Good afternoon Welcome everybody to this remarkable event that we're so honored to host here at the Stanford Graduate School of Business and when I was asked by my colleagues on that I'm at Saru and I'm not at Madi to consider Letting and hosting and welcoming this event here to the GSB. It was one of these wonderful Times when I can say yes, and this is absolutely Something that we want to do here and that we're honored to have here at the Stanford Graduate School of Business increasingly our students and our alums are concerned with and wanting more material more and Programming around Passionate capitalism around purpose and around principal leadership and so this event is one of many I hope that we will be able to bring some of these topics to our community. I Don't need to do long long Introductions to our speakers today all of you I think know both of the speakers and but let me just say a few words as you know We have with us today on the spirituality side sad guru who is the founder of Isha Foundation and has taught millions of people about spirituality intentionality Compassion and bringing these topics to environmentalism Education and of course to business on the capitalist side We have another remarkable human being Jonathan Coslett who's a CIO of TPG Was a Baker scholar at Harvard Business School, which is a remarkable honor as well and Serves on many boards of many purposeful organizations including the Stanford Children's Hospital He's somebody who was touched by the learnings of Sadguru and somebody who is bringing some of those learnings to a business perspective in a very impactful and purposeful way So without further ado, please join me in giving a hearty Stanford GSB welcome to our speakers and our panel today Thank you very much. Good afternoon Good afternoon Just a couple more minutes on the end of that introduction for Sadguru so I ran into Sadguru. It's probably been about five years or so now through somewhat of a happenstance type of situation, but Getting to know him. I learned that there was a whole nother world of teaching and Philosophy that I could bring to bear to my life and to my work and to my children and It's been quite amazing and Sadguru has been a leader for change change in the world change in people's lives now for 35 almost 40 years and He's traveled around the world quite a lot There are nearly 10 million Volunteers that work for Sadguru's organization Isha group and at any particular time Isha group is focusing on Tens and tens of difference of causes. So for example just recently Sadguru was able to Empower and mobilize a few people in India We'll talk about that in a minute a few people in India to try to help save the rivers that are slowly but surely Going away because of deforestation. So he thought this was a real issue and a real problem that needed to be Addressed so he Organized a rally for the rivers where they went from the south of India to the very northern part of India about 6,000 miles plus or minus In a in a motorcade and with motorcycles and cars stopping along the way and ate a few people join them He had 160 million people join him and in that 160 million people was a force that ultimately led to discussion with the government of India with Prime Minister Modi and Within a very short period of time the government of India has already Enacted most of the the presentation and the purpose and the plans that Sadguru had laid out for trying to save the rivers That's just an example of you know, what he has been doing around the world It's a remarkable man and a great philosopher a great teacher a yogi and also a great friend So on my journey In business, I'm now 2027 years out of business school. So my 27 year career From sort of 25 to 50 I think it's really interesting as we all know as we get older that we start to see that what you thought as a 25 year old Maybe when you're 50 it can literally be 180 degrees different from your perspective when you're 25 It's you know, you we're going from competition sense of competition to a sense of collaboration From speaking to listening from answering to questioning From the destination to the journey from achievement to purpose and from leadership even from leadership to something else called inspiration and Those are the types of things. We're going to talk about today We're going to try to weave them into a business context and more of a real-world context because we're here at the GSB the Stanford Business School and With that maybe we'll kick it off with our first discussion item And we have about 50 minutes and we'll allow for a few questions at the end But we have about 50 minutes and we'll just hit a couple different topics and themes along the way that we think might Be relevant.  We've already received so said guru I Love quotes because quotes I think are ways to distill profound wisdom and Sometimes the quotes are spot-on and some times the quotes are actually totally off base so Descartes Said I think and therefore I am and we're here in the midst of the incredible brainpower of Stanford University and Stanford students that have incredible thinking power When you think about that and you think about I think and therefore I am How does that strike you? Good morning to everyone. I think this fascination with human thought Happened in pre renaissance era era because that population or that society had seen Very Dramatic religious imposition that nobody could think by themselves. Everything was already thought and ready in a book So for the first time they could think for themselves breaking loose from the dogmatic oppression So they felt liberated that they could think for themselves Since then I think this European influence has been big and we've made too much of our thought but What our thought is is essentially It's the data that we have already collected something that we already know We bring it out in permutations and combinations of various formats, but essentially All our thought is coming from the data that we already have that means No new possibility exists there This is I know very So we are thinking intellect is the only intelligence we have unfortunately, let's look at it this way essentially what you're referring to as mind is a Certain combination of memory and intelligence isn't it now What you remember what you have studied what you have acquired you remember all those things Human beings have a vivid sense of memory. That's one of our greatest faculties But every cell in your body remembers much more than your entire brain remembers Ten generations ago.  How your forefathers were so keenly that it is not even forgotten the skin tone Yes so What the amount of volume of memory that you have in a single cell in your body is Way bigger than what you could carry in your brain If it comes to intelligence, we know today that a single molecule of DNA is performing more functions than your entire brain actually So you're not managing it. There's an intelligence functioning, but only problem is you have no access to it People keep asking me said guru. How is this that you're constantly doing so many things at the same time? I say I think with my body Not with my brain. That's why I have my brain never works and it's silent and quiet I think with my entire body because there is a way to employ other dimensions of intelligence Right now because we are thinking intellectually This is the consequence of a certain type of education that all of us have gone through today modern education means it's purely intellectual So whatever you're doing intellectually has to be logically correct This is why even the science is losing traction and spinning in the same place now Because we are trying to fit everything into our logic logic is just a small aspect of our life It is anything that makes that means a world to you.  Suppose you fell in love with somebody and you logically look at it What is this love affair?   I think I'm sorry Saying I think so I exist. I'm asking you a simple question Is it because you are you may think or is it because you think you are? Right now because you think you exist what has happened these see today in the cosmos Hundred billion galaxies. There's not been a single accident. All right. Everything is going great Sun came up on time planets spinning on time everything fantastic But one nasty little thought in your mind and it's a bad day And those are the types of things that I think we all here in the West can learn from The yogis in the East and maybe continuing that discussion I'm a capitalist and I think that Adam Smith is a great philosopher and There's a quote behind us from Churchill that says the main vice of capitalism is The uneven distribution of prosperity. You have a lot of inequality in the world The main vice of socialism is the even distribution of misery I'm curious as to how you think about capitalism as a spiritual yogi Being a yogi is individual enterprise It is not a mass produced product it is something that one has to do within themselves So it's very individual So in a way you can say it's capitalist because you build your own capital within yourself But capitalism as a As a system as kind of not is not is obsolete now Because there was a time Let's say hundred years ago in whole of United States. Maybe Maybe 25 or 50 families held the capital So they decided everything so that was called capitalism Now it's the market which decides everything. So this is a market economy So this is a far more democratic way of functioning because anybody who has Good idea and is capable of executing that idea for him. There is no death for capital capital anymore So capital is available for everybody. So there is no capitalism. It is market economy But market economy needs to evolve further Right now wherever I go people keep referring to India as emerging market. I said, please don't refer to us as market place We're people So I'm looking at you as a market I think this is a very rudimentary thought that we are looking at people as markets If you look at them as people you would see how to enhance their life in that there would be a proper economy a more inclusive economy where Everybody is a partner in the economy somewhere we think That the customer is market and I am the economy I'm producing and supplying so I'm the economy. You're just a victim So there is another way I think the future is coming there that the customer of even a small product can be a participant Or a partner in the company. See if you have 10,000 partners in this town your business just cannot fail This is the firmest way to stand Suppose you have a billion partners across the planet your business just cannot fail. It's perpetual Right now you have victims when they realize they've been victimized You're going to get it I'm curious as you travel and let's compare the economic and maybe political systems as a whole between two very two of the largest the largest countries in the world India and China India is the largest democracy in the world China is the largest Communist system in the world When you travel between India China and even comparing it to the west How can we think about What's working and not working in that relative comparison of Those two largest democracies and communist systems in the world So democracy as a