We welcome you to Conversations About Ethics. Today's workshop and keynote speaker represent the 12th installment of Conversations About Ethics in the series, which explores ethical dilemmas that influence both health care delivery throughout the life cycle. The conversation about ethics is presented twice a year by the Ecumenical Center and the Center for Medical Ethics and Humanities with the generous support of the Methodist Health Care Ministries. We'd like to ask if there's anyone here with the Methodist Health Care Ministries to please stand. We'd like to recognize and thank you for sponsoring this evening's event. A special recognition and thank you goes out to their CEO, Mr. Kevin Moriarty, who has made possible, along with his board of directors, the funding to bring this to you this evening. Is there anyone from the Methodist Health Care Ministries here with us this evening? They may be joining us a little later. Dr. Ruth Bergren, my colleague, is the director of the Center of Medical Ethics and Humanities and regrets that she's not able to be here this evening. And she's actually on a global health work in Haiti at this particular time. And so she sends her best as well. I'd also like to say hello to Principal Delia McLaren and her students from the Young Women's Leadership Academy. This all-girl college preparatory school focuses on science, math, and technology fields where women are often underrepresented. And we're so very pleased to have them with us here tonight. Do we have some folks from the academy here tonight? I believe we have two representatives and the others are stuck in traffic, but they'll be here momentarily. Before we get started, I have a few housekeeping details to go over. Dr. James Evans and the planning committee for this lecture have disclosed no relevant financial relationships with any commercial interests related to the planning or implementation of this activity. 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Tonight's presentation is entitled Genomic Medicine. What do you know about your genome? At this time, I'd like to recognize to the podium Dr. Jason Morrill who will introduce our speaker for this evening, Dr. James Evans. Dr. Morrill.  Tonight's topic represents some of the most challenging issues of 21st century medicine and technology. Powerful new knowledge about the human genome is ushering in an era of personalized medicine. Researchers are answering questions that seemed out of reach even just a decade ago. Laboratory and computational discoveries are changing how medicine is practiced and understood. It's critical that we understand not only the science of these breakthroughs but also the legal, ethical and social implications in our culture. And it is critical that those who understand the technology communicate the purposes and implications of this technology to the public. Consider how patients and families are increasingly making decisions about health conditions not just months away but decades away. Who will be the messengers and interpreters of the information that people and families receive? Who will guide the families and their decisions? How will we train physicians and other clinicians to communicate information and guide decisions usefully, compassionately, and according to sound ethical standards? How will genetic information be protected? How will we balance the privacy rights of patients with the operative needs of insurance companies and employers? What role should the government play in regulating access to private information? And what other possible personal or informational risks lay ahead? To what extent is the pursuit of genomic mapping in medicine a shared social enterprise? Is genomic medicine a technological fancy, perhaps a privilege of those who can afford to participate? Or is genomic medicine the foundation of what will become a core practice and an essential right in our systems of health care? In a moment, Dr. James Evans will describe how genomic advances are affecting the practice of medicine and what they mean for your health and perhaps his insights will gesture towards answers to these difficult questions. First, let me tell you just a little bit about him. Dr. Evans is funny. I noticed that just a moment ago when meeting him. He is also the Bryson Distinguished Professor of Genetics and Medicine at the University of North Carolina School of Medicine. He evaluates and counsels patients with a variety of genetic conditions. He directs the Bryson Center for Human Genetics and seeks to integrate basic science investigation with clinical care. He is also the editor-in-chief of the prestigious journal Genetics in Medicine. His major research interest is how best to use powerful new DNA sequencing methods to diagnose genetic disorders ranging from cancer to heart conditions, developmental abnormalities, and neurologic diseases. Dr. Evans has extensive experience in the realm of policy regarding genetic issues. He has testified before Congress and presented to the United States Presidential Commission on Bioethics. He was also written up in the New York Times for his work teaching the nation's judges what they need to know about genetics. It is my privilege to welcome our most distinguished professor, Dr. James Evans. Thank you. I really appreciate it. It's a thrill to be here. I think that the work that this center does is very important because if we ignore the ethical implications of the science and the technology that are really changing our world, we're not going to be able to use those technologies and that knowledge to benefit. And in fact, it can cause harm. So what I want to ultimately talk to you about is how genomics is being used in medicine and some of the challenges that are being presented now and are on the horizon in the relatively near future. But I think it is probably instructive to back up and talk about a little bit of history first. And I think it's especially instructive to look at how technologies that have changed our world were first perceived when they were discovered. So this is the very first x-ray that was ever taken. That's William Rentkin's wife's hand. And you can see here her wedding ring. And it did not take incredible insight to recognize how this technology would be used in medicine. And in fact, the world literally beat a path to the door of the Rentkins. And within months, this technology was being used for obvious applications in medicine. But another technology that affects our lives every second since from our birth to our death did not have such a clear trajectory and that's electricity. Electricity was known by the ancient, the Greeks described it, for example. But as late as the late 18th century, Benjamin Franklin, who was very well known as a scientist before he was known as a statesman, made the comment that electricity is a fascinating phenomenon, but it will never be of any practical use, which is quite a remarkable statement given that it influences us every second. So I think genomics is more along the lines of the x-ray than it is electricity, but I'm sure there are surprises in store for what it can do for us. Certainly there will be ethical challenges in store for us. Also with new technologies, we have those who misuse it intentionally through either greed or perhaps not intentionally just through ignorance and seek to capitalize on the general ignorance about science and technology that exists in our society, something that has gotten even greater as we have advanced in our ability to understand the world in a scientific view. So understanding genetics has actually been something that has been a relatively recent phenomenon. It wasn't too long ago, really at the turn of the last century, that the only way to grapple with the phenomenon of heredity was through philosophy or poetry, for example. Thomas Hardy, one of the great English poets, wrote a poem that really encapsulates the mystery of heredity, and he wrote this before Mendel's Laws were rediscovered right around 1900. I haven't been able to find the actual date, but it's a beautiful poem. It says, I am the family face, flesh perishes I live on, projecting trait and trace through time to time's anon and leaping from place to place over oblivion. The year's aired feature that can in curve and voice and eye despise the human span of endurance, that is I, the eternal thing in man that heeds no call to die. It's a beautiful distillation of the mystery of genetics, right? The fact that something transcends generation to generation and retains its fundamental information and properties, but at that time, no one had the faintest idea. Well, there was one person who had the faintest idea, and that was Gregor Mendel, but nobody paid attention to him. So flash forward 50 years, and on a Saturday afternoon in February, February 28th, 1953, these two guys, Watson and Crick, walked into the Eagle Pub in Cambridge, England, and announced, we've discovered the secret of life. And for once, a boast made in a pub was actually true. They had, right? And they had done it using data that Rosalind Franklin had generated, unbeknownst to her, to the time of her death, probably from a genetic condition that caused her to have an incredible predisposition to breast and ovarian cancer. But how did we get from Thomas Hardy to Watson and Crick, right? Well, we got there to the application of science. And my, oh, there it is. And I think it's really important before we explore the current landscape of genomics to just think for a minute and explore science itself, because we live in a society where science and technology dominate every facet of our life. And yet, we also live in that same society in which most individuals don't really know what science is. And even more to our detriment, our decision makers rarely have a good grasp of science. And this is a big problem, right? And I think that we need to all work to try to ameliorate that deficit. Science is an intellectual toolkit. That's all it is. It's a process