‘THE ELVIS OF PMI-CP’|
Dishman Follows Instincts to Top PMI Cohort Post
If you’re straight with the universe, maybe the universe will be straight with you.
How else to explain the arrival of Eric Dishman, director of the Precision Medicine Initiative Cohort Program (PMI-CP), who owes his life and health to precision medicine and now wants to make the “Hail Mary pass” that saved him from kidney cancer common medical practice?
Five years ago, Dishman, now 48, was in full kidney failure and facing a life of dialysis with limited chemo options for his spreading cancer; a scar on his right wrist testifies to the arteriovenous fistula physicians had prepared for accessing his bloodstream. But thanks to a whole genome sequence, the donation of a kidney from a coworker at his former employer, Intel, and tailored treatments to eradicate his cancer, he is a kind of poster child for President Obama’s vision of precision medicine.
Getting his face on that poster involved following his nose; Dishman can trace the last 25 years of his career to a single decision to buy a book, Computers as Theatre, by Brenda Laurel.
“A moment of curiosity about a book in the architecture section of a campus bookstore put me on the path to NIH,” he said. “What a dream come true, to be swimming in a pool of health and medical excellence.”
The intellectual stimulation of being on campus for his first few weeks was “almost overwhelming,” he said. “I am certainly honored, and humbled and proud to be here. I feel like a kid in a candy factory.”
Dishman was an undergraduate at the University of North Carolina when he was diagnosed, at age 19, with rare kidney cancer. While training for a marathon, he had experienced fainting spells, which led him to seek a doctor. He graduated in 1991 with a triple major—English, drama and speech communication.
“While starting out pre-med, I was going to be a Dickens scholar as I embraced my passion for the humanities,” he said.
With his wife Ashley, whom he met in Chapel Hill, Dishman went from UNC to Southern Illinois University to pursue a master’s in speech communication. Later, they both enrolled at the University of Texas to pursue doctorates.
While in Austin, a fateful event took place.
“By my nature, I like to learn from lots of other disciplines,” Dishman says. He would browse the campus bookstore, looking for interesting titles. “It’s fun, seeing other classes’ books—I chose my classes that way.”
While rooting around in the holdings of the architecture department, he found Laurel’s book and bought it. “I probably stole some other kid’s book,” he chuckles.
“Laurel was the first female game designer at Atari,” Dishman noted. “Computers and theater joined my two passions. I stayed up all night reading it.”
The next day, while walking to class, he saw a poster advertising a talk on campus. The speaker? Brenda Laurel.
“I actually skipped my first class with my dissertation advisor to attend this talk, on virtual reality,” he recalls. He approached Laurel after the talk and the two immediately hit it off.
That afternoon, he ran into the advisor, who asked why he had missed her class. She told him that a friend from Silicon Valley was interviewing social scientists for a summer internship at 4 p.m. in the student union and asked if he wanted to apply.
He did. And the interviewer was Brenda Laurel, who hired him on the spot for a 3-month internship in California. “That was how my career in Silicon Valley started,” said Dishman.
“I was under intense chemo at the time,” he recalls. “The Texas heat was too much for me, so I took the summer internship while also transferring to the University of Utah, in speech communication.”
For the next 3 years, Dishman commuted from Salt Lake City to Santa Clara, Calif., teaching and taking classes for half the week, and interning for Microsoft billionaire Paul Allen’s think tank Interval for the other half.
“That was a crazy 3 years,” Dishman says. “I was getting cancer treatment in both places. All the flight attendants knew me.”
What began as a 3-month internship became an 8-year research and innovation adventure with Interval, developing new products and technology for health care and other areas. The company waited for him to complete his Ph.D. at Utah.
So Dishman never finished the degree— he is ABD (all but dissertation) because his job let him do more research than did his schooling.
He began taking advantage of how emerging technologies made it possible for more Americans to age in place and developed a nationwide reputation in the field. Prior to joining NIH this summer, Dishman had spent the past 17 years leading research labs and eventually running the global business as vice president of health & life sciences at Intel.
“I love hanging out with nurses and I love hanging out with geriatricians and people who focus on patient care,” he said. “I already sneaked over to talk to [NIA director] Dr. [Richard] Hodes, who is the only institute director I really knew beforehand.”
Dishman became the “aging-in-place guy,” which is how program people at NIH first knew of him. “People used to call me ‘the Elvis of Aging’ in those days, an embarrassing but funny title—it has stuck with me. Now maybe I’m the Elvis of the PMI Cohort Program?”
And now that Elvis is in the building, PMI-CP is taking off toward its goal of enrolling more than 1 million participants over 3-4 years who will exhibit “quadruple diversity—of people, geography, health conditions and data types.” Of the latter category, Dishman says, “New technologies and data types will emerge over time that we can’t even imagine yet.”
NIH recently awarded $70 million to establish the program infrastructure. In addition, NIH has enlisted communications firms with expertise in reaching diverse communities to support participant engagement efforts.
