What to Do When You’re Told There’s Nothing Left to Try | David Fajgenbaum, Kiah Williams | TED

0:03 Alexandra Tillmann: Alright, David, Kiah, thank you so much for being here.

0:09 Let's jump in.

0:10 Can you both share when you realized that life couldn't just happen to you,

0:17 that you had to actively start choosing a path forward?

0:22 David, I'll start with you.

0:23 David Fajgenbaum: Sure.

0:24 I might start back when I was a medical student.

0:27 I had promised my mom that I would become

0:28 a doctor in her memory when she passed away,

0:31 when I was 19 years old, and in my third year of med school,

0:34 I was really on my way to making that progress,

0:37 helping patients in my mom's memory when I personally

0:39 became critically ill with a disease called Castleman disease.

0:42 I was so sick that I had my last rites read to me,

0:45 I spent six months in the intensive care unit,

0:47 and my doctors told me that we were out of options,

0:50 but they gave me chemotherapy, seven different chemotherapies all at once.

0:53 And amazingly, those chemotherapies worked.

0:56 They saved my life, but what they also did is they opened my eyes

0:59 up to this idea that none

1:00 of those seven chemotherapies were made for my disease, but they saved my life.

1:05 So when I relapsed a year later, my doctors told me,

1:07 "We're out of options, you're going to die from this disease." I said,

1:11 wait a minute, didn't you give me these seven

1:13 chemotherapies that weren't made for my disease and they worked?

1:16 How do we know there's not another drug out there that could help me?

1:19 And so this sort of opened up my eyes.

1:21 I eventually discovered another drug that could save my life,

1:24 but opened my eyes up to this idea that even

1:26 when the world thinks there are no more options,

1:28 no more hope, sometimes there's a solution that's

1:31 literally as close to you as your neighborhood pharmacy.

1:33 Kiah Williams: I think for me,

1:35 it was when I was young, my family just fell apart.

1:37 And we were teetering at the edge of poverty.

1:40 And I remember going outside, I grew up in West Philadelphia,

1:44 I remember going outside one night and literally saying to myself,

1:49 like, I have to be the one that saves myself,

1:54 that creates a new path for myself.

1:55 And so I'd always, you know, focused on school and trying to do well.

2:00 But I made this decision at a young age to just say, like, I was like,

2:03 I need to get out of here and I need

2:06 to do something and have a better life than this for myself.

2:09 And the only one who's going to do it is me.

2:12 That obviously wasn't true, I had a ton of help from like,

2:16 teachers, even my parents, etc.

2:17 But I remember being very young, 15 years old,

2:21 and saying, like, "I've got to do something different,

2:24 I need to do something different and better" and was able to, like,

2:27 work really hard, buckle down in school,

2:29 got a full need-based scholarship to Stanford.

2:32 And essentially that was the beginning of me recognizing, like,

2:35 I could harness my own power and try to make something of myself.

2:41 And I think fast forward years from then,

2:43 when I was actually working in clinics, in medical clinics,

2:47 and was going to be the first doctor

2:48 in my family and would see patients who weren't getting better,

2:52 doctor leaves the room, it's just me in the room as a health coach,

2:56 talking to patients about whatever they want to talk about,

2:59 and learning that sometimes people weren't getting the medicine

3:02 that they needed because they couldn't afford it.

3:04 So that's why their blood pressure is still high,

3:07 their cholesterol is still high, their diabetes is not getting better.

3:10 And I realized that I wanted to do something that could address that at a root

3:14 level for those patients who were trying to take care of their health.

3:18 And just all of these external factors were blocking their ability to be well.

3:23 AT: You know, as you both talked about,

3:25 our life is shaped by our circumstances, right?

3:29 Some more formative than others.

3:31 You nearly lost your life.

3:34 And some we can control more than others,

3:37 but they all contribute to where we head.

3:41 As I shared, you know, these can be dramatic, or they can be small.

3:47 David, you know, your near-death experience with Castleman's disease

3:51 led you to become both patient and researcher really simultaneously.

3:55 And Kiah, as you just shared,

3:58 the economic resources of your family that you were born

4:02 into really affected kind of, what you dreamed for your future.