that we've developed for better understanding the world and in hopes of controlling the world. It is based on these basic tenets. You all learned in elementary school of observation, hypothesis, generation of the hypothesis, measurement, prediction, experiment. And then critically, it's an iterative process, a reapplication of those types of approaches in order to come closer and closer to an underlying truth. And it has a long history. Roger Bacon, for example, this gentleman named Edward Grossateste, was one of the first people to advocate what is probably the most critical aspect of the scientific method, which is experiment. But it hasn't been very long. It's only been a few hundred years that experiment has been recognized as an important facet. Science is an intensely practical endeavor. It really demands nothing more than predictable results. It's not a belief system. And it's achieved a remarkable measure of control over the world. We're in a room that is climate controlled with the flick of a switch we can cause lights to come on. And the fruits of science are technology, but they're not the same thing. Technology and science have an interesting and a synergistic relationship, but they're very much not the same thing. Science is the process that often leads to better technology, which in turn propels our understanding and advances in science. And really importantly, of course, it's necessarily tentative. We can never ever be absolutely certain in science. We are always open to revision if it's justified by data. And the trajectory, therefore, isn't smooth because we do a lot of iterations in our attempts to understand the world. And that means that the history of our efforts are stuttering, they're full of blind alleys and U-turns, but in the end, they've been shown to be remarkably successful. Mendel was not absolutely right. And we have come up with exceptions to Mendel's laws. Likewise, Newton described the world to a very close approximation, but Einstein was able to describe it better. In the end, though, we have made a lot of progress and we've achieved tremendous success in controlling our world. And this has philosophical implications in addition to technical implications. The very fact that science is so successful says something about it. It says that it is a way of glimpsing and underlying reality. There's an old saying, I'm not sure how old it is actually, that there are no pure social constructionists at 30,000 feet. In other words, the fact that most of you are willing to get on an airplane is a very strong testament to the fact that you trust science to glimpse the underlying reality of the universe and act on it. You would probably not trust an airplane that was built on principles other than scientific principles. There's an important corollary to this and that is that common sense is not necessarily a good guide to underlying reality. And I remind myself of this every time I look at a sunrise or sunset. It's very difficult to look at a sunrise and really internalize the reality that the sun isn't moving, that we are actually spinning at 1,000 miles an hour on a tangential route and that's just appearing to make the sunrise. So science can also be seen as a way to short circuit being misguided by our inappropriate and our incorrect intuitions. So flash forward another 50 years from 1953 to 2003 and by that time the human genome had been sequenced. And our ability to grapple with the human genome is limited by one major thing and that is it's really, really big. And I know that doesn't come as a surprise to any of you but it bears thinking about just for a minute to try to get your head around just how big the human genome is. This is about one millionth of the human genome. And if I showed a slide like that every second we would still be here in 12 and a half days taking absolutely no breaks and I would have only gotten through the haploid component of your genome. That is the part that your mom or your dad gave to you. Now the genome is filled with fragments of genes and throughout that genome are polymorphisms where you differ about every thousand bases, every thousand rungs on the DNA ladder. I've been told that it's humorous to own one DNA tie that's kind of pathetic to own as many as I do but I wore this one in celebration of being here tonight. So about one out of every thousand rungs on your DNA ladder differs from the person sitting next to you and many of those are frankly meaningless. They don't affect your health, they don't affect traits, they don't affect anything. Some of those however do influence traits like what color eyes you have, they're few things as genetic as what color eyes you have. Some of them influence medically important characteristics and occasionally there are mutations, there are serious changes in your DNA code that results in a dramatic influence on your health. So the question is we've got this ability now to dissect and define your genome, what do we do with that? What's the potential for benefit there? Any time a new technology is rolled out you hear the criticism sometimes very justifiably that if you've got a hammer everything looks like a nail and sure enough we've been using this technology to just bash the heck out of every genome we can find and there's a role for that because we find out a lot when we do that but as a physician what I wanna know is how can this technology be used for bettering people's lives and I'm especially interested in how that can be used in sick people and how that can be used in healthy people. So what are the right nails for the use of this very powerful instrument? Well in sick people it's pretty clear that it is going to be an effective diagnostic tool for those conditions that have a major very prominent genetic etiology. So take this woman who's 47 years old and she has a sudden cardiac arrest she's fortunately resuscitated successfully but in EKG what's noted is that she has a syndrome called long QT syndrome in which individuals have a very high risk of sudden death it's a very grim disorder. It's treatable if you know about it you can really make huge inroads in decreasing an individual's susceptibility to sudden death if you know about it there are pharmacologic approaches that are very successful you can use implantable defibrillators et cetera. The problem is up until a few years ago we couldn't know what mutation was responsible for somebody's long QT syndrome in the majority of cases because there are many genes that are implicated and which gene is implicated as a cause for an individual's long QT syndrome has a lot to do with the successful treatment of it but now with massively parallel sequencing we're able to detect mutations and by so doing we can guide a patient's treatment and just as importantly to most of these people we can guide evaluation of family members to figure out who's at risk and who isn't who needs to go on these agents who might need an implantable defibrillator and who can rest easy that they are not at a high risk for sudden death. Now sometimes you hit a home run when you apply this technology and you not only make a diagnosis that matters in treatment but you make a diagnosis that really changes somebody's life and for the rest of my life whenever I give a presentation I'm gonna show this slide, all right cause this is one of the best cases I've ever had as a researcher and a physician and I don't wanna imply that this is the norm for the application of genome sequencing but it is the potential at times to achieve results like this. So we had a 36 year old woman who was diagnosed when she was six years old with hereditary spastic paraplegia. Within a year or two she had such spasms of her legs and basically loss of control of her legs that she couldn't walk and needed two crutches or if she was going very far a wheelchair. And that's her when she came to her first appointment. She also in addition to this disability had painful episodes of spastic contractions of her legs multiple times a day they were very painful and very disruptive to her life. We entered her in the study that we're doing in which we use whole exome sequencing which is a kind of a little brother of whole genome sequencing in which you sequence all of an individual's expressed regions or their genes. And what we found was a mutation in the GTP cyclohydrolase one gene which had been previously described to be associated with a condition called DOPA responsive dystonia and of course what caught our eye was this DOPA responsive aspect of the name of that disease. DOPA is a very routinely given drug it's you all know people on DOPA because it's the first line of treatment for Parkinson's disease millions of people are on it. It's a very safe drug so we called up her neurologist and we said why don't you try DOPA and she was very excited to do so and she walked back in six weeks and had left her crutches at home. I felt like a faith healer it was unbelievable. And maybe the best part or probably the second best part about this was it also vindicated my career and my daughter's eyes because Cosmo picked this up right and there's the story about bad girl sex and am I normal down there and it picked this up as a mystery diagnosis and as I said my daughter was fine finally understood why I went into medicine. So this technology will be useful in those people who have difficult to diagnose diseases that are primarily genetic in their etiology but if you really wanna make an impact on health you need to start with healthy people because it's a whole lot better to prevent disease than to cure it even when you can do that later on. The problem is that there are challenges to applying technologies and knowledge to healthy people. This is the world's happiest colonoscopy patient that's Katie Couric and she's got a lot of reasons for promoting colon cancer screening because her husband Jay Monahan died at the age of 42 because he had a dramatic predisposition to colorectal cancer. He had a Lynch