A Brilliant Journey

Nov 3, 2005

At practically every meeting we've attended together, I inevitably end up telling Larry how much I've learned from him. And almost always, he cracks up and tells me how he needs to surround himself with youngsters like me who look to him with admirable eyes. :)

From a 26-year-old doctor who signed up to deliver a Native American baby on the occupied Alcatraz island in the 60s, to a bus journey to the East with the likes of Wavy-Gravy, to doing service at a Himalayan monastary for years, to leading a team of 150,000 doctors to eradicate smallpox in the world, to starting Seva Foundation (with the help of Steve Jobs and Grateful Dead) for the blind, to creating the technology that gave birth to the first online community (pre-Internet), to launching several business ventures, leading Google.org (and being on the cover of Rolling Stone along the way), Dr. Larry Brilliant's life truly reads like a movie script. And the story is far from over.

Although Larry has probably made the covers of all major media, I had yet to read an article that did justice to his spirit. But thanks to a recent GBN interview, here is Larry in his *own* words.

Dr. Larry Brilliant

I was your standard antiwar doctor in the '60s. I'm from Detroit. I went to undergraduate school in philosophy at University of Michigan, then medical school at Wayne. Then I came out to California for my internship, at what's now called Pacific Medical Center. I was going to be a surgeon. But shortly before my internship finished I developed a cancer of the parathyroid gland. I had to have surgery myself. I finished the internship, but I couldn't go straight into my residency. I was going to take some time off while I healed.

Then I got the strangest call in the world. I had heard that Native Americans had taken over Alcatraz island in the San Francisco Bay. And that one of them, a woman named Lou Trudell, wanted to deliver her baby on Alcatraz. Alcatraz represented a mystical reconquest of native lands. It was the first piece of land that had been retaken by the Indians after so many years of the white folks taking over Indian land. So it was a big deal. And she wanted to have her baby on that piece of land. Had there been a vote in the Bay Area, I think that 125 percent of people wanted the Indians to live there. But it wasn't just our vote. The Coast Guard had ringed the island. There was no water, no electricity, very little food, and no medical care. So I volunteered to go out there. I was the only white guy on the island. I lived there until she delivered her baby, which is another very long and wonderful story. The father of the baby, John Trudell, has become a good friend. The baby was named Wovoka, after the great Paiute/Sioux medicine man who had created the ghost dance religion.

Anyway, I helped deliver the baby. When I got back to the mainland, there are all these movie and TV crews. They all wanted to know about Indians. My entire knowledge base about Indians was the two weeks I was on the island. But I suddenly found myself on TV and on the front page of the Chronicle as an Indian expert. Then I get this weird phone call from Warner Brothers saying they'd seen me on television, and did I want to be in a movie and play a young doctor. This was very heady stuff for a young kid from Detroit, Michigan.

They said they'd build a free medical clinic on the island to compensate me if I acted in this movie. So I agreed to act in this absolutely terrible movie. It might be the worst movie ever made; it was called "Medicine Ball Caravan." It turned out to be about hippies and about rock 'n roll bands, so I met Wavy Gravy and the Hog Farm Commune and Stewart Brand and Ken Kesey and the Grateful Dead and Jefferson Airplane and Dave Crosby. I became the doctor for a lot of these rock 'n roll bands. So I went from being a pretty straight-laced medical student in Detroit to being in the absolute heart and center of the cultural revolution that was San Francisco. And I don't think I've ever recovered from that.

Well, it only makes sense if you live it chronologically. The movie was to show how rock concerts were done and how hippies lived, so the Warner Brothers movie took us on all these buses. We had about 15 psychedelically painted buses as we went cross country and then to England, where we ended with a big Pink Floyd concert in Canterbury. When the concert was over, Wavy and a bunch of us looked around and said, "What are we going to do now?" And Wavy said, "Let's get two more buses and go to Nepal."