4:06 These are the realities of your lives,

4:08 but you manage to use it for your creative fuel, for your energy.

4:13 Can you talk a little bit about how you took those things

4:16 out of your control and used them to expand rather than to contract,

4:22 which I think can be a very natural experience for some people?

4:26 KW: I think— there's a really good quote that one of my co-founders used,

4:31 and I love this because I think it so speaks to me,

4:35 "sometimes motivation follows motion." Not the other way around.

4:40 And so I think sometimes literally just

4:42 by putting one foot in front of the other,

4:44 you don't have to have 100 percent of the answer.

4:47 You can have five percent of the answer.

4:49 Just start moving towards that.

4:51 And so I think when we think about this big issue,

4:53 even of 30 percent of people in the US not being

4:57 able to get medicine they need because it's just too expensive.

5:01 We don't have to have all the answers to fix everything now.

5:04 We can just start on the thing that we know to be true,

5:07 which is this is a dumb problem,

5:09 and we know that there's surplus that exists to actually meet some of that need.

5:13 And let's start moving forward with that now.

5:15 And I think a lot of that also,

5:17 just like from my personal experience and just thinking about

5:20 my own family and kind of where I came from, I mean,

5:23 my dad always told me this growing up,

5:25 he was like, you know, my grandfather wasn't literate.

5:28 And people would ask him like, well, how does he function?

5:32 And I remember someone asked specifically,

5:34 how do you drive if you can't see street signs?

5:37 And my dad told me that his father said to him,

5:39 "I look at the stars." And so I'm like, if my grandfather can look at the stars

5:45 to find his way and navigate through streets,

5:49 what excuse do I have to not do everything

5:52 I possibly can for the patients that we're serving, and to plot a better life?

5:58 Look at the stars.

6:00 AT: It's incredible.

6:01 And David, how about you?

6:02 DF: I love that.

6:04 For me, I think that the moment that that drug sirolimus,

6:07 which is the drug that ended up saving my life,

6:10 the moment that drug started working for me,

6:12 I started seeing my results improving, started feeling better.

6:15 I just haven't been able to get this question in my mind.

6:18 If this drug is working for me,

6:20 how many more life-saving drugs are sitting at our local

6:22 pharmacy that could treat more patients and more diseases today?

6:26 And I think exactly as Kiah is saying, you know,

6:28 once you see something like this, once you experience something like

6:32 this, whether it's learning about access to medicines or the work we're doing,

6:36 learning about the fact that there's all these hidden

6:38 cures that are unmatched, you can't unsee it.

6:41 Especially when you see the impact that it has on humans,

6:44 patients that are alive because of these medicines.

6:46 And so I think, to answer the question,

6:48 once you see something like that, it's about continuing to push forward and say,

6:52 OK, maybe this helped me, but can this help the person down the street from me?

6:56 Can this help someone else in my community?

6:58 And then when you start seeing that it can,

7:01 you can just keep asking bigger and bigger questions.

7:03 Can it help people all over the world?

7:05 And I think that's so important in guiding us.

7:07 AT: Kiah, you just were touching on something.

7:11 You were talking about the fragility of healthcare across the country,

7:14 which really led you to start Sirum.

7:18 In your work, you often confront systems that are

7:22 not easy to change or that aren't fair.

7:26 And you've witnessed, as you shared, families that are making impossible choices

7:31 between being able to afford medicine,

7:34 being able to get food on the table for dinner.

7:38 These are issues we're all hearing about every day on our news, too.

7:43 How do you counsel others who see systems working

7:47 against the greater good or perhaps are plagued by injustice,

7:53 but wonder, do they really have the power to make any change?

7:58 KW: I think that's a very timely question.

8:01 What do you do in your own community?

8:02 What do you do in this state,

8:04 what do you do in the country, whatever level you're looking at?

8:07 And I think Sirum has really shown me the power

8:11 of getting out there and just getting stuff done.

8:15 We started as a very ragtag, like, this started as a student project,

8:20 and has grown now to the largest redistributor of unused medicine.