political system is one thing As you as Churchill said maybe in democracies misery is equally distributed When things have to be done it gets slowed down Inordinately simply because you have to convince everybody involved And not everybody gets the point by the time they get the point the time has passed many times So this problem is there But the most beautiful aspect of democracies Not always is it right most of the time it gets itself wrong In spite of that the best thing about democracy is It's the first time in the history of humanity that we can change power without bloodshed That's the most important thing. We should never forget this Otherwise even within a family if power had to change there was bloodletting Nations major nations are changing power without a drop of blood That is the first time in the last hundred. I mean in the last 10 000 years It is only in the last 50 60 years. This is happening across the world So we should not underestimate the value of that though there are unnecessary impediments in democracy Which goes on what can be settled in 10 minutes goes on for 10 years of debate Yes Like you're talking about What to say economies which are at different stages of development If you say united states, it's at a certain stage of development If you say republic of china, it is at a certain stage of development. If you say india, it's another stage of development I don't think you can handle all the three with the same norms and rules Because they are in different age groups. You can't handle a five-year-old kid and a 15-year-old youth And a 25-year-old adult the same way So they are in different stages. They need to be nurtured and handled in different ways China is a great example where In a forceful manner in a very forceful manner almost in a brutal manner They have taken out a billion people out of poverty in a matter of 40 years. That's not a small thing People focus on brutality But the most brutal thing is to keep a whole population a lifetime of poverty is the most brutal thing Shooting somebody is not so brutal compared to Keeping them in poverty for a whole lifetime or generations of people Generations of people were in extreme poverty So to move them out forcefully it was taken out of that I think now they're making the necessary changes. Maybe the world expects faster changes, but They're making the necessary changes of shifting from a communist and forceful way of handling things to a more market-oriented Way of handling. I think it's a very wise thing to do. There is no perfect way to do these things Nobody knows what is the perfect way when a billion people are involved in the economy India is doing it the hard way, but in a more stable way, I would say because when it happens forcefully It is easy to use force on people when they're very poor When people are poor stick works When they become effluent the stick won't work. They will turn around and bite That time will come for china before that they must Chain themselves. I think they are moving in that direction. Are they moving rapidly enough or not? Is only something we have to see how it happens But india is going the hard way in a democratic way democratic way means we are constantly confused about everything Yes, that's what democracy means Because for everything a hundred people are involved What can be done by one man can just take a decision But hundred people are involved. It looks like a confusion. It is a confusion, but it's a more stable way of growing because people are involved in this like In china, there may be one leader or maybe five people ruling the country in india There are one billion people ruling the country in everything. Everybody is on This leads to a lot of impediments and confusion at the same time. It creates a very solid base It creates such a solid base. It doesn't matter what happens to world's economy You will see india is always going at its own pace Simply because everybody is involved at some level So These are two very drastically different ways of developing an economy Hmm, I don't think you can do What china has done in india indians are If there are three people there will be five opinions so You can't manage is like that. We are little So people were asking me satguru. What do you think about india's trajectory? We are like, uh, you know, I was very closely involved with wild bees at one time when I was young So I said we're like like a like a swarm of bees We are buzzing and seem to be going in all kinds of directions But the the whole swarm is heading in one direction, but each one of them is Doing their own thing Progress is a lot of progress. It feels like the change the pace of change in the world is so fast. There's incredible progress. We're here in the heart of Uh part of the world that prides itself on change and disruption and progress and innovation What are some of the things that we're not thinking about? As uh, we're not talking about with all this progress in terms of some of the implications So, uh We're getting too carried away with economy economy today Anywhere you go even if you go to your grandmother's place you discuss economy Hello, even your grandmother is talking about economy Economy we must understand is just an organized way of handling our survival. We should not raise it to heavens That's not how it is But the entire world has taken to this today everybody. There are whatsapp economists in india Or Or you don't use that platform much here, whatever I mean, there are social media economists who are advising on a daily basis what should happen to the world all this stuff Leaving that aside, you know first time when I went to the world economic forum Uh A computer manufacturing company that was the second largest company at that time so People were almost resentful as to why I am there. What is a mystic doing in an economic forum? So this person came up to me and asked something like this So I said see what's your business? He said that we make computers.  It doesn't matter what you're making essentially You have forgotten. This is all about human well-being All business is about human well-being and that's my business And it should be everybody's business So in all this economic jargon, I think we are forgetting somewhere. This is about human well-being People who are running the economy are getting destroyed destroying themselves and the planet And the economies of the world have become like this Uh when in 2008 when I was at the economy economic forum There was a little bit of a trend of depression beginning to happen Particularly all the american billionaires who came there. They were carrying an extra long face Because they were a few billions less Than what they were three months ago So they asked me to handle a session called recession and depression So I said recession is bad enough You don't have to You know compound it with depression But anyway right now the way we are driving our economic engine is such That If we fail we will be depressed But if we succeed we will be damned for good I said better. You're depressed Because this is like, you know in india. There's a proverbial story About a man sitting on the wrong side of the branch and cutting it when he succeeds he will fall That's something that all of us as business We are we are going in that way when we succeed we will fall That's not good. Our success should raise us but our success will bring us down Once in a way recession is helping us to slow down Otherwise business as usually if all economies on the planet or the global economy is fully thriving and on I think uh in 25 years time, there'll be a serious economic ecological crisis Serious stuff not simple stuff. This rally for rivers you were talking about This since 25 years when I was very actively engaged with south indian rivers, you know I floated down rivers. I lived along in the forest and rivers because I I didn't go to any university All I did was spend time in the jungles So I have a very intimate relationship with them In 25 years on an average across the country 44 depletion of water levels have happened 44 in 25 years 25 years is not a long time for a subcontinent But in 25 years 44 depletion has happened some rivers have depleted over 70 Hundreds of tributaries small rivers have completely gone dry. This is our way of handling economy Ripping off our fundamental source of life and handling economy. What does it mean? So In india it is very stark because of the population and land pressure that we have But it is so everywhere. It may not be so visible, but it is so everywhere So we need to devise or bring down our pitch of Economy in our own minds. I think we're talking too much economy and less of life It's time when you meet people you talk something about life. How are you doing? No, no, how is your company doing? What's your stock? This is the talk It's time you ask how people are doing because all this economic Aspirations that we have is essentially towards human well-being In pursuit of well-being. We have done all these things in last hundred years We have come to a place where In the entire history of humanity, we are the most comfortable generation ever physically I'm saying Never before any generation had these kind of comforts and conveniences as we are enjoying right now. Yes Never before anybody could have thought of these kind of comforts and conveniences But are we bursting with well-being or joy or love? Because of this? No, we are seriously neurotic these days And we are cribbing like nobody Because earlier we used to just crib in the neighborhood today. We are on the facebook And global cribbing is happening for smallest things. So it's very important that Our economy is just another tool one more tool For the well-being of life on this planet If we forget that Our success will be Our failure unfortunately Speaking about neurotic. I want to do a little a little tangent on just one question about politics About some of the leaders In the world and sort of generally we have a handful of Very powerful people in a handful of large countries. You're trying to walk me into your minefield No So it's it seems strange and odd to me that we have leaders in places like Russia and syria and north korea and iran and many other places That have a little bit different sense So i'm i'm i'm curious as to A mystics perspective on where we are today with the leadership around the world There's a quote up behind us from gandhi That says when i despair i remember that all through history the way of truth and love has always won There have been murderers and tyrants and for time they can seem invincible But in the end they always fall Always Should we take solace in that? No One falls and the next one is bread So uh I have highest regard for matma gandhi. This is his the coming year is the 150th Birth anniversary for him. I'm very much a part of that But uh, is he right on this one?  