cover of episode Dan Doctoroff on Living with ALS and Building the Future

Dan Doctoroff on Living with ALS and Building the Future

2023/11/16
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Dan Doctoroff discusses how his ALS diagnosis has altered his perspective on life, focusing more on the present and less on the future, while maintaining an optimistic outlook and a commitment to finding a cure for ALS.

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Hi, everyone, from New York Magazine and the Vox Media Podcast Network. This is On with Kara Swisher, and I'm Kara Swisher. And I'm Naima Raza. Today, we're going to play you an episode with former New York City Deputy Mayor Dan Doktoroff. Yes. He is the guy who worked relentlessly under Mayor Mike Bloomberg to give us Brooklyn Bridge Park, the new Yankee Stadium, which I've never been to. Have you? No. No.

I have not. More subway lines and Hudson Yards, which is good for business, but bad if you don't like malls in New York City. Yeah. For this, we forgive him. But Carrie, you know him well, more from his sidewalk labs and Bloomberg Media days, right? Yeah. He's someone who was one of the more frenetic...

I have met in not just public life, but media and worked for former Mayor Bloomberg at Bloomberg. He ran the company. He also worked on a lot of digital stuff. And he was one of the media people that was very early to understanding digital or at least accepting it because he's got a really curious mind.

and, you know, peripatetic mind, which I really appreciate in a media executive. And I, you know, he's not also an easy person necessarily all the time. He was super aggressive and all kinds of stuff, but he gets stuff done. And I think we don't pay enough attention to people who are not necessarily the, you know, the Bloombergs or the musks or the, the big front people, but this guy was highly effective in his life. And now he's facing a really terrible diagnosis. Yeah.

He suffers from ALS and he's doing a lot of work to try to find a cure. And so I thought it would be great to talk to him. So Dr. Off went on from being deputy mayor, this number two in command, as you said, to running this media company, which is broader than a media company, does terminals.

And then he went off to Silicon Valley venture, actually, a little bit, which is not uncommon for former government officials. He worked at Sidewalk Labs, which was this Google venture focused on building new cities. Yeah. How do you create the modern city, if possible? It can be really interesting because we do have to change our cities because most people will be living in cities. What are cities? And I appreciate the effort. I'm not sure it worked as well as they had hoped.

I actually applied for a job there, by the way, at CyWalk Labs. Oh, did you? Yeah, because I had interned at Google and then I'd worked on city development in Asia. Cool idea. Yeah, it was a cool idea. I didn't get the job. I told Dan afterwards. He said he should have hired me. Maybe I could have fixed Toronto for them. I don't think so. The arguments about cities have been going around, but we have to be thinking hard about how we live in a city going forward, not just from technology, not using technology, using how we move people around, using technology.

Et cetera, et cetera. And we want to talk to him about New York in particular, but also about this futuristic city, which is this obsession of the tech luminati, which is like, you know, Elon's building these two cities out over in Texas, which are not really future cities, Snailbrook and Starbase. They seem more like Renaissance company towns.

I guess, yeah. And then there's the Flannery Associates group with Mike Moritz and others who are building that city in Northern California. Do you want to say anything about that? No, I don't. The less said, the better. We'll see. We'll see. They're locating it in a place called Vacaville, which means cowville. And there's a lot of cows there and a lot of cow shit. A lot of cow shit. Does that have meaning for you, Kara? No, it's just a very windy place.

cow poop area of California, but whatever. Sounds good. They're suing the farmers because they felt the farmers had overcharged the billionaires. Oh, well, too bad. If you want to build a city, it costs. You know, it's just interesting. I still find it interesting. There was Brasilia. There's all kinds of people trying to do this over history. Dubai is a totally invented city. And it seems to be working for them. Yeah.

But they had a lot to subsidize it. But Doctoroff, when he helped build New York to what it is today, obviously had a lot of vision and also had a reputation for being, as you said, aggressive, a tough cookie. I don't think people call men tough cookies, but pretty intense boss. Yeah.

Lately, he's changed a lot in large part because of this ALS diagnosis. Yeah. You know, the thing is he is tough, but a lot of people urge me to do this because they love him. You know, he yelled at me more than anybody, but he was amazing. So, you know, I don't think that that's the way you should be necessarily, but I do think he's really someone who's taking on ALS the way he's done his whole life. So it's a different kind of aggression, of course. He's...