8:23 But sometimes it's literally just picking up

8:25 the phone and calling a local legislator.

8:27 So, for example, we actually were able to launch

8:31 a home-delivery pharmacy in the state of Georgia,

8:33 but the way that that happened was literally we

8:35 got an email from a retired person in Georgia,

8:39 and we got one of these emails that was like, it was like all purple font.

8:42 So we were like, how legitimate is this?

8:44 Everyone knows those emails that you get in inbound to your like, hello@sirum.

8:49 And we were like, this may or may not be legitimate.

8:51 Concerned citizen that says, "Hey, how do I make this happen in my state?"

8:55 Emailed us in, called his local legislator,

8:59 got us a meeting with the chair of public health in the Georgia legislature.

9:05 That was the beginning that was the spark.

9:07 So I think we can actually trace back

9:10 in every area that we're working in this country.

9:13 It was usually just one person who was concerned.

9:16 It was a concerned pharmacist who saw unused medicine.

9:19 It was just a random person who read an article about us and said,

9:23 "I want to do something, what can I do?" And we said,

9:25 if you can get us a meeting with the state, that would be awesome.

9:29 And like, from that moment of just them calling their legislator to say,

9:34 "Hey, I want to see this program happen, we were able to make inroads.

9:38 So I think that it can feel very— A lot

9:42 of it is just unclear what is the path forward.

9:45 Again, you don't have to know every step,

9:47 but doing something rather than nothing,

9:48 choosing action over apathy, I think it just bears out.

9:53 And I've just seen this multiple times,

9:55 the value of an email or a phone call, and what it can be to changing,

10:00 fundamentally, the destiny of our organization,

10:03 but also our ability to serve tens of thousands of more patients.

10:08 AT: Incredible.

10:10 David, I'll turn to you.

10:13 Many people feel like they need permission or like,

10:17 a dramatic wake-up call to chase their audacious dreams or really affect change.

10:26 But what would you say to someone who senses this can't be all there is,

10:30 you know, but isn't sure quite whether or how to show up?

10:35 DF: Yeah, great question.

10:37 I think that no matter what you're going

10:39 through in your life or the challenges you're facing,

10:42 I think it's worthwhile asking yourself, what am I hoping for every day?

10:46 What am I wishing for?

10:47 What am I praying for?

10:48 Like actually reflect on the things that you're

10:51 praying for, wishing for, and hoping for every day.

10:54 And that can oftentimes tell you exactly what you should be doing,

10:57 because whatever you're hoping for and you're wishing for, that is

11:01 actually the inverse of what you should be doing.

11:03 You know, what can you do today, tomorrow,

11:05 and the next day to create the thing that you're hoping

11:08 for, to solve the problem that you wish would be solved.

11:11 And there are a lot of challenges

11:12 that we face every day that feel insurmountable,

11:15 and many that truly we have a hard time actually having an impact on.

11:19 But there are also many problems in our lives that we're hoping for a solution

11:24 for, that we actually have something that we

11:26 can do to help to solve that problem.

11:28 And as Kiah mentioned, it may be that we can call a state legislator,

11:33 or maybe it's that we can post something

11:35 on social media to raise awareness about a problem.

11:37 But there are tangible things we can do.

11:39 But I think it all starts at reflecting on what are you hoping for?

11:43 What are you wishing for?

11:44 And I think that's a great place to start

11:46 with, what you should be doing every day.

11:48 AT: Yeah, you call that, in your TED talk, actionable hope, right?

11:52 That it's not enough to just hope for something more,

11:54 to say, well, in six months or in a year, right?

11:59 Maybe talk a little bit about that.

12:01 DF: That's right.

12:02 I've realized there's this circuit and it all starts with hope,

12:05 you know, what are you hoping for?

12:06 And that hope really needs to drive action.

12:09 And if that hope drives action, what I found is it often will drive impact.

12:12 And what does impact do?

12:13 It gives you more things to be hopeful for, more hope.

12:16 You create this incredible circuit.

12:18 Hope, action, impact, leads to more hope, action, impact.