It's everywhere Prejudice is there means tyranny is there, right? What is the scale and what is the competency of the tyranny is the only question We have not strived to Craft an education system Where we don't produce tyrants We are producing tyrants. Maybe they're running companies Maybe they just have three people in the family and they're doing their tyranny right there Or maybe they're school teachers Uh They could be anything but tyranny is all over the place Only a few fortunately are super competent They organize themselves into large-scale suffering Others are not able to organize themselves I would say We should be able to celebrate competence Because that's the only thing ultimately If we want to celebrate competence, we need a more inclusive human being My competence should not work against you. When is this possible? Only when in some way in my experience you're a part of myself So we need to bring this into every structure When we say when I initially said Unfortunately, our education is too intellect oriented. We must understand what is the nature of the intellect Intellect if I ask you would you like to have a sharp intellect or a dull one blunt one? Are you must choose sharp? Are you must choose? I'm going to bless you Sharp one or blunt? Sharp So essentially it's a cutting instrument. It's like a knife So you have a knife in your hand Whatever you give it to this knife, it will cut it open and see This is the nature of the intellect. Dissection is the only way intellect can know anything So suppose you want to sue something for that also you use your knife You'll have everything in tatters. That's all that's happening That's all that's happening to the world People are using their intellect even to put things together. It doesn't work like that You should know where your intellect is relevant where it is not Our education system is kind of celebrating this intellect for everything So whatever you give people are putting into their dissection mode This is why relationships are breaking down The people don't know the value of human interactions people do not know what it means to get together Because if you put it through the intellect, what is the problem? It's better to have friends on the facebook They're safe You can you can delete them whenever you Don't want But a real friend he nags you he sits right next to you but Inclusion is not there in our experience because we are becoming more and more intellectual As intellect develops as the significance of intellect becomes paramount in the world Nobody can be with anybody Because you will dissect everybody in your mind and actually nobody is okay Sincerely look at this and see nobody is actually okay except you If you ask any I think this is a business school, but if you last time I was a medical school So if you ask any psychiatrist, he will tell you if you think nobody is okay, this means you're getting sick Yes, it is if you think nobody is okay except me You going towards megalomania And this is happening to every human being large scale our very education systems and every other system As they become more and more intellect based This is inevitable because this is the nature of the intellect It will not only slice everything it will cut you into pieces It will cut you into pieces And you should not be surprised in another hundred years If you have 30 to 40 percent of the people on this planet being schizophrenic Yes, you should not be surprised at all because It is very much like that unless a lot of children don't go to school Yes If everybody goes to school if hundred percent population goes to school for next hundred years You will have minimum 30 to 40 percent schizophrenic Because you are making intellect paramount It will cut everything into pieces when it's done with the world.  Hello It's about enhancing life Not just playing some game which is against life Right now it's become like this People have started this like a game that they cannot stop. It's an addiction game That you start doing this doing this In the stock market you have all that But where is it? The wealth on the planet has remained the same in the last billion years Is not changed We can make products out of it things out of it, but it's essentially the same material, isn't it? See it's like You stand in front of the mirror There is only one person One person becomes two in the mirror if you put one more mirror This can become hundreds of people Now you think there are hundreds of people No, there are no hundreds of people. There's only one person Yes Similarly with wealth similarly with everything there is only that much We should see how to use it in a sensible manner Of course, we want to live well.  No, no, we must understand this There is there's today. There's a study which says If all the worms on the planet disappear today In about 12 to 18 months All life on the planet will disappear worms believe me Those lowly worms you call somebody a worm. That's the worst thing, right? If all the insects disappear in somewhere between three and a half to five years all life on the planet will disappear But if all human beings disappear The the planet will flourish Let's let's relate that to Ambition we're here at a business school where we've got really talented students about to start their career so relate that to ambition and relate that to The struggle that that many people find to define success Ambition is a a constipated expression of human longing Human longing if you look at yourself Wherever you are you want to be something more, isn't it so? Hello I've been talking terms Wherever you are you want to be something more or no Yes What more it depends what you're exposed to if you know money you're thinking more money If you know wealth more wealth knowledge more knowledge love more love pleasure more pleasure Whatever you know whatever may be your currency, but you would like to be something more If that more happens right now You want something more if that happens you want something more So what is it that you're looking for you're looking for a limitless expansion If you're looking looking for limitless expansion What is your means see it's like this you want to go to india You think your tesla will take it No, I have nothing against the electric car But I am saying You won't even reach los angeles your battery will run out Now if you want to go to india if not an airplane at least you must have a A craft which is capable of navigating the oceans, isn't it? So similarly if you're looking for infinite expansion, what is the means? The means that you have right now is all physical in nature in the sense Everything that you know as life is only by seeing hearing smelling tasting and touching the five sense organs You cannot see hear smell touch or taste anything. That's not physical So in your entire perception of life, you're only seeing hearing smelling tasting and touching physical dimensions of existence When we say physical Physical exists always because of a defined boundary without a defined boundary. There is no physical nature But now you want a boundless expansion through physical nature If you try to become boundless, it's like you're trying to drive tesla to india No, you cannot you need an appropriate vehicle for that So that vehicle is now the most corrupted word on the planet called spirituality Spirituality does not mean religion Spirituality does not mean looking up or looking down Spirituality means you want to touch a dimension beyond your physical nature because If you have little awareness, you know that physical about you was accumulated over a period of time. Yes Hello, you're not born like this, right? It is accumulated what you accumulate can be yours. It can never ever be you You can pick up as much as you want if you have the ability to carry But when time comes you'll have to Shed it. This is just a piece of the planet what you're carrying Before you and me came countless number of people have walked this planet. Where are they? Uh, they're all topsoil This will also become topsoil unless your friends choose to bury you real deep Fearing you may raise from the dead So essentially ambition is just the same thing you want to expand But how much expansion you want to expand limitlessly? Can you do that physically? Never So Ambition is just a constipated version of this innate longing which is there in every human being to expand limitlessly If you become conscious you would expand limitlessly Finding the right vehicle for that Otherwise it finds this kind of destructive Constipated destructive expansion, which we call individual ambition Which is very destructive and my ambition and your ambition always is bound to be Conflicting it cannot be another way as long as you're incapable and I'm incapable We are doing a small pool each other fine, but I am big I want to expand you're also big You want to expand in competence.  He tries to conquer the world So this tyrant exists in every ambitious person, but fortunately incompetent And and how unfortunate that we think incompetence is fortunate, isn't it? The greatest thing is human being should function at its fullest possibility But now we are hoping they function at less than As limited as possible. Otherwise, they don't know where to stop It's like somebody starts eating and he doesn't know where to stop eating When to stop eating It is a problem with lots of people. This is the same thing Unfortunately, we give it all kinds of decorative names, but essentially it's the same thing So one can move from this personal ambition to a larger vision What is the difference? Essentially the difference is just this ambition is about me Vision is inclusive And if your ambition or if your longing is for something more than your own comfort and fulfillment Then you will find success every moment of your life If you're ambitious, you find success only once in a way, you know constipation is like that There's a the quote behind us is Success does not lead to happiness But rather happiness leads to success And maybe in the context of a coin a term you've coined inner engineering you can talk about that Happiness leads to success. It's not that success leads to happiness I think till now what I've been saying in a way is happiness is success Because it's human well-being that we are working for if I'm already well, is that not success? When when people are working so hard for their well-being If I sit here simply breathing and I'm very well, is that not success I'm asking So just because I am happy does it mean to say I won't do anything You tell me in your lives all of you When are you willing to do more when you're very joyful? Are you willing to do more or when you're miserable? You're willing to do more When you're joyful, you're willing to bend backwards and do whatever is needed, isn't it? When you're miserable, can we get you going? Oh very difficult Miserable and depressed people you can't get them going for smallest things, isn't it? But when you're joyful you will not just bend forward you will bend backwards and do whatever is needed I was it's only after coming to united states. I got this term, you know tgif it sounds like your company, but Tgif okay Thank god it's friday This means five days of the week you're suffering Two days you're going to enjoy No life never will work like that We we've made sure in our organization in isha even in our school. It's seven days Because if you if you're really joyful about what you're doing Where is the question of thank god? We have an opportunity to do something that we want to do Isn't it not like thank god? I got a break Not just me hundreds of people around me are today 20 