He's trying to figure out a way to solve what is a really terrible illness and is so debilitating. And to see someone like this who is so lively in so many ways be diminished every day is probably very hard for his friends and family. Very much. And ALS is a progressive neurodegenerative disease that affects the nerve cells in the brain and all along the spinal cord. And a lot of people know it as Lou Gehrig's disease, the famous Yankees.

He was the famous Yankees guy. He was the great baseball player and he had it and died of it and gave an amazing speech when he retired. But it's a centuries-long curable disease that affects many people, Stephen Hawking being another example.

But apparently someone new is diagnosed with ALS every 90 minutes, which I really didn't know. Although my aunt has ALS. I'm so sorry. Yeah, not genetic, but rare form. And it is really hard because it's a disorder that she's lost her voice very early, but it also heightens your emotions. Everything is intensified. I don't know if that's from ALS or from the medications, but...

But it's certainly hard to see someone's life change so precipitously and so dramatically. But Dan is working very hard to change that. So let's take a quick break, and we'll be back with Dan Doktoroff. Okay, Dan, good to see you. So let me start off by asking the obvious question. How are you doing? I'm doing great.

You know, it's two years since I was diagnosed, and I'm still pretty independent. You know, I'm progressing, as they say. My hand doesn't work so well. My foot, my hip, my breathing is labored. But I really haven't had a bad day since I was diagnosed yet.

It's good to be an optimist. Yeah, you really are. Wow. You remind me a great deal of my brother who has muscular dystrophy. He has the same attitude. He's the sunniest person I know, which is really, I think, helps his illness, although it's degenerative in any case. Why don't you explain what ALS is? Some people may know it better as Lou Gehrig's disease, but explain what it is first. Yeah. So ALS is a disease of the motor neurons.

And those are special cells in your brain and spinal cord that send signals to the muscles to move. And for a variety of different reasons, those motor neurons die. And when they die, they can't send the signals to the muscles to move.

And so the patient gets increasingly paralyzed. And what eventually kills the patient is respiratory failure because the muscles that help you breathe don't work anymore.

The average patient, and this is really tragic, dies within three to five years after diagnosis. Some people last obviously longer, like Stephen Hawking. But we are making incredible progress toward treatments. We're not there yet, but we are making incredible progress. Yeah.

Okay, so you told Justin Davidson at Curb that you declined to get tested for genetic predisposition, that both your dad and uncle had ALS. Only after your diagnosis did you discover you did not, in fact, have a genetic predisposition. That was confusing to me. Talk about the revelation, how you came to terms. My dad, my uncle, and actually their first cousin, all had the same genetic mutation that causes ALS,

or frontotemporal degeneration, which is the disease that Bruce Willis was just diagnosed with. ALS and FTD are on the same clinical spectrum. So I never wanted to be tested because there wasn't a cure. And if I tested positive, I would have to tell my kids.

And I didn't want to do that. So two years ago, I was diagnosed in a complete shock to me. And then the genetic testing came back and I do not have the same genetic mutation that my father, uncle, and their first cousin had. I have some other cause of ALS, which is

to this day, still a mystery. So it's not genetic, so it's not via the family? Well, we don't know for sure because there are a number of people who don't have the mutation, but have a parent that does, and it's much more than the random odds of having ALS.

So there's something else going on, but we haven't figured it out yet.

You haven't figured it out. It's interesting because I had my, with muscular dystrophy is a big thing in my family. My aunt had it. My brother has it. I think my mother has it. And I finally got tested. And it was a big decision, I have to say. I found out I don't have it. I thought I might. And it was a relief because I didn't want to tell my son. That's one of the, you know. Exactly. You know, I said I didn't want to be tested because I didn't want to tell my kids. But had I been tested,

I would have had a false sense of security and relief. So things just work out in weird ways. So when you got diagnosed, how did it manifest itself? Because you're a very active person. The one thing I know about you, having dealt with you quite a bit, is you have a lot of energy, I would say. You still do, obviously. But what was your signs for that? So it was very weird.

My wife and I were in Iceland on a trip where there was a lot of activity. A lot of riding on little horses. Yeah, we did that too. But we climbed about and I was exhausted. And I'd just been biking two weeks before and I was fine. Then it fell out of the kayak.