syndrome. The problem is though that we have to think hard before we start inflicting our technologies on healthy people in part because they have less to gain than sick people. When a sick person comes to me in clinic there's an understanding that I may not be able to help them that most people understand that medicine can hurt them as well but when you start out healthy you kinda only have a downward course as your only option. In addition, when you try to implement public health measures you have a different relationship between the provider and the recipient. Patients come to us but healthy people don't come to us. We go to healthy people and say you should have colonoscopies, you should have pap smears, you should have mammograms. So we have to be careful about that. The individual isn't seeking us out. In addition, the benefits are less obvious. Great news, you didn't get sick. That's not very dramatic to tell somebody and the downsides are easy to see and every intervention we have ever come up with in medicine has potential downsides. In addition, the applications are implemented and mass. We do them in everybody and the problem with that is that everybody has to say including people who have an agenda and including people who are simply wrong. Does anybody know who this is? This is Jenny McCarthy who's done a lot of damage in her advocacy against vaccines. I can think of actually no greater single advance in the history of medicine than vaccines and discouraging people from vaccination I think is a big problem. So because of all of these things, policy issues are orders of magnitude more difficult when you start with a healthy population. And I think the lesson is that the ratio of benefit to harm has to be very high before you start implementing such things. But I think there are opportunities for the general public, the general population to benefit from these technologies. And the one that I'm most interested in, this is me as an infant with one of my DNA ties. I think of in terms of newborn screening for adults. Newborn screening has been a singular success in the realm of genetics as a public health intervention. The diseases that are screened for are not common but they are so bad and they are so preventable, right? If you pick the right ones to screen for that it still makes sense to test everybody. Well it so happens that roughly 1% of us in the general US population harbors a mutation that leads to a very high risk of a preventable disease and a good example of that is Lynch syndrome. Lynch syndrome results from mutations in one of four genes and if one has such a mutation one is at a very high risk for colorectal cancer. And the way we diagnose it now is just a little too late. We wait for people to tell us that a bunch of members of their families had colon cancer and maybe died or we let them get colon cancer and look at their tumor and say hey this might be Lynch syndrome. Not a great way to diagnose this, right? Well massively parallel sequencing now offers a technology by which we could screen carefully selected genes that when mutated cause a high predisposition to a preventable disorder and inform people before they get sick so they can take preventive action. It's not all about cancer, BRCA 1 and 2 are examples of this but also there are genes that when mutated cause a very high risk of vascular catastrophe et cetera things that if you know about them you can intervene. And as I said about 1% of us carry such mutations and we can find those now with massively parallel sequencing and indeed we have an effort at UNC in which we're piloting this type of approach. But when we start thinking about especially taking healthy people and looking at their genome it kind of pays to ask what's in your genome that you wanna know or don't wanna know. So let me ask you a question and get a show of hands. Here is a short list of a few really bad genetic diseases. I mean the very existence of these diseases presents profound challenges to philosophers and theologians and ethicists but I won't go there. But there are forms of Alzheimer's disease that strike at very young ages that if you have a mutation in one of a handful of genes will essentially guarantee you're gonna get Alzheimer's disease. Same with a disease that's grimly but accurately named fatal familial insomnia. If you carry a mutation so just think about yourself for a minute in your life that essentially guarantees that you will develop a severe and untreatable neurological disorder in the next 10 years, do you wanna know? So who here would say yes, I wanna know. Okay, we've got a roughly half I'd say maybe a third. Who here feels like no, I don't wanna know. So not quite as many but a substantial number. Who here doesn't know? So I think that the doesn't know is probably the quote right answer in the sense that we know from Huntington's disease where I actually have data that although many people espouse an interest in this when push comes to shove, fewer than one out of five people actually elect to know which I think says something about how powerful and how useful denial is in our lives. And I'm not saying that in a pejorative way. I think denial is very useful if we really got up every morning and internalized the fact that we're gonna die and all our friends and loved ones are gonna die, we might not get out of bed, right? But the point is that your genome has value heterogeneity. That is you see the same information perhaps in very different terms from somebody else and we have to navigate that. That's a challenge to our new ability to define and dissect one's genome. There are a lot of other challenges that we have to come to. One that frustrates me is exaggerated expectations and claims. You hear oftentimes that soon everyone will have their genome sequenced and I don't really buy that. It's typically predicated on low cost, right? It's gonna be really cheap. The problem with that is, it reminds me of a really well-known personal finance aphorism that an elephant for a nickel is only a bargain if you have a nickel and you need an elephant, right? And I don't think whole genome sequencing is really an elephant that most of us need even if it's virtually free. Moreover, low cost upfront is an illusion in medicine, all right? Misapplication of medical tests is very, very expensive. And not only in terms of cost, but in terms of morbidity and mortality to individuals. And the most recent example of that probably is the premature implementation of massive PSA screening. Probably not a great idea upon collecting the requisite data. This costs a lot in terms of dollars as well. And I would add that patients and healthcare systems aren't well-served when we seek information that we really don't understand and we're not sure how to use. I think we have to be careful about what information we seek in medicine. It's not only needless, but it begs for misinterpretation and overinterpretation. Medicine has a lot of hubris associated with it and it's very, very tempting when you have a result in hand to think you know what's going on. And what I would plead for is the need to establish evidence that we really do know what's going on before we implement such things outside of a research setting. And we have to be guided by evidence. And when we ignore the need for evidence, it's a real problem in medicine because the stakes are very high. A great example of this is hormone replacement therapy. There was a time not too long ago when every post-menopausal woman, it was recommended that she go on hormone replacement therapy. And it's not that that can't be useful. There's a role for HRT, but it's clearly not something that we should be doing in a reflexive manner to everyone because we cause excess mortality.  Again, I'm not saying it can't have a role. It can, but it should be an individual decision. And the most grim reminder of this to me is something that we did when I was an intern on a routine basis. When a patient came in with a heart attack, we would put all of those patients on a lidocaine drip, the same stuff you get at the dentist to deaden you up. And the reasoning was really seemed almost unassailable. This is a PVC, a premature ventricular contraction. We know that people who have just had a heart attack have a lot of these. And we know that we can suppress these by giving lidocaine. And we know if you have a lot of these, you're at an increased risk for death from a dysrhythmia. So why the heck wouldn't you give lidocaine? So we gave lidocaine to everybody. And then when the studies were done, it was found that we were actually increasing mortality. So what I wanna get at with that anecdote is that all of the reasoning in the world is not good enough to implement things when the stakes are as high as they are in medicine. We have to see evidence of benefit. And there are a slew of other examples like this. The medical literature is littered with the bodies of hypotheses that seemed great, but were implemented before proper evidence was accrued. So what we've now seen, of course, with the rise of this technology is, we've seen the rise of a variety of claims of commercial offerings for DTC that is direct to consumer genomics. So I wanna just explore for a minute what kinds of information you can get from such things. For example, your ancestry, common disease risks and reproductive guidance. It reminds me a little bit of the quote by Andy Warhol that buying is more American than thinking, right? And I think there's some truth to that. Now, ancestry is a fairly harmless pursuit, right? So I have no problems at all with companies selling kits to look at your ancestry.  