hours a day seven days of the week 365 days on on on and on and uh this is because We are first joyful And then we are doing our work We are not doing our work in pursuit of our happiness This is an expression of our joy So the more opportunity you get the better it is This needs to happen to the world If you were joyful you would do only what is needed But if you're trying to milk joy out of this world, you will do all kinds of desperate things Isn't it? Why is my well-being against your well-being? Because I think For me to be happy. I must do this this and this No, I am joyful by my own nature because human experience essentially comes from within. Is that so? Hello Your joy or misery both happens from within you. Is that so? What happens from within you at least what happens from within you must happen the way you want it, isn't it? See this is all human beings are seeking They want pleasantness in their life. They want everything to be pleasant If your body becomes pleasant, we call this health. If it becomes very pleasant, we call it pleasure If your mind becomes pleasant, we call this peace. If it becomes very pleasant, we call it joy If your emotion becomes pleasant, we call this love. If it becomes very pleasant, we call it compassion If your very life energies become pleasant, we call this blissfulness If it becomes very pleasant, we call it ecstasy If the surroundings become pleasant, we call this success. It is only for making the surroundings pleasant, you need the cooperation of people around you. For all the other levels of pleasantness, of body, mind, emotion and energy is entirely your business, hello? Some people say, no, I'm not interested in all this, I want to go to heaven, why? Because the advertisements have always said, heaven is a very pleasant place. If we told you right from your childhood, God lives in heaven but it's a horrendous place. Do you want to go there? No, you will pray from here only. So essentially you're looking for pleasantness, highest possible pleasantness for yourself, isn't it so? What you want for your neighbor may be debatable, but what you want for yourself is always highest level of pleasantness. To achieve this pleasantness, we are doing so much circus on the planet. To create a pleasant surroundings, we need some work. But the rest is all internal, isn't it? To keeping body, mind, emotion, energy pleasant is completely internal. So you need to engineer this in such a way that it is naturally pleasant. There are many ways to look at it, one simple way to look at it is, all human experience has a chemical basis to it. Or in other words, this is a chemical soup. Are you a great soup or a lousy soup? That's all the question is. If you become a great soup, this feels wonderful. If everybody cooperates, we'll create something very wonderful around us. If everybody does not cooperate, you are the pleasant part of the lousy soup. That's my choice you always have, isn't it? So we've probably got one more theme I want to end with. And then we'll actually open it up for a few questions, a couple questions. We've got about probably 10 minutes after this. So behind us is what could be my favorite quote of all, because it talks about what we're all here for, which is relationships. It's by Maya Angelou. It says, people will forget what you said and what you did. But they will never forget how you make them feel. And we're on this earth together for a very short period of time. So happiness and satisfaction comes a large part and a large part from the relationships we have and what we do in those relationships. How can we implement those thoughts both in our lives and in the context of our careers? I thought you would respect what I'm saying is far more revolutionary than, you be nice to me, I'll be nice to you, business. Because a whole lot of relationships start off with this intent. But most of the time they don't succeed. People who had the most pleasant early interactions could get into horrible states of conflict later on, all right? Individual people, groups of people, nations, all levels it's happening. This is because I expect you to make me happy.  This is always a time bomb. It'll tick for some time and it'll explode unless it just peat us out. So I'm telling you this, why should how I feel depend on you? Because how I feel is coming from within me. This must be determined by me, isn't it? Hello? The moment I think I'm feeling miserable because of you, there's a conflict. Yes or no? So it's very important that human beings have to mature into this possibility that you feel joyful, you feel miserable, you feel horrible or you feel wonderful, this is essentially you're doing. Somebody else, what are they doing? What they know best they're doing. What they know best maybe allows the option. But they're doing what they know best. Right now they're abusive because that's what they know. They don't know any better. But why should that determine how I am? If the moment there is this fear of what will, how will I feel? Maybe I will suffer. Once there is fear of suffering, your entire life becomes half stride, sir. It'll never be a full stride because the fear of suffering cripples human beings. Right now, this is what has crippled humanity. The fear of suffering, what will happen to me is always a big issue. What will happen to me should be determined by me. What happens around me, of course everybody has a stake. But what happens within me, why is it that somebody else can decide this? Whether I am blissful or miserable must be determined entirely by me because this is in my hands because experience is coming from within. Somebody can stimulate something or somebody can stimulate something positive or negative but essentially whatever the input, what I make of it is always me, isn't it? The moment you have fear of suffering, you will not do what you could do. In our lives, if we do not do what we cannot do, there's no problem. If we do not do what we can do, we're a disastrous life. And this will happen to us and this has happened to us in a big way to humanity. A whole lot of human beings will not do what they can do simply because of the fear of suffering, what will happen, what will happen, this must go.  What happens around you, we will collaborate. What happens within me, there is no collaboration, this is dictatorship. So we probably have time for just a couple of questions because there's a classroom coming in here in about 20 minutes. Why don't we open it up for a couple of questions? Is there a microphone? I don't know if there's a microphone if there is one there. Okay, here we go, where the mic is. Guruji, what is your ambition? Did you just come in? No ambition, I'm just fooling around. Guruji, I got a question for you. Can you comment about your laughter? I've seen a lot of people laugh, but nobody laughs like you. You have such a joyful laugh, it comes from you. Of course everybody laughs differently, so what's the problem with that? See, these days these kind of things are going on, some pathetic, apathetic kind of yoga is going on. People call this laughing yoga.  This is crazy. See, this is like you, you understand there must be flowers in the garden. If you want flowers in the garden, you don't buy plastic flowers and fix it there. You have to do something which doesn't look like flowers. You have to handle the soil, you have to handle the manure, water, sunlight, none of them look like flowers, none of them feel like flowers, none of them smell like flowers. But if you handle these things right, flowers will come. So laughter will come, not because you have taken a stand. Every day I must laugh for… you know, because just recently I was reading somewhere, somebody is advising one American to-do teachers, you know, what are the things you must do. Every day ten minutes a day you must laugh. You will be in the psychiatry department soon. If you are in a certain state of pleasantness within you, without knowing why a smile will spread on your face, with very little tickle you will laugh. So laughter is a consequence. Don't try to create the consequence. You work this process, the source. This is the… okay, this ambition can be handled like this, the young man is asking about ambition. See, ambition means you are resulted… you are interested in the result. Recently when we did this business event in India, so they all came to our yoga center, which is spread over 400 acres and 4,000 plus people are living there and lot of things happening, variety of activity, all are volunteers. Nobody is paid for, nobody is trained for the job. And you can't fire anybody because they are volunteers. Look at my troubles. So they looked at this and said, these are all top companies in India and they said, how do you run this place with such efficiency? We take the best people from management schools, we cannot run it like this. What is… what is the secret of this management? I said, see, this is all. We are devotees. Not devotees of some god, we are devotees of the process that we have taken on. We are devoted to the process, not to the result. Because we are so devoted to the simple process that we are doing, everything looks phenomenal and there are results. Result is a consequence. You are only interested in the flower, not in the root. You think you're going to have a flower? So whether it is joy or success is a consequence. We are too focused on the consequence. You need to be devoted to the process. I think the most important question or last question will come from this young lady. Hey, don't ask me difficult question. I don't mean to be rude, but what's… like everybody has a limited amount on this life, but if you are trying to teach everyone something, then everyone's going to pass away soon, so what's the point? Oh, existentialism. Uh-oh. Woo, that's another hour. Oh. And this is from the youngest. This is from the youngest. Alright, that's a tough one, Mr. Guru. So if we are trying to teach something, it's going to take a long time. Let's say I want to teach you something which will take a thousand years, then your question is relevant. I'm talking about not teaching you something, just opening up a dimension within you, which is naturally in a certain way. Is it true, what did you have for breakfast? What's your name? Arna. Arna. Agna. Okay. What did you have for breakfast? Uh, a bagel. Bagel.  Does a bagel look like you? So you eat this bagel, right now this work is going on, the bagel is becoming a little girl. Yes or no? So is there an intelligence within you which is capable of turning bagel into a human being? You have. Suppose I could take a bagel in my hand and make it into a human being. Who would you think I am? Must be the source of creation, isn't it? But you are doing it.  When you're such a fantastic human being that you can turn a bagel into a human being. You are not a small possibility. You are a tremendous possibility because in two, three, four hours you can make a bagel into a human being. Is it a small phenomenon? When you're able to do such a thing, you becoming joyful, how many thousand years should it take? If you allow me, we can make it happen in a few minutes. But if you become another, it'll take a few hours. Thank you guys very much. Thank you very much. Maybe again next year.