“All forms of media will be part of a targeted, national marketing campaign,” Dishman said. This includes TV, newspapers, the web, doctors’ and nurses’ offices, the health provider organizations that have signed on to PMI so far, and even a mobile van that will reach distant outposts. “There will be multiple threads of engagement, both nationally and locally.”
Dishman said his recent preview of a video unveiling PMI’s “mark-itechture”—naming, branding and messaging—“made me weep and jump up and down, at the same time.”
The cohort start-up team, hired earlier this summer, recently held a 3-day kickoff workshop, solidified its governance model and created 11 working groups, “from privacy and security to protocol development. There are lots of swim lanes of work, all happening at the same time…NIH had given us a good head start. It’s not like we’re starting from scratch.”
Dishman was recruited to NIH by Dr. Kathy Hudson, NIH deputy director for science, outreach and policy. “I first really got to know and work with Eric on the ACD PMI working group and he really impressed me with his creativity, smarts and good humor,” she said. “He brings a wealth of experience and expertise to his new post including his social science research background, his experience at Intel and his perspective as a patient. As an architect of this program, I am over the moon to have Eric firmly at the helm.”
Much of the momentum for PMI starts with the President and HHS Secretary Burwell, Dishman noted. “The president basically told us, ‘What do you need from me?’ I’m not from government, but I understand that that’s not always the case.”
At Dishman’s most recent checkup, his physician reported that he is still cancer- free, with perfect function in his one new kidney, “so go forth and conquer.”
Perhaps more catalyzing than Obama’s support has been Dishman’s own experience.
“This Hail Mary pass, this miracle of the Human Genome Project completely changed everything about my treatment and life expectancy,” he said. “The PMI Cohort Program is about making that kind of capability a normal part of care for people, not a Hail Mary pass or a miracle. I want to turn what was a lucky break for me into the normal course of health care for everybody else, and it will take accelerating science on top of the 1 million or more volunteers to get us there.”
He continued, “We’re building a data and science platform that ultimately thousands and thousands of studies can be built on top of and accelerate breakthroughs so that everyone has precision health. That’s the goal. It’s a big tent, and pretty soon there are going to be a whole lot more people under it. No one on the planet has done [something of this scale] before.”
And no one on the planet may be better suited to the job.
From Passionate Living to Precision Medicine
Even if he hadn’t been cheating death for the past 29 years, it seems likely that Eric Dishman’s appetite for life would have been oversize.
The Charlotte, N.C., native began life with an advantage: a photographic memory. It was in third grade that he realized “my memory was really different.”
“But 23 years of lotsa, lotsa chemo” have left him with “chemobrain. Not only do I not have a photographic memory any more, but I am horrible with names now,” he said. “My neurologist told me that the fact that my brain works at all is a miracle, in and of itself, and that I shouldn’t be worried about anything.”
But before that loss, Dishman’s acute memory was a boon to his creative life. While a UNC undergrad, he indulged passions for singing, acting and playing the piano in numerous bands. He played the Shakespearean roles one minute and the role of a British pop star in a TV soap opera send-up called General College the next. In such productions, he knew not only his own lines, but also those of the entire cast.
When he sat for his Ph.D. orals at Utah, Dishman had nearly an unfair advantage—in composing his answers, he could literally see the reference pages in his mind and quote them verbatim.
At about the time he realized he had a different kind of memory, Dishman began the habit of daily journaling. It is a discipline he has maintained over the decades, through the cancer and transplant experiences, all the way to PMI.
“I’ve written many unpublished novels and short stories,” he said. “I go where the creative juices go.” He is currently writing two books on the topic of innovation in American health care, but insists, “There is some future in which artist Eric will be back and those novels will see the light of day.”
Dishman’s other passions include snow sports and gardening. An avid snowboarder, back-country skier and sledder, he says he was born with a love of snow. “I want Francis [Collins, NIH director, who hired Dishman] to tell me if I have a gene for it,” he jokes.
He enjoys nothing more than hiking 3,000 or 4,000 feet up, then sledding back down. “It’s the most fun thing adults can possibly do.”
For the past 8 years, before Dishman and his wife Ashley, a communications scholar and social scientist, came east, they lived on a 5-acre farm outside Portland, Ore. “We grew apples, pears, grapes, cherries and plums,” he said. “We had a massive vegetable garden where we had recently reduced our inventory to 60 varieties of tomatoes and 35 varieties of peppers,” most of which was donated to a local food bank.
“Both of us are really focused on reducing hunger,” he said.
While waiting for Ashley to join him at their new home in Kensington, Dishman set out to learn guitar. “But I don’t think I’m going to be good enough to join Francis’s band,” he said.
Nonetheless, rock guitar plays a part in his biography: Paul Allen, for whom Dishman worked as an intern, is the patron of the Jimi Hendrix Experience Museum in Seattle. He had Dishman’s team consult on some aspects of the exhibit.
As Dishman brings his considerable energy to the burgeoning PMI cohort effort, there is only one topic that elicits a different sort of PMI—precision misery index. Do not mention the last-second Tar Heel national championship basketball loss last April. Some memories resist even chemobrain.