of Google's health initiatives?

你典型的工作日程是怎样的？你觉得未来可能会如何演变？

What does your typical schedule look like, and how do you see that potentially evolving over time?

对，这可能既是优点也是缺点——实际上我几乎没有过典型的工作日。必须保持高度灵活，事情总是瞬息万变。不同团队有不同截止日期，临时会议不断出现，不同机构的领导会随时约谈，必须随时准备应对这些变化。

Yeah. And that's maybe something that is either a pro or a con depending on how you look at it, which is there probably is no typical day that I've seen, actually. I've just had to be really flexible, and things change on the fly all the time. Different teams I'm working with will have different deadlines and different meetings will come up. Different, you know, leaders will wanna talk at different organizations and just to be ready for all of that and to be able to adapt on the fly.

所以我有时会与开发人员一起工作，评估大语言模型的输入输出；有时则与大型机构领导层开会讨论如何合作开展激动人心的项目；还有些日子要赶论文、参加研讨会，或者像现在这样有幸与你们交流。

And so some of my time is working with, developers and looking at, you know, input and output from LLMs and evaluating it. Right? And, some other days, I'm sitting in front of big organizations with their leaders talking about, hey. How how are how can we meet together and and do something really cool and exciting? There's other days where, you know, I'm trying to catch up on papers or going to conferences or getting the opportunity to talk to to, you know, the both of you here as well.

一切都在变化。每一天都略有不同，但总体主题就是要做好准备，然后适应任何可能出现的情况。因为这个组织非常庞大，比如，我不可能一个人掌握所有与肿瘤医学相关的事情。但当然，总会有人主动联系说，嘿。

So everything is changing. Every day is a little bit different, but the theme overall is, like, you know, being ready and then being adaptable to whatever the situation may hold. Because this is such a large organization. Like, there's no way that I myself can be on top of, like, every medical oncology related thing, for example. But, you know, of course, someone will reach out and be like, hey.

我现在真的需要帮助。你能提供什么支持？我会说，你知道吗？好吧，我会尽力调整并帮助你，这样我们就能作为一个团队共同成功。

I really need help on this right now. Like, what can you offer? And I'll say, you know what? Okay. I'll try to adapt and and help you so that, you know, we can succeed together as a unit.

这非常有道理，尤其是在谷歌这样的地方。我认为事情发展得太快，同时进行的项目太多了，变数难以预测。你之前提到，每当遇到机会时，你总是好奇这个机会能给你带来怎样的学习和成长，无论是个人还是职业层面。我很好奇，在即将结束时，你当初加入谷歌时是怎样的情景。

And that makes a lot of sense, especially at a place like Google. I think it's it's things move so quickly, and there's so many initiatives that are going on concurrently. The variability is unpredictable. When you you know, you mentioned earlier that whenever you go into an opportunity, you're always curious about what that opportunity is bringing to you in terms of learning and growth, you know, personally and and career wise. I'm curious, you know, as we wrap up, what that looked like coming into Google.

比如，你刚加入这个职位时，心里想着要学习哪些东西？然后，在你在这里的这几个月里，这些想法发生了怎样的变化？你如何看待这个职位与你整体职业生涯的契合度，以及你希望从中获得的学习？

Like, what were you coming into the role thinking about these are the things that I I really want to learn coming in? And then, you know, just within the the months you've been here, how has that changed, and how do you see this role, I guess, fitting into your overall career and the learning that you hope to take take from it?

我一直渴望从事更具规模效应的工作。最初我从事的是学术性肿瘤医学，那曾是我的思维模式。对吧？所以关注患者层面的影响，做研究，推进临床试验。

I've had this itch to just work on things that scale more and more. So I started in, you know, academic medical oncology. Like, that was my mindset. Right? So affecting things at the patient level, doing research, advancing clinical trials.

在临床试验领域，从学术角度来看，你推动的大部分项目往往是早期阶段试验。而让我对工业界药物开发产生兴趣的是全球性三期大规模随机研究。所以我转向了那里，因为我想了解这些科学成果如何规模化，为患者开发出新颖的治疗方法。后来这又把我带到了另一个阶段，我开始思考如何优化流程，因为我们的数据运作存在很多低效问题。

In clinical trial world, most of the things that you're driving, from an academia perspective tend to be earlier phase trials. And so what got me interested on industry side drug development was global phase three large randomized study. So I I pivoted there because I was like, oh, I'm really interested in, like, how this stuff scales from a science perspective to develop new and exciting treatments for patients. Then it took me to a different spot where I was like, oh, well, how do we make this better? Like, there's a lot of process and inefficiencies with the way our data works.