And I tried to get back in, and it felt like I was suffocating. It was just very weird. And so when I came back, I didn't think it was ALS or anything. I went to a doctor who had treated me for a back problem. And he noticed that my body was twitching.

which is a symptom of ALS. And he called in the head of urology at the hospital, and he just looked at me and said, he knew my family history, that I had a 6 in 10 chance of having ALS. So I was pretty astounded by that.

Because I had formed an ALS research foundation and knew the leading clinicians and researchers in the field, I went to see two of them. And they tested me.

doing all sorts of different tests, breathing tests, strength tests, tests of my muscles and how they react to shocks. And they both concluded that almost certainly I have ALS. And yet the genetic testing still hadn't come back. My primary symptom

not the exclusive void, is respiratory, the disease is really attacked

My diaphragm first. Yeah. But one of the things you're doing, much of your professional work in New York City and elsewhere, which we're going to get to in a second, even the work you're doing with Target ALS, and I'd like you to explain that, is aimed at the future. Now, I asked this of Steve Jobs, too, when he was sick, sick with pancreatic cancers, what he had. How do you think about the future while living with a terminal illness? Does it give you an extra...

Amount of urgency? No. Something happened to me when I was diagnosed. As you point out, I've always been so focused on the future. In fact, I've been so focused on the future that I never took time to appreciate any of the things that I achieved because I was always on to the next thing.

So when I was diagnosed, something flipped in me and I stopped thinking pretty much about the future with one exception. I'll get back to that. But I don't think about the future course of the disease much anymore.

I've changed pretty dramatically that I live pretty much day to day, which is phenomenal. And I do think, and it's a speculation, but my natural optimism leapt in to protect me somehow. Because if you do think about the future course of this disease, it can be really debilitating.

But I don't. I'll give you an example. My granddaughter was born on the weekend I was diagnosed. Wow, congratulations. Yeah, but before she was born, while I was being diagnosed, I think to myself, this is so terrible. I'm probably not going to live to see her turn five again.

And once I was diagnosed, once she was born, I never think that way. I just revel in her growth and development. And I just love being with her because I'm in the moment. It's also changed me.

You know, I'm definitely much more patient than I was. I'm not competitive anymore. I'm present.

And probably a bit nicer, too. Oh, okay. We'll get to that in a minute. After all of this, you motivated to start Target ALS. Talk about some of the biggest changes and advances in the research from the time of, say, your father's diagnosis to your own. So after my uncle died, which was after my father died, I decided, you know, it's so personal. I assumed it was hereditary. In my family, I had to do something.

So what I did is I brought together a small team of scientists because there really hadn't been much progress in ALS research since the disease was discovered in 1870. And this was after 2010. And they developed a set of hypotheses about why ALS

There was so little progress. It was about funding, barriers to entry to do, scientists getting involved in the field, the lack of industry involved in the disease. Yeah.

IP issues were laced throughout, which slowed everything down. And so we decided to form Target ALS, which would remove all those barriers. And so what we do is we fund multidisciplinary cross-sectoral consortia of researchers to

on important ALS topics. Why do motor neurons die? What do we do about it? We also fund research tools that anybody in the world can use for free that are critical to advancing research. We focus on

bringing industry into the field by involving them in everything we do.

We partner with other related diseases because ALS has a lot in common with other neurodegenerative diseases. Right, such as? Alzheimer's, Parkinson's, Huntington's. There's a lot of overlap. So we partner with other diseases as well. And that strategy is,

has been phenomenally successful. You know, we funded 60 consortia over the last 10 years. Targeted Alice was formed in 2013. And where are we in terms of a cure of this? These are so many diseases like this that have been with us, as you said. For the first time ever,

We've seen symptoms reversed in patients. Now, it's for a very narrow set of genetic mutations, but it's pretty remarkable that

something that nobody ever would have thought was possible five years ago has happened. We have a series of clinical trials underway. And again, I'm convinced that

that a clinical trial I've been in has extended my life. Right, right. And is there something that we will take? Is it a government intervention? Because there's so many various... Obviously, cancer is the top one people are looking at, and Alzheimer's more and more, which is related, as you said. Is there a reason why the Sloan-Essence is just there's so many diseases? Well, I think what...

momentum attracts attention. And because there's been so much progress in ALS research over the last 10 years, they're building momentum. And people believe, these companies believe that the disease is tractable, that it'll be solvable, and that they can make money from it.