Well, we're especially fortunate now to have one of the leading experts on smallpox and the person who was instrumental in the eradication efforts with us today. Dr. D. A. Henderson is now the director of the Center for Civilian Biodefense Studies at Johns Hopkins University. Welcome Dr. Henderson. Very happy to be here. The first one confused me last year since smallpox has been eradicated but I guess things aren't always as they seem. You're right Doris. You know, smallpox was eradicated by the World Health Organization. The last naturally occurring case of smallpox occurred in Somalia in 1977. In fact, smallpox represents probably the greatest public health success story in the history of public health. It is the first and heretofore only eradicated disease and we now this year celebrate the 21st anniversary of the global eradication of smallpox. In 1978 there was an additional laboratory case or two in Britain and in 1980 the World Health Organization formally declared smallpox eradicated. I wonder now if Dr. Henderson you could give us a description of that eradication campaign. Right, in 1966 the people at the World Health Assembly discussed the question of undertaking an eradication program and it was finally decided that we would and they allocated some 2.4 million dollars for the effort per year. The strategy as we began the program was twofold. One was to vaccinate 80% of the population in each of the endemic areas and the neighboring countries with the thought that this would markedly reduce the incidence of smallpox so that we would then be able to move on with our second phase of the program which would be reporting surveillance to find the cases and then containment. So that you would set up for each hospital and health center a reporting system so they would report every week whether they say smallpox or not and then there would be a team go out and if they had smallpox then they would vaccinate in that household and in the village and thereby stop the spread of smallpox because it spreads as a continual chain. Each individual is going to infect another individual and every two weeks you have a new case and every individual who develops smallpox has the typical disease. It's not like polio or other diseases we have many atypical cases. Every case is a person with rash and fever and all of the other symptoms. So it was very easy for us to identify a case and then contain it and stop the spread of these chains. Tenure target was set to complete the task. We missed the target by some 26, seven, eight months and 26 days. So at any rate the last case as you say occurred in 1977 in Somalia and since then there's been no smallpox anywhere in the world. Now as far as I've been led to believe there are two recognized repositories of smallpox or variole virus in the world that the Centers for Disease Control in this country and at the Institute for Virology and Biotechnology at Kultsovo in Russia. Is that your take on this? Well certainly from the World Health Organization when I was there and those who follow me we worked very hard to try to get the smallpox in as few places as possible so to be the least possible risk of spread of that virus getting loose again and really causing trouble. And I would say up until probably three four years ago we were pretty persuaded that this was the case. Now on the basis of people who've defected from Russia we understand there are probably two maybe three more sites in Russia. We also have the problem in Russia as we all know of chemists and physicists leaving the country to go elsewhere. Biologists have done the same. Are there possibly sites in other countries that may have the virus? We don't know but you can speculate. Well I'll tell you what at this point Ted why don't we talk more about the smallpox virus? Okay Doris the smallpox is caused by the variole virus and the variole virus was responsible for millions of deaths. One of the great diseases of antiquity again just like anthrax and plague. Responsible for again millions of deaths dating from before the 12th century BC as far as we know. The Egyptian pharaoh Ramses the fifth probably died from smallpox and that theory is based on examination of his mummified remains. After smallpox was introduced to the new world it's estimated that at least three and a half million Aztec Indians died of the smallpox. Well in fact Ted I think it's been even more severe a problem to the Indians than that and many people don't realize this but as we've gotten back in the history we began to realize that the death rates among Indians may have been as high as 75 to 90 percent. A really remarkable number of deaths and we have many accounts of whole Indian tribes being wiped out within a period of really a couple of years. There were so few people left that they couldn't sustain themselves and they died out. So that in fact when the pilgrims landed in North America they had very little difficulty with the Indians but what's not talked about is the fact that this was only two years after a major epidemic wiped out huge numbers of Indians along the eastern seaboard and permitting the pilgrims to settle peacefully. You know Doris I think there's the perception out there amongst a lot of people still that biological warfare is something very new product of a brave new evil world if you will and I think we showed yesterday that in fact that's far from the truth in 1346 against again the plague was used against Kafa. Well I'm here to tell you that unfortunately even in the United States biological warfare is nothing new it dates back a couple of hundred years. During the French and Indian wars Sir Jeffrey Amherst of the British army was tasked with capturing Fort Carillion now known as Fort Ticonderoga from its Indian defenders and he hit upon the idea of taking these scabs of smallpox victims grinding these scabs up and placing that infectious powder into blankets and then passing the blankets off as gifts to the Indians and in fact this unfortunately worked as well the Indian defenders of Ticonderoga succumbed to the smallpox. Isn't this what you call the gift that keeps on giving? That's right, the gift that keeps on giving. Right and Dr. Henderson I think probably can tell us some more terrifying stories concerning smallpox you may have learned from Dr. Alabak. Right I think from that time of the French and Indian wars until now we've until very recently certainly there's been no thought or threat of smallpox being used in this way in fact in a large part I think it's because we've had so much vaccine that's been available and people have been vaccinated around the world but Ken Alabak who was the number two man in the Russian bio weapons production setup tells us an interesting story that in 1980 just as we decided as the World Health Assembly pronounced that smallpox had been eradicated and advised that everyone stopped now for vaccinating which they did. They saw this in the Soviet Union as an opportunity and with this they developed a very large production plant for smallpox virus as he tells me the plant one plant has a capacity of producing 100 tons of smallpox virus per year and this is still extant developed since 1980 and a large scale production facility so this is something that is really very much of concern at this point in time with all of the troubles in Russia right now. Well smallpox I guess can be an even greater threat than some of the other agents because it can be transmitted person to person correct? Yes it can and I think the two major diseases which can be transmitted to person to person are plague and smallpox but actually smallpox is much easier to transmit than plague and so I think in my judgment I would rate smallpox right at the very top of the list as the most severe most serious of the problems that we face. You know Doris I just want to re-emphasize something we said yesterday from a military perspective one of the main tenets that a battlefield commander wants to adhere to is to maintain control of the battlefield so a disease such as smallpox if a commander unleashes that disease it does its dirty work but then it affects the civilian population and continues to propagate and the battlefield commander in essence loses control of the battlefield from so from the perspective of a military weapon perhaps smallpox isn't quite as attractive but to the terrorist who doesn't care what he unleashes on humanity this may be in some sense the ideal weapons. Right how does the virus cause the disease? Well following an asymptomatic incubation period of about 12 days actually ranges from seven to 17 days but you can almost set your watch by this 12-day average. Following that 12 days there's then an infection that develops in the respiratory mucosa proliferating virus particles circulate around the lymphatic system to the regional lymphatics from there a minor viremia ensues and virus spreads to the liver the spleen the lungs the bone marrow once that happens the prodromal symptomatology starts you get two to three days worth of fever nausea malaise the I don't feel goods during that time a major viremia ensues seeds the skin and following that the characteristic exanthem that most of us would know smallpox by develops. Okay well as well as Dr. Henderson Dr. Don Hopkins a former deputy director at the CDC was also someone closely involved with the smallpox eradication efforts in the 70s in India and Sierra Leone. So let's listen to him describe cases of smallpox that he treated. It was a really sad thing to see when you knew somebody had smallpox so they were just coming down with it because you and they knew that it was between them and God as to what the outcome would be. People felt very ill this this this virus is said to make people feel as though their skin were on fire even before the rash begins they have headache backache and felt generally flu like symptoms felt miserable already a virial a major this as the virus progresses people would get these severe rashes on their skin the same thing often was happening in their throat and in their intestines and so you have people who are turned into monsters before their eyes before the eyes of their of their family and who often die some of them who got hemorrhagic smallpox were transformed even more they were just bleeding from all of their orifices most people apparently died just because of overwhelming viremia but also with severe diarrhea just as their skin could be seeing to to to to descovate internally sometimes people would be losing the entire lining of their bowel or having fluids to ooze into their into their lungs sometimes the virus would attract would attack vital places such as the heart directly for example and as infection wore on sometimes people get secondary infections of the open wounds on on their skin but sometimes with very severe rashes people would just slough great chunks of their skin which would then be open just as if they had been burned to secondary infection it was also a peculiar stench associated with all of this decaying flesh on a living on a living person and so to go into a village where you had several people like this and other villages terrified some of them unimmunized was a very it was a very sad thing to see knowing also that you had nothing to offer a person other than palliative kind of things really when they have progressed to the state of already having