我在想，有没有一个组织和我有相同的兴趣？于是我就去了那里。之后的情况是，好吧，我在这里学到了很多。我如何将这些经验应用到像Grail这样的公司？他们正在全球范围内对数万名患者进行多癌症检测的试验。

Like, where is there an organization I can go that has the same interest? So went there. Then it was, okay. Well, I've I've learned a lot here. How can I apply some of this at a company like Grail that's doing multi cancer detection in essentially a global scale for, like, tens of thousands of patients on a trial?

于是我就去了那里。然后很自然地，我就想，好吧，这还能发展到多大？当然，恰好在合适的时机出现了合适的机会，那就是谷歌，我们如何为所有这些不同的组织提供工具，开发可扩展的解决方案，并在全球范围内产生影响，无论这些方案是否真的与药物研发、癌症或癌症筛查相关。对吧？

And so then I went there. And then, naturally, I was like, okay. How much bigger can this get? And, of course, like, the right opportunity came up at the right time where which was Google, which is, well, how do we give all of these different organizations the tools to develop solutions that scale and drive impact globally regardless of whether it is actually related to drug development and cancer or cancer screening. Right?

从健康的角度来看，在我们共同所处的这个生态系统中，还有更多重要的事情。

There's so much more out there from a health perspective that is important in this ecosystem that we're all sort of sitting in together.

是的，这是个非常精彩的回答。关于这一点我有很多想说的，因为我在临床实践方面思考了很多，关于如何平衡临床实践与技术在更广泛范围内的影响。首先，回到临床试验这个话题，讨论它的学术层面很有意思，对吧？

Yeah. That that's an incredible answer. I I have a lot to say about this because I've thought a lot about this in terms of the the clinical practice, the balance between that and and kind of these broader scale impacts of technology. I think first, you know, just going back to the clinical trial thing, it's it's interesting to talk about, you know, the academic side of that. Right?

比如，我最近在读关于免疫疗法的资料。我在日本的一个博物馆时，他们谈到这是上世纪九十年代的一个发现，比如PD-1受体。而现在我们身处2025年，我记得第一个检查点抑制剂是在2014年问世的。这些创新和发现，几乎花了二十年的时间才真正应用到患者手中，当时很难看到它的影响。但如果你想想那些参与药物研发的人，最终你影响了数量庞大的患者，虽然你并不认识他们，但你确实为社会带来了广泛的影响，虽然不知道具体帮助了谁，但知道你帮助了如此多的患者。

Like, I was reading about immunotherapy. Recently, I was in Japan at a at a museum, and they were talking about how, know, this was a discovery back in the nineties of, like, the p d one receptor. And and here we are, you know, in the 2025, and I think in 2014 was when the first checkpoint inhibitor actually came out. So these these innovations that have and discoveries that have come out, you know, over two decades ago almost took that long in order to actually get to the hands of patients, and it's hard to see that impact then. But if you think about anyone that was working on that drug development path, ultimately, you're impacting an incredible amount of patients on this broad scale that you don't really know the people you're impacting, but it really is this broad scale impact that you're able to give to society, not necessarily knowing everyone that you're helping, but knowing that you are helping such a broad, you know, amount of patients.

另一方面，在医学领域，尤其是如果你没有工作到极限的情况下，能够看到你影响的人，每天回家时知道，好吧，我为这个人做了些事情，对患者产生了更深的影响。这种影响的广度与深度之间的平衡，我认为作为一名从事创新的临床医生是件非常美妙的事情，因为你既能通过与患者的互动产生深刻影响，也能通过解决社会问题产生广泛影响，比如在谷歌这样的地方开发模型，其他人可以利用这些模型创造医疗干预措施，同时也能在内部实施这些措施。我觉得你在这两者之间找到了很好的平衡。

And then there's the other side where in medicine, it's it's nice, especially if you're not, you know, in a place that you're working to a toxic limit, but you're able to see the people that you're impacting and come home every day knowing that, okay. I I did something for this person and had this, like, deeper impact on a patient. And this this this balance of, like, the breadth of impact versus depth of impact, I think being a clinician working in innovation is such a beautiful thing because you get to have both flavors of the really deep impact that you get with patient interactions and the help that you're able to provide there, but also the breadth of impact by working on these societal issues and place like Google being able to develop models that other people are then able to take to create medical interventions, but then also be in a place that does them in house. I feel like you get such a great balance of of both.

是的，你完全说中了我为什么在目前角色的各个领域做这些事情的原因。

Yeah. You hit the nail on the head as far as, like, why I do what I do in all these different spheres of my current roles.