And so they wouldn't do it unless both of those conditions existed. Yeah, of course not. Well, that's the Dan Doctoroff I know. We'll be back in a minute. Let me talk a little bit about your business career because it's really quite astonishing. Let's start with Sidewalk Labs, which you resigned as the CEO. This was a Google company, which later fell in the Alphabet umbrella. Talk about Sidewalk. I've been following it for a while. It's called Sidewalk Labs. Yeah.

Talk about this smart city mission because you had only one landmark project, the Quayside Project in Toronto. It was shut down in May 2020. You had cited the pandemic and economic uncertainty as the main reason for killing this waterfront project. But of course, when people move into these smart city areas, and I've been following them for years...

It faces a lot of criticism, the idea of making a city in a lab, which is, of course, it's called CyWAC Labs. Yeah. Our proposal was less about privacy and digital stuff than it was about mass timber buildings, getting to climate-positive things.

Moving people around in different ways, doing new approaches to public space. A lot of the criticism up in Canada was focused on privacy, but the reality was we weren't going to use data in public.

what people thought we were. I think that was an overdone excuse for a lot of people who didn't want the project to go forward. But out of it, we developed a series of companies that continue. I'll give you an example. CityBlock Health was an idea that came out of

the exploration of what we could do socially. And CityBlock Health, which by the way in four years achieved a $6 billion valuation, is all about finding new approaches to care for the urban poor.

In a different way. We created a company called Sidewalk Infrastructure Partners, which uses digital technology to enhance infrastructure. We created a company called Mesa.

which enables easy retrofits with sensors and things to lower the energy consumption in Class B and C buildings. A company called Delve, which is a new way of planning projects.

using AI and machine learning. So a lot of companies came out of it. Come out of it. And that happens a lot in technology. But the project, as you noted, got a lot of scrutiny. You had a particular reporter, Josh O'Kane, who wrote about it, including a document that he got a hold of called the Yellow Book that outlined the vision for expansion. And one of them was including cameras and sensors, which you just mentioned. You thought that was over-

Yeah, because we had proposed a system. You know, the use of data in public space is not ever regulated. There are cameras everywhere and it's never regulated. We had proposed a system of government control where they would dictate

every use of the data, and we would live with that. So again, I think it was completely overblown. But people are nervous about this. And the idea of cities being manipulated goes back as far as Robert Moses, right? This idea of- It goes way back before that. Way back, way back. But I'm saying he's the most famous. Obviously, I'm referencing it because of New York.

But the idea of messing with cities really does make people nervous for either its privacy reasons or moving people to the wrong places or it being fake, right? This was a 12-acre site, which is experimental, where everyone would choose to live there. And we thought we could teach the world about how to evolve using technology

And it was a partnership between government and a private company, and that it would be controlled. So, yeah, experimentation is critical. But experimentation under the right conditions, I think, is also critical. And we were totally open to having government as our partner.

So was the problem Google? Because it's like the old expression, I'm government and I'm here to help you. Google and I'm here to help you is also nerve wracking. I remember when they were trying to do various things in San Francisco, they were pushed back rather substantially. Yeah, I think the perception of tech, big tech, certainly didn't help. And

But I think at the end of the day, we withdrew because we didn't feel like

we were going to be able to get through the innovations through the governments. And we were dealing with three levels of government. And it just wasn't worth it to spend all this time and end up with something that wouldn't be a huge advance. So we were through. So have you been watching these future cities? Elon Musk is...

building this Texas utopia outside Austin meant for Tesla employees. And a group of Silicon Valley billionaires was buying up land in Northern California to build their own city. I'd love to hear your thoughts. Talk a little bit about how you look at that, because it's a never-ending quest by wealthy people to do this. It's often wealthy people try to manipulate and try to rethink cities. Yeah. Look, I think experimentation is good.

No one's forcing people to live there. On the other hand, there are always political issues in terms of buying up land, forcing the government to agree to different things. It's got to be a partnership between government and the private sector.

And that's what, by the way, was our whole philosophy in New York City government after 9-11. I'm going to get to that in a second. It's got to be the private sector and government working together. Let me talk specifically about New York itself. You were deputy mayor of New York City and you had a huge impact in New York City.

of a real place in terms of all the changes you made. Where do you think the city is now? And I'd love you to reflect on the various and sundry things you did, which were rather extensive in the city itself. Well, I think obviously COVID and return to work, we don't know exactly where the trends will go.