the rash you know Doris as a pediatrician i think you could see it would be easy to confuse this disease initially with chickenpox and in fact that's the primary disease in the differential diagnosis of smallpox not too many other things that would look like this so initially on the first day or two or maybe three of the xanthum it would certainly be very easy to confuse it i think would be easy to confuse a case of smallpox with a case of chickenpox once the disease progresses though and you get to the point you saw in some of these pictures i think you could see it's pretty easy this is a no brainer diagnosis essentially and i guarantee that after you've seen a case or two you'll never forget it won't be too tough to make the diagnosis thereafter um ted i think you're absolutely right on that and uh i'd say 90 percent of the cases turn out to be very typical but not at the beginning it gets to be a little bit difficult right at the beginning and i think perhaps we can see a succession of pictures here which may portray this the individual once he was infected with the disease would have a very high fever i would feel aching pains in the back and uh and headache he'd have nausea may be vomiting may even have enough of intestinal pain that he might look like an acute abdomen and this goes for two to four days normally and the individual usually goes to bed he's feeling really rather miserable then the rash begins now we have here we have day two you just see uh small macular vascular macular lesions coming up and we go on to look at subsequent days you'll see this is the same child day by day this is i should note at what we call an ordinary case of smallpox it's not a serious case day four you can see it's becoming a little more apparent and you will note that the the lesions if you look at those on the face you'll see them all at the same stage of development they're all kind of pustular if that were the case of chickenpox you would see scabs and pustules and little macules all in the same area but here you see all those lesions are the same now we're up to day seven we move on to uh what do we have day nine next day eight and at this point the patient is feeling very miserable indeed and uh he has the most of the lesions are going to be on the face on the arms on the legs there will be some on the trunk but not as many and we call that a centrifugal distribution uh it's in contrast to chickenpox in which there are more lesions on the trunk and many fewer on the face arms and legs why this is so we have no idea we go on to the next uh slide now this shows foot and hand now you'll see the pustules on the palms of the hand there and similarly in the soles of the foot uh this is also classically smallpox you'd rarely see those lesions in chickenpox on the palms and soles now let us move on to the next uh well now you see scabs are beginning to form uh and uh some of them you'll see on the upper chest they're beginning to fall off they leave depigmented areas for a period of time we go on to the next now we're up to day 20 now most of the scabs are separated and the individual will have on the on the face wherever one of those pustules is present there will be a scar so that the individual will be really quite extensively scarred so as we think about it the difference between smallpox and chickenpox and chickenpox is the one disease that really was confused most often with smallpox with chickenpox you have the centrifugal smallpox the centrifugal uh distribution and in chickenpox centripetal you have the lesions appearing in the any one area are all the same with smallpox and thirdly you will see them on the palms and soles and with that you shouldn't have any difficulty in diagnosing it this is a truly horrible disease i mean does everybody have the same type of symptoms well Doris as uh Dr. Henderson alluded to about 90 percent of patients would be expected to develop what you just saw here variala major there are variants of the disease however um again that child you saw was variala major but variala minor uh and i think we have a slide of that uh this woman here this ethiopian woman you can see doesn't really look that sick and in fact she's still able to get out and about go about her daily chores take care of her family despite having this variala minor disease variala minor features milder systemic toxicity smaller pox lesions it has a much lower mortality rate one percent in unvaccinated victims versus the 20 to 40 percent that we would have seen with variala major but ted what determines whether you get major or minor well uh i think dr. Henderson might be better able to talk about that probably strain differences amongst viral strains there were two major two differences two types of virus one was a variala major which caused the severe disease and that's what we saw throughout all of asia and a lot of africa the other disease with variala minor which only caused one percent death rate and we saw that in ethiopia we saw it in southern africa and we saw it in latin america so that i think if we were worried about this as a bioterrorist agent we would be looking at variala major as being the one that would be used i don't know if you wanted to say anything about any of the other variants uh flat type smallpox hemorrhagic smallpox right i think in dr. hopkins pictures there were a couple of patients that had the hemorrhagic form these are particularly of concern the individual comes down with this sort of disease with all the hemorrhaging and it's very atypical there's no real rash as such and so that uh you're very apt to miss this diagnosis entirely when we've had these cases admitted to hospital they are uh pose a special problem because they excrete a lot of virus they expose patients they expose staff and in a bioterrorist attack these are cases that are likely to get into the hospital before the diagnosis is made because they have a shorter incubation period as well so the ones the hemorrhagic cases and what we call the flat cases which the skin just sort of forms a velvety kind of swollen texture are very difficult to a diagnosis indeed well it seems the clinical picture is very diagnostic of smallpox is there any other way to diagnose the disease well in the laboratory i think the very straightforward way to get a diagnosis very quickly and that's to take a little of the postulate fluid or a little material from a scab and you put it under the microscope an electron microscope and you will see a picture there it is of this very characteristic kind of brick shaped organism now you can't tell whether that is smallpox or vaccine vaccine the vaccine virus or cowpox or monkeypox but if you're seeing that patient as sick as that you know it isn't cowpox you know it isn't vaccine and unless you're in africa it's not going to be monkeypox so that's smallpox okay now smallpox is contagious does that mean that anyone who comes in contact with a smallpox patient will get the disease well doris when smallpox roamed the earth about 30 of non-immune people who came in close contact with a victim would be expected to develop the disease that incidence would increase in places with a low relative humidity as was seen in parts of africa where this disease held on the longest i guess it's difficult though in the individual case to decide who's going to become infected and who isn't and dr hopkins i think has had extensive experience with exactly that question okay well why don't we take another look at dr hopkins describing his experience with the infectivity of smallpox in uh in in some instances you you really couldn't predict this virus i recall uh very much an instance in which we had an explosion of smallpox around a prominent man who had died of smallpox both of his wives had been infected and in fact one of them gave birth just before her rash appeared when i arrived in the village this baby had lain on the floor of this mud hut between the mother and the mother's co-wife both of whom had severe smallpox rashes the baby was about a week old and had not been infected i vaccinated that baby that day and came back a week later to see a very nice vaccination scar and i visited that village several times the baby survived i still uh do not know or understand why that child was not infected because in fact pregnancy put women at much greater risk of dying of smallpox and the fetus was also at risk because under those circumstances suppressed immunity the fetus and the mother often got severe smallpox and would die but that child at the best one could tell didn't even get uh infected in other instances there were situations where people did not even know they had been exposed to smallpox they either had encountered somebody who was in the prodrome and didn't yet have a rash or they simply didn't know that somebody had a rash they didn't didn't notice but one of the advantages about this disease was that people who were infected to others generally unless they were in in the in stages of the incubation disease they had a rash and not only that they had a rash on their face so you generally wouldn't know it but sometimes every now and then when we encounter people who didn't know how they had been infected or or by whom and in in those instances it was airborne from somebody uh that they didn't they didn't even see the rash well once you've been exposed is there anything you can do to prevent the disease from occurring well i think you can prevent the disease if you're vaccinated beforehand and it would appear that if one were to vaccinate someone within say the first three four five days you might prevent death from the disease now at one time we had uh vaccination was worldwide and in this country every child was required to have vaccine by school entry so that we were a very well vaccinated population but most of the rest of the world was too then in 1980 with the declaration that eradication had been achieved the decision was made to stop vaccination it was a wise move because the vaccine is not without some risk now we've had no vaccine used in the u.s for probably 25 years so we have a very large susceptible population as far as vaccine is concerned we now have probably enough to vaccinate five six seven million people in storage at this point in time but we have no vaccine manufacturing capacity anymore in this country and indeed we don't have any in the rest of the world so that is the much vaccine as we have right at the moment something we're going to have to be very careful about using do members of the military still get vaccinated well Doris uh the general public stopped getting vaccinated in 1972 in this country for a while after that the military continued to vaccinate then they stopped a few units started up again there were some minor service specific differences but basically sometime in the 80s the military stopped vaccinating as well and i think it's safe to say that probably virtually no one under the age of 25 right now in the united states has been vaccinated well i'm just slightly over the age of that and i was lucky enough to get vaccinated as a child so i'm safe right right well i wish i could say yes but we now we know that the vaccine given once is not going to be fully protective and it was learned very early that revaccination was going to be necessary so i'm not sure that you or anybody else at this point who's vaccinated 25 