I was still recovering from the surgery, and I didn't really want to go back to work. So my wife and I got on the bus. We were on the bus for the movie and then we really got on the bus?the same bus that Stewart Brand was on, which was now Wavy's bus. We spent two years, from 1970 to 1972, driving from London to Katmandu. The idea was sort of "there's a cyclone in East Pakistan, let's bring some medical supplies to East Pakistan." We lived for those two years in Afghanistan and Iran, Turkey to the Khyber Pass, India, Nepal. Wavy and I and our wives walked from India all the way up to the Tibetan border to Mustang. We had two porters, one carrying his toys and one carrying my medical equipment. After awhile, I barely remembered that I was a doctor. My primary identity at that time was as a traveler. Then one day, after we came back down from Mustang, we walked into the American Express office in New Delhi, which was where everybody went in those days to get mail. In front of us in line was this fellow Baba Ram Dass. He had just gotten a copy, the proof, of Be Here Now, this book that he'd written. He gave it to Wavy and we sat there and read it. We were transfixed by it. Just as so many people in our generation remember exactly where we were when John F. Kennedy was killed, we also remember where we were when we first read Be Here Now.

So my wife, God bless her soul, decided that she wanted to meet Ram Dass's guru, thinking that it wasn't Ram Dass that was the magic but his teacher. She went to go see him, and then she dragged me to go see him. That's how it came to pass that in 1973, we were living in the Himalayan monastery of Neem Karoli Baba and studying Hinduism, Buddhism, Christianity, and Islam. We did Buddhist meditation and visited Hindu pilgrimage sites. For the better part of two years, we lived a very monastic existence. We'd get up early in the morning and pray and sing and chant, and in the afternoons we'd read the holy scriptures of Hinduism and Buddhism and the Bible and the Torah and the Koran. We'd read the Dhamaphada and the Tao Te Ching. We were part of a community of serious students of the convergence of religions.

One day, while I was trying to meditate off in the corner, my guru called me aside and said, "It's time for you to leave the monastery. You are to go down to Delhi and join the United Nations as a diplomat. You're going to be a UN doctor, and you're going to help eradicate smallpox. This will be God's gift to mankind because of the hard work of all of the health workers that are trying to conquer smallpox."

Now a number of things are interesting about that. First, I didn't know what the hell smallpox was. I had never seen a case of smallpox. I barely remembered that I was a doctor. My primary identity had shifted again from traveler to religious seeker. Second, the idea of working for the UN was preposterous to me. I'd never had a job in my life. I'd gone from medical school to traveling. So I said, "Marahaji, that's silly. I can't do that." And he said, "Go!" He kicked me out.

So I went down to the World Health Organization office. It took me 17 hours. I walked into the UN office wearing a long white robe and sporting a beard down to the middle of my chest. They said, "What are you doing here?" I said, "Well, I've come to work for the UN. I'm here to help eradicate smallpox." It was clear they wanted to call in the gooney squad, but they were very nice. "Thank you very much. We'll call you, don't call us."

So I went back up to see my guru. He said, "Did you get your job yet?" I said, "No, Marahaji. There's no job." He said, "Go back again!" So that same day I turned around and went back out. The next day I showed up at WHO again. They said, "What are you doing here again?" I said, "My guru said I'm supposed to come here and get this job." I did that a dozen times?17 hours each way, each time. After a while, even a stupid guy like me begins to realize that I ought to lose the monastic robe. So I cut my hair and trimmed my beard and put on a suit and tie. I wish I had a time-motion frame of all the different concessions I made to modernity. But after 12 times, I looked fairly respectable. I walked into the office again. They were pretty tired of seeing me. While I was sitting in the waiting room, a tall American guy walked in. He had a big smile on his face. He looked like a football coach. He said, "What are you doing here?" I said, "I'm here to work for the smallpox program." He said, "That's great. Who deputed you here?" That was a word I hadn't yet heard, but basically you don't just go to work for the UN; you're deputed by a government. So he was really asking what government had deputed me. I said, "I've been deputed by a guru who lives in a Himalayan monastery. He said smallpox is going to be eradicated, and this is God's gift to humanity." Then I asked him what he did. He said, "Oh, I'm the head of the smallpox program. I'm here from Geneva. I'm here to see Indira Gandhi because there is no smallpox program in India, because the Indians don't feel that it's a priority compared to diarrhea and tuberculosis deaths." He said, "We've eradicated smallpox in all but four countries, and the worst is India. I wish we had a smallpox program here." Then he said goodbye and that it was nice to meet me. That was D.A. Henderson, who became the dean of Johns Hopkins and the head of bioterrorism and the head of the smallpox program. I later learned that D.A. wrote a note in the WHO record: "I have met Dr. Larry Brilliant. Nice kid. He appears to have gone native."