But I'm an optimist about the cities. I think people want to be together. At the end of the day, you have to have a quality of life, starting with safety, that induces people to come.

I was always a proponent of what I called the virtuous cycle of the successful city, that you wanted more people running more residents, more jobs, more visitors, because the marginal benefit from a revenue perspective of those additional people was greater than the marginal costs.

And you could reinvest, hopefully smartly, the additional revenues back into quality of life. As quality of life improves...

more people come and the cycle perpetuates. You said, I think cities are going to be fine. Um, let's first talk about the pandemic and, or I don't think anything affects New York permanently. Um,

Talk a little bit about what happened, you know, the outgoing sort of wealthy taxpayers leaving, for example. Yeah, I think that's to some extent overblown. I've seen statistics. A couple thousand people actually left. Some of them were very wealthy, and that had an impact on the tax base. The big issue is...

The issue on commercial real estate, people don't need as much space because people work from home. The business around the office buildings are less busy than they were. But that's mostly in Midtown and Downtown.

If you actually look at the activity level, the people on the street throughout the rest of the city. In neighborhoods. In neighborhoods, it's dramatically greater. And so we've seen a shift in.

from the activity levels in Midtown and Downtown to other neighborhoods. Is that fatal to a city? Because that's a situation in San Francisco, for example. Well, again, it's robotic quality of life. But I led a commission, co-led a commission, for the mayor and governor in 2022.

to think about strategies to rebuild the city, particularly Midtown and Downtown. And there were three major components to it. You've got to create in Midtown and in Christmas and Downtown a more vibrant 24-7 community. So converting old

old office buildings to residential is critical. Being able to build higher apartment towers is critical. Having entertainment and things on the streets and new attractions is critical.

being able to adjust zoning so that there can be more and different businesses. What you want is just to attract more people for more hours of the day in these districts. How problematic is the crime issue? I don't think in New York it's dramatic. You know,

Everywhere in the country, crime escalated through COVID. If you look at New York, for example, murders are down over the last couple of years. We still have property crime issues that need to be addressed. Yep. But...

New York is still reasonably safe. We've seen crime drop on the subways as well. But we have much more to do. We're not back to the bad old days by any stretch of the imagination. I agree with that. The ongoing migrant crisis, do you have any opinion or insight how to handle the situation? Well, the big issue is

is less the number of people by getting them to work. And the federal government has been pretty inflexible until recently by allowing migrants to work. But if we can get them to work,

then they'll earn money, they'll move out of shelters. But it's all about economic mobility. Immigrants for New York, it's always been a driver of growth.

But if you limit their activities, they're drained. It's a problem. And so we need to get them to work. I probably would have registered the migrants according to the federal regulations and just let them work.

So one of those things is having a mayor like Bloomberg and empowering people like you to do things. And one of the things that was written about you was the enemy was inertia, a toxic substance that asphyxiates good ideas. Does New York City need a mayor like that or mayors like that or deputy mayors or even a Rudy Giuliani? And I'm talking about the 90s Giuliani, not today's Giuliani, obviously. That's a different Giuliani. Yeah, look, I'm...

You have to have ideas and ideas that inspire people to invest. People are not going to be inspired to invest, unlike people are convinced that you can execute and make the city better and better. Going back to that virtuous cycle that I talked about is that every city needs investment.

But every city needs confidence that they can execute in order to get people to invest. You know, in the 20 years up until COVID, 18 years, New York added a million new jobs to

It was almost twice the rate of new job production that the rest of the country had. We had neighborhoods that blossomed in ways that no one ever would have imagined.

In the Bronx, we had a huge increase in the number of businesses. In Brooklyn, it increased in the Bloomberg administration by almost 50% the number of businesses formed compared to prior years.

Queens, Staten Island. In fact, the only area that did have an increase in the number of new business formations was Manhattan. So it's all about inspiring confidence. So in that regard, let me go through a lightning round of leaders. I'd love your assessment of them and then a piece of advice you'd give them. Eric Adams. I think he's inspiring.

I think he has the right philosophy. He focuses on crime and quality of life issues. He believes in business that drives a large part of the tax base.