But we're narcissistic, right? We really like looking at ourselves. And I spent $95 several years ago to find out my ancestry. So I got my mitochondrial haplotype and my y-chromosome haplotype. And it turns out that my ancestors are from Europe. I mean, who'd have thought that, right? I got that result. I was not $95, I never looked at it again. It was pretty obvious. I could have just used a mirror. So I would just, you know, it's interesting. I'm not trying to dissuade anybody from getting that, but you also might wanna think about whether you probably know the answer already. Common disease risk assessment I think is more problematic. That has been a hope of genomics for years now that we would be able to impact common diseases through analysis of one's risk. And the problem is that common diseases have many causes and genetics is only one, right? We've got exercise and hypertension and smoking for heart disease and diet. So this place is an inherent limit on how useful any genetic analysis is ultimately gonna be for telling you something useful about your risk of heart disease. And what I think is even more profound is the conflation of absolute risk and relative risk. I know what you're gonna die of, okay?  Now, a few of you will get lucky and like get shot or something. But to a first approximation, we're gonna die of common diseases, right? So the question is what does it really mean to parse our relative risk? If I tell you you're at a 0.8 relative risk because of your genetics for heart disease, you still may very well die of heart disease. In fact, it happens every day. So what I would caution you about is that it's hard to get useful information out of adjusting risks for things that you're no matter what gonna be at high risk for. And we're all gonna benefit from the same interventions like these really difficult things to do, like eating right and exercising, et cetera. Another challenge of implementing this technology in my mind is the role of the market. Now don't get me wrong, I think that the market can be a very useful thing. I mean, we would not have these great smartphones which I love, I'm like sutured to this thing, all right? And we wouldn't have that without the market. But in medicine, I think it's problematic to rely on the market to propel the uptake of a complex medical test. It's often marketed with unrealistic claims or as entertainment. My friend Peter Byers coined the term Narcissism, right? Which I think is pretty good. And the fact is that genetic analysis is a complex medical test. It does the power to hurt, to help, and to confuse. I don't think aggressive marketing is the way we want technologies to gain a foothold in medical care. I think that harnessing the market for the developments and innovation with regard to technologies is great. But as far as implementation, I think there are major problems with that. And I would also remind you that we all have a shared stake in using medical tests correctly. The libertarian argument does not hold much water in the realm of healthcare because even Bill Gates, I guarantee you, has health insurance, okay? We all are in a shared environment. So when you use a medical test improperly or I use a medical test improperly, it impinges on all of our pocket books. Now you can't talk about genetics very long, especially the ethics associated with it, without thinking about reproduction. Because really, reproduction is all about genetics, right?  It was in the New York Times a number of years ago. And it was about an ad that had been placed in Ivy League alumni newsletters. They didn't take out an ad in my alumni newsletter, the University of Kansas, go figure. But what they wanted was this couple offered, they said, we want an egg donor. We want her to have SAT scores of over 1400. We want her to be five, 10 or taller. And we want her to be athletic. And we will give $50,000 to the winner, right? To the egg donor that we pick. And I think most of us feel a little uncomfortable about this and it's sometimes a little bit hard to figure out why we feel uncomfortable. I think part of it is the illusion that we really have that much control over our progeny. I think any of you who are parents know that in the end we probably don't. But I think it also is instructed to reformulate this ad. Because how do you feel about it if instead of saying this, it just said, let me go back. If it said, we want these traits, but we'll just reimburse expenses. We won't give 50,000. That might be a little more palatable. But what you don't see is you don't see this. And I'm not sure the world needs a lot more tall jocks that are good at standardized tests. But I can tell you if I can bequeath, I say that as a short non-jock. But if I could bequeath one thing to my children, it wouldn't be those things. It would be probably a positive attitude towards life. Now, I know that's harder to quantify, et cetera, but you can actually, you can quantitate those things. And if I were trying to select a sperm donor or an egg donor, I would be interested in those types of things. But what this gets to is the fact that we are inching closer towards designer babies. This is a patent that was taken out by 23andMe, the major direct-to-consumer genomics company. They were very quiet about it, okay? But this patent was granted last year by the USPTO. And it's a method. It's a very nebulous thing. They can't do this yet, but they wanted to get, they wanted to stake it out. And it's a method for asking people what traits they want in a child and then delivering a high probability of that type of child. Now, I think most people would not check the box. I want a high probability of colorectal cancer in my offspring, right? But what they also included were things like, okay, I want a child with blue eyes who can taste bitter or can't taste bitter, who is a likely sprinter or a likely endurance athlete, right? And it's hard to think at first why we are made uncomfortable by that. And I would warrant that most of us are made a bit uncomfortable. I mean, after all, we do try to optimize our progeny. We go to all kinds of lengths to optimize our progeny, so how is this different? And I struggled with that until I read in the Dalai Lama's book, The Universe in a Single Atom, he puts his finger, I think, on why we're uncomfortable. He says that thus society will find itself translating in inequity of circumstances that is relative wealth into an inequity of nature through enhanced intelligence strength and other faculties acquired through birth. In other words, we can at least kid ourselves that we are living in a society where everybody has an equal chance. And we know that's not true, but it's kinda true to an extent. But if we lock in those advantages biologically, we are no longer, we can't even pretend we live in that kind of society. And traits do have a genetic component. None of you are shocked or probably made to feel uncomfortable by the fact that height and weight and blood pressure have a genetic component. But it is also the case that things like personality traits are vocational interests as adolescents and things like religiosity, which not surprisingly tracks with traditionalism have a genetic component. So a better understanding of these things not only holds out the fear of a dystopia, like design or babies, but it also holds out the hope that we could use such knowledge for human betterment. So if we could understand bad behaviors better, this would be a good thing, all right? Diabetes and cancer are very costly, but just in terms of money, substance abuse, which is really a behavioral problem, costs more than those two things combined. And as a general physician for 30 years, I'll tell you that I don't think there is another set of diseases that causes more just absolute human suffering than psychiatric disorders. So if we can understand these things better, maybe we could intervene, maybe we could ameliorate some suffering. Well, we know that 50% of the Earth's population has inherited a distinct genetic factor that predisposes to a proclivity for engaging and risky behavior. It's the Y chromosome, right? It cuts across all demographics, all borders, all time.  And that is, I warrant, and there will be arguments with this, but that it has some biological basis. And if we could understand those things better, we could approach perhaps substance abuse and addiction more effectively. Now, in a study that sought to understand more about the interplay of genetics and environment, a real landmark project was done by Caspi who followed over 1,000 children for 26, until they were 26 years of age, and they assessed the genotype of an important gene that controls a variety of neurotransmitter levels called MAOA, as well as their exposure to maltreatment growing up. And those with both a low MAOA polymorphism and who were maltreated had very distinctly elevated outcomes for things like conduct disorder, 10-fold increase in violent crime, 85% of males with a low MAOA genotype who were also severely maltreated developed some sort of antisocial behavior. So you can say then that in this context of maltreatment, the low MAOA polymorphism increases susceptibility to the ill effects of such maltreatment, or you can flip it around and say that, gosh, a high MAOA genotype protects against such an outcome with maltreatment. And one of the things I love about genetics, unlike most medical specialties other than, for example, psychiatry or neurology, is that it forces you to grapple with some fundamental philosophical issues. And one of those is, for example, free will. We know that our behavior is influenced by genetics. What does that say about free will? What does it say about the judicial system in which we hold people accountable for their behaviors? And it's not that I'm advocating that violent criminals be given a pass. We unfortunately are unable to correct that and such people do need to be quarantined from the rest of society. But I think it is a fair question to ask how much choice they had. Is free will an illusion or is it real? There's a large body of philosophical thought that holds that free will is actually a very, very good illusion. And there's some very interesting evidence to suggest that may be the case. So the question is, as we understand this better, largely through genetics and