years ago is going to be protected against the disease Dr. Harrison you know i was vaccinated in childhood if god forbid i ever came in contact with smallpox could i at least expect to get a milder case of disease i think some of the people would get a somewhat milder case and might not excuse me might not die as a result of the infection which would be i think fairly important but uh indeed after 25 years we have the feeling it's not going to be a lot of protection that you will have we're in the same boat together all right now if i get exposed to smallpox and i've never been immunized or it's been a long time what do i do next well Doris one of the first things you should consider is to get vaccinated again the vaccine is licensed it's very effective that's not to say that civilian practitioners would have access to it necessarily but in a national emergency like a smallpox exposure hopefully we would be able to procure vaccine and give to you so you'd want to consider getting vaccinated the vaccine is effective we know that from the eradication campaign in africa it's administered by intradermal inoculation with a bifurcated needle a process that became known as scarification because of the permanent scar that resulted in in fact we believe that if you didn't get a scar you didn't have an adequate vaccine take so that thing that's right there on the arm that's it right that's it the scabbing and the scarring show that you have had a good clinical take so for a while at least in the past you were protected if you didn't have that again that's an indication that the vaccine you had been given might not have been effective if you get revaccinated however you might not develop a scar the second time around you usually do develop a vesicle five to seven days post inoculation you get some surrounding erythema and induration of that vesicle lesion forms it scabs over and it gradually heals over the next one to two weeks that would be the way we would normally expect it to play out now dr Henderson you said the vaccine is not without some risk what are some of the other side effects beside the scarring well there's several not let me mention those and for just a moment but i think it'd be useful to look at a picture of a normal vaccination because it's very few people have seen this in this day and age and it you can see it looks somewhat ugly there's this postular lesion in the center you'll see some erythema around there it's redness out there for quite a distance the individual may have some fever he may have some lymph adenopathy associated with this and this is just a normal reaction i think there are many who look at that and say well there might maybe there's some bacterial infection there and maybe we ought to do something about it but in fact this is not bacterial super infection this is just the normal reaction that one may have now if we can see a couple of other reactions uh i think we have some that we can show here here you see a number of lesions around the main lesion that may come about as a result of the individual scratching the lesion and spreading it around that area when you get that kind of spread there's nothing to worry about in fact all each of these lesions will basically go through an evolution as though they'd all been inoculated at the same time so it's not a big problem however you can spread it to other sites and they can be a problem and here you see a woman who has rubbed her eye after having been inoculated and she has a vaccinal infection of the eyelid now that shouldn't be a problem but if it gets onto the cornea it can be very serious and and that is not so good we go on to another one here now here is a situation with a child i think this is a childhood leukemia and people who have a vaccine or immune deficiency disorder may have this very severe form of a vaccine in which the organism keeps growing and it's called vaccineinacrosum and this can often be fatal and this is quite a serious matter to have that for a vaccineinacrosum you can use vaccineinimmune globulin to treat it but it's not a pleasant disease are there certain people who shouldn't be vaccinated well doris as dr hinderson alluded to there is a condition called that eczema of vaccinatum and that can occur in people who have eczema and i think we have a picture of that eczema is a significant dermatologic disease in many patients and eczema vaccinatum is a horrible condition that is associated in cases with mortality and so eczema was a relative contraindication to vaccination i should point out though that you know if you were truly exposed to smallpox smallpox a very deadly disease and you might still consider immunizing or alternatively giving vaccineinimmune globulin to those patients one of the worst side effects was seen in immunocompromised individuals and we just saw the picture of a belukemic child who was inadvertently vaccinated in this day and age with the advent of modern intensive care bone marrow transplantation and the hiv epidemic we see far more immunocompromised patients than we ever did before and people with hiv or these severe forms of immunosuppression probably should not be vaccinated even if they get exposed to smallpox and that's going to be a judgment call but the alternative for an hiv patient for example would be to just give them vaccineinimmune globulin instead of immunization there's an issue though with pregnant women and i believe we have a picture of a fetus who died of fetal vaccinia when his mother was vaccinated during the days of smallpox immunization now this brings up a kind of a tough conundrum for us again smallpox a very deadly disease smallpox deadly to the fetus if the mother gets smallpox as well and so pregnancy is not an absolute contra indication of vaccination if you get exposed to bona fide smallpox and you're pregnant you probably should still be vaccinated this really isn't that common a condition but it's a condition clinicians should be aware of. Well Dr. Henderson and it sounds like the vaccine can be kind of dangerous to use. Yes i think in showing these pictures i think this is emphasized too much the reactions to the vaccine when in fact serious reactions to the vaccine were not all that common uh one in five hundred thousand was the number that would have a serious reaction it isn't to say that they wouldn't have some lesions on another part of the body that was not serious but serious reactions one in five hundred thousand and that's not a very high number we'd like to have none but no vaccine is totally safe every vaccine we have protects and you you want that protection it also has some risk and you're weighing benefit and risk all the time as one looks at it i think Ted as you've said uh if you're faced with a situation where you're exposed to smallpox uh what contra indications are there and i know uh during the global program and smallpox eradication we considered this very carefully and we finally said you know smallpox is so dangerous compared to vaccination that the only contra indication that would would be appropriate would be that if the individual looked like he might die the following day then you won't vaccinate him because he might be wrongly blame the vaccination for the death so that i think uh this is i think puts it into perspective is to just how important the vaccination is under the times of terms of a threat okay what is vaccinia immune globulin well Doris uh vaccinia immune globulin or VIG is a way to provide passive immunity to people exposed to viriala but i want to emphasize that VIG is really designed to treat the complications of vaccination more than it is to be a treatment for viriala the u.s army maintains a modest supply of vaccinia immune globulin and it can be used for those eczema patients and pregnant women and severely immunocompromised patients what about public health measures i mean wouldn't cases of smallpox be an emergency situation uh we always regard smallpox as an absolute international emergency because if smallpox really is out in the community the potential for spread across the world is there and so that to regard this as an absolute emergency is key now just how uh smallpox might spread and the potential of smallpox as an aerosol became apparent to us in 1970 and that year there was a an electrician a german electrician working in pakistan who came back to a town of machete in germany uh he had some diarrhea he had a fever they thought he had typhoid fever and so they decided to isolate them they isolated him in one room of the hospital and were able to verify that in fact there were only two nursing sisters who saw that patient they vaccinated everybody in the hospital or gave them vaccine immune globulin they vaccinated a hundred thousand people in the in the town they uh they quarantined the hospital so nobody would leave and what happened well let us see the next picture i think this is the this is the picture actually of the german electrician now he developed smallpox three days after he was admitted into the hospital he was immediately evacuated to a german smallpox hospital yes they had special smallpox hospitals in germany and in britain which were kept fully uh equipped to be opened only if smallpox was introduced into the countries i think it's an illustration of how much the country's worried about smallpox so he was only in that hospital a very short time now what happened can we see the next slide here you see the green that three days or four days where he exposed possibly could have exposed others and you see this big wave of cases of some i think it's 17 cases that occurred and those cases occurred in rooms adjacent to his they occurred in rooms on the second floor of the hospital he was on the ground floor there were some of those cases which occurred on the third floor of the hospital there was one case in a visitor who had can't come to the door of a long corridor opened it way the patient's room was way at the other end opened the door asked for directions closed it again and uh 11 days later he had smallpox now what was what was strange about this what was strange was that the patient had cough and with smallpox we rarely saw cough uh we suspect he may have had a complicating influence at the time and there's nothing that's going to produce an aerosol quite so effectively as cough so that we figure figure in this case that this was an aerosol of smallpox which covered three floors of a hospital spread from that patient and i think it illustrates i had what the potential of smallpox in an aerosol to spread to infect to really cause a lot of trouble and bear in mind those people in the hospital most all of them had already been vaccinated in childhood and now they're older and they came down with the disease and some died so there is some real cause to be concerned with an individual in that situation this is a scary disease right you know Doris i think every parent out there is familiar with the fact that if your child has chickenpox and their lesions become scabbed over it's safe to go back to daycare back to school or wherever it's important to remember though that in the case of smallpox patients are infectious to others from the time of onset of the xanthum until the scars are completely or the scabs are completely healed until the scabs have fallen off if you will so very different in that sense from chickenpox infectivity as