But I don't think people have yet been convinced that it can execute. I'm not saying he can't, but we need to demonstrate that he can. Kathy Hochul, not inside New York City, but very important. I really like Kathy, Governor Hochul. She is dealing with a very difficult legislature. She's more moderate.

than the Assembly or Senate. The biggest problem New York has is a lack of housing. New York's economy grew, but we didn't add enough housing. And so housing costs have gone up. And despite the fact that

which is a mystery to me, that we've lost some people during COVID. The apartment rates have actually escalated until this month. And the state legislature has been very difficult and has been reluctant to

to agree to an incentive program to build housing. We have said in New York City that we have to build 500,000 units of housing in the next 10 years. Statewide, it's 800,000. And without cooperation from the state legislature,

it's not going to be possible. Not going to be happening. All right, Jano Lieber, the head of the MTA? I love Jano. Jano and I worked together on the rebuilding of the...

the World Trade Center site. He was the number two to Larry Silverstein. We had huge fights, but we respected each other. And I think he is doing an amazing job. I think he's been a great leader for the MTA. Okay. Last two, Kathleen Karate, the woman, Mayor Adams' anointed rat czar.

Well, I don't know enough about the progress that's been made, but I will say having a rat sour is very impressive. And by the way, Herb Bloss, Jessica Tisch, who's a sanitation commissioner,

He's a star. All right, last one. Michael Bloomberg, your old boss, does he have a political future? I don't think he has any interest in politics. That's not to say he can't be helpful to candidates that he believes in.

But I have to say about Mike, I spent 13 years working for him, six in City Hall and seven at Bloomberg, where I was CEO. And Mike's one of the great people on the planet today.

I'm on the board of Bloomberg Philanthropies. They do incredible work. But as a leader, he was the ideal leader for New York coming out of 9-11. All right. Last question. You said you were surprisingly happy earlier since your diagnosis and you still have a busy life. You obviously do. Yeah.

How do you maintain that optimism? I just do. You know, I've explored a lot about why I'm so happy. And yes, there's a lot of bad things going on in the world, but everything else going on in the world. But, you know, with a limited lifespan, I try to analyze things

why I have been so happy. First, I don't think about the future that much, with the exception of ALS. Secondly, you know, I've been surrounded by so many people who've been so loving and supportive. Third, I'm grateful for my life.

You know, I've had a great life. My wife, Alisa, and I have been together 46 years. We had three wonderful kids, two grandchildren. I have a lot of friends. I've done what I wanted in my career and outside my career. And so I don't have any regrets about

No material regrets. But then at the end of the day, I found that what's key to life is relationships and having a purpose. And my purpose right now is all about eradicating ALS. And that's what I...

I decided to dedicate my life to when I was diagnosed, and it was obvious to me. So relationships and purpose is really what life's all about. And by the way, I've been having a good time too. Oh, good. I feel a lot less pressure. I spend more time traveling, seeing people I care about.

And that's, yeah, also makes me happy. Well, then I'm going to go hug my kids right now. How about that? I think you definitely should do that. I'm going to go do it. All right. Dan, you're a real legend. People don't realize you're one of those behind-the-scenes people I was aware of that had a lot of impact in your life. And I hope you do eradicate ALS and you get a cure, if not for you, then for many of the people that come after you. And that's the way it goes. Thank you so much for doing this.

I loved hearing from Dan Doktoroff. You obviously know him well. Do you think he's changed? How did you experience him? I've always enjoyed. I think he's the same. I don't think he changed that much. I think he's become more thoughtful about mortality, which is something I think about a lot, as you know. So, you know, I think he wasn't really paying that much attention to legacy issues.

In a lot of ways, he just goes do, do, do. Very typical of many people like him, especially New Yorkers, right? Do, do, do and move, move, move. And I think he's really gotten very thoughtful about legacy and where it goes and trying to leave something behind. He already has in many ways, if you think about it. So many ways. But in this way, it's given him a moment to think about his life.

Yeah. For someone who is so invested in the future of cities, and this is something that's been kind of common theme of the profiles that have been done on him recently, his letting go of the future, except for in this one cause and NALS, but his kind of focus on the present, certainly. Yeah.