neurochemistry, are we gonna someday be able to detect violence alleles and do something about them, to correct them, right? What about preemptive correction of such things, like the movie Minority Report? Now on one hand, we already treat violent individuals with nonspecific court-mandated psychotropic drug. So we already kinda do this in an extraordinarily blunt and not real effective way. A better understanding of such things could perhaps help us more effectively treat such people. But of course, people are probably squirming a little, as I say this, because it could also lead to a real dystopia, right? I don't really wanna live in a society where we're casually altering people's brain chemistry because we have a hunch that maybe they're gonna do something bad, right? That's pretty scary. And there's the unintended consequences. Every time we do something in science and technology, there are usually things we didn't anticipate, including things like stigmatization of people who are now labeled as perhaps potentially violent. So science is not gonna solve these dilemmas, right? We're not gonna come to resolution of these ethical dilemmas through science, but I can tell you this, we're gonna need a scientifically literate populace and scientifically literate leaders if we're gonna successfully navigate these challenges. And that's a problem, right? Because again, we live in a society where most people don't really know what science is. They run from it, they're turned off by it at young ages. Half the population, women, are discouraged in very overt ways from pursuing science all too often. And the problem with that is when we misunderstand and when we misapply science, the consequences are formidable, right? They're formidable in fairly trivial ways by people buying electric corsets, right? But they are formidable in absolutely existential terms when we misunderstand some issues that put our entire planet and our entire species at peril. So what we need to do is we need to work on creating a scientifically literate society. And I think there's actually one educational reform that could go a long way towards helping with that. And that is some type of statistical literacy. My kids went to a very good public school, all right? Junior or middle school and high school. And yet, while they had to take trigonometry and pre-calculus, they never had to take a course in statistics. And I can tell you, I haven't taken a lot of mathematics that I don't use my integral calculus very often, right? But everybody can use statistical reasoning. Whether you're staying at home and taking care of kids and shopping and trying to get the right product, whether you're going out in the weather and you have to understand what a 30% chance of rain means, which depressingly a lot of people don't when it's tested. Our policymakers need to understand something about statistical significance. And when coincidence is just coincidence, right? And why a rare event doesn't necessarily should be generalized. The press isn't very good at getting these things across. And there's this idea that statistics are boring and dry and yet we have an entire city, not that far from here, that's based on probability, basically based on misunderstanding probability, right? On the part of the consumers. So it doesn't have to be boring. Science needs to be taught in a way that its actual relevance to one's life is made manifest. And I would also add, as somebody who is passionate about science, that we need to emphasize the beauty of two. Because I will tell you, as most of you I think appreciate, but much of the population doesn't, that an understanding of science is an unbelievable boon to our appreciation of the beauty of the universe. From understanding how mountains arose, understanding that these stars, that the light that's impinging on your retina is literally millions of years old, right? It does nothing but enhance the beauty. I bristle at the idea that enhanced understanding somehow makes art dry or makes beauty less manifest. I don't think that's true. So I wanna finish up by addressing the elephant in the room. You can't really talk about science and technology and all without discussing at some point, if you're honest, science and religion. And it is the fact that a scientific worldview is not inherently inconsistent with the belief in the existence of a God. And when I say it's a fact, I mean it's empirically evident. There are scientists, very good scientists who are able to reconcile a belief in a supernatural God, right, with their scientific endeavors. Religion's persistence I would add is insured by the inherent limits on our own understanding and on our drive to understand. We're never gonna be satisfied with an incomplete description of our universe and yet we're never gonna have a complete description of our universe for a reason I will say in a minute. On the other hand, the uncomfortable thing for many people is that there's no question that religion is constrained by science. I'm sorry but the earth is not 6,000 years old. It's 4 billion years old and there's plenty of evidence to support that and we can't cling to religious views that are manifestly false. But scientific understanding itself is also constrained and we can't think of science as an absolute antidote to all ignorance in the world. And the reason I show my dogs, this is Sparky and this is the auxiliary backup dog, Lily, is no matter how hard I try, I would never be able to teach Sparky integral calculus. It is just beyond his brain, right? And there is every reason to realize that our brains have limits too. We are not up to the job of omniscience. We are limited by our biological resources. We will never completely understand the world. There will always be room to wonder and to invoke religion and supernatural explanations. I love what Ken Jennings said when the IBM computer beat, just crushed everyone, right? At Jeopardy. He wrote on his final Jeopardy thing, I for one welcome our new computer overlords, right? Because it is interesting to think that while we are limited in our ability, could we build machines that could build further machines that ultimately are not limited in an attempt to understand the universe? But we're left with a paradox, right? Science can demonstrate our need for emotional warmth and connection. It can explain through neurobiology, through evolutionary biology, why we need those things and it may even be able to inform how to achieve those things in the best way possible. But it can't fulfill that need alone. Science, science will inform that quest but will not solve that quest for us. And for that we need one another. I want to end this with just a few other random challenges that I will not offer the answers to, okay? One is concerns about genetic discrimination. This remains a concern. Gina, the Genetic Information Non-Discrimination Act is wonderful and it has helped me in my practice because I can assure patients that they're not gonna lose their health insurance because they're gonna get a genetic test. Unfortunately, we have no protections against long-term care insurance, life insurance, disability insurance and that's a problem. And I think we need some kind of protection although it's a thorny issue because we already do discriminate say with life insurance because I need to pay more than a woman of my age because it's more likely that I will die and that's fair, right? So I mean some discrimination in life insurance is probably reasonable but it is disturbing that people can be born through obviously no fault of their own with the mutation that obviates their ability to get long-term care insurance or disability insurance. I thought allealism was kind of, I threw that in there thinking, yeah, that's possible. And then I saw this quote by the co-founder of 23andMe in the Washington Post who said, we envision a new type of community where people will come together around specific genotypes. Now that's a little scary, right? I understand that it'd be good if people with disease mutations could come together and promote research and that's probably what she meant. I don't mean to pick on her but we have to be careful about coming together around specific genotypes. The human beings have done that in the past, right? In my own state of North Carolina with mandated sterilization in Europe in the 1930s, right? Gene patenting was largely alleviated by the Supreme Court in June of 2013 when they ruled that human genes are not eligible for patent protection and that's wonderful, okay, that's great. But we still have some problems. That's not the case in Canada, for example. There is a new case that hopefully will achieve the same result. It achieved the opposite result in Australia where patents still exist. But the problem is that people are keeping some labs, are keeping the data secret that they generate on patients. And I can tell you as a medical geneticist that we need to share these data or we're never gonna figure out how to interpret people's genetic tests. So I think this is a problem. Privacy issues are huge. Your genome is a digital archive of information. That is not a metaphor. It is an actual digital store of information. And we are really good at storing, disseminating and hacking digital information. In this paper, they used public databases to look at DNA sequences and in 20% of the time, they were able to find a name, address, and phone number just from the DNA sequence and then going online. You can imagine a prosecutor's eyes lighting up that a blood spot might show not only a DNA genotype but could show a telephone number and an address. The problem is they also had an 18% false positive rate which is wholly unacceptable in the criminal justice system, right? So we're gonna have to grapple with those. I love this quote from the co-founder of Sun Microsystem, Scott McNeely. He said, privacy is dead, deal with it, right? And I think he's right. I think privacy is dead. We're not gonna put that