12:21 And all of a sudden, years later,

12:23 you're sitting here with these two amazing people and all

12:25 of you and able to share about an organization,

12:28 Every Cure, that's saving lives of patients all over the world.

12:31 But it all starts with that first hope and turns to action and impact.

12:35 AT: I know we're going to talk about a lot today,

12:37 but, you know, for Every Cure and Sirum,

12:39 like, how can people be part of it or support the work that you're doing?

12:45 DF: Sure, I'm happy to start.

12:46 Yeah, absolutely.

12:48 So many of us in this room have received medicines

12:52 for diseases that they're not approved for to treat us.

12:56 It's called off-label use.

12:57 In fact, 20 to 30 percent of all

12:59 prescriptions in the US every day are off-label.

13:01 So doctors are trying drugs for diseases they're not intended for.

13:04 Unfortunately, it happens very randomly and there are a lot

13:08 more opportunities for those drugs to be used systematically.

13:10 But it's just not profitable in our system to find a new use for an old drug.

13:14 Eighty percent of drugs are generic, so unfortunately,

13:16 the system isn't built for this, to find new uses for medicines.

13:19 But the reason I share that as background

13:21 is that that means that most of you all

13:23 have received a drug for a disease it wasn't

13:25 intended for, and maybe it helped some of you.

13:28 You can go to everycure.org/ideas and you can tell us

13:30 about a drug that you've received that maybe has helped you,

13:33 that we can look into.

13:34 We can look into our AI platform to see how

13:36 is it ranking versus all of our other repurposing ideas.

13:39 Second is that you can help to support us financially.

13:41 We run large clinical trials that are very expensive,

13:44 and we want to reach patients all over the world.

13:46 And finally, awareness raising is really important.

13:49 We find treatments for diseases that we never would have imagined,

13:52 like lidocaine for breast cancer or DFMO for Bachmann-bupp syndrome.

13:57 And amazingly, the problem for a lot of these medications is just awareness,

14:01 just getting that drug to the patient.

14:03 It's a matter of letting patients and doctors know.

14:05 So helping to spread the word about our work at Every Cure.

14:08 KW: For us, there is an opportunity, if you have— in some instances,

14:12 individuals can actually donate their unused medicine

14:15 as long as they're in sealed containers, unexpired.

14:19 So there's an opportunity for you to potentially donate.

14:22 The other thing I would just say is, this is TED.

14:24 Like, y'all are well-resourced, well-connected individuals.

14:28 If you want to see us come to your state to bring

14:32 a full solution for medication access to your state, reach out.

14:37 AT: You know, going back to what David was talking about,

14:40 actionable hope, I think that's such an important thread.

14:44 And Kiah, we were talking yesterday,

14:47 and I've heard you say before that it's a privilege to do hard things.

14:52 Kiah also has a new baby, so she's in the thick of doing hard things right now.

15:00 And something that you also have said is

15:04 that, really thinking about short-term pain for long-term gain.

15:08 So maybe talk a little bit, Kiah,

15:10 about how you kind of, rationalize those feelings of the pain and the gain.

15:16 KW: So like, hope is a tough concept for me because I am...

15:21 I am a probably realistic, pragmatic pessimist.

15:26 Like, I don't think anyone who's ever worked

15:28 with me would say "Kiah is a hopeful,

15:31 optimistic human." Which is kind of a weird thing to say,

15:33 considering I'm doing social entrepreneurial work

15:36 and trying to have impact in this world.

15:38 So like, why am I doing this?

15:39 And how do I get up every day and continue to do it?

15:42 And I think a lot of it comes down to like,

15:45 you know, when you are having personally experienced,

15:48 when you are living at the edge and you're like,

15:50 I've just got to put one foot in front of the other.

15:53 I've got to make sure I have what I need.

15:55 I have to make sure there's a roof over my head.

15:57 I have to make sure there's electricity because the electricity got cut off.

16:01 Like, you're not necessarily thinking about the hopes

16:03 and dreams of the future that you want to have.

16:06 You are thinking about living today and making to tomorrow.

16:09 But I think that in and of itself, I've realized,

16:11 is a form of hope, because you do not just lay down and die.