I went back and told my guru that there was no job and no smallpox program. He looked at me with his big smile and said, "Go back again." So I did. And I was hired. I was hired as the mascot. I was 26. I think I was probably the youngest medical staffer in the history of WHO, the youngest medical officer in the history of the United Nations, and the first WHO medical officer not to be deputed from a monastery instead of a government or a laboratory or a university. It violated all the rules on local hiring. You never hire an American in India?you hire an Indian in India. But I didn't know all that. I thought they had hired me because I could type and I spoke English. I don't think they even knew why they hired me. So I started off, having never seen a case of smallpox. And I had the most amazing experience a human being can have, which is to be part of the eradication of the first disease in history. I did that every weekday for years, and on most weekends I took a bus ride up to the Himalayan monastery to talk to my guru about it.

What does it mean to eradicate disease? What is suffering? What is God's will in the context of this mortal disease? How should we organize our lives when there is such suffering? What does it mean to challenge God's existence? I had over 5,000 little babies die in my arms or around me from smallpox. Mothers would come up to me when they saw the WHO seal on my Jeep, and they'd say, "Please help my baby," but the baby was often already dead from smallpox. How do you keep your heart open in hell when you're faced with buzzards flying away with little arms with spots on them? Or rivers clogged up by dead bodies? What kind of a world is it? What kind of a species are we? What are the ethical mandates on us? How do you deal with that?

I was lucky. I could go up and talk to my guru while he was alive and then other mystics and Buddhist teachers and Hindu teachers and a bunch of Jesuit priests in India. I could hang out with a spiritual community and talk about what I dealt with every day with the United Nations program to eradicate smallpox.

So I started off as the mascot. Nicole Grasset, a phenomenal Swiss-French doctor who had been one of the leaders of the Pasteur Institutes, was the only staff person in India when I showed up. She built the program from one staff person to a program of 150,000. It was the largest UN program in history at that time?something like 500 doctors from 35 countries came. Because I was third or fourth person hired in the program, even though I didn't know anything about smallpox when I started, I eventually wound up running most of the program in India.

I think it's fair to say there's never been anything like it in history. On my first day, I walked into a meeting of what was called the Southeast Asia Regional Steering Committee. It happened to be "counting day." Once a year, every country was asked to report the death rate in their country, the disease prevalence. So you had all the health ministers from Mongolia and China and Korea and India and Sri Lanka and Pakistan and Afghanistan, and then all the consultants who were from Sweden and Norway and Czechoslovakia and Africa and America, all sitting around this table. Remember, I was a hippie kid who had been on a hippie bus for two years and then living in a Himalayan monastery. I walked into that meeting, and to my eyes all those faces?from black Africans to white Swedes to ruddy-faced Mongolians?the faces looked like a rainbow. In a mystical sense, when I looked at all those faces, the rainbow of facial hues, it looked like the fulfillment of the promise of humanity. That was, to me, the United Nations. That was what it meant. That was the possibility.

So I was filled with the potential for the UN. I worked on the smallpox program in India and Bangladesh and in Nepal for many years. And then I was on the international staff to the global commission to certify the world free of smallpox in Burma and in Afghanistan. I was the last UN smallpox inspector sent to Iran?in 1978, I think?to look for hidden smallpox.

Smallpox is a virus, and it is spread almost exclusively respiratory. If I had smallpox and I was the conductor of an orchestra and the violins were in the front, the horns were in the middle, and the percussion instruments were in the back, then during the process of conducting a three-hour orchestra I would infect approximately 100 percent of the violinists, 60 percent of the horn players, and maybe 25 percent of the percussionists. The droplets that would come out of my mouth are small enough that they achieve airborne status only for about 12 to 14 feet. So I become a viral transmitter. If I cough, I transmit it further. After a 7- to 17-day period of incubation, they would get sick. For two to four days they would have what's called the "prodrome"?fever, chills, and flu-like symptoms. Then the rashes would begin, mostly on the head and face, then working their way downward.