genie back in the bottle. What we need to do is we need to deal with it. We need to figure out how to set up policies and structures that penalize people for the improper use and encourage the proper use of all the data that are out there. How many of you have a grocery store card that gets you a break when you buy groceries, right? Probably everybody in the room. And when you do that, you're making a deal, right? They get to know everything about what you buy and you get a break on dog food, right? I do the same thing. I think it's worth it. But they know a lot about you by what you buy. They know who you're gonna vote for in the next election. When decode, one of the direct-to-consumer companies went bankrupt, one of the envisioned solutions in the bankruptcy court was that the data that they had accrued over several years would become the property of a venture capital firm in Cambridge, Massachusetts. Probably not what the people who spit into those tubes and sent it off to the company really were counting on. So we're gonna have to grapple with who will control, have access to this information and how we ensure that it's used predominantly for good. And I will end with a cartoon from Hilary Price, Rimes with Orange, about the dangers of genetic engineering. Create a dog that's scared of cars that's clean enough to enter bars who never would a cat mistreat whose breath's forever minty sweet. But first, before we splice a gene, let's think about the unforeseen. Our good intent to hybridize can engineer a bad surprise. A dog who might be quick to judge or God forbid who holds a grudge, who leaves behind its role traditional and offers only love conditional. So I will stop there and I think we got some time for questions. So if you can go to the microphones, right, because otherwise they're recording it and it'll be a big blank. Yes. Hey. Jim, come and play. That's it, go on. I noticed that you didn't use one term, you skirted around the phrase sometimes, but the term eugenics. Yeah. And could you comment on, did you intentionally disregard that or? No, not really. I think that I alluded, right, when I talked about coming together around specific genotypes. Genetics has been, it's not one of those fields where there's just the potential and the hypothetical chance of misuse. It has been misused. It has been horribly misused. If you look at Nazi Germany, if you look at our own country, the eugenics movement was very strong. And I think that that came from several things, including hubris, we thought we knew more than we did. But what I would emphasize, too, is it came from a lack of understanding of genetic principles and a lack of evidence that what was being done was actually going to benefit. So I think that, again, that eugenics is both a strong argument for the work of a center like this. And it's a strong argument for our policy leaders and our population to have a thorough understanding of science because most of eugenics was just bad science in addition to being horrific from an ethical standpoint.


Remember a hallmark card when you carry enough to send the very best. The hallmark cards bring you Fred McMurray in the Hallmark Playhouse. Each hallmark brings you Hollywood's greatest stars and outstanding stories and presents as your host one of the most distinguished actors of the American Theater, Mr. Lionel Barrymore. Ladies and gentlemen, this is Lionel Barrymore. You know, whenever we on the Hallmark Playhouse turn to the books of Bellamy Partridge, we are sure to find a story that both warms the heart and brings a smile of remembrance. And this is, as it should be, Mr. Partridge writes of the things he knows best, of the American small town at the turn of the century, of his father, the country lawyer, and of his family. Tonight's story is about that family and is titled, appropriately enough, Big Family. And to play the role of the father, we are very happy to welcome back one of our favorite stars, Fred McMurray. And now, here is Frank Goss from the makers of Hallmark Card. When you want to remember your friends, there's one way to make sure the card you send receives an extra welcome. Look for that identifying hallmark on the back when you select it. For words to express your feelings and designs to express your good taste. Let the hallmark on the back be your guide. For that hallmark tells your friends, you cared enough to send the very best. Lionel Barrymore appears by arrangement with Metro Golden Mayor, producers of The Clown starring Red Skelton, Jane Greer and Tim Considine. And now, here's the first act of Big Family starring Fred McMurray. The story of an American family. The story of a big family in a little town of half a century ago.  When Francis and I moved here to Phelps, New York, there weren't any paved roads, because the automobile had just been invented. Yes, and it would still be a few years before they put up the telephone poles along East Main Street. Come to think of it, there wasn't much of anything on Main Street, but a huge three-storied house with a mansard roof and a forest of chimneys. The day we got into town and before Francis and I unpacked our bags at the Woodpecker Inn, old Dr. Hobson drove me out in his carriage to see that house. Look at it this way, Mr. Partridge. You're brand new in our town. You want to get off to a good start in the law business if you want to attract clients? You've got to do something that'll make Phelps sit up and take notice of you. You want to fire their imaginations? Sure, me got ambition. You buy this here house and that'll do it. It sure will. You may be right, Doctor, but there's only Francis and myself. How will we ever fill 16 rooms? That's where the ambition comes in, young fella. Take my advice and buy this house. Well, I took the doctor's advice and made a down payment of $1,000, and Francis and I moved in. It wasn't long after that when Dr. Hobson paid us his first professional call, and every year or so he was back again. First there was Thad, then Louise, Elsie, Cecilia, Herb, Bellamy, Stan, and Leslie. All right, Sam, you can go in now. She's all right, huh? Francis, she's doing fine. By the way, what are you going to name the new son? Leslie, I think. Leslie pronounced, lastly. Don't be too sure, Sam. Francis? Have you seen the baby, Sam? Yes, dear, I've seen him. Is he good-looking? What a question they ask, my dear. He's your son. Oh, flatterer. Not at all, dear. Because of their mother, I've got three of the prettiest girls in town and five of the best-looking boys. And someday, someday every one of those girls of ours... I know, I know. Is going to marry a rising young attorney and the boys? They're going to have their names right under mine on the office door. Samuel S. Partridge and son's attorneys at law. Francis and I never regretted a big family. For eight children, I've just eight times as much fun as one. There were some years, of course, when I worried how I'd take care of eight ravenous appetites on a country lawyer's income. I remember one winter that problem was solved very nicely. It was the end of the day, and as I drove the rig up to the house, Louise and Bellamy leaned over the porch railing and stared open miles. Mother! Mother! Come see what daddy is it, Sam? Just what it looks like, a side of beef. Sam, can we afford it? No, no. But you remember I said I was going to handle Alex Slocum's divorce case? Well, this is my retainer fee. Courtesy of Slocum's meat market. What's the matter, Francis? Well, I just feel a little humiliated, as if we were being fed by the neighbors, eating on charities. My dear, times are very hard right now. My clients can't pay cash. Most of them can't pay at all. But the only man in town with any ready cash is Finneas Dodd. Yes, and a lot of good debt does this when Mr. Dodd takes his law work to an attorney in Rochester. I know, my dear, but let's not complain. This winter, at least, we're eating like millionaires. Sam, come help me carry this beef to the storeroom. Francis and I thought surely that meat would last until spring, but then came an early January fall. Sam, have you looked at the thermometer? It's going higher. I know, and I just smelled the beef. It's higher still. Now we can't let my legal fee go rancid. We had beef for breakfast, beef for lunch, beef for dinner. When the children were hungry between meals, there was more beef. When Herb got a black eye, he wore a beef steak. When the lady's sewing circle called, instead of tea and cakes, they had tea and steaks. Francis, Francis, guess who I brought home to dinner? Finneas Dodd. He's in the parlor. Finneas Dodd? Oh, Sam. Well, it's important that we make a good impression on him, my dear. Now, if we can handle him right, I think I can get Mr. Dodd to be my client. Oh, but Sam, our dinner... Don't worry about that. Just serve porterhouse steaks for everyone. Nothing impresses Mr. Dodd like success and when he sees all eight of our kids eating steak... Sam, we used up the last of our meat this morning. The last? Yes. Tonight's dinner is pork sausage. We raced to the nearest neighbor and followed three chickens, but even that didn't save the day with Mr. Dodd. Although I doubt you'll have need to remember it, Mr. Partridge. I'm a vegetarian. I didn't get Finneas Dodd's business, but we still managed and managed happily. Francis saw to that. When she wasn't cooking and cleaning and preserving, she was making over her dresses to fit the girls or cutting down my suits for the boys. There are those suits. By the time a pair of my trousers had been handed down to Thad and then to Herb and then Bellamy and then Stan and finally to Little Leslie, about all I could recognize of the original would be my hip pockets. But the boys didn't care. The important thing to them was ice skating on Frisbee's palm and swimming and fishing and building the Fourth of July bonfires. I remember one Fourth of July that got a little out of hand. The whole town had turned out that evening for the big bonfire in