16:16 Candidly, like.

16:18 And this is something I say to myself because I am not an optimistic person.

16:21 I'm not a very hopeful person.

16:23 "Well, Kiah, you have options and hopefully you choose to make this world

16:26 a better place and to keep going." And I think what you referenced around,

16:30 like, how do I make this all work in my head, is, at the end of the day,

16:36 now that I am not in that situation where I am worried about basic needs,

16:42 like, it's such a privilege to be able to choose the hard things in your life.

16:47 For so many people in this world that is not a choice that they have.

16:51 That thing is sitting right in front of them, staring at them every single day.

16:56 So the fact that I have food on the table,

16:58 good health insurance, a roof over my head,

17:02 I get to now choose what are the things that I'm going to take on that are hard.

17:08 And so like, I reflect on that, especially now

17:10 being on a stage like this in a room like

17:13 this, what a privilege it is for me to choose

17:16 hard things and to go out and tackle those.

17:19 And all of us in this room, I think mostly, probably,

17:22 have the ability to choose the hard things

17:25 that you're going to tackle in your life.

17:28 So you can choose career, you can choose to start a new job,

17:31 you can choose to start a new organization.

17:33 Like, these are all choices that we have, and it's a privilege of choice.

17:37 And so I think for me, that is what gives me more hope.

17:41 And that lights a fire under me of this idea of every day I get to wake

17:45 up and choose to go out into this world

17:47 and tackle some of these systems of oppression.

17:51 Systems of inequality.

17:53 And so like, what a beautiful life that is,

17:56 to be able to wake up every day and be at Maslow's hierarchy of need at the top,

18:01 working on self-actualization.

18:04 AT: David, for people who are navigating

18:08 some of that crossroads that you're talking about,

18:10 a big change, maybe it's you want to start an organization or change jobs,

18:17 but for those of us who might be in that place but feeling a little bit stuck,

18:21 what small everyday choices or mindsets do you share with people

18:27 to kind of help them move forward or build like, a more meaningful path?

18:31 DF: I think there's three things that can

18:33 really help you during a really tough time.

18:36 And I learned this from the six months that I spent

18:38 in the intensive care unit when I was dying from my disease, Castleman's.

18:44 And the first is that you have to have a vision for what you're fighting for.

18:48 So you have to be able to actually see what is

18:51 it that you want and that you're wishing and hoping for.

18:53 So for me, I was wishing and hoping

18:55 for a family with my girlfriend at the time, Caitlin.

18:58 I was wishing and hoping that I would be able to find

19:01 drugs in memory of my mom and treat patients in her memory.

19:03 That vision was so important for me as I

19:06 was struggling to survive for those six months.

19:09 The second is that you have to have an amazing team of people by your side.

19:13 My sisters literally held both of my hands

19:16 eight hours a day for those six months, giving me the strength that I needed.

19:20 My dad sat with me, my girlfriend was there with me as well.

19:23 They provided strength and support.

19:24 And of course, when you think about it from a professional perspective,

19:28 the team that you have around you is everything, right?

19:30 It's so important, it is truly everything.

19:32 And the third is that you have to take things one step at a time.

19:36 If someone had come to me at the beginning of the six-month period and said,

19:39 "You're going to suffer the most unbearable pain you've ever felt,

19:42 you're going to be on the brink of death for six months.

19:45 You're going to say goodbye to your family." I would have said,

19:48 there's no way I have the strength to make it for six months.

19:51 I would have said, "Where's the white flag?" No way I can do that.

19:54 But taking the approach of one step and one breath at a time helped me so much.

19:58 I remember there was one point, about 11 weeks into that illness,

20:02 where my doctors told me that we were out of options,

20:05 and I started slowing my breathing.

20:07 It was so painful to breathe and I was starting to let go.

20:10 And I remember looking up at my sister and everyone else had said goodbye,

20:15 you know, said goodbye to all the people that I love.

20:18 And my sister looked at me and said, "Just breathe,

20:21 Dave." And I remember hearing that and I was like, "You know what?

20:24 I can do maybe one or two more breaths, let's go." And I did a couple more.