There's a good description of smallpox in the book of Job, where it says that the devil smite Job with boils from the soles of his feet to the top of his crown. Smallpox is the only disease that does that. There's no other disease that will give you boils on the soles of your feet, on the palms of your hands, all the way up to your face. The boils develop over a four-week period.

There are five different kinds of smallpox: confluent, hemorrhagic, flat, ordinary, and modified. Flat smallpox and hemorrhagic smallpox are 100 percent fatal. Hemorrhagic smallpox has a particularly cruel predisposition for pregnant women; every case of hemorrhagic smallpox that I saw was a pregnant woman who died along with her fetus. Regular smallpox kills about one out of every three. About 10 percent of people who get smallpox are blinded to some extent. That's how I got interested in blindness? so many victims of smallpox would become beggars because they had pox marks on their face and they were blind. About 20 percent of people who have smallpox get pneumonia from it; secondary infections are usually the cause of death.

Smallpox is without a doubt history's greatest killer. It has killed more people than all the wars and all other epidemics in history. To give you an idea of the magnitude, in the last century alone, from 1901 to 1999, smallpox killed 500 million people. My favorite slide that I show?the one that brings my interests in philosophy and religion and biology together?is a list of all the emperors and kings and queens who died of smallpox. The Aztec emperor, the Inca emperor, Pharaoh Ramses III, and Catherine the Great's son all died of smallpox. It makes you realize that we share a common humanity when we share a common cause of death. No amount of wealth, power, or fame can stop anybody from death. In those days, no amount of wealth or power or fame could stop anybody from dying of smallpox. So what does it mean when you've eradicated a disease?when one of the many forms of human suffering is lifted from mankind's burden? It's a very noble thing.

All the nations in the world signed a certificate certifying the world free of smallpox in 1980. 2005 will mark 25 years. That'll be big-time.

Q: What did you do once smallpox was eradicated?

Well, I didn't know what to do. I looked at all the other possibilities at WHO and decided the truth was that I hadn't had any training; I was a mascot who had grown into the job. So I went to the University of Michigan and got a master's, and my wife got her Ph.D. Then I joined the faculty as a professor of epidemiology and international health. I taught planning. In fact, my officemate at the University of Michigan was Peter Schwartz's guru, Don Michael. When he was writing Planning to Learn and Learning to Plan, we were right next to each other. He was a wonderful man, and we became good friends.

I taught in the international health planning and economic development departments and in the medical school. I was on the faculty at Michigan until 1988. I had started in 1978; the last two years with WHO overlapped with Michigan. But the group of us who had eradicated smallpox, some of the core group, kept in touch as the years passed. We wanted to do that again. I mean, if you're a doctor, eradicating a disease is like a mountain climber climbing Mt. Everest. But this time I wanted to do it without it being stuck in the bureaucracy and diplomacy of the United Nations. I wanted to do it in such a way that my friend Wavy Gravy and spiritual people like Ram Dass who had such good hearts but no academic credentials could play a role.

So I started the Seva Foundation. In the early days, Seva was this delicious montage of professors and UN bureaucrats and diplomats and people from the Centers for Disease Control and Wavy and Ram Dass and a lot of people from the spiritual community. We decided to go after blindness. The Grateful Dead became our friends, supporters, and house band; we would do rock concerts and raise money to give back sight. Over the last 25 years, Seva's projects in India, Nepal, Tibet, Bangladesh, Guatemala, and Tanzania have given back sight to more than 2 million blind people.

Initially, we'd go into a country, do an epidemiologic survey of what the causes of blindness were, and then build facilities that met those needs. In most of the world the major cause of blindness is cataract. Not cataract like you see it now in a 75-year-old, but cataract in a 45-year-old. We built hospitals and created technologies to make implantable lenses very inexpensive, so that they would meet the needs of the poor and we could give back sight for free. I'm sure that Seva's programs have given back more sight than anybody else in the world. Not Seva, but our programs, because we became a foundation that would raise money and fund other programs around the world. So that's been another continuous thread for me. I'm the chairman of Seva even today. I'm still very much involved in it. One day, as luck would have it, the biostatistician WHO had hired to do the survey in Nepal became ill, and I was asked by the UN to conduct a survey of blindness in Nepal. There had never been a national survey in Nepal?it's hilly, with a lot of mountains, which makes it hard to do a survey. The Grateful Dead did a concert to fund getting me a helicopter. We flew medical teams to all the little remote areas and up to Everest. It was pretty amazing. The pilot, Darrell Ward, set the world altitude record with me as ballast. It was quite an adventure. Then, on the last day of the blindness survey, the helicopter crashed. The engine failed. Thankfully, nobody was hurt.