front of Phelps Dry Good Store. People were lighting Roman candles in the youngsters. Hours included were setting off canning practices. The window of the Dry Good Store was still pile high with unsold fireworks. Sam, the store window. Hey, look out, somebody threw a canning cracker through the glass. There's plenty of noise, but not too much damage. Then suddenly Francis and I realized that one of our children was missing. Bellamy researched everywhere and when we found him, it was at home in his own bedroom. I just got kind of tired, Daddy. I see, Bellamy. I wasn't feeling too good. And maybe a little scared too? Bellamy, you can tell me. Son, did you throw that canning cracker? I didn't know. We'll go through the window. Then you didn't mean to do it. Oh, no, sir. And then I wrenched and nobody knew I did it. But I know you did it, Bellamy. And what's more important, you know. But, Daddy... Son, a wrong that nobody knows about is just as bad as a wrong that everybody knows. Can't you see that? There can't be public honesty without private honesty first. What can I do, Daddy? Well, we'll take care of this together, Bellamy. Tomorrow morning. I didn't look forward to it any more than Bellamy did because the owner of the Phelps Dry Good Store as well as a good many other business in town was Phineas Dodd. We found him going over the damaged good with his store manager. So, this is the rascal that caused all this, eh? Yes. But it was an accident, Mr. Dodd. And naturally, I expect to pay for the damage. Oh, I don't think that'll be necessary. You said it was an accident. What? But you still have a loss and I want to take care of it. I'm not doing nothing at all. I see. Mr. Dodd, do you mind if I look over your merchandise? Mr. Potridge, if you'll come back some other time. Mr. Potridge. It looks to me as if the only goods damaged is some stuff that's been around here for years and years. Mr. Potridge customers are coming into the store and we're very busy. Your whole stock is insured, I suppose. It is. But now look here. You know, Mr. Dodd, someone scrupulous merchants try to collect more than they should from the insurance companies. If I paid for this damage, it might be only a tenth as much as you might get if you... Mr. Potridge. I'm sorry, Mr. Dodd. But I brought my boy down here today to give him a lesson in honesty. I don't like him to see this. Or do I like an insurance company cheated? I'll be blamed if you aren't the contriious human being I ever met. And the honestest. All right, then how much oil you serve? Sam, have a cigar. I beg your pardon. And calculate a man like me needs the honestest attorney he can find. Here, have two cigars. Are you sure you want Mr. Dodd's business? Oh, he isn't as bad as he thinks he is, Francis. Old Phineas just loves a sharp deal. And the town will be a lot better off if there's somebody to lead him out of temptation. I suppose so. Lastly? Yes, Mother. Family? Follow me? Bedtime for the eight o'clock? It's taken a long time to get established in this town, my dear, but we've finally done it. Now I think our worries are just about over. Oh, a more piano tonight, please. How on Francis would be able to take things easier? We need to have more time to spend with each other. Children! It's all right, Mother. Her just let down the banister. Oh, I'm sorry, Sam. What were you saying? Well, I didn't, but I'm going to say it right now. It's been a long time, too long a time, since I've told you how much I love you. Oh, darling. Mother! Mother, will you tell Elsie she can't wear my bustle to the party? Oh, good heavens, there's family. Every moment there's something. Well, naturally, my dear. Yet I wouldn't change it for the world. Sam, sometimes I think you're the most patient man. No, no, my dear. Just the luckiest. An act of big family is starring Fred McMurray. For the calendar shows that a very happy day is coming up soon. A day that sort of breaks up the long winter months between Christmas and Easter holidays. Of course, that day is St. Valentine's Day. Now, everyone from your kid's sister or older brother to your grandparents likes to be remembered on Valentine's Day. So better plan to drop in soon at a store that features Hallmark cards. You'll find a wonderful variety of Hallmark Valentine's to choose from. There are Hallmark make-your-own Valentine kits that the children can assemble themselves without paste or scissors and send their school chums.  And of course, you'll find a beautiful, personal Hallmark Valentine for that one extra special person. A Valentine that says what you want to say, just the way you want to say it to your sweetheart or husband or wife. There are lots of delightful Hallmark Valentine's too for you to send good friends and relatives.  Now back to Lionel Barrymore and the second act of Big Family, starring Fred McMurray. For some man, happiness comes only in some spectacular achievement. Samuel Partridge's happiness was of the simplest sort. It was bound up with his friends. Through his work as a country lawyer and with his wife Frances and their eight children. I never was one for reckoning time by the calendar. I'm sure I couldn't give you the year and the month in which Elsie first joined the church choir, but I remember it clearly. And the winter when Stan broke through the ice on Frisbee's pond and almost drowned. And the summer when Louise decided she was no longer a child. One Sunday afternoon, Frances and I were having iced tea on the front porch. Oh, Louise, would you like some iced tea, dear? No, thank you. Well, here, Louise, take this chair. I'll pull up another. Oh, please don't bother. Rather really. Are you going somewhere? No. There's no place to go. Oh? Well, dear, you could run across the street and see Sally Hoffman.  Leslie and his piano were making the power absolutely unbearable, always. Leslie? Leslie, will you be quiet, please? There you are, Louise. That really doesn't help. If it isn't Leslie, it's someone else. There isn't a room in the house where I can get away from the children. The children? Well, dear, there's no one in the kitchen right now. Mother, how can I think in the kitchen? Oh, so that's it. We've got 16 rooms in this barracks, but somehow we forgot to provide a thinking room. Do you think I ought to build a special one for you, Louise? Well, it doesn't have to be anything that expensive, Father. Just some place where I can be alone. Do you have any specific idea? Yes, Father. A tennis court. A tennis court? Of course, my dear. What could be a more logical place for deep father? All alone with one's racket wrapped up in one's mood and the tennis net. Well, I might find one or two others to share it with. Oh, of course. Tom Osterfield plays tennis, doesn't he? Does he? Oh, uh, if you'll excuse me, I think I'll go back and finish reading my novel. Oh, Sam. Yes, I recognize the symptoms. Our first daughter has fallen in love. That's going to cost me a tennis court. Tom Osterfield, huh? He's, uh, studying to be an engineer. Now, Stan, the girls don't have to marry attorneys. No, I suppose not. It, uh, would look rather odd if my office door read Samuel Partridge and Sons-in-law. No, I guess my boys will be enough. This court was a great success for a while, but then Louise went away to school and fell in love with another boy, the boy she was to marry. But the first wedding in the Partridge family was Thads. During one of his college vacations, he took a trip out west, and one day we got a letter. Frances had just finished reading it to me. Well, she, um, she sounds like a fine girl, doesn't she? Yes, yes, she does. But I'm just sorry Thad isn't coming back to finish college. He would have made a fine attorney. I know how you must feel, Sam, but you do want Thad to be happy. Oh, of course, my dear. And I suppose her will be just as good as Sam. Perhaps I should have mentioned this before, but Herbert said something to me a few days ago. Um, he didn't want to hurt your feelings. About what, my dear?  I see. He's not too good a student for no. No. Well, I guess it's really my fault.  Anyway, in this house, we'd have to sue each other to keep busy, I guess.  And perhaps it should just be Samuel Cottage and son. Yes, my dear. That means Bellamy. The summer before Bellamy was to go to college, we had a quiet talk in the library. I know how much the law means to you, Dad, but somehow, it just doesn't interest me. Well, look at it this way, son. I spent most of my life building up a business here. And it's a good business. But in a few years, I'll want to start taking it easier. Well, it would help me out if you were my partner. And then someday, the business would all be yours. I understand all that, Dad. But I want to do something that's, something that's important. Oh, I see. This is not important. I think a writer is important. That's what I think I'd like to be, to write books and things. That's the course I want to take in college. All right, Bellamy. Whatever you want. You do understand, Dad. I think so, son. I think so.  