20:27 I can do a minute of this, I can do an hour of this.

20:30 And those couple of hours to couple of days were the difference

20:33 for the time we needed for the chemotherapy to kick in to save my life.

20:37 And so I think with all these challenges that we face,

20:40 if you can have the vision for the future, the support by your side,

20:43 and then really take things one step or one breath at a time,

20:46 I think we can overcome so much.

20:48 AT: Resilience is a topic that's been touched

20:50 on a lot over these last couple of days,

20:52 and I think that the perception often is that social

20:57 entrepreneurs or leaders like you are always full of hope,

21:01 like, always ready to go forward and conquer more.

21:06 Like, is that how it feels to you?

21:08 Do you always feel that way?

21:10 KW: I think I already said no.

21:12 I'm a very pessimistic human.

21:16 In a lot of ways, on a daily basis.

21:18 But I am, it's interesting, I don't know that I have always hope.

21:22 I know that I have faith.

21:24 And I know that I have faith, weirdly, in this country.

21:28 I have faith in humanity.

21:30 And I think going back to what is the vision that you want

21:34 to see and what is the world you want to live in, like, it's much better for me,

21:39 and I can wake up and be happy and recharged thinking

21:43 about this world and humanity as a race that is ultimately going

21:46 to save itself than it is to think about this country

21:50 or humanity as a race that's going to implode and destroy itself.

21:55 AT: It's helpful to hear.

21:56 KW: So...

21:57 I think, yeah, a lot of us are tired, like, people are tired.

22:03 And at the same time, like, this is it.

22:07 Like, I think you had mentioned previously

22:09 this concept of short-term pain, long-term gain.

22:12 I think many of us are in this room or watching this talk,

22:16 because you've had a lot of really cool opportunities to be successful.

22:20 And I think what we learned from that is delayed gratification oftentimes.

22:25 To say, OK, you put in these hours studying,

22:28 you do schooling, you wait for that promotion,

22:30 you work hard, you put your head down and you grind to get to some next step.

22:34 And that is great, that is awesome.

22:37 At the same time, I want to just raise the alarm

22:41 that we cannot defer life and we cannot think about like,

22:45 well, you know, right now is really challenging,

22:49 hopefully five years from now to be better.

22:52 I think that there is a time in which you have to decide for yourself,

22:55 when am I in that grind-it-out, delayed gratification.

22:59 I'm going to just put in the time and then pop my head out later.

23:03 And when are you going to say to yourself, like, this is my life now?

23:07 How am I going to make decisions and take new actions that change my life,

23:11 my family, my community, my world for the better?

23:15 AT: I find that so powerful.

23:17 David, anything you want to add to that?

23:19 DF: I just completely agree with Kiah in everything she said.

23:23 I think I probably fall on the end of the spectrum

23:25 of being maybe a little bit more optimistic and hopeful.

23:28 Which I think is great,

23:30 I think the important thing is that it's finding some balance.

23:33 I think it's important that we get to work together and do tough things.

23:37 But I think that what I would say is that I sort of, you know,

23:42 have the mindset of what's possible in terms

23:44 of treating patients with horrible, deadly diseases.

23:47 And I get a chance to see people that said goodbye to their family,

23:50 that were on their last legs and were able to save

23:53 their life with a medicine that wasn't made for that disease.

23:56 And it's hard for me to put it into words.

23:59 Just what that means when you get to see someone come back,

24:03 literally, from the dead, where you literally get to see someone walk

24:06 their daughter down the aisle on their wedding day,

24:09 get to hear their child speak to them for the first time.

24:13 These things are so powerful and they give you so much energy.

24:17 It's hard to describe.

24:19 I think another piece of this is when you say goodbye to people you love,

24:23 and you start to wake up and you're like, oh my gosh, I got another day.

24:26 Like, this is incredible.

24:28 It gives a glow to life that's hard for me to overemphasize.

24:32 At the same time, we also have patients that we're not able to help

24:36 and patients where we try everything for them

24:38 and they still die from their disease, diseases that we're working on so hard,

24:43 and we want treatment so bad and we just can't find them.