It happened in a very remote part of Nepal. The helicopter fell like an oak leaf in autumn. When it finally hit the ground, Nicole turned to the pilot and said, "What happened?" Darrell was holding on with literally white knuckles. He said, "Oh, nothing. Just a simple spare parts order?one engine." I was back in Kathmandu. I had to figure out how to get a replacement engine into a remote part of Nepal. Who pays for it? Who flies it in? Who carts it out? It was complicated because the helicopter belonged to Evergreen Helicopter in Oregon. We had gone in through the courtesy of Senator Hatfield's office. But the helicopter was built in France by Aerospatiale; President Mitterrand's brother was the chairman of company. And the U.S. ambassador had helped us get it through India. So I had to coordinate all these different people in order to get a new engine.

A guy named Jacques Vallee had created a piece of software called Notepad, which ran at Stanford University. Notepad was one of the first computer conferencing systems. I had an Apple computer with me in Kathmandu given to me by Steve Jobs, who was one of the people who helped me start Seva. And I had a 300 baud acoustic modem. I signed on to Stanford's computer system?remember, this was 1980? and with that Notepad system I was able to get Senator Hatfield's office, Evergreen in Oregon, the UN, WHO, the Seva office in Ann Arbor, and President Mitterrand's brother all online together. We negotiated who would pay for the new engine, who would fly it in, and when it would get there. It came on PanAm. Seventy-two hours later the helicopter had a new engine. I had never seen anything in the United Nations work so smoothly. So I think it's fair to say that I fell in love with the technology of computer conferencing.

When I went back to Ann Arbor, Steve Jobs came to visit me. He had been giving me money for Seva. And he said something like?and this is not an exact quote?"Why don't you start your own damn company, with your own damn product, make your own damn money, and fund your own damn charity." That's not exactly what he said, but that's the way it felt.

And so I did. I took the computer conferencing system that Bob Parnes had created on the University of Michigan computer system and had it ported into Unix, which became known as PicoSpan. Then I built a company around it, and we took it public. That company created dozens of different computer conferencing systems, one of which was The WELL.

I remember seeing Stewart Brand in San Diego in 1984, at a meeting on electronic communications. I tried to persuade him to co-venture with me to build and run one of these systems. He was pretty dubious. I said, "Look, here's the deal. I'll give you the equipment. I'll give you the software. I'll give you some money. You just provide the labor and the community." And that became The WELL.

The original idea for The WELL was that we would take every item in The Whole Earth Catalog and then people would put their reviews on and that's how the conversation would begin. But what's really interesting is that I started 15 or so different systems like The WELL. They all died, except that one.

The reason The WELL succeeded and the others didn't is because of Stewart and because of the intellectually agile, technically interested community around him. And because of things that Stewart did, like demanding face-to-face meetings, saying "you own your own words," and keeping the price low. At the time, we didn't know about Metcalf's Law?that the value of a network increases exponentially in proportion to the number of users. But Stewart intuited Metcalf's Law and did everything exactly the opposite of what all the venture capitalists were telling all of our other experiments to do.

Put money into marketing. Make the price high. Stewart said, "No marketing money, only word of mouth, and keep the price low." The VCs said, "Get lawyers, and make sure people understand the rights and privileges of what they write." Stewart said, "You own your own words." Stewart intuited business principles and organizational principles that were better because they were based on a community and a genuine love for that community.

I took the money I made from starting The WELL and used it to fund Seva. For years Seva was funded by those technology experiments. I was fortunate because that was way before the Internet; it was just about the time microcomputers were getting started. So I've been able to go in and out of technology and medicine and go back and forth. I tell my kids that when I run out of money, I go back into corporate America and make money, and then I give it away, and then I usually count wrong, run out, and go back again. And so it will be until I die.

[ If you have any comments for Larry, feel free to post below. ]

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"Service doesn't start when you have something to give; it blossoms naturally when you have nothing left to take."

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