是的，太棒了。贾斯汀，今天聊得很愉快，非常感谢你的时间。关于如何在临床领域发展职业生涯，同时保持这一领域并进一步探索创新和产业方面，以及如何利用你的专业知识，我们听到了很多深刻的见解。如果你对那些考虑进入产业的临床人士有任何建议，我们很乐意听听。

Yeah. Awesome. Well, Justin, it's been great, you know, talking today, and I really appreciate your time. A lot of really good insight talking about what it's like to be on the clinical side and go through your career and still maintain that side, but look more into the innovation and industry side of things as well and how you can leverage your expertise. We'd love to hear if you have any advice for people that are clinical thinking about going into industry.

我们的听众群体多样，既有正在接受医学培训的人，也有对医学更偏向建设性方向感兴趣的人，但我们很想听听您基于自身经历对医疗创新者有什么建议。

Our listeners have you know, they vary from people that are are in medical training versus people that are just interested in in medicine on the more builder side, but we'd love to hear about any advice you might have to medical innovators based on your own journeys.

是的，完全同意。我认为当前的学员们面临一个有趣的问题，在LLM时代，各种新事物层出不穷，当然所有东西听起来都显得非常自信。对吧？而大家都在担心幻觉问题。

Yeah. Absolutely. I I think the current trainees that are out there, they're they're faced with an interesting problem, I think, with the era of LLMs, which is, you know, there there's all of these different things coming out, and everything sounds really confident, of course. Right? And everyone's worried about hallucination.

所以我想说，要保持批判性思维。对吧？当然要以健康的方式质疑事物，但要始终保持质疑态度，真正理解是什么驱动了LLM的输出。要真正理解技术背后的运作机制。一旦你能够解锁这种能力并保持批判性思维，就能将其应用到任何技术领域。

So I would say, you know, maintain that that critical thinking. Right? Like, question things in in, of course, a healthy way, but always be questioning things and really understand, like, what is driving the basis of, like, an LLM output. I'm really trying to understand the mechanism undergoing behind whatever the technology is. And once you're able to kind of unlock that and keep that critical thinking skill available, you can apply that regardless of what technology it is that you're working on.

我想说的第二点是不要害怕探索。勇于展现自我，虽然这可能会让人很不舒服，特别是要走出临床的舒适区。当然这也可能伴随着失败——我几乎不想用'失败'这个词，因为我认为在这个过程中总能学到东西。有时你全力以赴却未能如愿，这确实令人沮丧。但请记住，要继续尝试。

I think the second thing that I'll say too is, you know, don't be afraid to explore. Put yourself out there, and it can be really uncomfortable, especially going beyond the clinical walls. And, you know, it can be fraught with failure too, and I I almost don't wanna use the word failure because I think you can always learn something along the way. And and there can be times where you put yourself out there and you don't get what you want, and it can be really dejecting. But, you know, keep trying.

坚持下去。我自己在这条路上就多次面临这种情况。有些机会我申请了两三次都没成功，但事情总会有转机。你会找到方法让它实现的。要坚定不移。

Keep doing it. I've certainly been faced with that many times myself along the way. There's things I've applied for two, three times and never gotten it, but things will work out. You will find a way to make it work. Be be adamant.

对自己的能力保持信心。是的，有时候不要害怕承担一些风险，要明白：即使事情没成功，我还有别的选择，还能学到新东西。

Be confident in your ability. And, yeah, just don't don't be afraid to lean into some of the risks sometimes and understand, hey. If things don't work out, there are other things I can do. There are still things I can learn.

这些建议太棒了。永远值得去尝试新事物、冒险一试，因为你永远不知道它会带你走向何方。即使今天遭遇失败或拒绝，明天可能就会为你开启全新的机遇或道路。

That is phenomenal advice. It's always worth shooting your shot, trying something new, and taking a risk because you never know where it may lead. Even if you have a failure or rejection today, it could lead to a brand new opportunity or a whole new path for you tomorrow.

是的。如果你们中有体育迷的话，都知道有时候关键在于大量出手。对吧？就像尽可能多地射门，你只需要成功一次就够了。

Yeah. If any of you are are sports fans, you know, sometimes it's about being a volume shooter. Right? Like, take all the shots on goal that you can get. You just need one to work out.

没错。贾斯汀，再次感谢你今天加入我们。能了解你的经历真是非常棒，我们很期待继续关注你的职业生涯以及谷歌的健康计划。再次感谢。

Right. Well, Justin, again, thank you so much for joining us today. It's been phenomenal getting to know you, hearing about your experience, and we're really excited to continue following your career and also Google's health initiatives. So thanks again.

是的，我也一样。非常期待看到你们电视台如何发展以及你未来的成就。

Yeah. Likewise. Really excited to see how the the TV you grow and what you end up doing.