I mean, it sounds like you don't think he's... Yeah, well, he's got only so much energy. Everyone has a clock on them and they don't know what the numbers are. And in his case, he does. He has some sense. And so he's going to focus on the thing he can do the most, which is dealing with finding a cure or mitigating ALS, which, you know, it's one of those diseases that there's so many of them, degenerative diseases that...

would be great if we could solve them. Parkinson's, Alzheimer's, so many. And I love that he's bringing his commercial approach to it, right? This is a person who understands how business works, understands how incentives work. And I'm sure he's a real asset to Target ALS and to the ALS community trying to solve what is a really challenging disorder. It was interesting to hear him speak about his business experience in that regard. Did you think he conceded sidewalks

Kind of. I don't think he's a look backer. I don't think he's a man who looks back much. So he's like, yeah, it didn't work. Okay. Well, it didn't work, but it spat out a lot of things that did work, right? Yeah. He was making the argument that they did incubate other things, whether it was CityBlock Health, which is a great company run by Toyana Jai. There's a lot of interesting, that's what often happens. But I don't think he's someone who wallows in failure. But I do think this idea of the future city is something that is...

smart cities, I mean, smart homes have already happened. I think that the computer and privacy aspects are really what get in the way, right, when it comes to the city? I guess. I think a lot of the way we think about building and creating cities and homes and stuff like that is still artisanal in a lot of ways. And you can bring technology to bear in really interesting ways. Often it moves into privacy violation kind of things, but it doesn't have to be that way. On the privacy point, that's

That's how we met, by the way. Remember, we did that video on CCTV in Bryant Park, and we did that video, which you called dire, Cara, at the time. It was dire. It was dire. I think people don't realize how much they're being tracked. Yeah, but also, sometimes it makes you feel safer. In London, I feel safer because there is CCTV. As long as it's run by a democracy, I guess.

Yeah, well, I mean, Democracy or Bezos, I always find it kind of crazy that people have so many issues with CCTVs on their sidewalks, but they're happy to let Jeff Bezos' Amazon app. They have the Echo and everything in their house. Well, that's why people don't think about it. Not me. Not you? No. My sons unplug everything. My one son unplugs everything. Yeah. Anyway.

You know, cities are under siege right now. And of course, San Francisco gets the most attention, but every single city has major issues, whether it's New York or Houston or Miami. And so how are we going to make these cities work better for the residents over the future is a really important issue because most people, again, will be living in cities. And Trump in particular really kind of

I mean, I know it goes way back to the suburbs and whatnot, but Trump really tried to change the narrative around cities and kind of paint cities as evil, decrepit places. Well, that's part of his whatever. Yeah. But there are, I mean, cities are also amazing points of imagination and vision and execution. Love New York. Love Washington. I love cities. I love cities. I think it's where everything happens. Yeah.

Yeah. I hope Adams has vision. I appreciate it. We obviously taped this interview before Adams was under investigation for all this campaign finance stuff. But Dan's point about whether...

You know, you have ideas, the ideas that inspire people and then invest behind those ideas. That's important. And so far, the greatest idea I've heard from Eric Adams as a New York City resident is the rat czar idea. And trash, trash cleanup. I'm not a big fan of Eric Adams these days. They're not as inspiring as the things that brought you Grand Central or Flushing Library, right? Like Mara Gay, who writes for the New York Times editorial board on New York Times.

It says if you look at something amazing in New York, somebody had that vision, right? Somebody had the idea to dream that up. And I don't know... Thank you, Jackie Kennedy for Grand Central Station. Yeah, or Bloomberg and Co. for all of the West Side development. Barry Diller for Little Island. The High Line on Little Island, sure. I think New York is just exceptional in the sense that there's no other city in the world that you can get...

people who are the best at everything they do, at any single sector. Great city. Better than San Francisco, Cara, will you concede it? Different. I don't like to pick cities. I love all cities. I really do. I love Los Angeles. I love London. I love Singapore. I love all cities. When you run for mayor of San Francisco, you're going to have to change that tune. Yeah. I like San Francisco the best, but I like all cities. Look at her preserving her political capital. Want to read us out, Cara? Yeah.

Yes. Today's show was produced by Naeem Araza, Christian Castro-Rossell, Kateri Yochum, and Megan Burney. Special thanks to Kate Gallagher. Our engineers are Fernando Arruda and Rick Kwan. Our theme music is by Trackademics. If you're already following the show, you get a seaside villa in Marin. If not, it's a techtopia in Vacaville for you.

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