And for two months, I was laid up at home. Someone had to carry messages to and from the office and take notes at my bedside. When that duty fell to Bellamy. Dad, Mr. Dodd is downstairs. He says it's important. Well, then don't keep Phineas waiting, son. Bring him up. It's about putting telephones into this town, Sam. We want to get a company started. We need your help with the bonds and stocks and state regulations. All right, Phineas. I'll do what I can. Bellamy, I'll give you a list of the books and papers I'll need. I just thought I'd drop by, Sam. See how my patient's doing. No, I'm good enough, Doctor. Just blame Tyre to wearing this plaster union suit. Yes, I've spent all day with Laura Osborne. I'm on the way back to see her now. Poor woman, I don't think she'll last the night. Oh, I'm sorry. Wait a minute, Doctor. She said something to me about drawing her will a while back and then she never did anything about it. Yes, I know. She tried to tell me about it today, but I couldn't help a much. Bellamy. Yes, Dad? Pitch up the rig and then get me into it somehow. We're going out to Laura Osborne's. She'll transfer as a property, fly on stopping by for advice. And then finally I was on my feet again and it was the day for Bellamy to go away to college. For Francis, the train leaves in 45 minutes. I know, dear. I've got Bellamy's bags almost back. Mother, where's my mandala? Oh, look in Stanley's room, dear. Now then, I think I have everything. Stockings, shirts, ties, underwear, underwear, comb, and rug. No, no, Francis. I know. You think I get used to the children going away, but each time it's just as hard. Something happens to them when they're at college and when they come back, they're different somehow. Yes. Yes, they're men and women, my dear, but that doesn't change their love for us or ours for them. It's sure funny, but I can't find my mandala at any place. Well, the last time I saw it, Bellamy, it was on the piano. Oh, that's too easy, Dad. But I'll look anyway. Oh, uh, Dad. Yes, son? I've been thinking. Do you suppose an attorney could be a right or two? Well, I imagine that's possible. Yes, but you don't seem to think an attorney is important. You're important, Dad. When your leg was broken, I saw how much people needed you. How much you mean to them? I guess it doesn't matter so much about being famous. It's more important to help people, to be of service. I've always felt that way, Bellamy. Then if you still want me in your office, Dad... Son, your desk will be waiting for you. Thanks, Dad. Dug on that mandala and better be on the piano. Oh, I'm so glad. Everything's worked out just fine. Yes, my dear. Everything's worked out just fine. Well, I never doubted it for a minute, darling. I guess I shouldn't have doubted it either. Because everything will always work out fine for us. It always has. It can't be otherwise when two people are in love and that love is multiplied eight times. Learning how to be a friend is a very important part of a child's education. And that, I believe, is one reason why so many schools encourage the youngsters to exchange valentines with each other. Sending a valentine to a school chum is both friendly and fun. And it's even more fun when the youngsters can make their own valentines. Well, at the fine stores that feature hallmark cards, you'll find hallmark make-your-own-valentine kits that are just perfect for children. They're easy to assemble without paste or scissors. And some have movable parts like the cowboy riding a pony and the lady in a rocking chair that really rocks. You'll find these hallmark valentine kits from 29 cents to 79 cents. One kit, for instance, has 20 cutouts with envelopes. There are also lots of hallmark valentines all ready to mail for both children and grown-ups. Humorous valentines, friendly valentines for friends and relatives, and of course, beautiful personal valentines for that one special person. Remember the hallmark on the back of the valentines you send shows you carrying up to send the very best. Here again is Lionel Barrymore. Thank you, Fred McMurray, for another fine performance. You know Bellamy Partridge's story of big families as American as ham and eggs, and you as the family man, well, you were perfect for the plot. Well, thanks, Mr. Barrymore. As a matter of fact, I enjoy doing this type of story because I think the real American family is one of the great sources of our country's strength. I don't think we can ever have too many stories of this kind. I certainly agree with you, Fred. I was interested, too, in those hallmark make-your-own-valentines that Frank Goss was just talking about. I think they're a great idea because the kids get a big kick out of making things for themselves.  First thing you know, the whole family's having a wonderful time together. That's right, Fred. By the way, you remember when you were with us on hallmark playhouse earlier this season? You told me that a hallmark card had selected one of your paintings and reproduced it on a hallmark Christmas card. Yes, I remember that. Well, I just want you to know that I sent quite a few of them to my friends at Christmas time. It was a beautiful painting. Well, that's nice to hear. Thanks very much, Mr. Barrymore.  Now, tell me, what's your story going to be next week on hallmark playhouse, Mr. Barrymore? Well, next week we'll present an exciting story of adventure and romance set against the background of the Revolutionary War. It's called Trenton 76 by Elizabeth Burbridge and Robert Lee Johnson. Our hallmark playhouse is every Sunday. Our producer-director is William Gay. Our music was composed and conducted by David Rose, and our script tonight was written by Lyndon Sinclair. Until next Sunday then, this is Lionel Barrymore saying, Good night. Four hallmark cards that are sold only in stores that have been carefully selected to give you expert and friendly service. Remember a hallmark card when you carry enough to send the very best. Redmond Murray will soon be seen as the star of the forthcoming Republic picture, Fair Wind of Java. The role of Francis was played by Lorraine Tuttle and others in the cast were Anne Whitfield, Polly Bear, Ted DeCorsia, Sammy Aug, and Joel Davis. Every Sunday, hallmark cards present two great programs for the whole family's enjoyment. On radio, the hallmark playhouse with host Lionel Barrymore. And on television, Sarah Churchill brings you outstanding dramatic entertainment on Hallmark Hall of Fame. Consult your paper for time and station. This is Frank Goss saying good night to you all until next week at the same time when Hallmark Playhouse returns to present Jane Wyman in print in 76 on the Hallmark Playhouse. This is the CBS Radio Network.


There is a million tissues that birds are us that I can play with. If your bird is tired of tissues, check out that. Bliders and hatchlings, do you want to see the prettiest bird in the world? This is Leo, you guys are going to love this video because today we're just going to play with a bunch of birds. I'm going to show you what my house looks like with 10 parrots roaming free. You don't have to have parrots to enjoy this channel. Just check out what a life of flighted birds looks like. And lucky for me, I have lots of friends that love my house and love the birds. So let's just hang out. This is Michelle. We just got done doing Michelle's head shots. Yes, we did. It was so fun. And she had to change her jacket because tie like leather. Yeah, tie would have eaten that. This is Miguel. You guys might remember Miguel from a previous video. If you don't, you got to go back and watch it. I looked like a total bully, but I'm not. Now Miguel loves birds, which bird do you love the most? Jersey. But me and Merlin are pretty close to that. Uh-oh. Okay. Somebody has complaints about that. Did you hear what he said? He said Jersey's his favorite. Oh my God, her heart.  No, no, leave Michelle's clothes alone. That was for her head shots today. Okay. Why does she always like the girly stuff? Uh-oh, Michelle. There's already a situation. Somebody's been hanging out on your shoulder. Brando. Brando, this is my shoulder. Not this one. Yeah, but it looks like Brando's been hanging out on your shoulder even when you aren't here. See? You can't hang out on Michelle's clothes. I wanted you to hang on my shoulder, not my clothes shoulder. Yeah, since when do you do that, Brando? That's naughty. Are you rummaging through stuff? All right. Oh my God, Leo. Finally I got Leo flying on camera. Did you see how he looks like he's like, Oh, I'm making it. I'm almost married, I'm almost married. Look at you guys. Vinnie, what do you have to say about all this? Anything? Oh, since when are you quiet? What is this? Is it time to sing, Jersey? Miguel, for you, better come over and make her look like you appreciate the song, Miguel. Don't be hesitant or she's going to be upset. Miguel and Jersey sitting in the tree. Yeah, like this. This one from being cute to just being different. You don't want it, right, with Jersey? I don't want. I know. What's wrong with you? Vinnie? What did I say about saying that word? You'll say it? Okay. Vinnie, why are you so upset these days? Are you handsome? Uh-huh. Did you know we did Michelle's photo shoot today? Yeah. Does she look good? No? Thanks, Vinnie, for the photo confidence. I appreciate that. Oh, Brando loves you. Brando's your best friend, huh? BFF. Yes, thank you for that. So funny. Brando, what do you have to say about Miguel loving Jersey more? Rocky, are you beautiful? Where is Gran- Brando, no! She went after your pearls. All right. Where are those pearls? How did you even find pearls? Now she's mad. Now she's going to yell at you.  Or you only have my jewelry. Why are you always after Michelle's jewelry and purse? You can't have that. No, not yours. Do you want your baking spoon? Auntie's going to get your baking spoon, okay? Okay, relax. What are you baking? Crumple it up, Michelle. Throw it up in the air at yourself and catch it with yourself a few times. Yeah. And then you can finally throw it onto the table. Yeah. Hi, Jersey. He's like, I love this. There is a million tissues that birds are us that I can play with. Tissue. If your bird is tired of tissues. Check it out. I'm a doughnut thief and when I get a tissue, I won't leave because my name is. Is the best toy store in the nation. That's where I buy all mine. I find some cute boy. Bird Danny, what's going on over there? I hear something. No. He comes. She gets so excited. Is Cody your best friend? Okay, because Jersey's excited about you right now. Sniffs so good. Comber, you know your sniffs. One for Jersey. Can you throw it to Cody? I'm going to tell Cody how to play. Who was this game? Hey. But you could still show her how to play. You're short. This is how you play Cody. Jersey to the dinosaur. I'm Jersey to the dinosaur. Hey, Jersey to the dinosaur. Hey, I'm Jersey. I'm a dinosaur. I'm Jersey. I'm a dog in case you didn't know.