24:46 And so I think that when you bring all those together,

24:49 it's the excitement of life and the fact

24:51 that we're all here and it's just amazing,

24:54 the excitement of being able to help people that shouldn't be here,

24:57 that are living what we call overtime,

24:59 but it's also sitting with the pain of the patients we're not able to help,

25:02 sitting with the pain of the diseases that we're not able to treat yet,

25:06 and having that pain drive further action.

25:09 AT: What is one thing that you would leave people with?

25:15 Or like, an action that people can take to start

25:17 to like make change in their life starting today?

25:21 Kiah, I'll start with you.

25:23 KW: I think we're in an incredible moment

25:25 where thinking about what really matters to you, what really matters,

25:29 not the things— There's a million things

25:31 that everyone says that they care about, right?

25:33 Because, like, to be a good human, to be a good person,

25:36 you must care about a lot of things.

25:38 You must do all the things, you must vote, you must recycle.

25:41 You must go to see your dentist every six months.

25:43 Like, there's all these things that we all have to do.

25:46 I think there's too much.

25:48 There's so many things.

25:49 It's so hard to feel like you are a good person that is doing good things.

25:55 And I think this is a time— I've really

25:57 been thinking about this because I have a new priority,

26:00 which is I have a child now.

26:01 It's how do I focus on the things that actually really matter?

26:06 And for me, it’s understanding more authentically for myself,

26:12 what are the things that, like— for me,

26:14 it's again, it's like, what are the things that bother me?

26:17 What are the things that anger me, what are the things I'm excited about?

26:20 Like, for me, it's all about the strong emotions that come out and how

26:24 do I focus my life and my work and my mission on impacting those.

26:29 And it's going to have to be, for me, the way I choose to do that, is going

26:32 deep in a couple areas and having to maybe say,

26:36 I maybe didn't go to the dentist in the last

26:39 six months and like, I'm OK with that.

26:41 Like, maybe I'm taking a break from some

26:43 of these things because I want to focus on these others.

26:46 So I think it's really just understanding

26:47 for you what are the things that actually

26:50 just deeply matter and taking action on those because

26:52 it's the recognition you can't do everything.

26:54 And I'm a person who wants to do everything.

26:56 And so I think rather than being really sad about

26:59 that, it's using that as the empowering statement to myself to say,

27:02 I can't do everything but the things I'm going to do,

27:04 I'm going to do really well,

27:06 I'm going to be really focused and I'm going to see impact in those areas.

27:10 AT: But it is very important to go

27:11 to the dentist every six months, don't forget that.

27:15 David, just quickly.

27:16 DF: Sure, so, completely agree with Kiah's points.

27:19 And one way that I've sort of framed

27:22 this in a way that's been really helpful for me,

27:24 is that I've considered the moment that I nearly died

27:27 for the first time to be the start of my overtime.

27:29 And overtime is a sense that many of us can relate to.

27:32 So think about at the end of a sporting

27:34 event where your game goes into overtime,

27:37 and if you're playing in one of those games,

27:40 it can be really scary to be in overtime because like, at any minute,

27:43 the game could end, if you make a mistake in overtime, the game is over.

27:47 Make a mistake in the first half the game, you can make up for it.

27:50 So overtime can be really scary.

27:52 But overtime can also be really clarifying.

27:54 When you're in overtime,

27:56 you focus only on the things that are most important to win,

27:59 whatever that sporting event is.

28:00 And so I found for me that I've been in the state of overtime now for 15 years,

28:04 I guess I'm in my fifth overtime by now.

28:07 But in this overtime, it helps me to sort of cut out the noise,

28:10 the things that I don't care about, the things that aren't important to me,

28:14 and to just focus on the things that are really important to me.

28:17 And so I think that I've, when I was 25,

28:19 sort of first realized that we're all in overtime.

28:23 But the truth is, we're all in overtime.

28:26 And, you know, none of us know how long our overtime is going to go for.

28:29 But all of us have the ability to make the most of every second in overtime.

28:33 AT: What a great way to end.

28:34 David, Kiah, thank you so much for a great conversation.

28:37 (Applause)