dr. Henderson stated is enhanced in the presence of a cough contamination via contaminated bedding or other fomites really is not an important way of transmission only occurs fairly infrequently okay is there anything else we need to know about decontamination well just that all objects in contact with the patient the linens the clothing the ambulance and its surfaces etc require disinfection and that would best be accomplished by sodium hypochloride solution by steam or by fire the regular decon of soldiers after exposure to an aerosol remains the same as it would be for most other agents bleach or soap and water as a field expedient if you don't know that personnel have been exposed until after the first patients arrive it's been long enough by then in fact 12-day incubation periods been more than long enough so that decon of the unit at that point wouldn't accomplish anything you need to remember again the incubation period for smallpox is much longer than with many of the agents we talked about yesterday for example okay is there a treatment for patients who have the disease well Doris besides supportive care there's really no specific treatment at this time you sam red is working on some new pox viral therapeutics now and there have been some good results seen with a specific antiviral drug a sedofavir all right Dr. John Huggins from you sam red is the primary researcher on the side of side of a fear sedofavir thank you trials let's hear from him what his preliminary results are when we recognize that smallpox was perhaps a disease that we were not quite as ready for as we ought to be we ask ourselves what were the vulnerabilities and clearly therapy for smallpox was a vulnerability that the u.s. had and so we ask a question what potential therapies would there be for that and one of the things that we noticed is that the the enzyme that replicates smallpox is essentially the same enzyme that replicates herpes viruses and because of that a whole class of drugs developed against the various herpes viruses had a potential to work against smallpox so we went to the cdc and tested these drugs against smallpox and found that side of a fear a class of compounds are licensed for cmv retinitis also inhibited smallpox virus is difficult to work with and particularly do animal studies but also monkeypox and cowpox and other viruses that we have animal models that we could really test a drug to see if it would work and using those models we've been able to determine that in fact side of a fear does work and we're continuing to aerosol infect animals to simulate a smallpox infection and we can in fact treat those animals we're trying to determine at the moment how late an infection we can treat but it looks very encouraging for us certainly in the incubation period it looks like that it's going to be very effective we can prophylax animals that we're going to infect and we can treat animals at the moment 24 hours after we infect them and whereas the control animals develop a bronchodemonia much like patients with monkeypox do and like smallpox fatal smallpox cases do a control animal will develop fatal bronchodemonia and die with say pulse oximetry values down around 50 whereas the drug-treated animals never fall below 90 and are essentially asymptomatic during the entire treatment period so it looks like we've got more work to do but it does look like this drug has good good potential to work against smallpox I think that clearly since smallpox has been there is no naturally occurring smallpox we're never going to be able to do the classical two drug efficacy trials that the FDA normally requires we are going to where monkeypox exists and it has become a reemerging disease in the the old Zaire and we're going to look to see if in fact there are enough cases there that we can do a clinical trial but like a lot of other biowarfare agents we're probably never going to know truly that it works against smallpox until we actually have to use the drug luckily there is very little difference between smallpox and monkeypox both in the virus and in the way that say monkeypox infects monkeys so I think we've got very good surrogate models and we can treat monkeys and we can measure the same things that a normal patient would would measure so I think we're going to come very close although we're clearly never going to know that it works against smallpox until there's actually a biological incident. Doris I just want to clarify something for the studio audience you know Dr. Huggins works at USAMRAID and I bet there are people out there saying hey I thought there's only smallpox at CDC and at Colts Ova how's this guy working with smallpox just wanted to reassure people that he did that smallpox research at the CDC and not at USAMRAID all right well Dr. Hidderson I think we ought to now I think this drug that he's talking about certainly sounds pretty promising to me I don't know if you have any take on that yeah I think as we've looked at it it does look very promising but I think from the stage where it is now so it's actual use in humans there's a lot of work to be done yet and I don't think we we want to be too optimistic too early because we don't have very much of the drug there's a lot of testing to be done yet all right well we'd like to thank you very much for being with us thank you and now it's time to move on to Venezuelan equine encephalitis or V and we'll be right back with our next guest


I AM FOR BED," Nathaniel Gascoyne said, yawning hugely as he lifted his brandy-glass and noted with a look of faint regret that it was empty. Now, if only I had legs to take me outside and carry me home. And if only you could remember where home is!" Eden Wendell, Baron Pelham, said dryly, You are foxt, Nat. We are all foxt. Have another drink. Kenneth Woodfall, Earl of Haverford, raised his glass, which still contained an inch of brandy. Sample complete. Ready to continue?


We've been working on the budgeting and putting the data input for the budget. Quick recap on the budget. Remember that the budget is not something that we typically think of as part of the accounting process because the accounting process is past data that we're putting into the system to create the financial statements and work with the people we're doing business with, customers, vendors and employees, typically the data input being from these forms. The budget is future data. We need projections out into the future so clearly we need accounting knowledge to do that because it's still gonna be in the format of financial statements, but we also have to take in other information, management information, market information and so on so that we can make appropriate estimations about what's gonna be different from the past to the future due to more advertising, due to hiring more or less people, due to putting more money into property, plants and equipment or something like that. So the strategy that we would use is to take our income statement possibly and export it in some way, shape or form to Excel so that we can have that as the starting point from the past data and then use that to make a budget taking into consideration all these other factors. Once we have that created, then I would import it back into QuickBooks so that we can run QuickBooks reports such as the budget versus actual reports. That's what the QuickBooks system does well. So that's what we did in prior presentation to go to the first tab. We entered the budget, which you could find in the cog dropdown. We went to the budget over here, budgeting and we entered this budget. You can have multiple budgets. If we edit the budget, we can see our information here. So this is what we put into the system and we were a little bit off down below in terms of the budget that we had in Excel. So now we're gonna make some, check our numbers and make an adjustment. So in Excel we had the end result. This is probably the first number to check 125,965 because that will encompass if that one's correct, you're pretty solid that everything's correct. It was off over here if I scroll down a bit so I could see it. And so you could go through your budget here and find it but notice it's a little difficult to do that because you don't have all the subcategories or at least, and you have all these other accounts that are kind of muddying up the system. So I would actually just generate a budget now and then find the difference and then I'm gonna come back in here and make the change. So I'm gonna go to the tab to the right, right click on it, duplicate, now that we have a budget in place we can just find our budget right where we find all the other reports. It's in the reports on the left hand side and then we're gonna type in budget. I just type in budget, that's how I typically do it. And you've got your budget overview and your budget versus actual, those are the main two budget reports. Let's first take a look at the budget overview which I don't think is quite as useful in practice as it's just gonna give you a recap of what we already had in Excel but it'll be a good checking format for us. I think what QuickBooks does quite well of course is the budget versus actual report. Although this report's nice too because you can run it with different date ranges and whatnot up top, so that's nice. But in any case, before we get into that let's go down here and say, okay, what is off in our budget? So I know that this end result is off. So I could say, okay, that number's off. I could check each of the totals by month now and I could say, okay, well, I got 1037-3265. So if I go back over here, 1038, it's a dollar, that's fine.  So it starts to get out of whack right in February. And then I could check line by line up top if I could go, okay, then I can add up, say my income accounts up top and they should add up to 34606 and then I could go back on over here and say, okay, 34606 and I could check basically line by line 22, 22 there and then my business expenses, if I add them up, go down to right there, I think because these are the other expenses, 10,182. So if I go down, you can add them up thusly. Actually, I messed that one up, but in any case, that's the strategy I would take. But I could see where the problem is if I go through down here because I could see, okay, this one down here, I increased the interest in this category or I decreased it over time. So it was at the 334, the 318, and here I had 334 and I kept it constant. So I believe that's gonna be my difference. So I'm just gonna go back and change this one line item once I discover that. Gonna go back to the first tab, scroll all the way down to the bottom and let's say we want to change down here. There it is, this is the line I want. So it's gonna be another one of those items where I gotta do it line by line because I can't really copy it across. So I'll enter that here and then we'll see the change. Okay, so there we've entered the change. I'm gonna click off of it. So these are the new numbers I've put into place. Let's go ahead and save it. I'm gonna go back to my report now. I'm gonna run it again and see if it refreshes down here as we would expect it to do, it has done so. So that's how you can adjust your budget report and then you can go back in here and say, okay, the total is 125,965. So if I go back on over 125,961, it's off by rounding, most likely. So I'm pretty much okay with that.